Whiteness is a Helluva Drug
“Well, if you’re just going to default to that…” said the well-meaning White man and health care leader, with an eye roll, in response to my answering “anti-Blackness” to his question of why Black residents are pushed out of training disproportionately.
This, he said after I shared the findings of BDV’s own study, in which Black residents were three times more likely to have ever been placed on remediation and nearly twice as likely to have any negative disciplinary experience than their White, Asian, or Latinx peers. After I shared the findings of Gray et al.’s study, in which a knowledge evaluation process redesigned specifically to eliminate bias worked for everybody —except US-born Black internal medicine residents, even after accounting for board examination scores. After I shared the findings of Bower et al.’s study, in which HBCU surgical residency outcomes far exceeded national outcomes for pursuing academic positions and board passage rates, all with four times fewer dismissals.
Why, I asked in return, is it so hard to believe — given American history and American present — that anti-Blackness is the reason?
“I think you just don’t want to believe something so horrible could be true,” he said.
My right eye squinted at the level of denial. American Medicine likes to suggest it is somehow separate from the racist society that raised it. But it was American Medicine that produced Abraham Flexner’s 1910 report on the state of the country’s medical schools — a report that stated Black physicians were intellectually inferior and recommended closing five of the nation’s seven Black medical colleges rather than funding them to the same standard as White ones. Economists who’ve modeled the loss estimate that closure cost this country roughly 35,000 Black physicians who were never trained.
It was the American Medical Association — founded in 1847 — that excluded Black physicians from membership for the next 121 years and didn’t offer an official apology for it until 2008.
Yet it was easier for him to believe that Black resident physicians — who had cleared every hurdle, graduated college, graduated medical school, successfully matched into a residency program, all while far more likely than their White peers to come from underfunded schools, from poverty, to be the first in their family to do any of it — were simply, uniformly, less competent. Not the institution of medical training or the century of documented exclusion, but the Black residents.
To paraphrase one of the great poets of our time, Rick James: Whiteness is a helluva drug.
I’m reminded of when I first learned my story wasn’t unique. That every Black physician or aspiring physician has a story of being denied, disrespected, discounted, with only the severity and the consequences varying by degree. I was already double board-certified and a published author, with a partner who could cover the mortgage when it happened to me. I just had to pivot. Resident physicians don’t have that privilege. Their entire careers are derailed.
That was four years ago.
And in response to Usha McFarling’s two-part series, the trolls did what they always do: posted MCAT numbers by race, said Black students were getting into medical school with lower scores than their White and Asian peers. Black residents just can’t cut it, they said. Affirmative action runs out eventually, they said. As if getting into medical school were the finish line, instead of the start of two more standardized tests, four years of medical school, and a residency match, all still ahead. As if a private tutor and the ability to retake an over $300 exam three times doesn’t move a score more than raw ability ever could. As if the MCAT predicted anything beyond how hard the first year of medical school might be. Deciding who’ll make a good doctor based on an entrance exam score makes about as much sense as deciding who'll make an excellent quarterback based solely on their 40-yard dash and missing out on a Tom Brady because he ran one of the slowest 40s in his class.
Others dismissed McFarling’s reporting as anecdote. Where’s the data, they asked. Yet in the face of our data, Gray’s data, and Bower’s data, the well-meaning White man still could not fathom the truth: Black people are not the problem. Whiteness, and the belief in its superiority, is.
Vanessa Grubbs, Founder & President of Black Doc Village