Honoring Juneteenth
Synopsis
Illustration by Ashley Floréal
In honor of Juneteenth this year, we’re re-releasing one of our favorite episodes from our 2020 Black Voices in Healthcare series – Ep7. “Standout.”
Have you ever looked around and realized you were the only one? Standing out in the crowd can be hard, but it might just be your superpower.
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Contributors
Marla Law Abrolat, MD; Tomás Díaz, MD; Utibe R. Essien, MD; Erica DaVonne Farrand, MD; Akeem Nassor Marsh, MD; Ekene Onwuka, MD; Whitney Wellenstein, MD; and other healthcare workers who contributed their stories anonymously.
Credits
Hosted by Ashley McMullen, MD
Executive Produced by Kimberly Manning, MD
Produced by Emily Silverman, MD, and Adelaide Papazoglou
Sound engineering and additional editing by Jon Oliver
Medical student producing by Rafaela Posner
Original music by Janaé E.
Illustration by Ashley Floréal
Black Voices in Healthcare is sponsored by California Health Care Foundation and The California Wellness Foundation.
The Nocturnists is made possible by the California Medical Association and people like you who have donated through our website and Patreon page.
Transcript
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The Nocturnists: Black Voices in Healthcare
Ep. 7 Standout
Transcript
Note: The Nocturnists is created primarily as a listening experience. The audio contains emotion, emphasis, and soundscapes that are not easily transcribed. We encourage you to listen to the episode if at all possible. Our transcripts are produced using both speech recognition software and human copy editors, and may not be 100% accurate. Thank you for consulting the audio before quoting in print.
Ashley McMullen
You're listening to The Nocturnists: Black Voices in Healthcare. I'm Ashley McMullen. Have you ever been in a classroom, a meeting, or on a patient care team, and quickly realized that you are the only one who looks like you? I have. Many times. Going to predominantly white schools, I always stood out. And I remember all I ever wanted in those times was just to fit in, to be accepted. Being different can be hard, especially when society tells you that your differences make you inferior. But I remember that speech from Lena Wave when she won an Emmy for her writing on Master of None. She said, ”The things that make us different are our superpowers.” And now I live by those words. I stand out, loud and proud of who I am.
This week, we'll hear our stories about standing out, about the challenges of being the only one in the room. But also the virtue of our sense of style, sense of purpose, and individuality. These are our superpowers. Here's Episode Seven: Stand Out.
Whitney Wellenstein
I have been standing out since the moment I entered my family. My parents are white and adopted me when I was a baby. My older sister is white, and my younger sister is extremely light-skinned. So as the only brown person in my family, I've always looked different. I grew up in a very homogenous white town. All of my friends in high school were white. And even to this day, when people ask me where I'm from and I say North Dakota, eyes pop out. People choke. Response is always, "I didn't know there was Black people in North Dakota."
North Dakota is a lot of things. It's flat. Like, you travel on the interstate, you can see unobstructed for what seems like miles, which makes for crazy, beautiful sunsets. It's a place with all four seasons. The summer days are scorchers. At night, the tornado sirens and hail knocking on the roof are common sounds. But those winters, though! Mm. They are not for the weak. There's the snow, which comes down gently, like God is shaking out a down pillow. It's peaceful, it's pretty, it's calm. It sparkles as it settles. When the sun reflects off, it's so bright you have to squint. But then there's also the blizzards. They pile snow up so high it covers your car. And when you dare step outside, the wind is sure to whoop you in the face, so hard it stings from the wind burn. But if you think all of that is gonna buy you a snow day from school, you played yourself, because North Dakota don't stop for no blizzard.
So I was born in North Dakota, and I was adopted when I was about six weeks old. My family has always been close. We love sports. We love going on vacation together. We love Mexican food more than anything in the world. But from looking at us, you can barely tell that we're family. My dad is the most laid back guy in the world. He's my homie. My mom is a character. She's usually on the phone making a business deal. You know how these days you see a lot of the supe-woke, white, transracial adoptive parents. They acknowledge their privilege in that their brown children will have different life experiences than them. That is not my parents. They had more of the “we don't see color, everybody is equal” mindset that was unfortunately far too common in the ‘90s. I love my family, but I longed for someone that looked like me, shared my features, my skin tone, my hair texture.
I was one of about four Black people in my high school that had about a thousand students. I was the only Black person on all of my sports teams. I remember traveling to different cities for basketball and volleyball games. And there would also be one or maybe two sole Black girls on the opposing team. Being the only Black girl can become so much part of your identity that it almost becomes a competition rather than camaraderie with other Black people in your space. In books, they assume that you have the option to diversify your social circle. And they don't even have a chapter that describes this type of Black Desert. So, I fled. After high school, I was drawn to the diversity of metropolitan areas. I moved to Minneapolis and then Oakland, California, and then Cincinnati.
Shortly after the murder of Mr. Floyd, I went home for my sister's birthday. My stomach was in knots leading up to that trip, because I was dreading having the talk with my family. My younger sister is for the cause. My older sister is pretty apathetic. My mom is quite impressionable, and my dad is somewhat conservative. It went fine. Not every family has these conversations perfected and we are no different.
Erica Farrand
Growing up, ballet was the air I breathed. My mother put me in classes before I turned three, mostly because she didn't know what to do with a child who couldn't make it from A to B without bumping into something or tripping. But from the moment she put ballet slippers on my feet, something just clicked for me. You know, I don't know if it was the music or the discipline. But to this day, I get uncomfortable talking in front of more than a couple of people, but dance has always been a way for me to tell stories. And so, for the first 15 years of my life, it's what I did. You know, by the time I was in middle school, I was taking ballet classes four days a week. I was dancing with the professional company on the weekends. And this was going to be my life.
So, it culminates for me with a big audition in my eighth-grade year. And I am feeling really good about it. You know, it did not matter to me that there was nobody in that company that looked like me. I believed that by showing up and showing out, by doing the work and putting in the time, that there would be a place for me, that I would make a place for me. And I'm feeling good about this audition. And, day of, I am moving through the cuts and feeling really good, until, of course, you know, I'm cut and completely devastated. And trying to get out of that space before I dissolve. And I see the director of the company making her way towards me, and I just, I brace myself, steady myself for them. And she comes up to me. She says, "The point of a ballet company is to see the company, not an individual dancer. And your look is too distracting."
You know at this point, I cannot for the life of me conjure up the complex insecurities of a twelve- or thirteen-year-old girl. But I can recall, with acute pain, what it feels like to have your appearance just dismissed as “distracting.” I walked out that day and I didn't come back. I found an all-Black company to dance with and I explored other forms of dance. And although they didn't resonate with me in the same way, they did help me start to do the work of feeling comfortable with owning the space I occupy.
You know, several years later, I found myself now with a new passion–medicine. And, again, finding that there were few people that looked like me. But I believed, I resurrected this belief, that there would be a place for me. And so, I think I was a third-year medical student and I am rounding with a group. I'm the only person of color and we go in to see this patient. And he's an older white man. And he just, he must not have seen me initially. But at some point during the patient interview, he goes from being completely consumed by his pain and limited mobility to just pivoting and losing his mind. You know, he is, he's saying, "I did not sign up for this! Get her out of here. I do not want this Black bitch in this room!" And I'm standing there in my short white coat, cheeks are blazing, looking at this red-faced man just angry at me occupying space. And my colleagues are there, silently looking back, wide eyed, between the two of us. And it is humiliating.
My attending jumps in and just expertly diffuses the situation, redirects, wraps up the interview and ushers us out of the room without ever addressing the language, or the racism that transpired in that room. And so we get into the hallway, and I am, I am just fully expecting that there's going to be a debrief, you know. And in looking back on that situation, I am looking for recognition and validation and accountability from my attending. And instead, he says to the group, you know, "We're gonna round on this patient again tomorrow." And turns to me and says, "I think it's best that you stay in the hallway, because having you in the room is just too distracting." I mean, really? Thank goodness I had parents and mentors that told me otherwise. Because ten years later, that is still the best you can do.
Ekene Onwuka
Yesterday, I graduated from residency. Eight years, man, eight years I spent in this place! But yesterday was just, ah, I think it was just great. The highlight of the night was when I got the Golden Hands Award, which is the award they give to the chief resident who shows the best operative technical ability. It's the coveted award. And it just meant a lot for me to get it, because there were definitely periods in the residency where I wasn't sure how I was doing operatively.
This is also a special one for me, because when I was finishing up the third year and going into the fourth year, I did a pediatric surgery rotation. And I overall had a fantastic experience. Did well with a lot of the attendings. But there were a couple, including some in very, like, influential places, who scored me pretty poorly for the rotation, and actually said that I was behind in terms of operating, to the point where I was wondering whether or not I should even apply that year. Because peds surgery is such a tight circle, you know. People call around to their friends when they're picking who they want. And word travels. And so, I was so worried that this was going to affect my prospects.
And so, I made a decision when I was starting fourth year to go on each rotation and just hustle as much as I can, and try to improve, try to improve. And I wasn't completely sure whether or not those poor evaluations were true. But I made the determination that I was just going to act as if they were true. I was gonna do as many cases as possible and try to get as good as possible.
I had that same mindset when I applied to the pediatric surgery fellowship. I got the word that there were just rumors going around that I may not be up to par on operative skills. I don't know where they were coming from. And that was, of course, kind of scary. But I had a bunch of people who stuck up for me, who had worked with me, including my mentor and one vascular surgeon that I had worked with quite a bit, because I did five months on vascular surgery right after starting fourth year. And so I worked with her quite a bit and she called around about me and vouched for me. And then I was absolutely shocked when I got thirty-four interviews.
And so, for the last two or three years I'd been operating, operating, operating, thinking I'm probably one of the worst people in the class. And then to get this award, it's just like a, just like validation. This goes out to anyone who's ever suffered from imposter syndrome, who thinks they're over their head, or at a place where they can't compete, think they shouldn't be there. You definitely can. You can compete, and you can be the best.
But I don't know how long I'll stay here, to be honest. I think my old routine of just assuming that I'm behind has served me well thus far. And so, I may just take just a little bit of time to stay in this space, and be happy about this award. But by tomorrow, it's gotta be back to the hustle, you know?
And I'm sure there's a healthy space somewhere in there, between being confident, knowing you're good, like, knowing your worth, and, on the other end of it, assuming you suck and have to work really hard. But I gotta say, I just haven't found that balance. And until I find that balance, I think I'm much safer on the spectrum of thinking you need some work and hustle as much as you can. But for today, for today, I'll kind of just take some pride in these “golden hands”.
Utibe Essien
So, I got this email this week that kind of stopped me in my tracks. One of my colleagues reached out to me and said, "Hey, I've heard a few of your interviews on health disparities. And I can't help but think that maybe the Lord has put you in this spot, at this time, to help many. Kind of like Esther." And again, it stopped me in my tracks, because, I can't help but go back to my Sunday school lessons about this amazing woman in the Bible, who was placed in the very right moment at the very right time.
Twelve years ago, I guess, when I was studying for my MCAT and struggling with all the retakes, and wondering, like, was I ever going to achieve this goal that I had of becoming a doctor. The reason that I wanted to be a doctor–it wasn't because I was this amazing scientist, or because I wanted to do procedures, or had some crazy financial goals in mind. It was really to help the vulnerable, the marginalized, much like I saw my dad, who's also a physician, do time and time again, when I worked in his office in those summers back in high school.
And that has really been what's inspired me. It's inspired me through my first failed exam during medical school, and inspired me during the long twenty-eigtht-hour call days during residency. And during the time during fellowship, where I didn't seem like I was having much success at all. So at the end of the day, this email that I received reminded me that perhaps this very moment is what all those last twelve years were all about–was really just the perfect email for the right time.
Akeem Marsh
My full authentic self includes what the youth would call having a big body, a big bald head, glasses, and some form of Marvel memorabilia–usually two superhero rings that I flex all year round. And also different colored shirts, with matching watch for each color, and occasionally some socks that match as well. Now with the rings it really feels magical. Not exactly like a superpower, but maybe close to that.
I work with people that have a lot of trauma-related issues and emotional dysregulation that can manifest as aggression. I recall one particular incident when I approached the group of young men who were boisterously chatting with each other and being rambunctious, you know, letting their inner child out. My intent was just to check in, maybe socialize a little bit. As I approached, however, attention immediately turned to me and out of nowhere two of them hurl some fake punches at me. "Ay yo, how come you never flinch?" One of them shrieked. I say, "Yo, it's cuz I got the stones," referring to the Infinity Gauntlet ring that I have. The other kid that swung at me said, "Yo, this guy really thinks he's Thanos. Ha, ha, ha!” Everyone started howling with laughter.
That's the thing though, with being your authentic self. It really provides an in to get respect and rapport from people. My favorite part about that is when meeting with patients for the first time, you know, either in the first session, or maybe even after a few, I'll hear something like, "Well, I don't really like talking to people like that. Oh, but you cool." Or, "I really f***s with talking to you!" That's the type of stuff that keeps me motivated, keeps me pressing forward.
I was the kid that was eager to go learn. I would try and answer every question. My hand was always up. Let my palms, you know, feel a little numbness and tingling, after being up for so long. I would even remind the teacher about homework that wasn't collected. But you know, that stopped after a while, since it doesn't go over too well with other folks.
One pivotal moment that comes to my mind, of so many, is when I graduated from medical school. Let's be clear, most of the exams I pass, right? I mean, especially the big ones. You can't make it out without doing that. But I honestly failed more exams during that time than any other time in my career. And let me tell you, when it happens that really crushes your soul. Then it happens again, and you just start questioning everything, like, “Damn, was this really meant for me?”
But, hey, I did make it to that stage at NYC's world famous Carnegie Hall, where the graduation was held. I was dressed head to toe with the flyest, most expensive suit you ever seen. And also had these super fancy light brown Ferragamo shoes. Being able to walk across that stage, and get hooded by a senior doctor that you look up to, finally, legit, being able to be addressed as “Doctor” made it all seem like it was worth it. Like, damn, we really made it, after all of this!
Marla Abrolat
I was at one of those middle management meetings. And we were doing an icebreaker. You know, those ones where you have to choose: so okay, if you want chocolate ice cream, you go left, if you prefer vanilla ice cream, you go right. But the question was, choose your superpower. Is it the ability to fly? Or is it the power of invisibility? And I was frozen. I could not choose.
I mean, obviously, I could not choose the power of flight. Totally afraid of heights. I mean, ferris wheels is kind of like my high end, heart flutter, yeah, give me some benzos for that. And I definitely would not want to be invisible. I mean, my superpower is the exact opposite. My superpower is that I always stand out.
Now, for some people that might be uncomfortable, being the fly in the buttermilk, the grain of pepper in the salt. In other words, the only person of color in a very large bed of white folks. But my parents helped me understand that that was my superpower. I knew early on that you don't have to bother trying to fit in with them. You never will. So, don't bother. Don't play their game. Create your own game and invite them into it.
Because in your own game, you are the leader. And that's always been my superpower throughout my entire life. Knowing that I'm always going to stand out, and relishing in that. And the standing out was really apparent in those residency interviews. Completely standing out from everybody else.
You know, usually, what do you wear to an interview? You've got that navy blue suit or that black suit or, ooh, maybe you're gonna go for a pantsuit instead of a skirt. Now, I don't know about you but in the ‘90s they really didn't make those in maternity size. So, I popped out in the most gorgeous, floral, green dress that accentuated my gorgeous baby bump at seven months pregnant and waddled into every one of those residency interviews. Talk about standing out of this line of, of applicants in their uniforms. And here's the sister with the big belly and the bright green dress. It was glorious. And yes, I matched in my first choice.
Tomas Diaz
During medical school, I was a sub-I doing an away rotation in emergency medicine. And I happened to be there when the new EM interns were arriving for orientation. And so, they asked those of us who were rotating that month as sub-Is to participate as ultrasound models. And I was the ultrasound model for the fast station, which, in case anyone is unsure, fast is the focused assessment, using sonography in trauma, looking for free fluid in the abdomen, for patients with penetrating trauma, or blunt trauma.
And I was laying there as some of the new interns practiced their ultrasound skills, or really learned their ultrasound skills, and most of them introduced themselves to me. But as the first resident took the ultrasound probe, the faculty member who was guiding them through the station, pointed out that I was sort of a perfect model. And he said to the group, he said, "Oh, this is exactly the type of body that you will be ultrasounding–young, athletic, and..." He took a pause. And he didn't say it. But the new resident who was ultrasounding me, he and I made eye contact, as if we both knew that that pause was meant to serve as a placeholder for “Black.” That the patients who would be coming in, the victims of violence, specifically gun violence, who would come through the emergency department and require fast exams, would be like me in the sense that they were young, had athletic builds, and were Black. Most of the other residents didn't seem to even register that statement. I was left to my own thoughts, which were a little bit all over the place in that moment. And I was literally lying, shirtless and exposed, on a, on a table, as they continued to ultrasound me. In this moment, I had been thinking about how Black bodies, including my own, can be seen as expendable.
Anonymous Doctor
I got my degree in 1990. And ever since that time, I've always been amazed at the reactions of people when they hear that I am a doctor. When I first moved to do my training to Rhode Island Hospital, I would walk down the hallways and say hello to everybody. And folks just kind of looked at me. Like what is this guy doing saying hello to me, I don't know him.
But to all of the Blacks in the hospital, who worked in environmental services or in the cafeteria, cuz I was actually the first Black that did the residency program at Rhode Island Hospital in internal medicine, it was a big deal that I stopped and I spoke to them. And in speaking to them, it made them happy. It made them smile. And I knew that I was something that was an anomaly for them. To see one of their own walking around that hospital as a doctor.
I've been in primary care at the VA for 13 years. Probably in about my eighth year of being there, a patient showed up in my office, wearing a confederate shirt, and kind of tattered jeans and bandana. And I thought to myself, this might be a difficult case. But I always remembered what my mother and father always taught me, which was always be kind to everyone. He looked me up and down, and sized me up, but decided to go through with the encounter. At the end of that encounter that day, we actually, I thought, had a breakthrough in the fact that I was able to connect with him and I felt that he was connecting with me. Only time will tell.
Over the next couple of years, this man continued to come back to me first, which was a shock. But then, as we continued to get to know each other, I began to understand him better and where he came from. And he got to know more about me. And sometimes we spent more time talking about our lives than his medical issues. It came to a time in which I was going to leave the VA hospital. And this man had been my patient for five years. And so, I reached out to him to let him know that I was leaving and he scheduled an appointment to come in to see me.
On the day of the appointment he came in and he was a little somber. And he sat down and we started to have our usual chit chat. And we went through our work that we needed to do in order to transfer his care over to another provider and to make sure that I'd got him somebody that he might be comfortable with. And as we were ending that encounter that day, the man reached in his pocket and pulled something out in his hand. A pocket knife.
I've gotten a couple of different pocket knives during my time as a provider, but this one was definitely unique. It was a gold pocket knife in color. And on the front side of it was a full regalia Klu Klux Klan number imprinted on the knife cover. And on the other side of the knife was written out imprinted, “Klu Klux Klan.” And at the top of the knife was a little insignia of the Holy Bible.
So, I kind of sat back in my chair, and I looked at him and he said, "Well, Doc, let me tell you. When I first met you, this is what I used to think. I was heavily engaged in activities that were anti-Black. In fact, I probably hurt some Black people in my life because of the ways that I've thought and things that I have done. Over the years of coming back to see you, I've come to realize that maybe the way I was thinking about Black people was wrong. And maybe that you were not just an exception because you're a doctor, but maybe you were just that way because you're human. And so, knowing that you're about to leave, Doc, I wanted to just give you something, that every time you would look at it you would think about how your care, your compassion toward me, changed my way of thinking. Doc, I used to think like this but I don't think like that anymore."
He looked at me and I looked at him, and he reached across the desk, and he put down the knife.