Dr. Michele Harper is a New Jersey-based emergency room physician whose memoir, The Beauty in Breaking, is available now. A graduate of Harvard University and the Renaissance School of Medicine at Stony Brook University, she has worked as an ER doctor for more than a decade at various institutions, including as chief resident at Lincoln Hospital in the South Bronx and in the emergency department at the Veterans Affairs Medical Center in Philadelphia. This is her story, as told to PEOPLE.
When you’re Black in medicine, there are constant battles.
You constantly have to prove yourself to all kinds of people. Like any workplace, medicine has a hierarchy — but people of color and women are usually undermined. You’re constantly questioned, and it’s not by just your colleagues. It’s your patients. It’s people outside of your departments. It’s everyone, at all times.
I recently had a patient, a young woman who was assaulted. She wanted to file a police report, so an officer came to the hospital. At some point, I heard screaming from her room. She was saying, “Leave. Get out. I want you out of here.” Her cries became more and more distressed. She was in there alone. The curtain was closed. None of us knew what was happening. There wasn’t a doctor assigned yet to her, she only had a nurse. But everyone heard her yelling and no one got up.
Of the doctors and nurses on duty, I was the only Black person. She was a Black patient. Nobody went to check on her. I said, “What is going on?” Nobody answered. I asked her nurse. She casually replied, “Oh, the police came to take her report and that’s who’s in there.” So I replied, “Well, do you want to check? Because she’s yelling for help.” She just sat there. Everyone just sat there. I was horrified. I ran to the room. I was the one to take a stand, to see if she was okay and to ask him to leave the room because she didn’t feel safe, and she wasn’t under arrest. She was just trying to get help because she was assaulted.
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When I left the room, I found out that the police officer had said that he was going to try to arrest me for interfering with his investigation. Nobody in the department did anything for her or me. These are the risks we take every day as people of color, as women in a structure that is not set up to be equitable, that is set up to ignore and silence us often.
I feel a responsibility to serve my patients. That is my mission. What I see is that certain patients are not protected and honored; it’s often patients who are people of color, immigrants who don’t speak English, women, and the poor. I’m the one who ends up standing up for them. Is that how it should be? No. Is it my sole responsibility to do that? No. It is the responsibility of everyone in the department. But because of socialization, implicit bias and other effects of racism and discrimination, it doesn’t happen that way.
Racism affects everything with my work as a doctor.
Several years ago, I had applied for a promotion at a hospital. I was the only applicant and I was very qualified for the position, but they rejected me, leaving the position vacant. I subsequently left the hospital. Later, I learned they hired a white male nurse instead.
It’s not coincidental that I’m often the only Black woman in my department. There are limitations in hirings and promotions.
In medicine, there’s no consensus that racism is a problem. But there has to be that agreement and understanding or nothing will be done about it. We have to examine why this is happening.
For example: at hospitals in big cities, why doesn’t the staff reflect the diversity of its community?
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There’s no easy answer to this question. It relates to structural racism. There are so many barriers to entry in medicine for people of color: the cost of medical school, wage gaps, redlining, access to good public education and more. Until that’s addressed, we won’t have more people from underrepresented communities in medicine.
Further, for women and people of color who do make it into the medical field, we’re often overlooked for leadership roles.
If we had more people in medicine from poor or otherwise disenfranchised backgrounds, we would have better physicians, physicians who could empathize more. [Recent data from the Association of American Medical Colleges shows that of all active physicians in the United States, only 5% identified as Black or African American. As for sex, about 35.8% were female.]
Courtesy of Riverhead
If we had more healthcare providers with differing physical abilities and health challenges, who didn’t come from wealthy families… that would be a strong start. Studies show that these doctors tend to be more empathetic to their patients.
But, and perhaps most critically, people have to be held accountable when it comes to racism.
Often, a medical work environment can be traumatic for people (and specifically women) of color. Sometimes our supervisors don’t understand.
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When we do experience racism, they often don’t get it and may even hold us accountable for it. For example, I had a patient who, when I walked into the room and introduced myself, cut me off and said, “Okay, yeah, well, this is what you’re going to do for me today.” She really didn’t know anything about medicine. This was a middle-aged white woman, and she certainly didn’t know anything about me because I had just walked into the room and said my name.
So I explained to her the course of treatment and she just continued to bark orders at me. Eventually she said, “I come here all the time and you’re the only problem.” I’m also the only Black doctor she’s seen, per her chart.
I kept thinking, “This is absurd.” Part of me was laughing inside because she thought she could be so ignorant and inappropriate. The other part of me was pissed off that she felt so entitled to behave so indecently.
My ER director said that she complained. My boss’ stance was, “Well, we can’t have this, we want to make her happy because she works here.” And I said, “She’s racist, I literally just said my name,” and I repeated what happened. I continued, “So her complaint is not valid. There was nothing to complain about. Her behavior was out of line.”
My director’s initial response was just, “Well, you should be able to somehow handle it anyway.” That is not acceptable, and yet these situations happen constantly. So not only are we the subject of racism but then we’re blamed for the racism and held accountable for other people’s bad behavior.
Working on the frontlines of the coronavirus (COVID-19) pandemic, in a predominantly Black and brown community, I’ve treated many essential workers: grocery store employees, postal workers. Their stories weigh heavily on my heart. They’d tell me the same thing: we’re all getting sick. The bosses know we’re getting sick, but won’t let us take off until it gets to the point where we literally can’t breathe. We need to support our essential workers, which means having a living wage, affordable housing, sick leave and healthcare.
One of the grocery clerks who came in, a young Black woman, told me she didn’t know if she had the will to live anymore.
She and I spoke for a long time about how she had no one to talk to, and now because of coronavirus, she was even more alone than she used to be. She was being sexually harassed at work and the customers treated her horribly.
I asked her if there was anything we at the hospital could do, after I made sure she wasn’t in physical danger and wasn’t going to kill herself. She said no and that she felt safe. What she ultimately said to me after our conversation was, “I just wanted to talk and now, after meeting with you, I feel better.” She felt well enough to continue living.
That’s why we need to address racism in medicine. Because if the person caring for you is someone who hears you, who truly understands you — that’s priceless.
If you or someone you know is considering suicide, please contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), text “STRENGTH” to the Crisis Text Line at 741-741 or go to suicidepreventionlifeline.org.
To help combat systemic racism, consider learning from or donating to these organizations:
• Campaign Zero (joincampaignzero.org) which works to end police brutality in America through research-proven strategies.
• ColorofChange.org works to make government more responsive to racial disparities.
• National Cares Mentoring Movement (caresmentoring.org) provides social and academic support to help Black youth succeed in college and beyond.