New year, same racism

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RESOLUTIONS

In this series, Resolutions, we asked clinicians about their New Year’s resolutions. What are our contributors resolving in 2023? Here’s how they responded.

The year is new, but racism is not.

Racism swept through my family before I was born like a tornado, leaving in its wake destruction from which we will never fully recover. Racism rippled through my family tree from my ancestors all the way down to me, like ripples in a lake after throwing a stone, except the ripples don’t stop. Racism causes a type of trauma that only American descendants of slaves can fully understand, a trauma that is not acknowledged in the pages of my DSM-V. The impact of anti-black racism is never forgotten, permanently woven into our family histories.

The racism shows in my fair complexion which matches my mother’s. Growing up, my light brown skin often prompted questions from friends and strangers about whether I was mixed race, but I never identified myself that way. Mom, as always, gave me a brilliant, age-appropriate response when I questioned my racial background. Well, there were definitely white people in our family, but I’m not sure they were nice. As I got older, I learned what she meant. I learned that birth certificates were often changed in southern black families, adding black men as fathers to children who were clearly sired by a white rapist. So being light-skinned has always been unsettling for me, a reminder of racism, a reminder of the whiteness that was forced into my family without consent.

The racism manifests itself in the fact that I only met one in four of my grandparents. Indeed, there is evidence that black people live shorter lives than white people, in part due to the stress of racism and the poorer health care they receive.1-3 My maternal grandmother died of breast cancer before I was born. The white doctors caring for her did not treat her as aggressively as they should have, even though she left behind 8 children, my mother only 18 at the time and my uncle only 11. black people receiving less aggressive cancer care than white patients is also not a thing of the past, as a recent study shows.4 I wonder how many black people would be alive if it hadn’t been for white supremacy and racism. And I wonder why we don’t talk about it more, why we don’t get more angry. Again, I don’t blame black people for being forced to internalize our pain. We must survive.

As a psychiatry resident specializing in the mental health effects of anti-Black racism, crafting a New Year’s resolution is always a challenge. I don’t believe the issues stemming from anti-black racism will be resolved in my lifetime, so 1 year seems inconsequential.

Diligently working on a long-standing issue can be tiring, and sometimes I feel like my voice doesn’t matter. Moreover, as a black woman myself, I continue to be the target of racism, and I testify to it too. Black children are usually called the N-word with little intervention from predominantly white staff, black children are held back for behaviors that are treated with compassion in my white children, black patients are further traumatized by white therapists who assume they are uneducated and gang-affiliated who downplay their suffering and make offensive statements about being black. Each time, I speak, but I am not always listened to. Sometimes I am belittled or rejected. Sometimes I’m appeased by leaders who have the power to change the racist behavior of their staff, but don’t care enough.

But then I think beyond that.

I think of the tearful embraces of black parents when they finally see their child validated and respected by a doctor who looks like them. I think of sighs of relief as I name and validate the racism my black patients experience. I think of the calls for other hospital systems to use the hate speech protocols I created. I think of the countless emails I receive after publishing an editorial or giving a presentation. Sometimes the messages come from individuals who have changed their behavior to control their own racism. Often, the emails come from people who have experienced racist treatment themselves, but couldn’t find the words to sum up their experiences. Or they didn’t feel safe enough to tell their stories without retaliation.

So, in 2023, I decide to own and honor my voice. I am committed to continuing to move forward in my work to end anti-Black racism and the collateral damage it has caused, both within and outside of the medical system. Because my voice matters, and I will continue to use it.

Dr. Calhoun is a resident in adult/child psychiatry at the Yale Child Study Center/Yale School of Medicine. She is an expert on the mental health effects of anti-black racism.

References

1. Hill L, Artiga S, Haldar S. Key facts about health and health care by race and ethnicity. KFF. January 26, 2022. Accessed January 16, 2023. https://www.kff.org/report-section/key-facts-on-health-and-health-care-by-race-and-ethnicity-health-status – results-and-behaviours/

2. Thames A. Study: Racism shortens life and harms health in black people by promoting genes that lead to inflammation and disease. The conversation. October 17, 2019. Accessed January 16, 2023. https://theconversation.com/study-racism-shortens-lives-and-hurts-health-of-blacks-by-promoting-genes-that-lead-to-inflammation- et-disease-122027

3. KM Bridges. Implicit biases and racial disparities in health care. American Bar Association. Accessed January 16, 2023. https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/racial-disparities-in-health-care/

4. The number of cancer survivors in the United States stands at 18 million, disparities in care remain. Helio. June 23, 2022. Accessed January 16, 2023. https://www.healio.com/news/hematology-oncology/20220623/number-of-cancer-survivors-in-us-rises-to-18-million-disparities – in-care-remain?utm_source=selligent&utm_medium=email&utm_campaign=news&M_BT=661079236240

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