Overcoming Whiteness

My choice to become a doctor has always been rooted in a commitment to serve marginalized communities. The path I have taken has allowed me to serve diverse communities of color and afforded me a deep awareness of the challenges that they face. Coming to Michigan has forced me to confront my relationship to “whiteness” and my limited understanding of the barrier poor white communities face in managing their health and wellness. “Whiteness” goes beyond white skin; for me, it more importantly references a position of power that is automatically defaulted to those that pass as white and an entitled attitude that is often ignored/ excused. Personal experiences have caused me to have a hyper awareness/sensitivity to whiteness. In many ways it has been a survival skill and a tool for self preservation. However, as I begin to serve more and more white communities it is essential that I break away from this mindset to be better at serving all communities. I am reminded of one of our first tasks as medical students in our simulation experience. In the first weeks of medical school we we learned how to conduct a patient interview. A main component of this task was for us to begin to practice our skills in showing empathy and electing emotion from our patient. The experience stands out to me as a formative moment because it pushed me to become aware of the biases I carry with me.

I remember being nervous and thinking about all the different scenarios that would make this first encounter difficult. At the top of my list was “Older white man.” To top things off this was a recorded activity that we would then view with our small group for feedback. The thoughts swirled in my mind as we were escorted to our assigned exam room. We received the instructions to read the page at the door. Pulling the page closer to me I saw it read: “60 year old male patient in to discuss urinary incontinence and follow up on chronic illnesses.” I knocked on the door and entered the room and realized my patient was an Older White man. I took a deep breath and began our visit. My guard and senses were heighten when we first began to talk and feel each other out. But, as I moved through my interview checklist and utilized my interview skills my guard began to go down. As I did this I began to become more aware patient’s vulnerability in this visit. He sat across from me, in a hospital gown telling me about the embarrassment and shame he had been feeling with his newly developed health issues. We discussed his incontinence and the impact it had on his daily life. He shared with me the financial troubles he had been facing after being laid-off. He shared his fear of not finding work because of his age and how the loss of the automobile industry in Michigan has made life hard for him and his family. Although this was a simulated experience it forced me to address my bias and assumptions. It set the tone for how I will approach patients that initially make me uncomfortable.

I am a queer brown man; and I have had many moments in my professional and personal life where I have been challenged with toxic masculinity and have dealt with assumptions made by white individuals. If I’m being honest, the challenges I have in communicating with older white men comes from a fear of not meeting expectations of being a man, the expectations of fitting a masculine prototype, and the risk of being judged for my queerness. I value the ability to connect with patients and have found it difficult to connect with white men. It is not always easy to recognize and own up to moments where we may not be at our best. But it is essential to be willing to self reflect and push aside pride in order to work on eliminating our limitations to serve all patient populations. I appreciate this experience because it prepared me to work with the primary patient population I encountered while at my assigned clinic- white men. Having this encounter in simulation allowed me to practice patience. It helped me reframe moments of hypermascuinity and homophobia while rooming patients. I do not believe financial hardship and other challenges are an excuse for a patient to assert their assumed superiority. However, my awareness of my bias helps me think more deeply about the motivations behind oppressive behavior. Self reflection is my medicine; recognizing the ways I navigate the world serves my purpose of being a healer.