A Black man’s self-worth in medicine

Do you remember what you dreamed of becoming as an adult? I do, and I recall my father telling me I could be anything I wanted to be. My dreams were shattered as soon as I stepped into a prison and I am still trying to pick up the pieces of my self-worth.

“Wait, you’re a doctor?” “Nah, man he ain’t a doctor; he looks too much like us.” I am sitting in a high school classroom, it is late May 2018, full of young Black men and women. I know I am in the right place. It wasn’t the first time I have heard that, and surely will not be my last.

For those students, the concept of Blackness did not coincide with the possibilities of being a doctor. Who is telling these young men and women they can’t do what I do? Who is influencing their feelings of self-worth? Society? The educational system? Our government? Or perhaps the videos of young Black men and women losing their lives at the hands of law enforcement?  I understand why they didn’t believe I was a physician, because I understand their perception of self-worth through the lens they are viewed in this world. Is anyone surprised they did not believe I was a physician?

I understand why the students couldn’t envision themselves as physicians. Personally, my sense of self-worth was stunted before I spent a decade of life on this earth. I was in New Jersey spending time with my mom, when I began to understand how I was viewed by society. My mom had recently been diagnosed with lupus, and she was going to the pharmacy to pick up her immunosuppressants. When we stepped outside, I was ready for some ice cream. Instead, we were greeted by the police, who accused my mother of being a thief and “a junkie.” Those medications to help suppress her immune system were slapped to the ground, and her pills were crushed. My mother and I were taken into custody, where we spent most of the evening in jail. Everyone in the neighboring cells was Black, and I recall thinking, “maybe this is where I belong.” I can’t tell you when I realized the jail cell wasn’t where I belonged. But, I can tell you that even as a physician, I struggle to believe medicine is where I belong.

Entering training, I was hopeful that I would find a sense of value and belonging. However, as I have advanced through the years, I have come to identify some systemic flaws that undermined my self-worth and sense of belonging as a Black man in medicine. One of the most glaring is that in contrast to the cell I once sat in, there are so few Black men in medicine. Despite composing 13.4 percent of the population, Black people only compose 3.6 percent of U.S. medical school faculty.  Historically, our efforts to correct these inequities often result in disappointment. Black faculty experience lower rates of academic promotion (18.8 percent) compared to our white colleagues (30.2 percent) as well as higher rates of burnout. Still, my brothers and sisters have pressed on in hopes for a better future, putting countless hours of labor into addressing the structural integrity of our profession.

Like the high school students I mentor, I find it difficult to believe in my potential when the world tells me otherwise. The frustration I feel towards a system that compromises the self-worth of individuals at such a young age simply because of their appearance is indescribable.  Nonetheless, I find solace through the interactions with my Black patients. “I’m so proud of you,” “I can’t tell you what it means for my son to see a Black doctor,” “Stay strong. I know you are making your family proud.” 20 years after sitting on a bench in a jail cell with my feet unable to even touch the ground, I found my purpose through the patients I am lucky enough to serve. I’m now proud to be able to serve as an example to help Black children believe in their dreams.

Black Lives Matter more than this country has ever truly accepted. African Americans built the backbone of this economy without asking for much in return except for justice and equity. We now need society and our partners in medicine to help support our push for equality, so one day our children can fulfill the dreams they deserve as human beings. The recent push by institutions to develop anti-racist policies has given me some hope. However, I hope these efforts are not just a fad. I hope that this will be the start of a fundamental shift in the backbone of our society, where people become advocates for all. Black lives will truly matter when Black children can see themselves beyond the “jail cell” that the world envisions for them, and their opportunities become equitable.

Ian Simpson-Shelton and Dirk Gaines are internal medicine residents.

Image credit: Shutterstock.com