My Black Skin Makes My White Coat Vanish

The first time it happened I was a brand-spanking-new M.D., filled with an intern's enthusiasm. Proudly wearing my pristine white coat and feeling sure that I was going to save the world, I walked into my patient's room.

"Hello, I'm Dr. Kasongo. How can I help you?" I asked cheerfully. The patient was a pleasant African-American woman whose chief complaint was abdominal pain. I spent the next 10 minutes taking her history, examining her thoroughly and doing a rectal exam to spot signs of internal bleeding. I explained that I'd treat her pain, check her blood work and urine samples, and go from there. "That's great," she said with a smile. "When is the doctor going to see me?"

I frowned. Hadn't she heard me? Hadn't I just administered an invasive exam on her posterior? "I am the doctor," I told her, making myself smile again. Did she sense my newness? Was it my lack of confidence that made it hard for her to believe I had a medical degree? I decided that even though I was a 30-year-old intern, it must be the youthful appearance I inherited from my ageless mother that was confusing her.

That was four years ago. There have been many such incidents since then, ranging from the irritating to the comical, and I no longer have much doubt that what baffled my patient was the color of my skin. Several months later, I was having dinner at an upscale hotel in Las Vegas with a friend, when she started choking on a piece of food. As she flailed her arms in obvious distress, frantic cries of "Is there a doctor in the room?" rang out from nearby tables. I assured everyone that I was a doctor and administered the Heimlich maneuver successfully. Even as my friend regained her bearings, people at the surrounding tables kept screaming for a physician. Once the "real doctors"--two white males--came to the table and saw that her airway was clear, they told the staff that it appeared that I was in fact a doctor and that my friend was going to be fine. Yet, far from comforting them, this information produced only quizzical looks.

Over the years, the inability of patients and others to believe that I am a doctor has left me utterly demoralized. Their incredulity persists even now that I am a senior resident, working in one of the world's busiest hospital emergency rooms. How can it be that with all the years of experience I have, all the procedures I've performed and all the people I've interacted with in emergency situations, I still get what I call "the look"? It's too predictable. I walk in the room and introduce myself, then wait for the patient--whether he or she is black, white or Asian--to steal glances at the ID card that is attached to my scrubs or white coat. (I've thought of having it changed to read something like: It's true. I'm a real doctor. Perhaps you've seen a black one on TV? )

I remember talking to one of the white, male attending physicians in my training program after he witnessed one such encounter. "Listen," he said, trying to comfort me, "I can walk in wearing a T shirt and jeans and I'll always be seen as the doctor, even without an introduction. You will not." My heart sank as I thought of Malcolm X's words, "Do you know what white racists call black Ph.D.'s? N----r!"

Only a small portion of the growing number of female doctors--not quite 4 percent--look like me. Perhaps that's why, for most people, "doctor" still doesn't fit the stereotypical image of a black woman in this country. Unfortunately, black children may be even more adversely affected by this than white ones. That point was driven home to me months ago, when a 6-year-old black girl refused to let me treat her when her mother brought her to the emergency room and left us alone. She insisted on being seen by a white doctor, leaving me feeling both embarrassed and humiliated.

Throughout the years, I've spoken to other female doctors about their experiences. While my white, female colleagues sometimes get "the look," it doesn't happen nearly as often as it does for black, female doctors. My African-American peers have their own ways of dealing with it; some even pre-empt suspicious patients by saying, "Yes, I am a doctor, and you can check online when you get home."

I've decided to try not to be bothered by my patients' attitudes. Like all doctors, I've worked hard to get to where I am. And occasionally I see that there is hope for humanity. A few months ago I treated a white, eightysomething man who had pneumonia. As I set up his IV line, I noticed that he was staring at me. Finally he said, "It must have been very hard for you to make it." After a pause, he added, "A woman--and black." We both laughed. Someone understood.