‘Racism in medicine manifests as cumulative deprioritization over many small decisions.’

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Harry Alford III

Beyond the Rhetoric

By Harry C. Alford III

This is how Black people die

Are all doctors and registered nurses racist? Not overtly. “But this is one (common) way Black patients receive different care: cumulative deprioritization,” writes Physician Scientist, Tamorah Lewis. Cumulative deprioritization occurs when implicit bias unconsciously affects decisions. It is deadly.

Bias can play a role in whose COVID-19 symptoms are taken seriously, as in the case of Dr. Susan Moore. Dr. Moore was a Black doctor who died of COVID-19 after complaining of racist treatment. “He made me feel like a drug addict,” Dr. Moore said, accusing a white doctor of downplaying her complaints of pain and suggesting she should be discharged. Bias cost Dr. Moore her life. “Her medical degree did not save her from the racism that she endured while battling for her life,” tweeted Dr. Omolara Uwemedimo. From my experience this year, she’s absolutely right.

This year, when very little was known about COVID-19, my dad was admitted to the intensive care unit (ICU). He was diagnosed with flu and pneumonia. After a week, the hospital released him with fluid still in his lungs. Over the course of several weeks, my mom found my dad unresponsive three times in their bed. Three times she called 911. He was continually diagnosed with pneumonia again and again and again.

During the previous two hospital admissions, his blood pressure was allowed to soar, and his sugar glucose levels were high. It’s important to note that although my dad had diabetes and heart trouble in the past, he had no evidence of diabetes or heart disease in the most recent years.

When the cardiologist spoke to my dad for the very first time, for the third admission he said remonstratively, “So you are here because you do not take your meds regularly.” What!?

We knew then that we had to advocate for dad as much as possible. My mom, twin brother, and I created a 24-hour shield, working from the hospital by day on our laptops. We wore logos of all the schools we attended to show we are an educated family. We spoke openly about our dad, so the staff knew he leads a purpose-driven life. At night, my brother and mom alternated sleeping in the chair or on the bench. I went home at night to care for my toddler and pregnant wife.

We knew that if they allowed our dad to go home that night, that he might not wake up the next morning. We demanded to speak to every leader on the floor, insisting he receive a sleep study — a medical treatment without being admitted to a hospital — while still in the hospital. With every clarifying question asked, we were met with a demeaning valuation of his life.

In Dr. Moore’s Facebook post, Moore chronicled her discharge from the hospital, her return home, and her worsening condition.

“I was home for less than 12 hours. Spiked a temperature of 103 and my blood pressure plummeted to 80/60 with a heart rate of 132. I’m back in the hospital, a different hospital, Saint Vincent Carmel.” (Ironically, my brother and I were born in this hospital.)

Moore said that she was diagnosed with pneumonia but that she received “compassionate care” and the pain medication she needed at her new hospital. In her last update, Moore said she was being transferred to intensive care. Moore maintained that if she were white, she wouldn’t have received such poor treatment explaining, “This is how Black people get killed. When you send them home.” She died on December 20.

Death by COVID-19 or not, there is nothing insignificant about life, especially when taken from us. To our immense delight, we brought our dad home, and he is doing well. He’s able to blow socially distant kisses to his two grandsons from his driveway.

We saw firsthand how deep subconscious beliefs could deprioritize Black life.

As a society and in our respective professions, we must do a better job of being socially aware of our own biases. As Dr. Tamorah Lewis advised, “I unlearn it and actively fight against it in life and every patient encounter. But first, I had to admit it and look for it. If all in medicine followed suit, #DrSusanMoore would not be a hashtag.” I am amplifying Dr. Moore’s story and I’m doing something about it.

Harry Alford III is co-founder of humble ventures, a venture development firm accelerating tech startups in partnership with large organizations and investors.

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