Microaggression- “a statement, action, or incident regarded as an instance of indirect, subtle, or unintentional discrimination against members of a marginalized group such as a racial or ethnic minority.” (From Oxford Dictionary)

Before I took my graduation picture for medical school, the photographer said, “And what do you call that hairstyle? Do you need to fix your hair or something?”

I was wearing my hair in the puff that I had grown so fond of during my then 7 years of being natural. That day, my hair had made the most glorious puff in its own history.

This guy jumped in and made me feel small while I should have been celebrating one of the greatest achievements of my life.

As a black woman it is so difficult to gauge how much of yourself to show. You already feel that you just being black is enough to set off some alarms in the heads of potential employers, colleagues, and even the rest of the staff of the hospital. In order to make our blackness more palatable for people, sometimes, we make changes to ourselves. We speak in a certain way, we wear our hair in a certain way, we dress a certain way. The alternate is getting comments that we never thought that we would get from people who claim to be our friends and colleagues.

I just want to encourage you, black physicians and student physicians. You have a place in medicine and your representation matters. You belong here and we need you here.

Here are a few microaggressions that have happened to me or that I have witnessed:

1. People touching my hair (my person) without my permission/making disrespectful comments about my hair without any knowledge, as above.
2. Tons and tons of people referring to black women/men physicians as anything but Dr. despite having a white coat on and despite having badges that say in huge font  ‘DOCTOR’.
3. People giving us unsolicited nicknames/ refusing to learn how to say our given and cherished names.
4. The assumption that our spots in medical school, residency, and fellowship were given to us just because we are black and not because of our achievements and hard work.

These are just a FEW experiences that I have personally seen or had myself. If you want to cringe and also read some more of the things that black doctors go through, there are countless others under the hashtag #blackintheivory on Twitter. Also, its easy to just speak to your black colleagues about their experiences. Just be willing to listen.

But how do I deal, Lise?

Remember that this is my personal list of how I deal with microaggressions. You may find different ways to deal and that’s fine.

1. Always show grace. It is so easy to get angry and frustrated when you are pelted with these things all of the time. Don’t get me wrong, microaggressions are extremely anger-provoking, however, it’s almost impossible to do the second point on my list while angry.
2. Educate. Pull the person to the side and explain how what they said made you feel and how it could be hurtful. Explain the history behind why it’s offensive that your colleague called you Aunt Jemima (again, actually happened to me). I know, It’s not black people’s job to educate the world. If you’re tired, I get it. If there is some energy left, just consider taking a second in the moment or shortly after to explain. This one is actually very important because of the reason we all went into medicine – patients. I take the time to educate for my patients. If you, a colleague, are offended by something another colleague said, you can imagine how a patient would feel if this colleague were to say something similarly derogatory to them. Cultural competency training is effective, but I think that real time feedback is also important.
3. Find a tribe. Find people you can talk to about the things that are happening to you. This one makes number 1 more possible. This can be a trusted attending (doesn’t even have to be a black attending), other students, co-residents, etc. If there is no one at your institution or you don’t know anyone else black in medicine personally (first of all, that’s an entirely different problem), reach out to someone on Twitter, Instagram, or other social media. The goal here is to not be bottled up. You need to talk to someone about your experiences.

I am planning to continue to do some more formal learning about race in medicine. First book up is Medical Apartheid by Harriet A. Washington, which I will be purchasing when I get back to my local, neighborhood bookstore. Join me in the reading, it’ll be great.

Wear your puff,

Lise