EDITORS' PICK | 33,563 views | Jun 12, 2020, 10:30am EDT

‘I Am Tired’: What Black Doctors

Need You To Know Right Now
Jessica Gold Contributor
Healthcare
I write about mental health, the media, and everything in between.

Jasmine Marcelin MD, wipes away a tear during a #WhiteCoatsForBlackLives rally at the University of ...
[+] UNMC/NEBRASKA MEDICINE/KENT SIEVERS

The experience of frontline healthcare workers during the coronavirus

pandemic has been and remains headline news. We know what the
experience is like without personal protective equipment, to be infected with
Covid-19, and the potential risk for serious mental health outcomes. What
we don’t know is how this is disproportionately affecting black doctors.
Black doctors who have seen more patients who look like them be infected
and die from coronavirus. Black doctors who go to work and can feel isolated
and alone in their lived experiences, as they make up only 5% of the
physician workforce. And, black doctors who once again witnessed the
brutal murder of a black man, George Floyd, on camera by a police officer.

We can hypothesize based on what we know and say this will affect their
mental health more, but we also need to hear directly from them. This is the
time to listen and learn and center their experiences. In the first half of this
two-part series, in their own words you will hear from a range of voices,
from pathologists to psychiatrists, who will tell you what it means and feels
like to be a black doctor right now in the middle of two pandemics, Covid-19
and the national reckoning with racism.

Valerie A. Fitzhugh MD, Associate Professor and

Chair (Interim), Department of Pathology,
Immunology, and Laboratory Medicine, Rutgers
New Jersey Medical School
Valerie A. Fitzhugh MD, Associate
Professor and Chair (Interim)
Department of Pathology, Immunology, ...
[+] KEITH B. BRATCHER, JR. 2018
When the news about George Floyd broke,
I went through a myriad of emotions. The
one that has been the most consistent is
the pain. It's a raw, visceral pain. Every
time this happens (and it is heartbreaking
to have to keep saying every time), I think
"That could have been my brother, father,
brother-in-law, cousins, etc". I think back
to when I've gotten pulled over; "Keep your
hands on the wheel, be respectful, and
maybe this will be OK." I am so tired.
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I have gotten used to being an only. As a black woman in pathology, there is
a sprinkling of us about the country. In many subspecialties of pathology,
such as bone and soft tissue, genitourinary, medical renal, and forensics, we
are very few. So, imagine this scenario: a poorly written press release
interpreting the preliminary findings of the autopsy lacking the word
everyone was waiting to see: homicide. Instead of seeing that word, the
release seemed to accuse George Floyd. Suddenly, I was being asked to
interpret this "autopsy report". Gaslighting at its finest. I found myself in an
intersection between my race and my profession.

By defending the presence of forensic pathology, and in particular, this

forensic pathologist, was I siding against my people? I was afraid many
would think so. The morning after the press statement was released, I took
to Twitter. @DrFNA was on a mission. I took great care in my tweets. I made
it clear that I was hurting. I explained the difference between coroners and
medical examiners. I also explained, with much rightful outrage regarding
the press release, that this was not the preliminary autopsy report, and that,
despite our rage, we needed to wait. As a community, we are so used to
corruption in the handling of cases involving us. It became a “here we go
again” moment. This pain was compounded because there was a video that
showed it all.

I have been trolled on Twitter, so I am no stranger to insults. Much to my

surprise, there was no negativity directed at me. What I thought would come
to pass did. The next morning, the Hennepin County Medical examiner's
office released the preliminary report. Manner of death: homicide. The word
we were looking for. What we saw on the video, 8 minutes and 46 seconds of
a knee in the back of George Floyd, screaming for his mother. Screaming
that he couldn't breathe. For a fleeting moment in time, what we saw was
justified.

It’s no longer enough to not be racist. We all must rise against it. Many are
now talking the talk but must now walk the walk. It hurts that the black body
count continues to rise because people see us as less than human. See us as
the beautiful people we are. Please. I was born black, and I will die black. I
just don’t want to die tired.

Alden Landry MD, MPH, Assistant Professor,

Emergency Medicine, Beth Israel Deaconess
Medical Center
Alden Landry MD, MPH, an emergency
physician at the Beth Israel Deaconess
Medical Center in Boston, ... [+] ALDEN
LANDRY MD, MPH
comes quickly when off-putting comments are uttered by colleagues, even
those considered friends.
I'm tired. I'm frustrated. I'm overwhelmed.
I am stretched thin. I don't feel like I have
enough time in the day. I'm not ready to
have a conversation with you, but it seems
like I have to. These are all thoughts,
phrases, and utterances that I have
expressed to my colleagues over the past
the few weeks. Just as we were stabilizing
from the Covid-19 pandemic and
recognizing that we had likely made it
through the first wave, we were hit again,
but this time with police brutality. These
past few weeks have been an outright
assault on my mental health. Sleep is a
luxury, sadness is commonplace, and anger

When I am in the Emergency Department caring for patients, I am a

physician. It is my career, it is my profession. It is not who I am though. It is
not what defines me. If it were up to me, I would describe myself as a
Christian, husband, father, Texan, lover of many things including beaches,
BBQ, mojitos, and a good chocolate chip cookie recipe. Unfortunately, that is
not how this society in America would describe me. Reflexively, without
knowing anything about me, this society defines me as black man and along
with that ascribes the stereotypes to me. When people know who I am and
what I do, it is easy to know these attributes about me. When the
assumptions are made without knowing me the default options are often
that “I am less than” or a threat.

Being a black physician in times of injustice means checking your emotions

at the door because your professionalism may be called into question if you
bring in concerns from the outside world into the practice of medicine. It
often feels as if you have to strip your other identities away and carry
yourself in a manner that is stoic and aloof to society while being
compassionate to the patient in front of you. As George Floyd struggled and
pleaded “I can't breathe,” I couldn’t breathe because I felt that pain. As a
doctor it would be malpractice and a violation of the code of ethics of the
profession to ignore someone the way the police officer did George Floyd.
Sadly enough shortly after we saw the video, a case was presented at our
department’s Morbidity and Mortality conference and the chief complaint
was “I can't breathe.” I immediately drew parallels to the two situations. So
did the other black physicians in the group; disappointingly, many of my
white colleagues did not see the same parallels. I sent an email to the group
to explain to them what I was feeling and likely what the other black
physicians in our group were feeling. Unfortunately, it feels as if it may have
fallen on deaf ears as many struggled to reply, while others seemed to have
shied away despite me openly expressing discontent. It took a week for my
hospital, medical school, and the professional organizations that I belong to
ultimately speak up and denounce racism, call for societal reform, and speak
out against police brutality. It seems as if no one wanted to be the first to
speak up. It also seems as if everyone was scared to say the wrong thing, not
realizing that saying nothing was just as bad if not worse.

With the social unrest on full display as protests rose across the country, I
was driving into work for an overnight shift. Because of my clinical
responsibilities I was not able to join in the peaceful protest. My duality as a
physician and a black man were in conflict.
James Baldwin once said, “To be a Negro in this country and to be relatively
conscious is to be in rage almost all the time.” To be a physician and to be a
black man is to be in a constant state of rage but to have to bottle those
emotions up even if it may be to your own detriment.

Rebekah Fenton MD, pediatrician and adolescent

health advocate, Chicago, IL
#GeorgeFloyd, #Minnesota, and
#BlackLivesMatter trended on Twitter.
Just reading those three lines, I knew two
things: another unarmed black man was
murdered by police violence and my heart
couldn’t take reading it.

A few days before the news broke, I

suddenly developed a pounding heart rate.
Rebekah Fenton MD, pediatrician and
adolescent health advocate in Chicago, Probably anxiety, I thought. When the
IL REBEKAH FENTON MD
pounding followed me the next couple of
days, I tried every calming trick that I
know: breathing exercises, prayer, meditation, etc. It didn’t go away. My
father, a physician and concerned parent, recommended I see a doctor just
to make sure. I set up a telemedicine visit and cried while explaining my
frustration with the lack of control. “We can get an EKG and some labs”, the
physician summarized, “but, like you said, the etiology is most likely stress.”
I cried even more. My body was clearly trying to tell me something, but how
long would the message last?

I felt stuck in flight-or-fight, my body pouring non-stop adrenaline into the

bloodstream. I worried that remaining in this state too long would be toxic
to my mental and physical health. Chronic stress leads to increased
inflammation in the body, and increased risk of mental health concerns and
chronic disease if there’s no intervention. I also felt betrayed by my body for
expressing emotions that my conscious mind could not comprehend. I
thought I was fine: stress managed and feelings processed. I had a great deal
of stressful experiences in the last two years, and I had survived them
without a health scare. Why now, body, when I thought things were better?
After many more tears, I expressed gratitude to it for carrying me through
all those experiences. I honored my body’s strength and elevated its voice; I
committed to slowing down and listening for as long as it needed.

I had to break from social media for days to get the rest I needed and the
space to process my stress. I love advocacy, and I knew I couldn’t work for
others until I first tended to myself. I carried the stress of situations I
couldn’t change and therefore feelings I couldn’t release. I brainstormed
with my new therapist how to set boundaries so I could experience safety
within them.

On Sunday, Charlie Dates, a black pastor in Chicago, described the sacred

quality of breath and called on everyone to acknowledge that taking it away
is murder. I cried, not for myself, but for George Floyd, those whose breath
were similarly taken away, and all who rushed to the streets to stand for
equal value of black lives. While this is a major moment in US history, it is a
peak in a mountain range of experiences for black people in this country, an
acute on chronic stress. I can recall where I was and what I was doing when I
heard that Trayvon Martin’s killer was not convicted. The faces of Mike
Brown, Sandra Bland, and Tamir Rice are etched in my memory like family
members. This is the toll of being black in America, seeing a black person
killed and hurting, on top of everyday stress, because it's nothing new.

Utibe R. Essien MD, MPH, Assistant Professor,

Department of Medicine, University of Pittsburgh
School of Medicine
I’ve spent most of the past week looking for the words. Looking for the
words to comfort my younger brothers, whose memories of past,
unanticipated interactions with the police were triggered by the murder of
Mr. George Floyd. Looking for the words to say to the black medical student
 and black intern on my medical team as we
walked together on rounds, business as
usual, the masks on our face a subtle
reminder of the ongoing Covid-19
pandemic that continues to ravage through
our communities. Looking for the words to
encourage myself that with each new day,
the tears in my eyes, the lump in my throat
and the pressure in my chest will soon go
away and I will be okay again.

But I am not okay. The image of Mr. Floyd,

a black man like me, dying on the hot
Utibe R. Essien MD, MPH, outside the
hospital on the way to work at the
concrete in Minneapolis has haunted me
University of Pittsburgh, ... [+] UTIBE R. every day. His dying words, “I can’t
ESSIEN MD, MPH
breathe”, have brought back moments that
were so common as I trained to be a physician. Despite the myriad of famed
physicians and scientists that once walked the hallowed halls of
Massachusetts General Hospital, theirs were not the names that marked my
residency training. Those names were Michael Brown. Freddie Gray. Walter
Scott. Eric Garner.

For some reason Eric Garner’s death has stuck out to me the most. Perhaps
because his was the last video I could convince myself to watch, never again
subjecting myself the pain of seeing another man’s life taken from him.
Perhaps because his death reminded me of home, the NYPD uniforms from
my childhood surrounding him as he choked out his now infamous final
words, “I can’t breathe.” I wonder if Mr. Floyd thought about Mr. Garner as
he walked out of that Minneapolis grocery store one last time, his last words
eerily echoing Mr. Garner’s from five years before.

As I reflect over these deaths, I can’t help but think about the historical
pattern. I think about the months following Mr. Garner’s death, the anger
still welling inside of me as I cared for patients within the hospital walls
while my colleagues and supervisors remained silent as though nothing was
happening in the world beyond. I think about the Grand Rounds lecture I
was sitting in one December morning in 2014 when I received the
notification that a grand jury would not indict the officer whose chokehold
ended Mr. Garner’s life. I think about the warm August morning in 2019
when I turned on the radio to hear that the same officer responsible for Mr.
Garner’s death was finally terminated from my hometown police
department, over 4 years later.

Like Mr. Garner and Mr. Floyd, I still can’t breathe. I can’t breathe knowing
that the same chronic conditions that Mr. Floyd’s autopsy report held
responsible for his death are the same ones that placed him and so many
other black and brown Americans at higher risk from Covid-19. I can’t
breathe knowing that while my friends and colleagues have spent the last
three months fighting hard on the frontlines to ward off the deadliest virus
of our lifetimes, my community is now fighting hard on the streets to ward
off the not-so-novel disease of racism that has been killing black people for
the last three centuries. I can’t breathe wondering if the protests, the emails,
the kneeling, and the outrage will finally be enough this time, or if in another
five years will I be in the same position, helplessly looking for the words.

Theodore Nyame MD, Plastic Surgeon, Charlotte,

NC
Watching George Floyd being murdered by
a police officer was heart wrenching. It
served as yet another painful reminder that
many in this country view my life as
disposable because of my black skin. Many
people do not understand the reality of
what it is like to live in this country as a
person of color.
Husband and wife, Theodore Nyame, MD
The first time I was stopped and searched
and Sandy Charles, MD, pictured at
work. SANDY CHARLES, MD by the police, I was 13 years old and riding
my bike in my neighborhood with a friend.
We casually rode by a police cruiser and soon noticed that we were being
followed. Suddenly, the siren came on and my heart began racing. We were
questioned and searched for no reason. In that moment, my relationship
with police officers was forever changed. From a psychological perspective,
something changes when you are made to feel like a criminal at such a young
age. More recently, I was pulled over for an expired license plate tag. Two
officers approached my vehicle from both sides with their hands on their
holsters. They parked in a way that cornered my car in. As I turned over my
license, I noticed they had called a second patrol car in for “backup.”
Invariably they asked the same questions I am asked whenever I get pulled
over: 1) is this your car? and 2) are you really a doctor? It’s never spoken, but
I know when they see "Harvard Medical School" on my license plate, they
think the car is stolen. This has happened in every U.S. city I have lived in.

In time, I have learned to wear scrubs or keep scrubs in my car as proof. It is

analogous to being in an abusive relationship and doing everything possible
to keep the abuser happy in order to avoid being abused. In fact, I wear
scrubs or something that identifies me as a doctor almost everywhere I go. I
do this not to show off, but in hopes of being seen as “less of a threat.” I’ve
noticed that people treat me nicer. The constant need to appear less
threatening is a painful reality for many people in this country. As a father of
two young black children, I hope they never face racial bias but sadly, I know
that is unlikely. I am reluctantly preparing myself for the day I will need to
sit them down and explain what the color of their skin will mean to some
people. I am not writing this for sympathy but for those that deny that racial
bias exists in 2020.

Sandy Charles MD, Cardiologist & Director of

Novant Health Women's Heart & Vascular Center
As I painfully watched George Floyd being killed, I feared that one day that
lifeless body lying beneath a police officer could be my loving husband or my
precious son. The psychological toll of being on the frontlines of the Covid-
19 pandemic was easily surpassed by the dread of possibly losing a loved one
to racially motivated violence. As a physician, I made an oath to protect and
preserve human life and I treat all patients with the utmost respect and
compassion, no matter their race, religion, or socioeconomic status. Despite
upholding myself to these basic standards, I’m faced with the heartbreaking
reality that our country may never provide my beautiful black children with
equal treatment. I have trained over 14 years to become a cardiologist,
however, I am repeatedly referred to as a nurse by many patients. Despite
performing countless lifesaving procedures, I am repeatedly told that I do
not look like a doctor and questioned whether I have been adequately
trained to do my job. Being black in America is draining. Whether it’s
watching unarmed blacks being continually murdered by police or daily
reminders that you are considered innately inferior in the workplace, I look
forward to the day when we are truly seen as equal.

Jasmine R. Marcelin MD, Assistant Professor,

Infectious Diseases, University Nebraska Medical
Center
The last few months have been pretty traumatic for black people in this
country. As if it wasn’t bad enough to be battling systemic racism on a daily
basis just to live, a Covid-19 pandemic emerged with unimaginable impacts
on the black community. As if that weren’t enough, the killings of Breonna
Taylor, Ahmaud Arbery, and George Floyd poured hot oil into already
infected, gaping wounds. It is hard to really articulate the full impact that
this has had on one’s life and mental health.

For the past few weeks, I have existed with a cloud of sadness over me; I
cried frequently, I have been irritable, I have neglected most of my non-
patient care duties. I’ve withdrawn from social media and virtual

Jasmine R Marcelin MD, Assistant
Professor, Infectious Diseases and
Associate Program Director of ... [+]
socialization with friends. I’m exhausted
physically and emotionally. It takes a
tremendous amount of energy to walk this
path and still put on a brave face, pretend
like nothing is wrong, be present for the
people around you. Especially when those
around you seem oblivious to not only your
emotional struggle, but even oblivious to
the profound impact of what is happening
around us in the world. Most stressful for
me has been to have this conversation over
and over with my young son and watch as
his face, crestfallen, registers some
understanding of why racism exists. As I
DRS.

SARA BARES/JASMINE R MARCELIN

have been vulnerable about these feelings
with my colleagues, I have come to realize
what I am experiencing – I am grieving. Compounding my exhaustion is a
personal desire to “do more”, to use my privilege as a physician with a social
media platform and organizational leaders that seem willing to listen to my
words, while at the same time recognizing that I still have other
responsibilities of my job that I need to attend to.

I’m fortunate that I am surrounded by people who care deeply for me and
my emotional well being. My husband and I, though we have processed this
in very different ways, have daily discussions which help us both to
decompress. My parents and siblings, although all living internationally,
have given me the support and love I need to press forward. I have been
welcomed into a phenomenal group of black women healthcare
professionals and we have been texting and uplifting each other since the
pandemic began, and this has been so therapeutic.

I’m still not okay, still not myself, but yesterday, for the first time, I texted a
friend: “Today, I’m a little better.” Kneeling for George Floyd and for all the
black community began a healing moment for me; as I cried for him, and
Breonna Taylor, and Ahmaud Arbery, and Sandra Bland, and James
Scurlock, and Trayvon Martin, and Tamir Rice, and all of the other black
lives lost to racism in this country, I also cried for the future that I want my
husband and sons to have; I cried for the care that I want my black patients
to receive, the respect that black people deserve to have, and I cried for the
hope that the American Reality one day, will finally live up to the Dream.

Amanda Calhoun MD, MPH, Adult/Child

Psychiatry Resident, Yale Department of
Psychiatry
Amanda Calhoun MD, passionately
addresses the crowd of over 500 as the
keynote speaker at a White ... [+] ESAT
I think people miss the point when they
express compassion about how I must be
feeling as a black person, a black doctor,
“right now”. There is no “right
now”. Racism has affected the lives of
black people, long before Covid-19, and
long before the televised lynching of
George Floyd. Race affects every aspect of
our lives, whether we want it to or not, and
doctors are no exception. Is my mental

IMAL, MD health impacted by the constant, near

daily, acts of racism I experience? Of
course. But it always has been.

While I’m glad that the world seems to be listening now, while I’m glad that
people are now acknowledging the racism that we face, I have to break it to
you: this is not new for us. We just didn’t trust that non-black people would
listen because society often silences us when we do bring up racism. We
have been crying, for a long time, due to unarmed black people, children
included, getting murdered—people who went unnamed and unnoticed. We
have been struggling, for a long time, to do our work as physicians despite
hearing racist jokes about our patients and witnessing unjust care based on
the color of their skin. We have been having tear-jerking conversations, for a
long time, about racism since we were preschool age, sometimes
younger. We have been experiencing blatant and covert racism for a long
time, a long time aka 400 years. There is nothing new about right now,
except more people are listening.

Kimberly Manning MD, Professor of Medicine &

Associate Vice Chair, Diversity, Equity, and
Inclusion, Emory University Department of
Medicine
“Hey mom? Do we have any more
popsicles?”

My eyes drift away from the electronic

medical record and rest on my teen son.
The boyish features of his facial structure
have sharpened. He is becoming a man.
Thoughts of recent newsfeeds flood my
mind. My breath hitches.

I am a black physician, mother, and wife. I

Kimberly Manning, MD, Physician in
Atlanta, GA at Emory. KIMBERLY MANNING,
am also a descendant of U.S. chattel
MD slavery—the peculiar blemish of American
History that causes people to bristle when
mentioned. But that piece of my identity cannot be ignored. As I do my best
to care for patients and love my family, it plays like a broken record,
skipping on the same spot over and over again. There is no escape.

Each day when I walk into the safety net hospital where I work—a building
whose architecture was planned around segregation—I am served a
reminder. A quick swipe on my smartphone reveals the collective trauma du
jour being felt by my black peers and family members with story after story
on the news. Then, there is a 5-foot 4 inch thirteen-year-old boy standing in
front of me asking for a popsicle. A concrete symbol of my greatest fear and
America’s, too—but for completely different reasons. This painful
juxtaposition is my reality.

It’s no longer a secret that black people can’t breathe. But we also can’t
concentrate, stop worrying, or get away from the looming threat to our
bodies that all stems back to a faulty narrative. This initial lie made the
inhumane palatable—and worse, even suggested it was the will of a higher
power. That old story line would grow roots and poison the minds of new
generations and immigrants, too. Ultimately, it would reach my social media
feeds in the form of lifeless black bodies and newly populated hashtags. It all
hearkens back to that same false diversion in the yellow wood: You are less
than human.

Though history tells of the resilience of black Americans and the

longstanding example of our ability to emerge from unspeakable horrors,
know this: The impact is felt. Even when we can’t put our finger on why our
eyes are stinging with tears or our chests feel tight, somewhere in the back of
our minds we always know: You were stacked into boats, tossed into oceans,
and hung from trees because, like beasts, you were deemed disposable. You
were injected with syphilis, denied available treatment, mass incarcerated,
and killed in broad daylight by your alleged protectors. So, the real questions
are: how do you make a nation unthink something so deeply embedded into
its fabric? How can you breath when suffocated by that truth?

I walk over to the freezer, look inside and tell my son: “We do have some
popsicles. They were buried underneath all this frozen stuff.” He looks
happy.

And so, I refresh my screen and return to charting on patients. I respond to

emails from medical students and reconcile meetings on my calendar. Then
I glance over at my son, content with his popsicle, and feel glad. Perhaps
there are some other sweet spots that I’m overlooking right now. But these
days? I’m just tired.

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Jessica Gold

I am an assistant professor of psychiatry at Washington University School of Medicine in

St. Louis having been trained at University of Pennsylvania (B.A. and M.S. in… Read More

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