Say Their Names Page 9

  Benjamin Rush, a Philadelphia civic leader who signed the Declaration of Independence, called on Black people to assist and treat sick white people, claiming, without any evidence, that Black people were immune to the deadly illness. Rush was also a doctor, which lent credibility to his inaccurate positions.

  Determined to prove their worth, the African American community worked in various capacities with the sick: as grave diggers, nurses, drivers, etc. Of course, Rush’s contention was patently racist and wrong—and 240 Black people died trying to help white people.

  Further and insultingly, after the disease subsided, a Philly native named Mathew Carey, who had fled the city, distributed a pamphlet accusing Black people of profiting from the outbreak by pillaging sick people’s homes. Richard Allen and Absalom Jones, freed Black men, were outraged and published an eloquent denial of Carey’s claims called “A Narrative of the Proceedings of the Black People.” In it, they vehemently denied the charges, but mostly made the case of Black people’s standing as equal humans capable of good:

  The judicious part of mankind will think it unreasonable, that a superior good conduct is looked for from our race by those who stigmatize us as men, whose baseness is incurable, and may therefore be held in a state of servitude, that a merciful man would not doom a beast to; yet you try what you can to prevent our rising from the state of barbarism you represent us to be in, but we can tell you, from a degree of experience, that a Black man, although reduced to the most abject state human nature is capable of, short of real madness, can think, reflect, and feel injuries, although it may not be with the same degree of keen resentment and revenge that you who have been and are our greatest oppressors would manifest if reduced to the pitiable condition of a slave.

  Their eloquence resounded. But, of course, by then, the damage had been done.

  Psychiatry and the Pandemic

  Dr. Jessica Isom, a young African American psychiatrist who works at the Codman Square Health Center in Boston, calls herself a “Racial Health Equity Champion,” “Community Psychiatrist,” and an “Unapologetic Advocate for Black Mental Health.”

  The coronavirus forced her to wear all of her hats, sometimes simultaneously, as the pandemic—with quite a bit of assistance from the Trump administration—turned America into a virtual dystopian society.

  Patients seeking psychiatric help suffered from mental illness that caused paranoia, extreme mood swings, excessive fears, confused thinking, an inability to concentrate, withdrawal from friends and family, among many other concerns.

  Though many African Americans have traditionally looked at professional treatment with disdain or as a last resort, Isom saw “no shortage of Black patients” in the throes of COVID-19.

  For her patients, the pandemic placed them in the center of a parallel universe that Isom had to help them navigate, a task made more complicated by the social-distancing and stay-at-home orders, limiting her to over-the-phone treatment.

  “One thing we learned through this for Black people is that if therapy is offered, many of them will come,” Isom said. “A lot of them may come hesitantly at first. A lot of them secretly see me because they believe they will not get the reactions from family that they want to get…It was a revealing time.”

  It also was revealing—and disturbing—to Isom that the coronavirus exposed not only the country’s lack of preparation to handle the pandemic, but also the lack of calculation on the “psychological toll and the emotional toll of being a member of a group that’s disproportionately getting impacted by and dying from a pandemic. And you can’t talk about that unless you’re prepared to talk about racism,” Isom said.

  “How could you have a conversation about grief and loss related to this virus and not talk about racism and how it produced those vulnerabilities in Black people?” she asked. “So, I haven’t seen anyone—and I have been around a whole lot of psychologists and therapists—who has talked about being prepared for that collective grief.”

  Ironically, that lack of preparedness illuminated a larger concern, one different from the racism that caused the underlying conditions that made African Americans more susceptible to COVID-19. In the medical profession, a history of racism exists that baffles, particularly doctors of color, and contributes to the health inequities and unfair treatment that African Americans experience.

  “Everyone wants to be anti-racist, but they don’t understand how racist many institutions are,” Isom said. “In medicine, there are resources that systematically describe racial differences, biological racial differences in the minutia. So, I’m talking Black teeth versus white teeth. Black eyes versus white eyes. Black body parts versus white body parts. Black skin, Black nerves. Black everything.

  “This is the history of medicine that was ‘scientifically’ investigated—and I am using ‘scientifically’ sarcastically. That’s what’s been done. That’s the history.”

  To Isom’s point, according to the American Association of Medical Colleges, half of young white doctors believe Black people have thicker skin than whites or have less sensitive nerve endings so they can take more pain and that African Americans’ blood hardens faster than whites.

  A study performed by Proceedings of the National Academies of Science found that 40 percent of white medical students in their first two years embrace the preposterous thicker-skin notion. At the same time, the 2016 study indicated Black patients were not administered the appropriate pain medicine because their white doctor believed African Americans were not as sensitive to pain as whites.

  “Of course, young white doctors will think that way because they read it in JAMA—Journal of American Medical Association, the American Journal of Psychiatry,” Isom said. “They describe those beliefs. That was science at a time and even though people will explicitly state, ‘Of course, Black people’s skin is not different,’ subconsciously they have already absorbed the racial structure. So, their thoughts are rooted in conscious statements that were written and talked about freely.

  “I did a presentation and asked the audience [of doctors], ‘Have you absorbed any ideas of racial differences in Black and white people?’ and 100 percent said, ‘Yes.’ There was nothing else for them to say because it’s the truth.”

  These perpetuated false narratives often led to Black patients receiving substandard treatment when they sought medical attention. This damaging ideology played out at the end of 2020 in distressing fashion.

  Susan Moore, a Black physician in Indiana who had contracted COVID-19, died five days before Christmas and two weeks after she made public her concerns about treatment via a viral video that stated her unidentified white doctor dismissed her complaints of pain and requests for medication. She recorded and shared the clip on Facebook to expose the long-discussed (with little change) Black professionals’ concerns of deleterious treatment from white health care workers.

  Moore, an internist, was able to deftly communicate in medical terms with her physician at University Health North at Indiana University what she required based on her knowledge as a doctor. But she said in her video that the doctor told her, “You’re not even short of breath.”

  “Yes, I am,” Moore said she told him.

  He made this assessment having “not even listen[ed] to my lungs. He didn’t touch me in any way.”

  She said she eventually received a scan of her neck and lungs, which revealed issues: pus in the lungs and disease of the lymph nodes, she said. It was then she began receiving more opioid pain medication, after having been left for hours before a nurse gave her the dose.

  The white doctor, meanwhile, raised the notion of sending her home. “This is how Black people get killed, when you send them home and they don’t know how to fight for themselves,” Moore said.

  “He made me feel like I was a drug addict. And he knew I was a doctor.”

  She contended that she had to virtually make a scene, as much as could be made in her condition, to finally be “adequately treated.” She was eventually
discharged from IU North, but was admitted to another hospital after just twelve hours. Two weeks after that, she died. The hospital said they would conduct an external investigation into Moore’s claims. Indiana University Hospital president and CEO Dennis M. Murphy essentially blamed the victim, describing Dr. Moore in a press release as a “complex patient” and said the nursing staff “may have been intimidated by a knowledgeable patient who was using social media to voice her concerns and critique the care they were delivering.”

  “I put forth and I maintain if I was white, I wouldn’t have to go through that,” Moore said in the video.

  Isom said she was listening to NPR on her car radio when an addiction psychiatrist was interviewed.

  “I was driving so I couldn’t Google her,” she said. “This doctor was an addiction psychiatrist. The interviewer said to her, ‘Help me understand why persons of color are experiencing more addiction issues’ or some kind of question like that. And I was waiting for this person to say ‘racism.’ But she didn’t say anything like that. She didn’t know how to answer the question—and she was an ‘expert.’

  “I know addiction psychiatrists who would have answered that question by acknowledging structural racism, disproportionate vulnerability to disease because of racism, and all the other factors that contribute to increased stress, which contributes, or at least drives, substance abuse.

  “So sometimes they were asking the questions, but the people they gave the platform to answer the questions weren’t prepared to give real answers. There’s no conversation where you can’t say anything about racism…but she managed to do it.”

  Isom believes—hopes—vast awareness is on the horizon.

  “The root of that understanding is appreciating that it’s not a biological cause,” she said. “That simple, simple root is elusive, though. If understood, it could open the door to understanding so many things about Black people’s experience. So, it’s like an invitation.”

  Black Stress Matters

  It is not enough that at most every turn there is an element of life that causes stress for Black people. That stress results in trauma. That trauma leads to health issues.

  That unseemly pattern has played out so prominently there is a term for it: racial trauma.

  It has been examined at the Institute for the Study and Promotion of Race and Culture at Boston College. Racial trauma describes the psychological and physical indicators Black people endure after being exposed to a racially charged or stressful experience. And those experiences do not have to be a direct hit. The mere notion of racism can infuse stress or trauma in the Black body.

  The institute released a report in 2015 that read, in part:

  Regardless of a person’s previous understanding of racism, many people of color may find themselves struggling to process their reactions to the deaths of Michael Brown, John Crawford III, Eric Garner, Aiyana Stanley-Jones, Yvette Smith, Walter Scott, and Freddie Gray, as well as the lack of indictments of the police officers involved in several of these deaths. Anger, sadness, fear, feelings of helplessness, exhaustion, rage, and the desire to act may emerge at unpredictable times in an unpredictable manner.

  Dr. Terrell Holloway, a psychiatrist at Yale University, has studied the impact of stress and racial trauma on the Black population.

  “It’s fascinating because we think of trauma and stress with soldiers in a combat situation,” Holloway said. “But what about the stress of living in the inner city of Chicago or New Haven, for that matter, and worrying about being caught up in some kind of violence going to school that day? Or at school you’re worried about being singled out by a teacher that reinforces you might not be as smart as your classmates? You experience these things over your lifetime and due to this physiology response, it leaves you more vulnerable to heart issues and diabetes because it modulates your digestive system through secreting cortisol, which impacts how you release your digestive enzymes.

  “It all co-relates with the health disparities we hear about COVID-19. So, you’re more prone to infection and you’re going to get sicker from it.”

  If there is something Black people lead America in, it is in getting sick. The Racial Trauma Is Real report said:

  When people of color experience racism, it brings to mind both their own previous experiences with racism, as well as their awareness of the longstanding history of racism directed toward similar others in the U.S. Historical race-related events play a significant role in shaping how people of color view racism.

  For many people of color, early racial socialization experiences often include listening to their parents’ and grandparents’ stories of living through different periods of racial tension in the U.S., including the Civil Rights movement, Jim Crow laws, and for some slavery. While the passing down of these stories is an essential part of educating and socializing the younger generation about race and racism, the transmission of racial trauma is often carried across multiple generations as a result. The cumulative emotional effects and psychological wounding that is transmitted across generations is also known as intergenerational trauma, and can result in higher rates of mental health and physical health issues within communities of color as well.

  Significantly, despite centuries of evidence, there has not been a concerted movement to address the confirmed conclusions, and the report added:

  Many mental health professionals and scholars have called for the recognition of racial trauma as a mental health concern. Too many accounts from student trainees, colleagues, and professionals demonstrate a lack of awareness, knowledge, and the practical skills necessary to competently address racial trauma in mental health settings. This obliviousness exists despite a pervasive body of literature that explicitly states that a clinician’s awareness of race and racial factors (e.g., racism, racial discrimination) often determines clients’ of color ability to seek, continue, and benefit from mental health interventions.

  Dr. Holloway processed that information for Black people like this: “Understanding that the inflammatory system works based on how you perceive the world—and that you perceive the world based on racism—COVID-19 will do damage.”

  Generally, those most impacted by the coronavirus—and racism—were unaware they were caught up in a four-tiered system of racism that impacts health, Holloway said, and he notes that internal racism is based on experiences.

  “The thought that, if I’m going to an event with a predominantly white population, I’m worried about how my hair looks and will I be accepted by this group of people I don’t know,” Holloway explained. “It’s about how you process a situation that impacts you. But the fact that Black people have those kinds of thoughts speaks to the prominence of racism.”

  Then there is interpersonal racism, he explained, “where you were discriminated one-on-one, say, at a restaurant where I got poor service or no service,” Holloway said. “Or being followed around in a store. It’s the direct experience of racism that one experiences.”

  Additionally, Holloway lists institutional racism, those policies or laws that marginalize or put people of color at a disadvantage, such as public housing platforms and prison sentencing guidelines.

  Lastly, there is structural racism, which represents systems that maintain the hierarchy of supremacy.

  And it gets worse. “Black people experience all four levels of racism, either simultaneously or interchangeably,” Holloway explained.

  Which means African Americans are saddled with racism virtually every day of their lives, whether they realize it or not. And one’s temperament informs how one feels about the daily experiences in his or her life.

  One Black person could see being denied a seat at a restaurant because her nine-year-old wore shorts and a T-shirt as a racist incident, especially when there is a white kid around the same age wearing virtually the same thing dining in the venue. That was the case in the summer of 2020 at a Baltimore Harbor restaurant. It was captured on video.

  A worker and then the manager
told an African American woman that she and her son could not dine in the eatery because the child violated a dress code policy—when twenty-five feet away a white kid dressed virtually the same in T-shirt and shorts ate with his family.

  The video went viral, outrage ensued, and the workers eventually were fired. But the damage had been done. The nine-year-old boy had experienced interpersonal racism. “With the Black population, it doesn’t matter how old you are, you can have a racist experience that stays with you,” Holloway said. “No doubt that kid will remember that the rest of his life, and it will create a certain reaction in him when something similar happens.”

  It not only will be a factor for the child, but he could pass it on to his children, Holloway said. That process is called epigenetics, which, essentially, is how an individual’s DNA changes based on experiences.

  “Africans in ‘Wakanda’ never experienced racism of any kind, so they would have a different epigenetic outcome. Of course, ‘Wakanda’ isn’t a real place,” Holloway said. “In real America, various studies that show the Black population’s immune system and stress response can be passed on via epigenetics.

  “Look, my parents were ten when they got civil rights,” he added. “What does that say about my vulnerabilities? Their parents were sharecroppers. And their parents were slaves. So, it’s not as though it has gotten better over time. It’s just different.”

  Considering these levels of trauma that Black people endure daily, the devastation of the coronavirus was predictable to those who understood the underlying conditions that reside within the race.

  “African Americans on average will live six to eight years less than the national average,” Holloway said. “They are prone to be diagnosed with psychotic disorders compared to mood symptoms. And a part of that is biased by the people who are evaluating, and another part is from the racism we experience in this country.