Talking head (2021)
Being a woman is hard. Being a woman of colour is even more difficult. Being a woman of colour with a medical condition can feel like an impossible existence.
BY MOHINI NARAYAN
IMAGE BY PATSY WISNIEWSKI
Being a woman is hard. Being a woman of colour is even more difficult. Being a woman of colour with a medical condition can therefore feel like an impossible existence. In 2019, an American woman of colour visited the emergency room in excruciating pain. She hoped to get attended to efficiently, so that she could find some sort of relief. Instead, she left feeling vulnerable, ashamed, and dirty for simply wanting medical care. Literally the bare minimum. She was poked and prodded repeatedly at the expense of her anxiety, only for those in the white coats to ignore her pleas, feelings, and even frankly, life and death urgency. I’m sure many women who are reading this are nodding their heads in agreement, perhaps reliving that very moment of trauma.
Like every other young woman in the twenty-first century, I spend most of my free time mindlessly scrolling the Bird App in search of news of the ongoing atrocities that plague our society. However, a tweet caught my attention, and soon I was pulled into a very long thread where a young woman of colour, as a response to the original post, narrated the horrid details of her experience at the gynecologist’s office at her local hospital. As a young woman of colour myself, I was immediately taken aback whilst reading the responses to that thread. Not one, not two, not even three—but dozens of women responded with their very own experiences dealing with the hospital staff as a patient, especially when it came to their reproductive health.
I was overwhelmed with emotions that brought me to tears as I read how one of my fellow cysters was treated by urgent care workers as though she were begging for medical care (despite the hefty bill that followed!) after she started experiencing vaginal bleeding and severe abdominal pain. Affecting about 20% of women of reproductive age worldwide, Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder. Thus, the term “cysters” was coined in solidarity. Unsurprisingly, this wasn’t her first stint with the staff in the Emergency Room. Each time, her symptoms were disregarded, and she walked away with more questions than answers regarding her condition, along with a dent in her wallet. At this point, she was tired of hearing statements such as, “Black women have a higher pain threshold,” “You don't need that many painkillers, you’re Black,” “You’re just overreacting and exaggerating your condition,” “We don’t want you addicted to painkillers,” “You just want opioids.” Finally, she was prescribed a transvaginal ultrasound, revealing that endometrial tissues had started growing on other parts of her organs! She was scared and livid upon learning this because she had been visiting the hospital several times with similar complaints and was never taken seriously. It had escalated to the point where some of her organs became compromised.
Anyone in this young woman’s shoes would be outraged! As her post got traction, many women came out in support, sending words of encouragement, prayers, and advice of their own. Of course, they also shared their own similar experiences. Every day, BIPOC women are suffering discrimination in some form, and it’s truly heartbreaking to see that being demonstrated even by medical professionals. The very people who swore the Hippocratic Oath to do no harm are actually directly and indirectly harming their patients of colour by constantly ignoring their pleas. The system and the people directly involved have been failing BIPOC for decades, and it’s time we raise our voices against this unacceptable behaviour.
One Black woman related how it took her visiting eight hospitals in three different states, for them to actually believe she was truly in excruciating pain due to her endometriosis. She even related that a white doctor wanted to refer her to the psychiatric ward for “faking” her symptoms. Luckily, she eventually met a Black female doctor who immediately recognized the need for her to complete her surgery.
Nadine Dirks recounts her experience at the hospital prior to being diagnosed with Stage 4 Endometriosis. She was often told that she was being a hypochondriac and continued to face stereotypical comments by medical professionals. At this point, most of her organs were entangled because endometrial tissues were growing where they’re not supposed to. Thankfully, she survived major surgery and made a full physical recovery. But how can she heal from the mental scars she was left with?
How long should Black women suffer at the hands of medical professionals? How long should Black women be ignored when speaking of their pain—be it physical or mental? That woman’s condition would not have escalated to the extent of organ compromise if she was given the attention she deserved initially! Women of colour continue to suffer discrimination in medicine, but when the system teaches discrimination, can we ever expect change?
Medical students are often taught to make diagnoses based on conventional clinical presentations. However, a majority of these conventional clinical presentations are based on data collected from white and Euro-centric patients. A majority of the time, the clinical presentation varies according to ethnicity and race. One of the easiest associations to consider is how vastly different certain dermatological diseases, such as psoriasis, would look on a white person versus a black person. Yet, our mainstream medical textbooks only feature pictures of a white person with psoriasis. We live in a multicultural society, so it should be natural to learn about how medicine affects each ethnicity differently. Unless a medical textbook was written and/or edited by a person of colour, all of the pictures and examples feature only white and Euro-centric persons. It’s time for mainstream medical textbooks to start featuring disease presentations on patients of colour.
Thinking about the years I, an Indo-Guyanese woman, worked at the hospital in Guyana, I can recall the Indigenous women suffering a similar fate at the hands of medical professionals. It is wrongfully perpetuated that Indigenous people naturally have a lower-than-usual blood cell count, and so their baseline count level should be lower. Now, this harmful rhetoric completely changes the way medical professionals respond and treat their Indigenous patients.
I have seen first-hand how pregnant Indigenous women were not given blood transfusions until their hemoglobin (Hb) reached a borderline dangerously low rate. Many women reading this understand the consequences of having a low hemoglobin level during pregnancy. These include, but are not limited to, low infant birth weight, premature birth, and even postpartum depression.
I wish it ended there, but it doesn’t. Many Indigenous people have malignant (cancerous) health concerns, but were never given a blood transfusion because their blood count seemed “normal.” In reality, the cancer cells were feeding on the blood, whilst the patient got progressively worse! You’d think that after two or three times of this “coincidence,” there would be an intervention on how Indigenous patients were treated when it comes to baseline Hemoglobin levels, and level for blood transfusion. Sadly, you’re wrong. The system continues to fail our Indigenous people.
We go on social media every day and see posts encouraging inclusivity and anti-racism, but the people who truly need the message aren't being called out for their behaviour. The common individual can try to do better with all their might—and of course, that lessens the blow of facing discrimination—but our fellow people of colour continue to suffer at the hands of medical professionals. It is time we start calling out their behaviour and ill-treatment for what it is: discrimination against people of colour in medicine.
Mohini Narayan is a medical professional, an international student of colour in the the Faculty of Health Sciences & Wellness at Humber College, and an avid social media user. Mohini is hoping to use her voice to let other BIPOC know that they are not alone, and they never will be.
An earlier version of this story was originally created as part of Humber’s BHSW 1003-RNA Multiculturalism course.
Image: Patsy Wisniewski, Talking head, coloured pencils on sketching paper, 2021.
Edited for publication by Alex McKaigue as part of the Creative Book Publishing Program.
HLR Spotlight is a collaboration between the Faculty of Media & Creative Arts and the Faculty of Liberal Arts & Sciences and Innovative Learning at Humber College in Toronto, Ontario. This project is funded by Humber’s Office of Research & Innovation.