I immediately dismissed her as less-than for not, at least, leaving the baby in a warm blanket. Why try to kill him– a near-term boy who probably cried as he hit the cold toilet water.  There was just no state of mind that would justify such a heinous act.

I didn’t want to see her, didn’t want to force myself to smile, and didn’t want to be empathic. That’s just not how I felt. And, I would have to walk past the police standing outside her door, which only added to my discomfort.

I sat at the computer in the middle of the nursing station and reviewed her labs and read the notes written on the previous shift. “She’s fine. She’s ready to go to jail now,” I scoffed.

“Please be kind. She has been through a lot.” Bridget’s hand reached toward me as she spoke. She had been a nurse at this hospital for 25 years. Bridget was a white nurse who carried a toughness that belied her small frame and olive complexion. The type of nurse that every doctor wants around in the midst of an emergency. She has a keen clinical eye and calmly executes her duties.

“Are you kidding me?” I thought without responding to Bridget’s plea. The hotel maid heard the baby crying when she came in the clean the room. Who would do such a thing?

As I walked down the hall, a swarm of emotions filled my head. I was embarrassed by the admonishment. It was my role to exhibit professionalism and forgiveness. Confusion and surprise also visited my mind. In 25 years I have never heard a labor and delivery nurse defend an abusive mother. Not once. I have worked in six different hospital systems in the Northeast. Yet, today I was alone in my wrath because my negative emotions were not aligned with that of the clinicians around me.

Walking towards the patient’s room, I tried to cool my disgust: maybe she was raped and felt nothing but hatred for the baby; maybe she was a prostitute and was under duress; maybe she was homeless; maybe mentally ill, etc.

I said good morning to the police officers as I entered the room.

At first I saw a pair of slender feet that managed to escape the cover of the blanket. The room was too warm.  I was thinking about the temperature when the room, slowly, came into focus. The shades were drawn. A glance down at my notepad gave me a few seconds to put on my “doctor face.” I took a deep breath and managed a closed-lipped smile. It took a few minutes more for the scene to register.

The patient was white. She was not a Black mother.

I had to consciously un-wrinkle my face as I took in the blue eyes and light brown hair sitting up in the bed. He faced displayed no emotion whatsoever.

Wow.

I, a black physician, had assumed that she, the patient I deemed horrible, was a black mother. The picture of the crack mom is so inked into my mind. It’s a story printed there by decades of imagery that consistently delivered negative images of black mothers. It never occurred to me that the baby who was found bloodied, screaming, cold, abandoned in the toilet of a hotel room, came from a white woman. And, of this I am almost certain, Bridget would have never had come to her aide had she been a black woman.

Unconscious bias is all around.

it’s like the gleeful swimmer who is unaware that a shark is close by, until the shark bites. Or, like the fisherman who merrily gets his fish having never appreciated the harm done to the beings in the ocean by tactics that are harmful. We’re both guilty—Bridget and I. But I thank her still, for holding up the mirror.

I’m a sorry, Black mother, for my participation in the processes that contribute to your deaths. Alia McCants died after giving birth to her twins: implicit bias was responsible for her death. We can train our doctors and clinicians to do better. 

I was kind to the patient when I spoke, as I recovered from my fugue. Every patient deserves professionalism and respect. Every person deserves a chance to explain, or at least to ask for forgiveness. This should be the expectation of every clinician, no matter his or her creed or color, sex, gender—whatever the type of PRIDE celebrated. Certainly, Covid had made getting care even more difficult for women in general. As we emerge from the pandemic, we need to keep our attention steadfast on the issue of racism in healthcare in America.

~Juliet_MD~

Who best to make that decision? Even if she is in a partnership with another adult—her physical, emotional and financial wellbeing will be tested.

Does the right of a fetus matter? When does it start to matter? Or does the life of the mother matter more? And, does the life of the mother always matter more. Life here is defined wholly—the physical life, the financial life, and the intellectual life.

Raising a baby is hard work. There is nothing to be said that can ever prepare one for the sacrifices one will have to make. Nor will one ever be contain the willingness to literally die, to protect and safeguard this new being.

It’s OK to yes. It’s OK to say no.

Speeches and law will not show up in the middle of the night when you are tired. Skillful oration will not help you pay for childcare. Debates will not support you in those moments when you are forced to choose being your job and your baby—this will happen. They will not babysit so you can fulfill your dream of traveling to Paris.

And that’s just fine—for some. For some, life is meaningless without motherhood. Any perceived strife is the natural order of things and will never overshadow or trample real, almost palpable, joy.

Everybody deserves to chart their own path, define their own strengths and determine which sacrifices they hold dear.

This, I believe, is the meaning of choice.

There you have it. Now spread the word.

Juliet MD

“Right and wrong, wisdom, justice and goodness, were nothing but names, even though it might be argued that it was sometimes prudent to act as if they were more.”

~W.K.C Guthrie, The Greek Philosophers

Children. That is what they are–although they think that they are prepared and ready to face the world–often suffer one of the most traumatic and life altering events early in life and away from the protection that the watchful eyes of parents could provide.

Ross Duthat, a prolific writer on matters of politics and policy, wrote a thoughtful opinion piece in the New York Times about the dire state of college campuses with respect to the sexual assault. http://nyti.ms/1mrBNtZ  “In the debate over sexual violence on college campuses, two things are reasonably clear. First, campus rape is a grave, persistent problem, shadowing rowdy state schools and cozy liberal-arts campuses alike.”

Many parents focus on paying expenses and parting from beings who, for many, have given meaning to their lives. But, we have more to prepare for. Do we adequately give our young women the tools they need to protect themselves? Do we talk to them about drinking to the point of oblivion; falling down drunk in the presence of strangers; or the need to pay close attention to their surroundings? Have we taught our sons that to treat women with respect and not as objects is a true manifestation of manhood? Have we taught them about consequences?

Institutions need to do more. But, more work needs to be undertaken before we unload the laptop and dorm room supplies.

There you have it. Now spread the word.

Tweet @JulietMB_BTBB

From the American Sexual Health Association

HPV affects men and women.

Ask your doctor is you are a candidate for the vaccine.

There you have it!  Now spread the word. @JulietMD_BTBB