I was the attending psychiatrist working at a busy urban emergency room speaking outside a treatment room with a patient’s daughter, a middle-aged Caucasian woman. I was taking notes when a male trainee approached and interrupted, speaking directly to the patient’s daughter. He assumed she was the doctor (I was wearing scrubs and my physician ID) and called her Dr. Hart and mentioned he needed to discuss a patient. During a long pause, I reminded myself to control my breathing so there would be no change in inflection. I did not want to bring attention to the situation in front of the patient’s daughter. I introduced myself to the resident, gave him instructions, and continued my conversation.

I was walking away when the patient’s daughter asked if I wanted her to report the blatant racist experience she had witnessed. I was surprised as she told me that incident would not have happened if she was not a white woman or a man. At that moment, honestly, I was a bit relieved—someone understood my experience—it wasn’t all in my head. I responded that I appreciated her concern, but it was a training hospital and I would rather use it as a teachable moment. She warmly shook my hand. I came to work to be her champion and yet in a meaningful way she was mine.

I wanted to make certain the resident would indeed have an opportunity to learn rather than feel scolded. That afternoon, I approached a male colleague who was familiar with the trainee hoping to receive guidance. To my surprise, my colleague responded by asking me what actions I had taken that led to the situation and then added we were probably both wrong. And for good measure, he made several excuses for the trainee to excuse his responsibility for the situation and attribute the misidentification to my youthful appearance. I was shocked, saddened, and hurt. A stranger had understood my experience, but my colleague had dismissed me and even blamed me.

Later, the trainee approached me and apologized. We discussed the incident and I provided him a copy of the article “My Black Skin Makes My White Coat Vanish.”¹ He appeared relieved to have an opportunity to discuss the experience. I had been hesitant to disclose the incident with my colleague to the administrative staff because I’m a contracted physician, I feared being labeled a troublemaker who would be removed from the call schedule. To my pleasant surprise, the administration immediately offered support.

It was not the first time a patient or colleague was surprised that I was the attending physician, but it was the first time someone immediately validated my feelings. Female physicians are often forced to second-guess our experiences and minimize our value. Female physicians are often the victims of bias and discrimination including disparaging or disrespectful treatment or comments. More than 70 percent of female physicians report experiencing gender discrimination and those who belong to racial or ethnic minority group may face additional discrimination regardless of their clinical expertise or years of experience, impacting their mental health (2). Sources of bias and discrimination include more senior physicians, administrators, peers, allied health professionals, and patients.²

As psychiatric physicians, every day we meet individuals who can no longer trust their thoughts and instincts because of a mental illness. We are trained to recognize their illness and offer support. Yet, daily we miss opportunities to recognize when bias and harassment are negatively impacting our peers and we often contribute to a colleague’s anguish by minimizing or dismissing their experiences. Support does not always equate to a grand gesture or major professional risk, sometimes validation is all the doctor ordered, as simple as I see you and I hear you.

By
Dionne Hart, M.D.,
Adjunct Assistant Professor of Psychiatry,
Mayo Clinic School of Medicine