On a stormy July morning in the heart of Minneapolis, our team sits together in silence. Our traumatic night shift has just ended with a Black patient we admitted overnight abruptly leaving the hospital with his mother.
While enjoying a family dinner of fish, this 12-year-old boy had suddenly felt something stuck in his throat. His mom immediately called the nurse triage line and was advised to bring him to the emergency room. They spent the next 45 minutes on the city bus getting to our hospital as fast as they could.
The emergency room clinician was concerned that he had a small piece of fish stuck in his airway, nestled just above his vocal cords. He numbed up the site with nebulized lidocaine and started to do a bedside scope, but the boy had begun writhing, anxious and scared by the sensation in the back of his throat. More lidocaine was ordered with the plan for another attempt, but the clinician was called to the trauma bay for a gunshot wound. His colleague called me hours later to admit the patient to pediatrics with an ENT physician to scope him in the morning.
On arrival to the inpatient floor, his mother's emphatic voice could be heard throughout the corridor. My intern walked in to find her pacing throughout the room, frustrated by the unsuccessful bedside scope, the lack of reattempt, and what seemed to be an unnecessary hospitalization. My intern gently sat down beside her, listening. He understood her anger, and he shared his own apologies for what had happened. His calm energy pacified her, and she finally took a seat.
When the floor nurse did her assessment of our patient afterward, she contentiously challenged his mother, saying that she had not heard in her handoff of any attempted bedside scopes in the first place. Feeling her fury growing within, his mother excused herself for a smoke break. She stepped outside for fresh air to calm herself.
Upon returning, she found her son in the hospital corridor with security personnel by his side.
“Police!” She cried out. “They called the police on my son!”
I can't begin to fathom the fear instilled in a Black woman at the sight of security beside her son, fresh in the aftermath of George Floyd's murder and in the city that was once his home.
It all happened so fast. The charge nurse later explained that they had immediately called security when the patient had stepped out of his room and looked down the hallway for his mom. There was no time for us to explain to his mother what had happened over her screams of protest. She grabbed her son and her belongings, and security escorted them out of the building without any attempt at verbal de-escalation. They waited at a street corner, a Black mother and her young son, ride-less at 4:00 am.
My intern promptly tried to arrange a ride for them. Everyone he talked to, from bedside nurses to the operator to the emergency department social worker, ridiculed the idea and insisted that we don't bother covering transportation for patients who technically leave the hospital against medical advice. A mother's desperation to keep her child safe was met with a scolding, unforgivingly punitive medical system.
How could we have made her feel so unwelcome in a space designed to heal rather than hurt?
“This is systemic racism,” my attending says plainly, letting it sink in. “Don't ever let anyone tell you that it doesn't exist in medicine.”
His eyes meet ours, straight on, unflinching. I notice a weariness in them, his eyelids heavy. His gaze betrays the solemnity and sorrow concealed by his mask. Among our team of 3 American-born children of immigrants, I know we each have our own unspoken experiences in which we too have been treated differently because of the color of our skin.
“Hold on to this moment.”
I blink. Tears quickly obscure my vision. I blink again.
“Hold this moment in your head and in your heart.”
Staring emptily at my attending, I can't stop the sadness. I want to bow my head, to kneel against the ground, to let my tears splash loudly on the linoleum.
How can we who went into medicine to care for people be so awful at doing so?
My attending articulates exactly what he is going to do, today and the next day and all week. He thanks us, for caring and for trying. I feel chilled by the night's events; his sincerity warms me. I find myself astounded by my attending's perceptive words of validation and his promises of action. I still feel unsettled and off balance emotionally, but even without resolution, my colleagues' responses to injustice give me hope.
I walk out of the hospital underneath gray skies, his words ringing loudly in my head, pounding mercilessly on my heart. “Hold this moment in your head and in your heart.”
The author would like to thank the patient's mother for granting her permission to share this story, her intern for his diligence against systemic racism, and her attending for his wise words.
