The Flaws of The American Medical System Through The Eyes of a Black Woman
The last feature in Ars Poetica’s Writing Series for BIPOC Voices is written by Kia Allen. All pieces within the series have been curated by Shakilya Lawrence.
Photo by RF._.studio from Pexels
It took five trips to the physician’s office and two hospital visits to figure out I had an eating disorder and endometriosis in 2019.
I spent a year in pain, not feeling like myself, begging for help, and in turn, I felt like nothing but a burden. My issues were prolonged, and eventually, my condition worsened since medical professionals did not take my pain or concerns seriously. When I’d mention my uterine pain to doctors, they would sneer or tell me that it was “normal.” But how was debilitating pain normal? As a result, I missed many college classes due to the chronic endometriosis pain and developed anxiety-induced digestive issues that caused Cibophobia, a fear of food.
Because of my health issues, eventually, I developed panic disorder, and the anxiety I already dealt with worsened leading to my GAD (generalized anxiety disorder) diagnosis. And each time, going to the doctor’s office felt as if salt was being added to my wounds. One night, I had a panic attack so intense that I developed a migraine. My face and limbs began to go numb, which resulted in an ER trip. My treatment plan included an injection of an unfamiliar medication that made me shake uncontrollably and left me unable to keep my eyes open for an entire day. By this point, I was extremely underweight and had been losing weight rapidly. With every visit to the ER, I noticed it would be lower than the previous time. Before my diagnosis, it took months for me to even acknowledge I was eating 100 calories a day and that my appearance was changing as a result. I didn’t even notice until my parents pointed it out and demanded a doctor figure out what was wrong with me.
When I finally found a primary care doctor that listened to me and provided proper treatment, I was almost 100lbs. I lost around 25lbs in less than a year. As a result, I had to attend therapy and train my stomach to digest food properly again. The recovery process was hard and painful when it could’ve been handled properly when I initially expressed my concerns.
That period of my life changed me as a person. It’s almost two years later, and though I’m much better, I am still healing and learning how to use my new body. Unfortunately, this was not the last negative medical experience I’ve had.
“Within the American medical system, Black women face numerous risks to their health due to implicit biases, stereotypes, discrimination from health professionals who don’t take their concerns seriously, and systematic factors such as medical racism.”
This past summer, I went to urgent care for pelvic pain and yet, didn't receive a pelvic exam. Instead, I was just given antibiotics for a urinary tract infection. As it would turn out, I actually had an infection in my reproductive organs, which only worsened since I was misdiagnosed and received improper medical treatment at the urgent care. When I finally went to the emergency room and explained why I was there, the medical assistant at the front desk behaved as if my concerns were illogical or senseless and sent me to a COVID-19 unit for a reason I’m still unsure of.
To make matters worse, I recognize that all of these experiences are due to me being a Black woman, and it hurts knowing that other Black women are begging to be also heard, but having their pain and concerns invalidated.
Within the American medical system, Black women face numerous risks to their health due to implicit biases, stereotypes, discrimination from health professionals who don’t take their concerns seriously, and systematic factors such as medical racism. This long-term, negative treatment can cause chronic stress, eventually leading to biological wear and tear on the body. One of the biggest problems Black women face within the medical field is false misconceptions and biases about our experience of pain, leading to unsettling treatment discrepancy. In a recent study performed by AAMC (Association of American Medical Colleges), trainees who believed Black people are not as sensitive to pain as white people were less likely to treat their pain appropriately. Forty percent of first and second-year medical students supported the belief that “Black people’s skin is thicker than white people’s.”
Photo by Muhammadtaha Ibrahim Ma'aji from Pexels
The idea that Black women are less sensitive to pain is detrimental to our health because studies show that we experience physical “weathering.” This causes our bodies to age faster than white women due to constant exposure to chronic stress linked to socioeconomic disadvantage and discrimination (which is how I developed GAD). Being unwell for months and not receiving the proper help from medical professionals put me under great mental stress, which eventually turned physical. My therapist told me developing an eating disorder was my mind's way of trying to regain control over my body.
Physical weathering can also cause Black women to be three to four times more likely to experience a pregnancy-related death than white women. Black women are also twice as likely to experience infertility, with only eight percent (between the ages of 25-44) attempting to find medical help to get pregnant compared to fifteen percent of White women. This is mainly due to the disadvantages Black women face within the medical field — even outside of racial circumstances — such as socioeconomic factors and not having the same access to medical resources as White women.
And even when medical access is present, we can still be overlooked, and the risks are still shockingly high.
After her daughter's birth, Serena Williams developed a pulmonary embolism, a condition in which one or more arteries in the lungs becomes blocked by a blood clot. This resulted in her suffering a slew of health complications post-delivery, ultimately leading to her having emergency surgery due to a hematoma found in her abdomen. Her initial concerns about her shortness of breath were met by dismissal from her nurses, with them believing her “pain medicine might be making her confused.” Through persistence, Serena finally got her CT scan, which confirmed her suspicions; she had small blood clots settling in her lungs. Beyoncé similarly went through health issues during her second pregnancy. She revealed that she delivered her twins by emergency C-section after being bedridden for a month because of a condition known as preeclampsia. The condition causes high blood pressure and can damage organs such as the liver and kidneys, and can be life-threatening to the mother and the unborn child. These are both common health issues, and their experiences highlight that Black maternal disparities go beyond class and socioeconomic factors.
Though many doctors still largely disregard or discount complaints of pain/concerns by Black patients more frequently than their white patients, it’s only one part of the larger issue. Black women are also notably underrepresented and misrepresented in key biomedical research datasets. Data from the FDA shows that in trials for 24 of the 31 cancer drugs approved since 2015, less than 5 percent of participants were Black. Diversity in patient studies is needed to ensure that new treatments are safe and effective for all patients. Unfortunately, in contrast, Black participants are over-represented in studies that do not require consent. We should not be overlooked in the stride toward precision and personalized medicine.
Steps can be taken to reduce the stigmas and misconceptions surrounding Black women seeking medical help. One way is through required anti-racism and implicit bias training for all healthcare professionals. Contrary to what unconscious bias training programs are trying to instill, people are aware of their biases, attitudes, and beliefs, especially concerning stereotypes and prejudices. These biases and microaggressions are a product of their upbringing and social identity due to embedded racism within America’s systems. Another way is through patient-provider racial and gender concordance. Studies have shown a Black female patient receiving care from a Black female doctor has more trust, better communication, and shared medical decision-making.
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While we can’t undo years of systemic racism or implicit bias by ourselves, I always encourage Black women to immediately ask their doctor if they have any questions or be honest if they don’t understand something that’s said. It’s crucial for Black women to self-advocate and find a primary care doctor that genuinely listens and makes sure we are comfortable. Now that I have one, I’m confident that any problems that may arise in the future will be handled gracefully and thoroughly. And I hope researchers continue the work to update our current standards for more objective measures of pain.
It makes me angry that I have to beg for medical help — that I find myself being rushed out of doctor's offices or going home with only half of my health issues handled. It’s unfair that I had to make multiple visits and try out various doctors just to find one that would listen to me. The story I shared doesn’t measure to what I experienced in real life.
The medical system is flawed, and I desire to see change unfold in the future.
Kia is a digital artist based in North Carolina. She specializes in portraits, graphic, and concept design. Follow her on IG here.