Persist, persevere, prevail
By: Gwendolyn A. Poles, DO, FACP
In the mid-1950s, a three-year-old, African American girl told her mom she wanted to be a “missionary surgeon doctor.” Now a retired physician, her memory goes back to approximately seven-years-old, always wanting to be a “missionary surgeon doctor.”
From hence did that language come? How did a three-year-old toddler form that phrase given the era and that her parents were not well educated? Was it because she heard the word “doctor” at the hospital or “missionary” at church? Hmmm… she developed theories over the course of her career.
Despite racism, sexism, classism/caste (a word Americans don’t like to admit exists here), and physical disability, she persisted, persevered and prevailed. Between hospitalizations, frequent clinic appointments and regular blood transfusions, she graduated in the top two percent of her high school class, completed her bachelor’s degree at Franklin and Marshall College (F&M) in 3.5 years and graduated from the Philadelphia College of Osteopathic Medicine (PCOM). Her teachers, school counselors, nurses and physicians told her to pursue a more “realistic career.” Girls – let alone poor, African American girls – were not supposed to be physicians. In contrast, her parents told her to study hard to get a scholarship and her church prayed for her health and supported her goal. Did I mention that this aspiring physician had Sickle Cell Disease? Even then she had to learn self-advocacy to prevent conflict between clinic visits and school.
I am that three-year-old that had the audacity to dream big and work hard at achieving my dream, my calling. Between my family, church and the Christian faith that I embraced I was able to and continue to endure the racism, sexism and classism that persists in America. Although my undergraduate college experience was academically challenging, more importantly it was psychologically and emotionally grueling. F&M had turned co-ed two years prior to my matriculation but did not welcome women nor minorities. Out of more than 500 students, 20 were African American. Students, administrators and professors displayed overt racism. I persisted, persevered and prevailed fighting new barriers that were intentionally designed to derail my calling. Fast forward to eight years after graduating from college when I entered PCOM, whose culture was in stark contrast to my undergraduate experience. With some exceptions, administration, classmates and professors were kind and supportive. What a breath of fresh air! Then during clinical rotations, the racism, sexism, classism and ageism rose their ugly heads. Again, I persisted, persevered and prevailed, but it was still exhausting.
Residency was physically challenging, but I remained relatively healthy even completing an on-call night which resulted in working 36-hours with fever, chills and sweats due to a breast abscess. For young physicians in those days you absolutely could not call out sick and there were no “work hour restrictions.” The predominate patient population at my hospital was wealthy, white people, so here we go again. I was assumed to be the dietary aid – “Can you take my tray?”; the “TV Girl” – “I’m so glad you’re here to turn my TV on” to which I politely replied, “I’ll tell your nurse, I’m Doctor Poles, how are you today?” Then, “you’re too young to be a physician.” (I was in my 30s, but I’ll take the compliment.)
The last place I wanted to relocate to was Harrisburg – I swore I would never return to central Pennsylvania given my horrendous experiences at F&M and in Lancaster. Never say never as the saying goes. Prior to relocating, a white man confirmed my worst fears and advised me to live on the East Shore versus the West Shore, otherwise called the “White Shore” – his words. Then I arrived and quickly experienced racism within the medical community and area at large. Examples included nurses refusing to help find patients’ charts or refusing written orders, security guards repeatedly stopping me when coming back at night to see a patient, being ignored in leadership meetings and being called the “N” word standing in line at a department store.
Although I and others will persist and persevere, African Americans cannot prevail alone. Our profession takes pride in being a healing profession and “doing no harm,” so why are we (you) not helping to actively heal our profession? Health disparities are not new. They stem from structural and institutional racism. Racial implicit and explicit biases persist.
The percentage of African-American physicians has decreased from an average of seven percent from 1978- 2008 to five percent in 2018 (AAMC Diversity in the Physician Workforce Facts & Figures 2010; 17th Report of COGME). Minority representation in academia and leadership is dismal at best. The “ball” is no longer in my court or the court of minorities aspiring to, pursuing a career in or currently in the practice of medicine.
After reading the accompanying article by Dr. Ericka Pinckney, I urge you to take steps to evaluate how you have participated in the continuance of the status quo or have actively sought to tear down the institutional and structural racism in the systems in which you work, the community where you live, the faith community you embrace and the governmental policies you support. Physician heal thyself for the sake of all.
Gwendolyn A. Poles, DO, FACP is a member of the Foundation of the Pennsylvania Medical Society Board of Trustees.