Black Impact in Medicine: How this shaped the journey to medicine for me
Emefa Vondee. Editied by Omolara Akinnawonu • October 6, 2020
“Accomplishments have no colour.” - Leontyne Price
This statement says a lot in a few words - partially true in my opinion. For example, when we turn on lights or boil a hot cup of tea, we never sit down to think about the racial background of the respective inventor/creator. However, have you ever wondered what contributions our own black people have brought to the table? What about in the realm of medicine? We don’t learn much in school apart from how black people were oppressed. However, at notable times of the year such as Black History Month, we now have a chance to celebrate how far black people have come.
I’ve always wondered if I would have been able to live through the hardships and racial injustices our ancestors did - would I have the emotional strength to still pursue the goals and dreams I have now? History shows that both black women and men went against the grain dating all the way back to slavery, unwittingly paving the way for successors today. In 1721, an enslaved African named Onesimus, described the African method of inoculation against smallpox which was later used to protect American Revolutionary War soldiers. In 1864, Dr. Rebecca Lee Crumpler was the first African American female to earn a medical degree, and to graduate from New England Female Medical College, Boston.
I’ve come to learn the key things that have driven black people at the time of such prejudice: fearlessness and the will to want change. James Durnham, in 1762 began his own medical practice after buying his own freedom from slavery. He was owned by a number of doctors and was able to improve his skills to where he had his own flourishing practice, however he was later restricted because he did not have a formal medical degree. Some could argue that he was the first African-American doctor in the United states.
Black impact in the US revolutionised changes for black people all over the world. We can never forget the impact of Black British nurse Mary Jane Seacole. Many of us know of her but sometimes the depth of the selflessness of people like her gets lost in history, especially those who were not native to the UK. Born and raised in Jamaica, she helped treat those affected by the Kingston cholera pandemic. She then came to England in 1854 after the start of the Crimean War to join the British War Office to go and help wounded soldiers in Ukraine. After being rejected, she decided to raise money for herself to travel to Balaclava, Ukraine and set up the British Hotel where she could tend to the injured soldiers. She also visited the battlefield to treat the wounded and became known as ‘Mother Seacole’.
Her story shows us that when there is a will - there’s a way, despite the circumstances. It could be argued that in today’s era we have many more privileges than those who lived before us, but even so, you can’t help but feel inevitably discouraged sometimes along your medical journey. Now the question I always ask myself is ‘what if my story is the one that also paves the way for others?’ and ‘If I give up, what does it mean for others that come after me?’
Other examples of black contributions in medicine include Dr John Alcindor in 1873 who came from Trinidad. After graduating, he carried out research and published articles on cancer, influenza and tuberculosis and worked to prevent syphilis and tuberculosis in Great Britain.
Dr Harold Moody also came from Jamaica and studied in King’s college but due to racial prejudice, was not able to secure a job in a hospital. Despite this, in 1922 before the NHS was established, he offered a free health service to poor families.
There are many black pioneers of dentistry such as William Thomas Jefferson who joined the army as a dentist and oversaw the dental health for all of the soldiers all whilst serving as a lieutenant. He made several efforts to set up a regimen for black men at his dental practice. George F. Grant found interest in the dental field after being born to slaves and doing deliveries for a dentist. He later studied at Harvard Dental School and made several contributions to cleft palate procedures. He was the first black dentist to teach at Harvard Dental School.
“If you think you're too small to have an impact, try going to bed with a mosquito in the room.”
- Anita Koddick
Without these individuals and many others, it is clear that a vast majority of things we read in our textbooks today would be non-existent. If anything, the message is clear: Persevere despite the hardships we face as black people in society, even in present time. You just never know the magnitude of your impact.
- Emefa Vondee, 6th year medical student
References
https://guides.mclibrary.duke.edu/blackhistorymonth/chronology
https://dentalsave.com/blog/a-tribute-to-black-dental-pioneers/
Prejudice occurring in the pandemic has disproportionately impacted BAME professionals - how can we respond?
1) Introduction: About yourself and the career speciality you are in now? I am a portfolio GP, medical educator, entrepreneur, writer, author, visionary and champion for diversity within the medical profession. As a portfolio GP, I spend the majority of my time in clinical practice with the remainder of her time divided between a number of other careers and interests. As a medical school examiner at Queen Mary University London I examine students during their practical or Objective Structured Clinical Examinations (OSCEs). I also works for the General Medical Council (GMC) examining doctors who have qualified abroad and wish to practice in the UK through my role as a PLAB (Professional and Linguistic Assessments Board) examiner. Through my company, DreamSmartTutors, which launched during 2016, ( www.dreamsmarttutors.co.uk ) I support prospective medical students on their medical journeys whilst simultaneously aiming to increase diversity within the medical profession. As a STEM ambassador, I also aim to encourage school students to pursue Science, Technology, Engineering and Mathematics (STEM) subjects. I am also a keynote speaker, having delivered a number of talks at places such as Oxford university, The British Medical Journal (BMJ) Live Careers fair and The Royal College of Physicians Edinburgh. As a freelance writer I have written for the British Medical Association (BMA), the BMJ, the Medical Protection Society (MPS) and the Support for Doctors Network to name but a few. I regularly contribute to GP online ( www.gponline.com ) discussing important topics pertaining to General Practice and have published a short guide for those looking to understand a medical career in addition to this first of four poetry books. These can be found in the 'Publications' section on her profile below. 2) What is the most rewarding/most challenging aspect of your job? I enjoy being able to establish and maintain a long term doctor patient relationship with my patients. This is very difficult to do when working in the hospital. I am also able to follow patients up and provide continuity of care. This enables me to provide a high standard of care for my patients. 3) What can medical students/ aspiring students do now to get to where you are now? Everyone has a different path and therefore my advice would be to get to know yourself, your personality, what you enjoy and don't enjoy. This will enable you to create a unique career path that you are happy with. 4) What advice would you give your younger self ? Don't worry so much. Often the things I worried about during my journey to becoming a doctor were so unimportant looking back and I can barely remember what the worries were about! If you find you are a worrier then ask yourself, whatever you are worrying about in the grand scheme of things does it really matter and will it matter/will you remember it in 5-10 years? If the answer is no, then try not to worry so much! 5) What inspires and motivates you to do the work you do? I have always been an ambitious and highly motivated person. I enjoy learning new things and developing as a person.
In a world where there are prevalent medical ethics, such as recently stances on physician-assisted dying, views on abortions, gender and much more, I believe that maintaining faith has been so important to face these challenges and approach them with Godly wisdom. Faith for me has also been my first comfort in the stresses of medicine - the huge workload, the long working hours, the emotional labour. Making faith a priority can definitely be a challenge and my aim is to share some principles that I have found useful in managing this!
Growing up black comes with so much hardship, however, when faced with adversity, we are still able to rise and accomplish extraordinary things. With the resurgence of the BLM campaign alongside the protests happening in Africa, Black History Month is especially important this year, despite it being difficult to celebrate our success whilst enduring hardship. Africa is such a powerful continent with rich culture and resources and has so much to offer, but neo-colonialism and poor leadership have prevented it from its potential. In Nigeria, there are END SARS protests against brutality and oppression by the police. SARS Special Anti-Robbery Squad was created in the early ’90s to protect its people, yet over the years instead of protecting its citizens they have abused their position of power and murdered and tortured their people instead. People deserve to be able to live in peace and not live in constant fear. In Namibia, there are protests against sexual and gender-based violence and there's currently a holocaust going on in Congo. Ghana and the Ivory coast children are being trafficked, in Cameroon, there is the anglophone crisis and in South Africa, there is a rise in femicide. During the Black Lives Matter movement earlier on this year, we stood as one and our voices were being heard. We need to continue to use our voices and spread awareness for there to be change because all black matters matter everywhere. These are devastating times and it can be so heart-breaking and overwhelming especially having to face it daily, the weight of this can be unbearable but it needs to be acknowledged. We cannot live fulfilling lives without overcoming the hurt and the anger. Adversity as a black woman is nothing new; our hair, character and sexuality are constantly scrutinised but when it comes to our safety and the way we are treated people are not concerned in the slightest. This is deeply rooted in racism which is so covert nowadays we tend to ignore it and continue to carry the burden, but as Malcolm X said ‘The most disrespected person in America is the black woman. The most unprotected person in America is the black woman. The most neglected person in America is the black woman.’ Our pain and struggles continue to be overlooked and this is very much evident with the death of Breonna Taylor. Emphasising once again that every aspect of society is a reminder that racism and discrimination is very much alive, and it is going to take a collective effort to rid ourselves of centuries of hatred and prejudice. Her murder along with the countless innocent lives ruthlessly killed has once again shown us that black lives and especially black women are disposable, and we are invaluable and the very people that were put in place to protect her, are the ones who caused the most harm. Even in Nigeria the government, most importantly President Buhari has a duty to its people and to do right by them but rather than obliging the basic cry for help from the youth of their country they are governed by greed and corruption. Black Pound Day (BPD) founded by Swiss; a member of So Solid Crew, started for the first time at the end of June and allows us to celebrate black-owned businesses and help circulate more money within our own economy, which in turn helps us to give back to our community. Maya Angelou said, ‘You may shoot me with your words, you may cut me with your eyes, you may kill me with your hatefulness, but still, like air, I’ll rise.’ BPD helps showcase smaller businesses and gives us a way of celebrating our culture and success. GUAP media company has shown a new and innovative approach of displaying and promoting diverse individuals within the creative industry. Their magazine the Renaissance issue this year featured a prominent figure in the UK creative industry Nella Rose on the cover, which captured not only her beauty and showcased her talent and culture but highlighted the importance and influence she has within the community and despite the injustices we face we are still able to flourish. Sharon Chuter of Uoma Cosmetics came out with a Pull Up for Change initiative, which helps give economic opportunities to black people. The aim of her campaign is to hold brands and companies more accountable. It asks the ones who came out in support of the Black Lives Matter movement to release the number of black employees in the organisation especially in executive and senior roles. Many companies showed solidarity and support publicly, but it is important to see what companies are doing behind closed doors and what they are going to do to improve. This month is all about highlighting our success and educating ourselves and others as well as learning from these experiences. We still must be able to celebrate ourselves as a community and be able to uplift ourselves whilst recognising our struggles. We can celebrate ourselves by not being ashamed of our culture and truly embrace it particularly when it comes to food, clothes and our hair and normalising sharing our culture to our friends of different ethnicities. By Toyosi Omotoso University of Ostrava
“Why do we still need Black History Month (BHM)?” “It disregards other POC communities” “It’s way better than it used to be” “We don’t have a White History Month!” Sound familiar? Perhaps there is an element of truth to these statements. A truth that believes that things are actually getting better, that the black struggle isn’t “as bad” anymore or that we are creating our own division by only showcasing our success and not everybody else’s. But who is this rhetoric true for? As a young black woman, I take pride in celebrating BHM. I believe the foundations of our past must be brought to light, to not only black people but the world. The unfortunate reality is that we live in a world where those that have suffered at the hands of societal norms are not seen the same as their counterparts.
Hi, my name is Malone and I'm a third year medical student at St Georges University of London. I am one of the Co-authors of mind the gap which is a clinical Handbook of signs and symptoms in black and Brown skin. The summer has been quite hectic since I posted the work of Mind the gap on my Twitter page on the 18th of June 2020 as ‘Mind the Gap’ has been viewed over 100 million times with notable mentions from celebrities such as John Boyega, Lupita Nyonggo and Priyanka Chopra. I noticed there was the issue at medical school on the lack of teaching in darker skins on arrival this was very concerning to me because I was almost unable to even spot signs and symptoms on myself. I knew that if I couldn't do this on myself then how am I expecting myself to be able to do this on others. With increased awareness on some of the healthcare disparities that exist in the UK such as black women being five times more likely to die during childbirth and black men more likely to be sectioned under the Mental Health Act it became apparent to me that something needed to be done. I have spoken about ‘Mind the Gap’ on various platforms so I won’t repeat the same story again for this platform. Alternatively, I'm going to use this platform to speak about the impacts that it has had thus far on both myself and the world. Over the past two months had featured in many news articles such as the Washington post, Sky News, ITV News, BMJ, and the CBC in Canada. This has led to a great amount of attention surrounding my name. Unfortunately, with this attention has come a lot of hate. Many people we’re unaware of the need for ‘Mind the Gap’ and it almost felt like I was creating unnecessary agendas and given the political climate of the world in 2020 many people felt entitled to try and stifle our attempts. Of course, everybody is entitled to their own opinion and thoughts however many would go out of their way to express their thoughts by sending hateful messages and emails. As a student who is just trying to do something positive this of course would get me down, however one thing that I knew is that change will always be met with resistance. It was clear to see that some people hating the fact that ‘Mind the Gap’ was having such a good impact. Before the ‘Mind the Gap’ Handbook was released I could see a shift and a hyper awareness from the world that we need to do something about the lack of diversity in imagery. I could see that many news articles were now starting to include signs of how conditions present in COVID-19 on darker skin. This was extremely positive as I didn't believe that my co-authors and I could have such a big impact on the world. My aim with this blog post is to illustrate how resistance is a by-product of change. I want to use this opportunity to help people acknowledge that sometimes your ideas won't always be met with open arms however don’t let that get you down. This message is for anybody who may have an idea but is almost holding themselves back due to fear of not being accepted. I think it's so important to have faith in your own work and then from there everything else will fall into place. To keep up to date with mind the gap and associated posts please follow my social media. Instagram @malone_187, Twitter: @malone_mk Catch us interviewing Malone on Tuesday 27th October at 7pm over on our instagram @acmedicalmentors
Where do I even start? This journey was not an easy one AT ALL. It’s been a long and untraditional journey but nevertheless one of the most rewarding things I’ve ever done. LESSON #1: Even When Things Are Going Great, Don’t Get Comfortable In Year 11, I did 10 GCSE’s and managed to get: 4A’s 2A*, 3B’s and a C in Physics which to this dayyyy still baffles me, the subject just has me like
Medicine is all I have wanted to do since I was about 15. I never had a concrete reason why, but I would say I’m quite an intuitive person, and my spirit just took to medicine, it fit for me. I failed to secure an offer the first time round, so after achieving a first-class degree in Biomedical Science, I currently study Graduate Medicine at the University of Birmingham. Studying medicine as a Graduate is rewarding, and for the most part very enjoyable. I can’t see myself doing anything else. However, it has brought certain challenges which I wanted to share in this post for anyone that can relate to this, whilst giving a realistic idea for those considering it. Firstly, it is really intense, I will be studying consecutively for 7 years. Within that time, I have completed one degree, applied for Graduate Medicine (which is extremely competitive) and studied the entire 2-year preclinical course in less than a year. This is why it is so important to take breaks and be realistic with your workload to avoid burning out. I have multiple outlets which give me a breather and allow me to enjoy myself outside of medicine. I play netball, spend time with loved ones, run ACMM, attend every soca event possible and countdown to carnival every year. These things allow me to have a life outside of medicine which is crucial. Also, the funding for the Graduate Entry Course is substantially different to the undergraduate course. For the first year, it requires a contribution of over three thousand pounds, and in subsequent years you get a combination of student finance and the NHS bursary which is usually less than your previous student finance loan. It is therefore common that there is a financial pressure on graduate students, which is why many have a year out prior to beginning the course in order to save. I had an offer straight from Biomedical Science so was not able to do this. Unfortunately, financial pressure is not uncommon amongst students in general, but it is an even more important consideration for Graduate Entry Medicine.
2020 has been a rollercoaster of a year. It feels like with each progressing month another level of Jumanji is reached. This year was one I had so many plans for, particularly this summer, the summer I was to graduate and finally become a doctor after 8 years of university. There were times in the previous years where I just wished I was finished; I wished I was graduating already. At times I envied those graduating whatever year it might have been. As the saying (or the pussycat dolls song) goes, be careful what you wish for, because you just might get it. In April 2020, my wish came true. The circumstances however were those beyond what my mind could even imagine, a virus taking countless lives, keeping loved ones apart, sweeping the globe. If you told me three months ago that today, as I’m writing this post, I would be in my first working week as an employed doctor? I would not have believed you. Three months ago I had only just written my finals, celebrated with travel, well, I came home to a different world than when I stepped on the plane to leave. Class of Covid-19 as I like to affectionately call us, has been called up for duty. Who knew a global pandemic chose the year in which I was due to qualify to make its entrance into the world. I write this open letter to my younger, student, self and other medical students (both current and future) to say this. Don’t wish away where you are now, because tomorrow might not be what you expect. Each season in life has its purpose. The times I cried because I didn’t get any offers to study medicine? Well they led to me finding joy in Midwifery. The days when I worried how I would pass my exams, study and find go to work; they led me to be resourceful and manage my time. Not everyone believes in fate, or in destiny but I believe all those times and moments where leading up to this season, starting as a doctor in the most extraordinary of circumstances. These days will be written about in the history books and we are living through them. There is a lot of uncertainty for medical students and those that were planning to apply this coming September. There is restructuring of exams, cancelled placements, virtual lectures and other socially distanced changes. Take all the anxiety and worry that might come with the uncertainty and consider this an opportunity. Take hope and comfort in where you are now, for it is preparing you for where you might be tomorrow. Don’t wish away the experiences you are having, embrace the hurdles because they train you to jump higher. I know it is easy for me to say because now I am at the other end of this journey but with every ending there is a new beginning, different challenges, more lessons. More on early provisional registration of final year medical students and its impact on medical students Covid-19: medical schools given powers to graduate final year students early to help NHS Joint statement: early provisional registration for final year medical students Medical Students Are Not Essential Workers: Examining Institutional Responsibility During the COVID-19 Pandemic The Impact of COVID-19 on Medical Education
Earlier this year, I had a six-week placement in psychiatry and had the privilege interacting with many admirable psychiatrists who went above and beyond for their patients and with patients who kindly shared their stories and struggles with me. I knew this placement would be unlike any other I had been on and in this article, I recall the first time I clerked (interviewed) a patient with mania… and it was definitely a unique experience… Disclaimer: All initials and some details have been omitted/changed to preserve patient anonymity. Patient KL is a 16-year-old, male who was top of his class but in the last 6 months, this all changed as his behaviour changed from ‘calm and likeable’ to ‘angry and irrational.’ He stopped going to school for 2 months and spent all his time on his laptop, planning how to end world poverty and become a billionaire. He fell out with his family and in the days leading up to his forced admission, he hadn’t showered or ate in days; a common occurrence in severely manic patients. On interviewing him, he exhibited delusions of grandeur, concrete thinking, flight of ideas, pressured speech, auditory second person hallucinations and lack of insight. For the non-medics, this means he believed God and angels spoke to him and that he had been appointed by God to end world poverty. When talking about this, he spoke in a very fast, uncontrollable way and did not doubt these ideas at all. During the consultation I felt an array of emotions, including curiosity, confusion and sadness. Curiosity: As it was the first time, I had taken a history from somebody with mania, it was amazing to see grandiose delusions, an abstract concept I had only seen in textbooks, come to life. I wanted to know more about his ideas and where they originated from. Some of his ideas, regarding business and education, I’d find myself agreeing with until he’d then add something completely bizarre, thus reminding me of how unwell he was. I wondered how psychiatrists reserved from getting pulled into a patient’s convincing spiels. Confusion: I was confused as to what had caused/triggered this manic episode as he didn’t seem to have any past personal or family psychiatric history nor alcohol or drug use. In fact, he had so many protective factors against a serious psychiatric condition, such as supportive family, good education and more. My confusion at the seemingly random nature of his illness led me on to sadness… Sadness: The lack of any risk factors showed me that anybody can be struck by a mental health imbalance. This patient was a young man aspiring to get into university and I was saddened by the fact that he was so ambitious and hard-working, but this episode had become a hurdle he must face as he steps into adulthood. I hope that this illness does not throw him off his trajectory but instead can be used as fuel for his aspirations. Amused: Although this might sound cruel at first but I was not laughing at him but rather with him. During the consultation, we were able to build rapport as he still made jokes and these breaks of laughter allowed us to connect, even if only briefly, and reminded me of the human connection between physician and patient, a connection that sparks off real recovery as it allows you to truly treat the person in front of you and not just a bag of symptoms. After interviewing KL, I had ample opportunities on my placement to interview other psychiatric patients, all with an array of disorders but all from different walks of life. This further affirmed that mental health can affect anybody. This patient happened to be south Asian and his family were completely, understandably in denial and shock that their son had turned from a high achieving student to a mental health inpatient. The intersectionality of mental health and race is an important aspect to be considered as there is a wealth of evidence that being of African or Asian origin is associated with poorer mental health outcomes. Whether that be due to lack of access, delayed presentation, lack of family support or difference in prescriptions and treatment. As you can see from just this one encounter, that I experienced a whole breadth of emotions and it is for that fact that psychiatry is not for me. The 6-week placement left me emotionally drained and confused as you literally get thrown into patient’s worlds, from having to deal with very complex social issues to listening to their deep emotional turmoil. I have the utmost respect for psychiatrists because I honestly don’t know how they remain resilient in the face of very challenging patients with complex needs. Jessica Katanga 5th year medical student