For Amanda J. Calhoun, MD, MPH, being a Yale Psychiatry resident and an underrepresented minority is like looking at life through two different lenses.
“There is the clinical, ‘learn how to be a doctor’ lens, and there is the, ‘is this system really helping to rectify institutionalized racism?’ lens,” Calhoun said. “Some would argue that I should focus on doctoring first, and then later, challenge the system. But that is not just incorrect; it is impossible.”
Calhoun was among a select group of speakers - and the only resident - chosen to share their narrative stories about the patient experience and working as a doctor at the Feb. 5 Pediatric Grand Rounds.
Calhoun is a resident in the Albert J. Solnit Integrated Adult/Child Psychiatry program. She leads the Yale Resident Spanish Initiative and is co-Vice Chair of the Diversity Council of the Yale Resident Fellow Senate. Her research interests focus on the improvement of mental health outcomes in African/African diaspora and indigenous children as well as global mental health.
Calhoun’s speech at Grand Rounds, titled “Two Lenses,” centered on her experience as a woman of African descent working in the medical field.
She said the speech came as the result of a lifetime of both personal and second-hand experience with racism – and she was fed up.
“I wanted the chance to hopefully demonstrate the emotional burden of dealing with racism on a daily basis and watching it play out with my family, friends, and patients,” she said. “I also wanted other underrepresented minorities and people living with autistic family members, to feel empowered. I wanted to tell our story.”
In her speech, Calhoun recalled a time when her older brother, who is severely autistic, was thrown to the ground and handcuffed by a security guard at the local science center in her hometown of St. Louis, Missouri despite the protests of his home staff member. He had bruises on his wrists following the incident. Calhoun also talked about her grandmother, who died of breast cancer before she was born and received subpar medical treatment because of her race.
She also recounted her experiences with racism in her professional life, such as being called by the names of the other black female pediatric interns, “as if we all look alike,” she said. When colleagues comment that a patient “doesn’t look like she would do drugs,” Calhoun said she often responds, “What does a kid look like who does drugs?”
“Many patients who look like me do not trust the medical system, because the medical system has not yet proven itself to be trustworthy,” Calhoun said in her speech. “And although I am a proud member of the medical system, to be honest, I don’t always trust it either.”
Throughout her talk, Calhoun used statistics to illustrate evidence of racial bias in the medical system: Hospitals are more likely to suspect and report black and Latino families for child abuse, and more likely to avoid reporting comparable situations in white families. College graduate African American women are more likely to die from preventable childbirth complications than white high school dropouts. She also shared the findings of a 2016 survey where half of all white medical students surveyed believed at least one false statement about biological differences between blacks and whites, such as blacks having less sensitive nerve endings or a faster coagulation rate.
Calhoun told the audience that she was sharing her personal anecdotes as well as statistics because “I don’t trust that I’ll be believed by some of you if I don’t.”
“Unfortunately, one personal anecdote - or even many - of racism is often not enough,” she said after her speech. “Many people try to explain it away and convince themselves that there was something else that caused the issue - anything but racism. So, I chose to span multiple stories of racism, in addition to including statistics to back up the fact that this is not just about my feelings or my personal experiences. This is a social justice and human rights issue. Institutionalized and systemic racism is a pervasive problem today - not 100 years ago, not 50 years ago. Today.”
She characterized her speech as covering only the “tip of the iceberg” of painful experiences of racism and what she’s learned about systemic injustices against people of color.
“The reason why racism is so exhausting and draining is because not only is it constantly minimized and glossed over, but many people simply do not realize how deeply it permeates our lives as black and brown people,” Calhoun said. “It's like someone slapping you in the face over and over and over.
“I wanted to be a voice for underrepresented minorities in medicine and our underrepresented minority patients,” she added. “Sometimes I feel like people who do not identify as underrepresented minorities, unless they are allies, are completely oblivious to our experiences. So, I chose a very blunt, passionate, and heavy-hitting style of speech.”
Calhoun hasn’t always felt empowered to speak out in that way. She said it has only been since her arrival at Yale that she has been supported in sharing her experience.
“In Saint Louis, I would have never given this speech because honestly, it would have hurt my professional relationship with mentors and supervisors who were in charge of my academic success,” Calhoun said. “I did not feel safe being myself and fighting for social justice in St. Louis. Since coming to Yale, I have been very supported. I had a moment where I wondered, ‘Is this speech going to make people angry at me?’ But I realized that I had so many mentors in powerful places who would back me if there was backlash, that I felt safe to truly be a voice on these issues.”
Calhoun challenged the audience to not view social justice activism as two separate areas.
“Being a doctor, an underrepresented minority, and an activist is like looking at life through two different lenses. There is the clinical ‘doctoring’ lens and there is the rectifying systemic racism ‘activist’ lens. But maybe, these lenses shouldn’t be different. Maybe there should only be one lens. Maybe one shouldn’t have to be part of a marginalized group to fight for them to be treated fairly. Maybe social justice shouldn’t be an optional course but required curriculum. And maybe, just maybe, all doctors should be activists.”
Calhoun said she hoped her talk resonated with other underrepresented minorities and their allies - people that promote and work to intentionally advance a culture of inclusion.
“I’d like to empower them that it’s okay to take a stand and talk about these issues, and that we do not always have to cater to people’s comfort, and sometimes in order to get a message across you can’t cater to comfort,” she said.
“I hear you. I’m here for you. We can be here for each other,” she said.