Black People vs. Healthcare

In June I injured my right ankle. 

I was working out when all of a sudden I heard a loud *POP!* and felt that it could no longer bear weight. At first I was told by an urgent care doctor, “nothing was torn or broken”, that I’d simply sprained it, and that I would heal within 1-6 weeks. That felt like a crazy range of time to give, and did not feel true in my body, but I was excited by the hopeful news and trusted the doctor — as we’re told to do. 

I’ll spare you the details, which involve a questionable healing process, a reinjury, a second visit to the doctor, and an appointment with a physical therapist, but suffice it to say that by the end of August I was told (by the PT) that what had originally been billed as a sprain — multiple times, by *two* different doctors — actually might have been a tear of my Achilles’ tendon. 

A whole fucking different injury. With a whole fucking different healing process.

I was then referred to an orthopedic specialist, a White Man™️ who proceeds to talk over, undermine, and gaslight me, and at this point I'm livid. An interesting thing happens, though, to women — especially black women — when we get angry at a sensed injustice; all of a sudden we start to self-monitor. Is my voice even? Am I still speaking calmly? Can I choke down these tears? Can I stop shaking? Because God forbid we release any natural physical response one would have to being disrespected and then be labeled “angry” or “hysterical” in front of a medical professional who is supposed to understand how emotional responses manifest in the body. 

So this White Male™️ PA is doing the very White Male™️ thing of taking up space instead of leaving it for me to voice my concerns, but I manage to get enough out to demand an MRI. He obliges and even in that, makes me feel like he’s done me a fucking favor instead of his goddamn job. 

Weeks later I get the scan, a week later I review it with the surgeon and find out, indeed, my Achilles’ tendon is partially torn. (This is the end of September BTW, keep in mind the original injury was mid June.) My body — my sweet, beautiful, miracle body — did as much as she could to heal herself, but without having the proper external care for so long (and also in the face of some likely actively unhelpful practices given that I didn’t realize I had a torn tendon) it just wasn’t enough. So now I need surgery. And with the insurance plan I'm currently on, it would cost me upwards of $6.5K.

Through this whole fucked up saga, *particularly* after learning MID AUGUST that my Achilles’ tendon might have been torn, I wondered if my treatment through the healthcare system would have been different if I was white. Or even lighter skinned. Would I have received such negligent care, would I have been so dismissed, so discredited? Would I have had to demand my own MRI or would that have just been offered at the start? 

I have to ask because there is a history of racial disadvantage in this land that’s older than this fucking country, and has poisoned EVERYTHING — a fact I was reminded of by The 1619 Project, The New York Times’ podcast delving into the realities and legacy of slavery, it being 400 years since the first slave ship landed on American soil. 

As fate, or the Universe, or whomever would have it, the episode I listened to before seeing that PA was about healthcare. About the development of the healthcare system in this country, about how it came to be in large part because all of a sudden there were 4 million “new citizens” that were quite literally left to die by being freed without also being given any recourse to find shelter, employment, or food. And how the government sent I believe 100 doctors(?), to service 4 million people, because ultimately they didn’t actually want to keep them from dying, they just wanted to keep whatever diseases they were developing from spreading to white communities. In fact, there was a rumor going around at the time, popular enough to be argued in Congress, that the reason black people were suffering wasn’t because they’d been left desolate by the government, but rather because it is their right and natural state to be enslaved, and so freeing them went against their constitution, causing them to go extinct. 

White people, I swear to god. 

So I’m hearing this, I’m learning about the long, long, LONG history of black people being disenfranchised and undermined by healthcare in the United States, seeing doctors who cared little to nothing for their wellbeing, who thought them lazy, liars, or perhaps just suffering from the Darwin-flavored presumption that freedom does not agree with their nature. I’m remembering Dr. James Marion Sims, the “Father of Modern Gynecology” who built his legacy by performing cruel experiments on enslaved women, cutting them without anesthesia, under the pseudo science that black women feel less pain. I’m recalling the Tuskegee Experiment, where between 1932 and 1972, black men who thought they were receiving free healthcare from the government were actually injected with syphilis — I shit you not —  just to see what would happen. I’m recalling how black women are around 4 times more likely to die in childbirth than their white counterparts. And I’m reconciling all of this with my own lived experience of being ignored, gaslighted, spoken over in numerous doctors’ offices. Of course, these things cannot be equated, but my point is that all that history, that legacy of Healthcare vs. Black People, doesn’t disappear. It’s active in every doctor’s visit, every scan, every operation, for every black person in this country.  

This failure to properly care for black patients has an economic effect as well, because when black people go to the doctor and we are ignored, discredited, or gaslighted, symptoms worsen (as symptoms tend to do if untreated), until they become something far more devastating, dangerous, and COSTLY than they would have been had we been well taken care of to begin with. All of a sudden a family that was already disadvantaged in every other sphere finds themselves stuck with a five or six-figure medical bill that they can’t pay, piling on generational debt that becomes harder to carve a way out of. 

Do you see how this shit works? The ways education, economics, healthcare, food services, all intertwine to keep the disadvantaged disadvantaged?

It’s infuriating. I almost didn’t write this post because it felt too overwhelming, it made me feel too powerless, to face the real possibility that my skin and gender played a role in my diagnosis getting so fucked up. Also to realize that there isn’t really an alternative… I have to see a doctor and at this point, I have to get surgery. 

So anyway. Now I’m waiting for open enrollment on October 15th. Gonna shoot for a new insurance plan, a new hospital, a new doctor, and hope for the least racist one. Because that, I guess, is all we can do.