“How are you today?”
“How was your weekend?”
“How’s it going?”
As a Black woman and medical student in the often lonely world of higher education, I’ve learned to respond to these questions with a smile painted on my face and a “Fine, how about you?”
Even when I am feeling devastated, I sit and listen to my white professors as they tell me stories about upcoming trips and detail their latest scientific research. I try my best to focus on their words, but no matter what I do, the suffering of my community is often heavy on my mind.
In the past three months, COVID-19, the great exacerbator, has taken the Black community by storm. Black people are more than twice as likely to die from COVID-19 as white people. Elderly Black individuals are more likely to live in nursing homes, deemed hotspots for COVID-19, compared to their white counterparts, which puts them at greater risk of disease transmission.
I’ve personally witnessed the devastating effect of this inequity. Just one month ago, my great-grandmother, unable to afford at-home-living assistance, contracted COVID-19 at her nursing facility. Thankfully, she recovered, but the more than 21,000 other Black lives disproportionately taken by this deadly virus weren’t so fortunate.
While I was in my classes learning how to heal my future patients, I was also learning that even the power of medicine isn’t enough to quell the deadly effects of systemic racism. As I learned about research for a cure for COVID-19 at one of the best medical schools in the world, deep down I knew if and when a cure was discovered, my family probably wouldn’t be able to afford it.
I often thought about my grandfather, a 67-year-old truck driver with diabetes and hypertension, both risk factors for COVID-19. He should have retired years ago, but because he grew up in the Jim Crow South, his options for professional opportunities were limited, and he was forced to accept low-wage work. Today, he is finally making good money and is able to provide for our family, but it still isn’t sufficient for him to afford to retire. So he is still working, even during the deadliest pandemic the U.S. has seen in decades. I am terrified for his health and safety because beyond his being an elderly essential worker with various chronic diseases, I know that racism has also placed a special target on the backs of Black people in the path of COVID-19.
“How’s it going?” my professors asked me.
“Terribly, because COVID-19 and her sister, systemic racism, are ravaging my community and threatening the lives of the people I love.”
That’s what I wanted to respond, but I didn’t. Instead, once again, I conjured up my fake smile and nodded to whatever they were saying, words that seemed so unimportant compared to the images of my family’s demise that constantly flashed through my mind.
In those moments I once again left my Black experience at the door for the sake of my “professionalism” as a medical student. After years of doing this in high school and college at predominantly white institutions, this has become second nature to me. I’ve developed a mental checklist of sorts for myself:
Smile.
Sound articulate.
Don’t intimidate.
Don’t talk about race.
Definitely don’t talk about racism.
My entire experience in higher education has involved centering my professors’ and colleagues’ white comfort, often at the expense of my own mental wellness. I know this is a harmful practice, but the hierarchical nature of academic medicine and white fragility don’t lend themselves to safe, honest conversations about racism. In these kinds of environments, it feels impossible to answer the question, “How are you?” with honesty when you’re afraid to provoke white guilt or, worse, threaten or damage your academic success.
So I’ve learned to pick and choose my battles. And that often translates into moments when I suffer in silence as I enter the classroom as a medical student, where I am forced to suppress my frustrations and pains as a Black woman. So even as I mourned the disp