My harrowing journey to Angela’s world, and what I learned about earning her trust
My son K.C., 14, is creative and funny. His room is a riot of color and texture, filled with rainbow pride flags, stickers, collectables, bright stuffed animals, string lights, and superhero posters.
Colorful as he is, sometimes people see in him only one of those colors: brown. He is Hispanic. He has beautiful brown skin, thick brown hair, and chocolate brown eyes. The rest of our family is Caucasian; we adopted K.C. upon his birth to Mexican-American parents.
When K.C. was 7, at a suburban science fair for grade schoolers, K.C. made a beeline for one display, a Rube Goldberg contraption created by two college engineering students. It mesmerized K.C., who stood at the front of the exhibit while six other kids, all white, crowded behind him. The college students hosting the exhibit began engaging the kids, asking questions and offering freebie trinkets.
K.C. had a question, but the exhibitors didn’t respond, even as they answered question after question from kids standing behind him. K.C. wanted a trinket, but exhibitors distributed them to other kids behind him, somehow missing K.C.. Exhibitors posed challenge questions but ignored K.C.’s efforts to answer. My child was quite literally overlooked as the exhibitors peered over his head to engage the white kids.
I don’t believe this was intentional on the part of the student exhibitors. But I was seized with outrage. I made my way to the table and demanded the exhibitors pay attention to my child. They looked at me blankly with eyebrows raised.
When I got home I burst into tears. This really hurt. It was the first time I truly felt the impact of racism from the perspective of a victim—the wincing pain of your child being dismissed and ignored and the frustration of being treated as a crazy lady for pointing it out.
At work the next day, I recounted the story with a colleague I trust, Angela, an African American mother of two kids around the same age as K.C. “Welcome to my world,” she said.
I asked her about that world. She gave an example: a traffic dispute when a white woman called her the N-word.
Angela is misunderstanding me, I thought. What happened to K.C. wasn’t like that. Nobody aimed a racist slur at my child; that would be “real” racism. But my story and hers are both real racism from Angela’s perspective. That’s when I realized that, for Black or brown people, being ignored and being insulted are different in form but identical in function. They are acts that reinforce bias and disdain.
I asked Angela how she picked physicians for her kids. To begin with, she picked an African American doctor. That doctor was part of a practice with white physicians, and as her kids grew older she had to occasionally to see some of them when her chosen doctor was unavailable. Now, years later, she trusts all the physicians in the practice to see her kids. But it took years.
I asked her what they did to earn to her trust. She recounted that they looked her and her kids in the eye and listened. They didn’t rush through the appointments as if they had something better to do. They got on the phone when Angela called with a concern. They didn’t make her languish pointlessly in the waiting room.
Many clinicians would see these as small things. But the weight of history tells Angela—and K.C.—that small things are big signals of the true level of respect doctors have for their patients. Lapses in the small things trigger memories of mistreatment, invisibility, disdain, and indignity. They are as insulting as a slur.
I’d love to think I’m free of the bias that so enraged me at the science fair. But ever so gently, Angela reminded me of the time I excluded her from meetings on a project she was involved in. I thought it was a small oversight, not in any way racially motivated, yet I overlooked her in the same way those college students overlooked my son. Intentionally or not, I caused her harm, which is not a small thing at all.
Building an equitable and inclusive delivery system will require the trust of patients who are accustomed to being overlooked and treated as inferior. They may view routine lapses and errors as disrespectful to them on a profoundly personal level. Their trust will be earned only with respect for a different worldview.
Leah heads The Leapfrog Group, a national nonprofit founded in 2000 by employers aiming for giant “leaps” forward in patient safety and quality. She has advocated to put patients first over a 30-year career spanning a rural hospital network, the New York City Mayor’s Office, and the National League for Nursing. She grew up in Maine though she dislikes lobster and winter sports, and she lives in the Washington, DC, area with her husband Sam and two sons.