Dear Roger Clegg and Mark J. Perry

Dear Roger Clegg and Mark J. Perry,

One June 28th, an article you wrote for The National Review came across feed. The article is titled Color-Coded Meds and it is where you, Clegg, express your opinion about students of color being allowed to go to medical school–like its 1960 or something. This wouldn’t have meant so much except that I watched a video just a week prior of a mom refusing care for her son, who with chest pain may have had something potentially life threatening because there wasn’t a white doctor. As the president and general counsel for the Center for Equal Opportunity, a “conservative think tank devoted to issues of race and ethnicity”, I would have hoped that at the very least you hadn’t equated color with a lack of ability to do this job.

Then again, you didn’t exactly make up your own mind about this, Perry, you provided the opinion in the first place. The data you present in you AEI post looks quite damning at first glance. The graph, front and center, displays acceptance rates for individuals with a certain MCAT score and a particular GPA. This graph is then interpreted to say that black and Hispanic or Latinx applicants are more likely to be accepted than other individuals across any combination of test scores and GPAs. Then the “bottom line” as you call it:

“Medical school acceptance rates in recent years suggest that medical schools must have “affirmative discrimination” and “racial profiling” admission policies that favor black and Hispanic applicants over equally qualified Asian and white students.”

Back to you, Clegg! You then take this and make the following assertion:

“It’s bad for patients who will not have doctors as good as they might have had otherwise.”

You are both entitled to your interpretation of the data and to your opinion. I also know I am unlikely to change your 60-year-old minds about Affirmative Action. It is, after all, as emotional for you as it is for me. You think we’re undeserving and stealing your children’s seats while I think I have worked incredibly hard to earn the privilege of taking care of human lives. Here’s my counter argument anyway, here’s why we will likely be plenty good at doctoring:

1. The number of white and Asian doctors serving our community, who actually want to be there, who are actually making a difference, is minuscule. They fear to work in locations like the South Bronx or the South Side of Chicago. In fact, I was just having a conversation with a friend about the Bronx Lebanon shooting. He said to me “now I know not to apply there for residency” not realizing that it is that kind of deduction that has ultimately lead to the increased crime rates in the Bronx.

Those who end up in these places believe the inhabitants make themselves sick and don’t deserve the kind of care they would give their mothers. Having no doctors of color would mean that places like these will continue to get subpar care, will continue to be sick, will continue to miss school and work because of illness, and will continue to live in poverty.

My pediatrician of 7 or so years once told me a story. During her residency, she overheard a fellow resident pat himself on the back by saying “I just saved the life of an infant who will grow up to mug my grandmother.” The baby was Dominican. My pediatrician who got to hear this because she has the privilege of a few, shall we say, Aryan features,  is Dominican and her colleague had no idea he had just offended her.

This is why I went into medicine in the first place. Health disparities don’t exist out of nowhere. They exist because the doctors we currently have (a mostly white and Asian contingent) don’t provide care in a just way. At the macro level, the government throws money into medical research for diseases affecting mostly white individuals and diseases that affect mostly Black get chump change. At the clinical level, the doctors we have will say that patients are non-compliant with medication (which, by the way, is an inappropriate term), won’t listen to medical advice, and they’ll “grow up to mug my grandmother” as excuses to provide inferior care.

Which gets me to my second point…

2. It is almost (almost) unfair to ask white and Asian doctors to provide culturally competent care. They can’t be the only ones caring for all communities in the US. Unless you’re also saying that you’re a White supremacist, you agree that the communities of color in the US are here to stay and need care that is responsive to their needs.

White doctors have been asking Hispanic and Latinx families to stop eating so much starch for as long as we have been able to put a white doctor and a Hispanic or Latinx patient in an exam room together. The fact of the matter is, starch is a huge part of the cultures of this group and our Hispanic and Latinx patients are not going to change their entire way of life because they have been eating this stuff for centuries. Also, guess what, Hispanic and Latinx folks have more metabolic illnesses and heart conditions the longer they live in the US than they do on their homeland. Meaning their cultural diet has a limited amount to do with the illnesses they present with to the office.

Before you say that they should go back to where they came from, I urge you to realize a little bit of history. They are in the US because of the crap that the US has pulled on their homeland. The US has time and again gone into these countries and left them to war-torn and in poverty. The folks that were able to immigrate to the US do so in search of a better life than the one the US left them.

I am not saying that it is impossible for White and Asian doctors to care for all communities, they simply don’t have the best track record.

3. When you say we are unqualified and “not as good”, I invite you to entertain the notion that you can’t be a mediocre doctor (academically, you can certainly be a shitty doctor in other respects, but that’s a separate blog post) because they don’t let you.

Do you know what we have to get through in order to be named MD? You have to have been an excellent elementary school, high school, college, and medical student.

Yes, elementary school counts too because well, you wouldn’t send your kid to a school in the South Bronx if you had the means not, now would you? You wouldn’t because historically, they’re not the best places, and don’t produce the best students. The foundation a kid in this environment receives is not the sturdiest, right. The word gap is a thing that exists, right? There are violence and drugs everywhere you look, right? No one is teaching them to take standardized exams, right? You’d be crazy to send your kid here because sending your kid here would mean they start life at a disadvantage next to your friend’s kids. Yet, it’s crazy that some kids hailing out of here will be seated next to yours in the medical school classroom–and believe me, Affirmative Action didn’t hold any of our hands getting there. It simply recognized that we started the race with one of our legs missing and will get to the end of the finishing line at some point too.

You have to take a gazillion exams and not just pass them but excel at them. If you aren’t performing, they make you do it again until you do—because human lives are at stake!

Even after you have an MD, they don’t let you practice on your own until you have at least completed a residency. Which is hell for every resident I have ever spoken to–insane hours, attendings chewing you out in front of patients, competing with your colleagues, incredibly subjective evaluations, the list goes on. Not to mention the Boards examinations, for which we study months and months for. Have you ever studied for anything for months?

For those of us who have had very little support and resource growing up and while in school, its a miracle we even made it to medical school! We didn’t get in because of Affirmative Action, we got in because we were good enough, because we volunteered and worked in labs and never took the summer or other breaks off. We got in because the admission’s committee thought that our personal statements and letters of recommendation said we would work to diminish health disparities and bring health care to all people. We got in because they knew we could take on the course work, they knew we had the passion and commitment to do well in an everyone that is dog eat dog, incredibly cut throat.

We certainly won’t graduate because of Affirmative Action, we will have done that on our own. There’s no special treatment in the lab while dissecting your donor. There’s no special treatment in the classroom when a question is asked. There’s no special treatment on exams (they are taken electronically and the grader is blinded to who’s exam they are grading). When we graduate, that MD after our names will have been earned with arguably more sweat and teardrops as any White or Asian student will have shed in the process–because we had little support and a not so solid base to stand on…oh and all the naysayers telling us we won’t ever be good enough all along the way.

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