A Health Equity Trailblazer Shares Her Own Story of Medical Gaslighting

“[It’s an experience] that I write about in my book, about when I had appendicitis as a first-year medical student. I ended up going to the ER three times and was turned away the first two times. I was questioned about how much pain I was in. I was asked repeatedly about my sexual activity. The providers seemed suspicious about my responses. And so I ended up actually rupturing my appendix and missing a whole month of medical school.

And I remember I was there with my twin sister at each visit, and she even was in medical school with me and she said, “I think you have appendicitis.” But even as medical students, we didn’t feel empowered enough to even say that [to the ER doctors]. So you can imagine what the average Black patient feels like.

A lot of this medical gaslighting that you talk about — unfortunately for health professionals — is really deeply rooted in the history of our country, especially in terms of how it relates to pain. We know about figures like J. Marion Sims, the father of modern gynecology, who made really important discoveries and inventions — but did so in a horrific way on enslaved Black women, not using any local anesthetic even once local anesthetic had been discovered. But again, this [mindset is] based on racial and biologic essentialism, that Black people that we don’t feel pain. A lot of those deeply rooted myths and misconceptions have been absorbed [across this] country, and our health professionals are unfortunately no different.

Even in 2016, there was a study at University of Virginia where they gave two mock cases to medical students in residence — a Black patient and a white patient — and asked them to rate the patient’s pain then recommend pain treatment for the patient. Those medical students in residence consistently underrated the Black patient’s pain and gave them lower doses of pain medication. [The study also asked the residents to rate the extent to which biological difference among Black and white patients were true or untrue.] Those who underrated pain were more likely to believe in false myths that Black people’s skin was thicker, that we’re less sensitive to pain…And that’s 2016.

That unfortunately results in what we call pain inequity. When we go to health professionals and we say we’re having discomfort or we’re having pain, often — and this is not just anecdotal, it’s in the data — Black patients are dismissed or ignored. What that leads to is 1) misdiagnoses, delayed diagnoses, harm, and even death. But also what it results in is Black patients being less likely to want to seek care when they need it.

We call that a high burden of unmet needs in our community — that when we do have to seek care, we are less likely to do so because we don’t think that we’re going to receive quality culturally responsive healthcare.