Thread by @medicalaxioms

I had an old friend over for dinner the other day. He was the first Black doctor I ever mentored. I asked him what I did that was most helpful.

Here’s what he told me:
1/17

“1. You listened. You listened to my stories of how I was treated by attendings, the school, fellow residents, and patients. Stories of harms small and great. Comments ranging from annoying to really hurtful.”
2/17

“Nobody else involved in my training would just sit back and listen and give me a chance to tell them what had happened lately and how it made me feel.”

“Everybody else told me how to feel. Told me what those words and comments meant.” 3/17

“Everyone else told me what to do next. Told me some story about their own life. Told me how I didn’t measure up. Told me what I need to work on. Told me what to ignore. Told me how this person or that person was a good guy or a god doctor.” 4/17

I don’t remember doing this. I only remember that I was trying to help him out and the first step in trying to help someone is figuring out their situation. 5/17

I wasn’t going to tell him how it felt to be a Black doctor in medicine. (That seemed like the wrong idea from me being so white and all.) I needed to understand first. It took me 2 years of listening just to get where he was coming from. 6/17

“2. You got the administration off my back.” 7/17

I need to explain. I was asked to mentor this resident because he was “having trouble.”

“Underperforming” and “having communication issues” and “not at the level of his peers.” 8/ 17

Seeing that I needed some time to understand what was going on, I told anyone who asked that we were meeting regularly and that I was creating a thorough plan for academic remediation, practicing presenting patients at the bedside and medical decision making. 9/17

In truth, I did nothing of the kind.

We met up and I asked him how he felt. We rounded together and I asked him what his interactions were like with other attendings. I observed his practice and his ability to connect with patients. It was really good. He needed no help. 10/17

I concluded he had only one serious issue affecting his ability to succeed as a resident.

He was a Black doctor in a system of medical education struck through with systemic racism. 11/17

I didn’t lie per say when people asked. I just put our work together in terms that other people could understand.

So when I said, “Going through MKSAP test questions” I meant “listening to stories of attendings who acted like he wasn’t in the room.”

Basically the same. 12/17

In case you didn’t know, no resident or medical student can learn if they are placed under a microscope every day and treated like a specimen.

It’s too stressful. 13/17

We all need space and freedom and a relaxed atmosphere to learn and grow. Ask anyone with any brains. They will tell you. 14/17

So I got everyone off his back and told them I had the situation under control. They stopped pestering him so he could do his job and learn his stuff. 15/17

To summarize, he told me I did 2 helpful things:
1. Listened to him
2. Got everyone off his back so he could work and learn

Write that down. 16/17

Before he left he told me he had just received the “Clinician of the Year” Award from his huge hospitalist group.

I said, “I always knew you would be one of the best.” 17/17