A 🧵 on white privilege, and the way it operates on your behalf without you ever even needing to think about it.
We travelled to a small family gathering for Christmas; it was about a 13 hour drive. On the way home, our youngest, 2, began to feel sick and then to run a fever.
2/ (He's fine, by the way. It wasn't COVID; more likely RSV).
We still had 7 hours left and it was late, so we decided to get a hotel for the night. We looked at the map and booked a hotel room in the next town on our route; a random town in rural Missouri we had never visited.
3/ We arrived around 9 PM and got everyone settled in (we have 4 kids; it takes a while). The 2 yo's fever began to climb despite the tylenol we had given him earlier, and he's our child that spikes VERY high fevers when he gets sick. Like a dummy I hadn't packed ibuprofen.
4/ So at 10 PM the day before Christmas Eve I drove to the Wal-Mart... Which had closed at 9. Then I drove around this small town and visited every convenience store, corner shop, and gas station; every place I could find that was open, looking for children's ibuprofen.
5/ Because they were the ONLY places open, several were fairly crowded. People congregated around trucks in the parking lot, playing music; very much the small town vibe I remember growing up in rural Louisiana. I was the only one wearing a mask, but folks were still friendly.
6/ I never found ibuprofen, but 2 did ok and we got some the next morning before heading home.
And that's it. That's the whole story. But it took me weeks to realize how much my white privilege came into play that night; if you're white, maybe you haven't spotted it yet either.
7/ At no point did I feel afraid. At no point was I hassled, intimidated, threatened, or worse. Even wearing a mask, which marked me as different and an outsider, I was treated with courtesy, or at worst indifference.
This is the experience I expect to have as a white man.
8/ I booked a hotel in the next town on our route and not once did I think to visit justice.tougaloo.edu/sundown-towns to check their database of Sundown Towns to make sure it was safe for us, even though we could have driven on to a different town or a larger city.
9/ For those that don't know, Sundown Towns are towns that are predominantly or totally white on purpose; they are know to be unsafe for Black people to stay in or travel through, particularly after dark. You can read more about them here: justice.tougaloo.edu/sundown-towns/…
10/ We were driving through rural Missouri, a state with over 100 Sundown Towns. I stopped in a town at random, set my family up in a hotel, and drove around town walking into other people's spaces looking for medicine for my child. I didn't think twice about any of it.
11/ White Privilege means I feel safe in any town in American. Safe from the police, safe from the citizens. It means I don't have to consult a database. It means there has never been a sign warning me not to stay the night, or a whistle blowing at 6 PM to tell me to get out.
12/ If you are a white person who doesn't believe White Privilege exists, I'm here as a white man to tell you that your experiences are not normative; you being blind to that privilege doesn't mean it doesn't exist; your blindness is itself a part of the privilege.
13/ It's the not having to see, not having to think, not even having to make decisions about where me and my family will be safe that makes up the most insidious part of white privilege, because I don't even countenance the burden of all of those choices on my Black neighbor.
14/ White privilege means feeling the freedom to move about the world safely, and because we think everyone's experiences of America are just like ours, it means we can feel safe without ever having to think about the fact that we feel safe, or that someone else wouldn't BE safe.
15/ That degree of privilege is crazy, and it's no wonder it messes with our thinking. We have so much privilege that we can ignore or deny our own privilege while standing in a gas station parking after dark in the middle of the night in a town we've never set foot in before.
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About 6 years ago a patient told me they picked up their medication after our last visit, even though it cost over $200 and they had to borrow money from family to afford it.
The medicine was extended-release Nifedipine. It should have cost about $14.
The patient told me, with some hesitation or reluctance, "I'd like to switch to something less expensive if possible. I know you have to make your money somehow, but I just can't afford this medicine."
I'm not sure how it happened. I probably selected the brand name instead of the generic in the EHR by mistake. And then the pharmacy, by design or just not catching the error, failed to offer a cheaper generic equivalent.
@kidney_boy I'm the resident you're talking about here, sir; the very one. The one who stayed late, blew by duty hours, volunteered for the admission or the procedure; the one who covered his peers' shifts.
The thing you are missing is that I didn't make those choices, I had those choices.
@kidney_boy My spouse is an RN; we had talked this through together and had decided that's how those 3 years of residency were going to be for us. It was what we wanted, because we knew it was temporary and because I wanted every last ounce of training I could get out of those years.
@kidney_boy It was hard, but she chose to stay home so that I could do that, and I couldn't have if she hadn't been paying the bills, managing our meager finances, caring for our children, fixing our house, and creating insane amounts of margin for me to be able to be that kind of resident.
Thread: How a trip to the Veterinarian strengthened my resolve to train medical students in patient-centered care.
I teach clinical skills, patient communication, and doctoring at a medical school. This is my good boy Chuck. Today I had to bring him to the Vet.
2/ I should mention that most of these pictures are a few years old. We got Chuck (full name: Special Agent Carmichael) during 2nd year of medical school, and at 12 years old he now has a bit of grey around the paws and whiskers, but he's still as cute as ever.
3/ Our Vet in Waco was awesome; always took the time to explain the work-up and diagnosis, engaged in shared decision making, etc. Not all doctors love people but all vets love animals, so I just assumed that outside of somewhere like Banfield this was just how Vet visits were.
2/ The play "Wit" by Margaret Edson has a strange but important role in my journey to becoming a physician.
As a college freshman I was pre-law and did #theatre whenever I could for fun. At the end of the year, I was cast in Wit as part of senior directed one-acts.
3/ The play is about the fictional Dr. Vivian Bearing, English professor and leading expert on the Holy Sonnets of John Donne, and her diagnosis, treatment, and death from ovarian cancer. The play focuses on themes of mortality, personhood, and what it means to be fully human.