My textbooks are racist.

Being a black male medical student (yes we do exist), you quickly realize that you’re not just there as you, you are representing your entire race and gender. One that continues to let you down in every way possible but you continue to boldly represent. Being a black male medical student, you’re continuously interacting with teachers and consultants you cannot relate to, not culturally, racially or any other forms of -lly. White consultants assume that you’re there based on a quota system and the few black consultants want to make you believe that you need to work thrice as hard to be worth standing where you are, continuously telling you stories of how hard they had it during their “time” and how we should be grateful to have it the way we do now. Both completely out of touch with reality I suppose, it’s 2016 I cannot be grateful to the fact that I’m given the opportunity to have these specific set of struggles, I need change and accepting things as they are isn’t something I think I can do. Being part of a group of about 30 black males in a class of 314 students puts your race and gender into perceptive. How did we get here? People look at you and applaud because it seems as though you’re one of the lucky few who have managed to survive this far in a system that is in no way designed for you. As though we should still celebrate being a minority in 2016.
In the spirit of peace and ignorance I had accepted this and learned to deal with it to a certain extent; accepted the pressure that it came with and the shock on people’s face when I tell them that I’m a medical student or when they see me walking around the hospital in scrubs or with stethoscope around my neck. The constant “you don’t look like a medical student” or the confusions that all my black female friends MUST be nurses, because there’s no such thing as black female doctor right? I guess this fits right into the #WhatADoctorLooksLike problem; there’s are some physical criteria and we either have too much melanin or two X chromosomes with too much melanin to fit in. I had learned to deal with the look on the face of a white consultant when I was able to answer a question my white counterpart could not. Learn to politely smile when they felt the need to compliment my accent by telling me how well spoken I was, something I had never heard said to my white counterpart, it almost as if as a black man, I’m not suppose to articulate my words right, my knowledge of the English language is suppose to be limited. As a black man, my level of education and intelligence isn’t measured in the degrees I may have, the distinctions I continue to get or my ability to reason but rather my ability to flawlessly speak the English language in an European accent. To walk in a ward without a name badge on and everyone automatically assuming that you’re a poor black patient & not a medical student or young doctor. I dealt with it everyday I was in the ward, seeing consultants continuously asking my white counterpart as to what we’re suppose to be doing because the possibility that a person of color could know what’s happening is beyond understanding. I had to learn to keep quiet and not take offense when subtle racist or sexist comments were made in my presence.

But it was when I felt this very racism in the comfort of my bedroom that I lost my ability to cope. Like a shock of white while reading my clinical examination textbooks in preparation for an OSCE; I realized there was a lot of descriptions on how to identify jaundice, cyanosis, xanthelasma, pallor, hyper-pigmentation and hundreds of other diseases presentation, but these descriptions explain how to identify these on white patients, the images in my textbooks were all of white patients. I stood there in disbelief, thinking maybe I’m overthinking this, I’ve been studying for too long I should take a break. My discomfort, however, was too overwhelming to ignore as I put down the textbook to quickly pick it up again and go through every image in it never once seeing a person of color.
This is the prescribed textbook by an African university, a textbook used to train African doctors for African patients, but it had no African images or descriptions, not once in the hundreds of pages that made the textbook. My OSCE will be conducted on black stimulating patients, the wards where I will spend the first 5 years of clinical exposure is made up of 99% of black patients but I’m not studying for black patients, I’m not being taught for black patients, I mean how would I ever identify any these on a black patient? The author of my prescribed clinical examination book must have never heard of sick people of color. Maybe black people don’t suffer from jaundice, maybe it’s a Caucasian thing, maybe we don’t suffer from anaemia, cancer or anything that has the ability to alter our appearances. Maybe it’s all infectious disease with us, maybe I’ve had this all wrong, nah it can’t be – I took to the google streets to confirm my curiosity.

Dear Talley’s and O’connor

Black, colored, Indian, latino, Asian people with jaundice, cyanosis, anaemia, and hyperpigmentation do exist. I’d be more than happy to forward you images I found online for your next edition.
a disappointed BLACK MALE MEDICAL STUDENT (yes, we do exist) forced to used your textbook.


DSM 5 criteria for Medical Student Disorder

Fast forward 18 months from my last entry to Block 11B (or Block 12). Psychiatry, I felt a strong urge to write something about it after having spent the last couple of days trying to understand the difference between delirium, delusions, dementia, depression, bipolar disorder, schizoaffective disorder, schizophreniform and schizophrenia all the while diagnosing myself a few times with each of the previously mentioned conditions. Psychiatry was pretty interesting, the lecturers weren’t the most exciting people in the world but at this point, anyone who gives off too much energy is annoying so I’m not complaining. It was a little too philosophical which was quite a new experience. I’ve learned a bunch of cool new stuff too though; like I finally understand what Alice Grey had, (Alzheimers) or why Rajesh Koothrappali can’t speak in front of women (persistent selective mutism). I can also say things like Pseudologia fantastica which is a really fancy way of saying pathological liar.
All in all 2016 has been a long year and it just doesn’t seem to want to end. People talk about the taxation of medical school all of the time, I hadn’t been able to fully relate to that till recently. I’ve been running on fumes for the better part of two months now. My studying efficiency has reduced quite drastically, having a hard time focusing, remembering things I’ve covered and I’m just always tired (I could sleep standing up tired). To make matters worst I’m having mini breakdown and anxiety attacks on the daily now. I get random tension headaches (yes I can say that now, I’ve covered some neuro) every second day so I literally have to continuously take pain killers because the traditional “take the night off to rest” is not an option right now.

In the mist of all this I’ve made what I consider a noble prize winning discovery. I have discovered a new mental disorder, I call it MSD which stands for ‘Medical Student Disorder‘. After almost two years in this place I’ve concluded that we’re all suffering from MSD.
It has an insidious onset, taking months to years to manifest, varies between people. It’s exacerbated by stress, sleep deprivation, constant studying and a bad coping mechanism. There are many risk factors but the highest is a successful application and enrollment into a medical school. Symptoms start off quite subtle; change in eating and sleeping pattern. Followed by exaggerated curiosity that turns into paranoia. The paranoia is manifested in the form of self-diagnosing and diagnoses of others with the rarest conditions. Every tall person must have acromegaly, every chubby person is suffering from Cushing’s syndrome, if they’re limping its Trendelenburg. In this block alone I’ve suffered from a bunch of psychotic, affective and personality disorders and such and such.
DSM 5 criteria for MSD requires one major and at least three minor symptoms;

– Major symptom – Be a medical student

– Minor symptoms;

  • self-diagnoses of every condition known to man
  • change in sleep pattern (insomnia or hypersomnia),
  • decreased or increase appetite,
  • abnormal relationship development (Naming a cadaver Sam and sharing your life drama with him in the dissection hall because he gets you),
  • desensitization (Thinking about having a fatty pizza for lunch while removing the subcutaneous fat from Sam abdomen’s)
  • social cognitions (difficulty to relating to normal people),
  • everyday you tell yourself you will get your life in order and everynight you tell yourself that tomorrow will be that day.
  • A random urge to binge drink (either before, after or during an exam).
  • Apathy towards your textbooks followed by intense guilt for not studying which you still ignore because you have apathy towards your textbooks.
  • Having an overwhelming amount of knowledge but thinking you’re immune to most pathologies (e.g. educating your mates at the local pub or the bartender serving about the effect of alcohol on the body while drinking your seventh round of the night).

It’s still too early in my studies on MSD  to confirm but I wouldn’t rule out signing all diagnosed patients to a mental asylum, I’m teasing but to be honest yes we’re all a little loco. We see the world in our own weird way – tell me this isn’t textbook psychosis.