Category Archives: The Path We Took

The Path We Took

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Octavia M. Amaechi, MD

“Oh, you’re Dr Amaechi! You didn’t sound black over the phone!” The seconds following this all-too-familiar statement pass slowly. I glance at the weak, but recuperating, middle-aged patient I cared for over the past week on our busy hospitalist service. His wife had finally arrived to thoroughly review his complicated hospital course and plans for care after discharge after near daily personal updates from me via telephone. From his grim prognosis on admission, time spent at death’s door in the ICU, to making daily figurative and literal steps to recovery on one of our med surg units, we spoke frequently as her unforgiving work schedule and family obligations interfered with her ability to be consistently at his side.

Clearly surprised by the color of my skin she continues “I mean, you explained everything so well, and you don’t have an accent at all…” Still silent, I now glance at the nurse who paged me when she arrived as I requested. As a family physician, I aspire to the tenets of my specialty in every sphere—treating the patient and family in context of their values and individual needs. Patients are especially vulnerable when met with acute illnesses that invariably arrive at the worst moments. A milieu of diagnoses, tests and procedures, room transfers, fear and uncertainty, all heighten stress levels in the inpatient setting. Their values are tested (Do we want this feeding tube?) and their needs are unknown (How long will we need inpatient rehabilitation?). Consequentially, this environment can unshroud racial and cultural misperceptions, bias, discriminatory beliefs, or racism from those we family physicians have promised to serve.

His nurse speaks, “Yes this is Dr Amaechi. You spoke with her yesterday.” There’s another place I glance—to a much younger version of myself in fifth grade. In this moment, and unfortunately others like it, I recall my earliest memories of being accused and teased by classmates for “sounding white.” I am the first American born into a Jamaican immigrant family. I was raised in a neighborhood heavily influenced by Caribbean and a multitude of other cultures from around the globe in the very heart of Brooklyn, New York. How could I sound white, I thought? How do you sound like a color? At 9 years old I had no clue what this meant, but the words from my peers stung. I eventually realized, disheartenedly, that loving to learn, being intelligent, speaking with clarity, and other positive attributes were and often still are associated with whiteness.

Thankfully my social support system, especially my parents and older sister, setting clear expectations and giving constant affirmations outweighed the threat of peer pressure and stereotype conformation. I was encouraged to work hard for whatever I wanted, but also given the freedom to not be perfect. With very few resources and even less knowledge about the American education system I was instilled with miles of grit. Now as a faculty physician at the family medicine residency program where I trained in South Carolina, I still benefit tremendously from a strong professional and personal support system that now includes my husband and two children. Here I have succeeded in positions that align with my strengths, passions, and talents both inside and out of our large community-based hospital system. I have the privilege of teaching medical students and residents alongside outstanding family physicians. I have been awarded the distinction of Fellow of the American Academy of Family Physician and Designation of Focused Practice in Hospital Medicine. I have been elected chair of family medicine within my hospital system, chair our local women in medicine group, and am a board member elect of the county medical society.

Similarly, as an STFM member for just under 2 years I’ve received tremendous mentoring and sponsorship, been entrusted with leadership roles, and continue to collaborate on multiple initiatives and projects with family medicine colleagues across the country. I have been elected to serve as co-chair for the New Faculty Collaborative. I am also quite blessed and excited to work one on one with amazing mentors from the Minority in Medicine Collaborative as a recipient of the STFM Underrepresented Minority in Medicine Writing Scholarship. My STFM membership has allowed me to create many meaningful relationships, and simultaneously ignited my path for academic advancement. In fact, I can now add international conference speaker to my portfolio with successful presentations at the 2019 STFM Annual Spring Conference in Toronto, Canada!

I glance once more to my recovering patient. While there is no single right way to navigate such an encounter, this time my direct silence has spoken volumes. His wife realizes her error in thought and perception grounded in implicit bias that we all undoubtedly have in one form or another. She apologizes and once again my presence has changed the narrative of what one perceives a capable, caring, intelligent, physician to be. We discuss the most pressing concerns and I answer her questions, including one unexpected, but always warming: “Can you be our family doctor once he is discharged?”

One patient, one family, one learner, one presentation, one leadership position, one outreach endeavor at a time—as I strive for professional and personal growth and advocate for the community around me, I hope my life will always silence stereotypes of what a black voice can be.