BCMS Medical Record Fall 2020 - 55

M edical R ecord F eature

Persist, persevere, prevail

I

by Gwendolyn A. Poles, DO, FACP

n the mid-1950s, a three-year-old, African American girl told
her mom she wanted to be a "missionary surgeon doctor." Now a
retired physician, her memory goes back to approximately sevenyears-old, always wanting to be a "missionary surgeon doctor." From
hence did that language come? How did a three-year-old toddler
form that phrase given the era and that her parents were not well
educated? Was it because she heard the word "doctor" at the hospital
or "missionary" at church? Hmmm...she developed theories over the
course of her career.

and there were no "work hour restrictions." The predominate patient
population at my hospital was wealthy, white people, so here we go
again. I was assumed to be the dietary aid - "Can you take my tray?";
the "TV Girl" - "I'm so glad you're here to turn my TV on" to which
I politely replied, "I'll tell your nurse, I'm Doctor Poles, how are you
today?" Then, "You're too young to be a physician." (I was in my 30s,
but I'll take the compliment.)

Despite racism, sexism, classism/caste (a word Americans don't
like to admit exists here), and physical disability, she persisted,
persevered and prevailed. Between hospitalizations, frequent clinic
appointments and regular blood transfusions, she graduated in the
top two percent of her high school class, completed her bachelor's
degree at Franklin and Marshall College (F&M) in 3.5 years and
graduated from the Philadelphia College of Osteopathic Medicine
(PCOM). Her teachers, school counsellors, nurses and physicians
told her to pursue a more "realistic career." Girls - let alone poor,
African American girls - were not supposed to be physicians. In
contrast, her parents told her to study hard to get a scholarship and
her church prayed for her health and supported her goal. Did I
mention that this aspiring physician had Sickle Cell Disease? Even
then she had to learn self-advocacy to prevent conflict between clinic
visits and school.

The last place I wanted to relocate to was Harrisburg - I swore I
would never return to Central PA given my horrendous experiences
at F&M and in Lancaster. Never say never as the saying goes.

I am that three-year-old that had the audacity to dream big and
work hard at achieving my dream, my calling. Between my family,
church and the Christian faith that I embraced I was able to and
continue to endure the racism, sexism and classism that persists
in America. Although my undergraduate college experience was
academically challenging, more importantly it was psychologically
and emotionally grueling. F&M had turned co-ed two years prior
to my matriculation but did not welcome women nor minorities.
Out of more than 500 students, 20 were African American.
Students, administrators and professors displayed overt racism. I
persisted, persevered and prevailed, fighting new barriers that were
intentionally designed to derail my calling.
Fast forward to eight years after graduating from college
when I entered PCOM whose culture was in stark contrast to my
undergraduate experience. With some exceptions, administration,
classmates and professors were kind and supportive. What a breath of
fresh air! Then during clinical rotations, the racism, sexism, classism
and ageism rose their ugly heads. Again, I persisted, persevered and
prevailed, but it was still exhausting.
Residency was physically challenging, but I remained relatively
healthy even completing an on-call night which resulted in working
36-hours with fever, chills and sweats due to a breast abscess. For
young physicians in those days you absolutely could not call out sick

I persisted, persevered and prevailed - I became the Chief
Resident!

Prior to relocating, a white man confirmed my worst fears and
advised me to live on the East Shore versus the West Shore, otherwise
called the "White Shore" - his words. Then I arrived and quickly
experienced racism within the medical community and area at large.
Examples included nurses refusing to help find patients' charts or
refusing written orders, security guards repeatedly stopping me when
coming back at night to see a patient, being ignored in leadership
meetings and being called the "N" word standing in line at a
department store.
Although I and others will persist and persevere, African
Americans cannot prevail alone. Our profession takes pride in being
a healing profession and "doing no harm," so why are we (you) not
helping to actively heal our profession? Health disparities are not
new. They stem from structural and institutional racism. Racial
implicit and explicit biases persist.
The percentage of African American physicians has decreased
from an average of seven percent from 1978-2008 to five percent
in 2018 (AAMC Diversity in the Physician Workforce Facts &
Figures 2010; 17th Report of COGME). Minority representation in
academia and leadership is dismal at best. The "ball" is no longer in
my court or the court of minorities aspiring to, pursuing a career in
or currently in the practice of medicine.
I urge you to take steps to evaluate how you have participated
in the continuance of the status quo or have actively sought to tear
down the institutional and structural racism in the systems in which
you work, the community where you live, the faith community you
embrace and the governmental policies you support. Physician heal
thyself for the sake of all.
Gwendolyn A. Poles, DO, FACP, is a member of the Foundation of
the Pennsylvania Medical Society Board of Trustees. This article
originally appeared in the fall issue of PHP Update, a publication of
the Foundation of the Pennsylvania Medical Society.
FALL 2020

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BCMS Medical Record Fall 2020

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