We live in a world that includes conflict and misunderstanding. Often these misunderstandings occur with friends. Frequently, understanding the “intent” behind the misconception and its “impact” diffuses the conflict. Resolving the discord requires leaning into discomfort by embracing a courageous conversation regarding the impact. Racism and internalized oppression complicate the relationship between “intent” and “impact.”
In the spring of 1988, as an intern at a Children’s Hospital in a major urban city, I worked 100 hours a week, which included at least two sleepless nights. As the only African American resident in the program, the isolation could be profound. I found solace in the relationships formed with black ancillary and janitorial staff, and many of my Pediatric patients and families.
I met Jennifer, my closest fellow intern, for lunch. As we talked about the patients admitted to the hospital the night before, a comment from Jennifer filtered in from nowhere. She said, ” You know Stacie, I don’t see you as black.” Her tone was complimentary – light, airy, simple; the meaning, an insult – grave, surprising, hurtful. As I looked at her perplexed, she continued to explain herself by saying, “You are so articulate and well-traveled. ” Seeing that I wasn’t rushing to validate what she was saying, she kept talking. At no point did I correct her.
As I experienced this microaggression, I chose not to lean in, stop her rant, explain the misunderstanding. I decided not to educate her on the impact of her assumptions about me. I am African American, and my community is heterogeneous. My culture defines me. I am black, and I am proud.
We slowly drifted apart. I answered calls less frequently. The depth of my conversations became shallower. We found friendships elsewhere. I doubt Jennifer would point to her comment as the cause for us drifting apart, maybe she would. I will never know.
Fast forward 25 years, and I would have handled the interaction differently. I would have confronted the microaggression, explained its significance, and educated Jennifer about her assumptions and stereotypes. I would have reminded her that for me being the “exception Negro” was not a badge I ever looked forward to wearing. And, more importantly, that her comment assumed that being articulate made me less black and more white. It was a lost opportunity to educate someone about the power of the impact, regardless of intent.
Stacie L. Walton MD, MPH, recently retired from Kaiser Permanente as a clinical Pediatrician serving in the roles of both Diversity Champion and Communication Consultant. She served as a medical consultant in diversity issues for healthcare providers and institutions for over 25 years. Currently, her cultural competency themes highlight the impact of implicit bias and privilege in patient interactions and health outcomes, as well as, how effective patient-provider communication requires both competences and humility.
Stacie Walton MD 