We carry the burden of our patients’ past mistreatments. We know from history how doctors have participated in the medical violence brought upon Black people, transgender and queer community, and women–just to name a few. Think about the roles physicians played in the Tuskegee Syphilis Study which observed untreated Black men to learn the clinical outcomes of the disease, or our part in the separation of Indigenous children from their families in the Sixties Scoop and the Indian Residential Schools. While we ourselves may not have perpetuated this violence, to pretend that it did not take place is a huge clinical error.
We have to acknowledge the violent history of the medical profession. We have to recognize that the residual energy of this history lives within the clinical space where we meet with our patients. It inhabits the role we play. By understanding how historical violence interferes with the trust in our relationship with patients, we can begin to bridge the gap.
We do this by employing a trauma-informed approach, which I recommend using for any patient. As many of us know, belonging to a marginalized group isn’t a requirement for being traumatized. I’m a very privileged old white guy position and I’m still haunted by trauma.
Things doctors can do to address the burden carried by our profession:
- Commit yourself to working toward liberation of marginalized communities, including the removal of systemic barriers that impede access to healthcare.
- Take an Indigenous Cultural Training course offered by many health authorities and medical programs, and those of us working in medical education should ensure our students are learning and practicing in a culturally appropriate way.
- Make a donation of time and/or money to a non-traditional charity doing health work in a marginalized community where you are not a member.
- Inform yourself about cultural groups within your community that can support patient and, if needed, provide some patient navigation through the healthcare system.
