My grandmother died 12 years ago this week from colon cancer, at what some people might call the ripe old age of 82. I know the truth: due to lack of adequate medical care, she died too young. I also believe that race was a key factor. That I can only infer, though with plenty of evidence black lives are cut short through inadequate healthcare.
Reading Ta-Nehisi Coates’s lauded new book, Between The World and Me, and the many responses to it, I am cheered, in a grim fashion, by the rise in attention to physical and economic violence against black Americans. Part of that physical violence comes at the hands of the medical establishment. A study by the National Academy of Medicine found that, “minorities are less likely than whites to receive needed services... even after correcting for access-related factors, such as insurance status.” Of course, wealth inequality worsens that picture. Gender is a factor too. For example, black women are more likely to suffer from autoimmune disorders like lupus, but doctors are less likely to treat and manage their pain.
I have been deliberately provocative – calling the lack of regard for black lives “violence” when most others term it neglect – because it destroys, not just the individual, or the family, but the very trust of the medical establishment itself. It erodes the faith of patients in the will of doctors to have their best interests at heart, even when most caregivers do. If we now say #BlackLivesMatter, we must say it in healthcare as well as in all other spaces.
I come from a family full of healers. my sister and cousin are doctors. My mother worked for many years as a medical technologist, in the United States and in Morocco in the Peace Corps. But none of that changed the math when my independent grandmother spoke to her doctor. She was an old black woman. Her doctor never gave her a colonoscopy, for which she was well overdue at her age, not even after months of repeated complaints about intestinal distress, which he treated with palliative remedies like antacids. When the diagnosis of advanced colon cancer came back, apparently his face fell in shame. She lasted three more hard years, mainly hanging on for her family, I think. She and my family never sued. We are not the suing types. But sometimes I wonder if we made the wrong decision; if a lawsuit would have declared that her life mattered, not only to us but to society at large.
Who was Mary Catherine Stokes? She grew up poor and smart. She was a devout but not unquestioning Catholic who visited the Vatican and organized Easter egg hunts for local children; mentored young professionals; loved to entertain and made a mean lasagna. She wrote prose and fiction for the Baltimore Afro-American, raised six children, and later worked for the Post Office and the Social Security Administration, rising to a managerial level at the latter despite not having a bachelor’s degree. In an oral history I did with her and later played on NPR, she spoke of the many racial battles she faced during her life, including being blacklisted for years at Social Security for pointing out that in her office, for people screened using a specific aptitude test, all white applicants got hired before any black ones, regardless of their scores. She was later awarded a commendation by the agency for her principles. In our interview, she added discrimination never prevented her from seeking true friendships across racial lines, stating both wryly and truly, “Some of my best friends are white.” Given the longevity in her family history, my grandmother may well have been alive today.
I also wonder about my friend Teshima Walker Israel, who died two years ago this summer, also of colon cancer, also after having to beg to be treated when doctors dismissed her symptoms. I will never know if they fit the pattern of racial violence in healthcare, but we know it exists.
Thankfully New York, where I live, has a hero of a healer in Mary Bassett, the head of the Department of Health. A native New Yorker who practiced and taught medicine in Zimbabwe for many years, she is acutely aware of how everything from police violence to food deserts affects public health, and is not afraid to speak publicly. Her commentary earlier this year in the New England Journal of Medicine pointed out that black New York City women are 10 times as likely as white ones to die in childbirth, and “the tragedy of [black] lives cut short is not accounted for entirely, or even mostly, by violence.” I hope her work is taken seriously within the city, and her leadership by others in public health.
I cried for my grandmother this week, and for myself. I miss Mary Catherine so very deeply. Our hometown, Baltimore, needs women like her – the elders, the anchors, the soul-mothers who hold communities together. Gun violence may disproportionately target the young. But health violence cuts down people of all ages, who nonetheless die before their time, and leave our society the poorer for it.
