AAP Voices Blog

“I can’t breathe.”

It is a statement that sends a physician’s heart rate climbing. To breathe is to live. To gasp this as a final plea of desperation is a true medical emergency. In a hospital, it sounds code alarms. It sends teams running. We understand the patient could be on the brink of death. Here, moments matter.

Given recent events, it is hard to ignore the constant suffocation of our communities of color. Our minority populations live in a chronic state of emergency.

As a physician in the Deep South, I know this is not new. I see daily evidence of disparities built upon centuries of our systemic and institutionalized oppression and dehumanization. I consider my vocation as a pediatrician here a privilege. But I struggle with the continual bludgeoning of our children’s naivete of society. And, as a white doctor in Birmingham, Alabama, I am challenged by my young patients’ questions, whether vocalized or implied.

“Why are people like me dying?”

How do I begin to answer this question in a 15-minute clinic visit? My mind immediately begins to trace the origin of racism and discrimination in our country. Do I have enough time to explain that centuries of slavery were unsatisfyingly replaced by failed economic reconstruction? That to be Black throughout the 20th century was to be terrorized and disenfranchised by white supremacy? Should I explain that just around the corner from us, a church was bombed because of the color of its congregation? Or that a few hours away, unrestrained police brutality made a Sunday particularly bloody?

“Before I send you home, I want you to know that this pediatrician is trying to be better.”

I sit here, wanting to celebrate that just south of this historic city, a woman refused to give up her seat on a bus to a white person. I want to underscore the letters Dr. Martin Luther King penned from one of our jails, including the declaration: “Injustice anywhere is a threat to justice everywhere.” But how do I convey that almost 60 years later, his words continue to be relevant? How should I acknowledge that pervasive and institutionalized racism has not relented, but only become more public through the ubiquitous lens of social media?

“But how do I stay safe?”

I hear you, and I am distressed for you. It seems almost trivial to counsel you or your parents on wearing a helmet or buckling your seatbelt when I know that, even in a neighborhood park, you are at risk of discrimination. I cannot, in good conscious, guarantee your safety through the practical advice of staying in school, abiding by the law and not getting involved in drugs. I mourn for your viability knowing that I was born with a presumption of innocence and, you, a presumption of guilt.

How do you stay safe, you ask? In my mind, I will desperately default to, “Don’t be black.” More realistically, I want to tell you to always have your cellphone ready to record. I want to apologize that you will undoubtedly face abuse because of the color of your skin instead of being lauded for the beautiful, dynamic complexity of your soul. I want you to know that we have to do better because our injustice system will fail you and, seemingly only through national outrage, will your story matter.

But before I send you home, I want you to know that this pediatrician is trying to be better. I want you to know that despite my best efforts, I still carry subconscious biases, but I am working to identify and reconcile them.

As your doctor and as a fellow human, I want you to know that regardless of who you are, where you are from, the injustices you have faced or are yet to face, you are special. You matter. You are loved more than you can imagine. At the end of our time together, I will give you a high-five or a fist bump or a hug because, despite our different races, you are safe with me and I will always feel safe with you.

And even though I may only occupy a few moments of your day, please know:

I hear you.

I care about you.

I seek to better understand you.

And I will never stop advocating for you.

This is a pediatrician’s promise.