Physician Sriram Shamasunder in a book excerpt published by YES! Magazine reflects on how his off-duty encounters with racial discrimination in and around a Los Angeles county hospital helped him find "common cause" with his minority and undocumented patients.
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Shamasunder, who is currently a physician at UCSF, contributed to the book, "Endangered Species, Enduring Values: An Anthology of San Francisco Area Writers and Artists of Color."
Shamasunder writes, "Our patients were mostly poor, often undocumented. The doctors were mostly white." During his residency, Shamasunder noted, he "worked and lived in the hospital so many nights, it felt like home."
But his experience differed when he wasn't wearing scrubs.
A 'get-out-of-jail-free' card
Shamasunder recalls one time when he went to the hospital on his day off to finish some paperwork. Although the day started off like any other, he writes, "Later that morning, I got stopped by a police guard coming out of the bathroom, suspicious I might have been shooting up in one of the bathroom stalls."
Shamasunder showed the guard his doctor's ID, and "immediately apologies flowed like water from an open faucet."
Shamasunder believes that his race was a factor in the incident. In street clothes, he writes, "my dark skin is so much like my patients.'"
From that day forward, Shamasunder said he carried his doctor's ID anytime he entered the hospital. "Suddenly," Shamasunder writes, the hospital "was not a home where I could move freely without question."
Months later, Shamasunder had another run-in with discrimination when he decided to drive to the ocean after a long shift. It was 11 p.m. and the lots were full, so Shamasunder began to look for an open space. "As I circle for parking in my sister's black, beat-up 2004 Jetta, I can see a cop car eye me as I come around the block again in search of parking," he writes. "My black, beat-up car and my nearly black skin in this dark night."
The officer followed Shamasunder before pulling him over. The cop was "rude," Shamasunder recalls. "He shines the light in my eyes and asks what the paraphernalia in the back seat is all about. He doesn't give me a chance to answer" or explain the "ophthalmoscope and reflex hammer" in the back.
Moments later, the officer spotted Shamasunder's white coat and doctor's ID with his flashlight. According to Shamasunder, the cop asked if he was a doctor. "I say yes, at LA County a few miles away," he writes. Just like with the guard at the hospital, the cop "apologizes and apologizes. He says he didn't realize I was a doctor," Shamasunder writes.
Finding 'common cause'
"My doctor's ID becomes a get-out-of-jail-free card," Shamasunder writes. "An 'I exist' card" that distinguishes him "from the Black, the Brown, the sick, the poor, the nameless, the undocumented—from my patients."
He notes that this validation of his existence is something his patients do not have—to the detriment of their health.
"If the soul is ignored long enough, the body rebels. A mass in the throat rises to the surface of the skin. A cavity in a lung riddled with tuberculosis starts to bleed. The body announces its existence," Shamasunder writes. He continues, "Sometimes when I fill out death certificates, I wish I could write the cause of death as poverty. Or American racism."
As a doctor, Shamasunder says he hopes to "make common cause" with these overlooked patients.
"As a doctor, I aim to stand with them before the beautiful fire of their lives becomes ash," Shamasunder writes. "In this country, the only way I know home is through them. I want to reclaim a space for home for the Black, the Brown, the nameless, my patients, myself. I try to find my home through them" (Shamasunder, YES! Magazine, 11/26).
How to address health inequity in your community
With the shift in health care to focus on optimizing the health of individuals and communities, health care organizations are creating new strategies to address health care disparities in access and patient outcomes.
Advisory Board has created the Health Disparities Initiative, which provides actionable resources on a series of strategic imperatives and special topics to achieve equity of care. Interested in seeing research or resources that address your biggest health equity problems?
Download our resource, "Building Community Partnerships to Reduce Disparities," which includes studies featuring providers who have successfully partnered with community organizations to address health disparities and social determinants of health. You'll also find tools that can guide your organization’s community partnership strategy.
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