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- I have come to understand 
that in the fight

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for health equity, my presence 
as a Black woman physician

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is welcome so long as I 
am seen and not heard.

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This conditional acceptance 
has been a painful realization,

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and dissent is not 
without its consequences,

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a lesson I learned one 
night while working

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on the adult inpatient 
medicine ward.

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I received a call from 
the nurse of Patricia,

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a Black sickle cell patient.

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I learned that a pill find 
while cleaning out her handbag

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had been identified as 
a narcotic medication.

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Security and nursing staff 
requested our presence

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for a room search.

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Patricia's mental 
status had not changed.

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There had been no change 
in her vital signs

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or clinical status, and 
there was no indication

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that she had consumed any pills

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preceding security's presence.

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Upon relaying this to the nurse,

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and asking for time 
to review the policy,

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she paused briefly before 
asking me to confirm

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that I would not 
be participating 
in the room search.

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I sat for a while 
in stunned silence.

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If a room search was 
indicated for Patricia,

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why had it not been 
indicated earlier in the week

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for my other patient who 
happened to be a white male,

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when he left the unit, 
returned somnolent,

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and returned to normal 
when he got Narcan,

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the antidote for opioid 
pain medication overdoses.

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By the time I had learned 
there was no defined

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room search policy, 
it had concluded.

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When I visited Patricia 
later, she wept

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while recounting the 
indignity of being separated

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from her belongings, 
and being patted down

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by uniformed staff.

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Nothing had come 
of the room search,

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but she was left to pick up 
the pieces of her mistreatment.

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My internal response 
was a visceral thing.

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A living, breathing 
amalgamation of ancestral voices

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coalescing into a single 
reverberating word.

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No.

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This was wrong.

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But even rooted in the 
assurance of advocacy

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and social justice, an 
insidious, intoxicating fear

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pressed forward, 
determined to lull me

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into the safety of silence.

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Speaking up would be a 
radical act of defiance

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for a Black woman who 
has been conditioned

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to keep her head 
down, to be agreeable,

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to not make trouble.

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When Patricia's nurse 
asked to debrief,

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I steeled myself in a 
stance of curiosity,

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and asked many questions.

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What was the concern from 
a nursing perspective?

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How could we have improved 
our communication?

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How do we make decisions 
on when to implement

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a room search?

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What alternatives did we have?

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When invited, I shared 
my own perspective.

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Together, we created 
a plan to address

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similar concerns in the future.

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We shook hands and hugged.

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The chasm between us 
didn't feel so wide.

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While it wouldn't change 
what happened with Patricia,

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we could prevent harm 
to another patient,

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and that was something.

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The next night, I was 
informed that nursing staff

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had filed a complaint stating 
I had been unsupportive,

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and refused to act 
collaboratively.

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First came shock.

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Then anger.

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And when the anger was spent,

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an overwhelming 
emotional exhaustion.

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I cried for days afterward.

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It had taken me years of 
training and education

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to learn to abandon 
the lessons handed down

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by my forefathers to 
keep my head down.

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To be agreeable.

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To not make trouble.

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I wonder if they understood

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that through the weaponization 
of their feedback,

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they had taken something from me

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that I couldn't get back.

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What had they given up?

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I was ready to have 
difficult conversations

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to bridge the divide.

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But even though I had arrived,

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had been welcomed, even,

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I am still subject to 
the same inequities

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that my patients face.

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I think of Patricia often.

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I worry that the damage 
done to her is irreparable.

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I worry that 
progress is too slow,

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and patients are being harmed

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while we strive 
for what could be.

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I worry that while I believe

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being the dissenting 
voice was right,

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I may not always 
have the fortitude

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to always be a voice 
for the voiceless.