Is it even a thing to still use the term “woke”? Sam Sanders argues that “the muddling of the definition of woke is really what killed it” in his opinion piece entitled “It’s Time to Put Woke To Sleep.” He explains that woke came to represent a “shorthand for a worldview that values black lives” specifically contextualized by the social injustice of police brutality that fueled the Black Lives Matter movement. However, over the years since it’s resurgence, it has become a “buzzword” overused, often out of context, by well-meaning white liberals, corporations, and memes. While most would agree that words with the socio-political impact like “woke” are at risk for cultural appropriation, should that come at the expense of degrading the seriousness of its’ original intent? Even the first definition of woke in Urban Dictionary now reads “ the act of being very pretentious about how much you care about a social issue.” Is it enough to be “woke” when the white neighbor with the “In This House We Believe…” sign displayed in her front yard still doesn’t personally know anyone of color or people that identify as LGBTQ? Or, when a meme or quote on social media from so-called “woke”, bandwagon individuals in times of real, raw struggle becomes substitute for actionable solidarity? Not to mention when, in my profession, I continue to over hear “well-meaning” colleagues say things like “you know how those people are” in reference to patients and families of color, patients that may not speak English as a first language, and patients that may have lower health literacy. The reality is “well-meaning”, “woke” people can still be racist rendering the claim of wokeness without substance.
In medicine, race has conceptually and rightfully evolved from biological roots to sociological. Racism in healthcare has paralleled racism in society and continues to be a factor contributing to poorer health outcomes for Black Americans, Latino Americans and Native Americans. “Why America’s Black Mothers and Babies Are in a Life-Or-Death Crisis” by Linda Villarosa paints a vivid picture of this reality. She states that according to the Center For Disease Control (CDC), black women are three to four times more likely to die from pregnancy-related causes compared to their white counterparts. Black babies in America are also twice as likely to die as white babies. Even the American dream falls victim to racism. Both education and income offer little protection as a black woman with an advanced degree is more likely to lose her baby than a white woman with a less than eighth grade education. Further, some black patients are not believed by their healthcare providers when they present for care. Black women have shared stories about their provider’s dismissiveness to symptoms, disregard for pain, and angst when it comes to speaking with doctors. These women stress the absolute necessity to advocate for themselves. Implicit bias research in healthcare has found a significant, positive relationship between the level of racial/ethnic implicit bias and lower quality of care. As a black, female physician, I have a genuine stake in the racial injustice impacting black women. I am her and she is my sister, my mother, my cousin and friend. My wokeness propels me to engage “well-meaning” colleagues in the conversation of racism and to teach about the effectiveness of implicit bias training to save black lives.
Unfortunately, racism does not only negatively impact black patients. An article published in 2001 by the National Medical Association makes clear that black doctors are also “victims to varying degrees of discrimination in the U.S. at both personal and professional levels.” These include the peer review process, maintaining hospital privileges, and obtaining faculty appointments at teaching hospitals. Arguably, peer discrimination is often subtle and erodes the pretentious idealism of “progressive” work cultures. My personal experiences of discrimination from white, male physician colleagues and nurses have subjugated me to workplace isolation, belittlement, and disrespect. I have even had white parents devalue my skills as a medical doctor in performing standard procedures, stating a preference for a more experienced provider but were willing to settle for a white, non-surgical physician assistant. A valid response of anger and frustration is often curtailed for the sake of avoiding being seen as overly emotional, not a “team player” or unprofessional. These “curtailed” responses have become the status quo for people of color across industries faced with thinly veiled racism catering to white fragility. They are not in the interest of the victim. People of color suffer very real consequences as a result of workplace discrimination. In my case, it drove me to quit which is often what people of color, especially women do.
Black women makeup about 14% of total women in the U.S. population yet represent only two percent of practicing physicians. Numbers of black, female medical professionals in top leadership positions are even smaller. Data published by the Association of American Medical Colleges (AAMC), reported of all departmental chairs in academic medicine,14% were held by women faculty and only 3% were women of color. Embracing diversity and inclusion in the workplace has proven to produce positive outcomes. Specifically in healthcare, these outcomes include care better designed for focused populations, increased retention of providers of color, and a reduction in some patients’ distrust associated with healthcare systems. Women of color in work spaces challenge boundaries and create new realities. Bluntly, an organization’s idealistic mission and values will not be fully realized, particularly in healthcare delivery, until staff discrimination is addressed. This is rarely successful without white allies and people of color in leadership. It’s perplexing to expect healthcare providers to confront their own racial, implicit bias toward patients when it hasn’t been addressed with their peers. Genuinely woke healthcare organizations recognize these facts and intentionally attract a workforce that represents the diverse, patient population they serve.
Wokeness demands action and introspection. Action without introspection will be misguided and likely harmful. It’s not enough to post a quote, display a sign, or to have healthcare leaders wax poetic about the importance of equity in the workplace and yet fail to have real impact on the workforce. Wokeness is also relational. It inspires us to learn about the communities we serve. To invest in the neighborhoods we live in and to take an interest in a person’s story. I care about my neighbors of color because I know them. I care about my co-workers of color because I know them. I care about my patients of color because I’m interested in their story, have personal and/or professional relationship with other people of color and am invested in providing holistic care. Ultimately, authentic wokeness rises to every occasion, true to its original intent, because black lives demand it.