Find your Calling
MEDICAL AND MENTAL HEALTH UPDATE
Today I have the honor of presenting a guest post by the indefatigable Jennifer Thelus, a current Howard University medical student. She is also my former medical assistant and future colleague. Jen is going to make an amazing doctor! Here she shares her experience as a Black woman in medicine—plus her hopes and dreams for the future:
My name is Jennifer Thelus. I prefer Jen because Jennifer always makes me feel like I’m in trouble. I’m a first generation Haitian-American born and raised in Houston, TX. I moved to DC about 7 years ago when I started my undergraduate career at American University. After graduating from AU, I spent two years working with Dr. McBride at Foxhall Internists before starting medical school at Howard University. Growing up, I was one of those kids who always knew she wanted to be a doctor. It felt natural, like it fit with my character. As a doctor you are committed to learning and serving others in perpetuity. My experiences thus far, whether volunteering in the ICU to working at Foxhall, have only solidified that. Working so personally with Dr. McBride, I was able to pull back the veil on what it really looks like to be a physician—from the relationship built with patients to work-life balance. It was during this time that Dr. McBride went from being my boss to my mentor, and I’m forever grateful to have someone like her in my corner.
Arriving at medical school was a journey in and of itself for me. The biggest part was convincing myself that I belonged there. I mean of course I belong here, I worked in research labs, had tons of clinical experience and exposure, led community service projects, and supported grassroots community health organizations in Haiti. But imposter syndrome is real! The people I encountered through various opportunities rarely looked like me. I could count the number of students in my AU science classes that were Black, much less Black women. It often left me wondering, how I could be a part of something that rarely resembled me?
Minorities are faced with barriers to medical school that some may never experience. The most common and burdensome are financial barriers. There is a cost associated with everything. To name a few—registering for the MCAT, primary applications, secondary school applications, travel to and from interviews in addition to accommodations. MCAT classes alone easily cost $3000 and even up to $6000 not to mention transportation to and from each class, as most are in person. Most people I know, including myself, had to open credit cards just to pay application fees and book tickets during interview season. The MCAT, and the entire medical school application cost, are gatekeeping mechanisms. It has been proven the MCAT, like SATs/ACTs, are not effective measures of success in medical school, but rather a way to maintain a homogenous profession of the historically elite and privileged. Luckily, I had a community of support behind my efforts and I finally started medical school in the fall of 2019.
It seemed like the end of a journey, but, in reality, my journey in medicine had just begun.
Now with a year of medical school under my belt it feels surreal to finally be here. School at an Historically Black College/University (HBCU) is different. Our education is not only based on textbook learning but also experiences within the underserved community. It is crucial to understand there are things aside from medical conditions that affect patients’ illnesses and recovery. Books like The Spirit Catches You and You Fall Down by Anne Fadiman demonstrate that ignoring the beliefs and cultural backgrounds of patients during treatment can be detrimental to patient recovery.
My education at Howard is rooted in actively working to undo years of medical racism that led to atrocities like the Tuskegee Syphilis trial (Medical Apartheid by Harriet Washington outlines this dating back to slavery), and closing the health disparity gap. For example, Black women die at an alarmingly disproportionate rate during childbirth where mortality rates increase with level of education. In doing this intentional work to combat centuries of institutional racism, I hope to eliminate biases that affect the way minority patients seek medical attention and increase positive outcomes in treatment.
Right now, life as a Black medical student is hard. Shoot, life as a Black woman is difficult, period. I walk with a smile glued on my face in hopes of conveying to others, “I’m not a threat.” I watch my tone to make sure I’m not perceived as the “stereotypical angry Black woman.” I live in a constant state of fear for the lives of my Black classmates, men and women alike, afraid they may be taken too soon and never get to see the changes they make in their respective fields. I fear I may never get to see my nephews grow up because of the color of their skin. I fear I may never get to be the amazing physician I am working on becoming. But as a student consistently drinking from the proverbial fire hydrant, I often have to stuff those feelings in a box because I cannot afford to be weighed down by the heavy burden that is being Black in America. There is work to be done. If I plan on making a difference—a real difference—I need to be at the top of my game because there is no room for mediocrity. Mediocracy from Black women is not rewarded, much less tolerated.
There seems to be an endless slew of Black lives lost at the hands of police for unjust reasons, and medicine is no different. My mission is even clearer now. Black lives matter, not only when dealing with police brutality but also in medicine. Medical racism is pervasive. Just look at the first autopsy report rendered by the coroner’s office on George Floyd. To ignore this is woefully ignorant. As a future Black woman physician committed to saving lives, I cannot be complicit, and neither should other medical personnel.
In order to move forward in medicine we must address the pervasive, covert racism that exists. Three things that I believe are great jumping off points:
More minority representation in medical school literature. There are fundamental differences between white and black skin. The rosy appearance of a disease on white women looks different on a Black woman and can lead to a different diagnosis. Textbooks should reflect this. How can we expect doctors to be knowledgeable on all racial backgrounds if they are not exposed to it?
Physicians must be willing to recognize and unpack their biases to understand how they may affect patients. Instead of writing that a patient is noncompliant with their hypertension medication regime, ask more questions, go deeper. Can they afford the copay on the medication they were prescribed? Do they understand how the medication regimen is explained?
Insurance reformation. Fighting with insurance companies to receive basic medical care, at the very least, is unacceptable. It is imperative that everyone has access to insurance regardless of race, job status, or socioeconomic status.
I plan to dedicate my life to medicine, to ensure that the intentional work of combatting systemic oppression and medical apartheid continues. Although I am unsure which field I plan to specialize in, one thing is for certain I will be the people’s doctor—likely as a surgeon. My dream is to become the next Paul Farmer, as he has dedicated his life to the betterment of others.