Black Doctors Say Pandemic Reveals Enduring Racial Inequity Medicine Alone Cannot Fix

Jun 27, 2020
Originally published on June 27, 2020 3:22 pm

Dr. William Strudwick was finishing a shift at Washington, D.C.'s Howard University Hospital when his wife, Maria, texted. Their 19-year old son, Cole, wanted to join a protest five days after the killing of George Floyd.

It was 9 p.m. After dark, Strudwick weighed, he couldn't predict how protesters would act — or how police would treat his son. He wrote back one word to his wife: "No."

"When I came home, he was not there, and so I called him," Strudwick said. "And we had the conversation about him returning immediately."

To Strudwick's relief, the teen came home.

About one in six doctors in D.C. is African American, like Dr. Strudwick, according to the city's Department of Health. That's three times the national average, although still a small portion compared to the population that's 46% Black.

These doctors see in their wards some of the African American patients who make up the vast majority of the city's COVID-19 fatalities. For Dr. Strudwick, Dr. Janice Blanchard at George Washington University Hospital and Dr. Marcee Wilder at United Medical Center, working amid the pandemic, inspires a sense of duty – and sometimes despair.

Wilder, 38, grew up in New York and said she saw little difference between her childhood in Harlem and the mostly African American neighborhood where she works.

"I see myself in this community," Wilder said. "And so watching them suffer has been pretty hard."

Blanchard, 51, said she works to counter implicit bias that can lead to poorer health for Black patients.

"I think as a Black doctor, it's my responsibility to do everything in my power to make sure that a Black patient is getting fair treatment," Blanchard said. For many COVID patients, that was not enough. "You feel helpless, almost, that you're not able to help them."

A Black medical center

Strudwick, 57, was born in what was the Freedmen's Hospital, founded in 1862, to treat formerly enslaved people. Today it's part of the historically Black Howard University, where both of Strudwick's parents studied to become physicians. Growing up in Washington, D.C., it seemed natural to follow in their footsteps.

"The mayor was African American. All the doctors that I encountered were African American. Lawyers, politicians," Strudwick recalled. "So you didn't see any obstacles in terms of what you could do."

That Black middle class has been relatively insulated from the pandemic, Strudwick observed. So he was baffled when a friend suddenly passed away. They were the same age and they raised their kids together, two African American men appearing to lead parallel lives. But the friend died alone at home. His family blamed COVID19. Dr. Strudwick wondered if his friend quietly struggled to afford healthcare.

"He should have had access. He could have called me," he said.

Dr. Janice Blanchard stands outside George Washington University Hospital, where she works as an emergency medicine physician.
Tyrone Turner / WAMU

Challenge isolating large families

The frustration is familiar to Dr. Janice Blanchard, who noticed the public health guidelines for COVID-19 did not fit the lives of some of her patients at George Washington University Hospital. She remembers calling an African American patient to give a positive COVID-19 test result and hearing a crowded household on the line.

"And then, you're like, okay, I sound pretty silly," she said. "I'm telling them to socially isolate ... with seven people?"

Growing up in Chicago, Blanchard said her family had modest means, too: her mother was a teacher and her father, a bus driver. While treating the pandemic, Blanchard and Wilder cowrote a paper with other Black doctors in D.C. for Academic Emergency Medicine. They said COVID-19 was more fatal for their patients of color who had chronic disease; those patients developed those diseases because they lacked good food, space to exercise, housing and regular income.

"As Black and brown people, we're already starting off behind, right? And now you have something like COVID that's just devastating communities," Blanchard said.

'We need allies'

D.C.'s highest COVID-19 death toll is in Ward 8, a mostly African American area where Wilder works at the city's only public hospital. One man in his 70s arrived gasping for air, suffering from COVID-19. Wilder met with his daughter and explained his chances were not good.

Dr. Marcee Wilder stands outside United Medical Center, the public hospital serving Wards 7 and 8. She says her patients were more vulnerable to COVID-19 because they had less access to good food, steady income and reliable healthcare.
Tyrone Turner / WAMU

"As I was leaving the room, I remember her asking 'if he's not going to make it, can I come see him?' And I had to tell her no," Wilder said.

The man died less than a week a later.

Wilder said the man had high blood pressure, which worsened his chances. She said his death reflected the disadvantage of the neighborhood.

"Nothing would have helped even if UMC was a brand new, $20 billion dollar hospital, that would not have changed the outcome that we're seeing in COVID," she said. "This is not a medicine-related problem. This is a social determinants of health, poverty related, marginalized community problem."

Lately, the three doctors say COVID 19 cases have slowed. But Wilder says being African American weighs on her as she thinks about George Floyd's death and about who is worst affected by the coronavirus.

"We need allies. We need people in powerful places to see our humanity and decide that the time is now for action," she said.

That is why she marched with her husband and their two young daughters for racial justice in early June. Without coordinating, Blanchard attended that same rally, packing hand sanitizer and holding a Black Lives Matter sign above her head near the White House. And Strudwick and his wife walked three and a half miles from home to reach the protest.

The three doctors say the pandemic revealed enduring racial inequity — and medicine alone cannot fix it.

Copyright 2020 WAMU 88.5. To see more, visit WAMU 88.5.

MICHEL MARTIN, HOST:

Here in the U.S., the coronavirus pandemic has disproportionately affected African Americans, and many Black medical professionals have experienced that on the frontlines. Reporter Daniella Cheslow of member station WAMU in Washington, D.C., spoke to several African American physicians about working through this pandemic amid ongoing protests for racial justice.

DANIELLA CHESLOW, BYLINE: Dr. William Strudwick was finishing a shift at D.C.'s Howard University Hospital when his wife texted. Their 19-year-old son wanted to go protest the killing of George Floyd.

WILLIAM STRUDWICK: It was in the evening, around 9 o'clock.

CHESLOW: He wrote back one word - no.

STRUDWICK: When I came home, he was not there. And so I called him, and we had the conversation (laughter) about him returning immediately.

CHESLOW: The teen came home. Dr. Strudwick said, after dark, he couldn't predict how protesters would act or how police would treat his son. Dr. Strudwick was born in D.C. in a hospital built to treat formerly enslaved people. Both of his parents were physicians, and growing up, he had few doubts about following their path.

STRUDWICK: The mayor was African American. All the doctors that I encountered were African American - lawyers, you know, politicians. You didn't see any obstacles in terms of what you could do.

CHESLOW: COVID-19 has hit close to home.

STRUDWICK: Pretty early on in this pandemic, I had a friend who suddenly passed away.

CHESLOW: He and Dr. Strudwick were the same age, and they raised their kids together. It seemed like they were both in the Washington Black middle class. But the friend died alone at home. His family blamed COVID-19. Dr. Strudwick wondered if his friend quietly struggled to afford health care.

STRUDWICK: He should have had access. He had that. He could have called me.

CHESLOW: That sense of duty and sometimes helplessness is familiar to Dr. Janice Blanchard at George Washington University Hospital. She says she called up an African American patient who tested positive for COVID, and she could hear a crowded household on the line.

JANICE BLANCHARD: But then you're, like, OK. I sound pretty silly. I'm telling them to socially isolate with seven people.

CHESLOW: In Washington, three-quarters of the people who have died from COVID-19 have been Black, and Dr. Blanchard saw the same trend in her hospital. Those patients often worked in service jobs that exposed them. They were frequently low-income. Dr. Blanchard recognized these challenges from her childhood on Chicago's South Side.

BLANCHARD: As Black and brown people, we're starting off behind, right? And now you have something like COVID that's just devastating communities.

CHESLOW: Dr. Marcee Wilder feels that same frustration. She works in D.C.'s only public hospital in the part of the city with the highest coronavirus death toll. Almost all her patients are African American.

MARCEE WILDER: I see myself in this community, and so watching them suffer has been pretty hard.

CHESLOW: Dr. Wilder remembers treating an elderly man who had COVID and high blood pressure. That's common among African Americans and common in the neighborhood where Dr. Wilder works. She met with his daughter and explained his chances were not good.

WILDER: And as I was leaving the room, I remember her asking - she said, if he's not going to make it, can I come see him? And I had to tell her no.

CHESLOW: In the last few weeks, all three doctors say COVID-19 cases have slowed down. Their work treating the pandemic has gotten easier. But Dr. Wilder says being African American weighs on her as she thinks about George Floyd's death and about who is worst affected by the coronavirus.

WILDER: We need allies. We need people in powerful places to see our humanity and decide that the time is now for action.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED PROTESTERS: (Chanting) George Floyd, George Floyd, say his name, George Floyd.

CHESLOW: On the first Saturday in June, Dr. Wilder filmed this video as she marched with her husband and two daughters. Dr. Blanchard also joined the protest, packing hand sanitizer and holding a Black Lives Matter sign above her head near the White House. And Dr. Strudwick was there with his wife. The three doctors say the pandemic revealed enduring racial inequity, and medicine alone cannot fix it.

For NPR News, I'm Daniella Cheslow. Transcript provided by NPR, Copyright NPR.