Searching for Absolution

In recent years, issues of race, gender, privilege and bias have remained unresolved as society struggles with the economics of identity and class equity. Communities that are directly harmed by these unresolved conflicts are often left to also manage the fallout that results from the harm. Without adequate tools to process the pain associated with systemic inequity and bias, the behaviors that caused the harm are often perpetuated by the harmed population. Thus, harmful behaviors and practices are woven into the fabric of society through inertia and unhealthy coping mechanisms. This pattern may be easier to identify from a macro view of society, however, it’s often much harder to identify and course correct when experiencing harm on a personal level.

We are all capable of being harmed and causing harm. Taking responsibility for our conduct is not simply an act of guilt or acknowledgment, this often requires some proactive ability to prevent harm. But, preventing harm is not about walking around on eggshells hoping that you don’t hurt anyone. Preventing harm is the practice of acknowledging other perspectives because no individual is at the center of the moral universe. My recent experience at Bellevue Hospital provided me with an opportunity to reflect on how important it is to be mindful not to replicate the behaviors of the harmful, even under the threat of my own harm.

In December 2022, I experienced some serious heart symptoms that required a trip to the emergency room. My partner and I decided to go to NYU Langone, where my cardiologist works. As we drove from Brooklyn into Manhattan, I began to panic as my symptoms grew more severe. As we turned on First Avenue from the FDR Drive, we were rushing and I mistakenly identified Bellevue’s Emergency Room entrance for NYU Langone’s Emergency Room entrance (they are a block apart from one another).

While I dislike hospitals in general, walking into Bellevue’s Emergency room caused my discomfort to grow exponentially. There were several people in handcuffs with visible injuries, the facilities were unclean and the staff was unpleasant. Further, there were a few dozen people clearly affected by RSV, Flu or Covid symptoms in open areas. Additionally, several people in the emergency room were only seeking shelter for the night and at least ten people were in the middle of mental health crises. The hospital appeared ill-equipped to help any of these people. There were a few nurses milling around but there were only two doctors to treat the dozens of people. And then there was me, dealing with a heart issue and trying to control my anxiety from exacerbating the issue.

By the time my wife finished parking the car and met me in the emergency room, my EKG and bloodwork confirmed that I needed urgent treatment. So, when she told me that we were in Bellevue and not NYU Langone, I thought it was too late to leave. Although she tried to convince me to head across the street to NYU, I decided to stick it out at Bellevue since we were already there for an hour. After two hours, I was moved from the hallway to a bay with curtains. Having very little contact with a doctor, I began to worry. I expressed my concerns to a doctor who patted me on the back and told me that they would see me soon. After 4 hours a nurse told me not to worry and that she “wouldn’t place a crazy person” next to me because I “seemed normal.” After 5 hours, a young man with a finger partially cut off was placed in my bay. As blood was pouring from his hand two feet from me and he answered questions about his use of opioids and current treatment for STI’s, I told my wife we needed to leave. She gave me the “I told you so,” look and informed the nurse. The nurse sucked her teeth and said, “well, you need to wait for the doctor.” We waited 10 minutes for the doctor and when no doctor appeared, I removed the IV from my arm and we left.

As we approached the front exit into the street, a female doctor came running out towards us and demanded that we stop. We turned around and informed the doctor that we were going to NYU Langone because the environment was making me anxious. The doctor said, “well just for your information, I could have you arrested for leaving with an IV in your arm.” I told the doctor that I removed the IV and showed it to her. She asked that I throw it in the garbage. I threw the IV in the garbage and that’s when two hospital police that she had called, appeared. The hospital police asked the doctor if there was an issue and the doctor told them that I was unauthorized to leave the hospital with an IV in my arm. I told the officers that I just showed the doctor the IV and threw it in the garbage based on the doctor’s instructions. The doctor then replied, “he flashed something in my face but I’m not sure what it is- check his arm.” I refused to allow the officers to check me and proceeded to walk out the door. The doctor screamed to the officers, “arrest him.” Thankfully, the officers looked at the doctor incredulously and said, “he didn’t do anything.” The doctor grew flustered and went back into the Emergency Room. When I saw the doctor walk back to the Emergency Room, I went back to the officers, showed them that my arm did not have the IV and said something that made my wife cringe (it makes me cringe to repeat it). I said, “I’m a doctor and a lawyer and I know how I should be treated in a hospital.” And these words define a problem that would require honest reflection in order to identify.

I went to NYU Langone, had an emergency procedure, received world-class treatment for 3 days and was sent home to heal. And although I was thankful at the outcome, I was angry every time I reflected on the doctor ordering the police to arrest me. But as my wife continually reminded me, I needed to examine why I said, “I’m a doctor and a lawyer.” Yes, I have these degrees. But those details were never relevant to my treatment. My humanity is what qualifies me for care because educational titles can be illusory and misplace human worthiness. So, as I was prompted to dig deeper, I reflected harder on what troubled me. While I am a black man and the doctor was a white woman, just labeling her racist would be reductive. It would be reductive of her pathology, but also reductive of my response. Because although she had relegated me to being a criminal because I wanted better medical treatment, I had very little insight into her perspective, experiences or incentive for requesting such a harsh step. And while I’m quite sure race was an important factor in her assessment of me, I am much more concerned about the classism I embraced in response.

Maybe I was a bit understated in how I described the Bellevue Emergency Room. The Bellevue Emergency Room was filled with an inescapable level of trauma. The trauma of housing insecurity, mental illness, sickness, death and poverty was so palpable that no one in its orbit could escape it. And so this doctor was providing trauma informed care under the influence of her own trauma. A trauma that I do not understand, nor do I care to accept. That trauma is shrouded in her own thoughts about who should have the right to exercise agency over themselves and their medical care. Clearly, this black man should not have the right over his medical decisions. And, while I believe race influenced her decision to call for my arrest, her prejudice was based on how she viewed my social class. Sadly, my decision to cite my resume indicates that I subscribed to the same value system. I didn’t say, “I’m a human being and I have a right to seek better treatment.” I qualified my right to decent treatment by citing my education level. And, in that moment, I was exposed for embracing this woman’s value system by qualifying myself for humane treatment.

So, what was I supposed to do with these feelings? I was angry at this racist doctor for calling the police on me, yet I needed to resolve my need to explain my worth. That’s the flaw with some black responses to racism. We legitimize class-based racial arguments by explaining our worthiness as based on some human accomplishment. But, all humans are worthy of decent treatment. Even humans that miss the mark or commit crimes deserve decent treatment. But, I justified my worthiness with illusory titles that don’t actually establish anything good about me. I could be a doctor and lawyer and still be a terrible human being. And, now I was angry. I wanted to call my friends in local government and report this woman’s behavior. I wanted to create a viral social media post to call out her conduct. But those efforts would only stroke my oversized ego and would not solve any problems. Exposing a racist doctor might seem like a solution, but the trauma in that emergency room would only produce another problematic doctor. And, it would be intellectually dishonest to simply relegate her as a racist when my response was complicit with the problem. An honest examination of the events that took place required me to interrogate the systemic framework that justified the differences in these two hospitals and the disparate treatment based on class and economics.

And so this isn’t the “gotcha moment” that will “cancel” some flawed human, even though she is causing harm. It would be disingenuous to condemn this doctor in a search for absolution when she only accepted a set of values that have been given to her. Especially, because I accepted those same values, yet only became offended when they did not work in my favor. Indeed, I accepted the benefits of being treated at a better hospital. But do we live in a society where you are relegated to the racial and social justice that you can afford? That’s certainly the message and the standard I accepted as I left the under resourced Bellevue hospital and its under-served patients. Perhaps, I felt uncomfortable because I felt that I was better than my fellow patients at Bellevue. Maybe, I felt guilty because I could exercise an option that most in Bellevue could not. With me leaving Bellevue, it’s likely that this problematic doctor saw me exercising agency over myself and wished the same for herself. And so I left, wrestling with the emotions associated with this dangerous doctor and what harm she might cause to less fortunate humans. But, she stayed, probably aware that she was not qualified to help some of the most vulnerable people in our society. And, that intersection between my guilt for leaving and her guilt for staying is the only place where we would meet in the world, searching for absolution.

But searching for absolution and searching for solutions are different paths that lead to different outcomes. Perhaps, in our attempts to relieve our guilt, we choose to abandon solutions within our grasp. What becomes of an emergency room where a doctor learns about the community she serves and practices empathy as well as medicine? What becomes of a system where people like me stop defining ourselves by personal accomplishments and start identifying with the change we cause or inspire? The answer is simple: better. And so maybe the work isn’t to get rid of the guilt associated with the problems we inherit and how we respond to them. Maybe, the work is to embrace the compunction associated with the insecurity that informs classism, racism and every other social ill dividing our society. Because, real work is defined by how you engage to solve problems. And, there’s more meaning in searching for solutions instead of searching for absolution.