Black Males in Medicine

On August 28, 1955, a black 14-year-old male, named Emmett Till, was found murdered after he had been accused of flirting with a white woman. August 28, 1955, was also my eighth birthday. Today, I suppose that most parents would want to shelter an 8-year-old from such gruesome news, but I remember the magazines depicting the gory details lying around the house for weeks. In my young mind, it would have been merciful if Emmett had been hanged. I could not comprehend that his eye was gouged out, but I understood his extreme suffering at the hands of people determined to teach a horrific lesson.

My mother repeated stories of what whites in the South will do to black males for flirting with white women each time that we traveled to Arkansas or Alabama to visit extended family members. The necessity of my mother’s message was clear. You can’t shelter kids when there is life-threatening danger in what may appear to be an ordinary occurrence. Until the civil rights movement came along, a whole generation of young mothers did what was necessary to protect their children. Such messaging can have unintended consequences.

Recently, a colleague sent me an e-mail concerning the Association of American Medical Colleges (AAMC) report¹ indicating that the number of black males entering medical school is currently lower than it was in 1978. I flippantly responded, “Unfortunately, young black men are reading the signals they are getting from Ferguson and Baltimore and opting for the short-term view.” It was one of those e-mails that I, as a black male physician, should have put more thought into before hitting the send button. But, I stand by my statement and wish to explain.

After Trayvon Martin was shot, for many months and through his murder trial, the “stand your ground” defense was touted. To young black males, that sounded like a license for self-appointed authorities to kill. When police left Michael Brown’s body lay in the streets of Ferguson for hours, the black community saw the symbolic message of how powerless they were. From the nearly constant feed of live phone videos that we since experienced, showing questionable behavior by “authority figures,” the Emmett Till defense mechanisms have resurfaced. Community groups are now giving courses on “driving while black” and “do’s and don’ts, if stopped by police.” The vulnerability of simply being black in America is chronically refreshed, and young black males, in particular, struggle through what is (at best) unconscious bias against them. Striving to get into medical school seems to fly in the face of the hunker-down mentality, which is now so prevalent.

Two passages in the AAMC report caught my attention. On page 16, the statements are made that “18% of black high school sophomores in 2002 aspired to become a doctor,” and “The aspirations of African-American boys and girls and youth of color are just as high, if not higher, than [those of] kids from other racial and ethnic groups.”¹ But what happens after that? The lyrics of a 1970 song by the Whispers that say “Seems like I gotta do wrong, gotta do wrong, before they notice me”² come to mind. Is the clearest route to acceptance and admiration for the black male, the time honored route of high school, collegiate, and professional athletics? Coaches inspire black males, most premed advisors seem to discourage them!

If America is so bad for black males, how do people like me manage to become so successful? I have long known that relationships were the keys that unlocked my life. One of my first formative relationships was with my high school football coach. Coach also happened to be the driver’s education teacher. After driving around with me for 6 weeks, during the summer before my senior year, coach somehow became invested in my future after football. I went on to win 18 football scholarships to places like Nebraska, Arizona State, Maryland, Wake Forest, and so on, but coach tried to cut a deal for me with the recruiters from Colgate, Cornell, and Penn in which playing football was not a requirement. Only Colgate offered me a financial aid scholarship, and Colgate was where I went.

Then, at Colgate, I needed a part-time job and the financial aid office sent me to the physics department. Shortly after I started to work there, 2 faculty members began trying to talk me into becoming a physics major, and a physics major is what I became. As little as I knew about college as a freshman, it probably helped not knowing that physics was supposed to be hard! But here were people of unquestioned authority that believed in me long before I learned to believe in myself.

During my senior year at Colgate, a friend who had graduated 2 years before me got a job as a minority recruiter for SUNY, Upstate Medical University. He asked me to fill out an application to the medical school there so that he could get his number of applicants up. When I told him that I wasn’t a premed, he said if I could do physics, the science part of medical school would be easy. He apparently sold that concept to the admission committee because 6 months later I was accepted into medical school.

Once again, when I needed a job in medical school, a pathologist named John Bernard Henry, editor of Henry’s Clinical Diagnosis and Management by Laboratory Methods, hired me starting a relationship that probably resulted in me becoming a pathologist. I also remember the pharmacology professor who knew when my examinations were given and who would hunt me down after each examination to see how I did. My performance was never good enough for him. At his memorial service, I spoke and gave him credit for pushing me into the Alpha Omega Alpha Medical Honor Society.

So what did these teachers and others do so effectively to stimulate my success? I think the first thing they did was become my friend. They showed an interest in me. And, they would sit and talk with me for no apparent reason. More importantly, they believed in me long before I knew how to believe in myself.

In contrast, who makes friends with black males in today’s world? Why would anyone make friends with one, given the way they are so often depicted in the media? The messaging generated each time there is a high profile event between black males and police creates a negative impression that far too many carry permanently thereafter. Conversely, most young black males won’t mention wanting to become a physician for fear of being ridiculed. I didn’t consider a medical career until my senior year because if I had declared as a premed earlier, I might have been laughed out of the biology department at my school. When it is difficult to swim against prevailing expectation, you just try to avoid it.

Many of the black males in medical schools today are of Caribbean or African, not American, origin. Ironically, this trend implies that the messaging and stereotypes of low ability and prospects are not as overwhelming for black males who grow up in other countries.

By now, you probably see where I am going with this. Since 1978, numerous programs have tried to address diversity issues. In medicine, we talk repeatedly about the pipeline and fostering almost every aspect of the pipeline. The AAMC report lists several successful programs that improve outcomes. An Internet search on the phrase “Black Male Achievement” produces much information on available programs including academic discussions. But, the jump from high school to medical school is one of the highest academic hurdles and may be more sensitive to discouraging perceptions. Recent events seem to indicate that this alienation might just be too pervasive and may be actually getting worse.

Perhaps, the most powerful tool might be too obvious to be perceived. What would happen if we all tried to find a black male or two and started by just trying to make friends? Yes, this will be viewed with suspicion. Yes, offering a job or support with coursework or academics will help. But, showing friendship and respect for them and nurturing their futures might be the most powerful tool. In an age of polarizing political and social queues, the simple answer to this critical black male physician shortage may be to become friends with the next generation of them.

Finally, as a physician, a professor, and/or a director, you are of unquestioned authority to most young people. Believing in someone, before they have had a chance to believe in themselves, can be decisively important; not just to them as individuals, but to us as a society. I responded to it and so have dozens of young people who I have mentored. My message is that everyone should find a young black male, make a friend, and then believe in them, and maybe we can change the message that will be told 37 years from now.