Husband blames racism for wife’s death after C-section at Cedars-Sinai in civil suit

[nimbus]

I believe that systemic racism and race based health disparities exist. The data demonstrates it. However, I don’t know with certainty why the husband’s concerns were dismissed in this specific case, or whether race was a factor or not.

Cedars is a high profile hospital and they’ve had their share of high profile screwups with white patients too, e.g. Bill Paxton and the Quaid babies.

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[Agast]

This sentiment of “I am now the hated White Male Heteromale” is becoming quite prevalent.
Don’t even know if people really think this out before they type.

When I was a little kid I’d get into fights with my sister and make her cry, and then I’d get scared and start crying louder than her so my mom would be confused about who to punish. This reminds me of that.

 

[nimbus]

When I was a little kid I’d get into fights with my sister and make her cry, and then I’d get scared and start crying louder than her so my mom would be confused about who to punish. This reminds me of that.

Yeah it’s a victimhood snowflake contest. Even folks who have won the birth lottery like to play.

 

[We'llBeDoneIn15Minutes]

While that may be true most places, you have to consider the surrounding area. Look at the hospital board. Look at their donors. This part of la is filled with Jewish people who absolutely adore Cedars. Heck you get people who drive from the valley and even Santa Barbara to go to cedars - passing all the Ucla, Kaiser and Reuter private hospitals on the way

- someone who rotated through, attends a bunch of cedars fundraisers, family works for cedars

Personally I think people leaving Santa Barbara in the first place to head to Cedars are insane unless it's for a very specific disease not handled in Santa Barbara. Are you familiar with Santa Barbara Cottage Hospital? Put me there any day before Cedars.

 

[Twiggidy]

I am in the now minority and hated class of being a white heterosexual male - I mention that just as background.

Maybe this was racism? I really hope not. I want to believe it wasn't. I understand the issue of "black tax" my African-American friends have told me about.

But my question is this. Let's say it could be, or it couldn't be racist, and there is no way to know.

Does calling it racism help? Does making us more divided move us forward? If you tell me that I have an unconscious bias that I can't overcome - it will drive me towards tribalism (as others have mentioned). I don't want to mistreat people. I want to be fair, and kind, and professional, and compassionate. But if I am told that anytime I take care of a minority, I am not those things even though I don't know I am being biased - shouldn't my response be "well I DONT want to mistreat people. I don't want to be that person. So the real answer is that I shouldn't take care of any minorities." Is that really what we want to do?

I just don't see how that helps.

Teach me. How does that help - calling things the worst and most ugly words in society right now ("racist")?

I think my problem is there are two things going on here, both of which have some validity, but the "culture war" (if you want to call it that) behind one is drowning out the other.

Yes, there are racial disparities in maternal health care based on statistical data and that needs to be addressed, even if the wave of "well actually"s occur. On the other hand, there was poor medical decision making happening here regardless of the races involved.

You can make the malpractice case without even talking about race and just using nouns without descriptors. "Patient had blood tinged urine" "Doctor sat on bleeding for 10 hr in post operative patient". That's all you need. In the current climate, adding racial descriptors doesn't do anything but look like you're making a crusade, but it's tough when an actual crusade needs to be made, but likely isn't the reason for the tragic outcome that occurred.

If the nurse or MD had said I'm not doing a CT or takeback exploration on that 'you know what word (or similar)'......now it's a difference case.

My thing is you don't need to play "the race card" when you likely already have the winning hand.

 

[Dr. Rude]

I think my problem is there are two things going on here, both of which have some validity, but the "culture war" (if you want to call it that) behind one is drowning out the other.

Yes, there are racial disparities in maternal health care based on statistical data and that needs to be addressed, even if the wave of "well actually"s occur. On the other hand, there was poor medical decision making happening here regardless of the races involved.

You can make the malpractice case without even talking about race and just using nouns without descriptors. "Patient had blood tinged urine" "Doctor sat on bleeding for 10 hr in post operative patient". That's all you need. In the current climate, adding racial descriptors doesn't do anything but look like you're making a crusade, but it's tough when an actual crusade needs to be made, but likely isn't the reason for the tragic outcome that occurred.

If the nurse or MD had said I'm not doing a CT or takeback exploration on that 'you know what word (or similar)'......now it's a difference case.

My thing is you don't need to play "the race card" when you likely already have the winning hand.

Extra damages? Certainly worse of a PR problem than “ordinary” gross incompetence.

 

[Agast]

Perhaps the goal of pointing out racism is not to increase damages, but to warn other minorities and encourage culture change to prevent other people from experiencing the same thing?

 

[Mman]

We’re not even at this stage yet. We can’t even acknowledge that there are any disparities. Whether or not this case is related to that is unfortunately irrelevant to the true issue at hand.

increased peripartum mortality for minorities isn't some random opinion. It is a well researched and documented medical fact and has been so in the literature for a long time.

There is nothing to acknowledge in terms of the fact. The things that aren't settled exactly are the whys and hows. It is interesting that a similar disparity exists in England even with their universal health care.

 

[chocomorsel]

increased peripartum mortality for minorities isn't some random opinion. It is a well researched and documented medical fact and has been so in the literature for a long time.

There is nothing to acknowledge in terms of the fact. The things that aren't settled exactly are the whys and hows. It is interesting that a similar disparity exists in England even with their universal health care.

The person is criticizing the fact that people are arguing your point. That there are facts and research. Not disagreeing with you.

 

[USCTrojan11]

Personally I think people leaving Santa Barbara in the first place to head to Cedars are insane unless it's for a very specific disease not handled in Santa Barbara. Are you familiar with Santa Barbara Cottage Hospital? Put me there any day before Cedars.

Lol same, I really like that place. But people are familiar with the big brands and cedars is one of them if not the biggest "name".

Wish I could live and practice at cottage

 

[ryanjmy]

race based health disparities exist.

For sure. But that does not equate to

systemic racism

 

[Mman]

The person is criticizing the fact that people are arguing your point. That there are facts and research. Not disagreeing with you.

oh I know, just reiterating that the facts are already established

 

[ambiturner]

Disparities in healthcare outcomes by race, sex, etc are well documented in large studies, but has there ever been a case where doctors were accused of healthcare biases in the absence of overt racism? Will be interesting to see this play out although I’m assuming cedars will settle since it’s clear malpractice.

Seems like a similar legal situation as second hand smoke, which obviously results in excess deaths epidemiologically but difficult to prove causation in any individual case. There was a lawsuit against an airline by a flight attendant charging second hand smoke from workplace exposure back when they allowed smoking on airplanes, as workplaces have a duty to protect their workers from secondhand smoke.

Based on this case I’m sure hospitals will look at their legal risk and see the solution as more mandatory bias training sessions. They will spend no time trying to fix healthcare disparities and will continue building surgicenters in wealthy suburbs but will cite said training as a reason why they are not at fault.

 

[nexus73]

Bro what is this post? Do you want people to feel sorry for you for being a white Herero male? Like what are you even saying. Yes, things like this need to get pointed out. Make people think about it. Make people acknowledge that bias can exist. Look at this thread! Half the people don’t think bias played a role.

It helps because it makes people confront themselves. It makes you think about your views. I know I have become more cognizant in the past 10 years.

Did bias play a role? Is it even possible for us to know?

 

[Zekchar]

I am in the now minority and hated class of being a white heterosexual male - I mention that just as background.

Maybe this was racism? I really hope not. I want to believe it wasn't. I understand the issue of "black tax" my African-American friends have told me about.

But my question is this. Let's say it could be, or it couldn't be racist, and there is no way to know.

Does calling it racism help? Does making us more divided move us forward? If you tell me that I have an unconscious bias that I can't overcome - it will drive me towards tribalism (as others have mentioned). I don't want to mistreat people. I want to be fair, and kind, and professional, and compassionate. But if I am told that anytime I take care of a minority, I am not those things even though I don't know I am being biased - shouldn't my response be "well I DONT want to mistreat people. I don't want to be that person. So the real answer is that I shouldn't take care of any minorities." Is that really what we want to do?

I just don't see how that helps.

Teach me. How does that help - calling things the worst and most ugly words in society right now ("racist")?

Everyone ganged up on you. Even though I am a woman, I understand what you are saying and I agree.

Every time I sit through one of the DEI sessions where I am told that I am a racist and there's nothing I can do about it, I ask myself "why am I even here then" as I check out mentally. I try to do the best I can for my patients and those I am in contact with. If there is bias that is unconscious that bleeds into my work, well then there's nothing I can do about it by it's very nature of being unconscious and therefore I do not worry about it.

I don't think anybody wants the solution of all black hospitals with black nurses, doctors, pharmacists etc to come to pass. Boy would that cause an uproar. At the same time, is this the only solution to my white bias? The more I am told that I am racist and have unconscious bias, the more this dystopia becomes the solution.

Please don't start with the "educate yourself" or "have the conversion" tripe either since that gets us nowhere closer to the solution of non-whites getting subpar medical care. Nobody has a solution and the current DEI phase has nearly flamed out.

 

[Planktonmd]

For 10- 12 hours? Really?

If you are ever involved in peer reviews or case reviews you would realize that there is no limit to the stupidity and incompetence that people can demonstrate. It’s not racism unless you want to see it as such.

 

[ambiturner]

Everyone ganged up on you. Even though I am a woman, I understand what you are saying and I agree.

Every time I sit through one of the DEI sessions where I am told that I am a racist and there's nothing I can do about it, I ask myself "why am I even here then" as I check out mentally. I try to do the best I can for my patients and those I am in contact with. If there is bias that is unconscious that bleeds into my work, well then there's nothing I can do about it by it's very nature of being unconscious and therefore I do not worry about it.

I don't think anybody wants the solution of all black hospitals with black nurses, doctors, pharmacists etc to come to pass. Boy would that cause an uproar. At the same time, is this the only solution to my white bias? The more I am told that I am racist and have unconscious bias, the more this dystopia becomes the solution.

Please don't start with the "educate yourself" or "have the conversion" tripe either since that gets us nowhere closer to the solution of non-whites getting subpar medical care. Nobody has a solution and the current DEI phase has nearly flamed out.

I would agree that these sessions often deliver a message of hopelessness, with the modifier that the research shows that all physicians have implicit biases, including minority physicians against minority patients, so even a dystopian segregated hospital wouldn’t solve the problem.

 

[Planktonmd]

12 hours? Really? With no one taking him seriously? No one checking on her bleeding?
As a minority, I can tell you these things happen. Minorities get ignored and are labeled dramatic and histrionic and exaggerate.
They have happened to me and people I know. Where’s a White man complains and boom, stuff happens.

You know that you and I agree most of the times but I have to disagree with you here.
I refuse the whole degrading notion that a physician would treat patients differently in an emergency situation based on race.
I do accept though that certain physicians may have an ego problem that prevents them from seeing reality and admitting that they had a complication.
This is a Gyn guy who just did not want to admit that his 17 minutes C section may have resulted in a complication.
And please note that from his name it appears that he is a minority himself, he sounds to be from middle eastern origin.

 

[narcotics999]

This obstetrician (Dr. Arjang Naim) had multiple counts of negligence and mismanagement according to Medical Board of California. There is a detailed document if interested.

 

[nimbus]

What lady on ob doesn't have sinus tachy

Thank you for the information.

This seems mainly like a physician issue based on the timeline. So many opportunities for the OB to intervene but didn't. Not sure how racism would come into play. Just incompetence.

The "expectant management " line is especially damning.

I wish the husband/widower had posted time stamped vital signs. That would have been revealing.

 

[anaesthetic]

You know that you and I agree most of the times but I have to disagree with you here.
I refuse the whole degrading notion that a physician would treat patients differently in an emergency situation based on race.
I do accept though that certain physicians may have an ego problem that prevents them from seeing reality and admitting that they had a complication.
This is a Gyn guy who just did not want to admit that his 17 minutes C section may have resulted in a complication.
And please note that from his name it appears that he is a minority himself, he sounds to be from middle eastern origin.

Luckily, you don’t have to refuse any notion since it’s well-researched and well-documented that it occurs, and it occurs often.

I agree with you in that certain physicians may certainly have an ego problem that prevents them from seeing reality. You could say that some of these people may occasionally post online in medical forums as well.

Also, I think people should reject the notion that minorities are immune to bias. We are not and should be hyperaware of how we treat our patients.

Again, the problem we have right now is not whether or not a specific instance is due to racism but convincing certain people, including physicians, that the problem exists at all.

 

[anaesthetic]

Everyone ganged up on you. Even though I am a woman, I understand what you are saying and I agree.

Every time I sit through one of the DEI sessions where I am told that I am a racist and there's nothing I can do about it, I ask myself "why am I even here then" as I check out mentally. I try to do the best I can for my patients and those I am in contact with. If there is bias that is unconscious that bleeds into my work, well then there's nothing I can do about it by it's very nature of being unconscious and therefore I do not worry about it.

I don't think anybody wants the solution of all black hospitals with black nurses, doctors, pharmacists etc to come to pass. Boy would that cause an uproar. At the same time, is this the only solution to my white bias? The more I am told that I am racist and have unconscious bias, the more this dystopia becomes the solution.

Please don't start with the "educate yourself" or "have the conversion" tripe either since that gets us nowhere closer to the solution of non-whites getting subpar medical care. Nobody has a solution and the current DEI phase has nearly flamed out.

There are a lot of things to unpack here but since I can’t start with the “please educate yourself” bit, I will say this: even people who are well-meaning can manifest their prejudice in subtle ways that are harmful to those around them, including having the arrogance to say that “since there is no current solution to the problem, I’m just going to roll my eyes at it and continue being blissfully unaware and unabashedly hostile towards attempts at addressing the issue.”

I don’t know you, but I know and work with many people like you who adopt the same indifference towards any attempts at having that conversation. I witness daily the biases and prejudices we have towards our patients, and I’m not excluding myself from that cohort.

How many times have you taken care of a trauma patient who comes up emergently for an ex-lap from a GSW and heard your one of your colleagues say, “I’m sure he was on his way to church” or “He’ll be back next year”? I’ve heard it no fewer than three times this year from different people (who happen to be white), and my reaction will always be “well, what if he was?” We often have no idea of the circumstances that led our patients to us yet we automatically lean towards one conclusion or another, and we love to fantasize about the notion that as physicians, we “treat everybody equally regardless of race or status” but it’s simply not true. It is not rooted in reality, and there are plenty of data to suggest that we in fact do the exact opposite.

Anyway, carry on. Something about the persecuted majority.

 

[CD125]

There are a lot of things to unpack here but since I can’t start with the “please educate yourself” bit, I will say this: even people who are well-meaning can manifest their prejudice in subtle ways that are harmful to those around them, including having the arrogance to say that “since there is no current solution to the problem, I’m just going to roll my eyes at it and continue being blissfully unaware and unabashedly hostile towards attempts at addressing the issue.”

I don’t know you, but I know and work with many people like you who adopt the same indifference towards any attempts at having that conversation. I witness daily the biases and prejudices we have towards our patients, and I’m not excluding myself from that cohort.

How many times have you taken care of a trauma patient who comes up emergently for an ex-lap from a GSW and heard your one of your colleagues say, “I’m sure he was on his way to church” or “He’ll be back next year”? I’ve heard it no fewer than three times this year from different people (who happen to be white), and my reaction will always be “well, what if he was?” We often have no idea of the circumstances that led our patients to us yet we automatically lean towards one conclusion or another, and we love to fantasize about the notion that as physicians, we “treat everybody equally regardless of race or status” but it’s simply not true. It is not rooted in reality, and there are plenty of data to suggest that we in fact do the exact opposite.

Anyway, carry on. Something about the persecuted majority.

This is the kind of level headed and culturally aware response that I really appreciate. You would be a great colleague.

 

[chocomorsel]

You know that you and I agree most of the times but I have to disagree with you here.
I refuse the whole degrading notion that a physician would treat patients differently in an emergency situation based on race.
I do accept though that certain physicians may have an ego problem that prevents them from seeing reality and admitting that they had a complication.
This is a Gyn guy who just did not want to admit that his 17 minutes C section may have resulted in a complication.
And please note that from his name it appears that he is a minority himself, he sounds to be from middle eastern origin.

Not all minorities are created equal. Let’s agree to disagree.
I don’t know whether this was a racially biased case, just speculating. However I can tell you, and have said before even we minorities can have unconscious bias against our own race. And certain other minorities think they are better than other minorities. And we Africans think we are better than African Americans and they think they are better than us Africans and it goes on and on. Overall though, the Black person is at the bottom of the rung for minorities in this country.
It’s all about being conditioned negatively from a young age and having to have to remind yourself that the next black person is not just a tech or EVS or even a nurse. I have had to consciously work on this myself.

 

[Radetzky]

Unconscious bias is a fascinating field with little agreement even amongst experts as to what results in highly controlled psychological experiments mean in the real world.

It is undoubtedly true that unconscious bias plays a role in behaviour. Black high school students do more poorly on tests when asked to list their race at the beginning of the test.

The question is whether you can “debiase” yourself- literature so far seems to indicate no, and even that “cognitive debiasing” reinforces negative stereotypes. In addition it’s not clear that labelling unconscious bias as “racism” is accurate or helpful.

This is however an uncomfortable study which seems rather robust..

https://www.pnas.org/doi/10.1073/pnas.1913405117

 

[Twiggidy]

There are a lot of things to unpack here but since I can’t start with the “please educate yourself” bit, I will say this: even people who are well-meaning can manifest their prejudice in subtle ways that are harmful to those around them, including having the arrogance to say that “since there is no current solution to the problem, I’m just going to roll my eyes at it and continue being blissfully unaware and unabashedly hostile towards attempts at addressing the issue.”

I don’t know you, but I know and work with many people like you who adopt the same indifference towards any attempts at having that conversation. I witness daily the biases and prejudices we have towards our patients, and I’m not excluding myself from that cohort.

How many times have you taken care of a trauma patient who comes up emergently for an ex-lap from a GSW and heard your one of your colleagues say, “I’m sure he was on his way to church” or “He’ll be back next year”? I’ve heard it no fewer than three times this year from different people (who happen to be white), and my reaction will always be “well, what if he was?” We often have no idea of the circumstances that led our patients to us yet we automatically lean towards one conclusion or another, and we love to fantasize about the notion that as physicians, we “treat everybody equally regardless of race or status” but it’s simply not true. It is not rooted in reality, and there are plenty of data to suggest that we in fact do the exact opposite.

Anyway, carry on. Something about the persecuted majority.

All of this

 

[Mman]

How many times have you taken care of a trauma patient who comes up emergently for an ex-lap from a GSW and heard your one of your colleagues say, “I’m sure he was on his way to church” or “He’ll be back next year”? I’ve heard it no fewer than three times this year from different people (who happen to be white), and my reaction will always be “well, what if he was?”

I have made those comments quite a few times myself, but I still treat the patient the same as anybody else (as far as I can tell). I also make sure to check the news and find out the circumstances of the incident after the fact out of curiosity.

 

[LaryngoSpazz]

I can’t believe no one has mentioned the elephant in the room yet. This woman received substandard care because her male doctor was *gasp* SEXIST!

 

[chocomorsel]

I can’t believe no one has mentioned the elephant in the room yet. This woman received substandard care because her male doctor was *gasp* SEXIST!

Well, that is a terrible quality to have as an ObGyne if true.

 

[IMGASMD]

Well, that is a terrible quality to have as an ObGyne if true.

My take is that he (most likely a male or they…) was trying to be funny.

 

[coffeebythelake]

implicit biases exist. i don't know if you can call it racism... many of these biases, stereotypes, preconceptions exist within the realm of the subconscious. many aren't even aware of it in their day to day interactions. certainly i don't think the medical and nursing staff were thinking... "lets make this black patient suffer"

whether such implicit biases played a part in this tragic case i don't know.

 

[epidural man]

Are you sure you understand the issue at hand? I don’t think you do, to be quite honest.

It helps because there are many people in your every day life, in your physicians’ lounges, in your ORs, and on this board who don’t believe that systemic racism exists despite overwhelming evidence that suggests otherwise.

How does it help? By forcing the “silent majority” to look at themselves and their “great nation” in the mirror and acknowledge that there are huge differences in how minorities are treated compared to their white counterparts across all systems, not just healthcare.

We’re not even at this stage yet. We can’t even acknowledge that there are any disparities. Whether or not this case is related to that is unfortunately irrelevant to the true issue at hand.

That is the issue -- the sticky wicket.

When black young adults were asked this question - If two students (a black and a white) with equal grades and SAT scores applied to a college, who is more likely to get in? 95% answered incorrectly and said the white student would get in over the black student - despite that being completely false since probably the Philadelphia Plan circa 1967. Isn't that a problem that this simple and plain fact is completely misunderstood and believed by almost everyone in that demographic?

When you say "systemic racism" what system are you referring to? Clearly not our highest institutions of the land. Last year acceptance class into the HIGHEST institution of ALL the land (Harvard) was 18% black, much higher than our demographics of black would suggest (14%).

Do you mean on income earning? 7-8 of the top-ten income earning groups are people of color (I got that from a tweet)...

The point is...if we can't have an honest discussion about these things without finger pointing, or name calling - it makes people feel like they don't even want to talk about it at all. It makes people just leave the conversation alone.

As you correctly point out....these things SHOULD and NEED to be discussed. But by yelling RACIST for every unjust thing...does that REALLY get people to discuss these things on a level that moves the needle, or moves things forward?

 

[aneftp]

Cedars did or used to separate poor payor mix ob payors. A lot of hospital anesthesia practices do this. Not just one hospital. The Medicaid population gets assigned to the “partnership” track docs/residents/srna. The partners take all the private/commercial paying.

 

[chessknt]

That is the issue -- the sticky wicket.

When black young adults were asked this question - If two students (a black and a white) with equal grades and SAT scores applied to a college, who is more likely to get in? 95% answered incorrectly and said the white student would get in over the black student - despite that being completely false since probably the Philadelphia Plan circa 1967. Isn't that a problem that this simple and plain fact is completely misunderstood and believed by almost everyone in that demographic?

When you say "systemic racism" what system are you referring to? Clearly not our highest institutions of the land. Last year acceptance class into the HIGHEST institution of ALL the land (Harvard) was 18% black, much higher than our demographics of black would suggest (14%).

Do you mean on income earning? 7-8 of the top-ten income earning groups are people of color (I got that from a tweet)...

View attachment 355675

The point is...if we can't have an honest discussion about these things without finger pointing, or name calling - it makes people feel like they don't even want to talk about it at all. It makes people just leave the conversation alone.

As you correctly point out....these things SHOULD and NEED to be discussed. But by yelling RACIST for every unjust thing...does that REALLY get people to discuss these things on a level that moves the needle, or moves things forward?

It makes the people it doesn't affect leave the conversation which is kind of the entire ****ing point of systemic racism. Black people don't just get to walk away from the issues imposed on them on a daily basis at a systemic level like you can. The mere fact that you get irritated by something and can ignore it and live your usual life free from the issues that impact black people IS the entire problem.

 

[DarkBluMage]

That is the issue -- the sticky wicket.

When black young adults were asked this question - If two students (a black and a white) with equal grades and SAT scores applied to a college, who is more likely to get in? 95% answered incorrectly and said the white student would get in over the black student - despite that being completely false since probably the Philadelphia Plan circa 1967. Isn't that a problem that this simple and plain fact is completely misunderstood and believed by almost everyone in that demographic?

When you say "systemic racism" what system are you referring to? Clearly not our highest institutions of the land. Last year acceptance class into the HIGHEST institution of ALL the land (Harvard) was 18% black, much higher than our demographics of black would suggest (14%).

Do you mean on income earning? 7-8 of the top-ten income earning groups are people of color (I got that from a tweet)...

View attachment 355675

The point is...if we can't have an honest discussion about these things without finger pointing, or name calling - it makes people feel like they don't even want to talk about it at all. It makes people just leave the conversation alone.

As you correctly point out....these things SHOULD and NEED to be discussed. But by yelling RACIST for every unjust thing...does that REALLY get people to discuss these things on a level that moves the needle, or moves things forward?

MSN

MSN

 

[epidural man]

It makes the people it doesn't affect leave the conversation which is kind of the entire ****ing point of systemic racism. Black people don't just get to walk away from the issues imposed on them on a daily basis at a systemic level like you can. The mere fact that you get irritated by something and can ignore it and live your usual life free from the issues that impact black people IS the entire problem.

I disagree. I think if you believe this, you really don’t understand the issues or problems at hand.

 

[chessknt]

I disagree. I think if you believe this, you really don’t understand the issues or problems at hand.

What problem is that? That it annoys you to think that racism is implicit or exists at a structural level? Or that black people are angry when they get dismissed as pulling the race card when they call something out?

 

[Mman]

What problem is that? That it annoys you to think that racism is implicit or exists at a structural level? Or that black people are angry when they get dismissed as pulling the race card when they call something out?

I think you are both talking past each other about separate, albeit related, issues

 

[epidural man]

What problem is that? That it annoys you to think that racism is implicit or exists at a structural level? Or that black people are angry when they get dismissed as pulling the race card when they call something out?

I just did a case where the patient gave a history of getting a pain medicine for his back pain (which sounded like an IM injection) and he says the medication caused him to loose complete feeling in the left side of his body and now has left him hypersensitive to pain.

Upon hearing the story, and that according to the patient, the hospital told him that he better not sue and that they wouldn’t give him more information, the nurse was completely iincensed and angry. She couldn’t believe the injustice that had happened. She doesn’t know a lot about this stuff.

I, on the other hand, know a lot more about these sort of things. I explained to the nurse that I don’t know what happened but that the patient’s story is likely not even close to the truth. That a great myriad of things could have happened and that a single pain medication certainly did not have this effect. The most likely thing was that the patient had a stroke for whatever reason. The nurse, said - okay, I feel much better about this now - and mentioned “stroke” to the patient and they say “oh yeah. I kind of remember a stroke being mentioned”

The point is, these things are complicated and often the True story is much more informative - but we are anxious to make conclusive judgements based on small bits.

Consider the article posted above by DarkBlarMarge.

Is it possible that the boss was racist? Sure. That’s possible. Is it possible other things could have been at play? For example, maybe the boss hated the fact that Med-Peds residents get IM board certified only after two years and it really pisses him off every time he thinks about it and maybe that drove him to make unfair decisions. Or maybe he just didn’t like the residency director in general (and it had nothing to do with race) and so any decision made was directed at her but had consequences that hurt all the others. Or maybe when looked at objectively, there was no bias at all (which seems to be what some have concluded when looking at that specific case).

The point is, perhaps screaming racism at every injustice that involves a minority could actually hurt the minority cause.

By the way, one thing we all could do better is to seek to understand before we make judgements. I am trying to do that. So why do you think “ That it annoys you to think that racism is implicit or exists at a structural level?” Did I say that? Also, could you restate in simple terms what you think The point is that I am trying to make? I’m not saying you have to agree with it. But without malice, sarcasm, or emotion, try to restate what you think my point is.

 

[anaesthetic]

That is the issue -- the sticky wicket.

When black young adults were asked this question - If two students (a black and a white) with equal grades and SAT scores applied to a college, who is more likely to get in? 95% answered incorrectly and said the white student would get in over the black student - despite that being completely false since probably the Philadelphia Plan circa 1967. Isn't that a problem that this simple and plain fact is completely misunderstood and believed by almost everyone in that demographic?

When you say "systemic racism" what system are you referring to? Clearly not our highest institutions of the land. Last year acceptance class into the HIGHEST institution of ALL the land (Harvard) was 18% black, much higher than our demographics of black would suggest (14%).

Do you mean on income earning? 7-8 of the top-ten income earning groups are people of color (I got that from a tweet)...

View attachment 355675

The point is...if we can't have an honest discussion about these things without finger pointing, or name calling - it makes people feel like they don't even want to talk about it at all. It makes people just leave the conversation alone.

As you correctly point out....these things SHOULD and NEED to be discussed. But by yelling RACIST for every unjust thing...does that REALLY get people to discuss these things on a level that moves the needle, or moves things forward?

If your measuring stick for whether or not systemic racism exists is from asking young black students whether or not their white counterparts have an advantage over them in one specific area, or from looking at admissions from the top 1% of colleges, or looking at demographics from the top 1% of income earners, therein lies the problem.

Do you see it yet? This is a tired old argument from tone deaf colleagues who cherry pick examples to support their beliefs that systemic racism can’t possibly exist if “my one black friend says so.” I can’t be racist because I work with black people and interact with them in a friendly manner!

When the poverty rates of black and hispanic people aren’t double that of whites and Asians, when the incarceration rate of black and brown people aren’t 1.3-5x that of whites and Asians, when the median income of black and brown people isn’t 0.61 for every one dollar of their white counterparts, when the mortality of black women isn’t 2-3 times higher than that of white women, when there’s a Trader Joe’s and Central Market in my neighborhood of black/brown people and immigrants, I’ll believe that systemic racism doesn’t exist.

I’ll wait for someone to tell me that the reason these people are poor, broke, incarcerated, and dead is because they’re lazy, unwilling to work, choose to commit more crimes (because that’s just who they are), and are dying more because it’s all their choice. This is the 2022 equivalent of “let them eat cake.”

Yes, I agree. These things need to be discussed. No, I disagree that I should worry about treading lightly regarding these discussions as to not “scare away” special snowflakes who can’t handle the truth in data. People of color have been abused, gaslit, and ignored for far too long in this country to worry about any of that.

I agree that yelling “RACIST” for every little thing is exhausting, but as I mentioned before, we can’t even rally together people on this board to agree that systemic racism exists at all, let alone this country. There are people active on this board who think racism ended a long time ago. We’re a long way from home.

 

[epidural man]

What problem is that? That it annoys you to think that racism is implicit or exists at a structural level? Or that black people are angry when they get dismissed as pulling the race card when they call something out?

Also the other problem is that you think racism, discussions about racism with all the decisions and discussions, only effects POC.

 

[epidural man]

“If your measuring stick for whether or not systemic racism exists is from asking young black ….”

I know, right!? What idiot would think that giving a single example to make a very specific point tries to explain the whole argument of systemic racism ? Certainly not me.

“Yes, I agree. These things need to be discussed. “

I’m glad we agree.

“No, I disagree that I should worry about treading lightly…”. I agree we shouldn’t tread lightly. What I do think is we should define terms. What does one mean by “systemic”? Is that all systems? Certain systems? What happens in a certain system when you adjust for variables?

“I agree that yelling “RACIST” for every little thing is exhausting,”

Again, I’m glad we agree.

Poster on my son’s wall.

 

[epidural man]

In the spirit of curiousity, if some are curious about this complicated subject - I found this book incredibly fascinating with a tremendous review of the available data.

Here is a good introduction into the author.



Heterodox academy has a great deal of great articles written on the subject. That may be the best website on the planet.

 

[jwk]

Cedars did or used to separate poor payor mix ob payors. A lot of hospital anesthesia practices do this. Not just one hospital. The Medicaid population gets assigned to the “partnership” track docs/residents/srna. The partners take all the private/commercial paying.

Doesn't happen and has never happened in the two private practices I've been associated with over 40 years, and both were in the Deep South.

 

[nimbus]

Doesn't happen and has never happened in the two private practices I've been associated with over 40 years, and both were in the Deep South.

Same. We usually have only 1 doc covering L&D so they cover everyone. Except for a single resident at our highest volume (9000+ deliveries/yr) site, no CRNAs, SRNAs, or residents in the building.

 

[chocomorsel]

Same. We usually have only 1 doc covering L&D so they cover everyone. Except for a single resident at our highest volume (9000+ deliveries/yr) site, no CRNAs, SRNAs, or residents in the building.

Oh God. That sounds absolutely miserable. Like I would rather create an Only Fans than deal with that many epidurals and CSections. And I am shy.

 

[nimbus]

Oh God. That sounds absolutely miserable. Like I would rather create an Only Fans than deal with that many epidurals and CSections. And I am shy.

Believe it or not, it’s a highly coveted position due to $$$. Not for me though. Onlyfans wouldn’t work for me either because my feet are not that sexy

 

[IMGASMD]

Believe it or not, it’s a highly coveted position due to $$$. Not for me though. Onlyfans wouldn’t work for me either because my feet are not that sexy

How about hands? You get regular work out of your hands right?!

We had that system for a while too, only some of the senior partners can do OB. At 2000/pop.
9000*70% epidural rate*2000=**** load of cash.

 

[nimbus]

How about hands? You get regular work out of your hands right?!

We had that system for a while too, only some of the senior partners can do OB. At 2000/pop.
9000*70% epidural rate*2000=**** load of cash.

Yeah it takes a while to break into that OB call panel. It’s a self selecting group of energizer bunnies. Must have large bladders and enjoy never sitting down.

 

[nimbus]

How about hands? You get regular work out of your hands right?!

We had that system for a while too, only some of the senior partners can do OB. At 2000/pop.
9000*70% epidural rate*2000=**** load of cash.

I do have nice hands