I waited impatiently as the slowest elevator in the hospital rattled its way up to the floor where I would round on my patients. The scrub-clad woman standing next to me smiled and joked, “I can’t believe they are making us work on the weekend. How long have you been a nursing assistant?” Before I could reply, her glance dropped to the physician badge on my white coat. “I’m sorry,” she stammered. The door opened, she hurried off, and I headed toward the windowless office to review my list of new patients for the morning.
After discussing the overnight events with the team, I draped my stethoscope around my neck and headed into the maze of long and sterile hallways. For what would be the first of many times on this shift, I opened the creaky wooden door of a patient’s room. “Good morning,” I said to the patient and family members, one of whom handed me a tray with the remnants of a half-eaten meal. I tossed it into the trash can and I sanitized my hands. “I’m Dr Ukadike,” I continued, “but you can call me Dr U., like the letter.”
Embarrassment and wide eyes filled the room. “I’m so sorry,” said a family member in a voice that almost trembled, “We thought you were here to pick up the trash.”
It’s been 68 years since the first Black man graduated from medical school at this hospital. Many assumptions have not changed. I've spent over a decade studying chemistry, anatomy, and pathology, and I hold a master’s degree in public health and a medical degree, yet I am often viewed as help. At times I feel my way of thinking seems harsh, but the feelings of disappointment stay with me nevertheless. When I started my journey, George W. Bush was president. Despite my years of dedication and sacrifice I am still seen as someone who cannot be more than a janitor.
Though these situations are not new to me, after years in the hospital it still gives me pause. The assumptions of patients, families, physicians, and staff alike remind me of the color of my skin. Only 5% of American physicians are Black. I am reminded of the story of a Black man who on his first day of medical school was thanked by a professor for coming to replace the burned-out light bulbs.
From my first job in a hospital as a scribe in 2015 to a resident physician in 2022, I would be hard-pressed to name more than a handful of Black male physicians I’ve worked with. Currently, I am the only one in my residency program. As a scribe I asked my supervisor why the hospital didn’t hire more Black physicians, and his response was simply, “There aren’t many applying or available to hire.” It hit me that in that moment, at the age of 25 making $8.00 an hour, I was the only Black male employee in the emergency department who wasn’t a nursing assistant or a janitor. Nearly a decade later this situation is largely unchanged.
The obvious question then is why aren’t there more Blacks in medicine? Numerous factors add to the nuance in finding the answer to that question. Studies say lack of role models in the community or on TV, easier and more appealing financial avenues for careers, financial constraints, little encouragement at home or in schools, and negative peer pressure may contribute.
My goal in reflecting on my brief medical career isn’t to solve this problem, but to continue to keep it on the forefront of people’s minds. Change is left to those who are brave enough to face it, and without change I would not be a physician today. Contradicting society’s expectations is difficult, but I will continue to contradict that narrative at any cost. More Black men are needed in medicine, and I will do everything in my power to help facilitate that, including sharing my stories, advocating for those who are underserved, and uplifting those whose voices are not heard. We are not there yet. Until then, the janitor will see you now.
