Most medical specialties are debating the validity of using racial categories based on differences in skin color and hair texture to suggest biological meaning. Instead, just as the entire country finds itself preoccupied with a long-overdue racial reckoning, so does medical education. Medical training should have filled this gap.
Most physicians are unable to rely on lived experience to discern the way symptoms manifest on darker skin tones. But I am among the only 5% of physicians in America who are Black. This suggested an entirely different diagnosis that would not respond to the powerful and potentially dangerous intravenous blood thinners indicated for deep vein thrombosis.Īs a Black person who grew up in a family with skin colors ranging from beige to ebony, I was familiar with what redness, bruising, and rashes look like on different shades of skin. When I examined the patient, who was the color of black coffee, I could see what the White doctors could not: His skin had red, quarter-sized bumps that were tender to the touch on both shins. I was wary of the preliminary diagnosis, because it would be unusual for an active young man to develop a clot and extremely unlikely for anyone to develop clots in both legs at once. The other doctors suspected deep vein thrombosis because both his lower legs were swollen.
When I was a young doctor in residency training, I was summoned to the emergency room to evaluate a young Black man thought to have blood clots in both legs that could dislodge, travel to the lungs, and cause death. She says that coming to terms with hair loss hasn’t been easy. Hilary Alexis of Oakland says she lost her hair to alopecia because her physician did not diagnose it before it was too late for a medical intervention that might have slowed the disease’s progress.
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