Dr. Jen Barna talks with Dr. Tamika Cross about implicit bias and her book, “What A Doctor Looks Like.”
“It’s important, you know, if someone is telling you their story about a situation that has happened or has occurred, instead of writing them off or blowing them off or talking over them, just listen. You know, hear them out.” -Tamika Cross MD
In today’s episode, Dr. Jen Barna speaks with Dr. Tamika Cross, OB Gyn and author of the book, “What a Doctor Looks Like.” Dr. Cross knew at a young age that she wanted to pursue a career in medicine as a physician, but did not exactly know the steps it would take to achieve her dream. Through seizing opportunities, mentorship, hard work and perseverance, she was able to navigate many obstacles, including those related to racism, to ultimately achieve her childhood dream of becoming a physician.
One of many instances that highlight the extra burden of racism and implicit bias occurred when Dr. Cross was on a flight after attending a friend’s wedding, 30,000 feet in the air attempting to offer medical assistance to an unresponsive passenger, only to be denied access by crew members who did not believe she was a doctor. After sharing her story publicly, and gaining international media attention, Dr. Cross sparked a viral movement of thousands of medical professionals from all over the world that joined in solidarity posting pictures of themselves with the hashtag #whatadoctorlookslike. By exemplifying the diversity amongst doctors, this movement challenges the myth that there is one prototype for what a doctor looks like. In addition to starting an international conversation of bias in the workplace, Dr. Cross’ story became an integral part of diversity and inclusion training at schools and companies coast to coast.
Dr. Cross currently lives and practices medicine in the Houston area and is from Detroit. She is co-owner of Serenity Women’s Health & Medspa, which launched in the middle of the pandemic.
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Podcast produced by: Amanda Taran
Please enjoy the full transcript below
Dr. Tamika: It’s important, and you know, if someone is telling you their story about a situation that has happened or has occurred, instead of writing them off, or blowing them off, or talking over them, just listen. You know, hear them out.
Jen: I’m Dr. Jen Barna. Thank you for being here with me today on DocWorking: The Whole Physician Podcast. I’m super excited to bring to you Dr. Tamika Cross, OB-GYN, and her story is so interesting. She’s just published a book called What a Doctor Looks Like. And to give you a little bit of background as a young doctor early in her career, Tamika found that the stereotypes and constant need to be validated did not disappear even after 20 years of schooling that she endured. One of many instances that highlighted this truth was when Tamika found herself on a plane 30,000 feet in the air attempting to offer medical assistance to an unresponsive passenger only to be denied access by crew members who did not believe Tamika was a doctor. After sharing her story publicly and gaining international media attention, Tamika was able to start a viral movement of hundreds of thousands of medical professionals all over the world that joined in solidarity, posting pictures of themselves with the #whatadoctorlookslike.
By exemplifying the diversity among doctors, this movement was able to negate the myth that there’s one prototype for What a Doctor Looks Like. Besides starting an international conversation of bias in the workplace, Tamika’s story became an integral part of diversity and inclusion training at schools and companies coast-to-coast. I have to say, I am completely captivated by your book, and I highly recommend it. Dr. Cross, Welcome to DocWorking: The Whole Physician Podcast.
Dr. Tamika: Thank you so much for having me. I appreciate it. I’m looking forward to our conversation today.
Jen: Well, before we get into the ‘why’ of what motivated you to write this book, I would love to hear a little bit about you as a person and your experiences that caused you to become a doctor. You actually go into a wonderful description of this in the book as well. So, can you tell me a little bit about growing up as a child wanting to be a doctor?
Dr. Tamika: Yeah, so, I am from Detroit, Michigan, and moved out to the suburbs when I got a little bit older, going into elementary school. But still in the metro Detroit area. Yeah, I wanted to be a doctor since I was a kid. I know a lot of doctors say that, but I truly did. My grandmother was probably the only one that I was really close to that was in healthcare at that time. She was a registered nurse. Just talking to her about all of her different experiences as far as patient interactions and the different stories she had from nursing school, and things like that, it really made me interested in the sciences, and medicine, and things like that at an early age.
Then even taking it a step further when she started experiencing health concerns later on in her life being a part of her doctor’s appointments and the things that she liked about certain doctors or didn’t like about others and the bedside manners and understanding some of the logistical stuff, the systemic stuff behind why she likes certain doctor’s offices, why she likes certain clinics or hospitals, things like that. So, I was very involved in that process and so, I really wanted to be able to be the doctor that my patients can relate to, be the doctor that my patients can let their hair down, be comfortable with. So, that was probably my earliest inspiration into the medical field. Specifically, I wanted to be the doctor, I wanted to be the one treating the patient.
Jen: It sounds like your grandmother had a huge influence on you, not only as a nurse and as someone that you admired in healthcare, but also because she took you with her to her appointments from a young age, and I do think it’s interesting how so many of us look back, and we see these times when we were a young kid where other people might not have really picked up on the same cues or been as interested. But you were there as a young child, and you’re noticing who’s who in the room, and which doctors had a good rapport with your grandmother, and you were inspired by that if I’m understanding correctly.
Dr. Tamika: Absolutely, absolutely.
Jen: And so, that was the spark that led you to want to become a doctor down the road. You have an older brother as well, who you aspired to keep up with as a young kid from your stories in your book. Can you tell me a little bit about that?
Dr. Tamika: Yes, my older brother, Melvin, he’s about two and a half years older than me, and we grew up very close, same household, and a lot of similar interests. Just by default, I wanted to do everything that my big brother could do. So, I mean, from swimming, when he learned how to swim, when he could ride his bike without training wheels, when he could stay up late to watch movies, when he could be out with his friends. Even though, I was younger, I always wanted to do whatever he was doing, whatever he was allowed to do.
Yeah, my brother’s one of my best friends, and we’ve been close since we were kids, and still to this day. So, definitely somebody who I look up to as a role model. He’s not in the medical field, but just as far, you know, just his personal world values, work ethic. He’s an amazing husband, and father, and I love my brother so much.
Jen: It sounds like he was a wonderful inspiration to you growing up as you were a couple of years younger trying to keep up with him. You were intellectually challenged trying to do everything he did, which put you naturally very ahead of your age, it sounds like. I think that the description there is kind of the quintessential upcoming physician child who is very intellectually engaged, and really interested in trying all these different things, super smart high achieving kid. Basically, it sounded like from the book you’ve mentioned, a pivotal time where you went and attended a class or a summer program at Emory, where you went for 10 days and how that really influenced you as well. Were you a high school student at that time?
Dr. Tamika: Yes, I was in the summer between my 10th and 11th grade year, and it was called the National Youth Leadership Forum, and they have them in different specialties, but it was the one on medicine. One of my teachers had actually secretly nominated me for that. So, I had no idea until I received something in the mail, inviting me to this 10-day program. This was the first time being so far away from home by myself, except for like a local camp. It was a big deal for me to be able to go down there and just to be able to be exposed to the medical field on another level that I had never seen before, going into the OR, shadowing residents and doctors and medical students sitting in on procedures, like that was something I had never been exposed to. Well, most children, I don’t think are exposed to that at that age. So, yeah, I was super excited to be able to attend that at Emory. It was just confirmation of what I wanted to do as far as be a physician.
Jen: It sounds like it was a wonderful opportunity for you as a high school student to really be inspired and know that becoming a physician was the right direction for you. Then, reading about your experience, as you applied to college, you were looking nationally and went to one of the premier undergraduate schools in the nation, University of Michigan, Ann Arbor, and then on to medical school to specialize ultimately an OB-GYN. So, one thing that I’m really curious to hear about particularly in your story is that, despite the fact that you have this really kind of a classic story of a physician that so many of us can relate to and share in wanting to be a physician from a young age, you also talk about in the book, some disturbing interactions that happen to you as a child as early as age four when you first experienced racism. Can you tell me about that?
Dr. Tamika: I do start off the book talking about my first experience with racism as a four-year-old, and not really fully understanding it at that young age what it was. But yes, at the time, I was at a daycare that was pretty diverse, and we had just moved actually from Detroit, from the inner city out to the suburbs. So, it’s pretty diverse and that was my first time experiencing it. Because at that age, everybody just plays with everybody, right? So, it’s like, “Hey, you like to do this, you like to do that, you like to sing this song or whatever,” and those are the types of things that really foster those friendships at a young age. So, it didn’t really matter to most kids, at least in my opinion as far as you know, where you came from, what your background was, what you talk like, what you look like, things like that.
I remember one day one of the newer girls at the daycare, and she was Caucasian, and she was not allowed to play with me, and my other friend who was also African-American. Because she wasn’t allowed to play with me anymore, it was kind of confusing. I didn’t understand why and she explained that her parents told her that she couldn’t play with us anymore because we are black. I’m like, “Okay.” I remember just kind of innocently just talking to my mom about it when she picked me up from daycare that day, and just telling her why I wasn’t able to play with her anymore. Like I said, at that time, I didn’t fully understand it. My brother understood it, my mother understood that of course, and then over some time, I did until it kind of stuck in my head as my earliest experience with somebody not wanting to be friends or really her parents were telling not to be friends with me because of the color of my skin.
Jen: And fast forwarding to your medical career, you’ve experienced some other incidences that you describe in the book, and I wonder if you would mind sharing some more of that with us. Does another one in particular come to mind?
Dr. Tamika: Yeah, there are several– [laughs] There are several. I didn’t really experience a ton of racism after that as a child because the area that I was in, at the time, was diverse, but then over the years, it predominantly became African-American. It wasn’t as diverse. So, I didn’t really experience it. So, then going to actual college is when I experienced that again, where I became that minority again, and that was a different experience. So, I know, one thing that stuck out to me when I was in college was my calculus class, and so, all of us have to take calculus, it was a prerequisite for most degrees, and in particular to apply to medical school as you know. So, I was in my calculus class, and I was like, really good at math, that’s always been my best subject. I took AP Cal in high school. So, I was pretty confident with my answers in that class.
At the time, when I was at Michigan, it was only about 4% African-American. So, definitely a minority. I remember when we used to– the structure of the class, when we would have lectures a couple of times a week, and then we would also have a discussion or a smaller group, where we would sit and talk about the homework assignments and go work through problems and things of that nature. We also had team homework. With team homework, you had to get together with your group, just like any group assignment, and basically answer the questions that were assigned that week, and submit one answer for the group. Every time that I was in the group as the only African-American female, my answers were always questioned. Anytime I submitted an answer, it was like, “Let’s check your work.” I’m like, “Why are you checking my work and not checking anybody else’s work?” So, it was this constant, subtle, but not so subtle experience of my classmates just questioning the answers that I was submitting, and it always checked out to be correct. [giggles] But that got a little tiresome.
Then, I remember in particular, one day in class it was a very difficult, somewhat of a trick question that he asked us to work out, and people kept raising their hand going to the board, working it out, and getting the answer wrong. But he wasn’t saying that it was wrong. He was just like, “Okay, who else wants to try, who else wants to try?” So, that kind of continued and I didn’t raise my hand. I’ve always been that overachiever that raises my hand in class, and if I know the answer, I’m going to say like, “I don’t care.” But I felt like a fish out of water when I was there. This was my first year, I already had experienced multiple situations that made me feel less welcome when I was on campus. So, I was somewhat academically shy. I didn’t want to raise my hand, I was scared of being like labeled as the dumb black girl. I had never really felt that way before. So, I purposely didn’t raise my hand, and my teacher called on me, and so he asked me to come to the board and work the problem. I’m like, “Okay. I did not raise my hand.”
I went to the board and I worked out the problem and then he asked other people like, “Okay, anybody else have anything?” He didn’t say it was right or wrong. He just kept going through each person, and when I went up there, the answer was zero. So, it was like a trick question. But people were giggling when I was up at the board like giggling like, “Okay, that’s wrong. How did she get that answer, you know, etc.” So, again, I was just going to like, “Oh, this is why I didn’t want to go up there.” I sit down in my seat, and he goes through all of this, and then he basically ends up saying that the only person that was correct was me and that my answer was correct. People were shocked, and a couple of people in my class that were friends at the time fist-bumped me, and it was a good feeling, but I didn’t really feel that happy in that moment, because I didn’t like how my low self-esteem was put on blast in front of everybody and that a subject that I was so competent at and that I had already known that my answer was correct, and then here I am being questioned, just because of what I look like, it just was a very humbling experience.
After class, my teacher pulled me aside, and he could tell I was like on the verge of tears, and he asked me if I wanted to drop the class. It’s funny because I had actually considered dropping the class. I had to take the class regardless, but dropping that section. I had considered it because I had already felt so uncomfortable with the team homework, and I was just like, “Maybe I should just try to switch into another class where maybe it won’t be the same experience.” But then after class, when he asked if I wanted to drop the class, my teacher was Caucasian as well, I was thrown off by it, and I was like, “Well, what do you mean drop the class?” He was like, “Well, I’ve been watching and I can tell that you feel uncomfortable and I don’t like the way that they’re treating you, and you may do better in another class where you’re not experiencing this.” It came from a good place, but I think he felt uncomfortable watching day in and day out. It’s funny because I was planning on dropping it and when he suggested it to me, I don’t know, my pride said, “Drop the class. Like I would never drop this class. Like, yeah, right. It’s not a big deal.”
Jen: But you’re the one who got the answer right.
Jen: They needed you in the class.
Dr. Tamika: Yeah. I remember, I just had a good experience the rest of the class with him, because he just took a special interest in me, I guess. So, that was just like my first time, I guess it sticks out to me, because all those years of really not being questioned, and everybody knew I finished top 10% of my class in high school, and I was in the national honor societies, and Scholars Plus and I’m here at Michigan on a full academic scholarship, I’ve never really had my academics questioned. So, that was my first time of people just questioning me not because I did something wrong because of what I look like or my background. So, it really stuck out to me and it was a very difficult year to transition back to that when I was at the University of Michigan.
Jen: It does sound like a painful experience. As you said earlier, you’ve had multiple experiences like that even in medicine as a practicing physician, and as a resident coming up as you were becoming a practicing physician. There’s a story that you tell in the book of a time when you were practicing with a renowned physician attending who you deeply admired and you were thrilled to be working alongside of her as a resident. Can you tell me about that story?
Dr. Tamika: Yes. That story, I’ll never forget, either. I was a second-year resident at the time, as an OB-GYN resident at my program, we really worked with our special care unit, or the high-risk obstetric patients. We had a patient. She was pregnant and she was admitted with pyelonephritis or kidney infection. At that time, basically in pregnancy they can get really sick, whether they develop an abscess or they’re not improving on IV antibiotics. And again, I’m sharing this with the viewers, I know, you know this, but because of that, we were just really concerned with this patient, checking her vital signs, things like that. She had to leave the unit to actually go to your territory to the radiology suite in order to have imaging done because we were concerned that she wasn’t improving that there was some type of perinephric abscess or something like that. So, when she left the floor, we went to go check on her, my attending and I.
When we went to go check on her, she wasn’t doing well. She was tachycardic, she became hypotensive, she was lethargic, we were concerned that she was going into septic shock. So, we did call a rapid response at that time. So, the nurses rush in when you call a rapid response or code, the ICU team comes in, and nurses, they bring a crash cart, the ICU attending comes in. So, it’s just really to get all hands-on deck, especially, because we’re in the middle of a radiology suite at the time. So, that happened, and the first person to arrive was an ICU nurse, who was one of their, I guess, top nurses at that hospital. When she arrived, she was looking around like, “What did y’all call for?” We gave S bar, we gave like a checkout on why we were calling the rapid response, what the patient was here for, a quick one or two lines of what was going on. The patient was still alert and responsive, not as responsive as we would want her to be, but she was responsive. So she said, “she’s talking, she’s breathing, like, why did you call a rapid response,” which is not to the level of a code, but it’s like the step before, and it’s like what we’re trying to prevent the code. So, we’re trying to get intervention now.
We’re giving her orders, which at that time, it’s really not a time as you probably see like in a code. That’s not a time to question judgment, question cause. It’s like, “Okay, what do you need, and you get it, and you act quickly.” At the time, we were rattling off orders to her and she wasn’t doing it. I wanted to get an additional IV, I wanted to get some fluids, I want to get pressers on deck, things like that. She was just looking at me blankly. So, then my attending who was standing there right with me, who’s triple boarded in maternal fetal medicine, and OB-GYN, and Critical Care Medicine, and the director at the hospital. She’s African-American as well. She started rattling off the same orders like, “We need this stat, we need that stat.” She just wasn’t really doing anything. She was just sitting here questioning “why we were calling this” and “this was unnecessary.” So, people are arriving to the scene, and she’s telling them like, “Oh, it’s no big deal. Patient’s talking and patient’s fine,” blowing it off. So, then the ICU attending, tall white male comes in, and he’s like, “She’s going into septic shock. Why don’t we have another IV and rattling off the same thing that we had just ordered?” She’s like, “Right away doctor,” and she’s basically doing all the orders that he’s rattling off. So, he saw that dynamic. The patient’s stabilized, she was fine, and then afterwards, he pulled us aside in the hallway just talking about how embarrassed he was, and he didn’t know why she was behaving like that. But we all know why she was behaving like that.
It could have been gender, it could have been race because we were two African-American women. It wasn’t age because there was about a 40-year age gap between the two of us. So, I don’t think it was that. But either the fact that we are women or the fact that we were African-American, but she was not listening to anything that we said. So, he came in and said the exact same orders. So, that did stick out to me as just like, “Wow, well, I’ve been undermined, and I know, I’m just a resident, but here she is. Does she know who she is? Does she know good textbooks that she’s written, and the papers, and the research that she’s done all over the country? Regardless, we were dressed the same, we all had on the same white coat and the badge. She knew we were doctors, we introduced ourselves as such. So, there was really no confusion there. Yeah, it was a very unfortunate situation. Luckily, the patient did okay. But it could have ended very badly for the patient.
Jen: Absolutely, and that really brings to mind the kind of thoughts that might come through your mind as a resident, which would be, “Am I being overlooked, because I’m a resident, or is it because I’m a woman, or is it because of my race?” But having her there and having her be a senior person who was nationally well respected in addition to being highly respected in the hospital and a director, as you said, so that really clarified it. It was unquestionable and it’s disturbing that you have had to go through these experiences, but I’m especially grateful that you’ve written this book to talk about these experiences, because I’m sure from talking with other people knowing that you’re not alone, it must be very motivational. Is that the right word to use to describe what is making you be willing to tell your story?
Because for people who are not present when something like that happens, we need to know that these things are happening. After all of these experiences that you’ve had, there was another kind of a moment, perhaps a pivotal moment. I don’t know, I’m curious to hear from you that happened when you were not in the hospital, but had to do with your role as a physician, when you boarded a flight on October 16th, 2016 from Detroit to Minneapolis, and listeners may have read about this in the news at the time, or may have seen it on social media, but I’m hoping that you will tell us what happened there as well.
Dr. Tamika: Yeah, absolutely. As you stated, I was going from Detroit to Minneapolis on a layover, but also really coming back to Houston was my final destination, and back home for a childhood friend, her wedding, everything was great, and then yes, when we were on the flight, mid-air, there was a flight emergency where a patient was unresponsive. They needed medical personnel. So, they asked for physician or medical personnel. So, I guess, to backtrack a little bit. The first time actually happened, there was like shrieking. I had headphones on. I couldn’t hear exactly where it was coming from. When I first looked over to see what happened, they had blown it off and said, “Oh, he was just having a night terror. It’s fine. He was good. He was responsive.”
Then when it happened, again, they were like, “No, we need to get medical personnel to help.” This is just a couple of rows in front of me and on the other side of the aisle. So, at the time, the flight attendant was walking to the back while shouting out orders to the other flight attendants to crawl over the intercom on the plane to see who was on board to be able to assist. So, I tried to flag her down and she was passing my feet to let her know like, “Hey, I’m a physician,” and she was like, “Oh, no, sweetie, we’re looking for actual physicians right now.” I don’t know what she thought I was getting her attention for. I don’t know if she thought I was going to ask for a drink or ask for a cookie. I don’t know. But she immediately blew me off.
Right, when she’s saying that now you’re hearing it on the intercom in the plane where they’re asking for a physician, and so, I’m still talking to the lady, and I’m pressing my button because it’s a pressure call button. So, I’m pressing my button, and she’s like, “Oh, you’re an actual physician.” I was just like, “Okay.” We basically entered into an exchange, a conversation, where she starts questioning me like, “Oh, you’re a physician. Well, why are you in Detroit? Where are you coming from, and where do you practice and do you have your degree on you, what credentials do you have on you?” Just asking me all these questions, mind you, this person is still unresponsive. So, I’m just like, “Okay, can I assist the person?” But she didn’t want me to even get up out of my seat. So, she could verify who I was, and she didn’t believe the credentials that I had stated verbally to her. So, basically, there was this back and forth.
Eventually, somebody else, a middle-aged white man, comes from the front of the plane, and he’s walking back to where the unresponsive passenger is. That’s when she lets me know like, “Thank you, but we don’t need your help. He’s a physician and he has his credentials.” I was just like, “How do you know he has his credentials? You’ve been talking to me this whole time. You haven’t talked to this man. But you just know he has his credentials.” So, it was like just showing up and fitting the description is how I like to describe it. So, they let him assist the passenger, it’s fine, and then after some time kind of goes on, I guess, he was a little tapped out as well. So, they kind of just wanted a second person. So, she came back to me, asking me questions, and bringing me vital signs and things like that, like written on a little piece of scratch paper like, “This is the blood pressure, what should we do?”
As you know, being a physician, it’s difficult to imagine trying to treat a patient through a middleman. You’re not letting me actually interact with the person, you’re not letting me get a history, get an exam, you’re not letting me you know do anything. You’re coming and you’re bringing me little pieces of paper that has little values on it and trying to see, what would you do just to see if it matches up to what the other physician is saying? Normally, I wouldn’t even entertain something like that, but it’s an emergency, we are 30,000 feet in the air, I’m like, “Let me do what I can to help the patient, passenger,” excuse me. So, this continued, and the passenger was fine, and then she came back over to me towards the end of the flight and just started making small talk about, “Oh, what kind of doctor are you? Oh, my daughter just had a baby. Oh, you know, etc.,” and trying to just tell me that it was a big misunderstanding, and that she wanted to transfer some SkyMiles into my account, if I would give her my number. I told her, “No, it’s not necessary.”
As soon as I got off the plane, I recorded it and it essentially had to escalate up to the company, until somebody took it seriously because the first person I reported it gave me a free drink ticket. I knew that they didn’t get it. They didn’t get the gravity of the situation. I’m like, “I’m not looking for rum and coke. That’s not what I’m looking for.” At the time, I sat on a lot of different committees from a safety standpoint. I was actually a Chief Resident at the time. So, I sat on a lot of different safety committees at the hospital. So, that’s just how my brain works. Like this is a safety issue, how can we prevent this from causing a negative outcome in the future. That was kind of the mode I was in. So, I escalated up to the company all the way up to the CEO of the airline, and basically continued to call and write and meet with them until they revisited their policy, because essentially, they were saying that, she did act within the policy of the airlines, and that you are supposed to verify credentials and things like that, and she did what she was supposed to.
That’s when I went, with a mentor of mine, just showing data, and there was actually a recent article in JAMA that talked about that, and then the flight emergency, there’s not time for that. You’re supposed to be able to state your credentials, and then you’re allowed to help. Now, if I was going to sit over here and crack open somebody’s chest, yeah, you may want to verify my credentials online first. But you know, just to do an initial– because I mean let’s face it, you don’t have to be a physician to assist. If they had a paramedic, if they had a nurse, anybody in the medical field would be better than nothing. A flight attendant with no medical training, so they realize how outdated their policy was, and how problematic it was, and they actually changed their policy as a result of those continued meetings on December 1st, 2016.
Yeah, there was a lot that transpired from that. I did share in order to get their attention, because they were initially addressing the issue and importance of the issue. I did post my situation to social media, and that story is what ended up going viral, unbeknownst to me when I was on my second leg of my flight, and then that’s where all the news stories, and television shows, and things like that came as a result of that incident. Then that’s, of course, with any major company may see that they’re like, “Okay, let’s call this woman, let’s see what we can do to figure out what’s going on.”
Jen: First of all, I mean, kudos to you for everything you’ve accomplished, because it’s difficult enough to just be pre-med, and just go to medical school, and just be a resident, and just be a practicing physician. But to do it with the extra burden of these types of incidents, and things that make it more difficult to accomplish all the way through along the way. At what point did you decide to tell your story? Because that’s another burden, really, to have to tell you her story or to feel a need to tell a story. So, I’m curious what your thought process has been with that decision.
Dr. Tamika: Yeah. I think that incident is really what served as the motivation behind sharing my story, because I shared that one isolated event that happened on the airlines in 2016, and I saw how much it resonated with people all over the country and even in other countries. I have people in other countries sending me stuff, some stuff I couldn’t even read because it was in other languages. It really helped me to understand like, “Wow,” and I knew that this was not a unique incident. Yeah, this is an incident that I’m bringing to the limelight because people need to know that this stuff happens, but I know that it happens every day from colleagues and friends. But to understand like how much of an impact that it made, because as soon as I shared my story, all these other physicians from different backgrounds, different gender, nationalities, religions, every different background was sharing their story, and that’s where ‘what a doctor looks like hashtag’ came from.
Because in that situation, they didn’t believe that I was a doctor based on what I looked like, whatever that means. It’s like, “Well, what does a doctor look like?” We look like all different things, different shapes, sizes, colors. So, that’s when that hashtag really went viral. I understood that how many people needed to hear that story, and how many people could… by me sharing my story, it opened up that door. When I saw that it motivated me to want to share not only that one story, as you know, it’s only one chapter in the book, but to share all the other stories of the journey that I had in becoming a physician, because it’s very similar to a lot of people’s stories who look like me, whether it be another woman, whether it be another African-American, whether it be somebody else from an inner city, whatever it may be. So, that’s what really motivated me to share those stories, even though, some of those stories like some of my best friends, they’re learning stuff about me from the book that they’ve never even knew that I encountered, especially, just some of the different identity issues that I had as a light skinned little black girl. What that means and how my hair’s not like, you know, everybody else’s is and etc.
Because of that, it made me want to share my story, because I realized that it could motivate somebody else that is starting at that same point or starting at some point in that journey that, “Hey, you too can become a doctor, stay the course, and serve as like a motivation that there’s no cookie cutter experience that’s going to get you to becoming a physician. It’s really about perseverance, persistence, and really just blocking out the naysayers and staying focused on the dream and the goal.” That’s why the subtitle of my book is Society’s Unrealistic Dreams Are Your Attainable Goals, because society tells us so many things are unrealistic. Many people told me I would never become a doctor, including my advisor in college, who encouraged me to change my major. So, if I listened to those people, I wouldn’t be the physician that I am today. So, it’s really just to serve as motivation as well.
Jen: I think, it’s a wonderful point also on what we’re terming the new era of leadership in medicine, which we all recognize is sorely needed. I think we’re at the beginning of a transformation now, where people typically when they move up into a leadership role, they’re looking at other leaders, they know as examples, and it’s important to look within yourself, and see who you are, and how you can lead. I think you’re showing people that by doing what you’re doing and you’re showing people as an example yourself that younger physicians can look up to, and try to see themselves in you and the example that you’re setting. So, I think it’s a wonderful step that you’re taking, even though, it is a burden to tell the story, because unfortunately these things should never happen and it’s crazy to think that in 2021, we are still seeing this. Crazy to think in this century, we’re still seeing this. But since we are we need to address it head on and I really commend you for doing that and for opening this door for so many of us.
Dr. Tamika: Thank you.
Jen: Thank you. And is there anything that you would advise a younger physician at this point, if you were say, looking back to yourself and thinking with everything that you know now, what would you say to your younger self?
Dr. Tamika: I would say to myself or to any other young aspiring physician, stay the course and there’s going to be a lot of things that happen along the journey. It’s not going to be a straight path. It’s not a straight path for most of us. You’re going to have some bumps in the road, some curves, things of that nature, but it’s important. If that’s really what you want to achieve and that’s your goal, that’s your dream, don’t let anybody tell you that it’s not attainable or that it’s not possible for you to do that. I think it’s also important about what decisions you make and who you surround yourself around. So, I always tell people, you know, that’s really, really important. So, for me even though like my grandmother was my inspiration in becoming a physician, she wasn’t a physician. She was an RN. Her journey back many years before mine, is going to be very different, and it’s because of a track to go to nursing school. So, I didn’t have another physician in the family to look up to or to really teach me this blueprint. So, I had to really identify mentors whether they look like me.
Sometimes, some of them didn’t look like me. But to be able to have somebody that understood my background and that could help me get to where I needed to get. Sometimes, you have to put yourself in that uncomfortable situation and get outside of your comfort zone to be able to identify people that can help you get to where you need to get, and you really have to drop the pride sometimes to do that. And I do think that sometimes they can be more helpful if it’s coming from somebody that looks like you, because some of the struggles that you’re having along the way, may be specific to what you look like, and they can relate on a different level. So, when I went through that one of my mentors, the director I was talking about, Dr. Witte, when I went through that, that was a good person for me to go through that with. Because I could talk to her about it because I was discouraged after that. I was like, “Well, there’s no hope for me. You are near retirement, you’re still dealing with the same things that I would think is over and done with and is in the past.”
Jen: Did you see your reaction being different from hers in that situation?
Dr. Tamika: It was. My reaction was different from hers. She was appalled, but hers was a little bit more desensitized. It’s like, because you get used to dealing with it so much that we become desensitized to it. That’s how I was getting but that situation, I was like, “This is a big deal.” I wanted her to be more outraged. I was like, “Are you angry? I’m angry.” So, it was a different reaction. It really took, you know, her pulling me to the side and talking through that, that I don’t think everybody will be able to do if they couldn’t relate to that experience. She had had a hundred different experiences like that in the past through her journey in becoming a nurse and then becoming a physician after that. She has both in our past. So, yeah.
Jen: How would you advise someone who is dealing with a situation similar in any way to that?
Dr. Tamika: Yeah, I definitely think like again as far as having a good solid mentor that you can talk through those situations with whoever you identify as such is important. I also think it’s important to really– You have to pick your battles right– you have to pick your battles. So, it’s going to happen and you have to know that. It’s going to happen, and it’s going to happen again, and it’s going to happen again. And how you react to the situation makes the world of difference. So sometimes I think we just learn to just brush it to the side, we don’t want to be labeled as aggressive, we don’t want to be labeled as a troublemaker, we don’t want to be labeled as anything disruptive, and it depends on where you go, but we are kind of like, once you get into that position, sometimes people make it feel like, “You’re lucky that you had this chance.”
Jen: We’re conditioned to that way in medicine in general. We don’t make waves. You take whatever is put on you, and you just do whatever you can with it. Don’t complain. Yeah, as the culture already, and then–
Dr. Tamika: Yeah, and then, there’s definitely another element or another layer to it, I think being a woman, and there’s another layer to it, being a minority, an African-American, or another person of color. So, I think that those are important layers, because when you think about women, especially, like if you’re in a competitive field or you’re in a surgical specialty, it’s almost taught like, if you want to roll with the big dogs, suck it up. They’re going to talk about different, I’ve had times in the OR where they’re saying like sexist things, and you’re just told to just be quiet and ignore it. For years, it’s been a male dominated field. So, we’re supposed to just suck up and deal with the sexist remarks that we hear day in and day out or you tell somebody like, “Oh, yeah, well, the doctors coming in.” It’s like, “Well, I don’t see him like, well I’m here to help.” So, there’s just little things and then definitely being treated differently as a woman and then being a person of color is an added layer to that.
I encourage people like, “Yes, pick your battles. You can’t sit up here and argue about every time that something happens, that’s not fair, that’s going to happen. But at the same time, speak up. Speak up about it and a lot of people are concerned about speaking up, because they’re concerned about what the consequence is going to be. The consequence is going to be heavy. I’m not going to lie. That situation happened in 2016. Like I told you, I was a Chief Resident at that time of my program, I was interviewing for jobs. Literally, in the middle of interviewing for jobs, that’s when this happened. I was told by several people to take it down. Take down your post and stop talking about it or you’re not going to get a job. I had that option. I considered it. I’m not going to lie. I considered it, like, “Man, you work all this time to get here and you’re finally getting an interview for your first job as like a real physician, an attending physician, and this happens.”
That’s why I always tell people they’re like, “Oh, you did this for attention.” No, I didn’t do this for attention. Why would I want that kind of attention in the middle of an interview? So, I do think it negatively impacted me. Every single interview I went on that season asked me about it. “You’re the girl from the news, how does it feel to be famous? How does it feel to cause an uproar?” Sometimes it was the negative undertone. So, you have to pick your battles, but at the same time, I think it’s important to really understand what you’re doing, and know that the overarching goal, at least in my case, I feel like the overarching goal was more important than anything else, and I’m like, “If you’re not going to hire me because of this situation, when I was the victim in this situation, then I don’t want to work there anymore.”
Jen: Right. That’s a very important point. I think it’s really important to stand up for what values are important to you, and if an employer doesn’t match those values, you don’t want to work there anyway. So, that makes complete sense and I’m happy to hear that, that’s what you did, and it did work out in the long run. So, if it made you steer away from some places, then that’s probably for the better. [chuckles]
Dr. Tamika: Absolutely. I ended up taking a job at the place where I actually had residency at the University of Texas, and they were super supportive through the entire process. So, that let me know too like, how they deal with those situations that have any value. They didn’t tell me to shut up and be quiet and stop talking. Because the media was there. They were following me. They were coming to my job every single day. They’re calling our department every single day verifying if I was a real doctor, verifying, if I was 28 years old, verifying all these different things. It was tiresome for the department. So, they could have easily told me, “Tamika, we need you to be quiet.” But they didn’t. They encouraged me to continue to tell my story, and I appreciated that and that’s why I ended up actually accepting the offer.
Jen: Have you heard feedback from younger physicians at the University of Texas who were inspired by you standing up for what’s right?
Dr. Tamika: Absolutely. I actually, pre-pandemic– even through the pandemic, I did a little bit but pre-pandemic, I did a lot of talks from coast-to-coast talking about different things like this. So, I did do some talks at the University of Texas with some of their different like medical organizations and things like that and student organizations on campus. But I also even went out to California, and Harvard, and Oberlin University. So, I hopped around state to state talking about the bigger picture, not just the story. Yeah, the story is what brings everybody in, because they saw it on the news, but really talking about the overarching issue of implicit bias and things like that and what can we do to combat that.
Jen: Do you have solutions in mind for how to best combat that or a place to start?
Dr. Tamika: Yeah. I think the place to start is within yourself. Implicit bias, it’s unconscious. It’s important to know that we all have it, and to recognize it, so you’re not allowing it to interfere with the decisions that you’re making. You know very well being a physician that when you’re treating a patient, you have to treat the patient even if they have different morals than you, different beliefs than you. So, sometimes avoiding certain conversations sometimes it’s helpful, because if you know that this person, I don’t know this person’s a criminal, or whatever it may be. When you say it, it’s not going to impact your judgment. There are studies that prove that you do treat that patient differently. That’s just a part of being human.
Sometimes, it’s important to recognize, “Okay, what are the biases that I harbor and how can I put those aside and focus on, “Okay, how do I help this patient?” So, I think it’s important in day-to-day, but I think, it’s also important in the workplace, whether it be medicine, it’s really important, because this is somebody’s life on the line. But I think it’s important in other industries as well in the workplace. So, I think the first place to start is within yourself, identifying it, understanding that you have it. We all have it, and just being conscious of it, in itself by definition is going to combat the unconscious nature of implicit bias to avoid that from getting in the way of making your decision. Then, I think secondly, it’s important if someone’s telling their story about a situation that has happened or has occurred, instead of writing them off, or blowing them off, or talking over them, just listen. Hear them out and try to understand. You can’t always understand from somebody else’s perspective but try to understand where it’s coming from because I used to talk about this a lot.
There’s stories I talk about in my book dealing with different things as an African-American when all of the different killings of innocent black men were happening back to back and 2016 was a big one. When I talk about stuff like that to my classmates and some of them just like, “Oh, yeah, well, they deserved it, or they did this, they did that.” It’s just like, that’s probably not the best approach. Just hear me out and think about how do I feel every day, how do I feel going through? Well, you’re not the problem, you’re not this, you’re not that, and it’s like that could have very well been my dad, or my brother, or my nephew, my grandpa, or whoever. So, just I think trying to understand instead of just blowing off somebody’s situation, I think that’s important as well.
Jen: Definitely. Very important and very well said. This is Dr. Tamika Cross. Her book is What a Doctor Looks Like, just came out in March of 2021, and I really appreciate you taking the time to come on the podcast and tell us about your story, tell us your insights into implicit bias, and what we can all keep in mind, and try to do to move our culture forward in medicine to improve it. Thank you so much for coming on DocWorking: The Whole Physician Podcast.
Dr. Tamika: Thank you for having me. I’ve enjoyed our conversation.
Jen: As physicians, it’s our job to deal with complex and challenging situations. When we’re taking care of patients, that’s what we do, that’s what we’re good at. But there are situations that occur that are outside of patient care like being overscheduled, or a colleague who’s acting inappropriately, we may feel in the context of a very busy schedule that we don’t have time, or the resources to go to anyone, or to reach out for help in resolving this. But what if you were part of a community of like-minded physicians, where you could go confidentially and discuss these issues and look for solutions, and hear about experiences of other physicians, and how they’ve solved similar problems facilitated by a group of experienced coaches who specialize in working with physicians, so that you could go back to work, fix these problems with confidence, and get on to enjoying your life again.
Amanda: I’m Amanda Taran, producer of DocWorking: The Whole Physician Podcast. Thank you for being here. Please check us out at docworking.com and please don’t forget to like and subscribe. Thank you for listening.