publication date: Aug. 6, 2020

Guest Editorial

Living as an ethnic minority in a nation laden with discrimination

Coral_Olazagasti

Coral Olazagasti, MD

Hematology/oncology fellow,

Zucker School of Medicine at Hofstra/Northwell Health

 

Diana-Martins-Welch

Diana Martins-Welch, MD,

Assistant professor,

Donald and Barbara Zucker School of Medicine at Hofstra/Northwell

 

As a Latina, I feel deeply impacted when I see reports of hate crimes against ethnic and racial minorities in the news. The recent string of news reports highlighting police brutality and the victimization of black people has caused a great deal of pain in my heart, prompting me to reflect on my own experiences.

Being born and raised in Puerto Rico, I received my Bachelor of Science from the University of Puerto Rico followed by a Medical Degree in Universidad Central del Caribe in Bayamon, Puerto Rico. After much deliberation, I took a leap of faith to widen my horizons, leave behind the only place I knew as home and move to the mainland to pursue a residency in internal medicine in New York City. One would think that because Puerto Rico is a United States colony, the transition would be a rather smooth one. This was not quite the case.

My first block as an intern was in the Medical Intensive Care Unit. I remember that in my first week, a pulmonary and critical care fellow decided it was acceptable behavior to use an extremely derogatory term and tone to describe a Hispanic patient, despite being aware of my background. Not understanding what prompted my colleague to say such a thing, and at the time being somewhat naïve to a culture of discrimination, I ran and locked myself in the bathroom to cry desperately. Even now, I can close my eyes and remember the pain I felt in that moment. Since then, I have grown much thicker skin, but, unfortunately, the encounters did not stop there.

Throughout my six years living in the U.S., I can recount many instances of macro- and micro- aggressions, many more than I would like to remember. I have been subjected to many discriminatory experiences because of my race/ethnicity, culture, upbringing, skin color, and accent. For instance, I once had a white male patient fire me and the African American nurse working alongside me during a night shift—because of our race/ethnicity.

I have been questioned more times than I can count where I went to medical school because of the way I look, or asked apprehensively where I come from because of my accent. I have been made fun of for my heavy accent, or when I have made occasional mispronunciations. In one instance, I, along with other minority friends, was harassed by a group of white men at a restaurant/bar for speaking in Spanish while dining.

In an attempt to minimize the hurt caused by such scarring experiences, I have created walls and defense mechanisms that, in hindsight, were not the appropriate path to take. Early on I learned that if I start making fun of my own accent, the feeling of alienation would be lessened since I would not be the subject of someone else’s joke made at my expense. I have changed the pronunciation of my name to make it easier and more “American-like” even though I deeply dislike it. I have even taught myself to “tone my Latina down,” after being called “too eager or excited,” to try to fit better into what I believe is more socially and professionally accepted.

Even without clear intent, I’ve been made to feel less-than, which at times has had a great impact on my self-esteem as a physician. I often find myself comparing my abilities to others’ and doubting my potential. That is, until I remind myself that I have the same medical training as my counterparts that surround me and I should never put down my own sacrifices and hard work that have led me to where I am today.

As an expectant mother with a son on the way, I fear about the repercussions of bringing a mixed race child into this world and the impact it will have on his life. I will never want my son to experience firsthand the hate of others for something that is out of his control, or to be made to feel less deserving. I also realize that discrimination is an issue that has to be confronted head on. Speaking about it and educating others is the only way to overcome it. Throughout these times of self-reflection I learned that minimizing myself in the hopes of fitting to others’ impression of ideal is not only detrimental to me and my future child, but to other minorities that are made to feel like being themselves is not worthy or enough.

My career goals are the same that they were when I first decided to trust my gut and expand my horizons. Today, more than ever, I am convinced that I am where I’m supposed to be. This experience has taught me that I should use my journey as an opportunity to lead by example for other minorities who aspire to be physicians and achieve greatness, but do not have the mentorship or guidance.

Data from 2015 U.S. medical graduates showed that only 4.6% were Hispanic/LatinX, and 5.7% were Black or African American.1  Although there have been attempts to implement changes and increase diversity and inclusion, not much has changed throughout the years. As of 2018, only 5.0% of all active physicians in the U.S. identified as Black or African American, and 5.8% identified as Hispanic/LatinX.2 Similar statistics are seen in the field of hematology-medical oncology, where racial and ethnic minorities are largely underrepresented. A census by the American Society of Clinical Oncology has shown that only 2.3% of practicing oncologists self-identify as Black or African American, and 5.8% self-identify as Hispanic, despite accounting for 13% and 18% of the total U.S population.3

I want to be an example to others—that the sky is the limit when you work hard and believe in yourself. Additionally, I want to be a voice for my Spanish-speaking patients who express such gratitude for having a doctor who speaks their native language, and whose lives and medical care are positively impacted by having physicians who look and speak like them. Ultimately, I must not forget that over the past six years, the amount of positive experiences I have had along with the supportive colleagues, faculty and mentors encountered far outweigh the negative instances I have faced.

I believe there is a lot of improvement that has yet to be done, but I also know in my heart that we are on the right path. The good far outweighs the bad. By acknowledging that the U.S. has a discrimination problem, we can then make strides to effect necessary change. This nation was built by immigrants, and there is beauty in inclusivity and justice. In inclusivity we find union and power, and essentially, that is our nation’s goal.


References:

  1. Current trends in Medical Education. Washington, DC: AAMC; 2015. http://www.aamcdiversityfactsandfigures2016.org/report-section/section-3/

  2. Diversity in Medicine: Facts and Figures 2019. Washington, DC: AAMC; 2019. https://www.aamc.org/data-reports/workforce/interactive-data/figure-18-percentage-all-active-physicians-race/ethnicity-2018

  3. Facts & Figures: Diversity in Oncology. ASCO 2016.https://www.asco.org/practice-policy/cancer-care-initiatives/diversity-oncology-initiative/facts-figures-diversity


Corresponding Author:

Coral Olazagasti, MD

Barbara and Donald Zucker School of Medicine at Hofstra/Northwell Health
450 Lakeville Road
New Hyde Park, NY 11042
Contact Number: 787-398-5854
Email: colazagasti@northwell.edu


Disclosures: The author has no conflict of interest to disclose in relationship to this work

Funding: none

Copyright (c) 2020 The Cancer Letter Inc.