True Bravery

Giving ninety days’ notice to leave a job as a family physician at a community health center provided ample opportunity for me to say goodbye to patients. I listened carefully at farewell visits. A Black patient minced no words as she proclaimed to me, a White woman, “I will tell you what I like most about you. You listen and you don’t act like you know more about my body just because you’re a doctor.” Her words made a profound impact on me.

Since then, I’ve been thinking about the courage it takes to share truth about one’s body with those in power who control the health care system. For centuries, White people have systematically told BIPOC folks that their embodied experience is invalid. That they are not the experts on their body. That their voice should be silenced. BIPOC patients have expressed to me that many White health care providers minimize and undertreat their pain, trauma and grief. Even my BIPOC physician colleagues have described infuriating situations when hospital staff ignored their physical and emotional concerns, resulting in increased morbidity and mortality.

In my new workplace, I am working to expand our trans and gender-diverse youth health program. A phenomenal team of health care providers, behavioral health specialists and staff coordinators collaborate to help trans and gender-diverse youth be who they truly are. This team evaluates each child to ensure that the child’s dysphoria is truly about gender, that the gender dysphoria has persisted, and that no other health factors confound the dysphoria. At every visit I marvel at the bravery it takes for that child to come out to the world as their true selves. They are not who society thinks they are, and they seek respect and gender-affirming health care, despite politicians and others who try to annul their freedoms and deny their existence. Accompanying parents and family may not understand their children’s experiences firsthand, but they love and respect their children so deeply that they listen and trust them.

My unsung heroes are those who, despite institutionalized racism and transphobia in medicine and society, bravely express their truths. I also celebrate people in health care who listen intentionally, believe, and affirm these patients. Together, these unsung heroes transform open and honest communication into patient-centered care. If only these heroes’ bravery was contagious and could spread to government and institutions.

Pamela Adelstein
Newton, Massachusetts