FEATURE
I AM SORRY AUTHOR Susan Bornstein , MD
I
would like to apologize . In Jewish tradition , the time between Rosh Hashana , the New Year , and Yom Kippur , the Day of Atonement , is set aside to reflect on the thoughts and deeds of the past year . On Rosh Hashana , it is written , and on Yom Kippur , it is sealed . It is the time to look back and repent for one ’ s transgressions . However , the theology is specific on how this must be done . It is permissible to ask God for forgiveness for sins we have committed against God , but , in similar fashion to Alcoholics Anonymous ’ 12-step program , we must make amends directly with those living persons whom our words or actions may have harmed . Given the vagaries of memory in general , and mine given the duration and passage of time , and the number of opportunities to have committed offense , it is impossible for me to contact the referenced individuals directly . I hope that this appeal will reach at least some of them .
This year , with the unmasking of past and current police brutality directed at minority , primarily Black , members of our society , and the accompanying long overdue examination of our nation ’ s racist policies and actions , I have been motivated to examine and take responsibility for my own behavior . Specifically , for a long time I have been aware , at an abstract level , that racial discrimination existed in health care , and consciously tried to avoid this in my interactions with my patients , my colleagues , my staff and the hospital personnel . However , I have no idea if I was successful because I never tried to find out . When I complimented a Black patient ’ s finger waves , intricate plaits or fanciful weaves , by saying that I pined for hair like hers , that it always looked beautiful , and stayed in place for weeks at a time , it was meant as praise , as well as an attempt to connect , to establish rapport . Plus , I had the “ monumental ” inconvenience of having to wash and style my hair every day ! On reflection , could the comment have been construed by its recipient as meaning that I only wanted to have her hair , but not the totality of what being a Black woman represents ? While it may or may not have reflected that particular Black patient ’ s lived experience , the patient whose hair was only a part of her whole , the reality is that many Black women experience ( on average ) less wealth , more obstacles to higher education , covert and overt discrimination , redlining , suspicion , fear and poorer health compared to white women , compared to me . I certainly did not covet those things which made life harder , and I failed to recognize that it was impossible to have the hair without all the rest . I hope that my remark on my patients ’ hair was received with the positive intent with which it was offered , but it is entirely possible that it was not . I do not know , because I did not ask . If I had , I might have learned something that would have prevented me from volunteering a thoughtless , or worse , insulting , comment in a subsequent encounter . I might have learned more about racism in America , about how I could be anti-racist .
It is well known that doctors have even less time to spend with their patients than ever before , given the escalating pressure to meet productivity goals and the demands of the electronic health record , which takes attention away from the patient in front of us . In my zeal to meet my patients ’ medical needs , did I overlook their psychological and interpersonal ones ? Was I inadvertently dismissive of a team member ’ s contribution ? Was my hurried tone disrespectful ? Despite my efforts , did I fail to meet my own ( sometimes unrealistically ) high standards ? Simply failing to recognize that something I said or did was perceived as racist , demeaning or offensive does not excuse it . The sins of omission are no less egregious than the sins of commission . I will try do better . I apologize and ask for forgiveness . Ashamnu .
With gratitude and acknowledgement to Ibram Kendi , Ijeouma Oluo and Robin DiAngelo , whose words have expanded my consciousness and have made vital , illuminative contributions to our national understanding of racism and the false and destructive categorization of race .
This article was previously published in Dr . Bornstein ’ s blog , which can be found at www . susanbornsteinmd . com .
Dr . Bornstein retired from her gynecologic practice to focus on health care delivery system advocacy and reform .
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