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Off the Page

How Black women overcame enormous struggles to become physicians

The cover art for the book Twice as Hard by Jasmine Brown
The cover art for the book Twice as Hard by Jasmine Brown

Jasmine Brown, author of TWICE AS HARD, talks about the historical obstacles Black women faced to become physicians.

When Jasmine Brown was a student at Washington University in St. Louis, Missouri, she began to notice that she was the only Black student in her field of study. An aspiring physician, she also started to notice just how few Black female physicians she encountered. Today, just 2.8% of physicians are Black women.

As a Rhodes Scholar, Brown began the research that ultimately became her book, Twice As Hard: The Stories of Black Women Who Fought To Become Physicians, From the Civil War to the 21st Century. In it, she shares the stories of women like Dr. Rebecca Crumpler, the first Black woman who became a physician in 1864. Or Dr. Lena Edwards, who, at the age of 60, helped found Our Lady of Guadaloupe Maternity Clinic in Hereford, Texas, a mission devoted to serving migrant workers and their families.

On this episode of Off the Page, Crystal Sarakas talks with Jasmine Brown about several of these women, and about the struggles that Brown has faced on her own path to becoming a physician.

Read below for an excerpt from the book, Twice As Hard

As I sat in my cramped dorm room in Oxford, England, I listened to a voice resonating through my laptop. It transported me to the other side of the world. Back home.

“After I got a taste of this thing of college, then I had to have more of the same . . . I loved it . . . I mean, my getting back to college, I was delighted. Now my only fear there was that I could not possibly make enough money with my mother to go into the next year. So, I decided to make as much of that year as I could, you see. And so that I could at least say that I had two years of college, or three years of college, you see.”

The sound of Dr. May Chinn’s voice seemed so familiar. It felt as though she was one of my great-grandmothers. Dr. Chinn and I were born a hundred years apart, and she passed away forty years ago. Still, her voice bent through time and touched my soul. I could imagine us sitting on a pillowy couch in a cozy living room, both sipping a hot cup of English Breakfast tea as she told me her life story. She bravely hurdled the challenges of being a black woman entering the unwelcoming field of medicine in the early twentieth century. And she came out on the other side in triumph as a skilled physician who made a huge impact in her patients’ lives.

Her story resonated with me. As a black woman medical student who will be the first in my family to become a physician, I’ve faced my own set of trials. When Dr. Chinn recounted her experience with medical col leagues who disregarded and ostracized her, I felt the burn of salt being rubbed into wounds that have not had the opportunity to heal.

It was the beginning of my junior year in college at Washington Uni versity in St. Louis, and my first day back in my neuroimmunology lab after a few weeks of vacation. I approached the lab’s entry door with my ID in hand. An older white man whom I didn’t recognize trailed behind me. He didn’t provide any explanation about his connection to the lab. I didn’t request one. While the lab is large and composed of multiple smaller labs within one space, we have a culture of opening the door for one another. We assume good intent. This is the mindset I adopted as I prepared to give this unidentified man access to my lab.

Swipe. I placed my ID through the card reader, but a red light flashed in response. I reminded myself that this card reader was finicky. So I tried again.

Swipe, swipe. More red light. This time my cheeks flushed to match the color of the reader. It didn’t make sense. My card was supposed to work. It had worked all summer. I had even spoken with technology ser vices before my vacation to ensure that my card would still work when I returned for the school year. I was confident that the problem was with the card reader, not my card. So I tried again.

Swipe. Red light blinked back at me in innocence. I relented. Steeped in embarrassment, I asked the mystery man if he would open the door for us.

With raised suspicion, he countered, “Are you supposed to be in this lab?”

Immediately, my body froze. While his question may have seemed innocent, the doubt laced into his words brought me back to my child hood. Since elementary school, other kids have told me that I am stupid and will never belong in the highly praised realms of science and medi cine. “You’re black. Black people aren’t smart.”

When my AP calculus teacher announced that I had scored at the top of my class on the midterm exam, my classmates looked at me with shock. I was the only black person in the room. They didn’t understand how I could’ve outperformed them on a test, let alone a math test. Then, as I neared the end of my high school career, people who claimed to be my friends suddenly turned on me. They confidently explained that I would get accepted into college because I was black. Not because I had a near perfect GPA with countless AP classes on my transcript, coupled with the fact that I was president of multiple organizations and a var sity athlete. My academic achievements were worthless in their eyes. The only purpose I served was filling a quota. To make matters worse, numerous classmates told me that I would never succeed in higher edu cation or in a STEM career. I was a black woman, twice disadvantaged. Success was incompatible with my identity.

The mystery man’s supposedly harmless question excavated im mense pain that I had fought so hard to keep buried. Feeling like a deer in headlights, I answered his question without being able to vocalize the emotions that suddenly rushed over me. “Yes. I’m a student at Wash ington University, and I work here.”

He was not convinced by my explanation. “Can I see your ID?” I readily handed it over.

“Why doesn’t it look like my faculty ID?”

“Because I’m a student. I’m a student at the university.” My ID read “Washington University in St. Louis” at the top and had a recent photo of me in color, with the word “Student” below. After examining my identification, he remained skeptical. The air be tween us was tense. It was like I was a thief preparing to break into a lab to steal some chemicals. While I wasn’t the most strategic—choos ing to “break in” during work hours when the lab was filled with other people—I was still a threat. And he was the (still-unidentified) cop ready to right my wrongs. But none of this was true. I was just a college student whose excitement to reenter this beloved space had suddenly transformed into sorrow. He continued his line of questioning, and I continued to answer helplessly. Eventually, he gave up his defense of the lab and opened the door. I followed him in and quickly went to my lab bench.

Soon, I realized that this man worked right next to my lab. His office adjoined the room where I prepared countless specimen trays for qPCR experiments. With my white coat on and my lab notebook in hand, I tried to walk confidently whenever we crossed paths. I wanted to prove to him that I was truly a scientist in this lab, not a thief, while ignoring the queasiness that arose whenever I saw him. After that incident, he never said anything to me again. Never looked me in the eye. Never acknowledged my presence or the pain that he had caused me. Why did he treat me like that? Why didn’t he believe me when I told him that I was a college student working in the lab? The day with the faulty card was the day that I realized I was the only black person in my lab. When I attended research talks in the building, I was always the only black person in the room. It seemed like I was the only black scientist in the entire seven-floor building. And I was only a student! The only other black people I saw working in the building were members of the janito rial or kitchen staff. I guess based on this data sample, it was reasonable for this man to assume that I wasn’t a scientist in the lab—even though my photo ID should’ve been enough proof that I truly was affiliated with the university.

Following the encounter with that man, I no longer felt excited to go to the lab each day. I felt anxious. My fast-beating heart tried to keep my feet from walking to the train station. The smell of urine in the underground station became more repugnant, threatening to induce nausea. The stares I received from people as I shuffled off the train and onto the medical campus seemed more aggressive, echoing the message from the man in my lab: You don’t belong here. I felt like I was walking on eggshells. Something was bound to crack.

Then, one day, I was invited to attend a small group session with a visiting Harvard professor, through the John B. Ervin Scholars Program, an organization at WashU that supports students who exhibit leader ship potential and a commitment to serving their communities. As a part of our introductions, we were tasked to answer: “What makes you anxious?” Although I typically try not to be vulnerable in large groups, I decided to open up since I knew many of the people in the room. As I retold my experience in the lab, tears rushed down my face. I hadn’t realized how much this encounter had affected me. After the meeting, I spoke more about this issue with the dean of the Ervin Scholars Program. As I laid my wounds bare, a weight lifted off my shoulders. I was not in the wrong. And it was okay for me to feel the pain that I felt. My emotions were valid. Suddenly, I felt more comfortable speaking about the incident.

A few weeks later, I presented my research at WashU’s Fall Under graduate Research Symposium. As I stood crowded around a poster with two other black research students, my mind wandered. Sharing this biomedical space with them reminded me that, while I was the only black scientist in my lab, I was not the only black scientist at my university. That realization was followed by another. I was not the only black researcher who experienced microaggressions. Once I was able to look past my individual experience, memories of others’ experiences rushed back to me. I had numerous black friends from various academic institutions who had reached out to me for solace after facing their own personal traumas in research environments. I wasn’t alone. We weren’t alone. So why had these experiences made each of us feel so lonely? These incidents had seemed like isolated events. We were usually the only black scientist in our respective research spaces, so we oftentimes lacked support during these difficult encounters. Each of us wondered if we had done something that warranted the treatment we received. And it was difficult not to defer to the perspective of the person doing the microaggression, since frequently that person held a superior position in the lab. But these were not isolated events. They were recurring prob lems that signaled much deeper issues within the research community. Because we were typically siloed in different corners of a research institution, it was hard to see this pattern. But now that we were together at this symposium, the problem became vividly clear to me. This epiphany moved me to act. First, I founded the Minority As sociation of Rising Scientists (MARS). This organization aims to coun teract the detrimental effects of implicit bias and imposter syndrome through programming that promotes community among students of color pursuing research careers. It also brings awareness to the preva lence of imposter syndrome and introduces ways to combat it. Among its events, MARS offered a popular series of meetings where black grad uate students spoke about their experiences in science and gave advice on how we undergraduates could be successful in the field. Whenever we had these mentoring sessions, at least one MARS member would tell me how the session helped them with something they were struggling with, either in their current lab or in their pursuit of a research career.

The morning after one of these sessions, I walked over the bridge connecting my apartment to my college campus. I was on my way to an organic chemistry class. While a cold wind brushed against my skin, I was warmed by an energy reverberating from deep inside me. A sensation stronger than butterflies kindled in my stomach. I felt like I was walking toward my purpose. And while working to help others, I was tending to my wounds from the day with the faulty ID card, as well as many other related traumas.

A year later, I received the incredible news that I was selected as a Rhodes scholar. This provided me with a platform to have an even broader impact within the advocacy space. As my professional interests shifted toward medicine, I decided to apply my experience with MARS to tackle a similar issue within medicine. I pursued a master of philosophy in the history of science, medicine, and technology at the University of Oxford. My dissertation focused on the social and structural barriers put in place to prevent black women from entering medicine in the US. I figured that if I could determine the historical underpinnings of the underrepresentation of black women in medicine, I would be better equipped to help increase the number of black women, and other underrepresented minorities, within the field.

Initially, the research and master’s classes were extremely draining. I learned how deeply race- and sex-based prejudice ran. For centuries throughout the world, Europeans and white Americans employed tac tics to deprive black people of opportunities and deplete their quality of life. When I studied racial dynamics within medicine, I found countless social and structural obstacles meant to keep white men as the dominant group within medicine. It felt like so much was stacked against me as a black woman interested in medicine. At the same time, I struggled to find information on notable black women physicians. Up to that point, I had never met a black woman physician, and I hadn’t been taught about any in school. I knew they must exist, but their histories were buried or never properly documented to begin with. I became desperate to find them, to get to know their stories, and to understand what inspired them to become physicians. I needed to know how they survived and pushed forward in the face of so many racist and sexist obstacles.

After more than six months of mining the internet and archives for these women, I finally struck gold. I found an archive at Harvard Rad cliffe Institute’s Schlesinger Library that included interviews from 1976 to 1981 with notable black women who were in their seventies, eighties, and nineties. There were interviews with a handful of black women phy sicians in the collection. This is how I discovered Dr. May Chinn. Once I found substantive information about one African American woman physician, she led me to the next, and the next. When I felt my knees begin to buckle under the weight of the knowledge that, for well over a century, people like me had been rejected from medical schools and then residency programs solely because of their identities, these black women’s stories were my antidote. They gave me the strength to keep running in my own race toward a career in medicine.

So when I earned my master’s degree from the University of Oxford and then began medical school at the Perelman School of Medicine at the University of Pennsylvania in August 2020, I wasn’t scared. Yes, I was in pain from seeing so many of my people killed by police officers while people around the world lost their lives to COVID-19. I also struggled with the isolation of prolonged quarantines at the height of the pandemic. The circumstances of the pandemic made it impossible for me to meet my entire medical school class throughout my first year and postponed my white coat ceremony for over a year.

Despite the limited contact with my class, I found that prejudice still managed to seep through. At various points throughout the school year, I encountered colleagues who questioned whether my fellow black medical classmates and I had earned our spots at this prestigious medical school. We could be having a conversation about our medical school application cycle or our feelings about an impending exam, when a classmate would lay bare their views on the black medical students at Penn. They thought that our blackness, not our credentials, had given us access to this prestigious institution. Whenever I met these challenges, I kept my thoughts fixed on the incredible black women physicians who came before me. If they could do it, I could too.

As I trekked through those early days of medical school, I recognized that many students in my position didn’t have the stories of these black women physicians to lighten their steps. Inundated with the dominant narrative that white men are the leaders of medicine, they didn’t know how much black women had contributed to the field. If more black girls and women knew, maybe more would be inspired to pursue medicine. Maybe other underrepresented minorities in medicine would be inspired too.

Black women physicians’ stories have gone untold for far too long, leaving gaping holes in American medical history, in women’s history, and in black history. It’s time to set the record straight.

Excerpted from Twice as Hard: The Stories of Black Women Who Fought to Become Physicians, from the Civil War to the Twenty-First Century by Jasmine Brown (Beacon Press, 2023). Reprinted with permission from Beacon Press.

Off the Page