I was told as a Black woman you have to work twice as hard. Here’s why I chose self-preservation instead.
As a Black woman and pediatrician, I’m accustomed to viruses. That’s literally 80% of what I do. Yet this past week, I saw how one virus could invade not just our bodies but our way of life. In these crisis situations, many of us as Black women have been trained to default to the path of superwoman. Here’s why we should choose ourselves now more than ever.
In this climate of the Coronavirus, it is so easy as a physician to shift into a mindset where nothing else matters except the patient. We quickly shift quickly shift into going above and beyond, working to the point that we compromise our own health and well-being. We learn very early in our training that self-sacrifice is normal- a belief which is a guiding principle in the culture of medicine. I can say that I’ve even to some extent brought this sacrificial culture into my household. However, there is a double burden as Black women. We learn self- sacrifice very early with one message that many of us are familiar with- “you have to work twice as hard, to get half as far…”. I internalized this message, which led to my pervasive behavior of working to the point of exhaustion and this message convinced me that this was the only way to reveal my competence and know my value.
The journey for Black women doctors is one where we rapidly learn in our training and career that graduating medical school and finishing residency are insufficient proof of our aptitude to practice medicine when combined with our Blackness. Moreover, a significant proportion of us also learn that taking vacations or staying home because of illness, can be perceived by others as signs of less commitment to our jobs or inability to handle the work. This message of working twice as hard that has been passed down for several generations actually exacerbated doubts about my worthiness and increased my anxiety, which I later found out to be something called stereotype threat.
When I realized none of the “working twice as hard” behaviors worked to erase the racism and bias I experienced, I was devastated. It took several years of working as a physician (and being lauded by patients) for me to recognize how outstanding I was at what I do and to understand that my worthiness was not determined by being a compulsive workaholic. Yet, I also understood that Malcolm X was right that I was the most disrespected, neglected and unprotected person in this country, as a Black woman, and that no one would protect my value as much as I would for myself.
My decision to protect myself by practicing self-care as a Black woman in medicine, let alone practice it regularly, is an act of defiance. So while fellow women colleagues will shout about the benefits of self-care and are viewed positively when they practice it, Audre Lorde clearly recognized the unique difference in the experience of Black women who finally put themselves first. She famously said, “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”
This defiance of putting ourselves first must not only be part of our approach to our work but also in our homes. Black women, regardless of our profession, are the healthcare decision-makers in our families and households.Yet making healthy decisions for our families and choosing not to prioritize our well-being cannot co-exist. Even from an early age, our kids , particularly our girls, see the discrepancy and are more apt to do what we do, than do what we say. It truly means removing our connections to the Black superwoman schema that idolizes martyrdom. It means if I have a cold- I am not ignoring it. It means if I am ill or weak, I am resting not driving to work. These small acts are the warfare of self-preservation because they are a loud message to our workplaces, communities and even our families about how we deserve to be treated.
We must recognize how brazen the war we wage is when we choose self-preservation. We are literally battling a societal message that our humanity and our role as Black women is the overworked and underpaid pillar that everyone gets to lean on. We are battling messages within our own communities that lead so many Black women to continue life-threatening work practices that wreak havoc on our bodies, our minds and our feelings. This weapon, self-preservation, — eating when you need to, sleeping, napping and becoming physical activity, not only has to be learned but has to be taught to our next generation. Without this message, we often burnout and leave medicine, making it difficult to increase the representation of Black women in medicine (2% of all physicians). Even more distressing is the possibility that “the work twice as hard” philosophy will continue the cycle of little Black girls, doubting their intelligence due to the onslaught of bias and working excessively as a solution to pervasive discrimination.
However, even if we practice meeting our basic needs and eliminate the Superwoman behavior from our lives, we still have not reached true self-preservation. We need one more thing to protect ourselves in times of crisis. Connection. We have to maintain connections and too often we retreat because of the requirement that we become vulnerable. Who are you connecting with to share your fear, your concerns or your challenges in the wake of crisis? If the answer is no one, that needs to change.
Honestly, in my darkest moment last year in a hospital room, I had trouble with connection, even with myself. I had been so busy doing all the things, that i never invested time, energy or attention to myself, my vision, my goals, and my dreams. It was connection that saved my life, first connecting with myself and then with others. Connection helped me find my purpose and put my crazy dreams into action- like building a community for Black physician women to be themselves and tap into their genius. Yes, we have to practice social distancing in the wake of this pandemic, but it doesn’t stop our need for connection even while we work from home.
In this time, more than ever, Black women in medicine need to be able to connect, fight burnout together, and get clarity on what is most meaningful to them , what they want to achieve and then go do it, with the support of sisters in medicine across the nation. No one, absolutely no one, is going to understand how crazy it is to be on the front lines except those of us who are there. No one else understands the stress of the hundreds of emails explaining how we need to shift our healthcare practices. No one else knows the burden to continuously be the go-to resource for everything health-related in our families. This is why I created a virtual training network, The MPOWERED Collective, and we need it now more than ever.
Once I realized how much I matter, how valuable I am and the unique support I need, it has been so much easier to maintain unapologetically focused on my vision, to keep saying no, to ask for help, and to manage my time. This is what I gained from investing in connections, virtually and in-person, with motivated Black women and it is this that i would argue is the most important act of self-preservation.
For many women, self-preservation is a given for which there is no threat. For Black women, we continue to fight constant judgement, discrimination and devaluing when we choose self-preservation over self-sacrifice. We absolutely must be vulnerable and come together, because there is no doubt that this is a battle for our own lives, our next generation and therefore, one that we must win.
Omolara Thomas Uwemedimo, MD, MPH
CEO and Founder, Melanin, Medicine & Motherhood
Dr. Omolara Thomas Uwemedimo is a board certified pediatrician for over 15 years, public health professor, researcher and health equity advocate for women and children of color. Dr. Uwemedimo is CEO of Strong Children Wellness, a community-based medical practice in New York and founder of Melanin, Medicine & Motherhood, an organization focused on supporting the retention of Black women physicians in medicine, in order to ensure equitable for families of color. She has dedicated the majority of her career to communities of color, by providing medical care as well as developing programs to strengthen delivery of integrated healthcare and health education. She has worked in NYC, Boston and globally in 12 countries across sub-Saharan Africa, Asia and the Caribbean. She is a national speaker to both physician and community audiences in the fields of implicit bias in healthcare settings, inclusion and equity for women physicians in healthcare, racism in health, and health of marginalized children and families, including immigrants, low-income and racial/ethnic minorities. She has been featured in several media outlets including Newsweek, Reuters, NPR and CNN.