My name is Robert and I am a recent graduate of Lehigh Valley Health Network’s emergency medicine residency, I was not only the only black person in my class but also only the second black person to finish the program since its inception almost 20 years ago. My last year of residency was destroyed by hatred and prejudice in an attempt to silence me.

I would like to extend a special thank you to Dr. Elizabeth Evans, Jeanne Jacoby and Michael Nguyen who all risked their job, future career and professional relationships to stand by me, support me, and speak up for what is right. I would not have made it through this year without you.

And of course to my fellow residents who supported me when they became aware of what was happening. If you learned nothing else from me always remember that it is always the time to stand up for what is right and no matter how hard anyone or everyone may try they can never take your voice away.

Here is my story……..

Orange Flags

Since I was young, I had accepted that racism would likely follow me into medicine. The scenarios I always prepared myself for in my head involved patient’s calling me slurs or asking if they could have a white doctor. What I was not prepared for was that the majority of the racism I was to experience would come, instead, from my own colleagues.

It only took a few months for me to experience blatant racism from a co-worker. I was working night float and spending the majority of my time in the ICU. We were enjoying some late night snacks with a few nurses. I was explaining to them that I stopped eating oranges for a while because I had a bad streak of making a mess every time I tried to peel one. As we sat there giggling one of the nurses interjected and said ” I would love to see a monkey peel an orange.” It felt like time froze. I was embarrassed. I was angry. I was hurt. I felt that if I stood up for myself I was making enemies out of the nurses and would be shunned as a “bad intern”. If I laughed with her then I was condoning her behavior. I chose to do nothing as did everyone else in the group. There was an awkward silence before we moved on to another topic. For the next week I felt disgusting. Not only because of what she said but even more so because I didn’t stand up for myself. I made myself a promise that I would not be silent anymore no matter what the cost was: it was not higher than my own dignity and self-worth. I was in for a challenge.

The Challenge

Over the next several months I would be tested. Repeatedly. There was a nurse who thought it would be funny to quote Kevin Hart ” night, night nigga” she exclaimed and laughed at a social event outside of work. When I questioned her poor choice of words she responded by defending her choice because she did not use the ” e-r” ending. I went to work everyday following the murder of George Floyd and the black lives matter protests, I listened to so many people exclaim their hate and disdain for the protests. I had multiple encounters with a seasoned ER attending ( supervising physician for residents) who wanted to argue about why black people didn’t all love Abraham Lincoln, or what was wrong with Christopher Columbus, one time he even asked me if it were possible for black people to get sunburn while we were caring for a patient who was white. He followed up by telling me he was always friends with the “blacks” back home. There was a PA who once came up to me and asked about a patient in my care. The conversation quickly ended after they asked me “did a police officer kneel on his neck or something?” It was as irrelevant as it was inappropriate. Despite all of this I never lashed out at any of these people, I always approached them with dignity and respect even after they treated me in the opposite manner. I sought to educate them about the things they said or did that were inappropriate, hurtful or wrong. I was proud of the conversations I was having with my coworkers and the small steps I was able to take with them. Despite this somehow I would still be made out to be the bad guy.

The Principal’s Office

During my second year of residency I was called to the program director’s office for a meeting. I was anxious as anyone might be and had no idea what it was about. It turns out one of the Physician Assistants (PAs) in the emergency department had reported me for wearing a bracelet that said “Black Lives Matter.” In her email she stated that she was “intimidated” and “threatened” by me and that I should not be allowed to wear my bracelet; it was clear that she wanted me to get in trouble even though she never spoke to me about it and always smiled to my face. Dr. Kevin Weaver, who was my program director at the time defended me. He said firstly, that he knew she had never spoken to me about my bracelet or anything else meaningful because if she had, she would never have described me as “intimidating” or “threatening.” He also spoke with the HR department who determined that my bracelet was NOT AGAINST THE DRESS CODE and that I could continue to wear it ( this is going to be very important later). I was hurt that someone set out to intentionally try and get me in trouble and used such strong words to describe me despite all of our interactions being nothing but pleasant.

After that meeting, Dr. Weaver and Dr. Barr asked me to start a Diversity Equity and Inclusion (DEI) committee for our residency. They said they have been wanting to be more deliberate about being more inclusive and had struggled in their program’s history in matching diverse applicants. In the program’s entire history I am only the 2nd black resident to finish the program ( to my knowledge). I also was elected to the hospital networks multicultural and diversity task force and was the first resident to ever sit on that council. I was excited to make a positive change and embraced being a leader for our program and the hospital network.

The Good Times

During my time working on DEI initiatives we accomplished so many good things. We started a scholarship program for underrepresented minorities to come and rotate/audition with our program that was eventually adopted by the entire network and other specialties. We created a standardized scoring criteria to try and advocate for diversity and decrease bias during our application and rank list process. We started a lecture series for our program on topics that were never previously covered in our medical education including talks on LGBTQ+, social determinants of health, language barriers, and so much more. I was even invited to give lectures to other specialties grand rounds and their faculty/residents. And the last thing I started right before I resigned was the beginning of a pipeline/mentoring program for local high school students with an aim to increase representation of underrepresented minorities in medicine and in the community here in Lehigh Valley. The good times were good, but the bad times………The bad times were devastating.

The Tea

Everything changed in my 4th and final year of residency. Dr. Weaver had taken a promotion and was no longer program director. We had a new program director Dr. Shawn Quinn, who was a long time assistant program director and shortly after he took over is when things took a turn for me. On August 23, 2022 I received a text from a co-chief resident that the program coordinator, Dawn Yenser, texted her and told her she had to take down a picture she had posted of me on our residency instagram. The reason the picture had to be taken down was because I was wearing a shirt that said “blue lives don’t exist”

Quick Aside

• 1. “Blue Lives Don’t Exist” is not an anti-police statement, it simply is a reminder that being a police officer is a career in contrast to someone’s race. Police officers choose to be police officers and at anytime they can choose to no longer be one; they get to take off their uniform and badge and go into public or on vacation and not be judged or perceived as a police officer whenever they like. Black people do not have that as an option. Whether I want to or not my skin color is open for public perception and judgement 24/7, therefore saying “Blue Lives Matter” as a counter to “Black Lives Matter” is inappropriate.
• 2. When the hospital decided to allow us to have an instagram account the main stipulation was that it stated on our account that it was a resident run account and the views were of the residents and not the hospitals. So any argument that it would be against some hospital policy is null.

Back to the Tea

No one ever contacted me about the shirt or taking the instagram picture down. Not a call, not a text, not an email, not an explanation. After that nothing was the same. The first thing that happened that made me feel there was a divide between my residency leadership and myself happened when we (the chiefs) went to discuss some administrative things with leadership. We were talking with Dr. Barr when I noticed my initials on the white board. For brief context, during the administrative meetings when they have residents they want to discuss they put their initials on the board sort of like an agenda. I know this because as chief resident I had been to these meetings. I asked Dr. Barr what was going on and why my initials were up there, he initially told me it was nothing but when I asked him again he got irritated, raised his voice and said ” well if you must know your request is being denied!” I was confused so I asked what he was talking about and he went on to say that my request to do an independent study for one of my elective weeks was not being approved. The week prior I had texted Dawn and ASKED FOR HELP on scheduling an elective for a specific week since I was going to be out of town for a fellowship interview and wanted to still do something educational during my elective time but was not going to be in town for 3 days because of said interview. She never responded and I ended up figuring it out on my own. I remember walking out of that interaction feeling very confused, I asked the other chiefs if they thought that was weird or was it just me? They all agreed that something was off. This was weird to me because independent study for similar reasons ( interviews) had been done by multiple residents in the past AND BY OTHER RESIDENTS AFTER I WAS TOLD NO. This wasn’t something I made up and I wasn’t asking for any special treatment. I felt like they were making up rules and applying them only to me, for example Dawn would also tell me during that month that I was required to Ultrasound for 9 hours/day while on my ultrasound elective. NOBODY, not even the ultrasound fellows ultrasound for 9 hours/day, literally my hand would fall off.

I continued to feel that my program administration was avoiding me, isolating me, and there was a background feeling of hostility. It was anxiety provoking and upsetting and it made me miserable both at work and outside of work. On October 10th I had a meeting with Dr. Gillian Beauchamp about something unrelated. I mentioned to her that I felt very bad about how I was being treated and was developing a lot of resentment, I told her what I knew about the shirt/instagram and that I thought that was related to these other things that were going on. She told me that she already knew about that shirt, in fact they had a meeting about the shirt and the picture. She was under the impression that somebody had already met with me to discuss it. I reiterated that no one had said a word about it to me and she brought it up shortly after that to Dr. Quinn.

On October 19th, almost two whole months after this all started Dr. Quinn emailed me and said:

“Sorry for not directly being in touch with you or any other residents directly about this (other than generalized announcements) but we’ve been ensuring our due diligence with network HR.  I believe she had let you know their determination regarding specifically BLM material.”

He went on to say we could discuss it further in a meeting.

Now this was the first time that I had heard anything about BLM since I was a second year, I had been wearing BLM shirts, bracelets, and sweatshirts to grand rounds basically since I arrived here and as mentioned before was already told by HR that it was NOT AGAINST THE DRESS CODE. So as you can imagine I was confused.

I worked an entire ER shift with Dr. Quinn the day after he sent that email. He said nothing to me about BLM, the dress code, or how I was feeling. At the very end I asked him if there was anything else he wanted to say/talk about and he said ” nope, you did a great job” and walked out of the ER.

On October 25th, I responded to his email with a very long email explaining my frustration with the entire situation. I explained that I was hurt and felt alienated and did not feel I was being treated fairly.

On October 29th, he responded and said Dawn would be in contact to setup a meeting.

On November 1st, I replied to Dawn with my next 2 weeks of availability to meet. TO THIS DAY I have never received a response to that email.

A few weeks later I found out I did not match at Lehigh Valley for fellowship and I felt that what was going on had played into that. I also felt that the environment the program administration had created was not a safe space for people who looked like me, and I did not feel comfortable continuing on with the DEI committees and recruiting underrepresented in medicine minorities to come to our program. With a lot of regret and even more sadness I resigned from the DEI committee I started a few years prior.

Around this time is when I began to hear rumors from faculty and other residents about me. The first one I heard was that Dr. Quinn was having difficulty setting up a meeting with me and that I was avoiding him. Remember how I said they never responded to setup a meeting? Well add to that the fact that I literally saw him all the time for other residency/work related things and that this was in 2022 and yet he never once called or texted me or even emailed me to try and actually set up a meeting himself and hopefully you find that rumor as ridiculous as I did. To this day we have never had an in-person meeting about anything that has gone on this past year.

Instead he took a much more cowardly approach.

It Gets Worse

On December 6th I had my mid-year evaluation for residency. For some context, the way our program does it currently is by Webex and each Program Director /Assistant Program Director takes a class and does their evaluations. My evaluation was scheduled with Dr. Barr; however to my surprise Dr. Quinn was also there ( and to my knowledge he was not present for any of my classmates). At the end of the evaluation Dr. Quinn said, “well since we are all here I wanted to take some time to talk about the Dress Code and BLM.”

He went on to say that ALLEGEDLY someone in a different department had worn something that said Black Lives Matter and a colleague reported them to HR because they were offended by it. He said that HR had deemed that as against the dress code and told them they could no longer wear anything that said black lives matter. Dr. Quinn said they were using that as precedent and that I could also no longer wear anything that said Black Lives Matter. All of my counter arguments were ignored and Dr. Quinn stated ” this isn’t a residency problem this is a network and HR problem”

I reviewed the dress code thoroughly and could not identify anything that could be applied to Black Lives Matter so I continued to dress the same exact way I had for years to grand rounds. On January 12th, Dr. Quinn emailed me and told me that he saw me wearing a BLM sweatshirt to Grand Rounds the day prior and that it was an HR violation. I asked if it was ok if I wore shirts that said white lives matter? All lives matter? Or blue lives matter? Or were we specifically focusing on the rights of black people? I also asked if we were going to apply all of the policies to everyone or were we just going to apply the ones that singled me out?

This ultimately ended with Dr. Quinn reporting me to HR for “violating the dress code” and he said I could meet with HR and ask them my questions about the dress code.

The First HR meeting

The meeting was 2/1/23, the first day of Black history month. This would prove to be ironic in many ways.

Lorraine Pirino the Emergency Department HR representative started the meeting by asking me what questions I had about the dress code.

Now, I have basically been studying for 30 years of my life at this point and you better believe I studied that damn dress code like there was going to be a test. I highlighted, underlined, and marked up the entire thing and I couldn’t find one thing in there that applied to Black Lives Matter.

It’s important to note that I was under the impression that it would be myself and the HR representative discussing this; however, when I logged on to the online meeting, to my surprise, I was joined by Dr. Quinn (program director), Dr. Barr (assistant program director), and Dawn Yenser (program coordinator), all of whom I know disagreed with me wearing Black Lives Matter attire and none of whom were there to offer me any support.

The conversation began:

Me: ” I guess my first question is which part of the dress code are you saying applies to my Black Lives Matter shirts?”

Lorraine: ” under section 21, the last bullet point states that you can’t wear anything that is offensive, political, or an advertisement.”

Me: ” Ok so are you saying it’s offensive, political, or an advertisement? Because I don’t think it’s any of those things.”

Dr. Quinn: ” Well there is a BLM Political Action Committee (PAC) that you can give money to and they will lobby for political gains so that sounds pretty political to me.”

Me: “Just because someone makes a PAC and names it after a slogan, team, or anything else doesn’t automatically mean that it is inherently political. Anyone can make a PAC, it is not hard. For example the NFL has PACs and they lobby for things but just because you wear an eagles shirt doesn’t mean I automatically tie that to politics or assume you align with whatever politics their PAC aligns with.”

Quinn: “mumbles”

Me: ” Ok well he says it is political, what do you think it falls under Lorraine?”

Lorraine: “Well I think it can be interpreted as offensive.”

Me: ” Oh really….. which one of those words offends you? Black? Lives? Or matter?”

Lorraine: ” stutters, mumbles, rambles” but never answers the question

Lorraine: ” but during covid I made people take down stickers on their locker that said blue lives matter.”

Me: ” ok, what does that have to do with anything? Do you understand the difference between Black Lives Matter and blue lives matter? It’s ok if you don’t because we can talk about it.”

Lorraine: ” stutters, mumbles, rambles” but never answers the question

Me: ” Ok so who determines if we call something objectively offensive? Because you’re saying that some people can be offended by it and therefore essentially banning it but people can be offended by anything. People can be offended by the color blue, other religions, or anything they choose to but that doesn’t mean it’s objectively offensive.”

Lorraine: ” HR is determining, I am determining”

Me: ” Ok then why are we able to wear pronoun pins, fly the pride flag, and have mandated hospital training on LGBTQ and transgender rights? I am very much in support of all of those things but if you are going to say that I can’t wear shirts that say Black Lives Matter on them because people might say it’s offensive or political then what is your explanation for that? They literally are voting on whether or not gay marriage is legal AGAIN, not to mention transgender rights. I can’t think of anything more political than that right now. And I know people who work at LVHN are offended by LGBTQ rights because they openly voice their distaste for them in the workplace. So how come that is ok but Black Lives Matter is not?”

Lorraine: ” Well the network wanted to take a stance and really let the LGBTQ community know that we support them and their healthcare and wanted to improve their healthcare outcomes.”

Me: “What about black people?”

Lorraine: ” stutters, mumbles, rambles” but never answers the question

Me: ” How come 2 years ago when this same thing happened, my program director at the time ( Dr. Weaver) spoke to HR and it was determined that my Black Lives Matter bracelet was NOT against the dress code and it was approved for me to wear in the ED while I am seeing patients? From what I can see this policy was last updated in 2018 (before I started there) and you were our HR representative. So if you didn’t change, the policy didn’t change, I can only think of one thing that did change ( *looks at Dr. Quinn) then how and why is the interpretation of the policy being changed?

Lorraine: ” Well I wasn’t that involved with that discussion so I don’t know much about it but my understanding was that was an event that happened off hospital grounds.

Me: ” no, absolutely not. That was about me wearing it in the Emergency Department, what we are talking about now is for grand rounds which is an educational and classroom setting.”

Lorraine: ” Well I don’t know I will have to look into that further.”

Me: ” Ok well I don’t feel like we’re getting anywhere so my last question is this; under section 21, the one you are saying applies to my shirts it has at least 10 points before it that say things like sweatpants, ripped jeans, sweatshirts, sports attire, shorts, facial piercings, colored hair, graphic t-shirts, sandals, and poor hygiene are against the dress code. We have not had a single grand rounds my entire time here when someone is not breaking this dress code. So how come I have to follow the dress code but no one else does?”

Lorraine: ” Well everyone has to follow the dress code.”

Dr. Quinn: ” That’s ridiculous.”

Me: 😳

Dr. Quinn: “If you’re going to say that then you will have to apply the dress code at every meeting, every grand rounds for all the residencies and the entire hospital and that’s ridiculous”

Me: ” exactly, it has to be everyone”

Lorraine: “It has to be for everyone”

Dr. Barr: “Ok we can send out an email”

Dr. Quinn: ” no we aren’t doing that, that is ridiculous”

Me: ” Lol”

Lorraine: ” no you have to enforce the dress code for everyone.

Dr. Quinn: clearly upset continues to ramble

Me: “They aren’t going to enforce the dress code on everyone.”

Lorraine: “They have to”

Me: “I’m telling you they won’t”

Lorraine: ” They will. Keep track of anyone who is not and let us know if it’s not being enforced.”

Me: ” Ok I will follow the dress code, but ONLY if everyone has to follow it. If it is only enforced on me I will not follow the dress code. Also, I do not feel I have resolution and was wondering who else I can speak to about the interpretation of the dress code.

Lorraine: ” You aren’t speaking to higher ups about this, I’m HR, I interpret the dress code, I’m HR. I have told other people to follow the dress code and they didn’t ask to speak to higher ups so why are you?”

Me: 😳

The irony continued that day when I went to grand rounds afterwards to be lectured at for several hours about the importance of DEI in the emergency department and in medicine…………..

Rumors

Dr. Quinn did send an email that evening discussing “administrative updates.” The dress code was not mentioned; in fact they waited an entire week and after another grand rounds to finish before they sent out an email regarding the dress code.

The residents were all confused, they said the same thing I did. We never followed a dress code for grand rounds. Many of them never read the dress code they sent out and many people never changed their attire for grand rounds AKA they continued to break the dress code every week.

This is around the time when the nasty rumors started. The first one was expected. The dress code was because of me. I’m assuming this was a feeble attempt to turn my co-residents and faculty members against me. I knew this would be the narrative however I simply did not care. I knew that I had the moral high ground. This was a simple case of right vs. wrong and I had the benefit of knowing I was right. I didn’t care if Barack Obama, Oprah, and Beyoncé all walked in and told me to just accept the dress code. I would have kindly asked them to go play in traffic as well because it was obvious to me what was right and what was wrong.

The second rumor being spread was that I was going to be fired. “Rob better watch his back or he’s gonna get fired over this BLM stuff” is what I had passed down to me from faculty members. Once again, I am not sure if this was meant to scare me or if they really believed it. Regardless, fighting for what is right was much more important to me than a job. If I let them bully and harass me into accepting their racist and prejudice policies and practices I was no better than them. I was allowing the next person who looked like me that ended up here to be treated the same way and that was unacceptable to me.

The last one was the worst and the most disgusting in my opinion. After interview season had finished up and they were discussing their final rank list for matching residents, they started to say, “we can’t rank this person really high because they are too much like Rob, and we don’t want people like that here anymore.” This was also passed down to me by faculty members and was the most despicable. I wonder what they meant by, “too much like Rob.” Did they mean people who stood up for themselves? People who didn’t question them? Were they trying to avoid people who advocated for human rights? Or did they mean black people?

I don’t know what exactly they meant by that but I can tell you what it was not based on and that was my performance and merit as a resident. Not based on my own opinion or judgment, and not based on what I think of myself. I say that based on THEIR evaluation criteria. I always received high remarks and great evaluations on my ER shifts, by nursing staff, and off service rotations. I was told that I was respected by my peers and junior residents and had never been in trouble for anything OTHER THAN wearing shirts that said Black Lives Matter. I was even selected to be chief resident. Based on their standards of what a good resident was they should have been recruiting people “like me.” Maybe then they could have actually matched more than 3 residents this year in the match. In about a year I bet there will be a lot of people who wish there were 13 more residents at Lehigh Valley just “like me.”

Higher Ups

Because of my time working with DEI groups in the hospital network I had a relationship with the chief diversity officer Judy Sabino. I reached out to her in an email asking her to meet with me and some of my attendings (supervising physicians) who I trusted. I told her the entire story up to this point and she was devastated. She said she knew Lorraine’s (HR) boss and would set up a meeting with them to give them the opportunity to hear the entire story. She also said I should consider filing a claim of discrimination with the department of graduate medical education against my program. I agreed to meet with HR again and would discuss filing the claim in the near future.

HR Round II

I told Lorraine and her boss Jeanne Hoover the entire story as well. They shed some new light onto the situation. Lorraine said that she was intrigued by my programs willingness to pass the buck onto HR since they had minimal knowledge about the situation. Dr. Quinn had always exclaimed that this was “a network HR problem not an ER residency problem, this was coming from them not from us.” He also stated in one of his emails to me that he had been doing his “due diligence” discussing the network dress code with HR.

When I read “due diligence” I immediately thought they must have had several meetings and discussions about this to reach this conclusion. I am not sure what you think of when you hear/read “due diligence” but Dr. Quinn’s definition is one phone call to Lorraine, while she was on vacation that lasted a few minutes. No meetings, no real discussions, not even one.

At this meeting we also brought up the Hatch Act of 1939 and the U.S. Office of Special Counsel’s investigation and decision on Black Lives Matter as it pertained to Federal Government employees.

Briefly, the Hatch Act of 1939 prohibits Federal employees from engaging in partisan political activity. In 2020 the U.S. Office of Special Counsel set out to answer two questions regarding Black Lives Matter and its application to the Hatch Act and thus Federal employees in the workplace.

1. Is using Black Lives Matter terminology inherently political activity?
2. Is Black Lives Matter Global Network (BLMGN)- the the owner of http://www.blacklivesmatter.com and arguably the most prominent BLM-related organization—a partisan political group?

The answer to both of those questions at the end of their investigation was NO. You can read the report here –> https://osc.gov/Documents/Hatch%20Act/Advisory%20Opinions/Federal/Black%20Lives%20Matter%20and%20the%20Hatch%20Act.pdf

HR said they were inspired by the conversations and were going to have meetings with their bosses and reach out to me again to discuss next steps……That never happened.

The DIO

For those of you who are not in medicine or medical education we have to briefly go over a few definitions. First is the Accreditation Council for Graduate Medical Education (ACGME). The ACGME is the governing body for all residencies in the US. They set the standards and requirements for programs and medical education. The DIO is the Designated Institutional Officer. Essentially, they act as a liaison between the hospital and the ACGME.

Our DIO is Dr. Joseph Patruno and this is who Judy Sabino (DEI) said I should speak to about a claim of discrimination. He had already spoken to Judy, as well as one of my attendings, and took the time to brief Dr. Quinn that he would be meeting with me ( why? I have no clue) before he set up a meeting with me. I once again brought an attending with me because I am not sure anyone would believe the words that came out of this man’s mouth if I did not have a witness to corroborate it.

After I told him the story, he said he was sorry that I was going through this and asked what he could do to make this right. I asked him what was he capable of in his position.

Dr. Patruno: ” Well, I could send an email”

Me: ” An E-MAIL!?”

Dr. Patruno: ” Yeah, I could tell them how you are feeling and that they were wrong.”

Me: ” No thank you, I have already told them how I feel and that they were wrong, I do not need you to speak for me.”

Dr. Patruno: “Well the ER residency historically has done well, they have good board scores and are a good program so we aren’t going to shake up their leadership.”

Me: ” If there are no consequences there will be no change”

Dr. Patruno: ” Well this is the way it is here, it has always been a conservative area and it would be too hard to change.”

Me: ” Just because you’re conservative doesn’t mean you have to be racist and just because something is hard doesn’t mean you shouldn’t do the right thing.”

Dr. Patruno: ” Well your program is big, you are only 1/60 residents in your program and there are over 30 other residency and fellowship programs in our hospital. All the residents have problems not just you.”

” and when it comes down to it racism and discrimination is just not critical enough to do anything about.”

So not only was he admitting that he thought I was being racially discriminated against, he also was telling me to suck it up because he was not going to do anything about it……….

April Showers Bring More HR Meetings

2 1/2 months go by from the time program administration announced the dress code to the entire program and I follow the dress code every single grand rounds. After the email was sent in February there were never any other announcements, no enforcement, not even a mention of the dress code policy from program administration. Some residents changed how they dressed for grand rounds, most didn’t. Every week there were multiple violations of the dress code and nothing was ever done. Dr. Quinn was so arrogant about the situation he even had the nerve to tell one of my closest friends in residency that “this would only last a few months and then they could go back to normal.” Implying that once I graduate and left they would revert back to not having a dress code. Residents even began to intentionally break the dress code because they knew it wasn’t being enforced. That is until 4/26/23 when I decided to also not follow the dress code.

I walked in to grand rounds wearing one of my favorite Black Lives Matter hoodies. Within seconds of me taking my seat Dawn Yenser comes up to me and says,

” You need to take that hoodie off or I’m going to have to ask you to leave.”

Me: ” I will take this hoodie off when you make everyone else breaking the dress code do the same thing.”

For the first time in 2 1/2 months Dawn started asking people to take their hats off, take their sweatshirts off, and to go home and change out of their shorts and ripped jeans. Everyone was confused. Why? Because most of them were being asked to change out of the same exact types of clothing they had been wearing since the dress code was announced. Many of them had worn very similar outfits the last 2-3 weeks in a row. Why were we being disrupted during our educational time to suddenly care so much about the dress code?

Hate is powerful, it can consume you so fast and so strongly that you don’t even realize you’re showing it off for everyone to see. When Dawn finished asking people to change she texted me and said

“Everyone that has not been in compliance with the dress code policy has been told and has been taken care of. I am respectfully asking you to either take your sweatshirt off or go home change and come back.”

Me: ” Respectfully no they haven’t but ok”

As much time and energy they spent harassing me about the dress code I would have thought they would at least be as familiar with it as I was. There were still multiple people with sweatpants on, graphic t-shirts, and Dawn even had flip-flops on which were against the dress code, so I kept my hoodie on.

Dawn then had Dr. Quinn start texting me and using the hospital texting alert system to message me asking me to take my hoodie off. They could not stand it. Eventually I got hot and sweaty and took it off, but left it on the back of my chair for everyone to see.

I later found out that administration apologized to nearly everyone else that they made follow the dress code. They were sorry to make them follow these silly rules. Did anyone apologize to me? Absolutely not.

The next day Dawn conveniently sent out an e-mail reminder regarding the dress code, she also cc’d HR and other core faculty. She had the CAUCASITY to email everyone as if she was doing some noble duty enforcing the dress code and had the nerve to cc HR as if she was not guilty of ignoring the dress code and looking the other way.

I was fed up, I replied all to that email and I told the residents and HR the truth. They had done exactly what I said they would, they never intended to enforce the dress code on anyone other than me. They ignored the dress code for months until I wore something that said Black Lives Matter. They were so consumed by their hate that they showed the entire residency who they were and exactly what was important to them. They had no defense because everyone watched it play out over the past few months and when I connected the dots and explained their motives they lost their credibility because just as I was told I was merely 1/60 residents. Now I was 1/60 witnesses to their hate.

The Last HR meeting

Naturally my e-mail lead to yet another HR meeting, I was demanded to a meeting with HR, Dawn Yenser, Dr. Quinn, and Dr. Barr on my day off after a 24 hour shift in the ICU. In the email exchange I asked if I could bring support persons who were familiar with the entire situation to the meeting because I felt outnumbered. HR emailed me back in typical robot fashion and stated that HR was there to support everyone, yada yada yada. They never said I could not bring my support people even though I asked the direct question ” can i bring these people?” Naturally I was only told no once we showed up, HR insisted that it was against their policy to have people who aren’t directly involved sit down at the meeting.

Me: ” If they cannot stay then I am not comfortable having this meeting”

Brian Shaner: ” It is against our policy, they cannot stay”

Me: ” We have three options, we can all meet, you and I can meet alone, or I can go home.”

Brian: ” I thought you wanted to meet to discuss the concerns you were having involving your leadership.”

Me: “I NEVER wanted to have this meeting, I was DEMANDED to this meeting on my day off, I was not given a choice.”

Brian: ” Well I would really like to discuss your concerns with you and your leadership.”

Me: ” Thats great, we have three options, we can all meet, you and I can meet alone, or I can go home.”

Brian: ” If you are willing to stay and meet with just me then I would appreciate that.”

Me: “ok.”

Essentially the meeting was the same as before except Brian was able to make it through the meeting without saying anything blatantly racist although he was very adamant that Black Lives Matter was a political statement. There were a few important highlights……

Me: “From the time they sent the e-mail to everyone about the dress code until I wore my BLM shirt I followed the dress code every single grand rounds.”

Brian: ” Did you wear a hoody that said Black Lives Matter in sign language?”

Me: *Side eye ” I sure did, I can tell you the exact date, it was February 8th 2023. Interesting they would bring that up as a defense because First Of All our initial meeting with HR was February 1st, after that meeting Dr. Quinn sent out an email to the residency about updates and failed to mention ANYTHING about the dress code so therefore on February 8th I did wear that hoody because like I stated at the end of that meeting if EVERYONE has to follow the dress code then and only then will I also follow the dress code. It was not until the evening AFTER the February 8th grand rounds and AFTER I wore that hoody did administration send out any email to the residency about the dress code. After that email I wore more scrubs to every grand rounds.”

Me: ” Second of All I am 99% sure that none of them are fluent in sign language so how much energy did they put towards deciphering what my sweatshirt said? Granted, all things considered I don’t think it was that hard to figure out with everything going on but still why are they hyper-focused on me, what I’m doing and what I’m wearing.”

Brian: ” We don’t know if they know sign language or not”

Me: *More side eye “Did they tell you about anyone else that broke the dress code that day? If we go and ask them now do you think they can tell you what everyone else was wearing that day? I bet they can’t, but I can, you know why? Because I wrote it down, like I was told by HR. So why do you think they are OBSESSED with me and what I’m wearing compared to everyone else? I’ll give you a hint, it’s not about the dress code.”

____________________________________________________________________________

Brian: “Your leadership said they did enforce the dress code.”

Me: “EXCUSE ME? They only enforced the dress code when they tried to once again only apply it to me and I told Dawn that I would take my hoody off when she made every single person that was breaking the dress code do the same thing, THEN AND ONLY THEN did they enforce the dress code on anyone else other than me.”

Brian: ” So they only enforced the dress code when you said they had to enforce it on everyone and not just you?”

Me: “Correct, Dawn followed me from the elevator into grand rounds to ask me to change or leave. She walked by multiple other people who were there before me who were also breaking the dress code and said nothing to them. She walked right up to my ear and said I had to take my hoody off or leave.”

Brian: “wait so you’re saying she ignored other people breaking the dress code, followed you in and asked you to change or leave and only when you said they had to make everyone else follow the dress code is the only time they enforced it on anyone else?

Me: ” Exactly”

Brian: “Oh”

Me: “Yeah, OH”

Beware of False Prophets

DEI has been an area of focus for the last 3 years and medical education is no stranger to that. It has been a topic of discussion in all aspects of residency ranging from our textbooks to interview committees. For optimists it may seem like a step in the right direction, but that all depends on who is taking those steps and what intentions they have because false prophets only ever care about their own personal gain. Dr. Gillian Beauchamp is someone who I thought would be a champion for this exact conflict at Lehigh Valley Health Network. She is known within our health network and nationally for her interest and “advocacy” for many underrepresented and/or mistreated groups in healthcare and their communities such as patients who struggle with substance use disorder, minorities, and the LGBTQ+ community. She very quickly in her young career moved up the executive ladder using the backs of these communities as pillars for her success. However when it came time for her to speak up and speak out against these blatantly racist acts her true colors were finally revealed. Now what most “allies” do when it starts to get hot and sweaty is develop sudden onset silence paired with incredibly convenient amnesia and hide from all the conflict. Dr. Beauchamp has always been an overachiever so what she did was above and beyond. She actually sided with the prejudice. She made it known that she thought I was in the wrong and I should listen to HR because they were right about this, she struggled to maintain her persona while attempting to justify the things that were said to me and the way I was being treated. The Vice Chair of Education agreed with everything that had been done and wanted nothing more than for me to just comply. On top of that she still had the Caucasity to get up in front of me and the entire program and lecture us about DEI and the importance it has in emergency medicine? Hypocrite. This disappointed me more than anything HR or anyone else had said or done because I thought she was an ally and a friend. Turns out I was wrong about both, she also informed me that we were never friends and that I “misinterpreted our relationship” she said our relationship was always “purely a mentor-mentee relationship and nothing more.” I don’t think anyone who ever witnessed Dr. Beauchamp and I interact prior to our falling out would have described our relationship as anything less than friendship. When we saw each other we stopped whatever we were doing and rushed over to say hi and hugged each other with the biggest smile on our face, if that is not a hallmark sign of friendship I don’t know what is. So either she is manipulating students and residents to get what she wants out of them or she has blurred lines on what a purely mentor-mentee relationship should look like.

What About the ACGME?

Throughout this entire nightmare of a year I sought many people to help me. The ACGME was included in that list. Did you know that the ACGME put out a statement essentially stating racism and discrimination will not be tolerated in ACGME funded programs? That sounds helpful but it is nothing but empty words. If you go to the ACGME website and try to report work hour violations or most any other violation it is pretty straightforward. If you try to report discrimination you end up on a page that tells you essentially that they cannot help you and they recommend you speak to your HR department (LOL) or seek legal counsel……Tragic

So despite the fact that I was obviously and openly being discriminated against, despite the fact that I witnessed them discriminate against people when interviewing them for our program based on their possible language barriers, having medicine as a second career, and despite what they thought about “people like me” the governing body of resident medical education refers me back to my hospitals institutionally racist HR department?

The math ain’t mathin!

Thank You, Next

This last year has been absolutely miserable for me. I used to enjoy going to work and to grand rounds. I used to love to laugh and joke with other residents, attendings, nurses, and anyone at work. I enjoyed learning and having the opportunity to take care of patients most of the time. My last year of residency was supposed to be my best year of residency, I honestly received an outstanding medical education and had the opportunity to work with some truly amazing educators and physicians, this was supposed to be my year to really show how much I learned and how far I’ve come. Instead, I had anxiety everyday when I went in to work and I cried most days on my way home. It by far was the worst year of residency. This experience took all of that away, and other than making me joyless what exactly did they accomplish?

I know that by publishing my story I am possibly ruining my career in medicine. I know that some hospitals will see me as undesirable and many will refrain from hiring me or giving me an interview. I know that there is a strong chance that despite all of this nothing will change at Lehigh Valley Health Network or in medical education.

Knowing all of that I still chose to move forward. It has to change. We cannot continue to allow systems plagued with prejudice to not only exist but thrive. We cannot preach that we care about DEI and human rights but only see black and brown people as props for black history month only to be tossed to the side as soon as they make you uncomfortable. We cannot have people who choose hate and their own self-preserving motives to lead our next generation of physicians into the workforce. Medical education has to do better. Diversity and inclusion is not just a box we check to say we did it.

I am not sharing this story because I want anyone to feel bad for me. The last thing I want is anyone’s pity. I am sharing this story to spark discussion and motivate change. I am interested in outcomes not thoughts and prayers. Apologize to me with your actions not your words.

It starts with the ACGME.

• There needs to be a formal complaint process for discrimination. Point. Blank. Period. As the governing body of medical education you should not leave such an expansive issue up to individual HR departments or expect residents to seek legal counsel in the middle of residency. What happens when the HR departments uphold institutional racism? This should fall under you and I hope you move towards taking responsibility.
• There has to be some transparency for rank lists or the interview process. As chief resident I was a part of that process this year, even with using a points system to try and standardize applicants and eliminate bias it was still too easy to be prejudiced. Some faculty would openly discuss moving people down on the rank list because their english was not perfect (even though a large proportion of our patient population does not speak english as their first language!), they also love to claim that people who were choosing medicine as their second career were problematic based on their past experiences despite having multiple OUTSTANDING residents from our program who had chosen this as their second career. Programs are able to make their rank lists based on whatever criteria they choose. They could be discriminatory forever and no one would ever know because there is no transparency and therefore there can be no accountability.

Lehigh Valley Health Network clearly fosters an environment that is not inclusive or diverse and it plagues multiple departments. If you are considering coming here as a resident or employee I would not encourage you to do so if you are underrepresented in any shape or form unless they can change the following.

• Leadership needs a big shake-up in multiple departments
  • I spoke to multiple leaders in multiple departments who all defended or upheld the things that were being done and said to me. Every step of the way there was resistance to change and I was met with hostility when I chose to speak out.
  • There needs to be not only more people from underrepresented groups in leadership but, also more people who did not train at Lehigh Valley in leadership. There is this “brotherhood” that is decades in the making that prohibits “others” from breaking into leadership and also enforcing change or speaking out against wrongdoing. When you have entire departments that have been groomed since their residency in leadership positions you do not create an environment that is open to different ideas, values, or perspectives. ,
• Your HR department needs mandatory and extensive cultural training
  • If you are going to have employees that are not cis-white individuals then the people who claim to be there to “support” them need to have some basic understanding of different cultures and values or at least an understanding of how to learn about other cultures.
• Your Diversity, Equity, and Inclusion department should be SEPARATE from HR and other departments
  • By having the departments as one you are tethering the DEI department to all of the precedents that existed long before DEI was even in your business plan. This makes it challenging for them to support different ideas or perspectives if they differ from HR or whatever department they are linked with because there is already a standard that is being followed
• There needs to be a formal complaint process for residents to report discrimination and actual accountability for those who participate in discrimination
  • The first part is self explanatory
  • I’ll say it again: if there are no consequences there is no change. Reporting someone as a resident is a big deal. If you report someone that is responsible for your schedule, education and or future there are major risks that come with that on top of an already brutal lifestyle as a resident. Everyone that I spoke out against had no fear that any consequence was ever going to be brought to them, IN FACT they said that I should be worried or that I may be fired. Saying that you have a “no retaliation” policy is not enough and frankly ridiculous. You do not have to blatantly retaliate against a resident to cause harm, you can not teach them, not allow them to do procedures or other opportunities , or any infinite ways to make them more miserable and all of it can be disguised or explained away and not be called retaliation. You can do better.

That is a simple start to bettering your institution and I would discourage any student, resident, or employee who is underrepresented to seek employment there until they enact at least those changes

If you are reading this and have some rebuttal along the lines of “what does medicine have to do with social justice, racism, etc.” or anything similar, please take a step back and open your mind. Medicine is just as much social as it is science. If we are not engaging, empowering, educating, and fighting for ALL of our patients and communities then we are doing a an unjustifiable disservice. Human rights, social justice, and activism are apart of our jobs as physicians and healthcare providers.

If you knew this was going on and you did or said nothing, that makes you part of the problem. You can change that, speak up, speak out, say something. If you didn’t know what was happening but now you do but choose to be silent you are also a part of the problem. If you are witnessing something similar in your workplace or daily life and remain silent, you are part of the problem. Martin Luther King Jr. once said “there comes a time when silence becomes betrayal.” I am begging you, please don’t allow others to suffer in your silence.

Representation matters, it improves outcomes, it saves lives.

Black lives matter, Black doctors do too

I matter, now what are you gonna do?