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In this interview I got to chat with Racquel, MD who is a doctor, partner, mother and self-identified humanist. She grew up in Tucson, AZ where she completed university and medical school before going on to a residency in obstetrics & gynecology. Her blog started in 2014 as a creative outlet. You can find her on instagram @mindfulofmed where she shares her thoughts and passions, and movements like the #LatinxInMed campaign. Her passions include making space for mothers in medicine, and improving how women of color are seen and cared.

Here are takeaways from our conversation:

THE GLAMOURIZATION OF MEDICINE

As a first generation Mexican American, Racquel was the first in her family to navigate college and medical school. She went to a high school that was predominantly white, where it was ‘cool to be smart’ and that had great resources, which she was thankful for. She began to wonder if she hadn’t had that experience, where would she have ended up? She noticed the different opportunities that were given to different kids of colors and backgrounds. She began to learn about the differences in one’s upbringing and the pedestal that people are born into, which intrigued her. She went to medical school in Arizona where she’s from and was fortunate to be in a diverse class of well-rounded individuals.

In the first three months of med school, Racquel got caught up in being neurotic about checking off all the boxes of what you ‘should do.’ Racquel always loved writing and started a blog as an outlet during this time. Life is much different than what Racquel had this idea of- medicine is often glamourized and romanticized, which doesn’t fully represent what life looks like in medicine. If that’s the case, then what are you outside the bubble of medicine? Racquel likes to keep things in perspective by holding the notion that medicine is a job.

EMBRACE YOUR HERITAGE UNAPOLOGETICALLY.

Racquel shares the struggles of fitting into someone’s perception of you as a Latinx in communities that may not be diverse. Growing up, she used to go to Mexico to see her mom’s side of the family. Racquel’s grandfather is Afro-Mexican, and noticed how her grandmother favored the grandchildren with the lighter skin, which is something that children don’t realize at the moment but becomes internalized and unpacked in adulthood. Racquel was describing how white supremacy pits you against your own. Growing up, Racquel didn’t want to wear hoops or look ‘ too Mexican’- which is something at the time she truly wanted, especially going to a predominantly white school. Once she got to college, she embraced her Mexican heritage and being Latinx. Now as she is working towards becoming an OB-GYN, it’s especially important for her to have that representation, so she hyphenated her last name with her husband’s name. Lesson learned from Racquel: Embrace your heritage unapologetically- there is nothing wrong with you are.

THE REAL HISTORY OF GYNECOLOGY

The history of Gynecology is profoundly rooted in patriarchy. She shares about the The Granny Midwives of the South, going back to the era of slavery. They were known as healers with generational knowledge and delivered healthy babies with no formal training. When men came into that sphere, they learned from them and erected systems in medicine and obstetrics that we know today. Racquel is fascinated by the impact of women and the care of women in communities and believes work with women and babies is some of the most important work especially because they tend to be marginalized, which inspired her to take the route of obstetrics & gynecology. People blame systems and policies. It’s people that carry out these systems and policies without questioning it that is the problem. She is working towards being an agent for change in that arena and do the work her heart is calling her to do.

Medicine is the least of me and I need to keep it that way.

Racquel, MD

DISCRIMINATION FOR MOTHERS IN MEDICINE IS REAL

Unfortunately, discrimination continues in healthcare, especially with mothers in medicine. Racquel shares this article about physician mothers’ experience of workplace discrimination (caveat: the study isn’t diverse) such as being passed up on a job because of maternity leave, having to pump at work, etc. Maternal discrimination can happen along a spectrum. Racquel shares an experience that happened to her when she was an intern. She was in a research meeting two months in her residency.

She recalled how an important figure (aka, ‘the guy’ to go to if you want a fellowship) became offended that Racquel hadn’t met him since the start of her residency in July, although there were no requirements around meeting him. He approached Raquel with incredibly absurd ideas to leave her husband and give up custody of her son in the pursuit of medicine. He went on to tell Racquel “I can make it really easy for you to get in this field or really difficult.” It was a threat on Racquel’s family and career. Though people make you feel like it’s your fault, it’s really not- and anyone that makes you feel that way is also a part of the problem.

Not having full labor rights is also a challenge for residents. Resident unions are few and far between and are unable to accommodate for work hours, conditions, and accomodations. For example, residents may not have a designated place to pump milk and may be subjected to harsh words from other residents and physicians passing by, which is essentially an act of violence against mothers. It’s important to stand up for others when you something happen that isn’t right. Microaggressions are still a form of aggression. Whether it’s subversive or blatant acts of discrimination, it needs to be addressed. Unfortunately, when these issues are brought up to leadership, sometimes there isn’t much that can be done. Although Racquel and many others are advocating for a movement and wish that things could get better, change isn’t always that easy.

Regardless, change all starts at bottom and works its way up to leadership. The stakeholders now won’t be there forever, and those that are a part of the change can and will move their way up to leadership.

HUMAN RIGHTS VIOLATION

Racquel uses the analogy of residency resembling racketeering. There are human rights violations that occur in residency, especially with hours. The Libby Zion case was a case in the early 1980s that is interesting and relevant for anyone pursuing medicine. Libby’s father is a journalist and attorney and fought for change for resident work hours. In 1989, Dr. Bell was the first to suggest an 80-hour work week for residents with call restrictions, and was labeled as outlandish for his decision. In 2003, an 80-hour work week was granted to only four specialities in medicine. In 2007, there was pressure from ACGME to make all specialities an 80-hour work week. Conditions don’t get better without legal exposure. A lot of residents in many parts of the country lie about their hours because they are forced to. Racquel also briefly brings up the The Match and Antitrust Laws which can be considered another racket. There are many systems in the American healthcare system that work together to make medicine what it is- yet, how can it be a system if it’s for profit?

FINAL THOUGHTS

Medicine is a job. For Racquel, it’s more palatable for her that way and less consuming. She identifies with all the other wonderful things that add to her life, like her family and her interests. Medicine, or any job for that matter, should not consume you. For that reason, you won’t catch Racquel glamourising medicine in Instagram. She’s proud of her work and loves helping people and connecting with patients, but can separate work from the rest of her life.

Autonomy is a huge factor for feeling successful at work. Low levels of control at work can lead to greater levels of exhaustion. As a resident, you are essentially stripped from your autonomy. And on top of that, you’re supposed to be thankful for it.

If you sense discrimination is happening to you at work, have everything in documentation. You can file a charge for discrimination. Racquel talks about certain time frames that you have to have a charge filed in order for it to be considered in court. Even if you do nothing with it, it is for your best to file one. Another important factor is human resources. A word of caution: sometimes HR is there to protect those with tenure and power and may not have your best interest in mind. If you have an EEOC, you can still do something with that even if your HR is unable to do anything for you. Other resources include the American Civil Liberties Union and TIME’S UP Healthcare.

Racquel’s goal: to make medicine better for mothers and show up as herself no matter what space she’s in.

Recommendation for bilingual children’s books: https://lillibros.com/

Connect with Racquel:

https://www.instagram.com/mindfulofmed/

https://www.kevinmd.com/blog/2019/03/in-medicine-maternal-discrimination-is-real.html

https://mindfulofmedicine.blogspot.com/

Episode 72
Categories: BOLU Podcast

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