Stephen was built like an ox, his broad frame barely squeezing into the armchair he was burrowed in. He spoke with a soft, baritone voice and was so polite it almost seemed disingenuous. His glove-sized hand covered his face during most of our conversation, serving as a barrier from each painful memory he recalled.
Across from him sat my attending – a keen and beady-eyed psychiatrist of few words. She carefully dissected through his story, surgically extracting the pieces of information that fit into her clinical picture. Stephen teared up periodically throughout his story, sharing how he wanted to kill himself because he was in so much physical pain. Although his tale was long-winded, he came across as genuine and sincere. And about halfway through our interview, I noticed Stephen repeatedly glancing over in my direction.
Once his blatant staring became apparent to the entire group, he turned towards me and asked what my ethnicity was.
“I’m Egyptian,” I answered.
“So, does that mean you’re a brotha?”
“I’m North African, so I’m an honorary brotha,” I joked.
His eyes lit up, he reached out with his baseball-mitt hand, dapped me up and boomed “MY MAN!”
I let out a smile. As people of color, this was the exclusive nonverbal fraternity that granted us camaraderie in white spaces. It was our way of letting the other know, “I see you.”
As he continued on with his story, I felt inclined to believe him, despite how questionable some of the details were. But my attending wasn’t having it. She read right through his façade and retreated to the team room to collect evidence before calling him on his bluff. And sure enough, after careful review of his records, we discovered three other documents from hospitals across the Salt Lake Valley that all said the same thing in big, bold letters: MALINGERING.
I quickly googled Stephen to see if anything he had told us was true. He wasn’t a former champion bodybuilder. He didn’t have a daughter on a Utah college women’s volleyball team. What I did find, however, were arrest records. And even more shockingly, I learned he was a registered sex offender for having sex with a minor.
Stephen was a fraud. Despite this, I remember feeling a moment of sympathy for him. I thought to myself, “How desperate do you have to be to put on a show like this for three meals and a cot?” But I think the thing that frustrated me the most was not that he lied to us. It was the fact that to all the white providers treating him, they didn’t just see a drug seeker. They saw a black drug seeker. And for these providers and doctors in training who have limited interaction with black patients in our community, I grew nervous that they would form blanket generalizations about black patients solely based on Stephen’s performance.
But above all, I grew frustrated for allowing myself to be played in the first place. Because Stephen was a fellow person of color, I let my guard down and empathized with him regardless of what came out of his mouth. And that naivety led me to bias the care I provided him. So, where do I draw the line? How do I balance my shared cultural sensibilities with patients of color yet remain unbiased in my care for them? I don’t expect that soft spot ever to go away, but if I’m to become a fair and just physician, it is something I must learn to do.