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From the heart: Stanford cardiology chief reflects on his experience as a Black physician

Eldrin Lewis, Stanford's chief of cardiovascular medicine, opens up about racism and his hopes for future generations of Black physicians and patients.

Eldrin Lewis, MD, MPH, is chief of cardiovascular medicine at Stanford. But during his career as a Black physician, assumptions made about him and his role in medicine have made it clear that many people, including colleagues, patients and police, see all Black men in the same way.

"What it made me realize," Lewis writes in a Medscape commentary, "is that I could have easily been George Floyd. Because if I get pulled over, they will treat me just like every other Black man. I always drive with my hospital ID in the car. I always keep my hands in plain sight. I have that level of anxiety every time I get behind the wheel of my car."

Growing up in the Mississippi Delta, Lewis's upbringing was shaped by race and racism. His history book featured a Confederate flag on the cover. His high school did not hold a desegregated prom until 1987.

"Even though I was valedictorian of my high school," he reflects, "not a single counselor told me I should apply to Harvard or Yale or Princeton or Cornell. They didn't give me any advice. I had no clue."

Moving north

Lewis eventually left Mississippi. He earned degrees from Penn State University, the University of Pennsylvania and Harvard University, and he trained at Brigham and Women's Hospital, where he also worked and taught.

Eldrin Lewis, MD, MPH, chief of cardiovascular medicine at Stanford Medicine, says in a commentary, "We have to look in the mirror as physicians and say, 'Do we care enough?' "

But Lewis did not escape racism when he moved north. He writes:

"When I went to away to school, what I thought was, 'I'm leaving Mississippi. I know there's racism here. But in Pennsylvania, that's the north and it'll be fine.' But you see the same racism ― maybe not the same degree, but you see it."

In the essay, Lewis describes some of the indignities he's faced throughout his career, such as hearing racial epithets or being repeatedly asked where he went to medical school.

He writes about being mistaken for a patient transporter, even though he was dressed in his white coat and carrying a stethoscope.

"Every part of the hospital, every job is truly important, and we all work together," he writes, "but it's frustrating when you work so hard for so long ― four years of college, four years of medical school, and seven years of training ― and you get confused for transport."

Racial disparities in patient experience

Black patients also face racial prejudice, and the health consequences can be severe, Lewis writes. "One thing that's hard for me, for many reasons, are the poor outcomes we see in so many Black cardiology patients. I lost a family member at an early age from a heart attack," he writes. "He lived in a small town in Mississippi. He had a heart attack at the typical time you have a heart attack, 1:00 in the morning."

He then sat there at a small community hospital for six hours without getting treatment and without getting transferred to a bigger hospital where he could get the treatment he needed.

The rationale was that the ambulance drivers needed their sleep. By the time they called an ambulance, the damage to his heart was done. A simple heart attack that could have been fixed led him to die, all because of a lack of access to care. He was in his 40s.

He continues: "Why are there more complications in Black patients? Are our arteries different, or is the quality received from the doctor different? ... There are a lot of times we have to look in the mirror as physicians and say, 'Do we care enough?'"

An opportunity to make lasting contributions

Lewis joined Stanford as the chief of cardiovascular medicine in March. He sees the role as an opportunity to make lasting contributions that will benefit his Black patients, trainees and colleagues.

"If you look at the top cardiology programs, there are only three Black chiefs of cardiovascular medicine," he writes.

Just by being here, Lewis hopes he will help clear the path for others: "I'm excited to be the new chief of cardiovascular medicine at Stanford. I'm hoping by being here and doing a good job, others will say, 'I can do that, too.'"

Image by Андрей Яланский

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