The last time my youngest son was hospitalized, nearly two years ago, I lay in his hospital bed with him in my arms. We had recently returned from the recovery room after a successful surgery, and I admit I was both physically and emotionally drained. As a single mom of three, some days are certainly harder and more exhausting than others. However, the combination of having been on call that weekend, grieving the loss of a close friendship, a late night involving multiple attempts to obtain vascular access (place an IV) in my son, and an early morning transport to pre-op to discuss intraoperative management of my son’s medical devices, had left me feeling extra depleted that day.

Perhaps if I had been more awake, I might have had a more thoughtful response. And by “awake,” I do not simply mean more well-rested or caffeinated.

In my partial stupor I lay there intermittently making small talk with my son’s nurse. She looked at him, smiled, and cheerily said “I love his tan!”

My identity as a pediatrician/safety-guru is apparently so enmeshed that my first instinct was to be reflexively defensive. I neurotically and meticulously discuss sunscreen at every single well child check, day in and day out, five days per week. How dare she think I would fail to use adequate sunscreen on my child? 

And then it hit me.

My first instinct was to become defensive…but for the wrong reason entirely.

She wasn’t failing to recognize my adherence to sunscreen and skin cancer prevention guidelines. Her comment was not a couched dig at my clinical acumen as a pediatrician.

Before a single word could exit my lips, I let her comment sink in fully. She saw my son as “tan”….not as biracial. 

I quietly wondered how many more times he would hear similar comments in his life. 

By the time I processed those thoughts, she had fixed his IV fluids and left the room. Having paused too long, the moment was gone. And I had left all the words unsaid.

Looking back, I wish that I would have responded more quickly and with empowering, strong, educational comments. And as a pediatrician, let alone a pediatrician raising biracial children, I am ashamed that my reaction time was slow and my lack of response was embarrassing.

Growing up in the Midwest I felt surrounded by racism. While it can never begin to compare to the racism experienced by BIPOC, even as a white person, I faced the teasing and slurs related to my Italian/Sicilian heritage. And before I understood the importance of using sunscreen neurotically, I would return from my summers in California to comments about how I was so dark that I looked “like a black kid.” My mother had been called the “N” word, due to the belief that Sicilians are descended from Africa, and I still remember her explaining to me what the various slurs and comments signified and how they were inherently racist.

But let me be explicitly clear. I have never had to fear for my safety based solely upon my skin color. Not then in Missouri, and not now in California. As a cis-gendered, white female, even when I did face police harassment in the past, I did not have to remind myself, in those moments, to keep my hands where they could be seen. No guns were drawn. I never called out to my mom. 

While I acknowledge my white privilege, I will further acknowledge my extreme naïveté. I believed the endemic racism of the Midwest to be largely a regional phenomenon. It is time for me to be fully accountable for the fact that sunshine and family were not my only motivations for leaving the Midwest. Having been raised by an anti-racist mother, and now raising three children of my own, two half-Asian and one half-Indian, I figured we were buffered from white supremacy, living in Los Angeles.

Yes, that was a one-dimensional, dismissive, ignorant thought process. Yes, there are very lovely, anti-racist people in the Midwest. Yes, racism is endemic here in California as well. Yes, moving 2000 miles from the place where my then 4-year-old daughter was the only biracial child in her class, to a school with more than 50% biracial children, does not grant my own children immunity from racism. 

Certainly society is cognizant that our Black Americans have never been afforded basic safety against, let alone “immunity” from racism…right? 

Apparently not. 

I became even more acutely aware of this cognitive dissonance two months ago, as I was yelling at the TV like a crazy person, while CNN was inquisitively speculating as to why black patients are disproportionately affected by COVID. 

“Really? Is this a real question?”

You would have thought I was watching football, the way I was carrying on as my annoyance mounted. 

“Social determinants of health, poor access to quality healthcare, intergenerational toxic stress, economic disparities, essential workers!!!!” 

It turns out that CNN cannot hear my frustrated pleas nor see my frantic gesticulation. But it was yet another important reminder, amongst a series of countless, painful reminders, that not everyone got the memo that racism is a public health crisis. Thankfully within a day or two, physicians and public health experts had shifted the narrative to expose the root cause, racial disparities, thereby saving my TV further verbal aggression. 

However, I sat in my apartment a few weeks ago on a Saturday night, revising a grant proposal that, somewhat ironically, pertained to adversity/resilience, toxic stress, and trauma. As I did so, tear gas was being lobbed about half a mile away, and I was forced to face a larger fear. 

At no point in time did I fear protests or tear gas….not for a second. But what I did fear, and do fear, is the legacy I am leaving as both a mother and a pediatrician.  

It is not enough for me to merely break cycles of intergenerational trauma in my own life. It is insufficient to simply teach my own three children to be anti-racist. It is not adequate to merely treat my own cohort of patients equitably and advocate individually for them. Voting in November is not an all-encompassing solution.

It is both selfish and woefully myopic to act as if I live in a protected vacuum…a microcosm of perceived safety where, as long as I love and support my circle of black and brown friends, family, and patients, we will be fine. The truth is that none of us will be fine, not friends, not family, not strangers …not until systemic racism is dismantled. There is no room for complacency or neutrality, because “inaction” is a verb that is as equally powerful as “action.”

So while I once lay holding my son in a hospital bed, lacking the proper words, I will continue to find and fortify both my words and my actions, because my children, and all of our children, need a hell of a lot more protection than mere SPF can provide.