He frowned. “Then what are you doing here in my class?”
My mouth went dry. Why had he intentionally singled me out in this way? Race was the first thought that entered my mind. I tried to summon an attitude of 1960s-era Black Power defiance, but what came out sounded like 1990s diffidence. “I’m a student … in your class.”
“Oh…” he said.
Dr. Gale looked away, then walked off without another word. I staggered to my seat, sitting through the second part of his lecture like a robot, tuning out his voice. What had started out as a promising day was spoiled.
During lunch a few hours later, I replayed the encounter to three black classmates as we sat out of range of others in the cafeteria. I’m not sure what I was looking for, other than the chance to vent to people who might understand what I was feeling. Their response surprised me: Two of them burst out laughing.
“That’s messed up,” Rob said, almost choking on his hamburger.
“At least he thought you were a skilled worker,” Stan said, as the two laughed harder. “He could have asked you to pick up his trash or shine his shoes in front of the entire class.”
“That’s not funny,” Marsha said, glaring at them.
“What else are you going to do but laugh about it?” Stan shot back.
“He’s right,” Rob chimed in. “You know you want to laugh too.”
Marsha started to say something about reporting the incident or confronting the professor, but her militancy evaporated as Stan and Rob started quoting the comedian Chris Rock. I don’t recall the specific joke, but it made me smile and calmed me down enough that I could eat my lunch. Racial insults—big and small—were a part of our lives and sometimes humor was the best way to deal with it.
Yet the good feelings didn’t last. The afternoon lectures gave way to a different course, and with it, another professor. I could not concentrate at all. “Are you here to fix the lights?” played over in my mind. In high school and college, I had been mistaken many times for a potential criminal, hired help when I was a paying customer, and most favorably, as a six-foot-six budding professional basketball player. But it’s one thing to be insulted by a stranger you’ll never see again, and something altogether worse for your professor—who assigns grades that dictate your future—to cast you in such a limiting way.
Trying to apply reason to the situation, I told myself that at Duke, Dr. Gale saw many more black maintenance workers than black men in his class. And I also firmly believed that there’s no shame in blue-collar work. My dad spent thirty-five years as a meatcutter at a grocery store while my maternal grandmother—Grandma Flossie—worked her whole life as a housekeeper, or in the parlance of her times, a cleaning lady. What bothered me was Dr. Gale’s assumption that I had no business in his class unless I arrived in some service capacity. Sensitive as I already was about my place at Duke, this incident stabbed at the core of my insecurity. With one question, Dr. Gale had shattered my brittle confidence and my tenuous feeling of belonging at Duke.
* * *
In a color-blind world, Duke might well have rejected me; at the very least, its admissions committee would not have offered me a full-tuition scholarship to its medical school.
This troubling revelation occurred to me less than an hour into my first day on campus. The Duke Med Class of 2000 had gathered for the first time, crowded into an old lecture hall that was in its last year of use. It was a typically humid August day in North Carolina, with the temperature already approaching eighty-five degrees by mid-morning. Inside, an antiquated but powerful air conditioner chilled the room to the mid-sixties. Our eyes focused on the speaker who stood at a small lectern. An anesthesiologist by trade, she had short graying hair and spoke in a monotone that could put you to sleep without medicine. Nonetheless, the room crackled with tension. Our medical lives were about to begin.
“Congratulations,” she led off. “I’m proud to say this is the most accomplished class we’ve ever had during my time at Duke.”
Nervous laughter filled the room. On a scale of cutthroat competitiveness, future doctors are worse than Olympic hopefuls. Pre-meds arrive with better grades than those who attend law, business, or other graduate programs, and this is no coincidence. Although most schools deny it, getting into medical school is, to a large extent, about numbers. In keeping with our numerical obsessions, we craved our first glimpse of how we measured up against each other.
She began with our college grade point averages. “The mean was 3.7 on the standard 4.0 scale,” she said, leafing through papers that defined our lives as data.
My GPA was higher, but I discounted this edge since I had attended a less prestigious college than almost everyone around me. That realization had sunk in months earlier, during my admission interview at Yale. “I’m not sure the grades from your undergraduate college reflect what you’ll face here and beyond,” an elderly surgeon told me, his faced lined with worry as he viewed my transcript. And with that swipe of his verbal scalpel, he cut my straight-A record down to what seemed a B-minus average.
Next up were our scores on the MCAT, the medical school equivalent of the SAT. “The average combined score was 34,” our Duke professor announced.
I’d scored a few points below this class average. Based on percentile rankings that she went on to explain, my result was still as good as, or better than, those of a third of my classmates, but that did nothing to prevent my empty stomach from twisting into a painful knot. While admissions committees do consider other factors, I’m fairly certain that my community service record, leadership skills, and interview performance all rated average at best. These were not the talents that made Duke offer me a scholarship.
Things got worse as she boasted about the number of students from various prestigious colleges. “Twenty-five percent of the incoming class has an undergraduate degree from Duke,” she said.
Another quarter came from the Ivy League, most either Harvard or Yale. Of the remainder, the vast majority hailed from other elite private colleges, such as Stanford and Johns Hopkins, or highly regarded state schools such as the University of Virginia or the nearby UNC–Chapel Hill. While I had considered many of those schools four years earlier and been accepted to several, I attended the lesser-known University of Maryland–Baltimore County. At the time, it felt like the perfect choice, as it offered a full scholarship, the opportunity for playing-time on a Division I basketball team, and was only a forty-five-minute drive to my parents’ home. But now at Duke Med, I felt like a scrawny thirteen-year-old on a basketball court with grown men.
Why had Duke accepted me, and offered a full scholarship as enticement? As I played through the scenarios, affirmative action appeared to me the only answer. Seemingly dialed into my thoughts, the professor then turned to racial numbers:
“We have fourteen underrepresented minorities out of our total of one hundred students,” she said, as she smiled broadly. “That makes this our most diverse class ever.”
In academic circles, underrepresented minorities include blacks, Hispanics, and Native Americans; Asians are excluded from this tally because they enroll at colleges and medical school in very high proportion compared to their numbers in the U.S. population. In our class, all but one of these fourteen underrepresented minority students was black. Hispanic students tended to choose medical schools in a few large cities (New York) or states with large Hispanic populations (Texas, Florida, and California). At the time, North Carolina, and the city of Durham, had few Hispanic residents. Native Americans simply make up a very small percentage of the underrepresented minority pool, so they have little impact on the total distribution.
I scanned the room. About half the black faces clustered in a center area near the front, with the rest scattered, as I was, throughout the lecture hall. I had met most of them months earlier, during a weekend that Duke held for admitted black applicants. At the event, black medical students, resident doctors, and faculty all descended upon us to offer assurance that we woul
d not be racially isolated at Duke. Along with the opportunity to meet and greet prominent people at the school, current black students had organized informal gatherings that featured common African-American themes: barbecue at the local park, pickup basketball games, and a venture to a trendy nightclub. They did everything to show that they wanted us badly.
Duke was not alone in its efforts to recruit black medical students. Johns Hopkins filled our recruitment weekend with similar engagements, and it had a few aces that Duke lacked. Levi Watkins Jr., a black cardiac surgeon who implanted the first automatic defibrillator in a human, led the festivities. Our experience culminated with brunch at the estate of Ben Carson, the famed neurosurgeon then known best for separating conjoined twins. Even then, his story of triumph over childhood hardship had spawned a career unto itself with lucrative speaking engagements and bestselling books. In our eyes, he was the Michael Jordan or Denzel Washington of black doctors. Seated in his elegant living room amongst black medical faculty, residents, and current Johns Hopkins medical students, we heard the implicit message loud and clear: As admitted applicants, we’d been invited to join an exclusive community. Friends of mine attended similar events at Harvard, Yale, and the University of Pennsylvania.
This preferential treatment from these elite schools stemmed from their perception of us as “the best black,” a term coined by Yale Law professor and novelist Stephen L. Carter. In the post–civil rights era, college and professional schools still sought to enroll the best white students as they always had, but they also began a new, urgent mission: to bring the top black students into their halls. According to Carter, this aim resulted in a distinct set of standards where academically successful blacks were not judged against whites (or Asians), but rather against one another. “There are black folks out there. Go and find the best of them,” Carter wrote, describing the mentality that he saw as pervasive across several areas of society. This approach to admissions explains why I received a full scholarship to Duke and was offered early acceptance to Johns Hopkins during my junior year of college.
Yet even with these aggressive efforts, the numbers of black students and doctors are low overall. Blacks constitute about 13 percent of the general U.S. population but a much smaller proportion of the physician world. In the mid-1990s, blacks accounted for about 7 percent of medical students; that percentage holds steady today. That figure includes three predominately black medical schools (Howard in Washington, D.C., Meharry in Nashville, and Morehouse in Atlanta) that currently comprise about 20 percent of the black medical student population. Some schools have just a few black students. What might those numbers look like without affirmative action? Perhaps the past holds some answers.
Before the social and political upheaval of the 1960s, black doctors were a rarity—comprising less than 2 percent of all U.S. physicians. The vast majority of these doctors were educated at Howard and Meharry (Morehouse was not established until 1975) with the expectation that they would provide medical care to segregated black communities. Of the prestigious white schools that did admit blacks, none could be called progressive in that era. Johns Hopkins graduated its first black medical students in 1967. The University of Chicago had just one black student in its Class of 1968. Harvard enrolled just two black students that same year. Yet Duke, from its founding in 1930, has dealt with a racial climate in many ways more intense than its peer schools.
Among elite medical schools—those regarded among the top ten in terms of selectivity, national reputation, and placement of graduates in prestigious clinical residency programs—Duke alone is located in the South. Like most southern hospitals and medical schools, it was fully segregated through the early 1960s until a constellation of events occurred. In 1964, the U.S. Supreme Court upheld a lower court ruling in a North Carolina case that struck down the separate-but-equal doctrine in hospitals. The subsequent Civil Rights Act of 1964 and enactment of Medicare in 1965 gave the federal government the leverage to force the hand of southern hospitals into integrating their facilities.
At the time of these radical developments, you could count the number of black medical students and physicians at Duke literally on one hand. “During the late 1960s, they basically enrolled just one black student every year,” one black doctor from that era told me.
On the undergraduate campus, black students were not admitted to Duke until 1963, and their numbers were only slightly higher than at the medical school. According to those who lived it, overt prejudice in those early years on campus was rampant. It was represented by senior university officials’ membership in a prominent local country club that excluded blacks. It also took the form of campus cross burnings and other racist acts. This combined racism—equal parts blatant and symbolic—fomented black student unrest that culminated in the 1969 nonviolent protest and occupation of the school’s Allen Building, an episode largely credited with paving the way for Duke’s entry into the modern multicultural era.
Yet the stain of Duke’s racial legacy persists. In the late 1980s, well-known Harvard professor Henry Louis Gates Jr. was briefly a professor at Duke. He didn’t stay long, feeling unwelcome, and later publicly referred to Duke as “the plantation.” More recently, in 2006, Duke’s racial problems resurfaced when three members of the near all-white men’s lacrosse team were arrested and charged with the alleged rape of a local black exotic dancer. The case dissolved after the charges were shown to be false, but the race, gender, and class elements revived campus and community tensions while fueling decades-old stereotypes.
So while the days of cross burnings and swastikas are a distant memory, Duke still grapples with its legacy of racial discrimination. During my medical school interview at Harvard, I ate lunch with Kevin, a senior from Princeton who was the only other black person in the group of thirty or so applicants. We were considering all the same schools save for Duke. I told him how much I had enjoyed my interview at Duke and how beautiful the campus was.
“It’s a great school,” he conceded, “and it would be great to live in a place where it is seventy degrees in November.” He then looked around to make sure that no one else was listening. “But you know how they don’t have a good track record with people like us.” I must have heard some variant of this comment a dozen times during that interview season. It was clear that many black students viewed Duke through a racially tinged lens.
A few years earlier, in an effort to combat this perception, the medical school decided to offer full-tuition scholarships to the handful of underrepresented minorities (primarily black) it saw as most desirable. Anyone who has known a medical student or recent graduate recognizes this award as the lottery ticket it is. With rare exceptions, the only way that future doctors can get someone else to pay for their education is to serve in the military or on some rural outpost for a handful of years after graduation and training. But Duke’s offer came with no strings attached. At its essence, the scholarship was a form of recruiting reparations, a practical way to entice blacks students who might otherwise be scared away by stories from Duke’s past.
And it worked. For me, the scholarship was the decisive factor in choosing Duke over Johns Hopkins, which offered more prestige, a slightly better track record of training and hiring black doctors, and proximity to my family. It also bumped Duke ahead of three Ivy League schools on my list. I later learned that the free ride propelled the other five recipients to Duke for similar reasons. Back then, the scholarship was valued at $100,000 over four years, but factoring in interest rates for an equivalent loan over many years, it was more like $175,000, or even more. A lot of money for a group of people like us who’d never had much.
So there it was: Not only was I admitted to Duke, when in a color-blind world I might not have been, but I had arrived with a full-tuition scholarship in hand. Depending on your perspective, affirmative action had done its job, giving a working-class black kid the chance for an elite education, or affirmative action had reared its ugly head, taking a slot from someone else mor
e deserving while possibly setting me up for failure.
* * *
In our initial week on campus, we accumulated all the trappings of first-year medical students: parking passes, ID badges, and bulky textbooks. Classes started the following Monday. As I nestled into a spot in the middle of the lecture hall, nearly a week after I’d learned how I stacked up against my classmates, I saw three unfamiliar faces seated together a few rows in front of me. Two were black. Were it not for this, I probably would have overlooked them, assuming they were classmates whom I had not met or had simply forgotten in the chaos of shaking so many sweaty palms during our orientation. However, the numbers of black students in my first-year class was small enough that I already had a mental catalog of their names and faces. These two—one man, one woman—were new to our select company.
During a short break between lectures, I leaned over to Greg, a native southerner who’d gone to college at the University of Florida. “Who are they?” I asked.
“I don’t know for sure,” he said, “but I have an idea. Let’s ask Angela. I bet she knows.”
We turned around and looked up at Angela, another black classmate, who sat a few rows behind us. She was from New York and had gone to Yale as an undergraduate, where she’d been an English major. The gregarious type, she already had her finger on the pulse of medical student gossip. Later that day, as the three of us walked along a semi-enclosed path to the medical school bookstore, we asked her about the unfamiliar faces.
“They have to repeat first-year,” she whispered.
“Why?” I asked.
“I guess because they didn’t pass last year. What other reason is there?”
“That doesn’t look good,” Greg said.
“You’re right about that,” Angela said.
I agreed. Despite our varied backgrounds, we knew the stakes: Affirmative action may have done us a favor in admissions, but it certainly hurt us whenever a black student struggled.
Black Man in a White Coat Page 2