On Racism and Women’s Health

As I reflect on the events of these past two weeks, I feel drawn to share the story of my own journey with racism, and how this ties in with my passion for holistic wellbeing, especially for women in midlife.

I’m not even going to bother discussing the very real, incredibly important, and obvious, discrepancies in the quality and availability of healthcare for women of color compared to white women like me.

I assume we all know about that.

I’m going to go deeper, to a place that makes me really uncomfortable, in the hope that sharing this discomfort will help us all open our eyes and our hearts to a situation that is begging for us all to finally pay attention.

First, in relation to wellness, I have often stated that the purpose of life, in my opinion, is to uncover our deepest potential. As long as we are living in a way that does not represent our highest, most alive, integrated, and authentic self, then we still have room to grow. We are still not living in our most fully “well” potential.

In as much as we are not seeing clearly, and are operating from old harmful conditioning, we are stunting our potential wellness. And there is no way I can see that expressed more clearly than in this current invitation to face our own unconscious racism.

For women my age, we have been alive on this earth through some incredible times. We were born during the civil rights movement and the Vietnam war, after women were allowed to vote and had made enormous strides towards equality.

Now 50 years later, where are we?

And how do we each take responsibility, that is, be able to respond, in a way that leads to greater awareness and holistic wellness?

I am going to share some of my own story with you, in the hope that it opens up some possibilities in you and your own experience. In as much as I put my foot in my mouth and offend you, I apologize in advance. Just know that I am trying my best with what I know right now. And as my teacher Vinny Ferraro says, “If I wait until I am ready, I will never start. And we HAVE to start. One baby step at a time.”

My journey with racism has been almost all subconscious. Growing up in a liberal family in New Zealand, I was taught that all humans are equally valuable and that racists are “bad people.” I, on the other hand, was a “good person.”

I never met a black person in New Zealand, but our own indigenous Maori people had suffered a similar fate to indigenous people in all colonies. Like the Australian Aborigines and Native Americans, their land was stolen by British settlers in the mid 1800’s, and after a series of brutal wars, they were marginalized to small pieces of undesirable land.

I was not taught anything about this in New Zealand history class in the 1970’s- rather, I was taught the white version about the treaty of Waitangi that allegedly gave “equal rights” to the Maori people while allowing Britain to take over the country. As a result, the Maori people continue to be treated by many as second class citizens, with disproportionate numbers ending up in jail, being supported by welfare, lacking education, suffering from addiction, and domestic violence- just like the results of colonization everywhere.

I had some Maori girls at my schools- not many, because we lived in a relatively affluent area, but Tui and Lisa were two of my best friends at different times in my childhood. My family welcomed them into our home, but I never got to see their homes. They both lived in government housing and get-togethers were always arranged at my house. I don’t know whose choice that was and never thought about it until this week.

But the undercurrent that my house was “better” was just silently… there.

We never spoke of it. As we grew older, I was offered accelerated classes and more opportunities than Tui and Lisa, and we drifted apart. Neither of them graduated from high school. Tui got pregnant at 16. I never thought about them again.

My family and I were not objectively racist. The society we lived in was racist. Like the USA, the country was founded on racist principles. And like fish can’t see water, I was completely blind to the fact that there was a problem. For me, there was no problem. I dressed up in native Maori costume for “dress-up day” (we don’t have Halloween) and like all New Zealand children, I learned several traditional Maori songs and dances at school. As far as I knew, we were all the same. Maori culture was fun and a tourist attraction, not something held deep in my heart, but more as entertainment. I could choose to pretend to be Maori and then go back to my white privileged life.

Many of us my age remember the now unbelievable prevalence of racist conditioning that we were fed through in the 1970s and 80s. We thought “The Black and White Minstrel Show,” (a variety show with white men in black-face makeup and exaggerated black speech patterns) was hilarious, and one of my favorite dolls was a “Golliwog.” The Golliwog is a fictional character from a 19th century children’s book, and my Golliwog was a rag doll with brown skin, black frizzy hair, a sad face, big gold earrings and patchwork slave-type clothing. When flipped upside down, the Golliwog’s skirt would reveal a smiling white blonde-haired girl with braids and a beautiful pink dress.

I have vague memories of my mother entertaining me as a tiny child by flipping the doll one way then the other and meeting squeals of joy, like a game of hide-and-seek. Looking back, I can imagine my 3-year-old brain being imprinted with “White= pretty, good, happy, rich. Black= less-than, poor, sad”- over and over again.


My father, who was certainly not consciously racist, would read us “Uncle Remus” stories about b’rer rabbit and b’rer fox and the “Tar Baby” in his very best New Zealand Black Southern plantation accent. These and countless other things led to the subconscious, deeply-seated understanding that white is the gold standard, and everything else is less than that; even more, those “poor people” need help to be more like us.

Fast forward to my adult years as a doctor and lifelong activist for women’s rights, peace, equality, and all kinds of similar words… I had in fact been suspended for staging an anti-nuclear peace rally and was consistently left of center politically… so could I possibly be racist?

That’s just funny!


I am the least racist person I know. (This is a joke, of course, based on something one of our political leaders recently said.)

When I was an OB/GYN resident in the 1990s, I “moonlighted” as the Harris County Jail doctor to earn extra money for a couple of years. I remember this as being one of the most rewarding and enjoyable jobs I ever had. I had complete freedom and was in charge of the clinic at age 28, and some really interesting diagnoses, like the not infrequent cockroach in the ear and all kinds of abscesses and infections from rampant bacteria contracted both before and after being arrested.

I made a lot of friends and was treated kindly and politely. And over 90% of my patients were poor and black. The quality of healthcare offered and the resources that I was given to work with were appalling, but that just made it more of an exciting challenge.

What went right over my head was that I could choose to walk in and out of that jail every day, and they couldn’t. And what totally went over my head was that this was the county jail, and these men hadn’t even been charged with anything yet- they were awaiting arraignment.

So why did I see some of them over and over for up to two years?

The reason, I recently learned, was that they couldn’t afford bail. Looking back what I remember was the degree of acceptance that I, the inmates, the staff, pretty much everyone had about this situation. I didn’t hear a peep about thinking it should be different. This was just the way it was.

One of my clearest memories was working the 6pm-6am night shift for the first time and rushing to get through the huge pile of charts in front of me representing all the men who had come to see me at this strange time of day. I didn’t want them to wait, and worried that they needed to get back to their cells to sleep.

The charge nurse, a seasoned middle-aged black woman who had worked in the jail system for more than 20 years, told me “Honey- you have to work tomorrow. Just go and take a 4-hour nap. I will wake you up in a few hours. These guys aren’t going anywhere.”

Looking back, I was like a jail tourist. To me, it was exciting and fun. I could come and go when I wanted. And I made what at the time was a ton of money. Talk about white privilege. I wasn’t objectively racist, and I brought good care and a bright spot in the day to many suffering people. I genuinely cared about all of my patients. But I had no idea what was going on at a deeper level. No idea at all.

Fast forward a few years, I clearly remember in 2011 one of my longtime patients who happened to be black came to see me for her annual visit, and as she was about to leave, she hesitantly said “Dr. HS, I love you, but I need to tell you something. I am not going to be able to come back to see you.”

I was shocked, and asked in complete surprise “Oh my goodness, what happened?” She took out her phone, opened my website homepage and simply held up the picture of our group. “This is what happened,” she replied. “I can’t come to an office that doesn’t embrace diversity.” I was hit with a punch right in the middle of a giant blind spot in my chest.

What was she talking about? Of course, we embraced diversity. At the time we had a staff of over 50, and more than half were women of color. But as we looked at the photo together, none of those women of color were providers. She and I stared at a beautiful photo of 15 pretty, smiling white, white, white women.

Faced with my Golliwog, I started to tremble. “I didn’t mean for this to happen,” I explained… “I simply hired my friend, and then hired her friend, and then hired women from my old residency program which happens to be predominantly white. We just hired the best candidate every year. There wasn’t any racist intention, I promise!” She wasn’t moved. “You need to look at this,” she said. And then left.

I never saw her again, but she opened a door that I am forever grateful for.

What happened after that was a messy path of putting my foot in my mouth and saying “the wrong thing” at every turn as I attempted to understand what I was missing as white woman with incredible privilege trying to navigate a whole new world. As the leader of my group, our hiring process became openly anti-white. Any resume with a name like Jane Smith would be overlooked for one with a more ethnic name.

I was determined to make our picture look better.

Yes, that was my goal, I am ashamed to say. To make the picture look better.

My understanding of systemic racism was so shallow that this was as far as my understanding of diversity could go. Around the same time, I became actively involved in a surgical mission project in Sierra Leone, which at the time had the worst maternal and neonatal health record in the world, so it seemed a good place for me to earn some redemption. I could have worked in a local Houston underserved women’s group, but my “go big or go home” personality seems to always push the limits.

My 3 trips to Sierra Leone in 2011-13 were among the most transformational experiences that I have ever had. I helped a lot of suffering women and did an incredible amount of good work. I saved many lives. I raised tens of thousands of dollars in donations. I am not making light of the good that was done on those trips, but the thought process that took me there was in the “hero-victim” or “healer-wounded” frame of mind. I went there to help people who needed help, and to help them to be more like me. Similarly, when I moved my focus in 2015 to a Women’s health project in Malawi, the undercurrent of thought was around how we could help these “poor people” to be more like us.

Obviously I am not burning crosses in my front yard, spewing racist rhetoric or doing anything remotely suggestive of objective racism. But the subtle undertone of “white is best” and colored is great… if it defers to white, has certainly been the way I have lived my life. Yes, even as a doctor who goes on mission trips to Africa and has devoted my life to serving others and valuing each person as equally valuable.

A few years ago, I became fascinated with anything and everything to do with organizational culture particularly surrounding difficult issues like race, politics and religion. I started teaching mindfulness at the office, started talking about racism, and asking questions about what was happening in the world of medicine and if there was a better way to be. Naively, to my surprise, this was not received well. I was told flat out “you CANNOT talk about politics or religion or race at work.”

One night, after returning hyped-up from a Mindful Leadership conference in San Francisco, arguably more “evolved” than Houston in matters of racism, and sexism, I sent an email to all of my staff inviting them to start a conversation with me about “white privilege” (which I had just learned about) and admitting to the mistakes I had made, and committing to try to correct those mistakes in collaboration. I thought this would be met with great openness and joy from my providers and staff. In retrospect, not surprisingly, this was not the case.

After a few days of silence, I was informed that my email had caused quite a stir. My all-white partners called for an intervention with me at one of their houses and said they were not aligned with this kind of “racist rhetoric.” Several black staff members complained to HR that I was using racist language. I was called to the “Principal’s office” and ordered to issue an apology. “White Privilege” is not language that our organization at the time (HCA) felt was appropriate and could be misconstrued as “White Supremacy” or other racist terms.

My attempt to begin healing racism completely backfired. Several staff members resigned as a result of my “racist” email. I was heartbroken and confused. I contacted my diversity teachers to ask them what I did wrong. I will never forget the answer. “Susan, you have just opened Pandora’s box. When you start this conversation, you WILL put your foot in it. It will be messy and hard, but keep going.”

The Corporate solution of course was to bring in their Diversity expert to talk to the staff about “what I had done” and to attempt to heal the wounds. This meeting was actually wonderful and welcomed by me, and the presenter was highly skilled, and suggested that we all read a book called “Small Great Things” (which I highly recommend) … I won’t be a “spoiler” by telling you exactly what it’s about, but rest assured it was worth reading.

I committed myself to being open to doing my best to understand my own subconscious racism and to accept that my white skin gave me a wide range of privileges that I had previously thought were earned by my own hard work. Sure, I worked hard, but not recognizing that my whiteness (and I am SOO white) had a part in my success started to seem more and more delusional.

Then comes the guilt and shame for being white, which is a personal journey not worth discussing here since it deviates the attention back to me. And this is about not my suffering. It is about the suffering of others who do not have white privilege. I specifically do NOT want to ask my brothers and sisters of color to feel sorry for me for the suffering I am now experiencing as the result of discovering my white privilege. This is not about me. I can join a white affinity group that supports equality and equity and cry about my guilt and shame- but this is not the place for that.

Back to the present, here I am on June 7, 2020, just 2 weeks after the brutal murder of George Floyd on my unbelievably “woke” and also white privileged son’s 17th birthday, May 25, 2020, sitting in the fire… the fire of the reality that I have thought and acted in ways that promoted racism for my entire life. I spent most of the day today listening to “White Fragility” on audiobook simply because it is sold out in paper copy, which is an incredible development, and reassessing what I want to do next.

What should I do? What can I do? What can YOU do? I think one of my guiding teachers Chris Crotty says it better than I can:

If we want a different world – well-being for everyone – we must work to uproot the seeds of racism within ourselves. We must adapt our practices until we see more clearly how our own prejudices form habits of bias that can cause us harm. We must be committed to a deeper collective awareness of the ethical dimension of our lives – only by caring for others can we be a guiding presence in a more socially just and awake world.

This is our practice.