They were smart students from the town side with unpaved streets and no sidewalks, twin sisters excluded from the gifted trail because they were black.
A comment from a white classmate in Twinsburg, Ohio again stings: “’I don’t even think of you as black.’ I said thank you. ‘ And I felt pride, ”recalls Dr Brittani James with a shudder.
“I thought we were special. I thought the other people in our neighborhood weren’t as good as us, ”she said.
The twins were indeed special – they won free rides to the Ivy League, earned medical degrees from prestigious universities, and thrived in a profession where they are vastly outnumbered due to their skin color.
But their mission now is to dismantle the ingrained fanaticism behind this classmate’s backhanded remark.
At 33, James and his twin, Dr Brandi Jackson, joined the medical establishment in pioneering work to eliminate racism in medicine.
“We learn to see it and to undo it,” Jackson said.
James, a doctor in internal medicine, and Jackson, a psychiatrist, developed anti-racism courses used at two Chicago medical schools. They co-founded the Institute for Antiracism in Medicine, where physicians can earn continuing medical education credits for taking classes on how their profession made black patients sicker.
They are calling for federal legislation to require hospitals to disclose results by race, with penalties when black patients consistently fare worse. They even came up with a plan to create black doctor’s coats. It’s not as drastic as it sounds – black coats were the tradition in the 19th century.
Their latest achievement? Help bring a charge against the American Medical Association and the influential research journal it publishes.
The year of the pandemic and relentless police violence fueled their resolve to tackle structural racism.
“It is literally killing us,” James said.
In recent years, the AMA has made an effort to atone for decades of exclusion of blacks from its ranks. Even today, only 5% of all American doctors are black.
But in February, a podcast hosted by AMA’s flagship medical journal caused a stir. The tweet promoting the podcast read: ‘No doctor is racist, so how can there be structural racism in health? ”
It was “a boost,” said Dr Aletha Maybank, WADA’s head of health equity.
The sisters’ institute has launched a petition, demanding that the newspaper diversify its predominantly white editorial staff and ensure that medical research relating to race and racism is published. The effort has so far garnered more than 8,800 signatures.
WADA suspended the newspaper’s editor and a deputy editor resigned. The group held a meeting last month where James and other black doctors voiced concerns.
James says WADA’s new anti-racism plan – in the works long before the sisters’ activism – makes her optimistic. In an 83-page document released Tuesday, WADA pledged to dismantle structural racism within the U.S. medical establishment, including by diversifying its own staff and collaborating with outside groups.
The group reached out to James and other medics to discuss the plan – an encouraging sign, she said.
“We still have to keep our feet on the fire,” she said.
The sisters’ message is not new, said Dr David Ansell, a doctor from Rush who has worked with their institute. But their timing is odd – at the convergence of a deadly pandemic that has highlighted racial inequalities in health, a rise in white supremacism, and civil unrest linked to police brutality.
At such a time, he says, the sisters can make a difference.
Their scientific curiosity started young. James remembers taking “field notes” while spying on people. Jackson remembers turning their mother’s blue pearl case into an insect hospital.
“We emptied it and we went under the rocks looking for potato bugs, worms. We gave everyone their own compartments … then we went through them and made notes when they seemed slow. ”
Their parents were hard working and supportive, but the twins did not tell them when they were accepted to Cornell University, knowing the cost was prohibitive. They broke the news when they got full scholarships.
It was during a college summer program that James first saw a black doctor. She stared at him. “It was like a unicorn,” but it planted a seed.
They went their separate ways for medical school – Northwestern for Jackson, the University of Michigan for James.
Now, they serve as mentors to other medical students from non-traditional backgrounds. James treats patients at a clinic on the south side of Chicago and teaches at the University of Illinois-Chicago. Jackson has taught at Rush Medical College and is the director of behavioral health for a Chicago health network that treats LGBTQ and other underserved patients.
Resident physician Shan Siddiqi is a Canadian Muslim whose parents are from Pakistan. He works under James’ direction at a clinic where James says “the sickest of the sick” go for treatment, patients with chronic illnesses made worse by poverty, the stress of living in violent neighborhoods and now COVID-19 . Siddiqi said he was impressed with her compassion, taking the time to treat them like humans and helping them overcome challenges in obtaining medication or specialized care.
Jordan Cisneros, a third-year Rush medical student Jackson mentored, says her advice helped him through a difficult year. His father died of COVID-19 in January, and George Floyd’s televised death last May was personal.
“I had some trouble with the police. I have had some trouble with racism. I saw it first hand, ”he said.
Jackson’s tears over Floyd’s death let students know it was okay for doctors to be vulnerable, Cisneros said.
The sisters are extremely close, often finishing each other’s sentences, but there are also differences.
Jackson is single, loves to cook in her spare time, and thinks like a scientist in the kitchen, amazed at how a humble carrot can turn into something sublime with just a little butter and brown sugar.
James is married to a white doctor, a guy she thought was a math nerd when they first met, but who is now her partner in combat. She cries when asked what she wishes for their 1.5 year old daughter, Lillian.
“I don’t want her to have to live in a box like I did,” James said. “ I want her to raise her voice so she knows it’s good to be all she is, especially when the world is trying so hard to make black and brunette girls small and unheard. ”
Follow medical writer Lindsey Tanner at @LindseyTanner.
The Associated Press Department of Health and Science receives Support from the Department of Science Education at the Howard Hughes Medical Institute. The AP is solely responsible for all content.