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A doctor’s Survival Kit for the Hostile Environment and Racism in the UK

A doctor’s Survival Kit for the Hostile Environment and Racism in the UK

I am sorry you find yourself in this situation yet again. You are right to feel mad, to feel wronged, to feel betrayed. Your rage is justified. Don’t let anyone tell you differently.Hear me again: What happened is wrong. You are right to feel the way you do. I am here with you. I stand by your side.

These are the words I longed to hear from someone – from anyone – after a racially motivated incident just a week before the COVID-19 lockdown. The perpetrator knew I was an NHS GP when he shouted: ‘Go back home foreigner’.

How can I stay sane and thrive in a society populated by racism and many other forms of oppression? That is the question I was asking myself.

We have genuine choices to make. We can either dull ourselves and become passive-aggressive or hide in the slivers of class and status privilege we are afforded as health workers.  We can internalise racism or we may want to carry on with denial or trivialisation of the issue by offering easy fixes, a bit of diversity here, a bit of training there. Indeed, self-deception and dissociation are powerful tools. We can do all of that, but they are not the kind of choices I want to make.

I suggest we don’t wait for a top-down approach, for a saviour from the leadership, before we start taking care of ourselves.  ‘We deserve to have our humanities intact’ (Rev Angel Kyoko).

In that spirit, I would like to offer the lessons I learned after my latest overt racist experience to you as a gift of self-care in the aftermath of acute racial distress. May you pick what speaks to you and let go of what doesn’t.

1. Feel your emotions without judgment. Recognise that feeling is not acting upon them. Emotions are not a nuisance, but instead, they carry information and wisdom for you. Accept your humanity and vulnerability. Emotions need to be felt. You may experience rage, shame, humiliation, fear, confusion as well as nausea, headache, heaviness in chest, and an array of other physical symptoms. The tension stays in your body; your body will be responding to the distress.   

There will be a period of time when you have too much adrenaline and cortisol pulsing through your body, making you hyper-alert, agitated, and unable to rest. If you can cry, do that. You may want to scream, or run, or punch into the open air. Anything physical may help tone down the acute stress. If you need to rant, go ahead – but do not do it publicly.

Once your mind is calmer, there are mindful practices like RAIN (recognition, Allowance- Inquiry and Nurturing) that may be useful.

2. Nurture yourself with understanding and recognition. Create a sense of connectivity with your social world. We all need our suffering recognised and validated. Seek support, but choose your support system wisely. For example, social media may not be the best place for it when you are very vulnerable. You want to protect yourself from further harm in the early days.

BMA offers peer support group and counselling, so does Practitioner Health NHS. In my view, being stressed by racism is not a mental health problem. Rather, it embodies a heightened sense of injustice as a response to a racial experience. If you choose counselling, try to find a counselor who truly appreciates the complexities of race. You don’t need someone who blames your insecurities or who advises you to stop seeing yourself as the victim. It is a social problem, and don’t let anyone tell you otherwise. Some safe practices to restore a sense of connectivity are journaling, praying, meditating, yoga, spending time in nature, taking a bath, and so on.

3. Take some time off. Going right back to work may be a helpful distraction on the one hand, but it may also trigger you. Like anyone who goes through grief would tell you, there are plenty of people who will make insensitive comments, whether deliberately or through carelessness and naivety, the last thing you need is someone fuelling your rage and hurt. I experienced all sorts of reactions: from appeals to my identity as a doctor (although the incident didn’t happen at work) with the ethical pressure on me to be the ‘bigger person’ to imaginary medical excuses for his racism, portraying my offender as either someone with a mental health illness or demented (which is an insult to people suffering from these conditions).

4. Don’t explain yourself to anyone. It is not your role, when suffering yourself, to educate the dominant, or the privileged, or the ignorant. Neither is it wise to wait for others’ understanding to be in agreement with yours before allowing yourself to feel what you are feeling. For many it is uncomfortable to admit that racism exists. |They will tell you that racists make up only a minority of the population and don’t reflect the society at large; much like telling someone with a broken leg that they should not hurt, as car accidents only happen to a minority. Most white people are also not aware of themselves as a racial group. Naturally, they feel they are objective experts on everything, including your experience of racism. With fresh wounds from an experience with racism, now is not the time to present a thoughtful testimony to change hearts and minds.

5. Tracking and logging racist events: In order to help providing a picture of the scale of racism, consider logging the incident on these sites: http://stophateuk.org/ 

 

or 6. Re-define what justice means to you – justice is larger than one human life. Still, we can create ways to palpate it in this very life. The one thing that helped me most was a newsletter article written about the incident, but its effect lasted only 24 hours – until I saw the offender going on about his life with the same level of social respect as before. We want justice, but we will probably not get it in our lifetime. Justice maybe should not be seen as the end goal but rather as a way of living. Rev Angel Kyo states that justice is when our sense of connection and love is expressed in society. I’d lie to suggest that we can create that sense of justice every day. But we need little tastes of it every day because, without it, we will not feel fully human.

Long-term, we need some kind of regular practice and ‘racial awareness and literacy’ about the impacts of social prejudice1. Moreover, we are more than our struggles, including that for justice. As cliché as it may sound, we will learn to smell the roses, laugh, and love while we are walking on the bumpy and confusing road of justice.

I embrace you, my dear friend.

This blog originally featured in Medact


About the author

Roghieh Dehghan is an Iranian who grew up and studied medicine in Vienna. She has worked in the NHS for about 19 years. Currently, she is a GP in Islington and an honorary clinical research fellow in the centre of Gender and Global Health at UCL.