Just Hair, or Something Else?

By Dr. Adrienne Johnson, M.D.

How long does it take you to think about your hair every morning before work? Not how long does it take you to style your hair every morning, but how long do you actively think about what your hair will look like! Five minutes? Ten, at most? I have spent days thinking about how I should wear my hair. You read that correctly, days. I’m not a perfectionist when it comes to hairstyles, nor am I talented enough to execute intricate designs that pop up on Instagram and Twitter. I spend days thinking about my hair because I know it carries weight and ultimately can determine how I as a person am perceived. Some of those reading this will instantly understand the feelings and reality surrounding something as simple as hair, and most of you probably guessed I am a person of color; specifically, I am Black.

As medical students, during the first two years, we are judged and ultimately graded on how well we absorb, reiterate, and apply the information we have been taught. We have exams, quizzes, and fake patient scenarios. All objective data is graded on a scale of 1-100. However, over the final two years, we take all that medical information and are allowed to practice in clerkships or rotations. We enter healthcare spaces and are now part of a treatment team. Something else also changes; how we receive grades. We rotate through core medical specialties in our third year which is almost universally the same across all medical schools with minor exceptions. We spend time working with OB/GYN, Family Medicine, Internal Medicine, General Surgery, Pediatrics, Psychiatry, and Emergency Medicine teams. We meet new Residents and Attendings every day who tell us where to be, test our knowledge, and can influence our careers just from the few interactions we have. They also have the power to determine what grades we ultimately receive based on how impressed they were with us, sometimes from one day together. Now, this doesn’t sound too terrible, right? Just be smart, and you’ll be fine. But it’s not always about “being smart.” It’s no secret that these “objective” measurements can be intertwined with subjective biases. It’s known that when a person is more similar to another, they are regarded more highly during interactions. So what does that mean for people who are different? Their scores are lower, and they are deemed less professional, they are more likely to be excluded or targeted. I, a Black woman, walking through primarily White-cis-male dominated spaces, am not like the average resident or attending. So what do I do? What are my options to fit in?

Therefore, I spend days thinking about how to wear my hair. I know that if there is a chance, I could make the person responsible for my grade uncomfortable. I mean, state and federal laws are being introduced against discrimination based on hair, so it’s not like it isn’t a reality for me and those who look like me. Hair, the dark, curly strands on my head that grow according to my DNA, could make or break my academic standing. What if the scarf I wear to protect those strands is seen as unprofessional? It’s not just hair; what if the way I sound or talk is too different, so I’m perceived as unintelligent? No amount of “smarts” will make up for the person I am perceived to be by others.