A fictional story about a Black woman who faces racial disparity within healthcare until she comes across a doctor who takes her concerns seriously in her quest to find a diagnosis.

“Ma’am I need you to stop causing a ruckus or else we will be forced to escort you off the premises”.  

Those were the first words Dr. Mia Ramirez heard as she walked towards the unexpected early morning commotion. As she entered the clinic lobby, she saw Jim, the security guard, and Bart, the receptionist, talking to a woman who seemed quite agitated. “What’s going on here?”, asked Mia. “This woman refuses to leave without getting an appointment. I have been trying to explain that currently, all our doctors have no available slots, but she refuses to accept my answer. I even offered to refer her to a nearby clinic, but she refused and started yelling to see a doctor. That’s when Jim stepped in. Sorry for the disturbance, we’ll deal with it” replied Bart. “I see,” said Mia while observing the woman. She was a short, Black woman with curly hair and carried a small plastic bag. She did not seem like the kind of person who would willingly harass medical staff, but her eyes glistened with a mix of tears and something Mia had become familiar with seeing in patients during the several years she had worked at that walk-in clinic: desperation. Mia turned towards the woman and asserted “My shift ends at 2 am, so if you are willing to wait till then without disturbing my staff or the other patients, I will be happy to meet with you”. The woman nodded and muttered “Thanks Doc, sorry for all the fuss” as she walked to a corner seat in the waiting room of the MediMend clinic. Bart and Jim thanked her for stepping in as Mia made her way back to her office. Phew, it was going to be a long day! 

At 2 am, Mia yawned and opened her office door. The day had been seemingly never-ending. Yet she remembered to conserve enough energy to meet with the mysterious woman who had quietly and diligently sat all day in the corner seat. She took her seat as she heard Bart say “Ms. Williams? Dr Ramirez will see you now”.  

“Firstly, I would like to apologise for my behaviour this morning” sighed the woman with remorse. “My name is Naya. I am here today because I wanted to get another opinion on my condition” she said as she handed Mia her plastic bag full of medical reports. “Naya Amara Willams, 42, secretary at Woodland Primary” Mia read aloud from Naya’s case file. “And this is your fourth visit since your symptoms first started?” she asked as she flipped through Naya’s records. “I have been sick for a long time now” answered Naya. “It started with some bad back pain and shortness of breath about a year or so ago. Since then, the pain has only spread and brought along nausea and the loss of my appetite. I have been to multiple doctors, even had a mammogram taken but none of them said I had anything to worry about. So far, I have been managing on painkillers and the best I can do is numb myself till it becomes manageable enough to do my job. I’m the sole earner you see, and I still have two kids to put through college. Leaving work is not an option, but here I am because it is affecting my ability to provide for my family.” 

Mia patiently listened to Naya’s narration while simultaneously examining her medical records. She began to say “Well these reports don’t really indicate anything abnormal, have you considered-“when Naya cut her off. “Don’t tell me anything these reports already say, not one of them is the answer to my ailment. Judge me all you want for being stubborn, but I know myself and something is very, very wrong”.   

Despite what the reports presented, Mia found herself surprised at the conviction in Naya’s voice. “Alright, I won’t. Have you experienced any new symptoms since your last medical visit?”. Naya pondered on her question and slowly replied “Well, it seems as though the back pain has spread towards my rib area. I swear I’ve been trying to take it easy, but it looks like I have some new muscle strain”. Alarm bells started ringing in Mia’s head. “Did you just say pain in your rib areas? For how long now?” asked Mia as she held up the mammogram and examined it again. “Maybe 5 or 6 days? It started a few months after my last doctor visit” answered Naya.  “I am going to order a new mammogram for you,” said Mia as she began dialling the clinic’s radiology lab. “But why? The last doctor already did that and said it was all clear. She insisted when I asked if she was sure, said that some fancy AI had been used so she was quite certain…unless she and the AI were wrong? Is that even possible?” said Naya. “It is. Not all AI screening techniques yield accurate results” said Mia as she printed out a form and handed it to Naya. “Our lab will open in a few hours. It is quite empty today in terms of appointments so getting your results soon should not be an issue”.  

The next afternoon, Naya and Mia met again in the office. Mia looked Naya square in her eyes and said “I had a feeling your previous scan and doctor were wrong. I think they missed something very crucial on your scan which was why I asked you to redo it”. “And did they?” asked Naya with a quiver in her voice. “Based on your symptoms and scan, I think you may have breast cancer. I’m now scheduling a biopsy for you so that we will know for sure” answered Mia softly. “I’m sorry to address it in such a crude fashion but time is of the essen-“ Mia paused when she saw a small smile appear on Naya’s face. “I knew I wasn’t crazy when I questioned her diagnosis” Naya whispered.  

Once the sample was taken, Mia met Naya outside the lab. “The results should come in 3 to 4 days. If you give your contact details to the reception, I’ll be in touch with you” said Mia. Naya chuckled and looked at Mia. “I’m about to find out if my life is going to blow up. I’m not leaving this space till I do. I’ll be happy on my corner seat” she said in a tone that indicated finality. For the first time since Mia met Naya, she saw something new in Naya’s eyes: hope.  

3 days had passed since Naya stormed into the MediMend clinic. As per her proclamation, she barely moved from her corner seat in the lobby. Due to her constant presence, she was starting to befriend the MediMend staff and despite their rocky start, talking to Jim and Bart was slowly becoming an enjoyable part of Naya’s daily routine. On the third everning, Mia decided to celebrate the slow day by going to the nearby diner at the end of her shift. As she walked towards the exit, she noticed Naya in her usual spot and smiled at her. Just before exiting, Mia stopped and turned to Naya. “Have you had dinner yet?” she asked. “I’m heading out to dinner at the Moonlight Diner next door. Would you like to join me?”. Pleasantly surprised, Naya nodded, “It would be my honour”.  

“2 chicken burgers with sweet potato fries please” said Mia as she handed their menus to the waiter. “Is this your usual spot?” asked Naya as she took in the retro vibe of the diner. “It is, ever since I began working at the MediMend clinic. I came here on my first day after a gruelling surgery, and one bite made me forget all my worries of the day. Ever since then, this spot has been my happy place. Do you have one of those, a happy spot?” asked Mia timidly, unsure if this violated the boundaries of a patient-doctor relationship. “I do actually” Naya replied. “It’s at my desk at work. I try to make sure that my community’s kids can attend school and get their education. Working there is where I found purpose for the first time.” “Do you miss them?”, asked Mia as the waiter set down their food. “More than you can imagine”. “At least you don’t have to worry about bills, right? One of the perks of paid leaves” Mia said jokingly, trying to cheer the sombre expression on Naya’s face.  

“I used up all of those during my first rounds of doctor visits. I both literally and figuratively can’t afford to be here” said Naya with a sad smile. As she looked up, she saw a look of disbelief paint Mia’s face. “It’s normal Doc, we get a set number of sick days and it’s just that my body has been sick for more than the school can afford. But it’s okay, I’ll figure something out once I get back. Don’t look at me with pity.”  

“I’m sorry, I didn’t realise I was,” said Mia, trying to change her expression. The pair sat in silence as they finished their meal. “Let me” insisted Mia, as she paid their bill. “It’s my treat since you gave me the pleasure of your company”. As they started walking back towards the clinic, Naya took a deep breath and said, “I wanted to thank you Doc”. “What for?” asked Mia. “For restoring my faith in doctors” said Naya with sincerity in her voice. Looking at Mia’s confused expression, she continued. “These past few months have been difficult not just physically but mentally too. The first time I went to the doctor, it was based on my friend Sarah’s recommendation. She’s this colleague of mine who is very similar to me and had previously experienced similar symptoms. When she visited the same doctor, she was able to get her cancer diagnosis without any trouble. So, her positive experience encouraged me to visit him. He barely listened to me as I recounted my symptoms and said that all my problems would go away if I just lost weight. I was very confused because this was not what I was expecting. He even refused to give me any prescriptions for the pain. As I was leaving his office, I heard him say to the nurse: “All these people do is lie and look for their next pill fix”. I was shocked. I wondered what was so different about me and Sarah that caused us to have such different experiences. There was only one I could think of. Sarah’s white. I went home in tears. That experience made me quite skeptical about visiting a doctor. But the pain eventually worsened and new symptoms appeared. So I went to a different fellow, and he chalked it up to an infection and gave me some antibiotics. When I tried telling him that I was sure it wasn’t only an infection, he told me to calm down and not cause a scene even though I was speaking in the same tone and volume as him. For my third doctor’s visit, I decided to go to a big hospital because I wanted to be done with the diagnosis, and I assumed they would have the right resources. However, that visit made quite a dent in my savings with no successful outcome to justify its spending. We did indeed do the mammogram as you saw in my reports. I was quite hopeful because this was already progress compared to my previous visits. But when she said that she found nothing, I felt as though I was the butt of a very cruel joke. When I asked her if she was sure, she started describing the technical aspect behind the scans and used fancy words while refusing to explain them. She went on to brag about the expensive AI models that their hospital was using and that there was no way it could be wrong since it worked for most of their patients. And what do I know about these big-name AI things, so I had no option but to believe him. I had just about lost hope at this point”.  

“All I wanted was someone who listened and took my concerns sincerely. Someone who looked at me like I was human, and not a Black person looking for a fix or an illiterate poor who was not capable of understanding the technology used in my healthcare. That is also why I caused a scene the morning we met. I had decided that if I was unable to get my appointment, then I would play the stereotype of the angry Black woman if that’s all they saw me as anyway. I had just about lost every shred of dignity and self-respect, but then you came along. You cared, but more importantly, you listened. So, thank you for that.”  

Mia was stunned. She had heard about the racial disparities faced by Black women in healthcare, but to hear Naya recount her experiences as though they were just facts of her life rather than traumatic experiences was heartbreaking. The pair reached the lobby of the clinic and bid each other good night. The moment Mia reached her office, she locked her door and let the tears fall.  

The next morning, Naya met Mia in her office. “We’ve received your biopsy results. I’m sorry Naya, but you have metastatic or stage IV breast cancer.” Mia paused as she saw a whirlwind of emotions stir within Naya. “How..how is that even possible? I got a mammogram, the doctor said I was fine, it had even been checked with AI!” exclaimed Naya in disbelief. In a soft voice, Mia continued “Not everything AI models say should be considered the ultimate stamp of approval. Sometimes these AI models are not designed and trained with people of darker skin colors in mind. This changes the likelihood of the right outcome, so they should be used with caution. There is a risk that comes with using such models, one which your previous doctor should have explained to you. But you now have a definite diagnosis. We can discuss management options such as chemo-“ Mia was stopped mid-sentence as Naya stood up and began to walk out. “Naya? Naya where are you going?” asked a worried Mia, standing up to follow her. “Naya please stop. It’s raining outside, where are you planning on going?” But Naya did not stop. She continued walking, past the lobby, past her corner bench and out onto the pavement in the rain. Mia, Jim and Bart silently observed as Naya slowly began to melt onto the floor and weep. “Should we bring her in?” asked Jim with concern in his voice. “No,” said Mia, “let her be”. The trio continued to watch as Naya cried. Cried for herself, cried in relief to finally have an actual diagnosis but more importantly cried in mourning for a life that could have been if only she had been taken seriously earlier.  

*All sources used in the story are linked below