Thursday, February 24, 2011

On Race

by Leana S. Wen, M.D.

Mr. A is a 23-year old black man with abdominal pain.

Mrs. S is a 48-year colored woman who was the restrained passenger in a rollover MVC.

Sammy is a 10-year white boy with fever.

OK, maybe it’s just me, but there’s something different about how these medical presentations start. I went to medical school in St. Louis, and once in a while, we did hear of someone referred by race. Maybe someone with sickle cell anemia; maybe someone with a rare inherited disorder. Maybe. But race is a common and almost unavoidable descriptor in South Africa.

And not just in the medical setting. I came to South Africa for the first time about three years ago, and the woman I rented a room from, a lovely Africaans lady in her late-sixties, raved about my “Oriental” skin. Her son was dating a beautiful woman, a “colored” woman. She was also telling me that she and her family were extremely progressive and opposed the apartheid from the beginning, even resigning from the Dutch Reform Church because of its initial position on apartheid. But how could she progressive, I wondered, when she used such terms to describe people?

Race in South Africa is fraught with a troubled past that the country is still grappling with. Under the apartheid regime, race was the sole determinant of what opportunities a person had. Apartheid ended less than twenty years ago, and remains in the consciousness of all but the very young. Interestingly, the way that South Africa has chosen to deal with race is to be completely open about it. Some of my other work was done in Rwanda, where the Rwandan genocide of 1994 is still very much in the public consciousness as well. Rwandans chose the path of not talking about race and who was hutu and who was tutsi. South Africa has taken a very different route by making race front and center of self- and public- identity.

As I came to see, my old landlady was hardly a remnant of some kind of old world tradition. I asked one of the young registrars how I was supposed to identify the consultant, and she directed me to find the “tall colored man”. My fiancĂ© and I were looking for a DJ for our wedding, and the form to fill out asked for basic information: size of event, type of event, type of music requested, age of guests, and… the race of couple and race of guests. My South African fiancĂ© didn’t blink an eye, but my American sensitivities were startled to say the least. Can you imagine such descriptors being used for hiring a DJ in Boston?

So what about this obvious display of race—is it a good thing? I don’t think I understand enough of South Africa to comment. I can say that the people here find the political sensitivity around race in the U.S. in particular but also U.K. and Europe to be excessive. Why not just get it out in the open and obviate passive discrimination, they would say. You’re probably thinking about race anyway. I would argue, though, that my American eyes see race perhaps as being less distinctive and less important of a descriptive. The last ten patients I saw in the U.S., for example, do I really remember them as a black man or a white woman? I’m not sure that I did, but I’m not sure that it would have been a bad thing if I did.

Curious to hear your thoughts, on this and other topics. Please email me,

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