Why I Believe Racial Bias in Medicine Almost Killed My Baby

My 9-month-old son was admitted to the emergency department last May following what was described as, “seizure or stroke-like activity.” He had hemiparesis on the left side of his body, and his eyes and head were also deviated left — symptoms we had never experienced before with him, despite his developmental delays.

At the time I worked in healthcare operations and had often frequented that hospital on business. It was in an affluent suburb and had a great reputation. I also had a good working relationship with the medical director of the entire hospital system, so I felt assured I was in good hands.

My son’s ER visit began with a physician, who was cold and unfriendly, asking me questions that eluded to whether my child was being neglected or endangered. I assumed she was conducting standard child abuse screening, so I wasn’t concerned with being questioned. I explained to her that my son was currently under the care of a neurologist, as well as receiving physical therapy for his developmental delays. I also let her know he’d had eye surgery a few weeks prior.

The hospital staff proceeded to medicate my son with drugs, including anti-seizure medication. They performed a CT scan of his brain because the physician wanted to check for injuries, but it didn’t reveal anything. After a couple of hours in the emergency room, my son was still heavily sedated. However, the ER doctor, who never even returned to the room to give us an update, told the nurse to send us home. I asked whether or not that was appropriate, considering my son was not awake and unresponsive. She said it was a normal side effect of the medication and it would wear off in a few hours. Against my better judgment, I took my son home. I trusted the hospital staff and their judgment over my own instincts.

My son finally woke up three hours later, only this time his entire body was flaccid, he had spiked a high fever, his eyes were rolling into the back of his head, he was barely breathing and unresponsive. I called 911 and an emergency ambulance rushed us back to the exact same hospital, just four hours after being discharged.

This time my son was admitted to the Pediatric Intensive Care Unit where he remained for the next four days. While in the PICU a new physician ordered blood tests, a 24-hour EEG and administered intravenous medications, including antibiotics and more anti-seizure drugs. My son was placed in isolation and also had a spinal tap to check for meningitis or other infections because of his high fever that lasted for nearly three days. The accommodating PICU nurse even helped to facilitate a Red Cross flight for my husband, who was deployed 8,000 miles away, so he could come home and be with our son.

I have worked in healthcare, including participating in multiple Joint Commission ambulatory healthcare reaccreditation surveys and coaching my own staff on policies, protocols and procedures in accordance with national Joint Commission standards. I know what I experienced earlier that day in the ER with my son was more than inadequate care.

The doctor was curt, dismissive and her implicit racial bias influenced her decision to prematurely discharge my son. It could have killed him. At the very least, the hospital staffers working in the ER should have continued to monitor my son for seizures, ensure that his neurological status was stable and that his observations were within normal limits for his age and condition. Sending a 9-month-old baby home who is still heavily sedated, following “seizure or stroke-like activity” is grossly negligent.

Sadly, there is mounting evidence of implicit racial bias and discrimination in health care, even in pediatrics. Implicit bias can unintentionally influence behavior, such as perceptions about patients, decisions about patient management and adherence to treatment recommendations.

Dr. Tiffani Johnson recently studied implicit bias against black children in a large pediatric Emergency Department in Pennsylvania, and the results were astounding. Dr. Johnson’s research found that 91 percent of participants had bias against black children. Furthermore, pediatric residents had similar implicit biases as resident physicians from other specialties, such as family medicine.

What this means is that minority children are vulnerable to implicit racial bias from their healthcare providers, which can impact disparities in pediatric healthcare. Physicians and parents need to be aware of these findings. Don’t be afraid to speak up, advocate for your child and always trust your gut. I also strongly urge institutions to look at successful methods of reducing racial bias in medical decision making, starting with education and awareness.