"Race is just a social construction..." white academic types opine; as if it would matter if it was. Race is not only a social construction. I can not wipe the blackness off my face as Dolezal presumably could tissue off her dark make-up. Even when I wear my hair straightened, and have been stuck inside long enough to look racially ambiguous, in the USA, most people will identify me as black, or at least not white. This is a double edged sword in medicine, precisely because race IS very real.
Race is about genetics. Genetics matter immensely in medicine. Race matters not only in terms of exotic diseases like familial Mediterranean fever which effect only certain ethnic groups. Race matters not only in terms of very common diseases like breast cancer, where the genetics of certain groups can predict whether they will get the disease, but only within that group due to very specific genetic mutations (here in Israel breast cancer is caused by different mutations in Iraqui Jews versus Ashkenzi Jews). To be very real about it, race matters every time you want to even analyze basic labs. AST/ ALT? The Chem 7 panel? Yes, that basic...and I should know being black in Israel. Years ago, on checking, my liver enzyme values were so far off the population norms I looked like an raging alcoholic...but thankfully in Israel, most of the social construct around race - the one which would decree me an ignorant idiot- doesn't exist in my very specific case. I was able to explain to my doctor that the lab values were done by population norms, and I'm outside the population norms. Soon I'll be off to a nephrologist over a new abnormal lab value I have based on my creatinine levels. No one wants to talk about this, but African Americans really have a triple-whammy when it comes to kidney issues. Genetically blacks seem to have on average fewer nephrons than whites to begin with. Add to that in the case of African-Americans some very un-natural selection in terms of the conditions of slavery which I would guess began right on the slave ships when some people died of dehydration...and top it all of with blood pressure raising stress.
What stress? I'll give an example. About a year ago, I noticed my pule was high and I was sweating. I felt accelerated. Being a doctor, I saw the symptoms of thyroid disease. I knew given my particular personal medical background the chances I had such a disease were much higher than any general population. I feared a thyroid storm, and headed to the one emergency department in New York City where I knew no one. They subsequently began testing me for drugs in spite of my patient explanations. Their assessment of me as a younger black women with elevated blood pressure and pulse, was that I must be on drugs. When the tests came back negative, they decided I had anxiety and called psychiatry. I do have anxiety- especially when I'm fighting for my health in a racist system that seems designed to cause my early death. I believe the anxiety is appropriate.
What happened to me when I was treated, or more accurately not treated, for what was later diagnosed as thyroid disease (exactly what I told the personnel I suspected) is an example of race as social construction. The social construction is the idea of my inherent supposed stupidity, and imaginary status as a drug fiend. The results were of course very real, in that my diagnosis was delayed for days putting my life at risk. Yet, I would never want doctors to not know that I am black, and African-American in particular...genetics matter.
On both counts, the reality of race, and the social constructions around it, white academic types, reveal a sort of tragic cluelessness....and I can't say I am surprised. Academia is a place of so much in terms of time and resources dedicated to learning, but so little about reality is learned outside of the sciences. Most people in academia come from immense privledge..so for many of them perhaps race is just an issue of identity and social construction. Their opinions show just how far apart they have drifted not only from some of the populations they are opining on, but from reality itself...
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