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Being the resident on call in the hospital carries a lot of responsibility. It’s part of my job to make sure our patients in the emergency room are seen and evaluated by all the different people who might be involved in their care, including my co-residents. The hours are long and the work can be grueling, but it’s a necessary evil: I’m in my second year of residency and I’m learning how to respond to crisis and how to make decisions alone.

Several weeks, ago, while working an overnight shift in the emergency department of Cambridge Health Alliance, a social worker came to me during the sign-out, where one shift relays patient notes and treatment plans to another. She’d just evaluated a male patient who said derogatory things about her age and about being female. We often deal with patients who have deeply seated beliefs about who their health care providers should be, or what they should look like. Sometimes, those beliefs are insulting.

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Normally, when I see such patients, I try to treat them with dignity and compassion. But dealing with bigotry can be pretty exhausting, and it takes a lot of mental energy to set yourself up for that kind of discord. That night, as the resident on call, I could delegate his care to a colleague, and take the load off my mind. So I did.

Dr. Gaddy Noy, a fourth-year-resident, white and male, showed up. I told him what was going on, and I asked him to see the patient.

His response was not what I was expecting: Man, he told me, I’m sad that I’m placating his worldview, his idea of what a doctor looks like.

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I tried to defend my decision — he’s saying all these negative things about women, I said. But I knew Dr. Noy was right. I didn’t think it would be good for either me or the patient if I treated him that night, but I also worried that I’d used Dr. Noy to ease my burden. It wasn’t fair.

In medical training, things often happen so fast that you can’t really reflect on them until later. Dr. Noy saw the patient, and we carried on with that night. Weeks later, still troubled by our interaction, and seeking feedback on how to be a better leader, I asked him if we could sit down and talk. The video above has the highlights of our conversation.

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