The Color of Care from Executive Producer Oprah Winfrey (Full Episode) | Smithsonian Channel
- Hello, I'm Oprah Winfrey, and I wonder if something like this has ever happened to you when you're reading the news and a story just stops you cold. Well, that happened to me at the height of the pandemic. I read about a Black family in Detroit named the Fowlers, and I have to tell you their harrowing story would not let me rest. In fact, it haunted me. The father, Gary Fowler, worked hard his entire life to provide for his family, and at 56 years old, he was working 80 hours a week as a security guard because his greatest desire was to create a secure, beautiful life for his loved ones.
He became ill, started experiencing COVID symptoms. He went to three different hospitals. That's right. Three different hospitals. And here's what stopped me cold. Each hospital sent him home even though he told them that he'd put his own father in the hospital for COVID.
Try to imagine yourself or your loved one going to three different hospitals, asking, begging for help. Eventually, Mr. Fowler became so tired, so exhausted, he went home, sat in his favorite recliner, and that's where he died because hospitals did not think he was sick enough to treat. Can you imagine if access to life-saving healthcare for you or somebody you love depended on the color of their skin? Well, this devastating story had me wondering how many other Gary Fowlers are there out there? Research says there are far too many, and we need to do something about the larger pandemic that COVID has exposed, disparities in our healthcare system that cost lives.
I want this to echo through our culture and particularly our medical community. This needs to change. And my hope, my greatest intention for this documentary is for the stories that we tell and the realities that they represent to serve not just as a wake-up call but as a call to do something, a call to action. This can be changed, and we're the ones to do it.
[ambient background noise] - The World Health Organization is holding an emergency meeting right now out of growing concerns about the deadly coronavirus officially hitting the U.S. Here's what we know: a Washington State resident fell ill after returning from Wuhan, China, where the outbreak began. - The woman who answered the phone said, "Well, you know, he's really not doing well. He has no appetite, and he's not feeling good." They had no beds in the ICU, and so he never left the emergency room.
He never really regained consciousness, and he never left there, and we never saw him again. He was my brother and my playmate, my bike riding buddy, my tree climbing-- that was my brother. [soft dramatic music] - April 9th, they took him to the hospital. I'd keep calling and calling, just trying to reach somebody to find out what is going on.
And the way one of the doctors responded, it was like, "Well, do you really want him intubated?" I said, "Well, do whatever you can to keep him alive." It was as though... like he's a ward of the state. You know, he's on Medicaid and Medicare, and it's like so what's the concern? That didn't come out, but it was intimated that way. [siren wailing] By the 17th, he was dead.
- He'd be out in a few days, no big deal. We say goodbye, and... ♪ ♪ - The first case of the deadly coronavirus making its way to the U.S. - They put him in a wheelchair, and he just looked at me, and he just said like... "Mel, I want you to know "that I never knew a love like this before.
I love you so much." And I said, "I love you too. "We're gonna get through this. You're gonna get through this. You're young. You're healthy." But... - She was still on the gurney when she coded. - The daily death tolls-- nearly 2,900 people yesterday alone died of the coronavirus.
That's one every-- - I was talking to family, and they were describing calling for EMTs to come pick them up and the EMTs not arriving or the EMTs convincing them that they didn't need to go to the hospital or not believing that they were sick. They were describing going to the hospital and being sent home, not being believed that they were ill. - She had called twice.
They talked her out of going twice. ♪ ♪ - I was told, "You have COVID, but we can't give you a test "because if we test everybody that come in here, we'd have been ran out of tests two weeks ago." [siren blaring] - One of my sons took me to the hospital, and they turned me away.
- My husband had died, and I never got a phone call. [siren blaring] - Americans go from seeing this thing on TV in China to understanding that it is in their living rooms, it is in their schools, and immediately, it becomes clear to people who understand health disparities that Black people, Latinos, Native Americans, that they are gonna be in for a rough ride. ♪ ♪ [dramatic orchestral music] ♪ ♪ ♪ ♪ [somber music] ♪ ♪ - I'm Desha Johnson-Hargrove. Jason Hargrove was my husband. He was a bus driver for the Detroit Department of Transportation, and he absolutely loved what he did for the citizens of Detroit.
He put that blue uniform on every day proudly, you know, leaving the house 4:00 a.m., 5:00 a.m., 6:00 a.m., sometimes doing double shifts in a day for little pay.
His service was big for him. He loved being a provider for his family, so he did it with pride. Normal day, I mean, raise our beautiful children. We have five.
School, work for the both of us, church. The incident that Jason had on his bus this particular day, he complained about a female passenger who very carelessly would just outright cough repeatedly on the bus. She was not masked. She used nothing to cover her face, and it upset him very much.
Let me go into this video. ♪ ♪ You know, the crazy part is I have never... watched the whole thing.
Okay. ♪ ♪ - Hey, look, listen, man. I'm gonna say something. [clears throat] This coronavirus shit is for real. And for you to get on a bus, grown-ass person, and cough four or five times without covering up your mouth, and you know we in the midst of a motherfucking crisis... And they telling you every day what to do! Cough in your arm, sneeze in some tissue. That shit don't make no damn sense, and I mean that.
That was disrespectful. Disrespectful. I mean, damn, what the hell? Oh, man.
But yo, I gotta get outta here. I gotta make this run. Y'all be safe.
If you ain't got to go out, don't go out. If you go out, cover up your face, put some gloves on your hands, please. And if you see somebody coughing and they don't cover up, bust them in the back of the head. I'm outta here, y'all. I love y'all, peace.
- A couple of days later, his temperature was 101. I took him immediately to Sinai-Grace Hospital. They gave him a prescription for cough syrup.
They told him to go on a 14-day quarantine. They never tested him. By day four, Jason had extreme chills. He can't smell. He can't taste. He's coughing.
He has a fever, and he now has diarrhea. Jason held his hands up to me, and he said, "Baby, look... I'm blue."
I take him to Sinai-Grace. He says, "They listened to my lungs "and they told me my lungs were clear. "They told me that my fever wasn't high enough. "It was only at 99. "And that the color would come back in my hands."
So if this man is working out in the public every day, why don't you test him? I didn't understand that. The next day, he began to cough extremely bad. He says, "We're gonna go to Sinai, and I'ma be okay." My son Darshawn pulls up to the door. He lets them know that he needs oxygen. They send a wheelchair out.
They take him in. They won't let him go in. He's like, "Please, I want to stay with my dad." They tell him he can't come in. We'll take care of him. I call. I call...and I call and I call.
"My husband's been there all night, "and I haven't heard anything. "Can you have him call me? At least just have him call me." And she says, "Well, Mrs. Hargrove, he can't talk to you because he's on the ventilator."
How could this even happen? Like, what...[huffs] no calls? He's been there now for nine, ten hours. I keep calling. They tell me as soon as he gets a bed, they'll give me an update. Jason has been in Sinai-Grace Hospital now for two days.
They finally tell me he has a bed and he now has a nurse assigned, and they transferred me to the nurse. Nurse gets on the phone. She introduces herself. She says she's nurse Cheryl. Any changes in him, she would contact me. She said she was standing there with him at the moment, right then, and she says, "Your husband's looking good." She says, "I know that sounds a little crazy because, yes, he's on a ventilator."
She was like, "But everything looks good." The next day, April 1st, I make the call, and immediately the first receptionist tells me they don't have a Jason Hargrove. - Oh, well they said he's in room duh, duh, duh, bed duh, duh, duh, duh. So she says, "Okay, I'll transfer you to that department." They transfer me to the department. I do my spiel. "Hi, Desha Johnson-Hargrove.
I'm just calling for an update on my husband, Jason Hargrove." The nurse says, "Mrs. Hargrove, I need you to call back in 30 minutes. The nurse is busy."
Sure, I will. So 30 minutes go by. I call back in 30 minutes. I now have a different receptionist. "I don't have a Jason Hargrove." I give him the same spiel of where he is. He says, "I'll transfer you." They transfer me.
I get the same nurse again who says "Can you call back in 30 minutes?" I said, "Absolutely not. I will not call back again. "I just want an update. I just want an update. "You've had me call back already. I just want an update on Jason Hargrove." The nurse put the phone to the side.
I hear her speaking with someone in the background, and she's saying, "Bed 11, bed 11." And they tell her to tell me to call back. [somber music] I say again "No." She says, "Mrs. Hargrove, I need to let you speak to the doctor."
"Mrs. Hargrove"... ♪ ♪ "Your husband didn't make it. Mr. Hargrove has passed." ♪ ♪ Jason was in the hospital from Sunday till Wednesday. I never received any information from the hospital.
If it hadn't been for me calling them, I wouldn't have known anything. My husband had died. He has passed away, and I never got a phone call. They told me April 1st that my husband passed.
When I received the death certificate, the death certificate in fact told me Jason Hargrove passed on the 31st. My husband laid dead... all of those hours. All of those hours. A whole day before my call to the hospital to even find out that he had passed.
Here is a man who loved me. He did not play about me. You know, he protected me at all costs. ♪ ♪ I'm used to being his wake-up... And his goodnight.
He was my every day. My every single day. And to not have him... Here with me is... It just does not feel right. It just doesn't.
So Sinai-Grace, as well as the woman who coughed, shame on you. [somber music] ♪ ♪ - The story of public health in America wouldn't make any sense if you didn't understand the story of race in America. [ambient background noise] [chatter, clattering] [somber music] - The institution of slavery required putting a value on people's bodies, and the folks who did that were physicians.
They profited on doing that, and they profited on creating a science as almost a pseudoscience. Even up until the late 1850s, if you're a Southern physician, this is like a core competency to be able to evaluate people's bodies that way. And when you do that, part of the value is their progeny, so they were also evaluating their reproductive potential. - Everything in our country has been created at a time when slavery was the main driver and the main economic engine of this country, so medicine was as well.
- Slave women had surgeries performed on them, obviously without their consent, with no anesthesia, where they bled to death. They were permanently scarred so that the surgeon could get it just right before he did it on a white woman. - African-Americans, we have a very long history, a very troubled history with medical experiments. - There's a surgeon named Marion Sims who is regarded as the father of modern gynecology as a field, and most of the surgeries, including some of the instruments that are named after him today are based on his experimentation with Black bodies which he justified based on this idea that Black people experience pain differently.
- And of course, the Tuskegee experiments and syphilis being tested on Black people. - The United States Public Health Service conducted a study beginning in 1932. - Voluntary participant in a human experiment on untreated syphilis. - Henrietta Lacks-- her cells are used for development of all sorts of different medicines and research, and she's never even told about this. [somber orchestral music] There was Holmesburg Prison where Black men were experimented on from great scientists at the University of Pennsylvania.
Black folks, we don't go to the hospital until we're sick. Why? Because we don't trust. Because there was surgery being performed on us without our consent from the beginning of time. - When I really got into the details, of course, it was shocking to understand how the institution of slavery and its legacy influenced my field. For example, most textbooks only have images of white people.
In my field, one of the leading causes of morbidity and even death is hemorrhage, and the way that you know that somebody has lost a lot of blood is that they look pale. But if they're melanated, it's not totally clear that they exhibit paleness in the same way. And so you might be less likely to notice that in somebody who is not white, and you might not mean it, but that's just sort of how you've been trained.
You've only been looking at textbooks with people who are white-skinned. But I think for many of us, we think of racism as something that's outside of our present institutions, especially ones that are rarified like medicine. - Structural racism is pernicious and is pervasive, meaning you can't see the-- it's not so obvious, and it's everywhere, right? So it turns out, for instance, we have a long history in our country of redlining, of not allowing Black people to live in certain neighborhoods and really pushing them into other neighborhoods. ♪ ♪ Which neighborhood you live in has this profound effect on your health. - Your healthcare most depends on your zip code. ♪ ♪ That's the biggest indicator of how long you're gonna live, the quality of healthcare you're gonna have, what illnesses you'll suffer from.
It's your zip code. - The air you breathe has this big effect. Air pollution is not randomly distributed across every neighborhood and community.
What we know is communities of color, where they live, there's much, much higher levels of air pollution. Bus depots are often placed in those communities. Factories or things that will emit more air pollution are often placed into those places. It's not random. It's not random at all. It affects respiratory disease, asthma, and COPD and heart disease.
Just happens somehow that there's more asthma among Black kids than white kids. Huh, we don't know why. Well, we do know why actually. - So how do you explain that, America? I would say, "How do you explain that?" - Health care facilities in neighborhoods that are poor may not have the resources that they need to have MRI scans and CT scans, and so for these many reasons, we came into COVID with such health inequities.
- My father's engineering ring. So this is like the last piece of him that I actually really have. They were asking him to okay the trucks, the weight of the truck limits to go over the bridge to come to bring COVID products over like masks, sanitizer, and stuff for the hospitals, and he had to be there. He felt like, "Nah, this is what--this is my job. "I'm an essential worker. You can't tell me to be--" you know, and that's what he'd tell my stepmother.
"You can't tell me to stay home. "You're gonna tell the governor "that I'm staying home because you told me to stay home? I'm an essential worker. I have to be at work." So he didn't even make it, like, after he hit the hospital. Not even 24 hours, him being in the hospital.
He passed the next following day. - If you think about who are the essential workers who we said despite the fact that things are terrible, you still need to go in, they were disproportionately Black and Latinos, but let's talk particularly Black Americans. They didn't have the luxury of zooming in from home for their work.
They were in the subways. They were going to work at the height of the pandemic. - COVID-19 divided the world into people who could protect themselves and people who could not, and that was not just true across geopolitical borders. It was true within neighborhood blocks, and that was based on what people do for a living and whether or not they were valued in terms of being protected, and it was based on the housing that they have access to and how crowded they were.
It was very dependent in New York on how much they relied on public transportation to get the basic things that they need like food, and it was based on how they have always been treated by American medicine. ♪ ♪ - The Institute of Medicine came out with a report looking at systemic inequalities in medicine. They described the many ways that individual racism can come into play. Pain management, coronary artery bypass, graft surgeries not being done, curative lung cancer surgeries not being done, mammographies not being done-- like just all down the line.
- We may need to use the term unconscious more. They are not even known to the person that is exhibiting these issues. - My approach to getting individual doctors to make change is-- I always tell people, "Look at your own data." You think that all your patients care about-- you know, think that they're getting good care, being treated with respect. Do a survey of all your patients. Ask them if they all feel respected.
Ask them if they all feel heard. Ask them and look at that data broken down by race and see if there are some people in your panel who may not feel as respected, as heard, as cared for as you think you're trying to do. And I'll say, I understand. I understand. You don't feel like you're a racist. I don't feel like I'm a racist.
I feel like I treat everybody the same. We all do. So explain to me why there's such different outcomes. Most doctors and nurses, if you ask them, of course, they're gonna tell you they're not racist. Of course, they're gonna tell you they don't stereotype. And I think most of them actually believe that.
Then you look at the data, and you begin to unpack it. Look at it nationally. Look at it locally. And then you can tell stories with it that help you move the ball forward. - There's a very, very fine line between what we celebrate as clinical intuition and what can be effectively racism. We actually have quantitative algorithms...
That determine treatment based on race. Those kinds of algorithms that sort people based on their needs can actually be a really good thing, and not only in terms of providing good care, but in terms of holding the healthcare system accountable, because at the end of the day, we have to have a definition of what good quality care looks like. Part of what makes medicine, and American medicine in particular, something to be proud of, but all of our math that we use to predict how people are gonna do is based on the past, and if the past circumstances are based on racism or based on things that are not right or things that could be improved, what we ended up doing through those algorithms is perpetuating those very differences.
Black people are quantitatively less likely to get treatments that they might need because this calculation affects everything from how you dose drugs to whether or not you're eligible for a kidney transplant. - I think what is clear in the data-- if we just stick to the data-- is there are two groups whose health outcomes consistently are among the worst, and they are Blacks and they're Native Americans. And Native Americans are a very small group of Americans, and so in most national studies, they don't end up-- they just don't have a lot of people in those data, and so they tend not to get the same focus. And so you end up with the group that really ends up having pretty poor outcomes across every stage of life, and that's Black Americans. ♪ ♪ - She wasn't worried. She said, "Let me go to the hospital and get this breathing right, and I'll be right back."
And she deteriorates. I think it was a Sunday. And she deteriorated, like, so fast. By, like, Tuesday, she was on the ventilator. You know, Thursday, kidney failure. Friday swelling of the brain, and she just fought for the next four weeks. - My husband was calling saying, "They dismissing me out the hospital."
I'm like, "Dismissing you out the hospital?" He said, "Yeah." I said, "Well, why would they dismiss you out the hospital? Are you feeling better?" "No." We picked him up. He was so weak, he couldn't even get out the wheelchair, and the guy wouldn't help him, so I had to get out, help him get in the car, and bring him back home. He was weaker going home than he was when I brought him to the hospital.
So Tuesday I said, "Well, now we just gonna have to go back to a hospital." And he went on the ventilator sometime that Wednesday night. And that was the last conversation that we got a chance to have. They lost him. Yeah. My heart is just torn.
I never been alone, you know? So all of this is-- excuse me-- very new to me. Uh... - Racism disguises itself as medicine when you don't give the same care to your Black patient that you would want for your mother, for your sister, for your husband. When you don't take the time to explain a complex procedure to them because you believe that they, "A," can't afford the operation, they, B, don't understand the complexities, and they, three, won't follow the postoperative care, so you don't even offer it as an option.
Whereas the white patient you've explained option A, B, C, maybe even something experimental. But you don't take the time to explain it to your Black patient, and that is evidence-based. That's proven, and the institutes of medicine say that white doctors spend less time explaining complex procedures to Black patients. Why? 'Cause we're not smart enough? You think we're not gonna get it.
You think we won't agree to doing it, so why waste my time explaining it to you? - There are two main therapies for people with advanced kidney failure. They can go on hemodialysis where they get dialysis three times a week, or they can get a kidney transplant. Kidney transplant is superior. It's much, much better. Obviously more painful upfront, but once you get the transplant, you can essentially live a normal life. What we know is that Black people are much less likely to get a kidney transplant than white people.
So the question is why. When you do surveys of those doctors and say, you know, "Why do you make the decisions that you do?" They say, "Well, I make it based on my assumption "of who can go through a transplant and get through, "'cause it's a difficult process to go through, a kidney transplant." So again, that's that assumption. The doctors are assuming that it's going to be harder for that Black patient to make it all the way through the process, and so, therefore, they're less likely to refer. But what we know from the data and from the evidence is that physicians and nurses treat people differently based on their race. ♪ ♪ - My name is Cheryl Jean Fowler.
I live in Grosse Pointe Woods, Michigan. My husband, Gary Fowler, died from COVID. - My name is Keith Gambrell. I'm 33 years old, I'm from Detroit, Michigan, and Gary Larnell Fowler was my father.
When I was seven years old at a 4th of July party that his brother Greg was having, my mom's best friend, her name's Ng, she invited my mom and me to go with her to a party, and as we are coming into the apartment complex, my dad and his brother are playing football, and my mom's best friend goes, "There he goes, Cheryl. That's who I was talking about." Points to my dad.
She was like, "He's all right. He's cute." - At first, I didn't think he's my type. Like, I have a type, but his personality is what did it. [chuckles] Big heart, didn't see wrong in anyone.
My first date was--he had two kids, I had two kids, so my kids and his kids, we went out on a dinner date. We were the package deal, so our kids went with us, and ever since then, we've been together. We got married April 21, 1999.
- Me being a rebellious little seven-year-old that I was, "Like, this guy is trying to take my mom from me," you know? That's what I'm thinking as a kid. He's trying to take my mom from me, but he was a blessing, you know? He taught me how to work. He taught me what it was to take care of a family, how to be independent, how to not depend on anyone to take care of you but yourself, how to be truthful, how to treat your friends that you call your friends, and how you should be treated as a man in life.
- My husband worked 80 hours a week to take care of his family. He was a workaholic. That's what everybody called him. Where's Mr. Workaholic? - He'll leave 6:00 in the morning.
Wouldn't get back home till 6:00 Tuesday morning. So he did that for a while just to make sure his family was in a safe area, that they didn't have to worry about coming out the house, someone trying to take stuff from him, or leaving the house and coming back, someone breaking in. My dad worked his ass off to make sure that his family didn't need and want for anything. - We went everywhere together. My husband couldn't drive 'cause my husband has a problem with his feet from his diabetes, so I was the driver.
His father lived 20 minutes away from us. They would talk every day. They would see each other. They had him and his twin at 18, so they grew up together. - My grandfather started to feel sick the week of March 20th, 2020, but March 23, 2020, my aunt Shelly, she called me. She goes, "I can't get ahold of anybody, "but Grandpa needs some Gatorade, chicken noodle soup, "and I think your mom and your dad's "on their way over there, but can you just go check on Grandpa?" My dad lets us in.
Soon as he gets in the house, he's upstairs with Grandpa. And I scream upstairs. I go, "Grandpa, how you feeling?" He goes, "I'm okay, baby boy. I got the stomach flu. I'll be okay." 10:45 that night, my brother Garrett gets home from work. Calls me, tells me that he just found Grandpa passed out on the bathroom floor.
I get there as fast as I can. I go, "Grandpa, let's go to the hospital to get you checked out." And he's like, "No, I'm not going to the hospital. If I go to the hospital, I'm not coming home." So I go, "Grandpa, don't say that," like, "Do me a favor and go to the hospital.
"I'll cook you whatever you want, you know, when you get home." He goes, "All right, baby boy, let's go." So I go downstairs to talk to my brother Garrett in the kitchen. My grandfather's coming down the stairs on a stretcher with the EMS.
One's in front. One's behind. I go, "Grandpa, see you when you get home. I love you." He goes, "I'll see you, baby boy. I love you too." [voice breaking] And, um...
[somber music] ♪ ♪ Aunt Shelly calls us two days later, tells us that Grandpa tested positive for the coronavirus and my dad, my mom, and myself need to try to find a way to get tested. So I go tell Aunt Shelly-- I go, "It doesn't work like that." Like, they're not just giving out tests to random people who think they have the virus for some reason. You guys are shutting schools, corporations, everything down to protect certain people, but yet and still you're telling people to go home.
Like, it makes no sense. The day she tells us to get tested, this is also the day after he talks to his doctor. April 1st. "Diagnoses are fever of unknown origin, fatigue, nausea and vomiting, nasal congestions."
All the signs for COVID-19, and he couldn't get a test. It's about 3:00. I'm looking at my dad. He just looks tired. You know, he looks winded, and I go, "Dad, you okay?" He goes, "It's just the bronchitis," but he's coughing as he's talking to me. So I go, "You want to go "to the hospital to get checked out, man? "'Cause I believe you guys could possibly have the virus since you were around Grandpa."
So we go to Beaumont. My dad goes in. He's there probably two hours. Comes back out. His discharge papers says that he has bronchitis, okay? But to go home and come back to the hospital if you really need medical assistance. Beaumont is in one of the richest cities in the United States.
I think they honestly looked at this Black man and said that "Oh, you're fine. You're just overthinking what you see on TV," you know? Like, it doesn't work like that. It doesn't work like that. He heard that more than one time. March 30th, I call my mom. Now they both have fevers.
She has a lower fever of 100 this day, but my dad's fever is 101. So now we're on our way to Detroit Receiving, which is in Detroit, Michigan. Have a quarantine. The nurses are outside with the heart monitor, the thermometer before you can even go into the hospital. My dad gets out. He walks up to the nurse, and he tells her that his father is in Henry Ford hospital on a ventilator due to COVID.
He's experiencing diarrhea, a high temperature, dry cough, stuffy nose, headache-- all the symptoms that's on TV that they're telling people to look out for. My dad's telling this nurse that he has these symptoms. The nurse looks at my father and tell him, "Oh, sir, you're better off going to Henry Ford Hospital because they're more equipped to handle the COVID situation."
I don't know what their reasoning was to tell my dad to leave a hospital to go to a different hospital. We took my dad to Henry Ford after being turned away from Detroit Receiving. The nurse checks him out. She lets him in. So we're thinking our dad's about to get help this time. This is my dad's discharge papers for the same day, March 30, 2020 from Henry Ford Hospital in Detroit, Michigan.
"Please follow the instructions below. "Testing for COVID-19 is very limited. It has been restricted to those who are severely ill." "In the future, you may be able to get tested. "For the next two weeks, "you need to behave as if you have COVID-19.
"Quarantine, isolate yourself, "wear a face mask when you are around other people, "clean your hands often, "avoid sharing personal household items, "clean all high-touch surfaces every day, monitor your symptoms." My dad was crying in the passenger seat 'cause he said they were gonna let him die. They won't help him. He said he was done going to hospitals. Said he would just take care of it itself.
- Came back home. Getting weaker. Sat in his recliner. The boys take--helping him get to the bathroom, taking him showers. He said he--after that, he wasn't going back anymore 'cause he's tired of getting turned away. So I told him call the doctor, see if she can get him in the hospital. And she told him there was no beds available.
Then she wanted to see him the next day. - April 6, 11:45 p.m., I talked to my dad. He calls me. He goes, "You know..." He goes, "Grandpa just died."
I go, "How are you doing, Dad?" He goes, "I'm just tired, son." - And I asked him was he okay? He said, "Yeah, I'm okay," like he was asleep. - I go to sleep. My phone rings. It's about 7:35.
My brother Troy screaming like, "Daddy won't wake up. Daddy won't wake up." I'm like, "What do you mean he won't wake up? Like, wake him up," you know what I'm saying? "Like, wake him up." He's like, "Nah, man, he gone." It's like, "What do you mean he gone, bro?" He was like, "Daddy gone, man. He's gone." I stay 20 minutes away from my parents. I get to their house in eight minutes 'cause I'm just flying down 8 Mile.
Like, if the police were to pull me over, you're coming with me to my parents' house 'cause I'm not stopping for anything. I gotta get to my dad. Go in the house, go upstairs. My dad is sitting in his recliner chair next to the bed my mom and him slept in it for--forever. He looks asleep, but he's just blue.
You know, he's just not moving. He's not there. So when I seen him like that, I didn't, like, remember walking out the house. I just wound up back in my car, you know? Like, my dad's gone. I know the reason that he's gone-- because he couldn't get help. You know, like my dad didn't just die out of nowhere.
He's 56. So I called my son, Carmine. I tell him, like, "Pops-- Papa's gone, buddy. Went to heaven."
And he just broke down over the phone. I'm just sitting in my car crying. - When they came and hooked him up to the machine or whatever they do, they said that he was already gone.
So I asked them if they gonna take him and they said, "No, you have to call "the funeral home to come get him 'cause we not taking him." My husband sat in the house for seven hours. - Police were being assholes.
They were more concerned about my car, where it came from, than my dad being up here sleeping--dead in the chair. Dad had a cup of phlegm that was mixed with blood next to him that he had to the right in his recliner, but underneath the cup was a letter. "Heart rate irregular, oxygen levels low."
And then it has his doctor's name, which is Jackie. It was like a cry for help. ♪ ♪ I go upstairs. I talk to him. I sat with him. I prayed with him. Told him we would take care of Mom and we'll take care of the house.
We're going to put everything you taught us to use. Going to make you proud. I miss your phone calls. I miss your laugh. I miss our conversations. I miss your advice to me. I just miss you, man.
- I have a great relationship with my healthcare provider. You may have a great relationship with your healthcare provider. But what about the millions of Americans whose experience is different from mine and from yours? Yes, all of us make mistakes, but when mistakes become a pattern, we all need to pay attention, especially when lives are at stake. Health disparities were identified as a crisis in healthcare way back in 2003. That's 19 years ago.
So little has changed since then. Our healthcare system is made up of so many caring individuals. We all know this. But the history of unequal treatment based on a patient's race cannot be denied. We have so much in common, and yet people of color are treated differently by a healthcare system that promises to do no harm. Sadly, it happens every day.
Let's listen to the people behind the numbers. Let's get to know the life stories that show us what it means to live with health disparities. They have so much to teach us. Think about this.
What if each encounter with the healthcare system began with a recognition of our shared humanity? What if you saw yourself in that person? You saw your mother? You saw your sister? You saw your father? What if treating every patient as we would want to be treated: what if that would actually happen? It would lead to massive change and improving the lives of so many. We're fighting the impact of decades of mistreatment, but we are the ones who get to decide to do better. We can do better. So let's make the choice to be better and do better. Our future together. I know we can do it. - It's Black people. It's people of color.
It's Latinos who are saying "The things that you're "telling us to do we physically cannot do. We cannot stop going to work because we have to pay our bills. - When he was at the hospital, he comes and tells me, "Sidney, they sent me over to this room "and everybody was-- they wearing a hood, "wearing, like, long gloves, wearing plastic covers. "And they call me up and told me, 'Go clean in that room. He's gotta go. Gotta be ready for the next patient.'"
They didn't tell them anything. They just pretty much threw him there. So like on your own. That's probably where he got sick. The doctor went into his room and told him that he was gonna die from COVID. [sniffles] There was nothing he can do about it.
Then I called my dad, and I told him. He goes, "I'm gonna do everything I can to get you out safe." Then I started calling everybody I could, to the people, to the doctors I know personally. And he goes to me-- he goes like, "Sidney, no. I'm not coming out of this." Says, "I'm giving up. I'm tired. "I am just--" He goes, "Just, this is it. I'm not coming out of this."
From that point, I didn't-- I never saw him again. If they would have told my dad at the clinic where he worked to wear a mask, to wear gloves, he would be here now. - Someone in his job had COVID, and so he was like, "I just know that I got it." And we were on the line, on hold for, like, six hours, and we just couldn't get through.
We would go to the emergency room. They would send us back home. Then he got really, really sick, and I had to rush him back to the emergency room.
The nurse wouldn't let me in, and they put him in a wheelchair, and he just looked at me and he just said like... "Mel, I want you to know that I never knew a love like this before. I love you so much." And I said, "I love you too. We're gonna get through this. "You're gonna get through this. You're young. You're healthy." But...
[somber music] We've known literally forever. - We get the striking moment where Anthony Fauci says "We've known literally forever that Black people "have a higher rate of diabetes, of obesity, "of asthma, of all the different things that make the coronavirus especially deadly." - When you look at the predisposing conditions that lead to a bad outcome with coronavirus, the things that get people into ICUs, that require intubation and often lead to death, they adjust those very co-morbidities that are, unfortunately, disproportionately prevalent in the African-American population. So we're very concerned about that. It's very sad.
There's nothing we can do about it right now except to try and give them the best possible care to avoid those complications. - And Dr Fauci's words underscores what America was dealing with. It was that we couldn't change our society. We couldn't go back and give Black people better access to healthcare retroactively. And even though some people thought it was callous for Dr. Fauci to say "There's literally nothing we can do.
We've known about this forever," he was right. We know that a lot of Americans are gonna die, and we know that a lot of those Americans are gonna disproportionately be Black people. This is not a coincidence. ♪ ♪ - So at every single step, longstanding systemic racism of where people live, what kind of jobs they have, what kind of doctors they have access to, what kind of hospitals they have access to just chipped away and chipped away at what we first thought was going to be equal effects on white and Black communities.
And what we saw at the end was not a small difference but a huge one. These large gaps, much, much higher likelihood of getting infected, getting sick and dying. Still true today.
I think the frontline doctors and nurses have done a heroic job. I don't think the blame is there. But the healthcare system should have been much, much more prepared for this and should've seen this coming, and that didn't happen.
We often say, "Oh, that's just biology. So much easier to just explain it as biology. We've taken these effects of longstanding racism and we've almost created a biology around it.
Around lung function we somehow think that there are differences in lung function between white and Black people, and the most classic of which is around pain thresholds and this idea that Black patients have higher pain thresholds, which is really an idea straight out of slavery and still continues to affect the way doctors think today. And so if you take something like hypertension, which again, we just sort of, you know, in passing make the remark, "Oh, yeah. "Black patients are more likely to have hypertension than white patients." What's that about? What's going on there? How did that happen? - You know, but there are some days I miss that phone call.
There are some days I wish that I could just drive to his apartment and be like, "Poppy, did you eat? Let's go get something to eat," you know? "Could you cook some food and can you make some fish?" [laughs] You know? - When we first got married and we were living in an apartment, and I would be so happy when he came home, you know, and what have you. And I used to wash his feet, you know? [laughs] Yeah, yeah, yeah. I used to love hearing him come home and knowing we was there together.
And that's my Billy. That's my Billy. I don't look at this. I don't open this book and look at this, but that's him. That's him.
That's Billy. That's my Billy. ♪ ♪ - 42% of African American adults over the age of 20 also suffer from hypertension. 28.7% of non-Hispanic white adults suffer from that.
So what you see is consistently when you look at diabetes, when you look at having a child, when you look at asthma, when you look at living your life that African Americans have a harder time at living healthy and at being able to have access to health. - A Black baby during slavery was 1.6 times more likely to die as a white baby, and today they're twice as likely to die. ♪ ♪ A Black mother in the United States is three to four times more likely to die in childbirth. Three to four times more likely to die. It is absolutely damning and immoral that even as life expectancy has gone up over the last century, Black Americans are lagging behind by five to seven years of meaningful life, that infants are consistently twice as likely to die if they're Black.
I think the time is part of what's so damning. It's not just the disparities now. It's that that disparity has been there, and in spite of all the societal progress that modern technology's gotten us, all of the material comforts we have, that that gap meaning racism, has not gone away. - We have to look at this in the face and say Black people are under some real stress when it comes to racism. The coronavirus was like a heat-seeking missile, and Black people and communities that had been neglected were exactly where it found its target.
- My name is Cassandra Rollins. I'm from Jackson, Mississippi, and I'm a prior substitute teacher. I have four children, two in heaven and two here. My oldest is Shalondra Rollins.
My second oldest Sherrie Rollins. ♪ ♪ My third oldest is Tabitha Rollins, and my youngest is Tyler Ali... Who is deceased.
My oldest and my youngest is deceased. Shalondra was a teacher-- assistant teacher. They put her with the special needs children, and she just blossomed, and the kids loved her.
The staff loved her. Children period was just her passion. - Shalondra was the ultimate older sister. So supportive.
She would fuss, but anything we call for her, she was gonna do. Any party you needed help with, if you need anybody to go to the store with you, if you needed anything, she was always gonna be there to help. - Shalondra started feeling sick. It was in March, and she kept saying my sinus is bothering me. Then she kept saying my head hurting, and she would say she had the chills.
I said, "Shalondra, that ain't no sinus." I said, "You need to go to the doctor." - She went to see her doctor, and they told her that she had the flu.
Told her to go home and self-quarantine and gave her some antibiotics, and that was it. - I said, "How you feeling?" She said, "I feel okay. Just a little winded." - Tuesday morning, April 7th, and she complained that she couldn't catch her breath. I had heard a loud sound like something was falling in the bedroom. So I ran in and opened the shower door, and she was on the floor.
Her body was in-between the shower and the tub and the door, and I didn't want to hit her in the head with the door, so I kind of just nudged her until I can get the door open, and she was just there fighting for breath. - I didn't know whether she was--fell out unconscious or what it was, so I panicked. I started screaming and hollering and praying and asking God please not again.
Don't take my child. - Her daughter came in, and I gave her my phone, and I said dial 911. ♪ ♪ If it's to the point to where someone calls 911 and the ambulance is dispatched, that's an emergency. I don't care how minute you feel it is, what the--what the operator told you prior to you going-- getting on the scene.
We were called, so it's an emergency, and I feel like it should be treated as such. - There were no lights on or anything. - I know they had to mask up and everything, but there's ways you put on a mask.
You put on a mask quick or you... - Took them forever to get the gurney in, and she was just laying there. And I was like, "Just calm down.
I was trying to fan her. She kept saying she was hot and she was cold, but the entire time she was alert. They didn't even get her off the floor.
They told her fiancé to do it. He had to get her off the floor, put her in the chair, and push her to them. - Nobody gave her any oxygen. She was clearly struggling for breath. No one gave her oxygen. - They said they were waiting on her medicine.
We gave them the medicine. They still sat in--in her living room for a moment before they even wheeled her out. - They stood outside and had a conversation after she was put into the ambulance.
- They just were so "lackadais-y." Like, "Oh, okay. She'll be all right." It was just the fear in my sister's eyes, and she's such a strong person. Like, I never-- I wanted a big brother, but I never needed one 'cause my sister was my friend, my protector, everything, so to see her scared was just like--it broke me.
I called and asked to speak to the triage nurse. She was getting all my sister's information, so in my mind, she needs the information because they're already working on my sister. 15 minutes after that, the chaplain called me. When it was a chaplain, I knew it was-- it wasn't anything good.
And as soon as he said it, I dropped the phone. - I didn't know that when I was handing her that bag in the back of the ambulance that that would be the last time that I would see her. To be honest with you, when I gave her that bag, I expected for her to be home in a couple of hours. - When I finally gathered myself and I could talk, I called the chaplain back.
And it was almost like he wanted me to know that they didn't do anything wrong because he kept saying "She was the only patient they were working on. "The ER wasn't busy. They did everything they could." And my intuition was like, I think he's trying to appease me so that I won't ask any more questions, but I needed to know what happened to my sister because nobody was there for her.
And that's when I found out that she was still on a gurney when she coded. The autopsy, we didn't ask about maybe until two days later. The autopsy lab was too full and that we couldn't get it. They have nowhere in Mississippi they could do an autopsy.
And once I started getting conflicting stories from the chaplain and the nurse and then the charge nurse, I wanted to know what they were hiding, but they stopped responding every time I would leave a message. They wouldn't call me back. If she was not Black, and if she didn't--if she had the--I guess the good insurance is what I'll call it, she would've been in the hospital with the best equipment, with the best things. Or even if she was-- if she wasn't Black, I guarantee you she wouldn't have been sitting out on a gurney in a hospital with a known COVID diagnosis.
- I don't know whether it's Black women or just the whole Black population, but they treat you different. I can honestly say in Mississippi and Jackson when you have insurance and when you don't have insurance, you're gonna get better treatment. If you go to the hospital with no insurance and you're complaining of pain, they're just gonna give you some pain medicine and guess at it, but if you go to the hospital with pain and you got insurance, they're gonna run tests to see where that pain coming from. So yes, we are treated different.
And I've been on both sides of the coin. I've not had insurance, and I've had insurance, and I notice the difference in the treatment. This family has suffered a tremendous loss...
At the hand of negligence of other people. Peoples in authority from the government, to the ambulance, to the hospital. The people that's supposed to protect us. - Without my foundation, I feel like I'm just--I'm just on a bridge, and it could fall at any moment, and I don't know when something else gonna fall.
I live in fear of who's the next person. ♪ ♪ - Right now, I feel how I felt that day. ♪ ♪ - If she was white, they wouldn't have made us help get her up. They would have been at the house quick. They would have had sirens on when they came because the community that she live in is majority Black, so they are-- in my mind, they already knew they were going to a Black person's house.
That's why there was no sense of urgency or this is somebody's life, 'cause I don't think our life matters to them. - Medicine is made up of some things that everybody kind of thinks of when they think medicine, right? Doctors and nurses and clinics and hospitals. But of course, there's a lot more to it than just that. There's the labs where you get your tests. There's the X-ray machine places.
There are the insurance companies that actually pay, and they'll pay for some things but not others. There's government agencies that regulate and oversee all of this. The products that-- like the medicines, the pharmaceutical companies, the companies that will make devices.
You get a hip replacement, somebody's got to make that hip. The electronic records, for instance, where your doctor types in his or her notes. It's a super complicated system.
Millions and millions of people involved. Trillions of dollars. Hard to kind of wrap it all into one group, but it's-- they're all influential, and they all end up having an impact on what care you get when you go see that doctor. - There are a number, though, of perverse incentives in American healthcare. Large numbers of Americans are using public health insurance and even more will in the near future.
And Medicaid pays hospital less than commercial insurance does. And people of color, Black people, Latinx people or immigrants are much more likely to use public insurance. That affects the care that they get. We have one of the most expensive healthcare systems in the world, and we get some of the worst results. - What it's like trying to access care as a Black person in America...
It's like climbing a wall that's slicked with grease. I am from Philadelphia, born in north Philadelphia. North Philly is one of the poorest parts of Philadelphia. The city has given me so much of my toughness, so much of my ability to tell the truth, mean what you say, say what you mean. I am deeply troubled this morning with the number of coronavirus cases and deaths increasing substantially and more profoundly in African-American communities in Philadelphia, in Michigan, and Detroit, in California, in New Orleans, everywhere.
There was a lack of government action in Philadelphia, so I took action. I got all my Black doctor friends together from all over. - Dr. Pierre Chanson. - Dr. Wardlaw. - And we put out a video saying how you could prevent transmission, how you could keep yourselves safe.
- Stay 6 feet away. - Wear a mask. - And then I decided to go a step further and started the Black Doctors COVID-19 Consortium. [indistinct chatter] I thought really hard about the name Black Doctors, and I was very intentional because I know that Black people don't trust the medical establishment, have never trusted. Greg, you guys wanna move-- you guys wanna move the vans as well? We know that Black doctors have better outcomes with Black patients.
I need a crew that's gonna come with me, and we're gonna walk. No one was getting paid at all. Every person that showed up and worked 8 or 12 hours a day, they were there because they wanted to be there. They exposed themselves when one in four person in Philadelphia had coronavirus. When Black people were dying at a rate greater than everyone else, here I had these Black and some White medical students, Black nurses, Black doctors, in essence putting their lives in harm's way to take care of the Black community. That's what people felt.
[soft dramatic music] ♪ ♪ - This is literally the very first meeting place of the doctors and nurses who stepped in when the city of Philadelphia and the Commonwealth of Pennsylvania were derelict and caught flat-footed during the coronavirus pandemic. - There you go. - Okay. You're good. - People show up at the Black church and in particular, this church because they trust us.
We're 137 years old. This is not our first rodeo. We've been through this before. We've been through negligence. We've been through people despising us. And so, this is another opportunity for the church to stand tall. - You said just a COVID test.
- Just a COVID test. - All right then. - The disparities that my congregation faces every single day is sin. There's really no other way to talk about it.
♪ ♪ What Ala does is not a form of ministry. It is ministry. It is truly the Jesus elements, the red-letter Bibles, the stuff Jesus said and did-- feed, touch, help, visit. That's what she is. That's what she does.
- Results are right now back in about 48 hours, okay? We call everyone who's... - If America wants to survive, if it wants to be redeemed, if it wants to exist, it is going to have to handle some of the realities facing people who have found themselves at the bottom of the proverbial well forever. It's an existential threat, this kind of disparity in a country. And I think a lot of the people who politically think that this is a Black or brown or an urban problem are just involved in malignant neglect. This is no longer benign neglect.
This is malignant neglect. - I can tell you honestly, I was not expecting... So now to be able to be out there and be the voice and be their champion and say, "I got you" and mean it, it fills me up. All the sacrifice for all the elders and all the ancestors that came before me allowed me to be poised to do exactly what I'm doing for us because we need it and because others weren't there to give it to us the way we needed it with the quickness that we need it, and little old me from North Philly was able to get it done. That feels good.
It makes me angry that, in any other situation, a group that's hurting the most is the one that gets the resources, is the one that should be primary for the resource allocation, and yet again, another example of us not being first on the list. I'm tired of not being first on the list. So that makes me sad and angry. But I turned that anger and those emotions into more positive work to drive it forward for us, and that feels phenomenal. - No one number can get at the fact that we have an empathy gap when it comes to Black people and White people and healthcare. So you can look at all the different numbers, but when you think about the fact that when you show up as an African-American person to a hospital that the doctors don't see you as equally human, and they don't take you as seriously just because of the brownness in your skin, that, to me, is the thing that is the saddest, and it is a thing that we should all focus on and try to fix.
- This idea of doing no harm that we have in medicine... COVID-19 and the Black Lives Matter movement, I think have made it incredibly clear to many people that doing no harm is not enough. It's not enough to do no harm. You have to act. [dramatic orchestral music] - Every once in a while, there's a moment when massive progress is possible.
♪ ♪ I think this is one of those moments. I think COVID-19 is that moment that say