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<xTITLE>“Death by a thousand paper cuts.”</xTITLE>

“Death by a thousand paper cuts.”

by Phyllis Pollack
August 2020

PGP Mediation Blog by Phyllis G. Pollack

Phyllis  Pollack

The New York Times on August 1, 2020 published an article on microaggressions in the medical profession. (“For Doctors of Color, Microaggressions Are All Too Familiar” by Emma Goldberg). While the article does focus on doctors of color, it does have broader applicability, to anyone or any group who is “not like us” or part of our “tribe”.

The term “microaggression”  was coined in the 1970s by Dr. Chester Pierce who is a psychiatrist, and refers to “subtle, stunning, often automatic, and nonverbal exchanges which are ‘put downs’ of Black people and members of other minority groups; ‘micro’ refers to their routine frequency, not the scale of their impact.” (Id.)

It happens when the black doctor is “…mistaken for a janitor or food service worker even after introducing herself as a doctor.” (Id.) Or, a black doctor in her second year of residency in emergency medicine is mistaken for the electrocardiogram technician by a white doctor with whom she had worked previously on rotations. The black doctor approaches the white doctor to give a report on patients and he holds out his hand expecting the electrocardiogram scan. (Id.) Or, the black doctor is referred to as “sweetie” or “honey” by her white male colleagues. (Id.)

The article notes that these repeated microaggressions can take their toll: “’After the twelve-thousandth time, it starts to impede your ability to be successful,’ she [Dr. Sheryl Heron] said. ‘You start to go into scenarios about your self-worth. It’s a head trip.’ (Id.)  Another black doctor [Dr. Kimberly Manning] commented that “’People might not realize you’re offended, but it’s like death by a thousand paper cuts,’” Dr. Manning said. ‘It can cause you to shrink.’”

Part of the reason for these microaggressions is that the black medical doctor is very much a minority. The article notes that only 5 percent of American doctors are African-American while roughly 2 percent are black female doctors. Of all the doctors in emergency medicine, only 3 percent are black. Why?  Because our medical schools admit very very few black medical students: only 7 percent.  (Id.)  Yet, research also shows that black patients being treated by black doctors obtain better outcomes than when treated by white doctors. (Id.)

Women in the legal profession can no doubt tell tales of being victims of microaggressions. They enter a conference room to take a deposition and the white male attorneys mistake them either for being the court reporter or the secretary and so asks them to get them a cup of coffee etc. Ask any female attorney how many times a male attorney has called her “dear”, “honey” or “sweetie” without even realizing it. Most will answer “lots of times!”.

No doubt, women and minorities in other professions have similar stories they can tell!

In the end, microaggressions are about the assumptions we make, the implicit or unconscious biases we have and the words we use to express them. Words do matter! It is imperative that each of us stop and think twice before speaking words based on our assumptions. More times than not, our assumptions will be wrong and will constitute microaggressions causing “death by a thousand paper cuts.”.

… Just something to think about.


Phyllis Pollack with PGP Mediation uses a facilitative, interest-based approach. Her preferred mediation style is facilitative in the belief that the best and most durable resolutions are those achieved by the parties themselves. The parties generally know the business issues and priorities, personalities and obstacles to a successful resolution as well as their own needs better than any mediator or arbitrator. She does not impose her views or make decisions for the parties. Rather, Phyllis assists the parties in creating options that meet the needs and desires of both sides.  When appropriate, visual aids are used in preparing discussions and illustrating possible solutions. On the other hand, she is not averse to being proactive and offering a generous dose of reality, particularly when the process may have stalled due to unrealistic expectations of attorney or client, a failure to focus on needs rather than demands, or when one or more parties need to be reminded of the potential consequences of their failure to reach an agreement.

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