When Bias Is Quiet

After my most recent hospitalization, my nails and feet made me look like an extra from Michael Jackson’s Thriller music video. My mind and body had been through so much, and honestly, so had my spirit. I needed some major TLC. So, I went to my local nail shop hoping for a simple manicure and pedicure, just a little something to help me feel like myself again.

When I walked in, I immediately noticed that my regular nail tech was not there. After looking around, I realized the shop was under new management. The new staff approached me cautiously and asked what service I wanted. I told them I wanted a pedicure and manicure. There were about ten pedicure chairs available, and no one was receiving service in them, yet I was still told to wait.

Eventually, I was seated, and my nail tech began my gel pedicure. About five minutes into my service, I noticed a middle-aged Caucasian woman being escorted immediately to the pedicure chair next to me. Her nail tech greeted her warmly and began asking questions right away.

“How would you like your water temperature?”

“What color nail polish would you like?”

Then, a staff member brought her water and snacks on a gold platter.

I was bewildered

At that moment, my face betrayed me. I did not say anything, but my expression said it all. My nail tech noticed the interaction and then noticed my face. Suddenly, she asked the same staff member to bring me water and snacks as well.

What made the moment even more uncomfortable was that I ended up paying more than the woman next to me because I requested additional services. Yet somehow, I was not initially treated with the same level of care, attention, or hospitality.

A painful memory

As I sat there quietly sipping water that had only been offered after someone realized I noticed the difference, my mind drifted back to my hospital stay. While I was hospitalized, I was rooming with a middle-aged Caucasian woman with a thick Boston accent, the kind of Bostonian people joke about when they say, “park the car in Harvard Yard.” She and I were separated only by a thin curtain, which meant we could hear almost every conversation and every interaction with our medical teams.

When her doctors came in, I tried my best to mind my business. I put on my headphones. I listened to an audiobook. I played music. I did what I could to give her privacy, even though privacy was almost impossible in that room.
She, however, made it clear that she was listening to my conversations with my doctors. After they left, she would sometimes offer unsolicited comments about my care. But what I noticed most was the difference in how our pain was treated.

Every hour on the hour, she asked for pain medication. And if the nurses were late bringing it, she unleashed that wicked Boston accent on anyone who came into the room. She advocated for herself loudly, directly, and without apology.

On the other side of the curtain, I was trying not to be “too much”

I could recall several encounters where, if I spoke too loudly or became labeled as “aggressive,” security was called. That reality has a way of teaching you to shrink yourself, even when you are in pain.

Unlike my roommate, I asked for a small dose of the same pain medication she was asking for, just enough to get me through the breakthrough pain that would creep in when the temperature dropped during those cold Boston nights. I knew my body. I knew I was in pain. I also knew my hematologist had included my pain medication and dosage in my care plan.

Still, at one point, there was a refusal from the attending physicians.

I reminder from a stranger

I did not become emotional about the situation because, sadly, it was something I was used to. That night, I laid in bed quietly, trying to endure the pain. Meanwhile, my tough-as-nails roommate yelled from the other side of the curtain: “You have sickle cell! Why aren’t they giving you pain meds?”

She saw it. Even from the other side of the curtain, she saw the injustice. Meanwhile, I was just trying to survive quietly. The next day, I told my care team about the refusal of medication and was immediately placed on a PCA pump. But that painful night stayed with me.

Fast forward to the pedicure chair. Once again, I found myself reflecting on a small yet significant form of injustice. Was I experiencing bias during both occasions?

Absolutely.

I cannot say with certainty what was in anyone’s heart, but I know what I experienced

Bias is not always loud. Sometimes it is subtle. Sometimes it looks like hesitation. Sometimes it looks like delayed service. Sometimes it looks like offering comfort to one person automatically and offering it to another only after being caught. Sometimes it looks like making a Black sickle cell warrior prove her pain before she is treated with dignity.

What stands out most in both instances is that I minimized my needs until someone else — my nail tech or my roommate — recognized the injustice. Sometimes the person outside the experience can see the unfairness more clearly because they are not carrying the weight of trying to be “polite,” “not difficult,” or “not seen as drug-seeking.”
Bias may not always announce itself. But when you have lived long enough in a Black body, in a sickle cell body, in a woman’s body, you begin to recognize when something is off.

You feel it.
You name it.
And eventually, you stop apologizing for noticing.