What Tyre Nichols’ Death Reminds Us About Black Suffering

On January 10, Tyre Nichols died from police brutality. In bodycam footage from January 7, when Nichols was stopped by the police, Nichols is seen on the ground, crying for his mother while being beaten and assaulted with pepper spray. It is clear that he was in pain. In another video, Nichols is seen propped up against the police car, likely unconscious from brain injury. The police officers and emergency medical technicians (EMTs) around him appear indifferent to his condition.

This isn’t the first time the cries of a Black person have been ignored by authorities. In the footage of George Floyd’s murder in 2020, Floyd pleads more than 20 times that he can’t breathe, all the while with a look of despair on his face and the weight of an officer on his neck. In 2014, Eric Garner yelled multiple times that he couldn’t breathe while he was under a chokehold by a police officer. Alarming cellphone footage from a bystander revealed the lack of any real attempt by the EMTs on the scene to treat the motionless Garner.

Police in the U.S. are 3.5 times more likely to kill a Black person than a white person. Deep-seated systemic racism in the American criminal justice system continues to cost lives. But the graphic scenes of Nichols, Floyd, and Garner’s suffering, contrasted with the indifference of the people around them, begs another important question: Why didn’t the clear distress signals from these Black victims evoke enough empathy in the health professionals who swore to protect and save lives?

The failure to recognize and acknowledge distress in Black people is not unique to policing. Medicine has a long history of pathologizing Black bodies and dismissing pain in Black people. Medicine’s racist past bleeds into today’s medical practices, resulting in undertreatment and excess suffering for Black individuals.

Medical racism is a tale as old as time. Since the early 1600s, myths about Black bodies were used to justify slavery and white supremacy. And Black bodies, especially Black women’s bodies, were deemed abnormal. Slaves were thought to be physiologically insensitive to pain and suffering, and Black people have been repeatedly experimented on without anesthesia or consent. These outrageous, harmful, false beliefs persist in medicine today. In a 2016 study, half of participating white medical trainees endorsed at least one racist myth about Black bodies. These future physicians subsequently underrated Black pain and recommended less accurate treatments. And in a 2021 experiment, the predominantly white participants perceived pain and sadness much less readily on Black faces.

In the U.S., Black patients are 22% less likely than white patients to receive any pain medication, and 29% less likely to be treated with opioids for severe pain. Primary care physicians are twice as likely to underestimate pain in Black patients than all other ethnicities combined. Following childbirth, white patients are significantly less likely to have severe pain yet receive significantly more pain medication than Black patients. And for children with appendicitis, a condition that is usually very painful, white children are 10 times more likely to receive any pain control than Black children. Additionally, while Black people are 3.5 times more likely to contract COVID-19 than white individuals, given the same disease severity, hospitalized white patients are almost twice more likely to be transferred to the intensive care unit. Clearly, the racial care gap goes beyond just pain. We can only imagine how many Black patients with severe COVID-19 pneumonia shouted, “I can’t breathe,” before they were taken seriously.

Is the solution simply to have more Black doctors? After all, studies have shown that Black patients are more comfortable taking educational, preventative, medication-related, and surgical recommendations from Black physicians. But this will only go so far. Although the admission rate of Black students into medical schools is slowly increasing, the majority of teachers in medicine are white; and remarks from some leaders in medicine that disguise white privilege as meritocracy for entry into medical school are still prevalent. Furthermore, white male medical authorship continues to dominate medical texts, while Black skin is underrepresented. Finally, Black race is taught as a risk factor for many diseases, while the true culprit is often systemic racism.

On January 30, the two EMTs and their lieutenant dispatched to help Nichols were fired due to violation of Memphis Fire Department protocols. It has taken another tragic death to show that to truly make Black lives matter, diversifying the medical profession is not enough. Black voices need to be heard loud and clear in defining, describing, teaching, and leading medicine, so that the first time a Black person says “I can’t breathe,” they are heard; and so that the severity of a Black person’s pain is believed at face value by every member of the healthcare team.

Mengyi “Zed” Zha, MD, is a board-certified family physician who is completing a dermatology fellowship in Texas, and a nonfiction writer.