At the Intersection of Fear, Grief, and Love
Authors: Christopher Thomas Veal
Journal: Annals of Internal Medicine (2020)

On Being a Doctor17 November 2020At the Intersection of Fear, Grief, and LoveFREEChristopher Thomas Veal, BSChristopher Thomas Veal, BSUniversity of Vermont Larner College of Medicine, Burlington, Vermont (C.T.V.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M20-4113 Audio Reading - “At the Intersection of Fear, Grief, and Love” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads “At the Intersection of Fear, Grief, and Love” by Christopher Thomas Veal, BS Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail “You need to make sure you're dressed well if you're going to survive tomorrow night,” my mother told me, as tears began to well in her eyes. She knew I needed to return to medical school, but she was terrified.The seriousness of her instruction was familiar, but today it took on greater meaning. Because I am a Black man living in America, my parents always emphasized that my appearance could determine whether I lived or died at the hands of the police. If I were perceived as a criminal, I would definitely be treated as one; however, if I were perceived as “one of the good ones,” I might be permitted to make my case for survival.At least, that was my parents' thinking as we weighed the benefits and risks of my departure the following afternoon. I was 1 day away from starting my final year of medical school at the University of Vermont. After almost 3 months of quarantine with my parents in suburban Chicago, I was eager to return to the world of medicine. Unfortunately, the timing of this return came at a moment of profound national and personal stress.The night before, protests and riots began to escalate in Chicago and numerous other cities across the country, triggered by the unjust death of George Floyd in Minneapolis, Minnesota, at the hands of the police. As my parents and I watched the night unfold on television, we agreed that these events were about more than George Floyd: They reflected hundreds of years of pent-up anger over unjustified deaths of Black and Brown people in a system that continues to remind us our lives don't matter. The fire this time gathered fuel from the stress of the impact that COVID-19 had, not only on my infected parents but also on the claimed lives of three members of our extended family—underscoring the disproportionate impact this virus has on the Black community.Because I was a 27-year-old Black man driving alone across the country, my parents were understandably concerned. However, I desperately wanted to get back to medicine and my formal studies. I planned on staying at a hotel just outside of Rochester, New York, that night and finishing the remainder of my trip the next day.After I filled up my car with gas, my mother requested that we pray one last time together as a family before my departure. I was deeply touched by the fear, hope, and strength in my mother's voice as she prayed for me, the protesters, and the cops who I would undoubtedly encounter on this trip. When she finished, I gave my parents one final hug and began my drive down I-94. To reduce my own anxiety, I'd been trying to avoid watching the news right before leaving, so I really didn't know what to expect when I entered Chicago from the North Shore suburbs. I began to see signs reading “All Exits Closed,” and each off-ramp was blocked by ambulances, police cars, and cement barricades. In Chicago, freeway traffic is almost always bumper-to-bumper. Instead, cars were scarce and moving fast, heightening the feeling of solitude and fear.I received a phone call from my mother. Her voice sounded afraid. “The National Guard has blocked off our street,” she said, “and they're not allowing us to enter or leave our neighborhood until tomorrow morning!” My mother explained that their action was preventive and was supposed to protect the residents. Our home sits near a major mall that was previously targeted for looting and vandalizing. The police forebodingly concentrated outside the only two Black households in the neighborhood. My hands began to shake as I left the Chicago city limits.Upon entering Indiana, I stopped at a gas station off I-80. With my mask and gloves on, I entered the station. Despite my mother's instruction to dress well, my solid-white Banana Republic sweater and ironed khakis seemed not to matter to the approximately 15 White, mask-less patrons that looked me up and down with evident disgust. I quickly grabbed a bottle of Snapple without looking at the flavor and headed straight to the register. When I looked up, the eyes of the other patrons were still fixed on me. “Is it my hair? My mask?” I asked myself, before remembering that my own Blackness could feel threatening with news and social media highlighting looting and riots.After completing my purchase, I began walking toward the door. Suddenly, a man shoved me from behind as he exited. For a split second, I wanted to shout, “Dude, what the hell?” However, I reminded myself of who and where I was and chose to quietly return to my car and survive the day.As I entered the Cleveland area, the map on my iPhone vanished and I heard the ear-piercing siren generally used to signify a tornado or an Amber Alert. The emergency alert read that the mayor of Cleveland had issued a curfew for the downtown area that started at 8:00 p.m. and requested that people please stay safe and home.Without warning, my cell phone abruptly changed my route to avoid downtown Cleveland. Shaken, I called my mother to explain my phone's surreal behavior. As we spoke, two Humvees from the National Guard passed me. They were followed by four police cars and two cargo vans, each filled with three rows of men holding rifles and wearing black Kevlar vests and helmets. Like in Chicago, every exit I passed was barricaded, forcing me to stay on the freeway. I began to feel like I was in a war zone. I tightened my grip on my steering wheel and began to accelerate.I called ahead to my hotel in upstate New York. “This may sound strange, but I just drove through Cleveland, and I'm noticing all the exits are blocked off. Do you know if there's a curfew or lockdown where you guys are? I'm worried I might not be able to get off the Interstate.” The woman at the hotel sounded a bit confused but conceded, “The National Guard is here, and there are certainly a lot of police around at the moment.”“I believe there is also a curfew that started at 9:00 p.m.,” she added. A tinge of panic ran through me. Taking a deep breath, I asked, “Ma'am, I am African American. Do you think I will have a problem accessing the hotel after I get off I-90 from either the police or the National Guard?”After a disturbingly long pause, she asked, “Are you a protester?” “No, ma'am,” I replied. “I'm just a medical student making my way back to school.” Sounding relieved, she said, “Oh, then you should be okay! But you should expect to be stopped. I don't think they will give you a hard time, but if you have your medical ID, you should wear it.” I thanked her and hung up. Reaching into my bag, I pulled out my University of Vermont Medical Center badge and clipped it to my lapel.I arrived at the hotel just after midnight. I began to exhale a deep sigh of relief at having so far avoided any encounters with the police. As I unbuckled my seat belt, I looked up to my rearview mirror to find a sheriff's car behind me. My hands began to shake as a bead of sweat ran down my forehead. I rebuckled my seat belt and sat still, quietly staring at the car in my rearview mirror.After about 30 seconds, the sheriff's car pulled away. Again, a sigh of relief.As I walked to the entrance, I was greeted with a locked door. I knocked on the automatic sliding-glass door, looking at a 30-something White woman standing behind the desk. She looked terrified. “I have a reservation! I called earlier? Last name is Veal!” I yelled through the glass door.She looked down and typed something in her computer. After a few clicks, her worried face relaxed and she opened the door. As I approached, she raised her mask to her face and said, “Sorry about that! It's a crazy time right now!” I forgave her and carried on to my room.It is a crazy time. My surreal and frightening trip was intensified by the unique position of being a Black, male fourth-year medical student in 2020. The intersecting crises in public health, the economy, and social justice feel intensely personal. During and after the deaths of my relatives, I quickly became the person my family relied on to grieve and help them understand the devastating nature of COVID-19. I nursed my parents as they struggled through their illness, feeling guilty for remaining asymptomatic.In the midst of the continued pain this pandemic has caused, I continue to be reminded that—despite my hard work and education—I am more likely to be killed by a police officer than by the virus, just like any other Black man in this society.On the other hand, I am encouraged by acts of love. My godparents, both White physicians, instantly galvanized their Presbyterian congregation to pray for me during that fateful trip. In the following days, I received countless phone calls, e-mails, and messages on social media from people of all races and religions—lending support and reminding me that my life does matter. Comments0 CommentsSign In to Submit A Comment Julie TrevorUniversity of Vermont31 July 2020 Fear and Change I was riveted until I read “I am more likely to be killed by a police officer than by the virus, just like any other Black man in this society.” This exaggeration concerns me greatly that this is the intense fear instilled in our young black men in America and I wonder who or what is driving that fear and what can be done about it. There are roughly 200 black mean shot by police each year; thousands have succumbed to Covid. My greatest concern however is exaggerated statements destroy efforts to work together to address the very real problem of racial injustice; no doubt that will be used to halt discussion. So VERY happy Mr. Veal arrived safely in Vermont. Welcome back! Disclosures: This author has nothing to disclose. Karen FromholdNA3 August 2020 - I appreciate the courage it took to make that drive and to share your story. Thank you for letting us hear your experience. On so many levels, it should not be like this. Thank you for returning to complete your studies. As a graduate of UVM Medical School and a Family Medicine Physician, I will be pleased to welcome you as a colleague. Christopher Thomas VealUniversity of Vermont4 August 2020 Author's Response Re: Fear and Change Thank you, Ms. Trevor, for your thoughtful response to this essay. While I value your critique, I do take concern with your position that I exaggerated the long standing, and very real fear among Black men in America being killed by the police. Your statement about the roughly 200 black men killed each year is likely derived from The New England Journal of Medicine article published in 2016 that found there were 222 “legal intervention” deaths in 2013, or cases in which someone was killed by an on-duty law enforcement or other peace officer (Crosby AE, 2016). Despite the unsettling nature of this study's findings, this is likely an underrepresentation of the true mortality number, as the study is based on data from just 17 states. And notably excluded some of America's largest states including: California, Florida, Illinois, New York, Pennsylvania and Texas. What's more, the Death in Custody Reporting Act of 2013, which would have required states to submit quarterly reports on deaths in police custody, has not gathered data and made it public yet. This lack of reporting 4 years after its implementation prompted an investigation into the Department of Justice's failure to implement this law. The 2018 report from the office of the Inspector General states the Department of Justice “does not have plans to submit a required report that details results of a study on DCRA [Death in Custody Reporting Act] data." (Office of the Inspector General, U.S. Department of Justice, 2018) Just as the data on the true impact of police brutality on the Black Community is flawed, so too is the data outlining the significant impact of COVID-19. In a virtual Senate Hearing in May, Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, stated the widely accepted fact, that the coronavirus death toll is "almost certainly higher" than is reported (U.S. Senate Committee on Health, 2020). While the coronavirus is indeed an active threat to the lives of Black men, It does not have the over 400 year history of Black men being killed in this country unjustly by white individuals in power (i.e. slave holders, the Klu Klux Klan, the police, etc.). This chronic trauma of fear is ubiquitous in every generation of my family and continues to remain an issue in many Black American households. Case in point, George Floyd died with coronavirus antibodies in his blood only to die in police custody (Karimi & Fox, 2020). I agree with Jaime Slaughter-Acey, an epidemiologist at the University of Minnesota, when she states, “The fact that people are out there protesting, despite the risks of Covid-19, tells you that the fear of police brutality, racism, is much more terrifying. (Resnick, 2020)” Black Americans are suffering "a pandemic within a pandemic" (Bass & Stolberg, 2020). While we are still learning about the effects COVID-19 has on overall mortality in communities of color, we still must deal with the very real and un-exaggerated truth that for hundreds of years Black lives in the United States have not mattered. References Bass, B., & Stolberg, S. G. (2020, June 7). 'Pandemic Within a Pandemic': Coronavirus and Police Brutality Roil Black Communities. The New York Times, pp. 20. Crosby AE, L. B. (2016). Assessing Homicides by and of U.S. Law-Enforcement Officers. N Engl J Med, 375(16):1509-1511. doi:10.1056/NEJMp1609905. Karimi, F., & Fox, M. (2020, June 4). George Floyd tested postive for coronavirus, but it had nothing to do with his death, autopsy shows. Atlanta, , Georgia, USA: CNN. Office of the Inspector General, U.S. Department of Justice. (2018). Review of the Department of Justice's Implementation of the Death in Custody Reporting Act of 2013. Washington D.C.: U.S. Department of Justice. Resnick, B. (2020, June 1). Police brutality is a public health crisis. New York, New York, USA. U.S. Senate Committee on Health, E. L. (May 12, 2020). Full Committee Hearing- COVID-19: Safely Getting Back to Work and Back to School. 106 Dirksen Senate Office Building, Washington D.C. Disclosures: None Tim Lahey, MD, MMScUVM Larner College of Medicine13 August 2020 Proud What a powerful essay! You help us see what might be, for many, invisible. I’m proud to have the same home institution, jealous of your talent, and impressed by the erudition of your correspondence. Thank you for helping us see better, in both senses of the phrase Disclosures: The author has nothing to disclose. TabathaCarle18 June 2022 Thank you Thank you for writing this. Two years later I am still very emotional reading it. Also, still very angry at feeling not much/enough has changed. Please always continue to write with such passion and share with the world. Author, Article, and Disclosure InformationAffiliations: University of Vermont Larner College of Medicine, Burlington, Vermont (C.T.V.)Corresponding Author: Christopher Thomas Veal, BS, 89 Beaumont Avenue, Given Box No 370, Burlington, VT 05405-0068; e-mail, Christopher.[email protected]uvm.edu.This article was published at Annals.org on 28 July 2020. PreviousarticleNextarticle Advertisement Audio Reading - “At the Intersection of Fear, Grief, and Love” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads “At the Intersection of Fear, Grief, and Love” by Christopher Thomas Veal, BS Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics Cited byPlanning for diverse, equitable, inclusive research in health professions education: An integral thread in the ARMED MedEd research course 17 November 2020Volume 173, Issue 10Page: 848-849KeywordsCOVID-19EmotionsFearHand strengthPlaguePrevention, policy, and public healthQuarantinesRacial and ethnic issuesSweatWalking ePublished: 28 July 2020 Issue Published: 17 November 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...