The Necessity of Decoding the Racial Scripts of Daily Life

“We know you think we are racist! You are the racist one!”

The nurse declared this boldly and loudly in protest of the clinical decision I made as we stood in a small clinical room in earshot of patients. As one of two chief residents of medical education on an inpatient psychiatric floor, it was my responsibility to handle clinical and administrative decisions. The nurses, who were overwhelmingly white and women, and I had been hammering through the team’s response to repeated incidents of disruptive behaviors from a Black male patient in a manic crisis. He spent the daytime shifts pacing, exhibiting an elevated mood, and other disorganized behaviors suggesting he wasn’t well.

The middle-aged man, who had been in the hospital for just over one week, was well over 6 1/2 feet wearing soiled clothing, had newly braided cornrows and a hardened, exasperated look of frustration, as he bartered with staff a few feet away over the suggested behavioral plan. The nurses requested the patient eat meals in his room to avoid stirring up other patients who had reported being upset by his intrusive speech and mannerisms. He instead wanted to eat amongst his peers and struggled to make sense of the isolating suggestion.

In the clinical meeting room, I had noticed the nurse’s nonverbal communications of…