In a vascular surgery career spanning 20 years, Vincent Rowe, MD, has seen it all: Tending to patients at bedside, the vascular surgical services chief at Los Angeles County + USC Medical Center has had his very presence as a doctor called into question. In social conversation, upon answering the query of what he does for a living by stating that he is, in fact, a physician, he’s had to confront the response that suggested he should be playing basketball. On an airplane journey, he’s been asked to produce his medical license during an on-board medical emergency after answering a call for the aid of a doctor.
It’s been demoralizing to the point he now often refuses to identify himself as the senior medical professional that he is in certain social and everyday-life scenarios.
Yet, Rowe, professor of clinical surgery at the Keck School of Medicine of University of Southern California and a faculty member of the USC Cardiac and Vascular Institute, is philosophical about the differences between individual slights and the more insidious presence of systemic racism—and what it all means.
“It’s hard to categorize whether just a few individual negative interactions characterize systemic racism,” he says. “I’ve had things said to me from when I was in Tennessee all the way to just a month ago. Things that were racially insensitive and hurtful. But I don’t know if that means I’m experiencing the systemic problem.”
But ostensibly small—or sometimes subtle— instances of discrimination could mount up into something more.
“For example, over the years, when I walked into a patient’s room, in clinic or in the hospital, there were numerous times where I felt I wasn’t the doctor,” Rowe says. “They would comment to me, ‘Oh, when is the doctor coming?’ Or, ‘Who are you?’ And I would say, ‘Oh, I’m Dr. Rowe.’ Or even just the comment of, ‘Oh, why are you a doctor? You look like you should be playing basketball.’ Why? Because I’m a tall Black male, I can’t be a doctor—I have to be a basketball player?”
Over the course of time, Rowe says, such discourse wore him down.
“When I would travel on vacation with my wife, if I started a conversation on a plane with someone, they would ask, ‘What do you do?’ And I would say, ‘I’m a doctor.’ It was as if they couldn’t believe it, so they would have to keep asking me. Questions, questions, questions to solidify the fact that I actually was a doctor.
It got to the point that when we traveled, or even when I was around the city, or we were at an event, and we started a conversation with people where they asked me what I did, I wouldn’t say I was a physician. I would say I was an actor, struggling actor, or an electrician, and then I wouldn’t get any additional questions.”
The more visceral aspects of systemic racism—like the stop-and-frisk and profiling actions of police—were omnipresent when he was a student. “I got pulled over [driving] numerous times by policemen because of that during college and medical school especially. All of those things have always happened, and those to me are the more systemic parts.”
“When I started working at our county facility, I saw there was a significant amount of poverty and patients representing with diseases much more out of control than in our private facility,” Rowe explains.
“It was somewhat interesting to me to see that the patients seemed to have in some areas different outcomes based on race. That’s when I started looking at least at lower extremity disease on the outcomes of patients based on race.
“I published a few articles, but I never was able to really, clearly define it with a large grant and a big multicenter institutional study. We just took part in a national study called the BEST trial—the best endovascular or surgical treatment for patients with lower extremity disease—and I’m hoping that that national randomized trial that our institution was a part of will be able to find a more precise answer to the differences in outcomes based on race for patients with lower extremity disease.”
The country has lived these moments of consciousness over racial disparities before, only for the zeitgeist to move on, but he sees the storm that followed the killing of George Floyd by police as one that will prove to be more enduring.
“I think the majority of America is in a more accepting state and a different mindset,” explains Rowe. “I think a lot of that has to do with the #MeToo movement. I think America finally said, ‘Look, we’re going to stop this harassment of women that’s been occurring, and we’re going to look into the past. We’re going to not only look into it and say it’s wrong, but we’re going to prosecute people for it.’”
The consequences of that movement, Rowe continues, opened up a sensitivity in the country, creating fertile ground for change in other areas of the culture. “It’s at a good time that that mindset of America is still open toward racial inequity. There’s going to be some change—I don’t know how much—but I think there will be.
“I’ve been talking about this a lot. For 20 years, I only talked about science and now I’m talking about race. America is ready for it. There’s going to be some backlash. But it’s going to come from a very small group. The #MeToo movement prepared us because it has really cracked open some atrocities that were happening to women.”
Rowe then turns to a useful metaphor that underscores the stalking effect of race as having any sort of bearing on a person’s life. “You don’t want things to have an impact based on your race,” he says. “But you’re always thinking about it. It’s almost like the app on your phone that’s always running in the background. Maybe you don’t press to use it, and you hope you don’t have to, but it’s still running in the background and it’s draining your battery.
“That’s the analogy. It’s in the background, I guess it’s still there but it’s draining you a bit. Hopefully you go through days and days without it ever asserting itself. But you still always wonder because it’s back there in your mind. That’s how it feels.”