“What procedure are you referring to?” I asked. I didn’t accept what the cop was telling me, and I questioned why he felt comfortable instructing me to do anything at all.

“Ma’am, we do this all the time,” he said, sighing. The sigh telegraphed to me that this man, this older, taller, heavier white cop, felt I was both missing a critical point and wasting his time.

“Oh, do you all have a court order for us to examine this man against his will?” I asked, implying that this must surely be the missing piece of information.

“No, but he’s under arrest for a crime.”

“I do understand what you’re saying, but it is against the law to force a medical examination on a competent adult human being. If you don’t have a court order, I would be breaking the law to do further medical evaluation on this man against his will. So, if Mr. Thomas does not want a medical examination, there will be no medical examination, because this is his right and this is the law in the entire United States of America.”

Officer Quigley, the charge nurse, and the resident all stared at me. Then they began to explain to me that other physicians had forced such exams on patients.

“I’m sorry to hear that,” I told them. “I’m sorry to hear that there are doctors who will break the law for this reason. I am not one of those physicians.”

Lauren turned around and went back to her desk.

Carl, whose face communicated total disbelief, asked, “So we’re just gonna let him go, with no triage or anything? Because he wouldn’t even let me triage him.”

I turned back to the patient. “Mr. Thomas, is it okay to just take some quick vital signs on you? Just a couple of things like your blood pressure and heart rate? I promise it won’t even take two minutes. As long as your vitals are okay, we’ll get you right out of here.”

“I’m not putting on that gown.” He scowled.

“You don’t need to change for this at all.”

“Okay, go ’head.”

“Thank you.”

I turned to Carl. “Excellent. I already got the history, so triage is done. He refuses any examination, which is his prerogative, so I’ll start on his discharge papers now. Just give a yell with those vitals when you get them.”

I turned away from the triage area, the dumbfounded police officers, and the annoyed charge nurse. I overheard nurses on both sides of the department debating the ethics of my letting the prisoner go. I heard them telling stories of how it was common hospital practice to make an intervention; of how just the other day Dr. Brisbane, another ER doctor, had placed an NG tube up the nose of a patient, down the back of his throat, and into his stomach to pump gallons of GoLYTELY, the fluid used in a colonoscopy prep, into his gut until his stool ran clear, to remove the alleged drugs from his system. This was the first I’d heard of this frankly horrifying malpractice. Because attending physicians in the ER tend to work in parallel to each other, with their sole focus on expediting the care of their individual patients, the only time I got wind of what my colleagues were up to was during sign-out or through rumor.

This work just got harder. While practicing medicine was feeling increasingly crucial personally, between the hospital bureaucracy and the colleagues who brought their limited perspectives to work—they were, after all, only human—the prospect of it being a sustainable career path for me was diminishing.

As I listened to the war stories of heroic medical efforts on unwilling captives, Maria, a feisty Latina transplant from the Bronx, chimed in. “Yeah, well, Dr. Harper is correct. You cannot force an examination on anyone just because the police or family member or any third party happens to request it. We need to treat people like human beings. I’m tired of people treating certain people like animals.”

I wanted to stand up and second everything Maria had just said, but I already had, in my management of the case. Besides, I needed a rest from standing, knowing that just seconds after I finished wrapping up Dominic’s case, I’d have to stand up again. For those few moments, I typed. To the extent it was possible, I’d stay out of the line of gossip. I leaned toward Lauren, who was positioned at the computer station just in front of mine. “Don’t worry about this case. I’ll write him up. Just move on to the next patient. Nothing for you to do here, since I already took care of it.”

Lauren looked at me with her typical antagonism. “Are you sure? I can write it up. I’m actually waiting for a callback from Hospital Ethics. I told them the whole case because I don’t think he can refuse an exam and medical interventions. We really need the Ethics Board in on this one if you’re going to let him go. I’ve worked with Dr. Linden and Dr. Jacobson on similar cases, and we just tell the prisoners what we are going to do. They don’t have a choice. I don’t understand what you’re doing.” Her tone was more indictment than question. It was the tone she used to assert that she knew more than I did, and for reasons she would never have dared articulate.

It was the very fact that Lauren felt comfortable assuming greater inherent wisdom on the part of the white, male physicians Linden and Jacobson that might have horrified her to examine in herself. For these same reasons—their white privilege—she would have followed their instruction anywhere, even if they directed her to literally break the law. While she wouldn’t have spoken the words, her tone communicated one of the ubiquitous microaggressions faced by people of color and the content of her words showed how such a microaggression is inextricably linked to the gross aggression that follows.

Although I had been having issues with Lauren over the past sixteen months we had worked together, it occurred to me that, in this moment, she was being entirely honest. Yes, there was her typical peevish passive-aggressive tone, but I saw now that she genuinely didn’t understand. I knew her only within the confines of work, so I couldn’t pretend to know why she hadn’t considered these issues more deeply. Certainly, there was a type of privilege in it. Willingly or not, Lauren had donned the cloak of white male privilege, and it fit snugly over her own skin. After all, this is the only way oppression can function: It requires the buy-in of a certain percentage of those it actively oppresses in order to pit those groups of subjugated people against one another.

I thought about the powerful underlying assumptions that had made it so easy for the police to transport this patient to a hospital and for his sovereignty to be taken away. It could be related to his dealing drugs—though, we see all sorts of patients with drug-related issues, and they are not typically brought to the emergency department in chains. And there is certainly no expectation that we will simply accept that their bodies should be violated because of their alleged illegal drug use.

But for Dominic, it seemed somehow warranted, somehow a commonplace, that his rights as a patient should be tossed aside. I looked at him; his autonomy was so provisional. But then, had he ever had self-determination? Had he even been considered to have ownership of his black body? There was no medico-legal reason for a doctor or a hospital to usurp his decision-making capacity, and yet, for some people, it was expected. In the face of these truths, we are reminded that for many people, their bodies are not considered their own. For those whose bodies are viewed as suspect and threatening, those bodies, at the preference of a more privileged body, could be manipulated, even assaulted.

As I stood there in my white coat, I was reminded of Dr. J. Marion Sims, often referred to as the father of gynecology, who in the nineteenth century conducted experimental surgeries on enslaved women. The women, who had hopes of treatment from a purportedly competent physician, instead were pinned down on operating tables screaming in agony while he sliced into their pelvic regions without the benefit of anesthesia. Sims continued to torture enslaved women in these barbaric ways until he felt he’d perfected his techniques and felt comfortable performing them on white women, but in their case, with the humane addition of anesthesia.