Letter Sent to Dr. Toni Stern & Mount Sinai Patient Relations
Copy of Letter sent via email Dr. Toni Stern and Andres Moreira at Mount Sinai Patient Relations | MSWpatientrelations@mountsinai.org | Andres.Moreira@mountsinai.org
March 14, 2022 at 4:58pm EST (small typos have been revised)
Dr. Toni Stern
1000 10th Ave
New York, NY 10019
Dear Dr. Toni Stern,
Thank you again for inviting me to meet with you on January 25, 2022 accompanied by my aunt, Dr. — -. I could intuit your sincerity and Dr. Rodriquez reached out following that meeting to match me with a new physician, it is my desire to move forward peacefully, however I am still disturbed by the experience I had with Dr. Michelle Y. Francis on January 4, 2022. Despite the response letter I was given by Andres, the memory of that appointment remains an intrusive part of my daily life. Please help me move forward by lobbying for an apology directly from Dr. Michelle Y. Francis that addresses the root of the trauma and pain she has caused.
On January 25, 2022 I was still very shaken by what occurred and so embarrassed that my vulnerability was exploited by someone I trusted for their own ego gratification. When I talked about it that day, I had to stay surface and even dissociate in order to keep my composure. Upon reflection I realize that while my diplomacy was palatable for all, it could have fertilized ground for Dr. Michelle Y. Francis to spin this ordeal as a small issue around semantics and downplay her egregious conduct and aggressive behavior. You, as the chief patient experience officer, deserve to know the less palatable details of what occurred so that future patients do not have to experience this.
Summary of Appointment, January 4, 2022 at 1:00pm 50 77th St. New York, NY 10024:
I. Patient arrived at appointment, medical assistant directed patient to remove all clothing, wear paper half-gown and blanket. The medical assistant left, and the patient complied and waited for the physician.
II. Physician entered the room swiftly without speaking and focused her attention on the computer screen. After awkward moments of silence, the patient greeted the physician and asked how they were doing. The physician replied hunched over the computer “everything is rainbows, ponies, and unicorns”. Patient could sense sarcasm at the onset of the appointment and tried to use humor to lighten the room.
III. The physician spoke about how she had advanced warning about COVID-19 from medical colleagues in Asia and the patient replied that she too had advanced warning from her sister that was living in Korea as an English teacher, the physician then asked the patient if her sister is Black. The patient replied that she and her sister have the same parents, and both are Black. The physician went back to toggling with the computer.
IV. The physician questioned why the patient had stopped using oral contraceptives, patient noted that she is not sexually active, does not need contraceptives, and finds oral contraceptive side-effects unpleasant. The physician insisted that there are many benefits to birth control other than the prevention of pregnancy but did not mention what those benefits were. The physician said, “At some point before 50 you are going to have sex.” The physician counseled the patient about IUD options and made notes on the computer. The patient replied, “Yes, this is likely, I’ll consider it in the future.” The physician sighed in annoyance.
V. The physician continued to pepper the patient with questions about her sister and how she became fluent in Korean, and offered small details about how her daughter is interested in a foreign language. The patient detailed her upbringing and her travel experiences visiting her sister in Asia and how powerful learning a foreign language is for opening career opportunities. The medical assistant returned to the room for a few minutes during the right breast exam mentioning that her granddaughter loves K-Pop (music from Korean Boy bands) and then left.
VI. “There are Black people in Korea?” The physician said. The patient replied playfully referring to herself and her sister that Jamaicans tend to venture everywhere, but how she met other Black people while traveling in Asia and many were US military personnel.
VII. The patient expressed that many women in her family had suffered from fibroids and that she is concerned about them even though she currently has no visible symptoms. The patient also mentioned that she had heard different theories about what causes and amplifies fibroids including chemical hair relaxers, the physician interrupted the patient forcefully declaring that none of the theories are true and told the patient “You do know that you do not have to be a male in order to be a misogynist!”, the physician had suddenly become irate, moved her body rapidly, and then went into a long-winded tirade while the patient lay in stirrups. The tirade consisted of the physician exclaiming that is tired of all the woman bashing that has been occurring since the beginning of the pandemic. The physician was shouting and stomping her feet while waving medical instruments in the air wildly that were to be used to collect vaginal cultures. The physician went on to further exclaim how this is an example of blaming the victim and told the patient “You are at high risk for fibroids simply because you are Black!” The patient re-emphasized her concern about fibroids despite not having visible symptoms. The physician then said that 50% of Black women have them without any reasoning why this is the case, how to prevent fibroids, or any recommendation for follow up diagnostic testing to ensure that the patient did not have fibroids. When the patient raised the concern again, in a mocking tone the physician told the patient “Well maybe you are the 50% that does not have it.” The physician also noted that the chemical relaxer theory could be of some value if it prevents women from potentially damaging their hair.
VIII. The patient asked the physician calmly if this was their first-time hearing about the chemical hair relaxer theory as it relates to fibroids and she replied “Yes.” The patient then informed the physician to be aware that this theory is being shared broadly.
IX. The physical examination component of the appointment had ended. The patient asked if she should be concerned about her fertility. The physician stepped forward with one foot, leaning over the patient and asked curtly “Are you trying to get pregnant?”. The patient reiterated that she is not sexually active or trying to get pregnant but has been told repeatedly by her Jamaican relatives that she is considered “old” to be without children. The physician seemed annoyed by the question and angered by the reason for the question, waved her hands forcefully, pointed her finger, and exclaimed that she is from the same culture and the patient does not need to be concerned about her fertility given her familial national origin. The physician emphatically declared “This is why you see Jamaicans all over the world!” The patient knew the response from the medical professional was not scientific or in her best interests, but already weary, just accepted the physician’s remarks without protest.
X. The physician then directed that patient to put her clothing back on and wait for the medical assistant to draw her blood, the physician said goodbye and left the room.
XI. The patient complied and the medical assistant returned, inserted the needle multiple times claiming that the patient had slow blood flow.
When Dr. Francis was shouting and waving around the medical instruments I quickly thought about leaving, but felt like I could not. It was a cold winter day, I was nude, on the 2nd day of my menstrual cycle, and I have never used a metal speculum on myself, I did not know if the device would somehow pinch or even puncture my pelvic area if I had attempted to get up incorrectly. If I had got up to leave rapidly what would security or the other patients in the waiting room do or say? All I could do in those moments was just nod along with wide eyes and tolerate the indignities.
Dr. Kanos presented the idea of using this incident as a case study for medical students and residents. I am open to the idea if it will do good for the collective, but as the patient that lived the experience, there are intimate bodily sensations that are inseparable from the memory of that day. When Dr. Francis asked me if my sister was Black based on the premise of her living overseas as a teacher and having fluency in Korean, she had insulted me and my family just before exposing, touching, and examining my breasts. When Dr. Francis raised her voice accusing me of being a misogynist and then went on a long-winded tirade about woman bashing and her other personal gripes, I remember my entire body tensing up and the contrast of the cold metal on my vaginal walls. My initial shock grew to fear when she hastily picked up instruments from the pap smear kit and was waving them around violently as she stomped her feet to put emphasis at the end of each sentence. In my mind’s eye I can still see the patent black leather heels she wore from watching her feet bang the floor and hear the clicking sound.
I am not a doctor, but if you were to split me in half and then put my organs on a slideshow, based on my sensory memory I can pinpoint the exact area of my cervix that was grazed just as she was shouting at me that I was at high risk for Fibroids simply because I am Black. Dr. Francis was unrelenting in the way she handled me, and I cannot talk about what happened without the sensory memories also present, the burden of the memory of her disruptive behavior compounded with intimate sensations makes the weight of this on me akin to an assault. After the physical part of the exam concluded, she then further hurt me by dismissing my fertility concerns due to my familial national origin. There are so many layers to the betrayal of what happened, I do not know when I will be in the space to trust another physician with my vulnerability. I never want to be alone with a provider ever again.
My initial outreach was directly to Dr. Francis because I wanted to raise her awareness about the impact of her behavior. Her silence has been deafening, but also very telling. There is a crack in the moral compass of a woman that is loud, insanely disrespectful, and uses her pointed finger boldly only when the woman she is targeting her aggression towards is in a paper half gown. Raising your voice to call another woman a misogynist within the same space that you are concurrently exposing her, touching her body, and putting gloved fingers in her vagina is totally egregious and inhumane. If there was indeed a misogynist present in the room, it certainly was not me.
I now know that I am not the only patient that Dr. Francis has been haughty and dismissive towards. In fact, I recently had an exchange with another former patient that lost her baby during the second trimester that also experienced interpersonal irregularities while under Dr. Francis’s care. She expressed her regret when she heard my story and confided in me that at the time she did not know how to challenge Dr. Francis’s behavior and has since changed providers, she said that she is now planning to reach out to Mount Sinai and I encouraged her to do so if she feels she has an adequate support system.
Dr. Michelle Y. Francis’s behavior and statements would have been highly problematic if we were two women standing in a bodega or even in someone’s living room, the fact that it occurred in a clinical exam room while she was wearing a white coat acting in the capacity of a board certified physician and my body was exposed in stirrups is cruel.
I have spent hours and many sleepless nights questioning why this ordeal happened and what red flags I could have missed during my first appointment with Dr. Francis only to have my Aunt chastise me for “not telling her about the medical doctors in our family” as if that somehow would have been an invisible shield to protect me from Dr. Francis’s frightening temperament and demeanor. It would have felt inauthentic and just unnatural for me to start an appointment rattling off about my uncle’s tenure at Downstate. Furthermore, what about people who do not have doctors in their family? Why is the fact that I showed up as a jovial receptive patient with health insurance not enough?
I am not a patient that tries to badger my providers based on something I read via a Google search, my actual career keeps me in a state of informational overload most of the time. I like operating in my lane. I once respected Dr. Francis as someone with specialized knowledge in an area of medicine that will be relevant to me for life. I thought after my first appointment that this was the physician that would be with me through the journey of motherhood and beyond. She has delivered children for women that are a part of my extended social circle, the shock factor of this ordeal has left me to struggle with feelings ranging from the need to be hyper-vigilant and thoroughly vet my next provider or just avoid OB/GYNs altogether until I am trying to get pregnant.
Dr. Rodriquez provided a number where I can reach him and I want to move forward peacefully to find another OB/GYN, he insists that there are many that fit the criteria I am looking for, but I now have a recurring fear that if I come back to Mount Sinai West, then Dr. Francis could by happenstance be the doctor on duty (if and when I make it to the maternity ward) and further degrade me while I am in an intensified vulnerable state. What measures would be taken to keep Dr. Francis far away from me while I am a patient within the Mount Sinai healthcare system?
The fact that a physician that happens to be another Black woman took advantage of and violated me during an intimate exam is a deep scar that I will have to carry for life. At this juncture she could at least pretend to care and/or offer some form of restorative justice through an apology, the way that she behaved and has chosen to manage this grievance has exposed her lack of humanity. Everyone that has read the initial letter inquires about her response, the friend that referred me to her was very triggered upon learning about this incident and has continued to follow up with me regarding the outcome. Even if it is purely performative, I am asking for an apology from Dr. Francis that directly addresses the root of this traumatic experience.
“Would it have been better if she was white or from another group?” Is a question I have been asked. My response is always “of course not”, the prejudice statements and disruptive behavior can stand on its own. It is Dr. Francis’s lack of self-awareness as a Black woman and disregard for how she impacts others that pierces through me.
I have discussed the matter with women in my circle, some happen to be White, including a mentor in the banking industry and an executive at a pharmaceutical company. Their knee jerk reactions were similar when I started saying what happened, “You need to report him asap! This is harassment!” The righteous indignation dissipates as soon as I say “he” is actually a “she” and then their jaw drops when I reveal that she is Black. “Oh my God Roslyn I’m so sorry…if you get another promotion, just make sure your freeze eggs…I waited too long.” My mentor said. “Roslyn I knew that our experiences were different, but this is just WOW…the comment about your fertility is so ignorant.” These are seasoned businesswomen who have experienced their fair share of bias although they are much older than me and have the hierarchical privilege of whiteness. During our eye contact there was an unspoken knowing that the identity politics alone would make moving forward strenuous for me regardless of which path I take, including silence.
Considering our society’s history of inequity and trending narratives about Black maternal mortality, I am aware that the restorative justice I am asking you to help broker is politically inconvenient because Dr. Francis, despite her role as the aggressor, is a black woman on paper that may also hold other positions within Mount Sinai’s healthcare system. The optics are tragic.
All the Mount Sinai personnel I have interacted with as result of this grievance have conducted themselves professionally, however there is a specified degree of range required to juggle all the “isms” embedded in what occurred and the multi-layered impact not just for me but for the collective. I know that you have the range. I am asking for the same standard of restorative justice that our contemporary society holds men to when they make prejudice statements and carry out discriminatory harassment.
I have invested a lot in my career and enjoyed a quiet, private, and clean regimented life in finance before January 4, 2022 but this is not an incident that I can in good conscience allow to be swept under the rug without restorative justice, even if it means sacrificing my anonymity. The wound is too deep and the surrounding public health issues are too far reaching to not partake in vociferous truth telling and advocacy.
Dr. Michelle Y. Francis is a person that has benefitted and profits from underrepresentation in medicine but misused her authority to bully me. Now that her bad behavior has been called out, she is trying to hide behind white institutional power.
She saw my phenotype, had access to my demographic data, and made a gross miscalculation about how to treat me. I am concerned for younger women and girls who inwardly know something is wrong but are afraid to or do not know how to report it. Due to underrepresentation even if they do know that something is wrong, Black women and girls are notoriously discouraged from reporting abusiveness especially if the offender is also Black.
What she did was fundamentally wrong, no one deserves to be treated this way. This is what happens when patients are viewed as disposable commodities and not as human beings.
This is not an incident that Dr. Francis will be able to continue to run from. I have shared what happened with several women’s health advocacy groups and have been asked to consider providing public testimony in support of active proposed legislation that will expand patient protection policies. I am also being encouraged to reformat my original grievance letter into an Op-ed. As I continue to share what happened to me, I know that other patients will find the courage to come forward.
I recognize that Mount Sinai is an enormous institution and positive change in large organizations are often only accomplished incrementally. I do appreciate your initial outreach, admire the work you are doing, and hope this unfortunate incident is transformed into something good.
Sincerely,
Roslyn J. Smith
Please Sign My Petition: https://chng.it/Cv27KJZY
Listen to Audio of Mount Sinai (Erica Rubinstein, VP Patient Experience) trying to convince me to do a case study after being humiliated and discarded by my physician: https://youtu.be/vesdfNDGO48
