Pushed Out (w/ Dr. Khoury)

This is the podcast adaptation of the eighth episode of The Break Room! This one’s titled “Pushed Out.” Getting written up at work while Black comes with a unique set of challenges. Join our mental health experts as they navigate being “Pushed Out” of corporate spaces. Special thanks to our guest, Dr. Aysha Khoury! Part of the Living Corporate network, The Break Room is focused on mental health, wellness and healing for Black folks at work. You can expect real talk from real experts about the real ways Black folks can protect and heal themselves from racialized trauma at work. Catch a new episode every Thursday at 7PM Central! (Note: The Break Room is currently between seasons. Catch up while you can!)

Check out full episodes of The Break Room, video included.

Connect with Dr. Khoury on LinkedIn.

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Dr. Brian Dixon (00:09): Good evening, everybody.

Dr. Nikki (00:15): Hello. Hello. Hello.

Dr. Brian Dixon (00:15): It is The Break Room. We are back for I don’t even know how many episodes now. We are a staple in your Thursday evening. So I’m Dr. Brian Dixon. I’m a psychiatrist in Fort Worth, Texas, where I get to work with kids and adults and do some awesome things with mental health and I’m super glad to be here. I’ll kick it over to Dr. Nikki.

Dr. Nikki (00:39): Hi, my name is Dr. Nikki and I am a licensed psychologist here in the state of Texas, and I’m also a DEI consultant and trainer. I am always excited to be a part of The Break Room. I haven’t been on for a couple of weeks.

Dr. Brian Dixon (00:55): Yes.

Dr. Nikki (00:55): I’ve sort of been out. So I have to get my podcast sea legs back under me, but yes.

Dr. Brian Dixon (01:01): Well, yes, we are both glad to be back. So, Dr. Nikki and I were doing a hiatus, Dr. Jide and Dr. LaWanda were holding it down for a couple of weeks. And so before we introduce our awesome guest panelist today we want to always reorient you to where you are. So, The Break Room is all about being Black in the workplace and mental health in the workplace. So, Black mental health in the workplace. We always start the podcast off with a little bit of tea where we talk about a little something, something that always gets the conversation flowing, just like you would in the break room during your 15 minutes. We will then jump into learning more about Dr. Khoury and her story, and we get to talk back and forth about what’s going on when there’s lots of toxicity at work and what happens there, and then we’re going to move over into The Last Nerve because, you know, there’s always something that gets on your last nerve, and we’ll end the show from there. So, the tea. So, I’m sure Dr. Khoury has seen a lot of this. There’s this thing called Twitter, and there’s this thing called Med Twitter, and so when the Krispy Kreme folks said “Hey, we want to incentivize people to go and get vaccinated because we think it’s a good idea,” the Krispy Kreme folks said, “If you bring in your vaccination card and you show it to us, we will give you one free donut every day from now until the end of the year,” so all you have to do is you swing by Krispy Kreme, you show them your card and you can get a free donut everyday. And y’all, some people lost their damn minds. They were upset. And so, I want to hear from you all, what do you all think about that? That’s just… It’s… Yes.

Dr. Nikki (02:38): What I really thought? I’m going to be honest. We don’t have Krispy Kreme locations here in Houston. They are further out. I am grateful to God for that, because I am from Baton Rouge, and there is one Krispy Kreme in Baton Rouge, and I mean, it’s a whole thing around Krispy Kreme. The hot sign? Oh, my God. There’s so much nostalgia in me around Krispy Kreme and the hot sign and family and just fun. So, I would probably have a A1C of Krispy Kreme. So, I’m happy that there is not one here. But I also was thinking, I’m going home this weekend. I’m going to take my vaccination card.

Dr. Brian Dixon (03:26): Yes, child. Yes. What about you Dr. Khoury? What do you think?

Dr. Khoury (03:30): Well, I am from Atlanta and I am an internist. So I see people with A1Cs that are high. But let me tell you–

Dr. Nikki (03:41): You came here to steal my joy? My Krispy Kreme joy?

Dr. Khoury (03:44): Listen. No, because I was excited, except now that I’m living in California, I don’t think I’m anywhere near a Krispy Kreme. So, I’m waiting to go back home because I want my Krispy Kreme too. I mean, it’s all about moderation. Let’s not get twisted. I am someone who appreciates, not to take it serious, but someone who appreciates corporate citizenship. Krispy Kreme at the end of the day sells donuts. That’s what they sell. They sell donuts every day of the week.

Dr. Brian Dixon (04:10): Preach.

Dr. Khoury (04:10): Getting one donut a day, and I think it would be a very small group of people who would go every day because they think they’re just doing their job. Do I wish that they could have maybe given donuts to the legislators if they didn’t sign in voter suppression bills? Sure.

Dr. Brian Dixon (04:35): Okay.

Dr. Khoury (04:35): But we have to do what we have to do. So, I appreciate their corporate citizenship. When I go home, I’ll be getting my donut.

Dr. Brian Dixon (04:41): Yes.

Dr. Nikki (04:41): Hello.

Dr. Brian Dixon (04:41): Word. Yes. Because one of the controversies [for?] doctors on Twitter, it’s always tough to know what is entertainment, what is educational. And so, some doctors are very much on the fence of there are healthier options. Why wouldn’t it be Under Armour donating tennis shoes? Why are we glorifying Krispy Kreme? And I’m with you, Dr. Khoury. At the end of the day, they make donuts. That’s their job. They are really good at it. Now, for what it’s worth, Krispy Kreme is not my favorite. I’m a Shipley’s guy all the way. Oh yes.

Dr. Khoury (05:19): I don’t even know what that is.

Dr. Nikki (05:21): You don’t need to. It’s a trash pack of donut. Trash donut.

Dr. Brian Dixon (05:26): I love it. No, Krispy Kreme does that weird melty thing. You bite into it and it’s like cotton candy.

Dr. Khoury (05:31): That’s the point.

Dr. Brian Dixon (05:31): No, no.

Dr. Khoury (05:33): That’s why you go when the hot sign is on.

Dr. Brian Dixon (05:42): I love it. But it feels like the takeaway from all the Krispy Kreme nonsense is number one, get vaccinated. We need to be safe and being safe is really, really important. So, yes. Whether you go get your donut or not, make sure to get vaccinated. Well, that’s our tea with our donut. And so we’re going to move into the next part, because we want to have lots of discussion about toxicity, especially at the workplace for Black folks. And so, I’m going to kick it over to Dr. Nikki to lead this conversation and welcome Dr. Khoury to the rest of the podcast.

Dr. Nikki (06:20): Yes. So, thank you for that, Brian, for getting me to start it. I didn’t even know about it. That was all a revelation to me. So, thank you for that joy, and I know exactly where my vaccine card is and I am packing it. So, for the record you can follow me on Instagram @Dr.Nikkiknows so you can see me eat my donut for proof, if you’re interested. But we are super excited. I’m super excited to have my dear friend. I’m going to call her by her first name, because I know her by her first name, but I will definitely be respectful of her credentials. She’s earned every one. We have my dear friend, Dr. Aysha Khoury, and what we’ll have you do is introduce yourself. Share with the audienc, whatever parts of your bio that you want to share. We already know you’re a fan of Krispy Kreme over Shipley’s. I think that that affirms more deeply my friendship and love for you, that you have a discerning palate. But beyond that, tell us who you are, what your work is, what you’re about.

Dr. Khoury (07:23): Sure, sure, sure. I’m an internist who also trained in preventive medicine and public health. And even so, I’m going to get my donut. I’m an educator. I really have a passion for undergraduate medical education. So, teaching medical students. I’m from Atlanta. So, I’m a child of the civil rights movement and very much have been inspired throughout my life by John Lewis and all of the other great, incredible leaders that Atlanta produces, most recently Stacey Abrams. So, in 2019, I was recruited by Kaiser Permanente Bernard J. Tyson School of Medicine to be founding faculty. This was a unanimous offer. The leadership at the time was very excited about me. One of the things that attracted me to move from Atlanta to California away from my family, my friends, my church community was because the school was supposed to be dedicated to equity, inclusion and diversity. It’s written into the values, the mission, the vision of the school. The school was renamed after Bernard Tyson, who was someone definitely dedicated to racial equity, and it’s definitely something that they use in all of their social media. My kind of Med Twitter claim to fame, @AyshaKhoury on Twitter, was that within nine hours of having a discussion on bias and race and gender health disparities with my med school class, a subject I was asked to teach as a moderator, I was suspended because of a quote “complaint about the class.” My students came out in support of me unanimously. 91% of the student body wanted me back. And after 16 weeks of a supposed investigation, I finally came out on Twitter and shared my story. That was December 10th. And following that, I was eventually dismissed. So my claim to fame is being suspended and dismissed for talking about bias and racial health disparities at a medical school.

Dr. Nikki (10:20): We’re not going to claim that. What we’re going to claim is, and this is…

Dr. Khoury (10:25): My advocacy.

Dr. Nikki (10:26): Because that’s not your legacy. I am firmly of the belief that this is an important part of your story, but I do not believe this is your legacy for lots of different reasons. But for one, whenever I hear you talk about your experience so far, whenever I hear you talk about your identity as a doctor, you talk about yourself in terms of being an internist and educator. That piece is always a part of how you see yourself, and the difference between being a teacher or having a role as a faculty member and being an educator is that an educator is a calling.

Dr. Brian Dixon (11:08): Amen.

Dr. Nikki (11:08): That is a way of orienting yourself to the world. And because of that, and because of what I know of your character, I’m convinced that this is a very unfortunate, uncomfortable, heavy, negative experience that you’ve had, but it is not your legacy.

Dr. Brian Dixon (11:29): Amen.

Dr. Nikki (11:29): I would like to hear you talk to us a little bit more about–what was it in your understanding about the medical school and their emphasis on racial justice on equity that was particularly appealing for you? So, said differently, I remember I was like, “University of Houston opened up a medical school. You should come down here,” and you were like, “I don’t think so.” But you got really excited.

Dr. Khoury (11:58): Yes, I tried on quite a few opportunities, a few institutions that would have been closer to home. But what drew me, Bernard Tyson is someone who I’d gotten to meet in person, and he just leaves such an impression in terms of his leadership. And he’s someone who, as a Permanente physician, I had been able to observe. Unfortunately, he died the year that I moved for the position. And so I think in that we lost an incredible champion for the values of the school. When I read the values of the school and I read words that say, “We appreciate our community. We appreciate and want to respect the staff, the educators that come through our doors. We want to honor inclusion and diversity, and we are”–again, if you look at all of the social media, whether it is from the dean, the senior associate deans, the school at large, they have placed such an emphasis on values that resonate with me as a Black woman who grew up in America to become a physician, child of the cvil rights movement. No other school could have compared. The other thing is they were dedicated to being innovative and doing things differently. So, even in this, early on I suggested through my legal team that there will be a restorative justice process. Even in this, I thought “Here is a chance to really show leadership, right? I mean, even today, there’s controversy about how Harvard has kind of handled their communications about the rise in violence toward Asian-Americans. Here is a school dedicated to innovation. Here’s an opportunity. This is something bad that happened to me. There was no due process. This was personally devastating. And even then, I am still suggesting a restorative justice process, because I want to be part of that dream. I want to be part of fulfilling those values. So, there really was nothing else for me. Culture is built from the ground up, and if I was going to be able to be there early on, I hoped that I could influence the culture, and I had hoped that other people were similarly attracted by the mission, vision, and values of the school.

Dr. Brian Dixon (15:04): Yes. And Dr. Khoury, I would love to hear you speak on that, attending student relationships. So I’m teaching at one of the local medical schools as well, and I remember being a medical student and being on campus and being around your attendings, especially if you saw an attending of color. I’m like, “Oh, my gosh, a Black doctor. This is awesome,” and you get so close to them as students and they get so close to you. And so, especially because we’re a podcast all about mental health, I wonder, trauma, what does it do to the students’ psyche? What does it do to the attending’s psyche to kind of rip that relationship apart the way that they, like, propagated it? What do you think?

Dr. Khoury (15:53): I think it’s important to keep a lot of that confidential.

Dr. Brian Dixon (15:56): Got it.

Dr. Khoury (15:59): But obviously, there is an effect. For some of the students that was the first time they had in their educational career had a Black teacher.

Dr. Brian Dixon (16:10): Yes.

Dr. Khoury (16:11): I, again, being from Atlanta, I have a bit of a different background. I intentionally chose Morehouse School of Medicine. So, I was surrounded by Black faculty at all levels of being a subspecialist, primary care pathology, you name it. There was a Black medical mentor, someone who you could see, and that is so powerful. And moving here, moving to a city that does not have a large Black population, really helps you understand like how special cities like Atlanta are and how much of a privilege it was for my father to choose to raise me there. When we hear the statistic that we are only 5% of the physician population and Black women are only 2%…

Dr. Brian Dixon (17:06): Yes, correct.

Dr. Khoury (17:07): I had not really felt that until I moved to California. I’ll share one story I share with the students is that the day before my suspension, I had a Black patient who came and she said, “I saw your picture on the website, and I just wanted to come and see you,” and it was just because I was Black. It was just because she could see someone who looked like her and for her, that meant that she would be heard, that she would be listened to. And so, I can say for me what’s been incredibly powerful has been the student support.

Dr. Brian Dixon (18:01): That’s awesome.

Dr. Khoury (18:05): I mean, they have left me chocolates. I shared that on Twitter. They have left me cards. They have been incredible, and to be ripped from a calling is extraordinarily difficult.

Dr. Brian Dixon (18:21): Yes, goodness. And I’ll throw a comment out there and then I’ll kick it back to Dr. Nikki. So, about four weeks ago Dr. Khoury, we talked about Black excellence and we talked about John Henryism, and it’s really funny because yes, Black doctors are 5% of the the physician population, 2% are Black female doctors, and when you’re a Black doctor, you show up on every diversity brochure, you’re in every admissions committee meeting, you’re always around. And I’ve done that song and dance my whole entire career because I went to predominantly white institutions, and I now realize just how tired I am. And so, with John Henryism, you go above and beyond to show how awesome and competent and great you are, and then you burn out and your heart explodes. And so I worry for all of us, all Black physicians, that we’re doing too much. Not only are we having to educate students, which is our calling, and treat patients, which is our calling, but we’re also having to be DEI experts. We’re also having to be lawyers. We’re also having to be HR specialists. We’re also having to… It’s a lot. And so, I just commend you for all that you have been able to do, especially working with those students. So I just wanted to say that. Get that off my chest.

Dr. Khoury (19:47): Thank you.

Dr. Nikki (19:48): And I want to just say for clarity, for anybody that’s listening or watching, we want to be aware that Dr. Khoury has a legal process underway because of the way in which—well, this is my interpretation, so again, I don’t want to cause any undue characterization of the experience, but my understanding is part of the legal case is around the way that you were dismissed and the reasons for the dismissal discrepancy, maybe even in what you were first told versus what the final decision was. And so, I’m also curious to know, we talked about John Henryism, and then lately we’ve also been talking about the impact of engaging with white toxicity on your physiology. We talked specifically about what is white toxicity, and then we talked on the podcast last week about when toxic is too toxic, and we wanted to focus this episode on being pushed out because there is a very, I think, specific story in your experience around what I just heard you share, what I also hear Brian share, and I am personally invested in the betterment of this entire discipline. I have selected this as a way to use my talents and skills in the world. And I bring myself to that, but you, the medical school, the experience and what I would characterize as blatant white supremacy, I’m characterizing it that, was so relentless that it left you no choice. And this is why I use the term pushed out. I think it’s extremely striking that you say, even when things went left, even when you had been harmed, you were still willing to engage in a reparative process, and that the system in its structure, and this is why I labeled it as white supremacist structure, because to me, the system is more concerned with upholding itself than actually engaging in the human experience of whatever the industry is. And it was so invested in itself that there wasn’t opportunity to even have a movement for there to be resolution. So, I wonder if you could talk just a little bit about that experience of feeling pushed out. Would you characterize your experience as that? And then related to that about being so visible on Twitter, what was your sort of thinking around that? What have you been doing to sort of stand in the gap, so to speak?

Dr. Khoury (22:51): Sure, sure. So, I think first and foremost, I’ll address why I came forward. So, in my process of my suspension, my suspension was August 28th. June 10th, I received an email from my chair saying that he was going to recommend me for a promotion, and that would’ve come with a three-year contract. Within a matter of weeks, I am getting suspended, and I don’t know what’s happening with that promotion, but because it was the start of a new academic year they had to give me a contract during their investigation. So they gave me a contract for six months, and that was supposed to end on December 31st. As December 31st approached, they’re supposed to give you 30 days, right? 30 days notice if you’re not going to get a renewal. So they offered me a one month contract, and at that point I just started to feel like “Okay, maybe I’m not going to get the fair shot that I thought that I was.” At that point, I started having doubts. And this has been a really traumatic experience. I think anyone can understand that. To go through a process where you’re not told what policy you violated that led to your suspension, you’re not told what the complaint was. They made a decision without talking to me, without even hearing my side. I just get a call nine hours after the class to say your teaching privileges have been revoked. So, on December 10th, I had a session with my pastoral counselor. My faith is very important to me. And so we were just discussing, what has been happening and how I’m navigating this process. And one of the things that he said was something to the effect of we don’t understand the weight of our stories. And that really struck me, because part of it meant for me was other people might be going through something similar and could benefit from me being open. Now at the time I maybe had 20 Twitter followers. But something said, “Figure out how to create a thread and put your story out there,” and that’s what I did. And later on, someone asked me why I came forward and I said, “I don’t want to be complicit with my own trauma.” My silence was complicity with what they had done to me. When I was suspended, I was told that I cannot speak with other faculty. I cannot contact students. I can’t come to the campus. They went so far as to tell me, “We don’t want to see you here.Direct quote. And I will never forget that sentence.

Dr. Nikki (26:01): As if you are a threat because you revoked someone’s privileges and access because there is a perceived threat. What threat is there?

Dr. Khoury (26:15): Again, early on I said, “Okay, there is a complaint. I’m at an institution that believes in equity, inclusion and diversity. They have to do the things they have to do to protect whatever,” and I tried to play devil’s advocate, and I think that’s just part of going through all the motions where it’s like you’re reflecting on the day, you’re going back, you’re having conversations, you’re seeking clarity, but I slowly lost faith in that they would treat me fairly. And I think Nikki, to your point, I went from being someone who was being promoted, I went from being someone who in some ways was appreciated for the work that I had done, and the promotion shows that, to someone who was pushed out. And 18 weeks after my suspension, they come out with a non-renewal letter. And the non-live renewal letter is on Twitter. I mean, it’s awful. I misrepresent myself. What else did they say? I have poor judgment. My work product was poor, and that one was so stunning because they used all of my curriculum. Even after they published that letter, they were still using the curriculum I wrote with very little change. Sorry, I’m getting a bit emotional. So, I hope that that kind of addressed what you asked, but it’s stunning to go through the juxtaposition, because it’s as though the time that I had there was not reality, which I guess is where the gaslighting comes in, right?

Dr. Nikki (28:31): I couldn’t get it out fast enough. And I really want everybody to sit with the significant impact of that gaslighting part. So there’s this other concept from sort of the sociological world called cultural imperialism, as one of the ways in which systems and people that engage in oppression, they use this tactic. And cultural imperialism is this idea that I determine what is real, right, valid and true, and you either adhere to that or you are out. You are othered, you are decentralized, you are marginalized, you are put out. And in my experience and listening to you share your experience, it’s the gaslighting that is the reason. They are trying to, in some sense, indoctrinate you in to their reality. And you very much are grounded in reality. And saying, “That is not what is happening.” I mean, for you to go from saying you are being suspended because of what happened in the classroom to a dismissal letter that includes not that conversation at all. And then all of their social media saying it has nothing to do with that? Make it make sense. And it doesn’t.

Dr. Khoury (29:52): Yes.

Dr. Nikki (29:53): And I think the real impact of racial trauma, and I want to name that for you and I honor always how impactful and devastating this experience has been for you. But the part about racial trauma that makes it so devastating, that makes it traumatic is that you were still getting up everyday, trying to do your best. You are still getting up every day, trying to be grounded in reality and do all the things that not only you have been sort of socialized to do, but you are called to do. You are trying to do it. And there’s this constant sort of dismissal, this constant attack, this constant unnamed attack. Because the other thing that we talked about in terms of white toxicity was the politeness around it, the niceness around it. We’re not going to just come out and say that you made us uncomfortable, or that you made someone uncomfortable by having them reflect on racism in medicine. But we’re going to say, it’s best that you don’t show up here. And then when you take offense to that, well, I said it politely.

Dr. Brian Dixon (31:07): Exactly.

Dr. Nikki (31:07): I wasn’t harsh.

Dr. Khoury (31:11): If you read my suspension letter, which is again, also on Twitter, I’m addressed by my first name. And I think you know, especially being Black in this country, it’s your name is so important, right? And even when I asked as we’re going through this very serious process, that’s devastating to my career, please address me formally. There is this response about the culture of the school and it makes you… How is this an issue, right? If I as a provider, have a transgender patient, tell me any patient, doesn’t have to be trans, tell me my preferred name is X. I called them by that name.

Dr. Brian Dixon (32:21): Yes. Amen.

Dr. Khoury (32:21): Right? Because we all just deserve that very basic respect. But for me, that was also one of the more enlightening moments. And this is from the same person who said, we don’t want to see you here. But that really is very profound, that even as I am saying to you, “Please call me X,” you want to have and make excuses for why it’s okay for you to do what you prefer to do.

Dr. Nikki (32:54): Yes.

Dr. Brian Dixon (32:54): Yes. And to Dr. Nikki’s point, because now I’m thinking about what happened to me with one of my last jobs, which is why I said I have to quit and go do something else. The racial trauma. So, because eventually I was at work even though I’m the most productive physician, I’m doing my duty, I get called to the–we called it the principal’s office. Beause I mean, at the end of the day, we’re like, wait a minute, we’re all grown folks. Well, you don’t have to summon me anywhere. But I get summoned. And yes, I get written up, and I get the first and final, like y’all, I have never been written up in my life. That concept doesn’t make any sense to me whatsoever. And my first thought was, “Holy shit, did I do something wrong with the patient? Did I cause any harm? Did I write a prescription wrong? Did I forget something?” And no, it was because I was not being collegial. I was not being collegial enough because when I saw an error, I corrected it. Because I was being gaslit on a reply all email to the whole department that I was like, “No, that’s not how it happened,” and I replied all in a very what I thought professional way. And so, Dr. Khoury, I really want to hear your take on professionalism because that’s a whole thing in medicine.

Dr. Khoury (34:08): Yes. That is a whole thing. You made so many good comments. I want to make one point when you say about written up. I was never written up.

Dr. Brian Dixon (34:27): Yes. Which just blows my mind.

Dr. Khoury (34:28): I was never written up. And so, when it comes to getting the suspension and then getting this letter with regard to my termination, there was never a work improvement process. There was never a come to the side, you have a complaint, please sign this paper. All of the things that typically go into losing one’s job. And especially as an educator in academic medicine, there’s a whole handbook for how these things are supposed to be sorted out. These are not typical positions. There’s a process because we go through a lot of training to get to these places and we should be treated fairly. Professionalism is so steeped in specific culture.

Dr. Nikki (35:20): I’m going to go ahead and name it for you. I’m going to say it’s steeped in white dominant culture. And in particularly. it’s steeped in white male hetero patriarchal cultures. If we’re going to get specific with it, the Karens learned how to work it sooner than we do, because they get indoctrinated from birth than we do.

Dr. Khoury (35:40): Right. So, professionalism is not about your merit. It’s not about your work. It’s not about your ethic, your productivity. It’s not about your intelligence. It’s purely about how you make others feel.

Dr. Nikki (35:53): That’s it.

Dr. Khoury (35:54): Right? And so, if my hair makes you uncomfortable–and I did tend to, even the day I was suspended, my hair was natural. My hair is natural, but it was down. I wore a t-shirt that says “I can’t breathe. I had on an African print skirt. And I very regularly wear my hair, before we were wearing masks and face shields, I wore my hair as big as I could get it, and I had African print in colorful and it’s bold. And as I’m sure we’ve experienced, sometimes our mere presence is enough of a threat. But again, I thought I was in an environment where I would be accepted for who I was. So, I didn’t see these things. This is what makes me feel like me today. But as you know, being Black in America means you have to modulate your emotions. You have to modulate your tone of voice. You can’t laugh too loudly. You have to use certain diction in certain spaces. Otherwise, you could be considered unprofessional. It’s something I reflected on in one of my medium blogs about allyship.

Dr. Nikki (37:21): And I think that’s really important, that last clause. Because when you don’t do those things, you get pushed out, you get summoned. There are systems in place to bring you back into form, to bring you back into a zone that makes them feel comfortable. And when you don’t do that, there are always consequences.

Dr. Brian Dixon (37:47): Always. Yes.

Dr. Nikki (37:47): There are always consequences. And so, that’s an additional part of the mental burden of being Black in this country, is having to navigate all of that. How many of the consequences am I willing to deal with? How am I going to navigate through these consequences? Where is my unrelenting line of integrity? Where I’m just not going to. And all of that is sort of a constant negotiation and conversation and you have to consult with friends and get input and make sure you have an ally. Make sure you have an advocate, make sure you have a sponsor, make sure you have all of these layers. Just to show up and do your job. And we do it excellently on top of all of that.

Dr. Khoury (38:40): Yes. And Nikki, I want to point out that, especially in the medical community specifically, first of all, after George Floyd’s murder, you have public health communities declaring racism is a public health crisis. You have physicians coming out on their lunch to kneel outside of the workplace with signs about Black Lives Matter, kneeling for eight minutes and 46 seconds. So, this is the same summer that I get suspended for having a discussion I was asked to have. And that is ultimate gaslighting.

Dr. Nikki (39:22): It’s performative. I call bullshit.

Dr. Khoury (39:28): But when I moved because of the rhetoric, when I’m being asked to have the discussion and I believe “Okay, we are living our mission, vision and values. Right?” We’ve already done all–as in your workplaces we have the town hall meetings. “How do you feel? Tell us all your stories about racism.” And you participate in these things because you hope that it makes a difference because you hope we have this chasm that opened up a little bit. People can see. It had to be so brutal for people to see, but people could see the things that we talk about on a daily basis. You want to take advantage of that. I want to take advantage of that. So, let me tell you my story. And you think that people are listening, and then within a matter of weeks you get suspended and no one can tell you why. And no one can tell you what policy you violated.

Dr. Brian Dixon (40:30): Yes. And I’m sure there’s a term for this, but as you were talking, Dr. Khoury, it made me think switcheroo. Because yes, I get to the job and they’re like, Oh, we love your energy. We love your pedigree. We love everything about you.” And then you do what you came to do and they change it.

Dr. Khoury (40:46): Right.

Dr. Brian Dixon (40:46): And it feels like that is a theme in this country. We want a Supreme Court justice nominee. Oh, you can’t do that. It’s too close to the election.” And then they go and they just change the rules whenever the hell they want to. And then they expect us not to get mad. And I’m like, what the hell is this?

Dr. Khoury (41:06): And I think that’s, again, not being complicit. I don’t want my silence to be complicit. And then once I experienced that, just the outpouring of one, support, but secondly, the stories, every week, I mean, it slowed down a little bit, but even this week, receiving stories about everyone at every level, be it an attending, a specialist, a resident being pushed out. Similar stories. You’re stellar in your work. You’re set for promotion. You’ve never had a performance issue. And suddenly you don’t have a job? It’s what’s motivated me to keep talking. Something that will be coming soon to a Twitter near you, there’s a collective of us that are advocating so that we could have a hearing before Congress, before senators on the health committee, because I cannot call myself an educator, have this experience and think about my eight students and think that 20 years from now, 12 years from now, they could contact me and say, Hey, X, Y, and Z happened to me.” And my only response was Mm-hmm, happened to me too,” and I didn’t do anything about that.

Dr. Brian Dixon (42:25): Preach.

Dr. Khoury (42:25): So I can only do as much as I can in every way I can to make noise about this issue.

Dr. Brian Dixon (42:35): Amen.

Dr. Khoury (42:35): I have sent messages to all of the regulatory agencies within medicine from medical schools to hospital regulatory agencies. I’m trying to work with other state and now federal legislators. Because at least I will be heard. Now, I can’t control the outcome. But I have to make it a better space for the students who are coming after me.

Dr. Nikki (43:07): So, I put in the chat box because I had been thinking about this and I wanted to make sure I got the quote exactly right. So, I went to Google the Zora Neale Hurston quote, If you are silent about your pain, they’ll kill you and say you enjoyed it.” And I really appreciate what you’re saying. So many times I refuse to be complicit in my trauma. I refuse to be silent in this because the reality is the worst consequences already happened.

Dr. Khoury (43:34): Right.

Dr. Nikki (43:36): They fired you. I’m going to use the word fired. They fired you. And they lied, they lied about why they fired you. Again, this is my characterization of what I have learned about the experience. And then they won’t facilitate your… I don’t even know what the word is, transition even better. So, now you’re just sort of hanging out. Not doing the thing that you were called there to do. So I really am excited to hear about all the advocacy work that you’re doing. I wonder if you would share with us a little bit more personally, about what other tools, resources, skills, not necessarily skills, but what have you been using to help facilitate. Because it’s one thing–so let me be clear, what I’m saying is you still are practicing medicine in the same context and around many of these people that have treated you with such disdain, who have lied on you, who have probably talked about you behind your back and now you know it, but you don’t know who or who said what. And you still have to go into the work environment every day with that. And you’re not doing the job that you went there to do. So how are you making it through? This is always a podcast about mental health and so, I would love to know what supportive resources you have used. Because I think that’s another important part of telling the story, because a lot of us continue to suffer in silence and swallow our pain.

Dr. Khoury: I think I swallowed that pain for quite a long time. And again, I didn’t share anything publicly for 16 weeks. And it was only after that that I started to broaden the number of people who even within my closest circles who were aware of what I was experiencing. And I think what’s so important and something I share with my patients, there are moments where you’re so happy as a child, and whether that is something creative typically that as an adult you’ve likely abandoned, it’s always great to go back to those moments that make you feel happy. And so for me, it has been a lot of coloring. It’s been enjoying these random kind of Instagram live dance DJ parties, dancing in my socks on the hardwood floor. It’s talking to your elders or whoever those elders are. It’s not necessarily someone who’s older than you, but maybe someone who’s had similar experiences that you’ve had, and a lot of that is engaging on Twitter. Because so many of us have gone through this. And the only thing that we can do is continue to share our story. We cannot control how people in power respond. But we can continue to share our story. And I think that has been the most important thing for me. Other than that, gospel and prayer and talking and engaging in conversations like this has been really helpful.

Dr. Brian Dixon (47:19): Yes. Thank you so much for being with us, Dr. Khoury. We are at 47 minutes into the podcast and this is where we transition into The Last Nerve, y’all. Not the first nerve, the last nerve. So, we’re going to give that to Dr. Nikki today, and then I’ll be back to close us out.

Dr. Nikki (47:40): I’m going to do two minutes.

Dr. Brian Dixon (47:43): Okay. We’ll do two minutes.

Dr. Nikki (47:45): We set a timer too, because otherwise it’ll get off the rails.

Dr. Brian Dixon (47:49): Yes, like church.

Dr. Nikki (47:49): We talk for a minute and it goes too fast. I just want to also express my thanks. I know that again, talking about this can simultaneously be healing, but also triggering. And so, I appreciate you for being willing to share this time with us and with our audience and for recognizing that. I really am convinced that though, we may have physicians listening, we may have people that are other professions, there is something so resonant about your experience that I’m sure you have helped a lot of people by sharing. And so, I thank you for that vulnerability. I’m going to say on the record, I hope you get all the points. I want you to get every single one of them. I get to say it, she didn’t say it. I’m saying it because I rep for Black women, we are the blueprint. So, we should get all of our coins. I want you to get them. I want them to issue you a public apology. I really want them to name a damn chair in your name is what I really want them to do. But at the very least, I want you to get all yours. I want you to get everything that they said you couldn’t have. And I put that out here with all of this energy and fierceness, and I am convinced the universe is going to respond in turn. So, thank you for that. So my Last Nerve, it’s about not just the state of Georgia, but specifically the state of Georgia. I’m coming for you, Brian Kemp and them six other raggedy, pale-faced turkey necks that was standing next to you under the sign of a plantation. And if you think we don’t know that the symbolism wasn’t specific and intentional, you don’t know us the way we know you. For trying to repeal all of the work that our ancestors and our foremothers and forebearers have done, for essentially spitting on the grave of those who were attacked by dogs, attacked by fire hoses, spit on to try to repeal our very basic rights for voting. I want to say, “Fuck you.” We will not be silenced. We are our ancestors’ wildest dreams. We have learned from them. We are stronger than them. We are more leveraged than then. We are better positioned than them. We have more time, money, energy, and resources than they were afforded to have. We are not going to sit idly by and let that happen. I’m talking to you also, state of Texas. I’m talking to you too, the other 46 states across this country that are trying to take us back to 1945. We aren’t going. You’re coming our way. We have made it clear. You refuse to listen. I know you feel us breathing on your neck. That’s why you so shook. That’s why you’re trying to come as hard as you coming, but we ain’t scared because we got shit to do.

Dr. Brian Dixon (50:43): Preach.

Dr. Nikki (50:43): And your salvation, America, is in our liberation. You don’t get to have what you think you want to have and what you deserve without us. So, take notes. We just getting started and that is my Last Nerve.

Dr. Brian Dixon (51:01): Oh, child. Hey, man. Oh, Lord have mercy, I love it. Thank you Dr. Nikki, for speaking some truth to power. We are super glad that you all joined us this evening. We are on every Thursday at 7:00 Central Time, at 5:00 Pacific. We want to send much love and thanks to our guest panelist, Dr. Aysha Khoury. So, thank you so much for being here. I’m Dr. Dixon, Dr. Nikki, and we are out. Please follow us on Twitter at @TheBreakRoomLC or send us an email at thebreakroomlc@gmail.com. Peace, y’all. Have a good evening. Bye.

Dr. Nikki (51:38): Bye.

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