Code Black “I Can’t Breathe”


The country has erupted into a wave of anger that demands justice and reform; but what can we, psychiatrists, do when we hear “code black”?


As physicians, we are trained and expected to respond to emergencies. When our patients state that they can’t breathe we use every single medical leverage at hand to ensure that we alleviate their suffering, we take codes very seriously because they are life-threatening, so why do we so seldom respond to code black?

The suffocation of Mr George Floyd under the knee of systemic oppression is neither the first nor the last knock on the door of our conscience. The country has erupted into a wave of anger that demands justice and reform; but what can we, psychiatrists, do when we hear “code black”?

First, we need an honest self-inventory: many of us do not even “hear the announcement.” Acts of “micro” aggression are too common, frequently going unnoticed. We need to examine our implicit and explicit bias—and recognize and confront them around us when safely possible. There is nothing micro about aggression, our collective humanity diminishes with every hateful gesture we overlook; microaggressions if not challenged turn into transgressions and violence.

Where I work, when we feel uneasy about an interaction or a situation, we voice that we are concerned, uncomfortable and that the inappropriate speech or behavior needs to immediately stop (CUS), we cannot pick and choose when to pull the CUS card.

Second, we need to hold sacred spaces in our hearts for our patients and colleagues of color, we can speak up on their behalf without dominating or intruding, we should not place the burden of fighting hate and social injustice on the shoulders of its recipients. I recently came across a wonderful article about the topic that I shared with my superiors, How to Manage Your Team in Times of Political Trauma.1 The article suggests ways to boost psychological safety.

Next, I propose that we start looking at our contribution to the problem and its solution, we need to examine the roots of “othering” in our places of work, worship, and our social circles. It is never late to do the right thing, if we find a “rupture,” we should acknowledge our part and work on repairing it. One way to do this is through educating ourselves about the history and stories of our black brothers and sisters, it is not their duty to each us about their daily struggles, but it is our responsibility to learn. For me, since the horrific death of Mr Floyd, I have been delighted at the opportunity to learn more from the beautiful black culture.

Finally, this most recent wave of anti-black hate in the midst of a pandemic can take its toll on all of us, make sure you as a healer tend to your needs and nurse your wounds so you become more available to continue the “fight” for justice and basic shared human dignity, brace yourself, this is a race not a sprint.

Dr Reda is a Practicing Psychiatrist, Providence Healthcare System, Portland, OR. He reports no conflicts of interest concerning the subject matter of this article.


1. Kim M. How to manage your team in times of political trauma. Awaken. September 14, 2012.

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