Racist practices in health care can cause medical trauma, PTSD

Note: This story mentions suicide. As of July 16, 9-8-8 is the new, nationwide three-digit hotline phone number for Americans to call when they or someone they love are in crisis and need to be connected with suicide prevention and mental health crisis counselors. 

Glahnnia Rates was a thriving 32-year-old public health professional last autumn.

Sometimes, she put in 60 hours a week. But that was a given considering her multiple roles as the vice chair at Nevada Bicycle and Pedestrian Advisory Board, an epidemiologist during the ongoing COVID-19 pandemic and the president elect at the Black Caucus of Health Workers with the American Public Health Association. 

Then in November 2021, she fell. 

Four months later, the once vibrant and successful public health professional couldn’t walk, experienced multiple seizures a day and needed help showering, eating and defecating.

Multiple doctor visits left her without a clear diagnosis, and multiple calls to EMS left Rates scarred. 

Rates said her rapid deterioration was the result of inadequate care and dismissive treatment at all points of the medical system — from EMT first responders to doctors — and she said it’s because she’s Black.

The totality of her experiences left her suicidal. 

“There was more dignity in death,” Rates said. “I didn’t think I was going to get the help that I needed and at that point I didn’t care anymore, I didn’t care. I don’t want people, especially my friends and family, to see me like this.”

America’s history of underdiagnosing and neglecting patients’ pain is long — especially for women and marginalized communities. The foundations of the field of OB-GYN were based on experiments on enslaved Black women because of racist beliefs that they could endure more pain. 

Black Americans are 10% less likely to be admitted to the hospital compared to white patients and are 1.3 times more likely to die in emergency care, according to national data.

Rates knew this and as a Black woman in public health, she worked to help shape a more equitable healthcare system, but after experiencing the same racism in healthcare she spent her career advocating against, she was suicidal. She still has nightmares. 

Diamond Rodgers, a Las Vegas licensed therapist marriage and family therapist  whose work centers around how discrimination, racist behavior and policies can impact a person’s mental health, said that that negative and prejudiced experiences in healthcare can lead to anxiety, depression, PTSD and avoidance or distrust of not only yourself but also of the medical system as a whole.

“It’s traumatizing to go to the health and medical field and not be taken serious which also causes that avoidance because once again you have a physical trigger response to going to the hospital or going to the doctor,”  Rodgers said.

Berated in the ambulance

As Rates was trying to figure out what was wrong with her, her symptoms worsened. She would faint and have seizures. 

On Feb. 2, emergency medical service workers at the Las Vegas Fire and Rescue Station 6, who came to her house after her father called when they witnessed a seizure, refused to touch her, hold her head or strap her in the gurney.

During the ambulance ride, the EMS workers called Rates a drug addict and berated her as she faded in and out of conscientiousness and lost control of her bladder, she said.  

After multiple attempts, Rates has still not received documentation of the incident or of the complaint she has filed against Fire and Rescue Station 6. She said Derek Cox, the EMS QI Coordinator at Las Vegas Fire and Rescue told her that the cameras were not operating during her incident. 

While Rates’s father and his partner corroborate her experiences, Nevada Current reached out to the City of Las Vegas, which oversees the department, for the documentation of these incidents and statements regarding the experiences of the EMS team that responded. 

After multiple attempts none of the documents, requests for interviews or statements about the events, including if the cameras were operating, were given.

The City of Las Vegas is investigating the incident, said David Riggleman, the communications director for the city. Riggleman said that all city employees have mandatory online classes focused on the forms of harassment prohibited by federal law. 

But Riggleman did not clarify who or what department is overseeing the investigation or why the city would not provide Rates’s own medical documents to her. 

Rates said that despite Riggleman’s statement, she has not received any contact from the City of Las Vegas. 

‘All in her head’ at the hospital

Over the last several months Rates’s father, Glahn Rates, has borne witness to his daughter’s mistreatment and watched how little times have changed since he grew up in the Civil Rights era in the South and served as a chief master sergeant in the Air Force. 

“I would like to say I was surprised but I’m not,” he said. “From the time I grew up in Owensboro, Kentucky not being able to drink out of the water fountain of a white person or use the same bathroom, to one and a half to two years later to being in Vietnam fighting for freedom but I couldn’t eat at a counter in Owensboro, Kentucky, so I’m use to that.” 

The doctor that treated her at Summerlin Hospital Medical Center during the weeks after her fall said her pain was “all in her head” and that she should see a mental health professional. Rates said he also refused to check her shoulders, which Rates said were lopsided and one had a cyst filled with pus. The doctor, Rates said, told her that if he stubbed his pinky toe it would have more inflammation, and added that when he was in his 20s he hurt his back and was fine after a few weeks’ rest. 

“Deep down inside of me I do believe if Glahnnia had been a different color she’d been treated differently. I do believe that. It was just one thing after another,” her father said. “Years have changed, but times have not.”  

During her 12-day stay, her mobility deteriorated  to the point where she needed to use a bedpan. She was left in her own urine and excrement for hours. Her mother ended up buying her adult diapers. 

When Rates left the hospital, she was unable to walk, shower or use the restroom by herself. The physical pain and the emotional toll of her experience broke her. She was depressed, wondering if she was going to die. 

“I didn’t know where to turn, you went to the medical professionals and they didn’t know what was wrong with her and in many incidents, nobody seemed to care,” Rates’s father said. “She would try to tell the doctors what was wrong with her and many of the doctors wouldn’t listen.”

Rates filed a complaint to Summerlin Hospital Medical Center and received a statement explaining the physician who attended her those weeks that her condition worsened was a private practitioner and a self-governing body and said the complaint was forwarded to the medical staff and their employers. 

The doctor was an independent contractor through Platinum Health, and in a statement to Nevada Current their lawyer said that the medical staff would be in charge of any investigation and that Platinum Health may not be notified of any investigation as it is protected by law. 

The doctor who provided this care has not returned calls to Nevada Current at the time of publication. 

‘Black women are just not believed‘

Women are less likely to survive traumatic health episodes, are prescribed less pain medication and are diagnosed later in life than men. For Black women, the research points to even more troubling results: they’re three times more likely to die in childbirth than white women, are less likely to receive speciality care and have higher rates of mortality from breast cancer. 

“There’s a ton of gaslighting that goes on in the medical field so you are left with questioning yourself, your reality, your experience which can cause a mistrust within your ownself,” Rodgers said. “If I can make it so that you’re the problem, I don’t have to take accountability for my underlying racism because it’s not me especially with doctors … especially if I can blame it on mental health.” 

Rates tried to come up with reasons why she wasn’t believed. 

“To see me in that state and have no mercy and no empathy for me whatsoever, it has to be because I’m Black, even the same thing with the EMS people who accused me of acting like I was on drugs,” Rates said. 

At the end of February, she blacked out in front of a doctor for the first time.

When she came to, she pleaded not to have EMS called. She just wanted to go home and take the rest of her pain medication and end her life. 

“Black women are just not believed at all even when they are in excruciating pain, even when they can’t walk, even when they can’t feed themselves, even when they can’t wipe their own ass,” Rates said. “What do you have to do to be believed? Die?”

It wasn’t in her head. After months of trying, she finally got answers.

During the fall in November 2021, she suffered a cervical sprain and her doctors believe she damaged the vagus nerve — the symptoms of damage include fainting, near fainting, skin and muscle sensations, difficulty speaking and a drop of heart rate and blood pressure. The delay in treatment damaged the myelin sheath, the protective layer around the nerves, causing neurological problems. 

On Feb. 23, a doctor finally got her treatment. She got physical and occupational therapy. 

She was able to walk again. 

She could shower and go to the bathroom independently. She was able to work again. There is still a long way to go before her life resembles what it once was before early February — and while she’s healing physically, mentally and financially the wounds are still fresh. 

Rates and her father paid roughly $35,000 out of pocket for treatment from occupational therapists  and physical therapists, equipment like orthopedic shoes, wheelchairs and exercise equipment. Her insurance paid over half a million dollars in healthcare costs.

But trying to file complaints and get accountability for treatment has been challenging, Rates said. 

The City of Las Vegas has not given her documents on her EMS trip in February. She hasn’t heard anything about the complaint she filed against the doctor at Summerlin Hospital Medical Center. 

“It’s just mind boggling that it has to get that bad  before you’re believed,” she said. “Being in public health and  working in health equity … I just do it because I know that there are a lot of people who don’t have the ability to advocate for themselves, who would have to gone home and died.” 

There are no statutes that require anyone or any organization to report discrimination complaints to the state, said Kendall Holcomb, the public information officer for the Nevada Department of Health and Human Services.