Black People’s Pain Has Long Been Underestimated. It’s Time For That To Change.

Illustration by Ojima Abalaka (Women's Health)
Illustration by Ojima Abalaka (Women's Health)

Melissa Connelly watched as a nurse coaxed her wife, Kim, awake following her colonoscopy on November 4, 2020. Drowsy from the anesthesia, Kim couldn’t hold a can of ginger ale to her lips, so Melissa did it for her.

The nurse explained to Melissa that the procedure had gone well, but Kim would feel a bit woozy. Before heading home, Kim, who’s an ICU nurse, was able to ask about the drugs she’d been given. The nurse told her they had administered 5 milligrams of the sedative Versed and 100 micrograms of the narcotic painkiller Fentanyl.

Nearly one month later, on December 2, 2020, Melissa, who’s Black, was admitted to the same major Midwest hospital, this time for her own colonoscopy. She had the same doctor and support staff as Kim, who’s white and Asian.

Once the anesthesia was administered, Melissa says she was still conscious, though “slightly loopy.” And for a while, she watched her procedure play out on the monitor. She knew it wasn’t unusual to remain slightly alert and experience some sensation following sedation, so she wasn’t worried at first. “However, at some point, it hurt to the point that I audibly cried out, ‘Ow, that hurts. I can feel that.’” In response, Melissa was advised to “breathe in through your nose and out through your mouth.” She was shocked. “I remember thinking, ‘You’ve got to be kidding me. That’s the best advice you have?’”

When the procedure was over and Kim came to meet Melissa, Kim remarked, “You’re so awake!” And when Kim noticed Melissa was able to hold her own apple juice, Kim asked the nurses, “How much [sedation and pain relief] did she get?” The nurse replied, 3 milligrams of Versed and 50 micrograms of Fentanyl. Neither woman had a certified registered nurse anesthetist on their surgical teams, meaning it was the doctor himself who decided what their respective doses of anesthesia would be.

At the time, Melissa, who’s 37, outweighed a then-34-year-old Kim by 20 pounds. She’s also 2 1/2 inches taller, and, like Kim, has no underlying health conditions. Still, Melissa received only a half of the drugs her wife did. And when she felt pain, Melissa was expected to manage it on her own.

“I couldn’t have done a better ‘lab experiment’ than to have two identical scenarios and such a different level of treatment,” Melissa says.

Numerous studies investigating racial disparities in healthcare indicate that Black people’s pain is often perceived to be less severe than that of their non-Black counterparts.

“Racial disparities in healthcare, both access to care and quality of care, are the product of systemic racism and individual prejudice,” says Sophie Trawalter, PhD, associate professor of public policy and psychology at University of Virginia, whose research focuses on social diversity. The evidence is compelling, she says, and speaks for itself.

Garrett Hall at Sunset

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