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It is the first day of residency. The excitement about starting a new chapter in one’s life is mixed with the disorientation of acclimating to a new environment. Two colleagues, one African American the other Caucasian American, both experience the same mixed feelings as they approach the operating room case board to find their patient and begin their first case. As they stand at the board, the charge operating room nurse approaches the interns and asks the African American intern if she is “the help.” The African American intern is taken aback by comment but calmly responds, “No. I am a resident looking for my patient.” This scenario occurred in 2005, but still resonates with that doctor to this day. She did not know it at the time, but she was a victim of microaggression. While the conversation ended abruptly and no further events from that conversation evolved, the interaction made a lasting impression on the physician.
Microaggression
Microaggression was first coined by psychiatrist, Dr Chester Pierce, in 1970. Dr Pierce originally used this term to describe the continuing stain of racism in the United States (US) in a more subtle form than during the Jim Crow era. 1 As racism, sexism, and discrimination have become less blatant since the civil rights era, more insidious forms of discrimination, as with microaggressions, have evolved. 2 The term microaggression expanded in 2007 to include all minority groups as well as marginalized communities that may not “fit” into accepted societal standards. It also now includes both verbal and nonverbal exchanges. 3 According to the Oxford dictionary, microaggression is “a statement, action, or incident regarded as an instance of indirect, subtle, or unintentional discrimination against members of a marginalized group such as a racial or ethnic minority.” 4 Microaggressions can be a conscious or unconscious microprejudice. Furthermore, there are four subtypes of microaggressions: microassaults (the “old fashioned” discriminatory statements); microinsults (subtle snubs or humiliation that convey a demeaning message to the recipient as noted in the introductory scenario); microinvalidations (statements aimed to exclude, negate, and dismiss personal thoughts, feelings, or the experienced reality of a person); and environmental microaggressions (occur when microassaults, microinsults, and microinvalidations are reflected in the culture, process, and climate of the workplace).2,3 A...