As we ask how academic medical journals accept blatantly racist articles, I am reminded of the reviewer comments I received last year for an essay that was ultimately rejected. 1/

I had written about a Black male patient with untreated mental illness, substance use disorder, and a chronic medical condition that kept landing him in the ICU. My essay was about the moral distress of tinkering with someone’s medications while being unable to change systems. 2/

I forgot to mention this patient was also homeless. I said I didn’t know his exact circumstances but attributed racism, the War on Drugs, and housing inequities as reasons why he kept coming to the ICU. 3/

Reviewer 2 suggested some readers would think the patient was responsible for his circumstances. 3 said “would omit the reference to racism.” 4/

I’m not saying this was a great essay or needed to be published. But it was ultimately rejected. And I find it interesting that when I unearth my own struggle with depression, medical journals love it. But when I name racism without “proving it” then that’s too much. 5/

I think it’s a lot easier to stomach the idea that something was wrong with me that I needed to overcome rather than something is very, very wrong with our society. Nothing I said in this rejected essay was controversial. I can’t even imagine the comments other writers get. 6/