Tamika Cross is the young African-American physician in the Delta plane incident that took place last week. Her Facebook account of the reluctance of a flight attendant to let her examine a sick passenger went viral, and the mainstream media promptly picked up the story.  Delta and the anonymous flight attendant were hit by tsunami of righteous indignation. (A BET headline expressed the consensus, if a bit luridly: “Delta Airlines Almost Let A Man Die Because They Didn’t Believe this Black Woman was a Doctor.”)

But like a lot of tales of the persecution of African-Americans by European-Americans, the story’s worth another look.

Here’s how the drama unfolded:

1.  When a woman two rows in front of her was “screaming for help” because her husband was “unresponsive,” Dr. Cross did not identify herself as a physician to the flight attendant:

I naturally jumped into Doctor mode as no one else was getting up. Unbuckle my seatbelt and throw my tray table up and as I'm about to stand up, flight attendant says "everyone stay calm, it's just a night terror, he is alright". I continue to watch the scene closely.

The flight attendant had no way of knowing that the young woman in dreadlocks was a doctor.

2.  As Dr. Cross recounts the story, “A couple mins later he is unresponsive again and the flight attendant yells ‘call overhead for a physician on board’. I raised my hand to grab her attention.”

What the flight attendant probably said was, “If there is a physician on board, please press your overhead call button.” Dr. Cross failed to do this.

Then, according to the 4th year resident, “I tried to inform her that I was a physician but I was continually cut off by condescending remarks.”  It’s not clear what happened here, but all she has to say is “I’m a doctor.”  It wouldn’t be easy to interrupt that brief sentence with a condescending remark.

3.  The request to press the call button was now repeated over the public address system, and this time Dr. Cross followed directions. When she did, she was recognized as a doctor and was asked for her credentials. While this brief interrogation wastes time, as Cross complains, it’s not hard to see why Delta requires flight attendants to do this, unless the doctor happens to be carrying around his or her ID badge. The airline could be liable if it permitted someone unqualified to treat a patient during a flight. According to Dr. Cross, she was asked, “What type of doctor are you?  Where do you work?  Why were you in Detroit?"  The third question is irrelevant, and if it were asked, it shouldn’t have been. The first two are perfectly legitimate.  Providing her credentials should have taken about thirty seconds.

4.  According to Dr. Cross, what happened next was that

...another [sic] “seasoned” white male approaches the row and says he is a physician as well. She says to me "thanks for your help but he can help us, and he has his credentials". (Mind you he hasn't shown anything to her. Just showed up and fit the "description of a doctor") I stay seated.  Mind blown. Blood boiling.

It never occurred to Dr. Cross that the male physician may have followed directions, pressed his call button, and then provided his credentials to another flight attendant before proceeding down the aisle.

5.  Then, says Dr. Cross, “this heifer has the nerve to ask for my input on what to do next about 10 mins later.” 

I suspect that Cross doesn’t realize that the flight attendant had recognized the potentially grave consequences for her having permitted the older, experienced white physician to examine the passenger instead of a young African-American female, and is trying to placate the 4th year resident.

Cross continues:

I tell her we need vitals and blood sugar. She comes back to report to me a BP of 80/50 (super low, to my non medical peeps) and they can't find a glucometer. We continue down that pathway of medical work up, but the point is she needed my help and I continued to help despite the choice words I had saved up for her.

No, the flight attendant didn’t need Dr. Cross’s help.  All commercial airplanes are required to carry sphygmomanometers on board, and apparently the other physician knew how to use one, and was probably also aware that 80/50 is a very low bp. 

6.  The “heifer” now begins to panic. Her career is on the line for having offended this young African-American woman.

She came and apologized to me several times and offering me skymiles. I kindly [sic] refused. This is going higher than her. I don't want skymiles in exchange for blatant discrimination. Whether this was race, age, gender discrimination, it's not right. She will not get away with this.... and I will still get my skymiles....

Bottom line: if Dr. Cross had done as instructed, pressed the call button, informed the flight attendant that she was a doctor, and provided her credentials, there’s little reason to doubt she would have been permitted to examine the patient. 

Once upon a time, people of all races were taught that the decent, honorable thing to do is to accept a sincere apology.  You forgive that you may be forgiven, in St. Francis’s words. That era is history.

In any case, it looks to me that Dr. Cross boarded the Delta flight with a good-sized chip on her shoulder:

...last July, she posted about how Independence Day in the US did not originally stand for independence for blacks. It was, according to Dr. Cross, an inequality that still stands to this day. She punctuated this with instances of innocent black men shot by the police shortly after the 4th of July.

“Shackles don’t define bondage… the mentality of this country certainly does,” Dr. Cross wrote on the Facebook post, “Black people, you never were intended to share the equal liberty as others in this country, and you still aren’t today in 2016.”

This is the kind of statement that tells us a great deal more about the writer than about U.S. history or contemporary America.

But there is a reality behind Dr. Cross’s Facebook story. 

Among the 20,627 students entering med school last fall, just 793 (3.8%) were African-American women, vs 2,029 (9.8%) Asian women.  (Asians are 5.6% of the American population, blacks 13.2%). The two previous years, the figures were 734 and 712. A 2010 AMA study found that 6.3% of U.S. MDs were African-American, Black women making up 55.3% of this group. A more recent study put the figure at 4%. There’s no question African-Americans are underrepresented among U.S. physicians.

But who’s responsible?

Much as they would love to increase minority enrollment, medical schools do not have the latitude of undergraduate institutions in admitting unqualified and unprepared African-Americans. You cannot get through med school without having demonstrated a certain level of proficiency in undergraduate biology, chemistry, physics, and math. It’s costly to flunk med students and the schools haven’t been doing this for some time.  Courses are pass/fail, and you retake those you fail.

Two medical schools cater to African-Americans, Howard and Meharry. Between 1950 and 2004, the two graduated 3,335 and 2,771 physicians respectively.  The University of Illinois was a distant third, with 713.  Whites are eligible to attend both of the historically Black schools, of course, but you have to have a history of service to the African-American community and write a persuasive personal statement. 

Meharry and Howard students have an average MCAT (under the old scoring) of 27. A score of 30-31 puts you in the 80th percentile, and it’s extremely difficult to get into a good med school with anything below this. As it happens, Dr. Tamika Cross is a graduate of Meharry.

But even with the output of Howard and Meharry, both of which are small schools, African-American doctors are rarae aves in most hospitals and on insurers’ lists of eligible physicians.

In any case, perceptions of who might be a doctor have a lot more to do with gender than race.  Patients will sometimes address questions to male residents or 4th year med students rather than to the female attending physician, and, because doctors in most hospitals no longer wear white coats, patients will occasionally ask female doctors to empty their bedpan. 

The way to avoid this is for the attending to introduce herself to the patient, and introduce the residents and students accompanying her.  Good manners, in other words. Good humor is essential, too. Though med school enrollments are now almost equal, older patients in particular will continue to mistake female physicians for nurses, and a doctor who lets her blood boil is not acting as a medical professional.

The American novelist and diplomat Brand Whitlock once wrote, “There is this terrible and fatal quality in all writing, which should no doubt adjure us all to silence -- namely, that no matter how imperfect a picture the writer gives of everything else, he always draws a perfect portrait of himself.”

Tamika Cross’s account of the incident on the Delta flight reveals that she failed to follow simple directions, was unable to communicate clearly and intelligibly, and was unwilling to accept a sincere on the spot apology.  Her 4th of July ruminations strike me as a cartoon image of America.  Dr. Cross’s final statement in her Facebook post tells us everything we need to know about her: “She will not get away with this.... and I will still get my skymiles....”

Jay Michaels (as Josh Michaels) is the author of the novel Outlaws.