The team behind STAT’s ‘Color Code’ podcast shares how they approach stories of racism in health care

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By Kellie Schmitt

When health journalists interview patients, they tend to seek verification and evidence of the source’s experience. In accounts of medical racism, though, simply asking those questions can reinforce the trauma patients have experienced.

“In many cases, that’s almost like gaslighting your sources,” said STAT’s Nicholas St. Fleur, a reporter and host of the “Color Code” podcast.

That’s why St. Fleur emphasizes listening to patients when they voice their experiences of medical racism and health inequities, he said in a recent Center for Health Journalism Health Matters webinar. St. Fleur joined STAT multimedia producer Theresa Gaffney to share the eight-episode podcast’s patient-centered and often rather personal approach to documenting racism and inequities in the health care system.

Exploring inequities and racism 

The eight-episode “Color Code” series covers diverse topics ranging from diversity in clinical trials to bias in health care artificial intelligence. The team began their podcast journey with story ideas of health care inequities.

One episode investigated the historical roots of “excited delirium,” a controversial term often used to describe a state of “superhuman strength,” aggression and agitation. The team explored its origins in a medical examiner’s office in Miami during the 1970s and 80s drug crisis, Gaffney said. Even though the wider medical community now opposes the term as a medical diagnosis, it is still used in police encounters to justify the use of excessive force, disproportionately against Black men.

Another episode described the medical tragedy of Black children in an Indiana town in 1927. After a ringworm outbreak, these children received a radiation treatment. The parents reported being misled about the experience, St. Fleur said. The podcast focuses on a now deceased man who was left with a deeply scarred scalp for the rest of his life after receiving high-dose radiation at age 5. He was forced to hide the wound under a wig he wore the rest of his life.

“It’s horrific to see,” St. Fleur said. “Can you imagine just how visceral that was? How heartbreaking to have been the victim of this as a young kid?”

The episode poses the question of how to rectify the toll of medical tragedies like this in American history, St. Fleur said, and broaches the broader question of reparations: “What is owed?”

Focusing on patients’ feelings

The podcast highlights the validity of a patient’s feelings and emotions surrounding a particular health encounter or experience. The patient is seen as the expert on their own experience, and their stories are told in a firsthand way.

“In many cases, we do take people at their word when it comes to how they felt or how they experienced moments of racism,” St. Fleur said. While his team’s reporting does seek the perspective of health systems when possible, he noted that medical providers are unlikely to attribute their own actions to racism when confronted with such instances.

In an episode featuring Black maternal mortality, the focus is on the mistrust that results when a patient feels ignored. Instead of interviewing other parties to get their impression of the events, the focus of the narrative is on the patients’ own experiences as they walk away.

The podcast sets these individual episodes in a broader context by speaking to experts such as doctors and other medical providers about the racism they witness. They link to other reporting in case readers want to follow up and learn more.  The team also fact checks coverage when appropriate. In the ringworm case, they contacted a local historian to ensure the documentary’s account didn’t raise any red flags, while the “excited delirium” episode involved a reporting trip to Miami that added important context.

A transparent, open and personal approach

St. Fleur describes his podcasting approach as being open and “super transparent” with sources. When appropriate, he’ll consider bringing his personal experience into stories, such as a 2021 piece he did for STAT documenting his own colonoscopy.

The podcast offers an avenue for St. Fleur to share firsthand experiences with racial bias in a narrative way and offer his impressions of the featured stories.

“It’s bringing my whole self, not hiding my emotions, realizing, Hey, this really affected me and I’m going to share with you why, and why I think it’s important for us to delve into this story,” he said.

For example, in one episode he shares how he might have responded in a similar fashion to Elijah McClain, a 23-year-old Black man who died after Colorado police restrained him. Experiences like this “emotionally wreck us,” St. Fleur said. It wouldn’t have felt right to cover this story in the podcast without discussing how he personally processed the events, he said.

“I try my best to bring my whole self to what I’m reporting … why should I hide my emotions or how these stories impact me?” he said. “It allowed me to be vulnerable and share a bit about what goes through my head when I see these things.”

Kellie Schmitt

Showing those emotions centered the episode and offered the authority of St. Fleur’s own lived experience, Gaffney said.

Throughout the discussion, St. Fleur returned to the importance of truly listening to one’s sources and their experiences, rather that challenging them on the details or their experience or narrative of events.

“I make sure the questions I’m asking are asked with compassion and empathy and that I don’t give off the notion I am particularly doubting their experience because, in so many of these cases, that’s where the problem comes from,” he said.

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