Welcome to Small Talk, a series where we catch up with the internet's favorite Extremely Online individuals offline.
Did you know some doctors are taught that black skin is thicker than white skin(opens in a new tab)? Or that even the so-called data-driven algorithms used by doctors and hospitals to calculate doses have racial biases?
Those are the types of big questions that Joel Bervell, a third-year medical student at Washington State University, is asking his 331,000 TikTok followers(opens in a new tab).
Bervell created his TikTok account in 2019 during a busy first year of med school. What started as a place to share his experiences as a med student, scholarship tips(opens in a new tab), and more college-friendly advice has become a popular source for medical myth-busting that focuses on racial biases.
The 26-year-old creator calls himself a "third-culture kid." He was born in Canada and raised in Seattle, Washington, but his family made frequent visits to Ghana, where his parents are from. Bervell received an undergraduate degree in molecular cellular developmental biology (a mouthful, he says) at Yale University, and he now lives in Portland, Oregon.
Bervell's already made quite an impact on TikTok. He was recently featured on the platform's Discover List as an up-and-coming Changemaker(opens in a new tab), and he now shares content to his 51,000 Instagram(opens in a new tab) followers. He hopes his videos will help enlighten the general public and fellow future doctors, many of whom aren't being properly educated(opens in a new tab) about how biases manifest in diagnosis and treatment.
I spoke to Bervell about the nuances of translating life-threatening realities through a medium that often spotlights dumb pranks, memes, and generally light-hearted content.
Mashable: What inspired you to make your TikTok account? Was it for the memes in the beginning, or did you immediately know you wanted to educate others?
It was definitely for the memes. I think that's why everyone first gets on TikTok, right? My first video was actually way back in December 2019... It was about me transforming into Dr. Burke from (opens in a new tab)Grey's Anatomy(opens in a new tab). And I can't remember what the trend was called, but it had this song. It was like, "Dun, dun, dun-dun, dun, dun." And when the beat dropped I transformed into Dr. Burke. I posted that video and it got like 80,000 views!
After I finished my first year at medical school, I posted like a "My name's Joel, and here's what a year in medical school looks like" video(opens in a new tab). And I made sure to add the fun bits of [medical school], too, [like] my friends dancing outside [and] the fact that I didn't like learning how to use an ultrasound. People loved that video... It seemed like a new way to talk about medicine and combine my love of creating different content.
And when did you start making videos about race and medicine?
I think the transition into more serious content came during COVID. I had seen this article(opens in a new tab) someone posted online — one of the physicians I followed — talking about a device called a pulse oximeter. You put it on your finger and it measures your blood oxygen saturation level. The study said that the pulse oximeter has the ability to actually overestimate blood oxygen aspiration levels in people who have darker skin.
I did a deeper dive and realized research about it had been out for decades — like for more than ten years — but there's no warning by the FDA, which oversees medical devices. Nothing. So I created a video about that(opens in a new tab) [to say] "This is exactly what racial bias looks like."
As a med student, is there a push in the medical field to have these conversations more often? Or do you feel like your content is filling a gap?
I'd say both. I think there's a big push right now, but the problem with the medical field is it moves slow, which is good and bad. It moves slow because, of course, you want to do due diligence and make sure you're not creating more harm. But I think this is one of the issues that needs to move fast. Medical education needs reform. There are so many medical schools and there isn't a standardized curriculum.
What's the process like for creating one of your videos? Do you just see something at school and feel like you need to talk about it? Are you reading studies that inspire you?
I'm just kind of going through life. I'll see something in clinic(opens in a new tab) and use my Instagram or my TikTok account to tell a story about what happened and the lessons I learned... For example(opens in a new tab), a patient came in once and talked about how her daughter, when she was younger, had these spots on her back. Her daughter was darker-skinned, and physicians thought the spots on her back were bruises. The woman ended up having Child Protective Services called on her. But in fact, those [spots] are actually normal in babies. It's just a skin condition that fades over time.
I do my own research, too. I'm always trying to stay up to date on the literature in the New England Journal of Medicine(opens in a new tab). I've [also] connected with a lot of the researchers who are doing the primary research on [these topics], which has been pretty cool. Now I follow them on Twitter, and if they post something, I'll ask to make a video.
What's the response to sharing videos about racism in medicine online? Is there a different response to videos you post on Instagram versus the ones you post on TikTok?
There've been a few times where people have tried to say something isn't true, but I'll just say, "Hey, here's the article. Here's the research. Go read it. If you have things you don't believe, let me know and I'm open to conversation." I treat my page really as a community where people can discuss things. And I don't think there are any stupid questions. I think there are only questions that you've maybe not been exposed to yet.
I have a lot of physicians on my Instagram, so it's doctors who understand this work... If someone asks a question, there's a physician who can jump in and say, "Hey, actually I've been practicing for 10 years. Here's some more information. Here's a research article about it."
You have more than 330,000 TikTok followers, so you probably pop up on random people's feeds all the time. You might engage with people that normally wouldn't want to engage with your content.
Actually, that's why I love TikTok. I think a lot of the people who comment on [my videos] are like, "I have never thought about this before. And I probably won't think about it again, but you changed the way I view it." I think the biggest example of that is the dermatology series(opens in a new tab) I'm doing right now.
There are a lot of disparities when it comes to dermatology, because in medical school we're not really taught how to see things on darker skin And, similarly, you can't search what it looks like. If you go to Google and type in, like, "Lyme disease," it's going to come up with white skin. It's not going to show what a rash looks like on a darker skin.
If you had to direct a new follower to one video or one series on your page, what it would be? Where should they start?
I think the dermatology series is so great for visuals. You can see the difference right off the bat. The racial bias series(opens in a new tab) is good, because it's 30-second videos and I go through everything from racial bias in technology...to racial bias in the NFL(opens in a new tab), like the concussion payouts(opens in a new tab) they have. It really gives the full picture of how this stuff in medicine doesn't just impact medicine. It actually impacts every other sector of the world.
So you cover huge, potentially life-threatening topics. How do you deal with that level of seriousness on an app like this?
I was a little surprised when I started getting a following, because I was like, "This is very different than some content that's on TikTok." It's more serious, and it's also medicine, which not everyone understands.
The way I try and really balance that out is by not just making it "Here's a scary thing," but "Here's a scary thing, and here's a possible solution." I think blending [a serious topic] with ongoing TikTok trends is an interesting way to, not make it lighthearted or take away the seriousness, but to make it more palatable to people.
Sharing this information seems like a kind of double-edged sword. You want people to question biases in medicine, but you don't want to discourage them from getting treatment.
My biggest problem in medicine is there's always a paywall behind information for research... I think it's such a disservice to the general population to not be able to see this until it's reported in the New York Times, or Mashable, or the Washington Post, or somewhere else. My goal is to make this information more accessible and easy to understand, even if people don't have access to those places.
It's a hard balance for me to strike, not wanting to feed the distrust. But I also think it's important that this information is out there.
I feel like I've actually been building trust because of the content I'm putting out — partly because I'm tackling things that people feel they've always been seeing, but that hasn't been overtly said. It's like someone feels heard for the first time.
This interview has been edited for length and clarity.
UPDATE: Nov. 5, 2021, 3:04 p.m. EDT A previous version of this article incorrectly identified Bervell's birthplace as Kansas. He was born in Canada.
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