On Last Week Tonight, John Oliver argued for an honest discussion around gender and racial bias in medical care, noting that “if you are a woman and/or a person of color in the US, you may well have a very different relationship to our healthcare system than a white man”.

“Frankly, who better to talk at you for 20 minutes about this than me, the whitest of white men,” said Oliver, a self-described “walking cider donut – pale, filled with cake and found at every farmer’s market in the north-east” who gets a “sunburn while watching the Travel channel”.

Regardless, said Oliver, bias in medical treatment is a discussion we need to have in the US, around both sex and race.

On the issue of gender bias, Oliver cited numerous studies in which women were statistically misdiagnosed; a 2017 study found that women were less likely than men to be referred for knee replacements; another found that women over 50 and critically ill were less likely to receive life-saving interventions. This can be attributed, Oliver said, in part to dismissal of women’s pain as hormonal emotions, and a long history of studying male (as in assigned male at birth) bodies as a stand-in for all bodies.

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“Medicine has long chosen to believe that women are just hormonal men – or so children are tiny men, dogs are furry men, trees are big, hard still men, birds are men who can fly, fish are men who can glub and volcanoes are men who for some reason ejaculate lava,” Oliver explained on the logic of male bodies used in a study on, of all things, cancer risks for the uterus.

Moving on from gender, “if I may quote the inside of Donald Trump’s head when energy at one of his rallies seems to be flagging: let’s get to the racism stuff”, said Oliver, “because there is a huge disparity in life expectancy between black and white Americans, particularly black men”.

This “mortality gap” has numerous factors, Oliver explained, though he focused in particular on alarming misinformation and racist beliefs still floating through medical schools. One study from three years ago found that some doctors still believe there are “false biological difference between blacks and whites”; 25% of residents believed that black skin was thicker than whites’, for example.

Oliver was aghast at the findings. “Holy shit, you do not expect to hear that at a medical school,” he said. “You barely expect to hear it yelled across a table by a racist grandfather at Thanksgiving.”

He then pointed to a nursing textbook that was pulled just two years ago for its stereotypes on how different ethnicities describe pain. You expect textbooks to have typos or outdated information, Oliver said, not to “basically say that Hispanics think God is kinky and Native Americans will tell you wizard numbers”.

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The point, Oliver said, is that these misconceptions have tangible consequences. “Think about it: if a quarter of medical residents think that black people have thicker skin and nurses are being told that they think suffering is inevitable, that might lead to black people’s pain being treated differently.”

This bias was best articulated, he added, by Wanda Sykes, who recalled in a recent standup special how she was sent home from a double mastectomy with “ibu-fucking-profen” while white people are handed opioids “like they’re Tic-Tacs”.

Though some policies have been implemented to address specific issues – rules in California to fight the disparately high maternal mortality rates for black women – “clearly, we need to think much bigger here, and I know I am just not the best vehicle for this message”, Oliver concluded. So Oliver invited Sykes on the stage to offer comprehensive solutions based on personal experience.

First, doctors and medical students need bias training, Sykes said. “I know that doesn’t sound like fun, but it’s one of those things that’s not fun, but you should do it anyway, like reading with your kids.”

Second, Sykes said, “we need more non-white doctors in actual hospitals, not just the ones made up by Shonda Rhimes”.

And finally, until those two things are done, Sykes urged black women to advocate for themselves. “And if that doesn’t work, don’t worry: I’ve got a back up plan,” she said. “It’s called: bring a white man.”

Sykes then offered video clips of Larry David explaining symptoms “for every occasion”, from “lady heart attacks” to elbow pain, all of which were available for patient use on WhatsLarrysProblem.com.