First Person: Representation Matters in Medicine

First Person: Representation Matters in Medicine

My skin signals a message of reassurance to patients before I utter a word.

A distinct memory I have from my childhood in Sacramento, California, is overhearing my dad taking calls from worried parents. He has been practicing as a pediatrician for 25 years and answers every call with patience and compassion I deeply admire. As I grew older, my father started sharing some of his patients’ stories with me, and I began to realize I wanted to work in medicine and focus my career on work­ing with teenagers.

I felt a duty to give back because of privileges I had that helped make my path easier than most: college-educated parents, an upper middle-class household and a private education. Many aspiring doctors, especially from Black communi­ties, do not have these same resources, and I aspire to widen the path for those coming behind me through mentoring.

As a Black girl growing up wanting to be a doctor, I became aware I was the personification of my parents’ and communities’ dreams. I’d often hear, “Your parents must be so proud.” And, of course, they were. But I also put a lot of pressure on myself. I’d cry if I received a B grade. I’d stay up late studying. I was constantly trying to prove I was good enough.

My hard work paid off; I graduated valedictorian of my private school and attended Stanford majoring in human biology. I learned about my current field of adolescent medicine while at Stanford after my father intro­duced me to a doctor in that field at his hospital. I realized this was a way I could be a doctor and still talk to young people about their needs beyond physi­cal health. Asking them about school, friendships, home and much more would be a part of my daily routine.

When I was accepted to University of Pennsylvania for medical school, it felt like I had made it. Less than 3% of doctors are Black, female physicians, and I was on my way to becoming one. Carrying the weight of my community initially felt like an honor.

I’d smile brighter when a Black patient shared how excited they were to see me, or a high school student revealed how much she looked up to me. I spent extra time with patients and drew pictures to explain their conditions. I helped countless students with school applications and spoke on panels about careers in medicine.

Bolstered by confidence from my suc­cesses and the image they presented to others, I never expected I might fail. But, in my second year of medical school, I failed three exams in a row. I was devastated. I couldn’t conceptualize how to move forward because of the sense I had that Black people are not allowed to fail. When we do, there is a risk of dis­creditation. Our hard-earned successes can be excused as affirmative action, and our failures can become justification for denial of opportunities.

The dean of the medical school sat across from me, trying to understand why I had failed: “Did you have problems with tests before? Are you depressed? Stressed? Struggling with a learning dis­ability?” We planned for my remediation without ever acknowledg­ing the true answer: I am human. And as a human, I can make mistakes.

Today, as a fellow in adolescent medicine, I live out my dreams. I help adolescents and their families navigate life’s challenges. My skin signals a message of reassurance before I utter a word. One mom shared that I was “a god­send” when she saw my picture online. Another time, a young person said, “I feel like you’ll really hear me,” as soon as I walked in the room. I am evidence that representation matters.

The last year has shone a bright spotlight on racism across all sectors, including health care. The coronavirus pandemic has revealed the long-standing health inequities that communities of color struggle with. Those inequities are often what inspire Black physicians like me to serve. I strive to do right by my patients and live up to the standard of care they seek.

Yet sometimes, I disappoint my patients through miscommunications or a genuine mistake. “To err is human” and yet, doctors often feel greater guilt because our work involves people. For me, disappointment can feel like I have let a whole community down.

I wrestle to give myself grace, all while carrying the knowledge of historical trauma, the experiences of discrimina­tion I have witnessed in my training, and the hopes of the community that raised me. I take all of that into every exam room I enter.

I am learning to lighten the load through vulnerability with family and friends, therapy and humility. My therapist points out even though my responsibility has increased as a fellow, I am still learning. I also remind myself I am only one person in a collective effort to promote health equity. The responsibil­ity does not fall only on me. My contributions are only a small part of a larger movement.

I feared that every deviation from my “straight A” path would derail my dreams of becoming a physi­cian until failure taught me I could pick myself up and keep going. Whenever I share my experiences with medical students, I encourage them to find their passion, the area of medicine that helps them come alive.

The pressure to do right by your community lessens when you love what you do and seek to do it well. I hope the communities I serve can see me with the same kindness I try to show to my students. I hope they know I will continue learning, own my limita­tions, and do my part to uplift others. I cannot be perfect, but I can, and will, keep showing up.

Written By:
Rebekah Fenton, MD
Adolescent Medicine Fellow, Ann & Robert H. Lurie Children's Hospital of Chicago

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