'I'm a Black Doctor. I Feel the Weight of Representing My Community'

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 general pediatrician for 25 years and answers every call with patience and compassion that I deeply admire.

As I grew older, my father started sharing some of his patients' stories with me and I began to realize that I also wanted to work in medicine, but that I wanted to focus my career on working with teenagers.

However, as a Black girl growing up wanting to be a doctor, I became aware that I was the personification of my parents' and communities' dreams. At church or community events, I'd often hear, "your parents must be so proud." And, of course, they were proud of me. But I also put a lot of pressure on myself, creating higher standards than anything my parents ever expected of me.

I'd cry if I received a B grade. I'd stay up late studying. I was constantly trying to prove that I was good enough. My hard work paid off; I graduated valedictorian of my private school and attended Stanford undergraduate majoring in human biology.

I learned about my current field of adolescent medicine while at Stanford, after my father introduced me to a doctor working in that field at his hospital. Through talking to her about her work, I realized this was a way I could be a doctor and still have the opportunity to 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 percent of doctors are Black, female physicians and I was well 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 they looked up to me. I spent extra time with patients and drew pictures to explain their conditions. I helped countless students with applications and spoke on panels about careers in medicine.

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 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. "To whom much is given, much is required", I'd tell myself.

Bolstered by confidence from my successes and the image they presented to others, I never expected that I might actually fail. But, in my second year of medical school, I did exactly that; I failed three exams in a row. I was devastated. I couldn't even 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.

Black doctors, black female doctors, community
Rebekah Fenton is a adolescent medicine fellow in Chicago. As a Black doctor she sometimes fears that in failing to be "perfect" she may be letting her community down. Rebekah Fenton

The dean of my medical school sat across from me, asking questions to try and 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 am capable of making mistakes, just like anybody else.

Now, as a fellow in adolescent medicine, I finally get to live out my dreams. Every day in clinic, I sit with adolescents and their families, and help them navigate through life's challenges. Moving to Chicago felt like an opportunity to serve a diverse patient population, especially Black and brown youth.

My skin signals a message of reassurance before I even 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.

This year has shone a bright spotlight on racism across all sectors, including healthcare. 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.

Doctors, Black Doctors, Black Women
Rebekah Fenton was a pediatrics resident at Seattle Children's hospital before taking her current position as adolescent medicine fellow in Chicago. Rebekah Fenton

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, as a Black physician, disappointment can feel like I have let a whole community down. I sometimes fear I am perpetuating the very inequities I strive to correct.

I wrestle to give myself grace, all the 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 that even though my responsibility has increased as a fellow, I am still learning in this new role. Learning is a communal experience for me. I debrief with the social workers in my clinic to process patient interactions. This helps me decide how best to move forward in a way that respects the patients' experiences.

I also remind myself that I am only one person in a collective effort to promote health equity. The responsibility does not fall only on me. My contribution to care for Black and brown patients and advocate on their behalf is only a small part of a larger movement.

We live in a world that values perfection and in my experience, particularly from Black women. I aim to bring visibility to those of us who try our best, make mistakes and learn from them.

Speaking out about my own journey makes me feel less alone. My vulnerability allows others to see themselves too.

Perfection is not only a myth, but its perpetuation isolates us in our faults. 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 also tell them my success and failures to show there is no singular, perfect path to medicine. We all fall short of our own expectations at some point(s) in life and we succeed when we learn how to overcome them. Many recognize their own missteps in my stories and find greater hope for their future success.

I hope the communities I serve can see me with the same kindness I try to show to my students. I hope they know that I will continue learning, own my limitations, and do my part to uplift others. Because I cannot ever be perfect. But I can, and will, keep showing up.

Rebekah Fenton is an Adolescent Medicine Fellow at the Ann & Robert H. Lurie Children's Hospital of Chicago. Fenton was previously a pediatrics resident at Seattle Children's Hospital. You can follow her on Twitter @RFentonMD

All views expressed in this piece are the author's own.

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