On the day of my white coat ceremony, I felt like a pretender. I squirmed in the rigid, wooden seat, staring at the gilded columns and towering proscenium of the hall, wondering when I’d be found out. I imagined them calling me to the stage, slipping on the coat, then seeing me in it and saying, “Well, that doesn’t look quite right.”
I must have worn my thoughts like a billboard on my forehead, because the Dean of Yale School of Medicine read my mind. “I’m sure you’re all feeling a bit of ‘impostor-syndrome’ right now,” he said, “but trust me, admissions doesn’t make mistakes.”
Maybe I’m not alone, I thought.
When the speaker, Dr. Miller, rose to the stage, he began talking about the meaning of the white coat. I felt excited: whether I deserved it or not, I would soon wear that coat like a stamp of approval on my dreams.
Dr. Miller told a story of a patient he’d never met, but who had recognized Dr. Miller in the hospital as a physician.
“When I asked him why,” Dr. Miller continued, “he told me, ‘You just look like how a doctor should look.’”
I squinted at him. I tried to see what that patient had seen. Behind the podium, I saw an older, white man with pink cheeks, glasses, a tie, and yes, a white coat. I scanned the stage and saw several of his lookalikes: all white, almost all men, as though the feature figures of so many Norman Rockwell paintings had come together to celebrate how good and ‘doctorly’ they looked.
Not one of them looked like me. Me, with the dark curly hair, the deep olive skin, and the high cheekbones that hint at my distant indigenous ancestry.
I knew then that my instincts had been correct: that I didn’t fit the mold of a Yale-educated doctor. That knowledge steeled my resolve to prove them wrong.
I rose to the stage and reached my arms into the white sleeves my professor held behind me. I decided then to think of my white coat as a prop in a costume box: when I wore it, I would transform myself into someone fantastic, like a doctor, and no one would question me. My childhood beliefs on dress-up made it simple: glitter dress plus tiara equals princess. Thus, white coat plus stethoscope equals doctor. I looked forward to playing that part.
After the ceremony, I slapped on an extrovert’s smile and dove headfirst into medical school. I began to feel different from my classmates early on in orientation.
“Where are you from?” they would ask, one or two questions into the conversation.
“New Jersey,” I would answer, pressing the edges of my spurious smile. They would nod and emit a bemused “oh.”
“I thought you looked more ethnic,” one said.
More ethnic, I mused. The term prompted me to wonder how much of my heritage could be read in my skin.
As I sat with these classmates in lecture, a parade of white men imbued me with knowledge of signaling pathways and cranial nerves, but my professionalism instructor couldn’t distinguish between “ethnicity” and “race.” That lecture on health disparities faltered at the sound of his uncertain fingers scratching the stifled skin under his collar.
Later in the anatomy lab, our surgeon preceptors sidled up to the one man in my group — a tall, black man from Zimbabwe — and guided his hands through the most complicated techniques. I, and the two other women on my dissection team, craned over their shoulders, trying to broach this forbidden space where male surgeons primed their kind for prestige.
Worst of all, despite my white coat costume, my patients saw through me.
“Let’s talk about the difficulty breathing,” I began, practicing the phrases I learned in class. “Start with how it began and walk me through today.” Our patient looked up from her bed, right over my five-feet and one inch, and spoke directly to the white man in my group. I plucked the hangnails on my fingers as I nodded along to her story.
Before coming to medical school, I was hopeful. I believed that my understanding of color discrimination, of privilege and power dynamics, and of gender and sexual diversity would allow me to treat patients with greater sensitivity. I felt confident that my scholarly framework for social inequities would enable me to combat them. I trusted that my words, so saturated with compassion, were enough to forge bonds with the people I’d serve. I had not anticipated that I would become the object of my own inquiries on social justice: that my gender expression, my size, and my skin color would be the variables I’d study in evaluating my shortcomings as a developing physician.
I’ll be a doctor someday, but I might not be the kind that the patient in Dr. Miller’s story expected. I’ve learned that some of us — those with deeper complexions, short stature or unmasculine bodies — might be destined to pretend. So, I’ll put on my white coat and put on a good show. I will make-believe enough to make my patients believe in me.