At the Intersections: Conversations with Dr. Rhea Boyd
This article is first in a series of profiles highlighting empowering people from a variety of backgrounds.
Rhea was waiting for me at the South San Franciscan café we had agreed upon. With my camera bag slung loosely over my shoulder, tripod tucked under my arm, and notebook and bike handles in hand, I looked like an amateur videography junkie lost on the streets of South South Francisco (all in all, pretty accurate). Rhea caught my eye, noted my haphazard collection of baggage, and laughed. “Here I was expecting an iPhone interview!”
Rhea had graciously agreed to spend the afternoon sharing reflections and stories from her own her life journey, as part of a multimedia empowerment initiative called DiverseCity.
Rhea is a pediatrician whose chosen path involves splitting her time between the clinic and the community. For half of the week, she sees patients in the pediatric urgent care of Palo Alto Medical Foundation. For the other half, she leverages her medical expertise for community advocacy and empowerment. She is balancing two projects right now: one with the tech non-profit One Degree, which connects medical providers with resources to meet social needs; and another working to mobilize health leaders and criminal justice advocates to examine the impact of police presence on the health of communities of color. She is also a prominent growing voice in the pediatric health community, and she frequently shares her reflections on her blog, Rhea.MD.
Our conversation over the next several hours was many things: eye-opening, humorous, bracing, challenging. Below are some snippets, themes, and takeaways that I synthesized from our conversation. And because text alone cannot fully capture Rhea’s articulate and thoughtful reflections, I’ve also included videos of our conversation throughout to directly feature her voice.
Carving her own path
Reflecting back on her journey to medicine, Rhea says she had known for a long time she wanted to be a doctor. And not just any doctor: a pediatrician. She saw pediatricians as people who stood up for, and spoke up, for kids, and who had the power to understand and act upon social determinants of health in ways many other specialties did not.
In college at Notre Dame University, Rhea chose to craft her own major, Africana Studies in Health, where she dived into understanding the complex experiences of the African Diaspora and the ways social and environmental factors affected marginalized communities.
“I could not have gone through college and had as meaningful of experiences if I had to separate the two,” she says, referring to scientific medicine and social justice. “A lot of my interests are drawn from my own lived experiences as a black woman — realizing that life for me and family, is intimately related to where we work, where we play, where we go to school. And it is for everyone.”
She then takes a step back and acknowledges the challenge of this unscripted path. “There’s not exactly a wealth of places to find a job where you get paid for it,” she concedes with a small smile. Yet her approach was to keep piecing together small experiences that she felt were meaningful, throughout college and into her career as a physician. The very existence of her current career, and the growing momentum of her work, is testament to the possibility of blending the two into a cohesive whole. Her declaration to all those interested in pursuing a similar path: “I learned I can be a doctor and an advocate, one hundred percent.”
Early encounters with race and privilege
Questions of representation and belonging have been themes throughout Rhea’s entire career. Even now, as a physician at Palo Alto Medical Foundation, Rhea is the only African-American physician in either the pediatric or adult department.
But Rhea jumps back much earlier, to her formative middle school years and an experience that has shaped her worldview to this day. She and her sister had attended a predominantly-white Catholic school. On their way to school every morning, they walked past the predominantly-black middle school.
“I think of it all the time. I mean it was so stark. We would be these little black girls in uniforms on our way to our white school. And we would be walking through these older black kids [heading to their public school]. And yet, we were so different. They didn’t have packed lunches, they weren’t wearing uniforms.”
What did that experience mean to her? “At a really deep level, it never makes sense to blame poor people because they are poor, or to blame kids who don’t go to college for the fact that they don’t go to college, you know? I literally could have just as easily walked to the other side, if my parents hadn’t made the decisions they made. That they were fortunately able to make.”
She then brings this back to the question of representation facing medicine today, and why she chose to enter this field. “The ability of our field to care for poor and black people is proportional to how many poor and black people we bring to the top. So it’s so important to have more representation of the other — in all professions, but in medicine especially.”
Strength from insecurity
Rhea also had powerful words to share about keeping our insecurities and fears from stopping our work — because she knows all too well that struggle. In addition to being a physician, Rhea considers herself a writer (“I think in terms of writing,” she chuckles). While completing medical residency, she says she so deeply wanted to write about community health, to speak to issues she saw in the clinic and community, to contribute her voice to larger discourse. But another voice, the one inside her head, kept telling her that she wasn’t ready. She wasn’t yet a real pediatrician. She didn’t have enough to say. Her ideas weren’t credible. She did not write for many years because of this uncertainly.
“Finally, one of my co-residents and close friends told me, ‘You are already an advocate. Put your voice out there.’ So I started a blog as a medical resident, feeling very unsure of myself.” That blog was her first formal foray into writing. And through the act of starting the blog — taking a terrifying leap of faith, putting her work out there — she found herself, remarkably, starting to step into her own voice as a writer. She found others valued what she had to say. She built off that momentum, and now continues to write actively for various online sources, publishes regularly on her blog Rhea.MD, and has become a growing voice in the pediatric health community.
She reflects: “We can be shy or embarrassed about our greatest gifts. It’s funny: sometimes, the thing you are best at, you don’t want to display publicly. Sometimes, you have to put your own fears and insecurities aside, and be the person you imagine yourself to be. When you create that space of yourself, you also create that space for other people to put themselves out there. And you want to be a part of that.”
As a pediatrician, Rhea sees all manner of social issues masquerading as simple health problems. Just recently, she tells me, she saw a woman who brought her daughter in for a bug bite. The night before, she found a roach on her sleeping daughter’s face, so she feared it was a cockroach bite. She also shared that their family could not afford to leave the complex or to pay for pest control, so they just endured the roaches. They also endured other things, Rhea adds: gunshots, fear of leaving the house, chronic stress.
“That changes the game,” Rhea says, face stony. “You think they come in for something simple like a bug bite, which I can treat. But in reality they come in for safety…and I know my clinic doesn’t have anything for that. So I had to send her to another clinic — this woman, who came to see me on her work break, I had to send her to another clinic, one with a social worker. If that happened for everyone, that’d be unacceptable. You come in for antibiotics and we don’t have that — you’d be outraged. So it’s not okay that this is the standard of care.”
In many places, even today, this is the standard of care. We have the most cutting-edge tools to treat medical problems, but are woefully behind in addressing the root of those medical problems. Yet addressing rising rates of heart disease and diabetes will require more than better medical intervention; it will require understanding why some communities have disproportionately higher rates than others; how exposure to violence relates to health risks; how these issues can be prevented, rather than just treated. There are no easy solutions here.
Rhea acknowledges that this fight to bring awareness to social determinants of health can be tough, gritty, discouraging. Many aspiring physicians express a desire to work with underserved populations, only to be hit with the harsh reality of debt and school fees in medical school and be lured towards more “economically fruitful” paths. In addition, the problems at hand are large and change is oftentimes slow in coming. “Sometimes it’s hard to stay motivated. It’s such an uphill battle, to get these issues recognized. The problems are upstream, so what’s affecting someone’s health is not necessary what’s happening today. It’s from many years ago, over a long period of time.”
So how does she keep going? “Small victories are still victories. Even if I don’t change the system today, if I can bring together people who think about things differently and change the system for one patient who comes to the doctor and gets a housing referral — I’m doing the right thing. We’re on the right track.”
There are deep and complex intersections between health and social determinants. And there are more and more people — like Rhea, like some of her colleagues, and others across the nation — trying to bring those intersections to light.
“People who think at intersections,” Rhea says, “will be leaders in the future.”
So that’s where she is now — working, boldly, at the intersections.
More videos from Rhea:
For full video playlist, visit: https://www.youtube.com/playlist?list=PLdI4AFyWNRkUSh8660nO4rbcSC-SsyKVe