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I did not realize I was a perfectionist. I was far from perfect. It was not until I listened to a master class on perfectionism from a physician coach that I had my “aha moment.” I am now working extremely hard on training my brain to be an imperfectionist. To do that means to let go of the mental constructs that I have created for myself. In particular, I had to let go of the narrative that said to me: You are not someone unless you look like the epitome of success.
I was a young African-American doctor full of “firsts.” However, these firsts did not protect me from the hurt of failure or the heartache associated with imperfection. For sure, it did not provide me with what I longed for most, self-worth and validation.”
Frieda Millhouse-Jones is an internal medicine physician.
She shares her story and discusses her KevinMD article, “A Black physician’s perfectionism.”
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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.
Transcript
Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Frieda Millhouse-Jones. She is an internal medicine physician, and she wrote the KevinMD article “A Black physician’s perfectionism.” Frieda, welcome to the show.
Frieda Millhouse-Jones: Thank you so much for having me today.
Kevin Pho: We’ll get into your article in a little bit, but first off, can you share your story and journey to where you are today?
Frieda Millhouse-Jones: I’m originally from South Carolina. I moved to Ohio when I was eight years old and basically spent most of my upbringing and childhood there. I went to school, undergraduate, at Kent State University, decided that it was just way too cold up there for me, and decided to apply to medical school down south. I got into Emory in Atlanta, Georgia, and then stayed. I basically did my medical school training there and my residency, stayed on for a chief year, became junior faculty, and then left to go into private practice and join a practice that I’m still with here in Atlanta. I practice primarily outpatient medicine and enjoy what I do.
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Kevin Pho: Well, like you, I’m an internal medicine physician as well. Tell me some of the joys that you have practicing outpatient internal medicine.
Frieda Millhouse-Jones: Oh, gosh, so many. It’s interesting that you asked me that. It probably would have been a different answer earlier this year, because I burned out completely, and that’s actually kind of what led to the writing of the article that we’re going to discuss. But now that I’m back with a clear head and kind of a renewed sense of fulfillment in medicine, I enjoy the relationship with my patients. I enjoy being able to make a difference in their lives, to help assist them with their health goals along the way.
And even more importantly, I feel honored when they trust me enough to really share things that have been bothering them, things that have been hidden deep down that maybe they have not shared with anyone else, that they need someone to help guide them out of, whatever behaviors, or maybe help get them in the right place to treat their previous traumas, etc. And then just treating the whole person. I really enjoy that.
Kevin Pho: All right, so let’s talk more about that article that you wrote. It’s titled “A Black physician’s perfectionism,” and you’re going to talk a little bit more about your story, and I’m certainly interested in hearing about that episode of burnout earlier this year. But for those who didn’t get a chance to read your article, can you just walk my audience through it and share the story of why you decided to write it?
Frieda Millhouse-Jones: Yeah, so I think I have to include the episode of burnout, because that really ties into a lot of this. After the pandemic, I think, like a lot of physicians, I just pretty much crashed and burned. 2020 was hard on a lot of different fronts. There were a lot of family issues that I was experiencing, there was a lot of, what, social unrest, and then the pandemic, and just the constant taking care of patients with COVID, losing people that I’ve taken care of for 15, 16 years. It just got to a point where I got up one morning and I was like, “I just can’t do this anymore.” I literally kind of fell back into a chair and called my CEO. I was like, “This, I can’t.” I took some time away, and that time really gave me a lot of space to do some reflection.
I had some health challenges that I talked about briefly in the article with my daughter, and she suffers from a lot of perfectionism. So I had to sit back and think: Is this happenstance that she is like this, very paralyzed, and very, very much like, “If I can’t get an A, I’m just not going to do it”? I had to sit back and try to think, where does this come from? She had to have learned this somewhere. Is it genetic? Is it just social learning theory? Where does this come from? And it made me go back and start to trace the dots of my own start of perfectionism and how it’s manifested today.
So in summary of the article, I basically go back in time to when I first arrived at that school in Ohio. I’m the only Black child with a sea full of faces that don’t look like mine, and it becomes very clear that because of my ethnicity, I was going to be different. I was treated differently. There were, unfortunately, some racial slurs that were used. I remember being in the lunchroom and it being a total nightmare. And the one way that I had to try to combat this, or get back at the ways that these injustices made me feel, is that I was like, “I could just study harder. I’m just going to study hard and be better and get A’s and show you that I can be somebody.” And so I took that all the way through my primary education and secondary education. It paid off externally, because I became chief resident at a prestigious program and got into a prestigious practice. But very soon, it was starting to undermine my confidence and who I really, the person I could really achieve to be.
Kevin Pho: So give us some examples. When you said it was starting to undermine your confidence, what exactly do you mean by that?
Frieda Millhouse-Jones: Oh, well, I think that when we come into this world, we’re just these wonderful, innocent little children, but we are affected by our environment. And it’s no secret that in this country, racism and structural racism have been an issue for hundreds of years, starting with chattel slavery. There is this sense that African-American people were inferior. There are writings saying that we were lazy and all of these different things. And you can take that all the way through, from slavery to sharecropping to the Jim Crow South and convict leasing, and all these things. There have just been these constant stereotypes that have prevailed, and even though people don’t say these things, it’s in the back of the mind. So you always know that you have to try to level up.
In our world, in a lot of different atmospheres, especially in the educational system, there’s this myth of meritocracy, right? That you can just work hard and, by your own merits, pull yourself up by your bootstraps and get to where you need to be. However, we know that people come to the table with different advantages, or what some people call capital, right? You may have economic capital, i.e. more wealth. You may have social capital, with who you know. I would say that the way that I felt, definitely based on my elementary education and what I was being taught at home to try to protect me from structural racism, there is a sense that the only tool that you have in your toolbox to bridge the gap is to be twice as good. And that constitutes, or unfortunately, it breeds perfectionism.
Kevin Pho: So when you talk about how you have to work twice as hard and you have to be perfect to overcome the systemic racism that you experience, how does that affect you as a physician today?
Frieda Millhouse-Jones: Oh, boy. I would just work and study myself into the ground. Perfectionists are extraordinarily self-critical, right? So every little mistake is like a nightmare. It’s almost fatalistic: tons of rumination, tons of second-guessing, because every little mistake is an opportunity to look like a failure, to lose whatever bit of advancement, or, I won’t say privilege, but just whatever accomplishment you did gain. It just takes one little hiccup to lose all of that. And so, if you can imagine the stress that that creates, right? And it obviously led to my burnout, because you can only keep up that facade for so long. It’s not possible. It’s not sustainable.
Kevin Pho: So you mentioned you took a little bit of time away from your clinical duties as you reflected on this. What exactly did you do to overcome this? Because I’m sure that a lot of physicians experience similar feelings. What exactly did you do to overcome that and bring you back to work?
Frieda Millhouse-Jones: Lots of therapy, lots of therapy, and physician coaching, actually. Part of burnout also is just stepping away, right? There’s a lot of debate on what’s depression and what’s burnout, and burnout is resolved from being away from the work environment. Depression obviously just kind of prevails in other parts of your life. So having time away, I was able to get therapy, get coaching, write, read, just breathe, and be able to reflect on: How am I going to heal from this? How am I going to move forward? Because what I’m doing, or what I have been doing, is not working. And how can I reframe the way that I practice medicine, and the way that my life and work relationship looks from here on out, or here forward? And that’s what I did, and I’m still doing all of those things. It’s a work in progress.
Kevin Pho: We’re talking to Frieda Millhouse-Jones. She is an internal medicine physician, and she wrote the KevinMD article “A Black physician’s perfectionism.” Frieda, what kind of advice do you have for other Black medical students and trainees who may encounter similar obstacles to the ones that you described?
Frieda Millhouse-Jones: Wow. I just wish I would have had someone to pour into me, to let me know, “You are enough as you are,” right? All this messaging that we hear: You are enough. The real you is enough. And so you may be a success. You may think that you’re being successful because of all of this hardcore criticism and this unrelenting drive that you have. But you can be compassionate. You can make mistakes. Every opportunity for mistakes is a chance to just grow and do things differently, and you’ll be OK in spite of those things. Those are the things that I wish that I could have heard multiple times throughout my life.
Kevin Pho: And my final question: What’s your take-home message that you want to leave with the KevinMD audience?
Frieda Millhouse-Jones: Compassion is everything. You’re not going to do it right every single time. You’re your own advocate. You can pave the way for yourself and how you want to do things for the future, and it’s all good.
Kevin Pho: Frieda, thank you so much for sharing your story, time, and insight, and thanks again for being on the show.
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