“You can’t be nobody but who you are… That shadow wasn’t nothing but you growing into yourself. You either got to grow into it or cut it down to fit you.” — Rose, Fence

There is a unique privilege in medicine, particularly in family medicine, to be invited into the sacred space of people’s multi-generational stories. We don’t just see a patient; when we pay attention, we also see their ancestors, their elders, their children, and the living history that has shaped them. Over the years, I have learned that the stories we carry—both our own and those entrusted to us—shape how we present ourselves in the world.

For me, August Wilson has always been there when I needed to reflect, both personally and professionally. His work has walked beside me through some of the most defining seasons of my life, offering clarity, grounding, and a reminder of the deep roots that sustain us.

My journey with August Wilson began in 1987, during a tender and uncertain moment. I was returning to my training after a year away, learning how to balance motherhood with the demands of a medical career. In the middle of that transition, I found myself in a Broadway theater watching Fences—just days before the Tony Awards. James Earl Jones and Mary Alice were extraordinary, but what stayed with me was how the play held the tension between duty, love, sacrifice, and longing. I was a young mother and a young physician, trying to figure out how to hold it all together myself.

In 2010, Wilson met me again at another crossroads. I was starting a new position and wrestling with what it meant to stay in academic medicine—how to teach, lead, and continue growing. Once again, I saw Fences just days before the Tonys, this time with Viola Davis and Denzel Washington. Their performances were fierce and tender in equal measure. Sitting there, I felt reminded of why I chose academic medicine: to nurture growth, to witness transformation, and to honor the stories unfolding before me.

And then came 2023. I had just stepped away from the STFM Board and completed the third year of our Now Leadership through Scholarship Fellowship. I was in a season of rediscovery—figuring out who I was becoming after years of leadership and service. That was when I caught the 2023 revival of The Piano Lesson before the Tony Awards. It felt like Wilson was once again holding up a mirror, asking me to think about legacy, purpose, and what we choose to carry forward. I had seen other productions, but this one was riveting.

Across the decades, his plays have been a kind of compass for me. I’ve seen two productions of Joe Turner’s Come and Gone, two of Two Trains Running, at two of The Piano Lesson ( not including the TV production), the unforgettable screen version of Ma Rainey’s Black Bottom, the aching humanity of Jitney—which finally earned its Tony for Best Revival in 2017—and the final chapter, Radio Golf. Each time, I walked away with something I didn’t know I needed.

In medicine, we now talk about the social drivers of health—the conditions in which people are born, grow, work, live, and age, as well as the broader forces that shape daily life. These include economic stability, education, neighborhood environment, access to care, and the impact of racism and historical trauma. They are not abstract concepts; they show up in our exam rooms every day. They influence blood pressure, diabetes control, mental health, and healing. They shape how people navigate stress, opportunity, and survival.

August Wilson sheds light on the profound impact that various social forces have on the human spirit. He illustrates how economic hardship, migration, structural inequity, and generational trauma affect not just the body but the soul as well. His characters bear the burden of these societal challenges long before the terminology entered our medical dictionary. Through their experiences, we gain insight into how external conditions influence identity, relationships, hope, and resilience.

Wilson reminds us of something family medicine teaches every day: that a person’s health story is inseparable from the world that formed them. To truly care for someone, we must understand both their biology and their biography—their lived experiences, history, and the various forces that have influenced their journey. His plays highlight what we, as family physicians, often observe: healing requires acknowledging the whole story, not just the symptoms.

When you sit in the dark watching his characters, you aren’t just watching actors. You’re watching your family members. You see the patriarch whose dreams were cut short too soon. You see the matriarch holding the household together with strength and elegance. You see the younger generation striving to build a future while bearing the weight of the past.

Wilson’s work resonates because it tells the truth: that struggle and joy live side by side, that music and memory are forms of survival, and that our stories—no matter how heavy—are worth honoring.

I am still waiting to complete my journey through all ten plays, with three left on my map of Wilson’s century:

• Gem of the Ocean (1900s): The spiritual beginning of everything, anchored by Aunt Ester, the keeper of memory.
• Seven Guitars (1940s): A blues‑infused meditation on art, exploitation, and community.
• King Hedley II (1980s): A raw, unflinching look at generational wounds and the fight for dignity.

As a physician, I understand that an incomplete medical history signifies that there is more to learn, more to comprehend, and more to heal. Having accompanied Wilson’s characters through various seasons of my life, I believe that when I finally experience these last three plays, they will resonate with me in exactly the way they always have.

“I ain’t never found no place for me to fit. Seem like all I do is start over. It ain’t nothing to find no starting place in the world. You just start from where you find yourself.” — Joe Turner’s Come and Gone

As Black Maternal Health Week approaches this year, I find myself returning to the conversations that have shaped my understanding of equity, community, and care. One of the most meaningful took place on March 12, 2026, when I had the privilege of moderating a conversation with Dr. Ebony B. Carter at the Partnership for Maternal & Child Health’s Maternal Health & Perinatal Safety Symposium. As I prepared for that session, I found myself thinking the way I often do in my practice—as a family doctor who has spent years listening to patients, watching systems fail them, and trying to make sense of what healing looks like when the world around them is not built for their thriving. Dr. Carter’s work met me right in that place.
She is a national voice in maternal health equity, but what struck me most was how deeply her work was rooted in community. Her Keynote address highlighted her years of work and passion. Through the EleVATE Collaborative, she and her partners showed that when prenatal care is redesigned with racial equity, trauma‑informed practice, and community leadership at the center, outcomes shift in ways that feel both measurable and profoundly human. Their pilot work showed reductions in postpartum depression, stronger postpartum engagement, and promising signals in preterm birth—especially for Black birthing people, who continue to face the highest risks in pregnancy and childbirth. Reading her studies, I recognized the same truth I’ve seen in my own exam rooms: when people feel seen, heard, and respected, their bodies respond differently.
During our conversation, we talked about why equity‑focused evidence struggles to become policy. The EleVATE findings were compelling, yet the systems around us remained slow to change. Dr. Carter spoke honestly about the structural barriers—rigid reimbursement models, political headwinds, and the discomfort institutions often have with interventions that require them to share power. Her clarity reminded me that evidence alone rarely moves systems; relationships, persistence, and community pressure often do the heavy lifting.
We also spent time talking about early‑career researchers. I thought about the young clinicians and scholars who have confided in me about feeling discouraged in this moment—worried about funding, worried about backlash, worried about whether equity work is still welcome. Dr. Carter offered the kind of grounded wisdom that comes from doing the work long enough to know its costs and its rewards. She spoke about building authentic partnerships, staying accountable to the people most affected, and refusing to dilute one’s truth for the sake of comfort. As the inaugural Associate Editor for Equity at Obstetrics & Gynecology, she had seen firsthand how often scholars were told to “tone down” their framing. Her response was simple and steady: honesty is not optional when lives are at stake.
One of the most meaningful parts of our conversation centered on humility. The EleVATE team had been open about the moments when they got it wrong—around trauma, mental health, and representation—and how community collaborators helped them course‑correct. In a field that often rewards certainty, Dr. Carter modeled something far more important: the willingness to be teachable. That resonated with me deeply. In family medicine, humility is not a virtue; it’s a clinical tool. It keeps us listening. It keeps us learning. It keeps us human.
As I look back on that conversation now, I’m struck by how fitting it was that it took place just weeks before Black Maternal Health Week. Each year, this week calls us to confront the realities Black women face in pregnancy and childbirth—and to honor the community‑led solutions that have always pointed the way forward. Dr. Carter’s work sits squarely within that lineage. EleVATE wasn’t built in a boardroom; it was built in community rooms, clinic basements, and living rooms, shaped by Black mothers who knew exactly what needed to change. Their leadership wasn’t symbolic—it was structural.
Black Maternal Health Week invites us to speak honestly about the inequities that continue to shape the experiences of Black birthing people, but it also encourages us to notice and uplift the models of care that are making a real difference. My conversation with Dr. Carter reminded me that equitable maternal health isn’t an abstract ideal. It’s something we practice. It’s something we return to. It’s a steady commitment to centering the people who have too often been pushed to the margins, and to building systems that honor their stories and their strength.
As clinicians, researchers, and community members, we are called to build systems worthy of the families we serve. That work is slow, often uncomfortable, and always relational. But it is possible. I saw that possibility clearly in Dr. Carter’s work—and in the communities that shaped it.

“Whatever affects one directly, affects all indirectly.” — Martin Luther King Jr.

March is Women’s History Month, and the theme is “Leading the Change: Women Shaping a Sustainable Future.” March 8 is International Women’s Day. Many of my patients would say to me, “Thank you for taking such good care of me, but I worry about who takes care of you?” I have thought about that over the years.

The answer to that question is not so easy to elucidate. I started to reflect and realized that it is the women in my life who care for me and inspire me — not just one, but all of them. Each in her own way has led change and shaped something lasting. It started with my mother, who has always had a sixth sense and always calls at just the right time. She could look into my eyes and know I was not feeling well. Through high school, college, and medical school, she was my greatest supporter, but she never stopped reminding me that she “expected better from me.” That was because I was the oldest child. Not only was my mother there for me, but all my aunts were as well. I had four mothers. The biggest supporter was my grandmother, who always made me feel special. However, she loved all of us the same — evident in the way she handed out both praise and discipline.

My sisters are great. They have always thought I was the smart one. However, I think my sister Kathy is the smartest. She has fixed ripped seams, hemmed and sewn dresses, designed curtains, and just been there with her laughter and positive outlook. She finished her degree, retired, and then found her way back to work — because her gifts are simply too valuable to set aside. She continues to provide wisdom to all whose lives she touches. I witnessed this firsthand on what was the most tragic day of her life. Yet there she was, handling it with a grace that left me in awe. That is who she is — steady, generous, and quietly remarkable. She never has a harsh word or thought for anyone, even when life gives her every reason to.

In school, I had committed teachers who recognized I was a step ahead. It started in first grade. I recently saw my second-grade teacher — she was still so sweet and filled with praise. Until the 5th grade, I went to a segregated school. My sixth-grade teacher could have ignored me, but she made sure I was placed in the honors program for seventh and eighth grade. I was always an avid reader, but that program expanded my skills. Her willingness to lead change in a classroom where it was not always welcome was instrumental to my success in high school.

It was my first high school English teacher who pushed me the most. She fearlessly challenged me to write better and read more, despite my heavy load of math and science courses. She forced me to put pen to paper and graded my work honestly. I dreaded — but learned to rise to the challenge of — that “red pen.” My initial papers were hemorrhaging red ink. My challenge was to decrease the amount of bleeding.

I had my host of friends in high school. They were there when I lost the race for Student Body President. One of them became my roommate in college. It broke my heart when she left school to get married. My next roommate was also wonderful. When I go home, I still get together with several of my friends from college. We always went to parties together, and our rule was “We came together, we leave together.” That rule kept us all safe — a small but meaningful way we looked out for one another’s future.

My best friend from medical school is still my best friend. She is an OB/GYN. We have supported each other through many stormy times. She offered to whisk me away on the morning of my first wedding — she knew what I would later learn; it was not what was right for me at that time. However, there were no hard feelings.

In residency, I met my other long-time friend, a family physician. She called me once a week. For years, we met twice a year at medical conferences to catch up. She was an exercise fanatic, and I stayed in shape just to keep up with her. She is ten years older and still looks great. When her father died, I was in Maryland and could not get to the funeral. So when I was finally able to visit, we all went to see “Having Our Say,” the remarkable play about the Delaney sisters — two women who were themselves a testament to leading change across a lifetime.

My late friend, a Cardiologist, adopted me while I lived in Maryland. We would make shopping trips to Nordstrom for the Half-Yearly Sale, take Fridays off, and have a blast. She taught me about fine cooking and how to write a consultation. After her guidance, I received praise from a doctor at Johns Hopkins when I referred a patient. When he sent me a consultation note, he began by thanking me for the most thorough referral letter he had received in years.

All these great women were there for me — and still are. They are in my yoga class, among my female colleagues, former residents, and new friends. One of my dear friends from yoga class is a writer who encouraged me to start this very blog — and I am so grateful she did. We are all eagerly anticipating the publication of her novel, Gershwin’s Bess: A Novel, which promises to be a remarkable work. I also treasure my book group friends, who are so much more than fellow readers. Together we traveled to Paris, and it was truly the time of my life — a reminder that the friendships we nurture are among life’s greatest adventures.

Most importantly, over the past 40 years, it has been my husband who has stood beside me and, since we met, maintained a positive approval rating from every one of these women. He once said, “he never worried where I was because he always knew I was in good company.” He meant all my friends.

As we celebrate women leading change and shaping a sustainable future, I want to thank all the wonderful and courageous women who have been and still are in my life. They have taught me to be passionate, courageous, and to serve others with humility and compassion. They are the change — and because of them, so am I.

“The success of every woman should be the inspiration to another.” — Serena Williams

In this complex, fast-paced world of modern healthcare, I find it easy to get lost in metrics and throughput. But lately, I’ve been reflecting on Dr. Joshua Hartzell’s “A Prescription for Caring in Healthcare Leadership,” and it reinforces a core belief we share: Leadership is about empowerment, not control. Performance isn’t just about individual effort; it’s about the strength of the system supporting that effort. When we prioritize the health of our team, we allow our healers to truly heal.

Why We Need a New Approach

The need for this shift is backed by more than just my intuition. The 2025 Medscape Employed Physicians Report highlights a growing crisis: while many clinicians choose employment for stability, many struggle with a lack of autonomy and the crushing weight of administrative “noise” or “ burden”. The data shows that “limited influence on workplace decisions” is a top driver of burnout. To me, this is clear evidence that the traditional “Command and Control” model is no longer sustainable. We need a new prescription—one centered on the interprofessional team.

Empowering the Interprofessional Team

To solve the challenges of access and burnout, we must look at the physician as the leader of a high-functioning, interprofessional team. This means expanding roles and ensuring every team member—from our clinical support staff to our advanced practice clinicians—has the tools they need to succeed.

When a physician is supported by a robust, fully-resourced team, the entire practice breathes easier. This collaborative approach allows us to better address health-related social needs—those factors outside the practice walls that so often impact health outcomes and limit a patient’s access to care. By working together to identify these needs and providing timely referrals, we ensure our care is as holistic as it is clinical.

Technology as Our Partner in Care

A major part of the “prescription” is using technology to restore the human connection. Medscape data reveals that clinicians spend an exhausting amount of time on documentation. By integrating Ambient Voice technology and structured templates, we can free ourselves from the keyboard and be fully present with our patients.

We can go further by using AI-driven messaging tools to intelligently filter communications. This closes care gaps automatically and ensures only high-priority clinical questions reach the physician’s desk. This, combined with clinical support tools for evidence-based care, ensures we provide the highest quality outcomes without the mental fatigue of administrative “clutter.”

The Heart of the Team: Being Heard and Valued

Ultimately, the most successful healthcare organizations are built on a foundational truth: caring leadership is not a weakness; it is an act of empowerment. When we trade rigid oversight for radical listening and curiosity, we stop seeing staffing gaps as “performance issues” and begin seeing them as vital opportunities to strengthen our human bonds. By hearing our clinicians when they tell us the work is endless, we move beyond mere management toward true advocacy.

We must commit to an integrated model where compassionate leadership, smart technology, and team-based support work in harmony. Together, we don’t just “manage” a service—we ignite a culture where clinicians thrive, and because they thrive, our patients receive the world-class care they deserve.

“The leadership qualities of physician supervisors have a direct impact on the personal well-being of the physicians they lead.” — Dr. Tait Shanafelt