The Care Doctor: Rhett Brown, MD

 

[0:00] She said she had known since forever, but she still wanted to make sure that, was this who I was? And we talked about whether I thought therapy could change it.
And did I understand some of the consequences that might mean for my life to live this lifestyle.
But at the end, she just, she said, you’re my son, I love you.
And whoever you have in your life is welcome in my home and I will love them as well.

[0:31] Music.

[0:37] Paging Dr. Cook, Paging Dr. Cook, Dr. Cook, you’re wanted in the OR, Dr. Cook, you’re.

[0:44] Music.

[1:07] Welcome to the Prescription for Success podcast with your host, Dr. Randy Cook.
Hello everyone and welcome to Prescription for Success. I’m Dr. Randy Cook, your host for the podcast, which is a production of MD Coaches, providing leadership and executive coaching for physicians by physicians.
To overcome burnout, transition your career, develop as a leader or whatever your goal might be, visit MDCoaches on the web at mymdcoaches.com because you’re not in this alone.
And don’t forget that CME credit is available when you listen with us.
Just look for CMFI in the show notes to learn how.
Well, today we are bringing you part one of a two-part episode featuring a family practitioner from Charlotte, North Carolina.
He has served a diverse population of patients from birth through end of life for more than 30 years.
And he has a special interest in the care for the LGBTQ plus community.

[2:08] So, let’s hear my conversation with Dr. Rhett Brown. I am really looking forward to my conversation today with Dr. Rhett Brown.
He has a fascinating and really unique story to tell, and I just can’t wait to get into it.
So, Dr. Rhett Brown, thank you for being here and welcome to Prescription for Success.
Thank you, Randy. Randy, I’ve really been looking forward to speaking with you, and I have enjoyed your other podcasts. So thank you for the opportunity.
Well, I’m glad to know that you’re a loyal listener. We really appreciate that.
And so it’s going to be a pleasure to have an opportunity to talk to you.
I think you have a fascinating story, and I can’t wait to hear it.

[3:00] So as we always do, let’s have a conversation about your beginnings.
I know that you did, you’re growing up right there in Charlotte, where you are now.
So tell us about your family and what your early life was like.
So, yeah, so Charlotte’s been my home since I was 18 months old.
My parents moved here from Charleston and it was a great place to grow up.
And I was fortunate or unfortunate to start first grade, the first year of busing in Charlotte.
I remember those years. So I’ve seen the Charlotte transform and the positive impact that has had and also the struggles.

[3:41] When I was in elementary school, we were in a neighborhood that then started integrating and that was not supposed to happen and it wasn’t a thing to do.
And our parents ended up being part of the sort of migration out of that neighborhood to South Charlotte actually end up growing up in a little town called Waxhaw, below Charlotte. So watching, Charlotte transform and having the benefit of always going to an integrated school and having, friends of all races has been a great benefit to me in my life.
And about how old were you when you actually relocated?

[4:26] So, I, we, uh, eight, so I’ve had my first two year, kindergarten, first and second grade in, uh, uh, Charlotte and that, uh, amazing community, very much sort of like a leave it to beaver, uh, neighborhood and existence.
Was that traumatic for you in any way, changing homes and changing schools at that age?
It was. I realized maybe I had to learn how to accept change. I moved away from then my, best friend. I struggled in feeling like that first year being the outsider in the school.
And it’s like people already had friendships and new things. And that became a recurring thing, but sort of also think as everything a source of strength is as I got older into high school, my dad was in his career and was rapidly advancing at that time. I ended up going to, three different high schools in three years. Oh dear.
So again, it was that outsider and would have been going to a fourth high school, because of a job promotion. When I decided and talked to the guidance counselor, she said.

[5:42] I said, go ahead and apply.
You’ve got good grades. Your SATs are good.
And so I was fortunate enough to get early acceptance to Davidson and Emory.
And at that time, my parents, we were living in Gainesville, Georgia, and looked on the map, and Emory was an hour from my parents, and Davidson was three hours, so Davidson was the choice.
That’s pretty cool. And I’m always curious as to, I have some guests that never thought about medical school until maybe they were in their 30s, and some of them seem to have sprung from the womb, ready to go to medical school.

[6:25] When did medical school enter your consciousness? So I’m definitely more of the latter.
I’ve known or started saying, in kindergarten, why do you wanna be when you grow up?
It was, I wanted to be a physician.
I do not come from a medicine background, I think my mom.
If she had been born in a different era, a different time, would have been a physician.
She always had great reverence for medicine and physicians, and had always sort of said that she thought that being in the medical field was one of the greatest things anyone could do.
And I always want to make sure I made my parents proud, but it just seemed like always a natural fit. And it was a goal that I had set for myself at a very young age.
You’re a pretty good science student in high school?
I was very fortunate. I was academically talented and was able to do well in pretty much, all fields. And in some ways, looking back, my parents may have used that against me, because to get to med school, you had to have good grades, you had to be near perfect.
And I needed to make sure that I was, and even being terrorized in fourth grade.

[7:45] Taking cursive handwriting and penmanship. I’m a natural lefty, so my penmanship was naturally not that good and didn’t look like the letters that were on the board. I got a C in penmanship the first grading semester, and I was so afraid that that C would keep me out of med school.
Lauren, I should have known that being able to read your handwriting should not be a problem in medicine.
But I had an A the rest of the year in penmanship.
Wow. Well, that’s pretty cool. It was one of those things that if that goal needed to be achieved and I needed to have this in order to get to med school, you know, that was what I was going to be.
One other little unusual thing that I notice in your CV is that your undergraduate major was economics.
Typically, we see more of the chemistry and biology and the occasional physics or math major.
What was it that drew you to economics?
So I was very intentional about the Liberal Arts College and going to Davidson and also, you know, frankly chose Davidson because it had a wonderful pre-med reputation and I knew that they would get me prepared to get accepted to Medical School.

[9:04] I also sort of realized that I would get a whole lot of sciences in medicine and that if I just did.

[9:11] The basic requirements for medical school, there was a whole lot of other time in my education to learn other things. I also knew that I was going to be running my own practice someday. So, you know, back then at that time, that was before, you know, hospitals own practices.
That is an incredible amount of wisdom, I think, for someone at that age.
I have to admit that it never even entered my head.
And so when you went picking medical schools, it turned out to be University of South Carolina, the Medical University of South Carolina.
Did you pick that one on purpose?
So, yeah, I was fortunate to get accepted to both of them. My parents were living in South Carolina at that time, so the two South Carolina med schools were in state and I was fortunate enough to be accepted to both.
Did you find that the medical school was more or less what you expected or were there some big surprises there? As everyone says, the intensity was, you know, oh my god, I thought Davidson was a lot of information coming and then all of a sudden the fire hydrant got opened a little bit more and but it tends to be my my pattern is I need to prove to myself I can do this and once I had shown in the first few things that I I could master this.

[10:38] I was confident in myself that I also needed to make sure I was well-rounded and developed and not always purely studying. Sort of just like, okay, this is now my job. I’m going to be good at this job. But I also know that I need to have time to do other things. And this was also the time when I was more understanding and coming out to myself, my own orientation. And there was some from stress and thinking about that and worrying through that.
That was also taking some time that may have been spent in studies.
Well, let’s talk about that a bit. So your decision to come out was actually during medical school.
Yeah, well, I had, of course, knew that I had those feelings since I can remember.
But it was always this feeling that, you know, something will change it.
Maybe if I date the right person, if I do this, or if I pray hard enough.

[11:40] It will, something will change.
And then finally just saying, this is who I am. And do I accept it and start making, you know, friendships and support and coming out to people and close friends.
And so it would be this sort of dual life that I did have two distinct set of friends.
And there would be my med school friends, and then the friends I would see pretty much just on Fridays and Saturdays.
And I did not mix the two up.

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[13:37] Music.

[13:46] Hi, I’m Rhonda Crowe, founder and CEO for MD Coaches. Here on Rx for Success, we interview a lot of great medical professionals on how they grew their careers, how they overcame challenges, and how they handle day-to-day work.
I really hope you’re getting a lot of great information, but if you’re looking for an answer to a specific problem, management or administration challenge, or if you’re feeling just a bit burnt out, like maybe you chose the wrong career? Well, then there’s a faster way to get the help you need. No, it’s not counseling. It’s coaching. Rx for Success is produced by MD Coaches, a team of physicians who have been where you are. I know you’re used to going it alone, but you don’t have to. Get the support you need today. Visit Visit us at MyMDCoaches.com to schedule your complimentary consultation.

[14:49] We’ll get back to our interview in just a moment, but right now I want to tell you a little bit about Physician Outlook. If you haven’t discovered this remarkable magazine, please do so very soon.
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That’s a really great deal on this stunning publication.

[15:53] And now let’s get back to today’s interview. There’s so much here that I would really, really love to unpack if we can.
This is not intended to be a six-hour interview, and I know it’s big territory, but still.
This is so profound to me, Red, the pressure of being a medical student and dealing with the volume of academic material that has to be dealt with.
And into that mix, you’re going to throw this really monumental, life-changing decision.
Can you talk about how you managed to balance that and survive it.
I had made a decision and I made it actually had made this decision at Davidson about how I would approach, education and accepting of myself.

[17:04] Throughout as I mentioned earlier throughout high school and all had always been I had to be perfect. I had this conversation with a, dorm room classmate of mine Freshman year talking he was talking about how he had struggled in high school in math and he had made D’s and barely made it through geometry. And I was like, no, wait a minute. You struggled, but you were both here in Davidson, an academically tough school to get into. So you didn’t make all As and you were in the same place.
At the end of my freshman year, I had a 395 average. And I went to the pre-med advisor, and I said, what is the GPA I need to get out of Davidson to make sure I’m going to get accepted into med school. And he said, if you have a 3.3 or above, good chances are you’ll get into med school out of Davidson. All of a sudden that changed because I had gone to three high schools in three years. I had not felt a lot of friendships. That gave me permission, to take courses that I would not have otherwise have taken because I’ve been worried about, I in this English course, English Lit course, can I make sure I get an A in this course?
I may not have taken that course if I was still worried about being perfect.

[18:25] I may not have gone to some of the Thursday night or Friday night social things if I was worried about being academically perfect.
After the first semester of med school where I knew I could be top of the class, I knew I had the ability to do it, I also knew that I wanted to be a family physician.
It was not critical that I be AOA to get into a good family medicine residency program.
So I made the conscious decision I would not study on Friday nights or Saturday mornings.
So you were spending Monday through Friday being Rhett Brown medical student and you spent your weekends discovering this other Rhett Brown. Am I reading that correctly?
It’s just, it was also a little self-preservation, but at that time I was still.

[19:18] Leading a double life. I was not yet ready to blend both of those lives together. Growing up Up in the South at that time and growing up Southern Baptist, there was of course some internalized homophobia and internalized shame.
I can say it wasn’t until I was 34, 35 that all of that shame went away and I was able to just say who I was without getting it stuck in the back of my throat.
What about sharing this incredibly important change in your lifestyle with your family?
Did that happen and what was that like? That actually happened after I finished residency and had already opened my first practice. So it was on down the road something. Yeah, I was 28. I always had this fear because I had a classmate in Davidson who had come out to his family who had disowned him. And though I knew at a core level that that would not happen with my parents, there’s always that little bit of doubt. What if? What if? And the most important thing is not wanting to disappoint my parents and not having them feel any disappointment whatsoever. Back then.

[20:35] The parents got blamed for things. I didn’t want them to feel shame or that they had done anything wrong. They were not the cause of this. They had done absolutely nothing wrong.
But I also knew that they might blame themselves. And so part of me was protecting them, protecting myself. And as a good Southerner, we are very good at avoiding conflict.
Aren’t we, though? So, it’s like, yeah, why have this if you don’t have to?
But mom finally, I mentioned it in my first practice, we had our grand opening and invited friends and relatives to come and celebrate opening this new practice.
Just a month earlier, I had met someone that was becoming very special to me, and I invited him to the party.
And I felt very safe doing it because there’s no way everybody was going to know everyone at this party. And my mom being the noticing eagle-eyed mom she was, noticed something and how he’s, in that and came to me the next day and said, there’s something special between you and that, his name was Mark, so you want to talk about it. And as expected, she was supportive and.

[21:48] Loving and we talked through it and she wanted to know.
So she, it sounds as if she knew exactly what was coming. Am I reading that correctly?
She did. She said she had known since forever, but she still wanted to make sure that, you know, was this who I was? And we talked about whether I thought therapy could change it and.

[22:11] Did I understand some of the consequences it might mean for my life to live this lifestyle.
And, but at the end, she just, she said, you know, you’re my son. I love you. And whoever you have in your life is welcome in my life. That had to have been the lifting of a great boulder from you. It was wonderful and totally in character and not unexpected. And I was very fortunate.
But she said, you know, don’t let your dad know. She wasn’t sure how he would feel about it. And I respected my dad, again, did not want to disappoint him. And I always viewed my dad as a man’s man.
He built our houses. He hammered the nails. He built cabinetry. He hunted, fished. Great sports athlete and a good businessman.

[23:11] And sort of the southern man’s man. And we had grown up going horseback riding together and hunting together and fishing together.
But our relationship had sort of got distant during high school and college, mostly college, because we didn’t talk. Everything was communicated through my mom because she would, and I would talk several times a week.
And then our conversation with my dad would be through her.
He knew what was going on with me. I knew what was going on with him, but we really did not have a conversation. And so she told me that she had shared the story with him.
And I was like, oh God, oh God, what is this going to mean?
And I’m like, you know, it’s hard to imagine. It would have been nice to have some warning, mom.
Right, right. And it’s still sort of like, here I am 28.
I have just taken a huge loan to open a business. I am making payroll.
I am responsible for people’s lives.
And yet this conversation makes people like I’m 12. Oh my God, oh my God, what’s going to happen?

[24:12] So a few days later, I get an envelope in the mail, a letter from my dad, and that is just not something that we were used to getting.
We did not write letters to each other.
And mom had not told me what he had said or thought. And I was like, okay, this letter may change our relationship forever.
And I sat it down and didn’t open it for a day or so.

[24:39] And when I did open it, the letter starts off, you know, who do you think you are? How dare you?
What were you thinking? Why would you do this? Why would you not know that I am your father?
I love you unconditionally, and your sexuality does not factor at all into my love and support for you, and why would I have spent one day, one hour, worrying about him accepting me about this issue?
Why would I have been a 16-year-old holding this secret when he was always there for me?
That’s an amazing response. It was truly amazing. Do you think, as I am inclined to think, that there was an incredible quantity of wisdom, wrapped up in your mom, understanding that it was a good idea for her, to break the news and give him some time to work through it before he had to communicate with you at all?
What do you think?
She knew him and I’ve never, you phrased it in a way I’ve never thought about it like that.
And I’d have to take a minute to think it probably was her wisdom of knowing that he then had a chance to think about his response and was not a knee-jerk response.

[26:07] And you’ve given me something, a different way of framing it than I’ve ever thought. So thank you.
Well, I’m flattered that I got to take part in that. I know that the gravity of a decision like that within a family is profound in ways that, I can’t possibly understand.
And I’m really grateful that you are willing to share it with us because I think it’s a a great blessing for all of us who get to hear it.

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