By Dr. Joy Eberhardt De Master, WCI Columnist
I missed the first day of anatomy class, because my car wouldn’t start. I called my cousin for help and checked under the hood. The battery’s connections had corroded. Somehow, someway, I made it to a car shop—maybe with a tow truck. I don’t remember. But with a new battery secured, I raced off to med school—late, late, late.
One could say, “Girl, get your car serviced!” A reliable form of transportation is essential for work and for school and for everything.
What if I told you I cared for my car as best I could? What if I told you I didn’t have money for someone to fix it? So, I fixed it myself with help from my family. (I changed my own flat tire on the same car one cold wintery Chicago day stuck in the muck of gray snow.)
Car issues were nothing new to me. Growing up, I drove my siblings to school, and routinely, the car stalled on the carretera (“highway” in Spanish). I knew how to get it going again without causing a crash.
In reality, having a car was a privilege for me. In college, I had no car and worked federal work-study, aka the government gives colleges money to pay students anywhere from 50%-100% of their wages.
In 1998, I was years away from becoming a pediatrician, and the federal minimum wage was only $5.15 per hour.
It frankly didn’t seem like a good deal, and I didn’t understand why it existed. I could make $20 an hour tutoring math. I had doubts about the “benefits” the program had to me as a student. (Federal work-study is for those from financially disadvantaged backgrounds and is “awarded” to students. Interestingly, student income is only 4% of the college financial picture.) I had to work four times as hard in work-study as in my other job. And I remember being obligated to do it. (Fun fact I learned for this column: Schools could lose their federally awarded money if they didn’t use enough of it.) For me to work at my college, the school paid somewhere between nothing and $1.29 an hour. (I went to a not-for-profit school that was obligated to pay, at most, 75% of my wage. For-profits are obligated to pay up to 50%.)
Side note: The minimum wage in Illinois is $12 per hour as of 2022. It didn’t increase from $5.15 per hour until 2004 and didn't increase from $8.25 per hour until 2020. (Yes, only two years ago!) The CPI Inflation calculator shows $1 in 1998 is now valued at $1.74 in 2022. The same dollar was valued at $1.60 in 2020. A simple ratio of 8.25/5.15 equals 1.60—the rate of inflation in 2020. Federal minimum wage is $7.25 per hour. That same ratio 7.25/5.15 equals 1.40. The federal minimum wage is less now in 2022 than in 1998. I would have been making $3.68 per hour back in 1998.
So, why all this mumbo-jumbo about hourly wage? Because I used to determine my purchases based on how many hours I’d have to work. I’d go out to dinner and look at the menu. Some meals were two hours of work. Others were only one hour of work. I wouldn’t get a drink because it increased my hourly work. (I remember the shock in medical school when people spent more on drinks than I did on meals.)
Now, many years later, I don’t think of my “hourly work” when I go out to eat. I don’t blink an eye as my car is serviced. I have stepped into the world of privilege—a world of “reliable transportation” and the ease of others doing it for me, even going out of their way to make it easy for me.
Today, I had a mobile no-contact car service come to my work as I stayed inside warm and dry. They did “free extras”—checking tire pressure and topping off fluids and even arranged to have my leaking tire changed the same day. With a few taps of my finger, I approved the job and kept working.
But how do I remember that girl—the 22-year-old braving the cold with a dead battery and missing the first day of anatomy class? I remember my privilege. I know my power. I practice kindness.
Financially stable now, here's how I think about it these days.
Remember Your Privilege
We don’t talk about privilege enough. It is the reason some people have money and others don’t. It is the reason some of us fly around the world and others are scared to leave their “home.”
Privilege, simply put, makes life easier. Privilege often is money. But it can also be opportunity and knowledge. The “hidden ladder,” some call it.
If you are reading this, you are privileged. You read. That is a privilege. You understand the English language, another privilege most of us take for granted in a world dominated by this language.
What are my privileges? I have documentation to stay in the country where I live. I am light-skinned. I speak English. I have good health. I am also quick-witted, decent-looking, and educated. (Education can not be overstated. Having four years for university, then four years for medical school, then the three-plus years of residency/fellowship is a privilege many people don’t have.)
Because of my privileges, I am licensed as a physician in two states, and I'm a high-income earner. The world caters to me, and that makes me feel, strangely, uncomfortable.
The friendly greetings as I enter a Natural Grocers. I may be there to only use the bathroom, but no one pauses when they give me the bathroom code even though I have not purchased anything. (If you don’t look privileged, you have to buy something first to get the code on the receipt.) The lower lighting, good smells, kind words, and smiles rain down on me. It is a far cry from bagging my groceries during medical school with boxes and then shuffling out to fill my car with engine coolant before driving home to a cold apartment.
I wonder if the workers' friendliness is sincere. Or is it just because I can pay for what I need with no worries?
Know Your Power
Having money, opportunity, and knowledge are not bad. It does create different worlds and can lead to barriers among friends and family. We need to acknowledge this. We need to be aware.
The first time I flew back to Chicago after residency, my family asked me if I enjoyed flying first class. With my infant in tow, I was confused. Then, I realized that being the only MD in all of my extended family created the misperception I had “made it” financially and that I only flew first class.
The reality was I had strapped toys on my baby’s overalls (to not lose them and to have them close at hand) while the two of us shared an economy seat—the only way I could afford the flight after family leave and childcare costs. I sat amid my baby’s boogers and babbling.
Just because you have money doesn’t make you better, smarter, or more anything, really. It simply gives you power and more choice. You need to be aware of this power.
I also remind myself that money doesn’t mean I pay for everything for family and friends. I need to give space for others. I need to respect others—even if they make $7.25 per hour. It may mean I talk with friends about where we go out to eat or even if we do at all. Maybe we go to the cheaper donut place instead of the spot that serves Cointreau Crème Brûlée and Passionfruit Cocoa Nib donuts.
In Spanish, there is a phrase “tiene palanca”—to have pull (aka influence). Often, money gives you pull. How will you use it?
Be Kind
In 2021, I sold my rental. I wrote about it in a prior column and got many questions about what I did with the money. The need for certainty among the audience was palpable. I needed to list out steps A, B, and C to show how to be financially successful.
The reality is my focus was on having enough for myself and extending kindness. We are living in a pandemic. Some people are barely getting by. How do we make lasting change for ourselves and others? This is what I did.
Part of the proceeds went to support my extended family. That is a story for another time. And yet, it is a common story for first-generation professionals.
Another part went to help a close family friend complete college. First-generation college students with parents who have no prior college experience have a 20% rate of graduating. That means four in five of these students don’t graduate. It is even worse for Latinx—the graduation rate is 15%. That means almost six in seven students don’t graduate. No graduation means lower incomes and less wealth.
Even if you make it as a first-generation college graduate, your wealth accumulation is substantially less than a second-generation college graduate. You tend to earn a lower income, to have higher educational debt, and to get no inheritance.
A medical school classmate stated her dad paid off her medical school loans as a graduation gift. I was stunned. I had picked my medical school based on scholarships and living expenses. (Northwestern University was out of the question for me because housing costs were $1,000 per month and the scholarship was only available for two of my four years.)
So, how else am I kind? I have chosen kindness to my body and started personal training. I am learning to move in new ways. I am learning to relax.
My family is my priority. I have chosen kindness to my family. My family has invisible disabilities. The cost of disability is not acknowledged. Whether the cost is from income not earned or income spent due to the disability, we need to acknowledge it.
I have invested in my business—my new clinical practice. Capital investments are done. (Has anyone ever told you to never order furniture in a pandemic? OK, I will. Don’t do it. It may never arrive!)
What about you? Are you willing to live with a little bit of uncertainty and to examine how you accumulated your wealth? Have you thought about your privilege? How do you use your power? Are you kind?
To my 22-year-old self who was stuck in the cold with a dead car battery, I'd tell her to breathe and to know that “you are not alone.” I say to you, my reader, the same. Know that you should breathe and know that you are not alone.
As a white coat investor, do you ever think about your privilege and power? Does it affect your daily decisions? Do you practice kindness to yourself and others? Comment below!
[Editor's Note: We know you visit The White Coat Investor to learn about investment strategies and planning, and we’ve always strived to teach financial literacy to physicians, high earners, and anybody else who finds their way here. But the COVID pandemic has also shined a light on physician burnout and its dangers. That’s why we feel compelled to run articles and columns like the one you just read—to make sure white coat investors stay mentally healthy. We know mental wellness is what leads to a long, fruitful financial life, and we’ll continue to run pieces like this because combatting burnout has become such an important part of everybody’s financial journey.]
Great post!
Very nice post, tastefully done!
Great piece Joy.
Looks like your ‘privilege’ has enabled significant self-actualization. 😉
Nice to see you in print…in multiple locations.
NB: I don’t ask/demand WCI content be restricted to how to get more cents on the dollar and nothing to distract from that message. I also come to WCI to get the perspective of similarly educated, similarly privileged doctors like me on things like charity, how to help family members, money concerns, etc and appreciate the different perspectives of different religions and regions and origins and life/ career stages (LDS like Jim, immigrant docs, born privileged, etc etc) of the posters and writers.
Thank you for this excellent post. I really like it.
Now my comments: though I grew up privileged- professor’s kid- it was in a rich neighborhood where I was always the poorest kid, with Little House on the Prairie / South Dakota perspective (“Jenn only owns two pairs of pants! She bought them at KMart! Ha ha ha!” “Why would I need more than two pairs?”) A kind friend, without malice, once suggested we fly to NYC to buy clothes where they are cheaper (like he does). A true Jewish American Prince. Then I went off to an Ivy League college where luckily I worked with and met other kids with similar and even lesser privilege and learned things like it’s a privilege to be white and to be good looking 😉 , and it’s a privilege for your professor parent to have 4 months off most summers. It then took me ’til age 45 and moving to the South again, this time outside of the remarkably (vs the Southeastern US that is) nonracist (let’s not go so far as to say nonsexist!) military system, to recognize how dramatic wealth and white privilege are for me and mine. I told my kids things like “The driver in the car we just passed- what is their race? Black? Yep, we can get away with speeding and they can not.” NB I haven’t given up using my privilege, but a lot of my ‘charity’ is devoted to changing laws for the poor and minorities or direct aid to them, and I try to practice affirmative action when I hire out jobs to counter the opposite against such companies/ workers from many of my neighbors.
Funny how I run smack into my implicit bias when I worry ‘but is my female surgeon as good as an average male one? my kid’s Black dentist as good as a white one? What if they got some affirmative action to get where they are or are biased against those not of their own group?’ I comfort myself by reminding myself they may well be much BETTER than average to have made it to their position, and I certainly have no guarantee any white male is better than average, especially here amongst the good ol’ boy network.
I more quickly got over my family’s resentment of my wealth- the ones who seemed in need all party a lot more and go on a lot more tropical vacations than I have- and my brother and I (even more successful- he FIREd in his 30s not his 50s, not having kids had to help) have pinky promised not to subsidize our [math LOL] professor dad in his beyond his budget spending. It helps that they are much better off even if they don’t know it than this columnist was in her school years.
My mother recently disclosed to me that we were homeless when I was little. I knew I was the child of a never-married welfare mom- although I did live part-time with my schoolteacher dad- but this added another level to the frequent moving I remember. We never had other people fix our cars or appliances or pretty much anything else, we did it all. I give credit to this upbringing for the “just figure it out” attitude that brought me to my specialty.
I hated going to the “rich white kid” (I was white and poor) school- on scholarship- but I know the reason my parents made me was because it was the best education possible. How else could I take full advantage of the gifts- privileges- of a love for all things science (and math, and art)? It was an extremely rough road at times. But I am grateful for all the challenges, as I have learned to bring my “worldliness” to my patients in the form of an empathy and compassion they helped build.
I use my financial privilege first and foremost to care for the bodies of my family- meaning high-quality foods and medical care. I mourn the fact that these are indeed such privileges. I also make choices that I believe are most beneficial to our environment and society, including buying local organic foods, taking mass transit when possible, preferentially patronizing local POC-owned businesses (and never Amazon or Walmart), and planting native species in our tiny bit of urban soil. These are things I have the privilege to understand are “better”, and the money to choose them.
My personal privileges now include being white, American, highly educated, highly intelligent, relatively healthy, fairly tall (yes this is one I’ve been seeing the privilege of a lot lately, particularly in the context of being a woman in surgery), having a high salary, and being a home owner in a very expensive city. To me, having privilege means having gifts not given to all. My job is to reciprocate in the form of using my skills and talents to the benefit of all, and to make well-considered choices about what my money goes to support.
Nice post and positive message. A good reminder we don’t live in anything resembling a meritocratic society and that my “success” is mostly luck. As such, it makes sense to to acknowledge privilege and support people and policies aiming to improve opportunities and fairness.
I don’t know if it is “mostly luck” or not, but it’s important to recognize both luck and hard work as factors for success. Reasonable people can argue about the proportion each makes up.
Agree both are important, just making the rhetorical point that merit is far from the sole determinant of success. It seems that “talent”, “gift”, or whatever other term is used for some virtuous quality of successful people, is pretty evenly distributed through the population, whereas opportunity is objectively not – e.g., the hungry young woman with tuberculosis who grew up in an orphanage in Bangladesh could easily be me under different circumstances. I find it rather telling how much this type of discussion induces rage in many people in our current political and cultural environment.
I’m not sure I agree that it is as evenly distributed as you seem to think. Even looking at my own family and friends I see an awfully uneven distribution of ability even with similar amounts of privilege.
I think we’re saying the same thing – not that each individual is the same (obviously not), but rather that whatever virtuous quality in question can be found more or less at the same frequency between different populations or groups, however defined. Which is the opposite of what someone else said in reply to this post – that White people (whatever that means) worked hard to “earn” status and privilege, while non-Whites did not. A bizarre and historically ignorant take on things, but just my opinion, I guess.
The funny thing about privilege is that while we’re all deriding its role in determining success, we’re also all trying to give as much of it to our kids as we can by working hard, taking risk, saving, investing, and teaching them. I think the other commenter is saying, “What if a group of people did that generation after generation after generation? What would it look like after a few hundred years? It would look like privilege.” And in some ways it is, since that particular generation didn’t earn it themselves, even if their forebears did.
Feedback in the email box is both positive and negative:
First negative:
The idea that we don’t talk about privilege enough in 2022 is really off base. Articles like this one don’t further your goal of helping physicians stay mentally healthy – I’d argue they have the opposite effect. This piece is much more about pushing physicians to mindlessly accept the cultural narrative of the moment – something that has wrought more destruction to the profession in the past 24 months than in any other time in recent memory. The fact that the author is focused on how she needs to think about her success as privilege instead of the result of her (obvious) hard work, perseverance and optimization of her unique giftings is insulting to her accomplishments, even if she’s the author of such bad ideas.
I’d encourage you to read up on where the power and privilege language originates (Foucault, Derrida and, ultimately, Marx). History has already shown that espousing these ideas doesn’t lead to a more open or equal society.
Then positive:
Loved this post! As a blog and Facebook group reader, I feel that posts can be tone deaf when there is a lack of discussion about privilege. While we may all be doctors (or other medical professionals), we didn’t all have the same starting point in the game, which is one of our many contributors to our current success, income, socioeconomic status, etc.
While the ultimate goal of WCI is investing, I’m glad to see this post as one of the non-investment writings. Kudos!
Thanks for writing this. I was able to relate to my life incidents when reading yours.
As an immigrant physician from south asia, where i was minority, this topic is complicated for me to understand.
The concept of privileged is understood, its not given, its earned. Earned by multi generational hard work. White people are privileged coz since 1700s, they have worked hard and built nations and economies. People around the world respect that and hence respect the people. That is earned. Many civilizations havent done that, not even today. Cant understand why there has to be a guilt associated with privileged.
Many brown and Asian people come to this country, most are successful. Most work very hard and are owners of business and have significant assets, weather they know English or not. Some times they are discriminated BUT they are discriminated more by their own fellow brown/Asian people more than by Whites and blacks.
To me, the concept of self guilt coz you are successful totally does not make sense. To me this is a dangerous concept. Rest of the world doestnt care and laugh when they even think about it. I am still learning and havent bought into it yet.
I absolutely agree with the first part of your comment. Some portion (again, reasonable people can disagree on how much) of privilege is a result of the work of prior generations trying to make life better for their descendants.
As far as who discriminates most or has discriminated most in the past, I have no idea.
There is an argument to be made that previous generations didn’t “work” harder. They were as fortunate to be situated in Eurasia as someone is fortunate to be born into the US. https://en.m.wikipedia.org/wiki/Guns,_Germs,_and_Steel
As a dear friend relates (Her Serene Highness XXX from somewhere in Gujarat) “they always told us we made our fortune in rubies, but sadly it was actually slaves.” Generational wealth and position is not traditionally based on hard work and ethical behavior by all 30 prior generations. Even the white privilege enjoyed by recent ‘white’ immigrants to the US (and more recently, Irish Italian Jewish and other previously othered groups) is based upon the exploitation of hard work and suffering of Blacks and First Nation people.
Instead of focusing on “Privilege with Power”, focus on “Gratitude without Guilt”. I understand the writer’s intentions, but ultimately physicians are much more likely to over-care for those around them who, frankly, will never even care for themselves…all at the expense of maintaining balance in their own lives. Be grateful for any positives in your life, but you should never feel guilty for everything you earned, regardless of other people’s suffering. Rather than over-caring, it’s better to have compassion for other people’s suffering to maintain the proper balance, without losing your “self” in the process.
Mostly responding to the stream of comments. I feel no guilt for the privileges I enjoyed, which were legion. I do feel responsibility for lifting up those around me. The tide can rise for everyone.
I agree with that. Gratitude is important.
Great article. I’m similarly a first-generation immigrant and now an FP. I always thought that poverty, like dark skin, is a de-facto designation of a second-class citizen. It was downright humiliating and debilitating to be constantly poor, hungry and frightened in one’s own neighborhood. In a few weeks, I will give a presentation titled “Bridging Medical Literacy with Cultural Competency.” I plan to convey to my colleagues that physician cultural competency includes a good understanding of the social-economic factors contributing to health disparities in our most marginalized patient population. While physicians represent the top 3% of the economic ladder, we should be recognized individually for how well we understand and care for the bottom 33% of our society.
Maybe docs represent the top 3% by income, but not necessarily by wealth. But we’re here to change that.
I thoroughly enjoyed this article. Thanks for sharing.
Good article
Just want to point out little known fact about Federal Work Study. A student with Work Study funds can work at ANY not for profit and federal government picks up about 80% of salary.
Colleges rarely offer this information and prefer you work at their library or kitchen.
Once I learned the rules, I actually set up a non profit tutoring service. I was able to earn those higher wages and my students paid only 20%
Interesting.
Thank you for one of the best, most honest and most compassionate posts in years. I hope to find more of your writings in the future
Thank you, Dr. Joy. Your name is quite apt.
Gratitude is a powerful emotion. I work towards gratitude every day, and I also work on using my power and privilege to share opportunities as far and wide as I am able.
Thanks for all the comments. I find writing a vulnerable journey done alone and in community.
I’m grateful for the thoughts and welcome the discourse. We are all human and deserve dignity and respect on our journey to financial independence.
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