Dr. Makeda Dawkins remembers the moment clearly. A Caribbean patient explaining family achievements with characteristic pride was being discussed by the medical team, with some suggesting the patient’s statements indicated grandiosity or potential delusion. As the only Black physician in the room, Dr. Dawkins faced a familiar dilemma: intervene as a cultural translator or remain silent.
“I think it was hard for me to sit at those tables and sit in those conversations and find my voice to advocate for patients,” she recalls. “Being comfortable with understanding I have a voice, I think that was the most difficult part along the journey.”
For Dr. Dawkins, a gastroenterologist who completed her training at Westchester Medical Center, these moments of cultural interpretation have been as fundamental to her medical practice as any diagnostic skill or surgical technique.
When culture shapes diagnosis
The psychiatric example Dr. Dawkins cites isn’t merely anecdotal. It represents a critical intersection where cultural misunderstanding can lead directly to misdiagnosis and improper treatment.
“Psychiatrists have a lot of influence and a lot of power,” she explains. “If you’re not understanding the cultural context that your patient is coming from, you’re not going to be able to treat them to the best of your ability.”
She elaborates with striking clarity: “If you have a patient of Caribbean descent and they’re telling you Caribbean people can be very proud people and they’re telling you what they’ve accomplished and what their children accomplished, that’s a sense of pride for them. But if you don’t understand that and you’re treating them, you may interpret it as someone being boastful or someone telling fallacies and things like that, and that can influence your diagnosis.”
This dynamic extends far beyond psychiatry, affecting every specialty and every aspect of the patient experience. From how pain is expressed to family involvement in care decisions, cultural context shapes both medical presentations and responses to treatment.
The burden of representation
As one of few Black physicians in her training environments, Dr. Dawkins experienced what she terms “imposter syndrome,” compounded by the awareness that she represented her entire community.
“It was difficult for me at first to work in hospitals where I didn’t see people who looked like me as physicians, to navigate spaces in rooms where there was no one that I could assimilate with,” she says.
This isolation created a particular pressure to excel. “If I’m going to be the only African American Black person in this room, I need to know my information to a T, I need to be on my P’s and Q’s, I need to be sharp,” she remembers thinking. “I knew that I was a representative of my culture and people who looked like me, and I was also an example for people who were looking up to me.”
The psychological weight of this representation tax is substantial. Yet for Dr. Dawkins, it served as motivation rather than limitation, driving her to master her field and excel in academic medicine.
Translating across the cultural divide
The gap Dr. Dawkins bridges isn’t simply between doctor and patient, but between different systems of understanding health, illness, and the body itself.
“A lot of the times patients would say things or do things that I would interpret in our cultural context as something to be quote unquote of the norm, or very common,” she explains. “And when you’re behind the scenes and you’re having conversations, there’s some people who don’t understand it, and they’re mistaking it for something different.”
This role as interpreter requires extraordinary vigilance, as Dr. Dawkins must first recognize the culturally specific components of patient communication, then translate those elements for colleagues who may be unaware of their own cultural biases.
The strain of this dual consciousness is rarely acknowledged in medical training, yet it represents an additional responsibility carried disproportionately by physicians from underrepresented groups.
The power of diverse perspectives
The most rewarding moments in Dr. Dawkins’ career often involve witnessing the impact of her presence and perspective on patient care.
“The most rewarding part is always seeing the effect that I have on patients,” she says. “When they always tell me, ‘Oh, you look so young, and you’re so knowledgeable. Thank you so much, and this journey would have been so difficult without you.’ That really means something.”
These patient connections affirm the value of diversity in medicine, not merely as a social good but as a clinical necessity. Patients from marginalized communities often report greater trust, better communication, and more positive experiences when treated by physicians who share or understand their cultural background.
For Dr. Dawkins, this validation of her role extends beyond individual patient interactions to the broader healthcare system. Her presence changes both how care is delivered and how medical knowledge itself is constructed and applied.
Mentorship as medical necessity
Dr. Dawkins credits her own success partly to finding mentors who could guide her through the complex terrain of academic medicine as a Black woman.
“I think my most influential mentor is Dr. Myers, Dr. Alyson Myers,” she says. “Having mentors and having sponsors is so important, not only as a female, but as a Black female in these spaces, because you need mentorship. You need guidance. You need to know how to navigate these rooms and how to present yourself as someone who’s interested in academic medicine.”
This guidance proves essential when facing both subtle and overt barriers. Dr. Dawkins recalls being discouraged from pursuing additional specialty training after completing her internal medicine residency.
“Everyone’s telling me it’s going to be so difficult, and I should just be happy that I’ve made it this far and kind of cut my losses,” she remembers. Her mentor “really pushed me to be better and want better for myself.”
Dr. Dawkins now views mentorship as a professional responsibility, understanding that her visibility and success create possibilities for those who follow. Her journey from the CUNY School of Medicine to gastroenterology fellowship demonstrates a path that younger students can aspire to follow.
Cultural competence beyond the classroom
While medical schools increasingly teach “cultural competence,” Dr. Dawkins’ experience suggests that true understanding comes from lived experience and genuine curiosity about patients’ contexts.
“Always put yourself in a position to learn. Always put yourself in a position to be seen,” she advises aspiring physicians. “There are always a lot of opportunities for undergraduates, and even people who are not in medical school who are interested in doing a post back or etc. There are always opportunities.”
This continuous learning extends to absorbing different approaches from colleagues. “I work with a lot of physicians, and everyone has their own teaching style, and I pick certain things I like from each of their teaching modalities,” she explains. “I take bits and pieces from each person’s teaching style, and make it my own.”
For Dr. Dawkins, now specializing in digestive tract disorders as a gastroenterologist and hepatologist, this adaptive approach reflects the essence of cultural translation itself adapting to context, drawing from multiple traditions, and creating bridges where none previously existed.
“Medicine is always going to be difficult,” she acknowledges, but as both physician and cultural interpreter, Dr. Dawkins demonstrates how diversity enriches medical practice, creating space for fuller understanding and more compassionate care.
