Before I could finish my third knock, the examination room door swung open. I looked down, my gaze meeting a 4-year-old Black girl twirling effortlessly around the room for her well-child visit. Gross motor skills-check. She answered my questions about her shirt with ease and told me a story about her grandma. Language and communication-check. I handed her my pen. She drew a detailed picture of me with quite a large head, but I didn't take it personally. Fine motor skills-check. Milestones were on target. After finishing my examination and a discussion about kindergarten readiness, I asked her mom if there was anything else she wanted to discuss. Her mom hesitated. I reiterated that this is her time and nothing is off the table. Her mom sheepishly admitted that her daughter had begun saying that she is not Black. At that moment, as if a signal went off, the bright little girl said, "I'm not Black, you're Black… Black is ugly." The dagger of those words echoed, ricocheting off the walls, beelining to my gut. I looked to her mother who said that she had been repeating this to both her and her grandmother. Wounded and reeling, I sat stunned with a familiar sadness and disappointment. Saddened that this is likely one of many protective conversations her mom will have about self-love and navigating the world as a Black girl, disappointed at the possibility that a 4-year-old has started to pick up on cues of racism from her environment. Symptoms of internalized racism, heartbreakingly-check.A child's brain is a sponge, soaking up both the beauty and toxicities of this world. Internalized racism is the unconscious and conscious individual inculcation of the racist stereotypes, images, and ideologies perpetuated by white supremacy about one's racial group that leads to a system of oppression. 1 Similarly to this patient, I developed behaviors of internalized racism at a young age, showing before I had understanding that there is some societal classification system weakening my sense of self. When the world is entangled in racism, the default is for racist ideas to seep into a child's porous mind. An intentional and supportive environment can counteract racism's harmful sequelae, shifting self-doubt to selfdetermination and avoidance to acceptance. This patient's mom and I tag-teamed to describe that Black is beautiful, smart, creative, and worthy of love. I went to the Reach Out and Read library to see if there was a book that featured a Black protagonist. I hoped that her mom could use the strength-based story of a Black character to springboard conversations on race and positive identity formation. However, I came up empty. I could not find a single book that featured a Black main character, not to mention a book that discussed race.