Monday, April 26, 2010

just in case you didn't remember, i'll remind you that you're asian

ugh, so i fell off the wagon again re: blogging, which is really depressing since 2/3 of my intern year is over. i meant to document my intern year , or at least use my blog as a means to process the pretty significant changes that have gone on this year, but i think i've always felt that i've needed to have some sort of beginning, middle, and end to every entry and the challenge sometimes (or often) seems too insurmountable. my good friend liz eaman has made it a point to do at least one entry per month throughout her residency, and i think that's something i'm going to try to do from now on.

so, not even sure where to begin here. i thought about writing because of an interaction i had this morning with an older man (mediterranean maybe?) in a coffeehouse. at first, he was friendly, talking to me about michigan (as i was wearing a michigan sweatshirt) and how he used to live in detroit. soon, he started talking about how "you people came and started selling your toyotas, hondas, and all those cars and then americans couldn't sell cars anymore." i wasn't sure exactly how to respond as i didn't want to start a confrontation (and this guy definitely seemed like he could be really confrontational). he asked if i was korean, japanese, or chinese. i was like, "i'm thai, from thailand." he briefly talked about how he had served in vietnam (had he? i don't know, he seemed a little old to have, but who knows) and how vietnamese and communists were "invisible" and "hard to see." to clarify, he told me i was "american" as he could tell that i was "born here." as he was leaving, he told me, "baby doll, i wish you the best." it was really awkward, and the barista apologized to me afterwards for his conduct, saying he had recently tried to start a fight with another customer earlier, but people knew he wasn't totally right. i was like, oh, it's ok, but it got me thinking about other experiences i've had this year where people have made comments (direct or otherwise) about my race/ethnicity.

one, white patient from rural west VA who stated that she "couldn't understand me from the way i looked" and refused to let me go through her discharge instructions ( i did, anyway) but said she wouldn't leave until she "saw a white doctor." the white doctor never came, and she ended up leaving anyway. my attending (supervising physician) was really supportive, so that was good, but i always feel like you can't say anything to patients since you have to be the one being "professional" and you're not there to challenge their sometimes terrible beliefs about race, politics, whatever, but are there for their health.

two, on my last month in the medical intensive care unit (MICU), i went to do 'morning' rounds on some of my patients (this is around 4 or 5 am) and came out to the nursing area to look at some patient charts. the nurses were discussing my name, how it's ridiculous and how they always laugh when they read it, etc, etc. they didn't see me as i was on the periphery. i got the information i needed from the patient chart and walked away. i half mentioned the incident to another colleague, and they were like, oh, that sucks, MICU night nurses can be so annoying. i was like yeah, and then that was it.

in that incident, i felt bad because i didn't say anything, which is so unlike me and my character. i couldn't even say which nurses were talking about me at this point. i just know i felt crappy about it, but talking with other interns about our whole experience (which does a lot of ups, i can say, not just these downs), one person described it as "being an injured dog and getting kicked while you're down."

why didn't i say anything? i had been up for close to 24 hrs at that point and had another six or seven to go, i was tired, i didn't want to get into a fight, i didn't want the nurses that i depend on and need to work with for the next two years to resent me or try to "get back" at me, i feel like interns are really at the bottom of hospital totem pole hierarchy, it is exhausting.

i know, you've always got to pick and choose your battles. i guess i have been in battles regarding patient care, but i haven't been in too many battles for myself (at the hospital, anyway). although this has been generally okay and i feel like i have pretty good self-efficacy and confidence and all that, it has been a pretty decent beat-down by the system.

next time, i think i'm going to try to say something.