As medical students, we share a series of first times. The first times of seeing the baby take the first breath and listening to the screams as the baby is being passed to the mother to be held. The first times of delivering bad news and discussing palliative options when we were all tiptoeing for the right words and catching our breaths. The first times of holding patients’ hands as they struggle to breathe. We also experience everything in between, and we share this unbreakable bond united by a myriad of these first times. They may sometimes happen all at once during morning rounds or while collecting ourselves and resetting before moving to a different patient room. “Hi, my name is…, and I am a medical student working with … How are you doing today?” We conceal our emotions to match the mood of the new room.
Sometimes, it was hard to hide. There were also so many firsts that I experienced by myself and felt alone in a place far from home. In my earlier years, I lived in a safe bubble in the suburbs of Atlanta where names such as the Great Wall Supermarket ringed with pride and familiarity and Kung Fu Tea was a fan favorite. It was not until the COVID-19 pandemic coincided with the start of clerkships, during my sojourn in Greenville, SC for medical school, that I realized my bubble had burst and that I needed to reexamine my perspective as an Asian American in medicine. This essay is a compilation of random thoughts from my diary where I share my world with the reader and for the reader to experience medical school through my lens…
In front of a screen:
My everything in between, at times, had me lost for words and in desperate search for the right ones. My first time messaging the physician, “Hi, my name is Alyssa Guo, and I am a third-year medical student working with you starting next week… ” I relook at the message for any spelling or grammar errors despite using autocorrect. Then, a second time. A third time. Well, maybe I should look again just to be sure. Maybe I should try a different variation. How about “Hi, my name is Alyssa, and I am a third-year medical student… ” I reconsider including my last name in that initial text. Sometimes, there is not the luxury of omitting my last name. Sometimes, the default includes my full name, which is first seen before anyone reads the patient note. During my first time writing a patient note as I watch the sun retire for the day, I take a pause. When I finally turn in the note for the resident’s review, he gives a subtle nod of “I know it all too well with my first times too” as he reflects on his own medical school years of inefficiently churning out patient notes. Let me read the note just to double check for grammar mistakes. No, maybe just a second time. In a world where voice dictation is the norm and patient notes are sometimes filled with punctuation errors and grammar mistakes, truly, this should not matter. Except, the expectation for me is different as someone who speaks English as a second language and as someone with a last name of Asian origin. The pressure is high especially growing up with immigrant parents who were disadvantaged and ridiculed at every step and turn due to language barriers. It is difficult to think otherwise when I observe their experiences firsthand.
Whether I am alone in front of a screen or feel alone among my fellow colleagues experiencing many of our shared first times, I choose to reassure myself. The extra time is worth it, and I am justified in pursuing language (almost) perfection, whereby a mirror is held in front of my Asian identity (even masks cannot hide this). When I am alone, I am forced to reconcile how to fit into this Western mold made of caricatures.
In seeing color:
When I meet a new team, and we meet many new teams during medical school, I give a big smile through the mask. Nothing off. Everything is fine. This first time happens quite frequently now that I think about it. Our team stands outside the patient’s room and gives a brief overview of the hospital course and the plan for the day. I feel my attention drifting a little. A sudden realization hits me again that I am the only person of color on the team. Discomfort creeps in, and my attention redirects. I did not notice until now. Did they? The patient who tells me to “speak English” surely notices. He notices even when I forget. The patient who cracks a joke about Japan, as I walk by, surely notices. Was it Japan? I cannot remember the specific country since I hear different variations all the time. My classmate expresses discomfort at the encounter, but I brush it off as I let out a small laugh and pretend to be unbothered. They notice even when I try to forget. The patient with whom I am making small talk nonchalantly asks, “When you graduate, will you stay in South Carolina or go back to your country to practice?” Ma’am, South Carolina is not a country, but maybe Georgia is my final destination. Funny enough, Georgia is a country too. She surely notices. I let out a dry laugh and say “we will see.” Today, it is a blue moon in Greenville, SC. I glance at the new admission and see a last name of Asian origin. I remember. I actively acknowledge my background in hopes of providing a sense of comfort for the patient. I say my last name just a bit louder today when introducing myself to the patient.
When I am the only person of color on the team, I feel alone. Perpetual microaggressions and harmful stereotypes are always met with my sheepish smile (under the mask) as I navigate (more so avoid) them again. When I am alone, I choose to reassure myself to keep myself together today for tomorrow could be the day a patient looks to me for comfort because of my background.
These are my first times that are also all the time, uniquely mine and tucked away in my own thoughts.
Until now.
These are the first times that I feel alone but realize that I am not the first and only and definitely not the last. I thought about including advice on how to navigate uncomfortable moments, but I am still trying to figure that out myself. For the time being, just know that you are not alone.
Image credit: Dear Diary by incurable_hippie is licensed under CC BY-NC-ND 2.0
Editor-in-Chief
University of South Carolina School of Medicine Greenville
Hello! I’m Alyssa Guo, and I’m a fourth-year medical student at the University of South Carolina School of Medicine at Greenville. I received my bachelor’s degrees in Biology and Neuroscience from the University of North Carolina at Chapel Hill.
I’m excited to be part of Mosaic in Medicine to share voices that are often missed in medicine. I hope that our joint efforts in shining a light on difficult topics spark conversations that will change medicine for the better. It is also my hope that MiM encourages more reflective practice and encourage more narrative medicine publications, so that we can capture moments of history and their impacts on the healthcare profession. We are working towards building MiM to serve as a beacon of light in promoting health equity, allowing for those who come after us to understand the events that shaped us through reading our publications.
Feel free to get in touch with me at aaguo@email.sc.edu if you have any questions about MiM!
