South Asians (India, Pakistan region) in America also experience racial bias based on their brown skin – even when they are born and raised in the USA. They, along with East Asians have been used as the Model Minority wedge against black and HIspanic folks by the racist right. One of the reasons for South Asian “success” in America, is we are stealing the best and brightest with a strong commitment and background in education from the region. When we say we are “a nation of immigrants”, what that really means in no small part is we have been very successful at robbing the brain trusts for over 100 years with people from European countries before 1965, and around the world now. A large portion of the scientists who built the Atomic Bomb, and who later led our development of rockets were immigrants – educated for the most part in high-level European Schools.
America however, has had a complex relationship with racism for the “groups in the middle” – those that aren’t either black or white. Whether in the days of segregation, classifying the miniscule population of East Asians as “white”, and not subjecting them to segregated schools, to conditions which forced the building of separate “Chinatowns” in areas with any significant Asian population geographically segregated from the white community.
When a patient requested ‘no Indian doctors,’ I expected the hospital higher-ups to stick up for me. But they didn’t.
Despite being born and raised in Birmingham, Alabama, a city infamous for itsformer Jim Crow laws and the 16th Street Baptist Church bombing, the most culturally insensitive conversations I’ve ever found myself in went something like this:
“Where are you from, darling?”
“Birmingham! I was born here.”
“No, no, where are you really from?”
I guess my brown skin has always given me away as not really American, so with a quick smile and a congenial laugh, I have always replied with a simple “Oh, my family is originally from India.” Usually this satisfies whoever I happen to be talking to at the moment, and we move on to discussing their favorite place to grab some chicken tikka masala. You know, the only topic safe to discuss with Indians, apparently.
As a physician, I spend much of my day being a “people person,” if you will. From patients and their families to other members of the medical team, most doctors spend the large majority of their day communicating with other people. So we’re well versed with handling almost everything that comes our way, from the inappropriate to the mundane.
Just the other day in clinic, a patient of mine told me about his travels in South Asia and excitedly asked me where I was born after I told him I’m Indian. Upon hearing that I was actually born in Birmingham, he dejectedly stated, “Oh, please, you’re a fake Indian.” Ouch.
Despite this obvious personal affront, I have coped well with the identity crisis that comes with simultaneously being denied the right to call myself either American or Indian. This unique no-man’s-land has usually been cushioned by an ability to separate these casual conversations from my role in the doctor-patient relationship. Except, of course, in the unique situations whereby my race has precluded me from doing my job—not due to any issue on my end, but due to the patients on the receiving end of my care.
I remember early in my residency, a patient specifically requested that no “foreigners” take care of her. This request was made in passing, one time, to her primary doctor, who happened to be white. It never came up again while she was in the hospital, so nothing was ever really done about it.
Fast forward a year or so later in my residency when a patient’s family explicitly requested, well, actually demanded, that no Indian doctors directly care for their mother. This was a little problematic, from a medical and technical aspect, given that the majority of her primary team of doctors was, in fact, some variety of Indian.
As you can imagine, this situation was also ethically, morally, and personally problematic. I wish I could say that this situation was handled well and all misunderstandings were cleared—but the racism and disrespect of this request were brushed away, and the medical team was told by the powers that be to handle the situation with sensitivity. Excuse me, what?
As a medical community, we are all very aware of the racial biases and healthcare discrimination faced by our patients. In fact, NEJM and JAMA have both recently published perspective pieces on these topics. But very few people have taken a look at the opposite end of that spectrum and how the judgments placed on physicians impact patient care and physician well being.
Instead of ignoring these issues, we should be taking strides within the medical community to break down unfair judgments and racist ideals. Minority doctors all tell stories about these experiences and we usually laugh because that’s what makes us feel a little better, but deep down we all know how unfunny it is.
I really don’t mind casual conversation about the best Indian restaurant in town, or the nostalgic reminiscing about that wonderful Indian neighbor from so long ago, or even that little game I play every time somebody asks me if I know that other Dr. Khan/Patel/Singh/Insert-Brown-Last-Name-Here.
But I do mind being judged by the color of my skin. Of all the things that I had imagined brown could do for me, I never really expected it to make me feel out of place both inside and outside of the hospital.