To see my children reading books that showcase diversity made me realize more fully how much I wish I could have had the same experience. The inspiration for this book is my son – I wanted him to have a book with a main character with cochlear implants. I also wanted people to be able to easily recognize what a cochlear implant looks like, since to this day, my son’s cochlear implants are confused with some sort of gaming device, headphones, or hearing aids.

The book is available for preorder at Barnes and Noble or Amazon – it would be lovely to have your support. We need diverse books!

Under the new ruling, race-based admissions, even to redress past wrongs, is deemed unconstitutional. Leading up to the Supreme Court decision, Students for Fair Admissions argued that Harvard University discriminated against Asian Americans, holding them to a higher standard than whites or other races for admission. When the Supreme Court ruled in favor of treating all races equally in admissions, college admissions might change, but this will not guarantee Asians taking a bigger role in American life.

While Asian Americans as a group are highly educated, Asian Americans are underrepresented in professional or managerial jobs. Asian Americans are also not monolithic; many ethnic, linguistic, and cultural backgrounds include Chinese, Filipino, Indian, Vietnamese, Korean, Japanese, Cambodian, Laotian, Thai, Pakistani, Bangladeshi, and others. Asian Americans are the most economically divided racial group in the U.S. Also, one in every seven Asian immigrants is undocumented.

To push race-blind admissions ignores ethnic and historical racial differences. Race blindness becomes a denial of racism, a lack of acknowledgment that racism has shaped the U.S. The white advantage relates to being able to deny racism, having always been in the majority, with a history of being evaluated by other whites in places of power and authority. 

For college admissions, race-blind admissions assume that some objective, mathematical formula exists; for example, for a GPA above 4.0, one gets 30 points, for excellent SAT scores, another 30 points, for excellence in sports or music or some other talent, another 30 points, and 10 more points for excellent letters of recommendation. This formula can be altered, by adding or subtracting multiple categories and changing how many points are awarded. Given the Supreme Court decision, some suggest adding an adversity category, awarding points to those who have overcome significant challenges, regardless of race. 

But this formula does not truly exist. Admission into an institution or program is granted by a group of individuals that compose an admissions committee. Having participated in such committees, I know that there is an element of luck: if someone reading your application connects with it. There are too many qualified candidates for a limited number of spots at elite colleges; admission is not a guarantee for anyone. Race-conscious admissions are race-based in order to skew decision-makers to prioritize diversity and to be more inclusive to those affected by implicit and structural bias.

Asian Americans often are considered to have an advantage over other minorities, but this is a harmful myth. Asian Americans are not demographically underrepresented in elite colleges or in medicine; yet, this education advantage does not transmit to senior levels in the workplace. Throughout my education, there were often few to no Asian American role models for me among my professors and mentors. Asian Americans also are rare in business leadership and corporate boards. There is a true Asian disadvantage that persists despite decades of race-conscious admissions. 

Affirmative action is believed mostly to have benefited women. Despite this, although women have made strides in the workplace, gender bias and female disadvantage are still real. Gender blindness masks what women have achieved as well as the disparities that remain. Race blindness does the same to Asian Americans. Just as the experience of gender bias is real, the Asian disadvantage is real. Justice Jackson perhaps said it best, “Deeming race irrelevant in law does not make it so in life.”

Maternal mortality increased during the COVID-19 pandemic with about 800 women dying from pregnancy-related causes and childbirth every day in 2020. In total, there was one maternal death roughly every two minutes, equaling 287,000 deaths per year

And yet, many maternal deaths are preventable. Pregnancy is a medical condition for which women deserve proper care, and the option of abortion should be included in such care. For perspective, over 250,000 women in the U.S. are diagnosed with breast cancer annually, which can be treatable. A sweeping legal rule mandating how all breast cancer should be treated would never be able to account for the nuances of each individual case, and legal rulings on abortion suggest that all mothers and pregnancies are equal and the same.

While maternal mortality can affect women of any race, mortality disproportionately affects marginalized communities and patients of color. My own mother, an immigrant from South Korea, almost died the day after giving birth to my older sister. She experienced excessive bleeding in the postpartum period. Despite going to the emergency room of the hospital where she had delivered, the doctors sent her home, saying that she was being overly nervous. The bleeding did not stop or slow down. When she went back to the emergency room the same day, doctors discovered that she was in a life-threatening situation due to a portion of retained placenta. The experience was so traumatic that my mother temporarily decided to never have another child, only changing her mind when she saw pairs of siblings playing happily together.

Maternal care, both before and after birth, is important to help prevent adverse outcomes, including maternal death, but access remains a problem. Potential health risks due to pregnancy are myriad. These risks may happen early or late in pregnancy or after giving birth and include high blood pressure, diabetes, various infections, and bleeding. After birth, even one without complications, a woman’s body is changed, and health issues related to pregnancy can persist or be detected in the postpartum period.

Post-pregnancy health conditions may include high blood pressure, diabetes, heart failure, blood clotting, and depression or anxiety. But seven million women live in maternity care deserts, U.S. counties with no access to a hospital or birth center with obstetric providers. Ongoing hospital closures, particularly in rural areas, are exacerbating the problem. Even for women with access to obstetric care, costs of medical bills can be prohibitive. If continuation of pregnancy is being legally mandated by the government, valuing the pregnant woman would put priority on providing local, free, universal access to proper prenatal and maternal care.

To be sure, unlike other medical conditions like cancer, pregnancy can be sought and desired. But just because pregnancy may be enviable does not negate the potential health risks. And to be sure, pregnancy, unlike other medical conditions, involves a growing baby. While the debate over when life begins rages on, it is misogyny to disregard the rights of the pregnant woman who is undoubtedly alive. To value a woman includes allowing a woman the right to control her own body.

The majority of medical conditions and their treatment are considered private. Pregnancy has real associated health risks and should have the same privacy surrounding it as other medical conditions. Within a protected healthcare space, pregnant women and doctors should be able to discuss and choose how to manage pregnancy on an individual case-by-case basis

Threats of legal repercussions for abortion care adversely affect maternal care. The solution is simple. Unilateral bans on abortion should be lifted. The government should instead mandate abortion bans as constitutionally unsound and misogynistic barriers to a woman’s life, liberty, and pursuit of happiness.

I am a mom and my own mother calls me “Superwoman”, a moniker that didn’t empower me because trying to balance motherhood and the rest of my life has never felt easy. That being said, the sheer chaos surrounding Michelle Yeoh’s character in Everything Everywhere All at Once is thankfully fantastical and irreproducible, considering that I couldn’t write this with hot dog fingers.

Away from the metaverse, life as a mom can be difficult and stressful. Going further, burnout is a system problem related to chronic work stress, and the concept has been applied to parenting, with parental burnout characterized by physical, emotional, and mental exhaustion affecting two out of three mothers in the US. In this context, Yeoh’s portrayal of a superhero is relatable as it conveys the importance of a loving and kind support system to create more order and calm in life.

Due to where I live, and because I have relocated numerous times, my friends and family are scattered across the country. I know that I am loved as a human and as a Professor at an Ivy League institution in my roles as mother, physician, and teacher, but the emotional and physical support available to me is limited for logistical reasons.

Time is restricted for us all, and while I have been stably living in the same state for more than 15 years, the majority of my time has been dedicated to my children (one of whom had years of medical interventions) and my career as a physician.

Yeoh’s character in Everything Everywhere All at Once is an immigrant mother with the attached choices, dissatisfactions, and dreams; and yet she has the power to change reality. Both in the movie, and in her winning of the Award, Yeoh had a support network. She could not and cannot do it alone.

Moms are superheroes when we allow ourselves to rely on others, including our children, to build with them. Moms can’t do it all, and one superhero power is to accept or reach out for help. This is easier said than done, but the stressors of the COVID-19 pandemic, including the partial shutdown of healthcare and schools brings forward the realization that we all need each other.

As a mom, I sometimes navigate the most difficult times alone, afraid that I’ll be less able to fend for myself by accepting help because a certain amount of self-sufficiency is laudable. In hindsight, I overvalued mythical rugged individualism.

Yeoh’s historic Oscar win, and the story of Everything Everywhere All at Once, is a moving and visually stunning reminder that we can create our own superheroes, and they should not work alone. There is a loneliness to motherhood that small steps can overcome. Superheroes may seem to do it all alone, but even superheroes have sidekicks. Yeoh had help both as an actress and in her role as immigrant mother turned superhero. I hope her call to mothers as superheroes will make the realities of motherhood better seen and heard.

]]> https://visiblemagazine.com/how-michelle-yeoh-has-redefined-the-meaning-of-superhero-and-what-this-means-for-me-as-a-mom/feed/ 0 8784 https://visiblemagazine.com/interrogating-other-inclusion-has-not-been-enough/?utm_source=rss&utm_medium=rss&utm_campaign=interrogating-other-inclusion-has-not-been-enough https://visiblemagazine.com/interrogating-other-inclusion-has-not-been-enough/#respond Sat, 04 Feb 2023 14:42:23 +0000 https://visiblemagazine.com/?p=8451 The recent reaction to the shootings in California highlights the othering of Asian Americans. Asian Americans are variably set aside as a model minority, “privilege-adjacent”, with expectations of a malleable, hard-working, “invisible” group of individuals. Such monolithic stereotyping inevitably fails to contend with the true diversity of the Asian American experience in the United States.

“Other” relates to an “us vs them” mentality that Madeleine Albright suggests is at the root of last year’s January 6^th U.S. Capitol riot. “Other” is always outside of me or us, and implicit bias is often the root of the perception of “other”. “Other” might be based on ethnicity, political stance, gender, sexual orientation, or physical appearance.

My daughter is ethnically Korean but is culturally American. During a school lockdown drill, she was inadvertently locked out of her homeroom building. Not realizing the lockdown was in effect, she tried to pull open the door, and a passing staff member asked, “Do you go to this school?”

My daughter, a student at that school for seven years, was instantly and implicitly perceived as “other”, as someone who did not belong. Inclusion, on that day, was not enough.

Diversity training itself, when focused only on theory and not actions and behaviors, can lead to greater harm and disengagement, as argued in an Op-ed in The New York Times by Jesse Singal, author of The Quick Fix: Why Fad Psychology Can’t Cure Our Social Ills. A respondent, John Albin of New York, sagely wrote in, “By upholding race as a valid descriptor of people, diversity training upholds the very basis of racism.”

Diversity and inclusion alone generally assume that an existing group will take in an “other” that will then fit in with established norms and promote conventional culture. Inclusion may look nice, but it often does not allow for authentic, full self-expression by minority individuals. Instead, minorities are expected to be “well-behaved”, as viewed by the majority.

Diversity and inclusion can also become performative. Schools, workplaces, and organizations often focus on diversity, increasing numbers of underrepresented groups without truly acknowledging or supporting the individuals for their valid achievements, recognizing their unique needs, or allowing their voices to be heard. Diversity training itself likely falls short if we are not aware of structural racism, sexism, ableism and the universality of implicit biases and the subsequent actions and behaviors that tend to follow.

To be sure, you may argue that inclusion is a place to start. But we are past the starting line now; diversity, equity, and inclusion have been promoted since the 1960’s Civil Rights Movement. Let’s move toward true belonging, as promoted by john powell. Belonging can only be achieved by recognizing differences, by interrogating the meaning of “other”, by truly seeing what I do when I perceive someone as “other”.

My daughter’s school never probed why she was seen as “other” that day, despite the school emphasizing diversity, equity, and inclusion. There was no apology for making my daughter feel as though she did not belong, although the school did acknowledge the error in not guiding her to a safe space. Behavior matters. Let’s move diversity and inclusion efforts beyond theory and push for not only awareness training but also appropriate accountability and actions.

But the problem of citing women less often reflects a deeper issue of different networks for women vs. men (first author Kristina Lerman). The pervasive and insidious “other”-ing of women must be openly confronted before the relationship networks of women vs men can become more equitable.

Collaborations in scientific research are influenced by homophily, the tendency to seek out those who are similar to oneself; gender homophily is the tendency to collaborate with the same gender. Senior author Claire Morandin’s paper gives supporting data that gender homophily in scientific research happens more than by chance, even in fields where women are not the minority. Her research further supports that mixed-gender collaborations are more likely to publish in higher-impact journals, a good reason to step past gender homophily.

Networks influence not only scientific publications but also speaking opportunities. First author Christine Nittrouer’s paper on colloquium speakers at top universities exposed a gender difference. Invited speakers were more likely to be male. Importantly, women are not declining speaking invitations more than men; women are being asked less frequently than men. Female-led colloquiums were more likely to include women speakers (another potential example of gender homophily; in this case, benefiting women).

Visibility of women as speakers or authors helps promote women individually and collectively. The converse, invisibility (or absence) of women, is detrimental. A BMJ Open paper by first author Victoria Salem suggests that women leave academic medicine for multiple reasons that can be tied to ineffective relational networks, including a lack of authentic role models, poor mentoring, discrimination, harassment, and sexism. In a corollary article by first author Claire Vassie, informal social networks provide support and advocacy and are a reason women tend to stay in academia.

To be sure, through friendships, we learn early on that you cannot force someone into any kind of relationship. Even for adults, friendship is complicated, and Lydia Denworth has written a book on this important topic. As Gail Cornwall writes, friendships are important relationships that help set the stage for our other social interactions. While we cannot force individuals to create specific connections, knowledge of network differences for women compared to men allows us to take steps to equalize networking in academia.

 The different network maps of women vs. men in scientific citations resonate with me because I know that my own academic network has grown slowly. For me, the reasons are myriad but do include my shy and introverted personality, childcare responsibilities that prevented me from traveling and spending extra time at academic meetings, and possibly a lack of strong friendships as a child that influences the way I build relationships to this day. I also know from personal experience that my academic network has grown, over time, through academic writing, speaking opportunities, and strong mentorship.

My first academic paper was with a male mentor, my first teacher in the field of dermatopathology. At the time, my institution had three dermatopathologists, and they were all male. For what it is worth, a cursory glance over my curriculum vitae (CV) reveals that my initial seven academic papers are all with a male senior author. My own first senior author paper was in collaboration with a female trainee. The last 10 papers on which I have been senior author, there is a 50-50 split of female vs male first authors. Typing these statistics that are embedded in my CV, I am struck that these were not conscious choices. In the future, I will be more aware that the relationships and networks that I build for myself do directly influence not only my own academic record but also the careers of others.

Hearing loss or deafness can be a silent problem because there may be no way to know that someone has not heard you. The person who did not hear does not recognize they missed something. If the person speaking does not pick up on potential clues that the listener did not hear, hearing issues will go undetected.

I have seen this happen to my son, who has bilateral cochlear implants that give him access to sound. While I do consider cochlear implants to be a miracle medical device, an example of what medical research can achieve, cochlear implants are not able to exactly replicate the access to sound provided by the typical human ear. Particularly in my son’s case, he has trouble listening when more than one person is talking at the same time or when someone is talking but there are background sounds like an air conditioner. Granted, I have typical hearing and can occasionally misunderstand multiple speakers or a conversation at a noisy party, but these issues are common and daily for my son.

Through my son, I have learned several simple things that can improve communication. One, check that he has truly heard me before assuming that he is just ignoring me or being defiant. Two, body language is important. Three, sometimes tone and speed are heard more than actual words. While these are things I learned through interacting with my son, they apply to everyone, in any conversation.

Have you truly been heard? Whether one-to-one or one-to-many, your message may not be coming through in a comprehensible manner. Or, the words might be out there, but there is no actionable response, which ends up being the same as not being heard. The COVID-19 pandemic provides many large-scale examples of this, with recent articles on the underuse of Pavloxid being a prime example. Despite Pavloxid being an important treatment that can significantly improve outcomes in severe COVID-19 infections, the medication could save even more lives if it were used more. 

While public health messaging generally has no attached body language, interactions between individuals are influenced by the face and body. What is your facial expression conveying? What is your body language saying? In general, your message will be more effective if your facial expression and body language are tailored to the words and situation. If you can make eye contact and establish some degree of mirrored body language, in which whoever you are speaking to matches your gaze as well as your body positioning, there will be improved communication.

In addition to nonverbal communication via the face and body, paralanguage contributes to what is truly taken away by a listener. Paralanguage encompasses, for example, intonation, what words are stressed, and the rhythm of speech. Simple things that will make your paralanguage more trustworthy and confident include smiling as you talk, breathing naturally in a relaxed manner, and lowering your voice to the lowest natural depth. Mirroring your communication partner’s paralanguage improves the chance of being heard, reinforcing good eye contact and shared body language.

All of us should care about hearing loss and deafness and how to improve communication because the statistics suggest that we all interact with individuals affected by hearing loss or deafness. Even more than that, ensuring that another person is able to truly listen to what you have to say is relevant to each and every one of us. Everyone appreciates being heard.

The word cancer is scary, with an implicit association of cancer with death, and regardless of age, untimely death. But there has been an ongoing revolution in cancer treatments since at least 1998, with the approval of trastuzumab, a targeted cancer treatment directed against a protein called human epidermal growth factor receptor 2, abbreviated Her2. While medicine still does not have the cure for chronic diseases like diabetes, even advanced cancer that has already spread to different parts of the body can be cured. In order to achieve such a cure, shared decision making between patients and physicians is necessary.

Cancer is an uncontrolled growth of cells that is often somewhat unique to each individual. Cancer centers are increasingly utilizing personalized medicine to determine targeted therapy based on advanced testing that includes genetic sequencing of a given patient’s cancer cells. Indeed, a recent New England Journal of Medicine article documents some of the ground-breaking molecular advances in cancer care in the last two decades. Unfortunately, personalized medicine and genetic sequencing of cancer is documented to be underutilized. Meanwhile, Medicare has approved next-generation sequencing tests that are part of personalized medicine, for certain advanced cancers, if a patient desires further cancer treatment.

Thus, an important requisite for personalized cancer care is, “shared decision making with patients about the likelihood that test results will identify effective treatments”. Shared decision making allows for at least two expert viewpoints – that of the physician and the patient. The physician is practiced and proficient in medical diagnoses and treatments, and the patient is much more of an authority (than the physician) on his/her/their own life, goals, and ability to tolerate any given medical plan in terms of time, cost, and expected side effects.

To be sure, the fact that cancer can sometimes be cured does not negate the stress, worry, and fear that can come with the diagnosis. Patients should not be expected to parse through the medical literature. Yet physicians and the healthcare system are overburdened. The explosion in medical knowledge prior to and during the COVID pandemic has put even more pressure on physicians to contend with an advancing pace of medical practice. Similarly, physicians and patients must not assume that physicians understand what a given patient is facing, on a personal, individualized level. The length of a life lived is not necessarily as important as the quality of a life lived. Even with optimal guidance from a caring and knowledgeable physician, each of us can only decide for ourselves regarding weighty and life-altering healthcare decisions.

As a physician and patient, I believe three steps support shared decision making. If you get a cancer diagnosis as a patient, make sure to evaluate your own priorities in light of the different treatment options available for your particular cancer. Make sure that next-generation sequencing and targeted therapies are discussed – while not available for every single cancer, there may be something new or on the horizon for your particular cancer. Ask your doctor, if you are not sure, where you can get more information on management and treatment options, particularly if there are multiple. More than ever before, certain cancers can be cured, and shared decision making between doctors and patients is necessary.

Growing up, God was central in my Christian faith, like the majority of the US before the millennial generation. During high school, I attended a Presbyterian megachurch in South Korea, where evangelicalism was the norm, with huge gatherings promoting speaking in tongues, forgiveness, and entering God’s loving community as born-again sinners.

I say mostly because through elementary school, church was something we attended as a family, and because my parents were initially very sporadic about this Sunday activity, church and Sunday school were not routine. It was only after my family moved from the US to South Korea that my mother discovered community and leadership opportunities via the church. While this was in general a positive, it also led to family friction, as it became not just a preference but a requirement to prioritize God by displaying perfect attendance at Sunday service, at the very least, and more ideally at numerous other activities including church retreats, Bible study, and prayer meetings.

My father refused to attend church, and the weekly arguments between my mother and father were unpleasant. The fact that the raised voices and anger were seemingly about God was ironic to me. Even then, it seemed that God and anything related to God shouldn’t cause strife.

Aside from that, I still remember sitting in the backseat of the car with my sister, my parents in the front. I was maybe 12, the day could have been sunny or rainy, but looking out the passenger window, I had a deep conviction, an unshakeable knowing in an I am God. A God that exists, just that and no more. No qualifications as to what or who that God is, good or bad, just present. Here, there, and somewhere, all at the same time.

I return to that memory because life is hard, and I sometimes don’t even know right from left. The COVID-19 pandemic and various life events have made me question everything and anything these last two years. The languish and numbness of disconnection, the positive of solitude vs. the negative of existential loneliness, death being democratic and yet collectively politicized if a human life has a set monetary value. I have no real answers, and the state of the world has always been able to give evidence that there is no loving God.

It hasn’t been easy to accept that I just don’t know. My 12-year-old son whispered to me about two months ago that he doesn’t believe in God. I think he thought that I might get angry, but instead, I whispered back that I still do, and he might change his mind but it’s up to him. When I relayed the conversation to my 15-year-old daughter, she also agreed that she doesn’t think there is a God, but she respects my decision to believe in one.

I feel a certain amount of dread that I have brought my two children up in such a way that they think God does not exist. I revisit my formula of if God = love, and to them God = 0, love is a big fat zero to them. A world without love does not seem worth living in.

Meanwhile, I recognize that God = love might be incorrect, and maybe it doesn’t even matter if there is a God or not. It’s important to me, though, and I know I am not the only one who wonders about God and love and the deepest questions that relate to transcendence. For my kids who think there is no God, I like to believe that they think love = how mom feels about me. And then I remember my Bible study indoctrination (1 Corinthians 7:14) that children and spouses are sanctified by a parent’s faith, and I come full circle. If parent = love, and I do (imperfectly) love my kids, love exists. And since I still haven’t gotten away from love = God, then God exists.

My own father, who says to this day that he is not a Christian, does believe in God. Interestingly it is because he believes in math, in formulas, in pi as an example, that infinite string of numbers past 3.14, the end of which we cannot visualize. God, he says, is in that incomprehensible infinity that I can try to approximate through formulas.