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“But you grew up speaking Spanish, didn’t you?"

7/13/2016

I left my medical school interviews vexed by a now-predictable pattern of questions.

On my second major in Spanish: “But you grew up speaking Spanish, didn’t you?"
In response to my service work in Latin America: “And you have family there, right?"
Upon reading the title of my undergraduate scholarship, named for a brilliant and unselfish student from Puerto Rico: “So where are your parents from?"

Despite the fact that I had checked “White”/ “Non-Hispanic” on my application, my deep skin and dark hair invited assumptions that my accomplishments were somehow guided by an identity I never claimed to hold: they believed I was Latina. These interviewers were exclusively white, and their veiled rejection of my self-identity — an identity I thought we shared — made me feel different, ‘other,' and mostly angry.

I was angry that their ignorance and ill-informed assumptions about my ethnicity could belie my privilege as an American-born, native English speaker, and that their narrow, superficial image of Latinx identity could bias their understanding of narratives of self-identifying Latinx students. I ended up at the one school where neither of my interviewers assumed I was Latina. Unironically, both identified as racial or ethnic minorities. I'm sure they get what it's like to feel 'othered.'

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"So you were an illegal?"

7/12/2016

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"Your interviewer likes to play devil's advocate. Don't worry though, he's ultimately fair." This was the warning I received before my worst medical school interview. It was 5 minutes past the scheduled start time of my interview, and a spry older man walked into the lobby, past me, and into my interview room. As I look across the room, the admissions officer who had offered the warning mouthed "that's your interviewer," pointing at him. A few minutes later, as the door to the room opens, I thought "here goes."

I stood up to meet him, extending my hand for a shake. As I did this, he gave a confused look and waved me back into my seat. He walked past me, and made some casual conversation with the receptionist. After this, he walked past me again, back into the room, and shut the door. Confused, I look over at the admissions officer, who gives a puzzled 'I-don't-know' gesture. As another five minutes ticked by, I nervously thought to myself: did I do something wrong?

Again, the door to my interview room opened. This time, though, I sat and avoided eye contact. My interviewer said: "So you learned your lesson?"

"Yes, sir. I will not stand until you acknowledge me," I replied, surprised by my formality. "Good then, come on in," he said.

At this point, I would have to lie if I said I didn't have my guard up. As I sat down at a table across from him, before I had a chance to settle in, he launched his first question: "So you were an illegal?"

I felt my eyes widen in surprise. I took a deep deep breath before answering, "Yes, but the preferred term is undocumented."

As I took another breath to elaborate, he cut me off: "What do you mean by that?" he asked with a cocked head and questioning tone.

"Well, 'illegal' is a dehumanizing term. It connotes lower worth to the whole person, and promotes discrimination." Having studied and taught this topic, the answer was almost second nature to me. I explained further, even managing to cite a linguistics book titled Brown Tide Rising that analyzed the political rhetoric used during California's gubernatorial race in the 1990s. My interviewer was unimpressed.

We went back and forth on the relative merits of the terms 'illegal' and 'undocumented.' In the end, I was surprised and proud of how I had answered his questions. After all, just three years prior, as I was in the midst of fighting to stay in college as a Dreamer, I would have been paralyzed at just the thought of someone knowing my status. Fear of deportation and harming my family shackled me with fear. I remembered this, and thought of how awful this experience would be for someone who was still caught up in this struggle.

As these thoughts swirled in my head, my interview took an even steeper dive for the worst.

Here are some highlights: When I talked about returning to my home country for medical research, this interview responded: "Well, I'm from [insert low-income country] and I think we should blow the place up and start over." I asked if he meant this metaphorically. He said no. When I differentiated between the work I was hired to do in my lab, and what I did out of my own initiative, he asked: "So do you want to keep doing clinical trial work,” referencing the work I was hired to do. I said "No, I actually prefer the health disparities work I am doing on my own." His response: "So you're a whore. You're doing something for money that you don't want to do."

Any and every topic I brought up, was met with this type of aggressive and stupefying response. I tried to salvage these topics by conceding points and asking for clarification, to no avail. Near the end of our time together, I would learn his motives: "I was trying to get you back after you won that first argument," he said to me as I stood up to leave the room.

What happened outside our room though, was the worst to come. As we left our interview, twenty minutes past our scheduled end time, a nervous interviewee made the same mistake I had made: he stood up to greet our physician interviewer. "Why does everyone do this?" he stammered when seeing this. "You have to be like a woman at a dance. You have to stay seated until you're asked to dance!"

To everyone's misfortune, there was music coming from the receptionist desk. Upon hearing this, he said "wow, I like this song." As he tapped his foot and snapped his finger, he made eye contact with a nervous female interviewee and said: "Honey, if I ask, will you dance with me to this song?" With a nervous gaze, she said: "No sir, but thank you."

"Well, what if I said I would get you into this school if you dance with me" he replied. Laughing nervously, her eyes darting back and forth, she finally said "I... I guess."

At this, the physician stopped dancing, stood up straight, and while looking me straight in the eyes said: "You know what I'm thinking?" The only thing my mind could go to was that he was calling this interviewee a "whore," as he had called me. I was shocked. Trying to keep my best composure, I let out a scoff-turned-chuckle, as I shook my head and sat down.

As the interviewer went into the room with his next victim, I looked across the room at my female colleague. She was turning her foot into the ground, seemingly lost in thought as she tried to make sense of what had just happened.

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"The ombudsman told me that... I would just have to deal with it."

7/12/2016

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I am an administrator at a major university with a medical school. My previous experience with other medical schools were positive, so when I was told by a member of central administration that I was "a little too light in my loafers for my job" I went to the ombudsman. The ombudsman told me that discrimination due to sexual orientation is only a policy at the state level, but at the university, I would just have to "deal with it." I am searching for a new academic home and hope to leave this place as fast as I can.

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"Seeing initiatives like these...makes me realize I'm not the only one."

7/12/2016

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Ever since I entered a health professional program, there were things that made me feel isolated but I couldn't quite grasp what it was. I was coming in with both a chronic illness, which inspired me to become a health professional in the first place, and a minority background in a class that was majority white. I started to get the impression by both peers and professors that we by default knew better than others. The constant insinuation seemed to establish the lack of importance of listening and emotional intelligence in working with people. It wasn't unusual for students to joke around about accents, mock people who live in underserved areas and the such. Discussions on a healthy lifestyle would be framed as "I hope I don't become obese" or "get diabetes."

I tried to ignore these as best as I could because being the only minority student, I didn't want to be seen as somebody lacking a sense of humor or being "overly PC". But I would also be lying to myself if I didn't admit I felt out of place many times.

There were hardly discussions on health disparities, but I do remember one diversity initiative. I heard peers asking why we should learn this stuff and some expressing that it goes away if you don't talk about it. An atmosphere that rejects understanding the social circumstances of others made me continue to lose sight of why I chose to be in a health profession in the first place. With my own personal experiences and a prior interest in journalism, I had the tendency to focus on people in the context of current events, especially the focus on socioeconomic/political circumstances leading to injustices both domestic and abroad. It sometimes felt that paying attention to these things was divulging in an entirely different subject matter than my major, and sometimes I wondered if I was "wasting my time" being too invested in stuff that were not posed as issues relevant to my program. I'd go back and forth questioning if I should have studied something else.

Finally, I had an opportunity to do a project relating to health disparities. I was encouraged by faculty, so I felt that my environment was likely very supportive. During the course of the project, I discussed my ideas with a director working in a multicultural facility on campus. He had warned me not to be overly optimistic about its reception, as past efforts didn't always work out well. When I presented on the topic, some of the same faculty members who had encouraged me in my endeavors didn't even make eye contact throughout the presentation and were rather lost on their phones or other business. When I was finished, I was hoping I'd be asked questions or suggestions, but instead what ensued was an awkward silence.

Later, I worked at a clinic which specifically served an underserved population. Often I was working under white practitioners who I would get visibly frustrated when a patient didn't understand English or make assumptions that I knew made the patients uncomfortable as well. Sometimes patients would look to me to answer questions or facilitate the appointment just because I was the only other visible minority present and seemed to show some sense of understanding, even though I didn't have the full medical expertise. I felt exhausted and unsure of how to tackle many of these issues sadly pervasive in healthcare from academia to the practice setting. But seeing initiatives like these and spaces for students and practitioners to discuss their experiences makes me realize I'm not the only one and that my focus on these issues is something that is certainly very important.

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"We are perpetuating these stereotypes at a top ten medical school."

7/12/2016

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At one medical school in California, our problem-based learning cases frequently present patients of color as non-compliant, poor, and diseased. What is most concerning about this is that the majority of these cases are pediatric patients. Our pediatric cases so far this year have been: a Tunisian immigrant with sickle cell, a black child with diabetic ketoacidosis, and a white child with Leg-Calve-Perthe's disease. The case presented the white child as a brave "trooper" in dealing with his pain. On the other hand, our black female patient with diabetic ketoacidosis was described as "combative" in a tone that was clearly racially biased. When this was brought up to the faculty, they completely ignored our concerns, stating that "combative is a common word used to describe patients." Basically, we were told to suck it up and stop being so sensitive. When we brought up the clear racial biases that affect patient care and are reflected in this case, our ideas were not acknowledged, along with other ideas we have presented about educating students about the social determinants of health. It pains me to know that we are perpetuating these stereotypes at a top ten medical school. Furthermore, since our PBL curriculum is shared with other schools, we are not the only school using these biased cases as 'teaching tools'. This is one of many instances that demonstrate the clear bias embedded in our education.

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“But you grew up speaking Spanish, didn’t you?"

"So you were an illegal?"

"The ombudsman told me that... I would just have to deal with it."

"Seeing initiatives like these...makes me realize I'm not the only one."

"We are perpetuating these stereotypes at a top ten medical school."

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