I am a first-generation Chinese American. And, amidst the tapestry of threads that form my identity (mother, wife, daughter, woman, doctor), it is the piece I have often prized the least.
I was three when my proud parents and I emigrated from China, leaving our extended family behind. In one of my earliest memories, I am riding a crowded bus in Beijing. My aunt and cousin are pointing out the American tourists as we pass, commenting on their high nose bridges and round eyes and how these features are superior to our own. When we left for the airport, I could see the jealousy mixed with sadness in their eyes, and I distinctly remember my grandmother’s fervent hope that someday I would have “yellow-haired, blue eyed children.” As I matured, that dream was shared with me every time I visited. It would be such a privilege to have our heritage weaved by blood to an American.
I don’t know how much this influenced my choice of partner. Attraction is, after all, a complicated process. I found a caring and smart partner, who happened to be blonde and blue-eyed. When we married, I thought about the large family that we would create, but I don’t recall consciously participating in the fulfilment of my grandma’s dream. Yet the expectations and dreams of others shape us in ways we don’t fully understand.
Within four years, we were lucky to bring three babies into our family; first a boy, then a girl, then another boy. Each of them was born with blue eyes and blonde hair, and needless to say, my Chinese family was elated. I beamed at their exclamations. “Look at how fair their skin is! They don’t look Chinese at all! How beautiful!” Pictures of the children circulated widely among relatives and friends. “Look at their blue eyes. Little Americans!” The children were constantly told how lucky they were, how their little golden hairs symbolized my family’s wealth and status. Relatives would send on photos of their own grandchildren, with beautiful black hair and eyes, joking, “Want to trade?” My parents were commended for “making it” in America — not by their hard work, or by raising my brother and myself, but because they “assimilated” enough that their children not only found white partners, but, as a tour de force, had their own children who looked more white than Chinese.
I also reveled in my children’s “whiteness” as friends or passersby made glowing comments about the color of their skin, eyes, or hair, how they looked like their dad, how they wished their own half-Asian babies would have such light complexions. Once, a stranger mistook me to be my children’s nanny instead of their mother. All of these experiences were internalized and emerged as “pride.” But they have also been unsettling.
Why would I feel proud that my children didn’t look like me? That they chose to speak English over Mandarin? And why didn’t I feel comfortable speaking in Mandarin to them in public, especially in my new hometown? They have forgotten what little Mandarin they learned from their grandparents, and I and my parents allow it? That when they say a word in Chinese with a heavy American accent, we take joy in it? It has taken me years to understand how entrenched in racism I was. Am I a victim or a perpetrator? Likely both.
The truth is, I have practiced assimilation, consciously and unconsciously since I left China at the age of three. Growing up, I never spoke a word of Mandarin Chinese in public, which made it difficult (and a little amusing) to communicate with my Mandarin-only-speaking mother. During phone calls, I would move to an inconspicuous place and speak in a whisper, a habit that continues to this day. I remember being bullied for eating seaweed and rice during school lunch. After that, I adopted the practice of dumping my lunch, so thoughtfully packed by my parents, in the garbage and using my allowance to buy pizza and fries, an alternative that was more acceptable to my peers. I pretended I didn’t know how to use chopsticks. I pinched my nose to make it less broad. And I joined my peers in making fun of those who were less “assimilated” than I was. Once I was considered “basically white” or “white enough,” I wore this label as a badge of pride.
I have dedicated my twenties to medical training, and the last four years to psychiatry specifically. In psychiatry, we learn to recognize disparities in mental health, tuning in to transference and countertransference, and how our own identities influence our clinical interactions. And despite being immersed in this material for four years, it remains arduous and painful to look within and face my own biases. Psychiatry training is as much about patterns of mental disorder in individual patients, as it is about inspecting how issues of disparity and discrimination contribute to mental health, or lack thereof, on a systemic level.
As I have progressed through psychiatry residency, I have deflected countless racist and sexist comments that were directed at me, laughing them off instead of confronting them, justifying it to myself that it is just the price of “establishing a therapeutic alliance” with the patient. I’ve seen my other colleagues who do not fit the stereotypical “white male doctor” role experience similarly disparaging racist and aggressive remarks, and as we try to provide compassionate and equitable care while acknowledging our own biases and shortcomings, I am caught between an urge to act and a feeling of helplessness.
The concepts of “white adjacent” and “model minority” have emerged to the forefront of my attention amidst recent events. Asian-Americans have been classified throughout the last few decades as the “model minority,” a story of immigrants who “successfully assimilated” and “persevered” despite racial disparities. We are the minority “success story” of achieving the American dream and contributing to the greatness of American society. In believing this myth ourselves and doing our part to perpetuate racism, we simultaneously suffer from and reap the benefits of being “white adjacent,” of being a minority with access to the benefits of white privilege. This system of beliefs can, unfortunately, manifest in establishing a belief of racial superiority towards other minorities. I see this every day in discussions with my family and in the way my kids’ features are elevated above my Asian features.
Practicing in the suburban Northwest, I stand out, especially amidst the ongoing pandemic. “Take you and your virus back to your country,” I have had patients tell me, “Your people brought this here on purpose, didn’t they?” The racist remarks continue, “You have coronavirus since you are Chinese, right? I don’t want to be in a room with you.” “I have killed hundreds who look like you during my service … now is the time for your people’s vengeance isn’t it?” “I don’t trust Asians.” I am not alone in my experience of hate, microaggressions, biases, and racism now being targeted toward Asian Americans. Maybe it was always there, subtle and insidious, but we have been dismissive of it until now, finding it much easier to hide under the protection that being a “model minority” offered. And just as soon as our stories of triumph, our rags-to-riches narrative is elevated, rewarded with scholarships and college acceptances and seats in committees for promoting “diversity and inclusion,” our deeply racialized society is even quicker to turn its back, even on its “model minority.” In this way, being “white adjacent” for any minority group is a superficial and temporary position.
And this pandemic serves as a jarring reminder that finally, we cannot, and should not, hide. Our silent acts of assimilation, of joining in white privilege and reaping the benefits of doing so, of brushing off inequities targeted at other minorities as “if they worked hard like we did…”, the belief that we held about being falsely protected by the dominant culture has ultimately made us complicit in oppression. It is time to wake up, understand the voices of our fellow minorities, and join in solidarity.
In psychiatry, we are taught not only to accept and validate, but to question the status quo. We learn to call people’s bluffs, to tactfully challenge, to point out incongruities between thoughts and behaviors, to bring attention to things unsaid, to state uncomfortable truths, all in a way that still maintains the therapeutic relationship. Through this process, psychiatry training and practice puts us in a unique position to be activists, and I would argue, we have a duty to challenge racist beliefs, discriminative actions, and explicit and implicit biases. We do not all have to be public-speaking, rally-attending activists, but we have the opportunity to engage in introspective, dialogue-shaping, everyday activism.
“Eunice, you need to bring things into the room. Bring up the hard topics, the things you are noticing and seeing but don’t want to speak up about. I’ve noticed you shy away from tough topics a lot,” a mentor noticed after observing several of my interviews.
It is true. I have been working hard from a young age to consciously assimilate into a culture that is not my own. And if I was quiet enough, pleasant enough, accepting enough, or adopted a certain way of thinking, acting, dressing, then I would have “made it.” I would be accepted as “white enough.” Others would forget that I am Chinese. I would be a source of pride for my parents and grandparents. But recent events and the many dialogues with patients, supervisors and coworkers have stirred up many uncomfortable realizations about myself and prompted a need to act. In my role as a psychiatrist, my way of action is by writing, by using my training to explore complicated topics of identity and the biases we all hold, by acknowledging power dynamics, by shaping discussion and bringing this into our training curriculum, and by avoiding the comfortable urge to “laugh off” a targeted remark and instead challenging my patients. And when needed, such as when a patient wanted to switch psychiatrists because she had been assigned to my co-resident, another Asian-American woman, it is the duty of supervisors, the training program, the institution to support and stand up for their trainees, to voice zero tolerance for this behavior and challenge the patient’s biases, to invest in space and opportunities for exploring racism in the curriculum, and to invite marginalized voices to the leadership table. Such actions have large downstream effects on the young doctors, students, and the patients in our care.
In the musical Hamilton, Aaron Burr sings a powerful plea after learning of his exclusion from an unprecedented political decision: “I want to be in the room where it happens.” In my own quiet activism, this “room” is where my efforts concentrate. It’s where I tear down walls and beliefs I have held since age three. It’s where dialogue happens, where I challenge beliefs, where I help heal patients. It’s where I look at my children and feel pride in the facial features that resemble mine. Where I question my family’s racial biases. Where I, for their sake, use my training to speak up against systems of privilege perpetuated within our society.