Hey folks! For those of you who are curious, I've posted the speech that I gave at graduation this past Friday. It was a huge honor to be chosen by my classmates. I've also included the text here.
| jessica_guh_graduation_speech_2012.pdf |
Add Comment We all have that friend. The friend who in the middle of the conversation will pause to google whatever it is you're discussing or debating. Occasionally I find it annoying but more often, especially since I don't have a "smart phone" myself, I find it satisfying and convenient. Recently, while hanging out with said friend, we all discovered a new game. Since Google Search has an algorithm for auto completing searches based on the most popular searches out there, we realized that if we just fed in our ethnicities, we could get a pulse on what the masses were thinking about us. Some were expected, but others, well, others I could not have predicted. Most were hilarious. 
And then just a few more because I was curious: 
Sad but true: I’m not very good at writing about happy things. In fact, now that I think about it, I’m not very good at celebrating. Celebrating is not to be confused with partying. I like parties. I like laughing and being loud with friends. I like getting carried away into the night. Partying frequently happens in the setting of celebrating something so it’s never occurred to me that I might be bad at celebrating, but I am. It’s partying that I’m good at. Partying can be mindless, but celebration requires a sincere appreciation of something positive.  This is my dog. She is celebrating the birth of Jesus. Maybe it’s having high expectations for oneself gone too far. When I think back to many of the accomplishments that I’ve been supposed to celebrate for myself, they don’t tend to move me. Usually they’re related to studying hard, working hard, or training hard. These are all tithme consuming things that can be unpleasant at times, but ultimately they are just that -- time consuming and sometimes tedious. Or maybe it’s because that I’m so aware of my own privilege that these accomplishments are not as impressive as they may seem. There were not necessarily that many obstacles in front of me. What is so special about simply doing the work that was put before me? Conversely there’s an important distinction between humility and taking ones accomplishments for granted. However, regardless of ones reasons for not truly celebrating, I’m realizing that celebration is important when it comes to sustaining oneself. The victories are few and far between and the disappointments seemingly unfixable. Recently my classmates elected me class speaker. It’s flattering, an honor, and most of all, a surprise. So often I feel isolated and not just ignored but brushed off. Getting elected to speak at graduation by my peers does not align with my own impression of how my classmates see me. At some of my lowest points those around me often remind that the silent masses are not necessarily in disagreement. Sometimes people are scared to speak up; sometimes it’s not in their personality; and sometimes they think that since I’ve already said it, what point is there in saying anything? I shouldn’t assume that everyone thinks I’m unreasonable. I should celebrate this. Not just as a personal achievement, but as something positive that I need to embrace because how often is the dissenting opinion voted to give a speech? The world does not dole out affirmations. Strength, just like self-confidence is something that must come from within us. But, in those moments of weakness and doubt, why not take advantage of the few external validators that come your way? And so I will celebrate. Not with partying, but with a little meditation. I will sit and bask in the positivity, the way one basks on the beach hoping to store some away for the coming winter. Freedom from Self-Loathing: even better than getting to pee after holding it for a long time03/12/2012 I’m frustrated. The man sitting in front of me is an incredible person. He’s been the chair of medical departments and president of one of the world’s largest global health non-profits. He’s improved the lives of millions of people. I have everything to learn from him, but I can’t seem to get much from what he’s saying.
It’s hard to pin him down. He is willing to condemn fee-for-service reimbursement and endorse an accountable care organization model but the conversation stops there. He doesn’t even give me a chance to finish asking about his thoughts on single payer; he talks right over me. He’s most famous for both working in the pharmaceutical industry and also being a champion of increased access to medicines. When I ask him how he personally navigates the tension between the “incentive for innovation” and increasing access to medications worldwide, he describes the financial strategy of providing funding to help defray cost and risk to pharmaceutical companies, but there is no mention of his own inner, ethical dialogue. This is my chance to take advantage of the “old boys’ club” network and I feel it being schmoozed and side-stepped away with tangentially related anecdotes. I get the distinct feeling that this is how it feels to be a member of the press interviewing a politician and that confuses me even more because the context of our conversation is not an antagonistic one. We were invited to chat with him over a meal so that we could learn from him -- we were even asked to submit questions ahead of time! I’m also pretty sure that he doesn’t like me. Dammit. How depressing. I can’t even make friends when I want to. During a recent haircut, the stylist plucked a white hair for me. (Thanks). But upon closer examination, though the last foot of it was completely white, the few inches closest to the root were actually black. (Put it back!) Pigmentation of hair is a mysterious thing that most folks relate to genetics, age, and stress. A few possible correlates to my life: 
I have this habit: I count people. Every time I arrive at a function or meeting, I’m like a covert operative and immediately analyze the situation. But I’m not looking for possible emergency exits, I’m counting the number of white people. Sometimes I count the people of color instead. Basically I count whichever one is in the minority. These days, this usually means counting people of color and it’s usually in the single digits. Thus, the habit is not as all-consuming as it might initially seem; usually it only takes about one second. And while this sort of behavior might give me something in common with bigots, I’m not a bigot. I’m just not colorblind.  In times of stress we revert to old habits so it's not surprising that a few days ago I found myself tallying the race if each resident in every program that I was considering. As a medical student on the verge of graduation, the deadline for submitting our rank lists is just around the corner.
Unlike applying for college, medical school, or even most jobs, the residency application process is a mutual one. Nobody is accepted and nobody is rejected. Each residency program makes a rank list of the applicants they want with their favorite at the top. Each applicant does the same with residency programs. The lists are submitted and computer magic spits out the optimized combination. On “match day” the results are released and each applicant is given a slip of paper with the name of the program that they’ve been assigned. The process is similar to dating. It’s a complicated social dance of desperately trying to get a program to like you while at the same time trying to figure out which program will make you the happiest. The process is only intensified by everyone around telling you that it's the most defining decision of your career. As I reduced each smiling face into a hashmark on my paper, I thought about the email that had prompted this undertaking. It was from my friend and fellow Family Medicine applicant. In it she ruminated about the ranking process. She noted that most of the programs that we were applying to were dominated by white faces. Was that an appropriate thing to be concerned about? How much weight should diversity carry in the ranking process?  Lorena Reyes empowers herself by re-presenting the original image The mainstream media likes to claim that Occupy Movement is comprised of aimless activists without concrete goals. They should go ask Martha and Lorena Reyes, two recently fired Hyatt housekeepers who know exactly why the 1% who run everything need to be occupied and what the 99% is demanding.
Until recently, the two sisters worked for the Hyatt Regency in Santa Clara, CA. On October 14th, after 30 years of combined service, they were abruptly fired. According to the Hyatt, they were terminated for “stealing company time.” The hotel alleges that they took ten minutes too long on their lunch breaks. The Reyes sisters explain that housekeepers are assigned so much work that they frequently do not have time to take their legally-mandated, 10-minute break in the morning. It is routine and long-accepted by management for them and their coworkers to take an extra ten minutes during lunch to replace their missed break. The Reyes sisters believe that they were actually fired for a different reason. Their story begins in September during “Housekeeping Appreciation Week.” On arrival to work, Martha was greeted with a collage of her and her coworkers’ faces digitally altered onto the bodies of women in bikinis. She was horrified and took down the picture of herself and her sister, Lorena. Though it’s commonplace to see images of scantily clad women in the media, Lorena explains, “In my culture I was raised to be conservative with my body. I don’t like bikinis… I felt very uncomfortable knowing my male coworkers were looking at that.” Shortly afterwards, both women were fired. another piece of housekeeping: After some debate, it's been done. We are now officially at www.jessguh.com. So for those of you still subscribed to the RSS feed guhster.weebly.com/1/feed -- that's disappearing and you should get on the feedburner wagon. For everyone who is subscribed via email or the feedburner RSS, everything will automatically migrate.  H. pylori kickin it in the belly - from the New England Journal of Medicine The year 1984 is probably most well known because of George Orwell. More relevant to me, it was the year I was born. More relevant to researchers desperate to publish before they proverbially "perish," 1984 was the year that Helicobacter pylori was discovered. With a brand new bacteria that nobody knew anything about, it was low hanging fruit for publishable data. There's even a whole journal that is soley dedicated to H. pylori and it has a new issue every two months! More recently, it's become clear that H. pylori is highly correlated to the development of gastric cancer and most experts believe that it's causative due to the chronic inflammation that can result from infection. However, it's important to note that only a minority of people infected with H. pylori will go on to develop gastric cancer. In the medical student world, though critical and diagnostic thinking are highly emphasized, rote pattern recognition is just as important. During our internal medicine rotation and board exam studying common scenarios are pounded into our brains. Young African American woman with difficulty breathing? Sarcoidosis. Diabetic with an unhealing ulcer? Osteomyeolitis. The list goes on and on. The Asian claim to fame? The Japanese man who eats lots of preserved foods. He has gastric cancer.  But that's all I've been told. Basically, I can bubble in the right answer on a multiple choice test question. Nobody ever told me that gastric cancer used to be the second most deadly cancer in the world. Nobody ever mentioned that though the incidence of gastric cancer has drastically decreased worldwide, it's happened disproportionately. The incidence of gastric cancer in rich countries continues to drop, but even in the United States, according to SEER data, Asian Americans, Latin Americans, Black Americans, and Native American's have a much higher rate than other races. And absolutely nobody ever told me that the 5 year survival rate is only 25%.
Earlier this year I did a rotation at Asian Health Services (AHS) in Oakland, CA. AHS is a non-profit primary care healthcare system that provides services to low-income, linguistically-isolated Asian Americans in Alameda County. Part of my time there was spent reviewing the current research on screening for H. pyolori, gastric cancer, and Asian Americans. I could only find one study that actually studied gastric cancer in Asian Americans. It was an epidemiological study that found that rates of gastric cancer in Japanese families decrease in each subsequent generation after immigration. One other study used Japanese Americans as a subset for analysis. It was a cost-effectiveness analysis and they simply took data on white men in the United States and multiplied their risk by four. I'm not sure that counts. It's not surprising that though gastric cancer in Asians is common enough to warrant a board's question, there's been little research done on it in the United States. Asian American's are nearly invisible when it comes to health research. The US Department of Health and Human Service's Healthy People, in their 2010 Asian Americans/Pacific Islanders: Defining a Baseline, reported that only 0.1% of published medical research articles even mention API populations. This, in combination with the model minority myth, only perpetuates and contributes to the false notion that the API population does not suffer from any health inequities. Despite this having been recognized for years, little has changed in medical research and issues in data collection and analysis still remain.  from our family to yours This week is National Coming Out Week. And though we'll focus on celebrating the queer community, it's not a holiday. And despite the fact that its whole existence is due to prejudice and hate, it's not a memorial. When I was in high school, I started a Gay and Straight Alliance and I remember how big a deal National Coming Out Week was (though back then I think it was only a day). This was our chance to establish our presence. In an environment where any queer aspects of the curriculum were laundered and the social scene was assumed to be heterosexual, it was also our chance to challenge the norm. With our pins prominently displayed and posters strategically hung, I remember feeling like we were walking into battle. Long before "fierce" was campy, it was butch; and we were fierce. As my aspirations to effect change have grown, so has the scale of my efforts. The cynic in me says that efforts targeted at "small numbers of people" have no significant results. The egoist in me says that my time is better spent elsewhere. And yet I continue to advocate for grassroots change. It turns out my hypocrisy is not only limited to telling my patients to exercise regularly. A fellow activist and organizer once counseled me when I was complaining about how tired and burned out I was. "You need some inspiration," he said. Last year, the business school gave out rainbow pins during National Coming Out week. By the end of the week, nearly every business student had one. I didn't think much of it until a desperately closeted friend of mine said, "You know, seeing all these people walking around with pins -- even, like, the big footbally guys -- makes me feel like I could really come out and it would be ok." Talk about warm and fuzzy. Inspired by that, this year all of the queer organizations on campus came together for a button campaign targeted at the entire undergraduate and graduate student population. (See an interview with the organizer here!) In high school things were pretty black and white for me: you either take a stand for justice or you don't. These days I feel overwhelmed by the complexities of everything. Now I'm concerned about unintentional consequences, participating in programs that are more colonial than empowering, marketing my message so that it can be heard, taking leadership without taking power, and building smart alliances without selling out. But this button campaign... it builds a sense of community, it creates a sense of safety, and it establishes a presence. It's simple and it pleases me. |  about this blogA place where I can write my thoughts on race, on privilege, on class, on being a medical student. Part of the endless struggle to become a little bit more enlightened and feel a little less alienated.
Agree with me. Call me out. Pass it on. I post once or twice a month with smaller comments on mini-blog. about meMy name is Jess. In the interest of full disclosure: I'm a 27 year old Chinese American, student activist, past labor activist, and I'm currently a medical student. I'm queer. I'm a radical. I grew up in a mostly white suburb and my parents are white-collar workers. And I don't eat meat, but I miss it sometimes. Want to know when I post without checking back?
 categoriesAll archivesApril 2012 |
