Riddle Me This 01/23/2012
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: 
Add Comment 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? Occupy Hyatt 11/27/2011
 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. cause tidiness is next to godliness 10/19/2011
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. A Refreshing Moment of Simple Inspiration 10/11/2011
 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. some housekeeping 09/10/2011
If you are currently subscribed via RSS I have started using feedburner please update your subscription from the link below or use the updated link to the right. If you don't switch over, you should still continue to get updates, but I think they will be less pretty. Also, per request, you can now subscribe via email. If for some reason you stop getting deliveries please let me know! the state of LGBT related medical education 09/09/2011
JAMA published its annual medical education issue this week and there was an article on LGBT-related curriculum. I was asked to write a short blog response for Slate. Check it out! Tides of Anger 08/14/2011
 I've been quiet lately. Recently it feels like writing is more of a hobby rather than a necessity. I'm not totally sure why, but when I reflect on how I've felt the past few months, I can't recall having those episodes of acute dispair and anger that used to be so common. These days, it's almost as if the injustices of the world roll off my back. It's not even anger fatigue -- it's a true lightheartedness.
In some ways, it's a bit of a relief. Life feels easier and is less of a burden. I'm happier. I'm probably also more pleasant to be around. (Just the other night I had a dream where all my classmates rated each other from most to least liked. I was somewhere in the bottom ten percent.) There are reasons in my life to be happy. I've completed my third year of medical school and fourth year has been much less intense; I took a vacation and traveled all over Taiwan; I've been playing more ultimate and I even flew to Seattle to play on my college reunion team and with my sister; I've been cooking more. I've been having so much fun that my usual porcelin complexion has been replaced with one that can actually be accurately described as "of color." In fact, the other day I experienced the distinct pleasure of some old white guy aggressively yelling at me from across the street, "MABUHAY!" And while I'm sure that there are folks in my life that probably think this is a change for the better, I'm not sure. Without much motivating emotion, I've been less active. because every child deserves a sibling 06/19/2011
This is the official unveiling of the mini-blog! Think of it as the little, extra "travel" toothpaste that retailers sometimes wrap in with the big tube in order to make us feel like we got a good deal. Basically it's where I'll be posting smaller ideas that sometimes pop up but have not been developed into a longer blog post. It's a bit of an experiment so it may or may not stick depending on how popular it is. So let me know what you think! | What I've been watching: Daria, the complete animated series
 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 archivesJanuary 2012  |
