2-13-19 Asian patients rarely ask for pain medication.

"Cultural competency is the ability to think, feel, and act in ways that acknowledge, respect, and build upon ethnic, [socio]cultural, and linguistic diversity". -Lynch & Hansen, 1998

Healthcare providers must avoid "stereotyping" patients by race, sex, lifestyle, cultural, or religious beliefs, economic status, or level of education, as we do not belong to just one culture.

I'm a couple weeks late in posting this, but I had a lot to say after this lecture on Cultural Competency. When I first began applying to medical school, I liked RVU because it had this amazing honors track program that allowed students to go on overseas rotations and learn about Global Medicine. After being accepted to RVU, I applied for a minority scholarship detailing what I wanted to get out of my experience at RVU, and how I was going to utilize being in the Global Track to advocate for public health awareness and preventative medicine. Unfortunately, I was not a scholarship recipient. However, I was one of the writers for the Class of 2022 Vision Statement, and I made sure that becoming culturally competent physicians was one of the things our Class stood for. Basically, this topic of cultural competency and becoming adequate at understanding and advocating for patients' backgrounds was important to me. Then, this lecture happened.

Dr. Bentley gave several examples of how people stereotype all kinds of races and ethnicities. She had us vocalize what we thought of when we heard of people who lived in the South in the US. Phrases like "red neck", "conservative whites", "confederates", came out. But the first thing that came to my mind was "southern hospitality". Now, I'm not trying to say that my first thought was better than the others, but in my opinion, it is less harsh than some of the other derogatory terms that were shared. I was kind of surprised that she made us do that kind of exercise, since I thought the purpose was to make us kinder, less biased, more open-minded future physicians. At the same time, I understood that she was trying to prove a point: that even amongst a somewhat diverse group of first year medical students, stereotypes and prejudice still exist. The social stigma associated with a group of people, no matter how advanced in time we are, is difficult to put aside. An example of a "cultural norm" used in lecture was that "Asians rarely ask for pain medications, whereas patients from Mediterranean countries seem to need it for the slightest discomfort." I don't know about you, but I found myself nodding my head yes to this, even though in my own Asian family, this is far from the truth. My parents, both first generations from Japan and Korea, do not hesitate to take an Advil or Tylenol if they are in pain. So, why is it that I agreed with that statement? Another example: when I was a scribe in the Emergency Department, one of the physicians made a statement saying, 'You always see Whites and Hispanics in the ED, but you rarely see Asians. That's how you know that if an Asian patient comes in, you really gotta pay attention. They don't come in for no reason."

I found myself thinking about this a lot, and later in the lecture, Dr. Bentley kind of gave me some guidance in figuring out how I felt about this. She conversed with us about the difference between making generalizations and stereotyping others. She emphasized that the difference was not in the content of the information, but in the usage of it. For example, you could stereotype Asians by saying, "Mr. Kim is Asian so he must know martial arts", or you can make a generalization by saying, "Asians usually know martial arts. I wonder if Mr. Kim knows martial arts?" Utilizing our knowledge of other races like this keeps us in line and prevents us from saying disrespectful or bashful comments. Furthermore, as a future physician, this could help in actually discerning the patient's values and beliefs. Instead of jumping to conclusions about someone, we can use generalizations to learn more about them. The previous statement, about Asians rarely asking for pain medications, is a generalization in my opinion. That's why I think I nodded my head. Because even though it doesn't apply to my own family, the statement could apply to other Asians. Instead of getting worked up over every stereotype and weird exercise we did in that lecture, I tried my best to keep an open mind about it. I knew some of my peers felt very distraught after that lecture, and while I initially agreed with their statements, I now think that it was an exercise to get us started in broadening our perspectives. We cannot improve ourselves and become more culturally competent if we do not know and understand the insensitive things that emotionally affect our patients, right? If we stay ignorant to the stereotypes and malicious stigmas, then that's exactly the type of physicians we will become: ignorant ones. I, for one, do not want to be ignorant. I want to be informed. I want to make good choices. I want to practice good medicine. And I want to be able to connect with my patients. Medicine is never an easy profession to pursue. It never will become easier. Medicine challenges your beliefs, questions your judgment, and really makes you solidify your values. Becoming culturally competent is really important to me. But having to learn about it by becoming aware of hurtful stereotypes, especially those of my own race, really put me in a twist. Now though, as I reflect on that lecture, I feel slightly better about it. I'm learning, and growing, and that's all I can hope for on this winding journey towards becoming a physician.

My passion for Global Medicine and Global Health began after my medical volunteer trip to Nepal in 2011. This is where I met Prasiddha, who always made me laugh and smile despite him being a sick patient in the ward. Here he is on the day of his discharge!