7-9-19 ~ Cultural Awareness.

This post isn't exactly related to Global Track, but because it deals with a very personal issue to me and lessons I've learned, I decided to share with you.

As a first generation Japanese-Korean female and the first in my family to graduate from college and attend medical school, I learned how to advocate for my family since I was young. Though my parents speak English well, their understanding of it is broken, and many times I have had to translate or break down explanations, comments, or words into pieces that they can comprehend. Last September, my mom saw a gastrointestinal doctor for her ongoing acid reflux. She was highly advised to have an esophagogastroduodenoscope (EGD) in order to diagnose her problem and check for any abnormalities. However, because my parents own and run a small sushi restaurant by themselves, my mother decided to forego the importance of the endoscopy and continue working until I returned home from medical school over summer. I did not know any of this until my mom told me about it in May this year. My parents have worked incredibly hard to ensure the success of the restaurant and support my education, and because they cannot afford to hire another waitress or waiter, it is tremendously difficult for them to take time off for medical procedures, or even just to see their doctors. Still though, my mom's decision was shocking to me, and naturally, as any daughter might be, I was angry at her for her choice.

My mom scheduled her EGD for the beginning of this last June since she knew I would be home to take her to the hospital, run the restaurant while she was recovering, and nurse her at home. I attended her follow-up appointment at the GI office with her so that I could fully understand her medical condition and also explain to her the results. It turns out my mother had waited a little too long. The biopsies taken during her EGD procedure showed changes at her squamocolumnar junction in her esophagus, and she was diagnosed with Barrett's esophagus, a condition that is a precursor to esophageal cancer if not carefully watched. My mom, due to her broken understanding of English, laughed when she heard her diagnosis because she was ignorant of what it meant. However, me, sitting in the patient exam room with her and a year of medical school under my belt, started to fire question after question at her doctor because I learned that Barrett's esophagus is not an auspicious diagnosis. It is incurable and irreversible. It will either progress to cancer, or stay the same. The GI doctor reassured me that she would be okay, but I cannot help but wonder if the outcome would have been different had she taken the time to get the EGD performed last September.

If I had told her the importance of getting that procedure done sooner, if I had known more about her health prior to starting medical school, if I had understood my own culture's practices and was more considerate of the fact that Asians do not discuss their health issues openly and tend to internalize their pain, would that have prevented my mom's diagnosis? Even now, I worry. Even now, I feel guilty for not having recognized the cultural patterns in my own immediate family. However, now I understand and have a greater appreciation for the necessity of cultural awareness, cultural sensitivity, and cultural competency. These cues, if recognized, can save people's lives. These cues and patterns can prevent people from making mistakes, waiting too long, and being inactive about their health.

I am a first generation Asian American female, who comes from a family that relies on me to take care of them because it is my duty as their only child and because they cannot depend on anyone else. This is a part of my culture and is also a part of my struggle. However, I strongly believe that having this struggle makes me stronger, and will make me a better physician to serve my patients. While I embark on this next chapter of my medical school career, I know that I will be more cognizant and receptive to learning about different cultures, and use my experiences to help more people in the future.