Saturday, June 26, 2010

Observations on race and gender from Chemoland

[Be aware: what follows is somewhat of a rant, but it's also part of my observations on going through the hospital system as fully aware that I occupy a raced and gendered body]

If you are a new time reader to this blog, I have a semi-apology to make. Usually I try to write 2-3 times a week (or at least once a week), sometimes with fillers like YouTube videos or links to other sites, but oftentimes I try to write about my observations on race--all things racial--all things dealing with the intersections of racial identity (like sexuality, gender, class, region, religion, you name it)--or just my own esoteric observations of the day based on what's going on in the news or in politics and popular culture.

However, in mid-April of this year, the week after I came back from this fantastic conference, the annual meeting of the Association of Asian American Studies (of which I am a proud member in good standing since 2000--I think I only let my membership lapse once and when Bush sent around those refund checks in the mail his last year in office I used mine for a lifetime membership with AAAS--so now I never have to pay the membership fee when I go to the conference--WOO HOO! And I used the money where I thought it would be best used--to help an organization whose mission is to educate ourselves and others about issues surrounding Asian American populations and to be a mouthpiece for anti-racism wherever we see it (most recently the organization put out a statement condemning the racism of the Arizona state legislature for their many egregious laws and resolutions).

Anyway, back to my main story. So I come back all invigorated from this conference and I have to suffer one of the most maddening and anxiety producing doctor's appointments ever. And this really minor thing happened with the mamography technician. I mean, it was a very small comment that she made--and I know, I KNOW she didn't mean anything by it. But I'm setting up this context so that you understand that I JUST got off the plane Sunday night from this amazing 4 day conference where I was immersed with scholar-activists around the nation and the globe, going to panels and hearing some amazing papers and taking part in wonderful conversations and just hanging out with the friends I only get to see once a year at this conference. And reveling in being with people who shared the same shorthand and understanding of what it means to be Asian American.

So when I had my 8am mammogram appointment (the second one in 2 weeks -- long story) I was grumpy and grouchy for several reasons (among said reasons: fearing a breast cancer diagnosis). And my nurse was one of those folks who if you turned to the word "chipper" in the dictionary, there would surely be a picture of her. She was a middle-aged, petite, white Southern lady and as perky as you could be for 8am. She was also one of these white Southern women who has decided that as short or as surly as you are, she will just get chipper and perkier by the second. Which perhaps works on 99% of the people she sees.

But not me.

Of course things got off to a bad start the minute she asked me my name--as in, "Excuse me, how do you pronounce your last name?" Now, I want to be pseudonymous on this blog, but I'm going to have you imagine all of the last names that someone who is Chinese American could possibly have--and mine was not spelled in any unusual way--it was spelled and sounds phonetically as you would imagine. It's homonym, in fact, is a very common word in the English language. So I said to her in the most deadpan way possible, "How do you think it should be pronounced?" And this woman drew out my last name (which only has one syllable) in the most tentative way possible, nearly whispering it to me (what did she think I would do if she mispronounced it--if in some oddly peverse way she had managed to completely mangle it--that I would scream at her "NO! THAT'S NOT HOW MY NAME IS PRONOUNCED???!!!" But I realized quickly that I was making her nervous. Because I am not your typical Southern woman. Anyway, I nodded my head and she breathed a sigh of relief and said, "Oh good, I just wanted to make sure because it's different."

Different from what???!!!

Because I'm Asian???!!!

WTF???!!!

So now I'm seeing red. I mean, there's a whole backstory about how the hospital didn't get all the mammogram films from the other clinic I went to 2 weeks ago (and where I spent 2 hours between the mammogram technician and the ultrasound technician having my breasts poked and prodded and squeezed every which way), and there was the maddening bureaucracy of the hospital machine (which I had wanted to avoid when I first found the lump and went to my primary care physician--I had hoped it was just some kind of benign cyst but NOPE, didn't get lucky on that score). Anyway, there was an issue about whether or not I'd be able to get the biopsy that the doctor at the clinic assured me I needed--as soon as possible.

But back to the tech. So now I'm only answering her questions in monosyllables. Because I'm feeling a bit racially targeted here. And let me clarify. I'm not saying that she behaved in a racist manner. In fact, I think she did what she thought she was supposed to do. Encounter a woman whose last name seemed "foreign" and ask for the correct pronunciation. It's just that--I just got off a plane the night before where I was at a conference where I didn't feel foreign--where I was surrounded by hundreds of other Asian Americans and where our names, funny as they may seem or sound to others, were completely within the norm in our little world.

So being asked the correct pronunciation of my two letter one syllable name just made me feel that in a state of vulnerability, with my lab coat being tied in the front not the back and the stress of having to re-do mammogram films and potentially not getting a biopsy for the lump in my left breast, well to have Nurse Chipper ask me the correct pronuncation for my name because it was "different" just made me feel she was holding up a mirror to me and saying, "See, you don't look like the women I'm used to dealing with and I'm just trying to be extra sensitive to you."

In short, it backfired.

And my clear seething (I was trying not to yell at her) clearly made her even more nervous, to the point where she went into high gear perky-rambling mode. And here's where she made tactical error #2. So, there is some low level radiation when you do a mammogram, so they always ask you if you are pregnant. Now, unbeknowst to this poor tech (and unbeknownst to all you dear readers) what Southern Man and I had been keeping semi-private is that we had been trying to get pregnant. Not for too long, just a few months, but still, it was something we were hoping for. So the tech says, "Are you pregnant?" and I know the answer to this because I just got my period so I say, "No, I'm not" And she repeats, "Are you sure?" And I say, "Yes, I'm sure."

And you would think that would be the end of discussion.

But NOOOOOOO!!!! This the Perky Tech decides this is where she can make nice with me and make me feel at ease because she says, "Oh, at least that's one piece of good news that you won't have to worry about today!"

Here is where I would have slapped her if she had been any closer to me. It took all my power and strength not to scream at her "LOOK LADY! MY PARTNER AND I HAVE BEEN ACTIVELY TRYING TO GET PREGNANT FOR A FEW MONTHS SO IT IS NOT GOOD NEWS THAT I'M NOT PREGNANT RIGHT NOW AND IT DOESN'T NOT MAKE ME LESS WORRIED IN THE EVENT I HAVE A CANCER DIAGNOSIS--CAN YOU PLEASE SHUT THE FUCK UP!"

I think she sensed that her last comment was not making me feel like she was my best buddy, so the poor woman went into this hyperdrive of constant chatter. And I mean CONSTANT chatter--about whatever it was that could come into her mind. It was like she lacked any kind of filter--whatever thought floated into her head, she said aloud to me, whether she thought it was appropriate or not.

So she starts up with a stream of noise that at first is just about the weather and the traffic and the pollen but then as she is positioning me in the mammogram machine and taking the images she starts to comment on what she sees--meaning my breast tissue--which is dense. I have dense, lumpy breasts. I've known this about my poor breasts since I was in grad school and for that reason have always been extra diligent about self-exams. So this woman tells me what I already know, that I have dense lumpy breasts. But then she goes on to say that there's nothing WRONG with having dense, lumpy breasts. Lots of women have dense, lumpy breasts and they're fine--there's not a good or a bad breast, one is not better than the other, and she's sure that mine are fine just the way they are.

Again, WTF???!!! REALLY??? You are going to prattle on about the state of my breasts and that I shouldn't feel bad that they are dense and lumpy and that they're fine just the way they are???!!!

When it was done I marched out of the mammogram office and back into the changing room, where I was supposed to wait for the doctor to tell me my results. But I was fuming, and I realized that I realized that I had left my bag of personal belongings back in the mammogram room, so I let out a loud and angry "FUCK!" as I stormed out of the waiting room to go retrieve my bag. Of course, behind me were a group of women, all in various states of undress either waiting to get their boobs smooshed or waiting to have a doctor tell them the results of the mammogram films. And I did feel a bit guilty--I was breaking all rules of Southern womanhood and decorum. The loud swearing, the stomping, the angry seething I was doing in the corner of the room.

I finally get called after about 5 minutes (probably much to these ladies relief) and was brought into a small conference room where I met with the radiologist, who happened to be a fellow working with the main radiologist (after all, I'm at a teaching hospital, so I knew that this was part of the deal). I mention this guy being a fellow not because he's not competent, per se, but because I think his bedside manner leaved a lot to be desired, perhaps because he's still in training. So the first thing he says to me, as I'm sitting across from him, angry as all get out, still in my gown that is tied in the front, so that I'm having to make sure that my right breast isn't popping out since the gown is an extra-large (all the gowns are extra large) and I'm NOT. Anyway, he's not gowned, he's fully dressed, not even in a labcoat, and he starts to go over my results, beginning with the fact that they think I may have cancer in my right breast.

Now, you have to understand, what brought me to this point was finding a lump in my left breast, one I felt myself and then was confirmed needed more imaging by my primary care physician. But nothing was said about my right breast. Yet apparently there were some abnormal calcifications that they saw on the mammogram films that they were concerned could be early stage cancer, oh and by the way, he thought I needed a biopsy so they'd have to schedule one for later.

This is when I lost it. Because it is SO DISEMPOWERING to be sitting across a conference table when I am clutching at my gown and this guy is fully dressed and he's telling me that not only should I be worried by my left breast but there's potentially cancer in my right, oh and by the way, the biopsy I'd hoped to get done that morning would need to be rescheduled for later.

So unfortunately for this poor guy, he was not dealing with a nice Southern woman who understood all the norms and manners of the region. He was dealing with a very ANGRY ASIAN WOMAN who started to rant and rave and gesticulate with my hands (because I am one of those people who talk with her hands) and I began by talking about the really humiliating and upsetting interactions with the mammogram technician and that I had WANTED to have a biopsy scheduled for today and how could they lose the mammogram films from my other clinic and what does he mean to tell me I could have breast cancer in my right breast when we had only been focused on my left breast before. And in the middle of my rant I look down and notice that my right breast is flapping in and out of the gown as I keep waving my arms up and down in front of this poor guy--who is around 6 foot tall, white, with glasses, and clearly FREAKED OUT that this woman is yelling at him in this manner.

So I grab my gown, calmly look at him, apologize for taking out all my anger and anxiety on him, but then I ask him this question: Do you ever do a breast exam in this room. He says no. I then ask him if he ever finds a reason to ask a woman to disrobe in this room for any reason. He says no. And then ever so quietly I lean in and ask him, why on EARTH, if there is no need for me to be gowned in such a manner, is he sitting across from me fully dressed telling me the news about my potential cancer and treatment options while I have to sit across from him clutching my open gown--wouldn't this suggest an automatic power differential that leaves female patients completely DISEMPOWERED???

To which he says, "I dunno" -- clearly miserable and unhappy that he had the misfortune to meet me and have to talk to me about my potential cancer.

Anyway, that's the story I'm leaving you with today. Because I haven't been blogging much about issues of race, but I have been thinking A LOT about race and gender and sexuality as I've been going through the hospital administration, from the time of my initial biopsy and then subsequent cancer diagnosis to my current chemo treatments (which I have to say, the first 5 days kick my ass and I am feeling HORRIBLE right now--nauseous, dizzy, fatigued, and generally feeling like crap, and yes they have me on a ton of meds to try to relieve my symptoms AND I'm taking acupuncture AND I'm wearing sea bands on my wrists AND I'm drinking and eating all things ginger AND I'm trying other things that, lets just say, are supposed to simultaneously help control nausea, increase appetite, and let me relax (yes, I'm literally trying EVERYTHING).

Listen, I really will try to blog about things other than my cancer and chemo. But I confess, I am pretty self-absorbed with my health, esp. the 5 days following my chemo treatment when I just feel like absolute CRAP. Plus, every time I go to the hospital, I am struck by things anew related to intersections with this blog. So I'll be trying to include those vignettes from time to time, as well as to ponder the ways in which cancer, like everything else in our world, has intersections with issues of race, gender, sexuality, class, region, but especially CLASS--in terms of education, culture, and especially socio-economic position.

Hope everyone is well--and healthy--and if you're not either of things right now, then I hope you will be well and healthy soon! That's my own hope for myself.

5 comments:

Mommela said...

Aw, man. That blows. I'm sorry that you had to go through all of that. It's bad enough when you're getting routine results from routine tests, but I can imagine how much worse it was when there was so much more riding on that visit. If I were near, I'd ride shotgun to head off the hospital asshats for you!

Lesboprof said...

Jen:

I am so sorry about your experience. I just talked with my students about the fucked up things that happen to us in medical settings, based on race, class, sexual orientation, ethnicity, gender identity and expression, etc. The whole class was relating our stories, and it was a sad commentary on the state of medical care. I am especially bothered when gender-specific facilities, like those treating breast cancer and infertility, are so poorly run.

I wish you health and improvement on the chemo. I am also so glad you have Southern Man==he sounds like a winner. Hang in, lady, and know we are rooting for you and so proud of your speaking up and your self-care.

Logos Kai Eros said...

I just found your blog and wasn't sure if I would find it interesting and then 5 mins later I'm completely hooked on your story.

I want to say, I feel bad that you were put through the jolt of going from an environment where you felt comfortable to being thrown back into one where you were othered and disempowered.

But I also want to say, for one glorious moment, I lived vicariously through your story when you made the radiologist uncomfortable and freaked out. That's the kind of public outburst I've dreamed of having, but have never had the courage or spontaneity to do.

It also made me laugh out loud.

And I think it may have been a productive outburst, especially since you were able to explain it in terms of being disempowered.

I look forward to reading the rest of your blog.

And I wish you well with your health.

Donna Bickford said...

And the other thing that drives me nuts about our health care here -- where it is allegedly supposed to be really fabulous -- is that every medical practitioner acts like because one has a Ph.D. and not an M.D. that somehow one is completely unable to process information or to have any reasonable questions to ask. Give me a f***ing break!

Jennifer said...

Thanks everyone for your comments of support and care and commiseration. I have to say that the other side of the coin is that there have been some AMAZING people who have been sensitive and supportive at the hospital and who heard my complaints and understand where I'm coming from, esp. around the empowerment issues (my oncologist is one of them-she doesn't have me in a gown unnecessarily, which I appreciate).

I'll try to write about those folks too because I have to say, once you get a cancer diagnosis at the hospital I'm at, things kick into gear and pretty much people are 100% attentive to you in all ways that are important at a time like this. It's getting into the system and the insensitivity of NOT KNOWING that I think they still need to work on.