“Mujhe bauhat dard hai,” he said quietly.
I was not expecting to be of any help with merely four hours of medical assistant training behind me, and certainly not for my barely passable Hindi. Recently immigrated from India, “Ram” spoke in Hindi and made a simple living as a cab driver in San Diego. On his way home after his last ride of the day, his car was totaled. He was rushed to the emergency room, where an X-ray report revealed a fractured sternum. I had checked Ram into the clinic for his first follow-up after the accident.
As I was about to leave, the provider asked me to stay back and translate. Despite us both being of South Asian descent, Ram and I did not share a native language. Growing up in the metropolitan city of Bangalore, India, I had heard Hindi spoken enough to draw general conclusions. But the regret of not taking it as my first, second, or third language in school seemed to come rushing back. I grueled through twenty long minutes of halted exchanges. Although Ram got his prescriptions and the recommended six weeks of rest, I noticed the creases in his face deepen. How was he meant to make ends meet for the next month? Was there nothing he could do except sit through the radiating pain? I felt helpless not being able to relieve him from his distress.
I began to question how South Asians, as both patients and providers, encounter medicine and each other. Although recent data indicate that nearly 20 percent of active physicians in the United States identify as Asian, Asian doctors still received the lowest same-race patient visits, in addition to lower levels of patient satisfaction compared to their white counterparts. It begged the question of how representation really evolved for the South Asian community over the past few centuries.
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Imperial Pharmakon by Sandhya Shetty introduced me to the first woman of South Asian descent to make her way into American medicine: Anandibai Joshi. Joshi, an upper-caste woman from Maharashtra, India, embarked on an unpaved journey to become the first self-proclaimed “Hindu lady doctor” in the United States in the late 1800s.
When Anandi endured the loss of her ten-day-old infant, she felt the weight of being one in too many women, surrounded by passing trails of white coats, by physicians too daunting and too rigid in their Western practice to truly understand their pain. In a world of textbook biomedicine that failed to provide Anandi the empathy she needed, the childwife fought to challenge the long-standing narrative of the role of a Brahmin woman, and the subconsciously accepted image of a physician.
Anandi, and her life packed into eleven trunks, set sail to the United States shortly after. The onset of typhoid early on in her journey severely weakened her body, warranting repeated advice from physicians on board to fight the illness by wearing wool and eating meat stew. Still, Anandi remained unwaveringly sari-clad, jewelry-adorned, and vegetarian. And it was her obstinacy to stick to Brahminical values that made her become the living object of all she was fighting against.
As Shetty writes, staying true to her Hindu values as she immersed herself in Western medicine was more difficult than Anandi had predicted. She wrestled with her own conservative upbringing, which deterred women from pursuing an education (let alone leaving her home and husband to do so), and with the Protestant values institutionalized in Western medicine, which she would learn at the Woman’s Medical College of Pennsylvania. Beyond clothing and diet, she had to continually resist efforts from her American counterparts to convert to Christianity. But her refusals only made it that much more convenient for her colleagues to point to her deviance from Eurocentric medicine as the reason her prognosis worsened. She was neither enough for Hindu domesticity nor for Western biomedicine.
After four years of pursuing a molecular and cell biology degree, receiving a clinical medical assistant certification, applying to every job posting I could find, and handing my resume to every clinic within a 5-mile radius, I finally landed a position in a primary care office. Fortunately for me, I was not the first South Asian woman in the health care setting. I was swallowed into the group of Hindus and vegetarians, but as much as I was like Anandi, I also wasn’t. My split upbringing between India and the United States meant I was far more exposed and adaptive to the Western environment I worked in.
Take food, for example. For every free meal from a pharmaceutical representative or a new recipe my coworkers attempted and shared, my deviance from the meat-eating norm characterized me more than anything else. There were so many vegetarian South Asian women before me, and yet I still couldn’t shake the feeling that I took up too much space. I always needed to be singled out and accommodated for.
More than a century later, I am reminded of Anandi’s struggles in both the skeptics and the enthusiasts I meet. Anandi passed before she could find what she believed was the perfect symphony of Hindu nuance in Western medical practice. And despite the years it took to fight for our place in medical spaces, I often wonder if we really satisfied Anandi’s dying desire. Especially when an amalgam of both external apprehension and internalized guilt allowed my instinct to apologize for myself to persist.
If it took over one hundred years to get this far, I wonder how many more it will take to no longer be caged by the umbrella term of “marginalized.” In the melting pot of nuances under every identity category that makes up this country, it seems like the only answer is to make “no standard” the standard. The goal was never to be the next Anandibai Joshi, but rather to simply be our fullest selves. Is it possible for genuine curiosity and mutual respect to become independent of geography or context? Or is that asking for too much?
Krithika Karthik is an aspiring medical student.
