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Alright, so today is October 28th. My name is Maddie Tinsley and I am here interviewing Jess Dawson and we are doing this interview over Their Story. Before we get started, do I have your permission to record this interview? Yes. All right, great. So to get us started, can you tell me just a little bit about yourself and where you're from? Sure. So, I moved a lot growing up. I moved like eighteen times. I was born in Middle East, in the U.A.E. And then I moved to India, and then I moved to Canada. And then I moved to the US when I was eight, I moved to New Jersey. And then I moved to Seattle when I was fifth-teen.

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Okay, nice. So I guess, I mean, you talked a lot- So you mentioned that you moved, that you moved around a lot growing up. But where did you settle down again when you were eight, remind me? Where did you say in - New Jersey New Jersey, okay. And so, I guess kind of going from when you moved to New Jersey, when you were living there, what did kind of the community you were in look like when you were growing up? Including with your family, your neighbors? Kind of the area you were in? Totally. So, I moved a lot even in New Jersey. So, I think was really interesting because when we first came to the U.S. we were very poor and we lived in the basement of this like three flour house and I would sleep on the floor next to my parents. I was a free school lunch recipient and all of that. And then that was like around third grade, fourth grade. Like I was in the boys and girls club, which I loved. And I think a lot of these early experience inspired my, just kind of social justice work later. But as I kind of went through middle school, as we kept moving we would live in like slightly nicer places and I could tell that my parents were getting a little bit more affluent. But we're still always solidly middle class. I was definitely always one of the few Indian people there. I never lived in the like an all Indian community or anything like that. It was relatively diverse I would say. But I think a big part of my family is that we're very focused on education, so when we moved we always try to find a good school system. A public school system for me.

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Okay, so you talked a little bit about your family. I'd actually love to hear a little bit of a little bit more about them. So, can you tell me maybe a bit more about your parents and kind of what they did when you were growing up? Yeah. So my mom she worked for LG Electronics, which is, they make like washing machines and dryers and that kind of stuff. So, she worked there in the Middle East and that's kind of the reason why we kept moving a lot. She kind of like, worked her way up through that and then my dad he, since we move a lot, my dad kind of just does whatever he can. Like a lot of odds and ends jobs, and then eventually became a realtor. Okay, nice. Do you have any siblings? Yes, I do. I have a younger sister. She's 4 years younger than me.

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Nice. Can you like a tell me a little bit about her, kind of like what what she's doing right now? She should be just like finishing up college, I guess? Yeah, so she just finished her undergrad and she's currently applying for jobs at Amazon and Microsoft. So, we're all like very anxiously waiting for her to get a job offer. Gotcha. Gotcha. So kind of on that note, would you say that you are particularly close with your family? Yes. So my sister, she actually lives with me. She's just in Seattle right now with my parents because of the whole job thing, and we lived together last year. When I was doing my first year of internship, I was working at one of the Los Angeles County hospitals, and it was just really nice to live with her and our dog in Long Beach.

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Nice, nice. So, you mentioned that education was really important for your family and that you always tried to find good public school systems for you. So, can you talk about what your experience was like in school when you were younger? Yeah, before moving to the US, in Canada I was in a Christian school for kindergarten and first grade. I actually got to skip kindergarten because I was not in the public school system. In a lot of ways like I feel like that really set me up well because I was already- I was always a year younger throughout grade school and everything. I'm glad that I have that extra her of my life now. But after that Christian private school, I was in public school in Canada. Then I just remember moving to New Jersey, we definitely did not move to a very nice school system. Just remembering I had to take these history classes, it was around Thanksgiving time and I didn't really know the US version of Thanksgiving and just all of these things. Like in Canada we don't have Fs, we have Rs. So, I remember I took a quiz and I got an F and I didn't understand what that meant. So, that was kind of a little bit weird for sure. Then also, you know the use of the letter "u" and everything. As opposed like "colour", in the U.S. it's c-o-l-o-r. I just remember everyone was like, "You don't know how to write." And I was just like "We're in third grade, chill." But yeah, so I think kind of as we kept moving schools, we only slowly started to get better better schools. I think my parents knew really early on that I really loved to read. I think that really helped me a lot with kind of just being on top of my class and everything. I was just always very interested in learning new things. So, the biggest move was definitely moving to Seattle my junior year of high school. My parents and I we tried really hard to find a place that had a lot of AP classes because I didn't do the IB system or anything and I was trying to get get more credits and all that stuff. So yeah, we thought a lot about all of that. And, when I say we, I say I thought about it and I was like, we need to move here. Because my parents did not study in the US and a lot of stuff was very foreign to them. Absolutely. Absolutely. That's definitely understandable. Throughout that time did you have any kind of teachers or mentors within any of the schools that you attended that had a particular influence on you when you were younger? Yeah, totally. I worshiped my teachers. Throughout my entire life I kind of realized I like really loved them. All of my teachers for the most part. I was always a teacher's pet, and I feel like it explains so much now as a doctor. I think what was really important to me was I had a lot of doubt that I could become a doctor. For example when we moved to the U.S. when I was in 3rd grade, a lot of the people that were around me like were not college focused. People didn't really go to college. My best friend had already been left back a grade. So priorities were very different. I just remember moving to Seattle and the Seattle area, and then everyone had ivy league legacies and that was very foreign to me. So I definitely had a lot of imposter syndrome. I remember my good friends being like "why would you want to be a doctor? That sounds so hard? I don't think you can." It wasn't really like an, "oh I don't think you can do it," but more like an "it just sounds an insurmountable obstacle to overcome. But, I always kind of say my 11th grade AP Bio teacher Mr. Hatton. He even knows this. I literally have gone back and told him this. One time I asked him "hey, do you think I could be a doctor?" And he was just like "yeah, I really think you could." And I felt like that was kind of the first time I actually ever got very clear reassurance that yes, I am l smart enough and capable enough and I could thrive being a doctor.

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So, that's really interesting and that's really great that you had someone to give you that experience. So, as we transition into talking more your interest medicine, on a similar point did you have any particular experiences with doctors or healthcare provider when you were younger that made an impression on you? So, my family always tries to go to Indian doctors. I really like that they do that. I mean, just remember my pediatrician in New Jersey. I actually don't remember any doctors before before that, but he was an Indian guy, from South India, who spoke Tamil, which is the language my parents speak. It was just so like nice and comforting to go to someone who was able to speak the same language. When we were in the room we, well I didn't really speak very good Tamil, but my parents they would just be talking and it felt very comforting for sure. Also, it was really interesting because he was an Indian immigrant so he had totally redo residency. That's kind of the really wild thing for international people who are doctors and who come to the U.S., they have to do all of their training over again. So yeah, that was really interesting. And then when we moved to Seattle, like a couple doctors later, I found this other doctor who is Family Med and she takes care of really my whole family. Like my dad and the four of us. She knows all of our drama and just interpersonal stuff. She's also Indian and she's just so down with the cause. I've met so many doctors now and I'm just like "wow, you are extraordinary." I think she just has endless patience that I dod not and I'm just did just like "you're awesome for for having that." Wow, that's really cool. That genuinely really cool to hear. So, you mentioned a little bit- you've alluded to the fact that you had this early awareness that you wanted to pursue medicine. Can you talk a little bit maybe about how old you were when you really knew that you wanted to pursue medicine and what were some of the factors that led to that realization? So, actually like growing up I was worried that I was interested in medicine just because that was the thing to do. Especially, you know, as a first-generation immigrant to the U.S. and from an Indian family. It was definitely, like I really wanted to make sure that I wanted to be a doctor for me. So, I actually explored a lot of things. I actually kind of thought that I wanted to be a physicist, because I really liked physics. I really like astrophysics in particular. But then I did a lot of physics and then I was like, wait, astrophysics is actually my least favorite part. I like the concept, I just don't like, the equations are weird. I was just like, no, I can't do this. Then I was really into Art History. So I was like, oh maybe I could do that. Again Art History and astrophysics are not Indian parent approved specialties. I think kind of after I just realized thatI like to learn things. I thought that being a doctor would be really ideal for me because I wanted to do something that was, I felt significant in terms of giving back to society. I think I was kind of interested for sure in high school. I really wanted to be a doctor, but it was only until I came to college at American University that I realized that I definitely had what it took to be a doctor. I was a very competitive applicant and it was just nice to you know be good at classes and being like, okay cool I'm like the smartest one here. Like I can do it. That's awesome.

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I'm sure that was a really good feeling. Did you have any figures in your life that were kind of instrumental into your interest in medicine or I guess your realization that this is something that you knew you wanted to pursue for you? Yeah, I would say like so in undergrad at American I was an EMT at this fire station in Bethesda. I would do that every Friday night. Actually for a part of our part of college I actually lived at the fire station because they let you live there for free if you work there for forty-eight hours, which is like four 12 hour shifts. I would go to school during the day and then I'd come back to the fire station at night and then I'd ride the ambulance. But it was free rent, and I wasn't paying, you know free laundry and free food for the most part. So it was a very solid deal. I think really it was that experience and then also just knowing that everyone else on the ambulance team, they also all wanted to be doctors. And just kind of being in like this community and pre-meds just really passionate about it. I think that was kind of when I realized like, yes, I can do it. And also it's really fun to like do medicine and that was kind of my first taste of really doing it and like being responsible for other people. No, that's, that's really, really cool and it's really fascinating. I think you've touched on this a little bit but in a bit more detail, what was your family's reaction to your decision to like go into medicine? I think, well so it was a little bit complicated. I think kind of in college like they were really happy for me. They're like, "yeah, okay this is awesome." But they were also like "you came to this realization on your own. No one's forcing you." I was like, yeah, no one is forcing me. I want to do this for me. So, I think they were there definitely super proud of me and very encouraging. Actually it's really funny because I remember in med school my mom would quiz me but everything on the page was like a totally different language to her and she wouldn't pronounce anything right. But it was just so cute, just like the effort to try to help me. So that was really sweet. But I think there was a lot of drama with deciding where to go to med school and I think that's kind of, that was where there was like a little bit of riffs in my family.

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Okay. Okay, can you, if you're comfortable, can you talk a little bit more about that? Like what was kind of the what was the question or what were the med schools that y'all were debating on? Yeah, totally. So, I had gotten into Hopkins for med school and I really wanted to go there because it was really close to D.Cc and all of my friends were still in the D.C. area. Then also I just like was not ready to go home. I mean I got into a lot of med schools, it was really good. Actually I wanted to specifically do like an M.D. and M.B.A. to do like business administration. All the programs and I got into have this M.D./M.B.A. program except my home program, my state school, the University of Washington. My parents were so convinced that going to the University of Washington would be like the right choice for me because I'd be close to them. I wouldn't be as expensive as Hopkins. I think that was where there was a lot of like drama, and at the end of the day I felt sort of forced to choose the University of Washington. I think my parents have also come to the realization that they, they did force me. We have all sort of talked about that because, I think in retrospect. I don't think the University of Washington was the best choice for me. So yeah, I'm just, but I'm also like really glad, you know. I'm still, I'm really glad about the person I am. Absolutely. So actually the next kind of topic that I was going to talk about was your experience at medical school and at the University of Washington. So, as we kind of get into that, when did you graduate? So I graduated in June of 2020.

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Okay. Yes. Alright. So yeah, interesting time. We will definitely talk more about that. What field did you specialize in? So, actually originally I wanted to do Dermatology. I wanted to do dermatology in skin of color because I thought that was like a true unmet need and that was something that I was very passionate about. I know how like a lot of doctors are really trained to look at white skin to asses skin diseases and have a really hard time diagnosing things in darker skin tones. So that was really what I was passionate about, but I ended up not matching. Then the reason why is that I got a lot of feedback that was like dermatology is too conservative of a specialty to be doing what you want to do. And yeah, a a lot of the feedback was like people are afraid to say the wrong thing around you. So it was just I think a lot of white fertility, honestly. Yeah, I kind of had to-so last year during my intern year at the height of covid in Los Angeles I had to like kind of figure out, like, do I want to keep going for dermatology or do I want to try something different? I realized that I really loved critical care and I love doing procedures and kind of just like more, really high acuity care that I wasn't really exposed to in med school because I was so focused on dermatology. So it was really nice to be like, oh wait, I think I actually like other specialties. So, here I am currently doing a Master's of Public Health at Hopkins, but I'm applying into anesthesia. Nice. Nice. So, about your time at the University of Washington, just maybe a little bit of an overview of what studying there was like? And more specifically, did you feel that your identity as a first-generation immigrant affected your experience and affected your experience at the University of Washington? Yeah, totally. So, the University of Washington is a very unique med school in the U.S. It's the state med school for five states. So it literally covers the largest geographic region in the United States in terms of med school. We call it the W.W.A.M.I program for a Washington, Wyoming, Alaska, Montana and Idaho. For the most part, it's very centralized to Seattle because that's where all the primary deans are and a lot of the faculty are there, but we have all these satellite locations. So, for the first two years when you're in your clinical period, sorry I mean your preclinical period, like classroom and stuff, there's literally five other classes in different areas. I was in the Seattle cohort and there were people in like the Spokane cohort or the Anchorage cohort or the Idaho cohort. So, there are different groups. And I was the class president of our medical student association in Seattle. Like every region has had their only class president, but as the Seattle class president, I was the one responsible for organizing everyone. I think unless you have really been a Seattle M.S.A president, people don't really realize how much work it is. I was probably putting in like at least 20 hours a week for it, in med school. And during my first year of med school it was a very tumultuous time, like it was around the time of the election of Donald Trump. There was just I feel like this shift in like national thinking in terms of race and race politics was was introduced to like common vernacular. I just I don't remember thinking about it as critically in college, but when I came to med school I just threw myself into it and I was very passionate about having that lens. I definitely think being a first-generation immigrant affected that. But I also just realized medicine is inherently a very racist institution and just kind of coming to terms with that and working with the deans to be like, hey like this is what needs to change. Then trying to take in all the feedback from five different states that are not diverse. Like they are mostly white. Kind of just weighing all that and I think that really got to me like mentally. Yeah, like I got very, I became very anxious and like a little bit depressed. Then I think a part of it also was just being at home near my family. I didn't live at home, but they were definitely in my business every day. So it was just very overwhelming to kind of juggle med school, my family drama yeah, being class president, and kind of dealing with all this social issues in medicine. Yeah. It was a lot. That was the first two years and then the second two years, that's what I started doing my clinical rotations and because it's a state school for five states I did my rotations in some very interesting places. So like I remember during my internal medicine at Harbor View, which is the county hospital in Seattle. That was really fun, but very very intense. Last year I worked at a county hospital and I felt that the UCLA med students there had it so incredibly easy. I think that was very jarring to me, of course. Then like the second half of my internal medicine I did in Wenatchee which is this rural community in the middle of Washington at this like small hospital system. Then the next month I did it on this this island, this little island practice in the Puget Sound for family medicine. Then I did like my pediatric rotation in Boise. So that was really interesting. So it was just really fun and it was fun to move, but I think it was also very draining to put on a show and perform. Because I think a lot of people don't realize how performative third and fourth year of med school needs to be because they're literally grading you for your action. You kind of just have to be a golden retriever and be the puppy dog that does whatever they want. Sometimes there were things that I did not want to do or did not feel right, and I think in retrospect I realized I think the University of Washington has much fewer of those kind of checks and balances to prevent those from happening because it's just such a broad system. I did my surgery rotation on an army base in Washington. So I literally lived on base for six weeks at the army hospital. That was, that was really interesting. I had a fascinating experience, but I also recognize at the end I was very traumatized because of the sexism that was going on. When I was I would talk to people about it or try to bring it up, just the way it was like disregarded. So I think I had a lot of very weird experiences in med school and definitely messed me up a lot. Also, I had a lot of positive experiences and I think at the end I became a very strong clinical practitioner. Which is super evident when I met my co interns, when I met other med students. I was like, yeah, I did go through a lot in med school, but it made me a good doctor. Does that necessarily mean that to be a good doctor you have to go through those things? Probably not.

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No, absolutely. Absolutely. That's a really interesting experience and thank you for sharing that. There's one thing that I do want to circle back to. You mentioned that in third and fourth year when you're in your clinicals there is this pressure to like put on a performance. Do you feel like the fact that you are a first generation immigrant and that you are a woman of color, did you feel like that added an increased amount of pressure to perform in this setting? Totally, absolutely. Actually, my University, the University Washington did a study. So there's this thing called A.O.A. Are you familiar? Yeah-oh, you're not. Okay. No, I'm not. So, it is like a medical Honor Society.

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Okay. It's very prestigious. So people can get into A.O.A. through clinical grades, but then they also have to be nominated. So getting A.O.A is highly coveted because it helps you with your residency selections. Actually my school found out that they did this study that if you are non-white and if you're a woman you're less likely to get away. Yeah, because you're clinical grades, adjusting for all of these factors, they are likely to discriminate against you during your clinical grades. So the the results of that study came out like as I was entering my third year and I was very afraid. Like, all the time. I was just living in a state of fear because I just had to perform and I had to make sure people like to me and I felt like I could never say what I wanted to say. Not that I'm saying things that are bad, but I think it's the idea of catering to white fragility and this idea of kissing someone's ass. That was very very very challenging to me. And it's also it felt like very disingenuine toxic and I think that's kind of what made third and fourth year so horrible for me personally because I did not feel like I was being my true self. I felt like if I was trying to be my true self or trying to be more authentic that I would be punished with lower clinical grades and less likely to get A.O.A. Yeah, absolutely. So you said that came out your third year. Taking that into consideration with your experience at Washington as a whole, what was the position on the equity and diversity curriculum at your medical school? How aware did it seem the faculty and the administration was of these disparities in the medical field that are often caused by race? So, as I was saying in the beginning of the year 2016, in my mind, like it just seems like race was just so much more people's mind. I really do think the election of Donald Trump kind of had something to do with that and sort of bringing that all into people's forefront. But I think there are a lot of people who have been realizing that there are these issues in medicine, especially at the University of Washington. One of my classmates, their name is Ohenoah, they have been fighting so hard for medical education equality. They have just been repeatedly discriminated against and just kind of like blacklisted as being troublesome. They ended up leaving the med school, but I think that their legacy and the legacy of the people who have come before them was very important to pave the path that race is something that we need to be talking about. Kind of after-So, for example I was on this admissions committee where we were spearheading a new question because we wanted to have people reflect on the social determinants of health. Like, "Hey, how do you you contribute to them or how do you benefit from them?" Because I think at the end of the day we all had to recognize "what is our privilege? Why why do we you think the way we do?" Everyone has these biases but it's like about understanding a little bit more of them. I think that's what also made me so tired emotionally, because I was advocating for this what felt like all the time. I just remember, we were learning about the Tuskegee trials and it was taught by an ethicist. It was probably one of the most poorly done lectures of med school and it a kind of caused a mini revolt. We had to this thinking session where it wasn't about exploited patients, but they were like "oh, how could the researchers actions have been justified?' It was just so weird this kind of resource research exploitation goes on today. I think I think they realized that it was messy and before I graduated the Deans have been like "yes Jess we've butted heads with you but at the same time we think you've pushed the needle forward." At the same time I felt like I pushed it at the cost of sometimes my own sanity. Looking back on everything and kind of, I really love reading about social justice and staying on top of it. I realize a lot of the social justice initiatives that the University of Washington has got is all like a show. It's very performative to like white privilege and I think at the end of the day it's just to make white people feel comfortable that they're addressing things. Especially after being at UCLA Harbor and just seeing how it's different. At U.C.L.A. Harbor majority of my patients were Latinae and we spoke Spanish. It was kind just this very International population and they have to like be on it to recognize all these factors that have contributed to their health. I literally adore my program director, Dr. Mendez. She is such an incredible physician who cares so much. She gets it, like she's not putting on a show. It was just such a refreshing change I think from med school.

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Thank you. So, we are definitely going to come back to talk a little bit more about just kind of these health disparities in medicine. But we're going to switch topics really quickly to talk about Covid a little bit and kind of how it affected your experience graduating medical school and into your intern year. So, can you think back to March 2020 and just just kind of talk about your experience in those first few weeks of that pandemic and kind of how you felt during that time? Totally. So I actually took the winter quarter off. I took it because it just worked better with my schedule. I planned this World Tour for myself because my interview season technically ended in January. So, after that I went to Tahiti and then New Zealand and then Australia. And then I was like working on a dive boat, and then I completed a one-month yoga training in Bali. So, I was like actually getting ready to go back to the U.S. and I was in Australia It was the Monday of match week, in March, that I was planning on returning to the U.S. the next day. I mean in Australia people were wearing masks, but it was still not a huge deal. I think it was much bigger deal in Seattle, because of course, I think that was the first place that it came to in the US. But in Australia it was very chill so I was okay, Then that Monday morning, I found out that I did not match. That was pretty terrifying. So I was like, okay, I need to scramble and do what we call S.O.A.P, which the supplemental offer program. So, I was S.O.A.P.ing and then I realized I had to change my flight. Then actually my mentor was like don't come before Friday, which is match day, because you should just stay in Australia because you need reliable internet in case you want to do all this S.O.A.P stuff. But actually that Friday March, 20th that's when Australia closed their borders. So, I had to make it out of there before. So I was like on like the second to last flight out. At this time I had found out you I was going to UCLA Harbor for intern year and then I was just trying to figure out the rest. It was just really, really, really wild because Covid-19 was not even a thought, in my mind. It was more like I didn't and I need to return home. I remember that Friday of match day of coming to Los Angeles, the LAX Airport, going to Enterprise to rent a car and they said "you know, normally by this time of day I would have already rented out at least 5,000 cars, but you're the second person here." At this time Los Angeles had shutdowns. You weren't allowed on the road. Like, it was all over empty. It was very serious and I was very surprised because it was not like this in Australia. I was kind of just like, oh my gosh, what's going on? Like this is really wild. So, yeah. Then I went home to Seattle with my family, and it was just very hard to process all of this, like not matching and then Covid. Then I couldn't see any of my friends to talk to them or like be with them through this. So, that was really hard. But then spring quarter started and I had to, you know, I still had some classes that I had to finish in order to get my degree. It was very weird to have it all virtual. And just like- yeah- My mom, she would open the door of my room and I just remember one of my professors always joking "okay, there's Jess's mom." It was just literally very weird to end on a virtual note and then kind of not being able to see anyone during graduation.My dad hooded me in our front lawn. I think that was really special for him because he's definitely really glad that I became a doctor, but it was very isolating. I was very afraid because my dad is immunocompromised and I could not do do anything. I remember when I came home from Australia to Seattle we literally put all these tarps and separated the basement from the rest of the house so my sister and I could go in and protect my parents. So yeah, it was a bittersweet way to end. Then what was also very wild was I the Monday after my graduation is my George Floyd was brutally murdered and it was just very, very, very hard. Yeah. Yeah. No, I mean just the the influx of both of those things big things that happen in 2020 on top of it just being a big period of transition for you in general. I can only imagine the kind of tumultuousness that created. Talking a little bit more. I guess. Actually we can just kind of skip by that. Moving on. So, you graduated and you started your intern year in summer of 2020. So that was kind of both during the height of the pandemic but also the height of all of the protests over the murders of George Floyd and Brianna Taylor. So, just talking about those two experiences, how did that affect you starting your intern year and starting your residency and like moving on into the next phase of your medical career? So, I think actually in Los Angeles the summer of 2020 definitely was not the height of Covid. It was the winter of 2020 .That November to February, it was horrible. I myself, I called so many deaths. I just remember having like the state-mandated organ donation number on speed dial. In December I did CPR every single day, which is not normal for anyone and so that was very hard. But I think kind of during that transition point, at that point I was very- My sister and I we were both moving to Long Beach. We couldn't come to Long Beach to see where we were going to live. We literally just FaceTimed with a realtor and we're like, all right, we'll take it. You know, and I think for me I was just feeling very lonely and just excited to be in the hospital and be around patients and be meet my co-interns. I was kind of really hoping that people were a lot more socially justice oriented. I remember n the WhatsApp or the Group Me for the intern class to be like- I was like," oh, we should go to this Black Lives Matter protest." Because we're doctors and, you know, we need to be at the forefront and be like racism is a public health issue. I just remember I posted about this and then one other person posted and they were like, "yeah!" I was just expecting so much more engagement, but that other person's like my best friend. That kind of just like worked out really well in the end in terms of bringing us together. I think that it was just something that was just on my mind a lot. I think it was on my mind much more than my co interns, which was interesting. I wish that, you know, it bothered them more. Yeah, it was it was just very fascinating for sure.

00:48:23.600 - 00:53:05.900

Yeah, absolutely. And I want to ask you a little bit more about that in a second. But you mentioned that in Los Angeles, where you were doing your intern year, that the height of the pandemic was more of that November through February, the winter of 2021. If you're comfortable with it, can you talk a little bit more about your experience working during that time? Yeah. Oh man, that was definitely I think- I think that was probably, for the rest of my life will probably be literally the hardest time ever. It was just very, very depressing to have so many people die. Then also I think it was just really hard to not have family visit. Being like, "hey, you have to say goodbye through a window." A lot of like- we would talk about like compassionate extubation, which colloquially is pulling the plug. Kind of just- and I realized that I actually really love end-of-life conversations with family and kind of helping people realize like what their goals and priorities are. Which so morbid, but I'm like, no, this is actually really meaningful. Because I really am bothered by futile care. I totally understand when families are like, "hey, I want to do everything I can." But it is just that moment of being able to talk to someone and be like, "hey, we've done everything we can, this is where we are, what would your a family member have wanted?" Yeah. I think it was hard because also, because we were so-we had so many people. For example the emergency room was turned into an I.C.U. We were at two hundred or three hundred percent capacity, which means that unfortunately a lot of the emergency nurses, while they are technically able to provide I.C.U. level care, they're not like actually I.C.U. nurses. SoI think there's just a lot of- because there wasn't as much supervision we really had to do a lot of care. Like patients under our patients. Yeah, it was just it was very tough. Like I wanted- I like came home and cried so often just it was just hard. Yeah. Absolutely. I mean thank you very much for sharing with that me considering how hard it was. I really appreciate that. I guess my next question in regards to that, is I know that kind of the intern year is definitely I would say like an experience where you and your fellow co-interns probably become this cohort. So I was wondering, do you think Covid kind of- or what effect did Covid have on the sense of community you built with your fellow interns and kind of like your first year at this new like at the hospital that you were working at? Yeah, so I definitely think that the shared trauma brought us together for sure. But at the end I think I was like ideologically- like I just felt most connected with that one friend who was interested in the protests at the beginning. And yes, I liked my co-interns and liked my class, but also it was just not- like I knew I was only going to be there for one year so it was like hard to be like, "okay yeah, these are like my people or whatever." Besides, you know, my one really close friend and I was like ideologically we're on the same page. We care about medicine for the same reasons and it just kind of helped us sort of gravitate toward each other. But I think yes, probably this year trauma definitely helped people who were going to be there for a few years, at least.

00:53:05.900 - 00:54:28.900

Yeah, absolutely. Absolutely. So, thank you. I was going to do another little like shift, kind of bringing back in when how we were talking about your interest in social justice and talking about addressing racial health disparities in medicine. We've talked about how you've been aware of them and interested in them for a while, but a significant outcome of the pandemic is that it generated an increased amount of public awareness for like national health disparities, especially in communities of color. So, I guess I wanted to get a bit of your perspective on that. What do you think of like this new level of attention that's being given to these racial health disparities? Do you feel like it's enough or are we moving in the right direction as far as that goes? Kind of, what is your perspective? So, okay I'm also an a writer for ABC News. A medical writer for them. And it's kind of funny now that you say it, I kind of feel like they haven't really talked about it. Really. Yeah, at least like in my mind. Yeah, not to a point that like I'm impressed.

00:54:29.000 - 00:56:40.000

Okay. No, absolutely. Then, yeah, I would love to hear more about that, you know. Yeah, it's just I think we talk more about vaccine hesitancy now, but It's all about context. Yeah, like I really don't think we've been talking about like, a lot of racial health disparities that much. I think like, for example now it is very, very hard- a lot of doctors are having compassion fatigue. An example, like, people who are unvaccinated and then get Covid. And then it's just like, "Hello. What are you doing? Like, you have all the options." So it's hard to be like, you know, at the end they are like, "oh, give me everything." And we're all like, "you know, you could have just gotten a vaccine and prevented all of this." So that's really challenging, but at the same time it's the context. I don't think I could ever say that to, for example, someone who was black or African-American because it's about knowing the context about vaccines and medicines. Absolutely. The Tuskegee trials that were talking about it just, like I understand that deep-rooted distrust because that's has been the precedent. But I don't understand it in white communities of privilege because medicine has been designed for them historically. So that's kind of- that's something I sort of wish people were talking about more. I don't feel like people aren't talking about enough and like they're not even-I don't think people are acting on it appropriately. So, yeah, it's very disappointing. I think, you know, you would think with all of the horrible murders that have happened in just- like recognizing just injustice in general that people would be more aware, but I do not think that is the case. Yeah.

00:56:40.500 - 00:57:48.600

No, absolutely. And that's really interesting to get someone who is actually in the medical field perspective on that. So, thank you. You mentioned that, you know talking more about getting more attention for the history that leads into distrust of the medical profession that is very Justified within the African American community and other communities of color. You have mentioned that a couple of times previously, like with the Tuskegee trial. Do you see that as being like a significant puzzle- How do you see yourself I guess working to promote better knowledge and better understanding of that? ls that one thing that you would really like to advocate for specifically in your like medical career in in the future? Like getting better awareness for that? Do you mean like better awareness of the historical context or of like-? Yeah. Oh, go ahead.

00:57:48.600 - 01:02:23.000

No, sorry you finish your question. That was a big, very wordy question so I apologize. No worries. I meant more like getting people to understand more of the historical context behind what's going on, or is it more about like like kind of navigating this communication and hesitancy. I would honestly say both kind of like, what is your perspective? What is your perspective on how to best- how the medical profession can best overcome and work to improve that level of miscommunication and kind of distrust that's currently between the African-American community and other communities of color and the medical field. Well, I definitely do think it's really important to understand the history of medicine. I think are really good book is like Medical Apartheid and just all of these- Like medications have been tried on people of color, like experimental drugs, like Henrietta Lacks, like the HeLa cells. And then J. Marion Sims, he's considered like the father of Obstetrics and Gynecology and he did all these experiments on black women who were enslaved. You have to know that. That's is the history of medicine and that is the history of exploitation. And that's the baggage that some of our patients are coming in to and we have to know like "hey, this was a horrible thing that happened." I think acknowledging that and showing some awareness up for that is just a way to respect our patients. So I think knowing that. Actually I saw something recently how like critical race theory is actually American history. I believe that. I really do and I think it's this critical lens that we just haven't had. Whatever I was fed in public school was definitely a very whitewashed romantic narrative of history that I've been trying really hard to unlearn as a doctor and just as a medical student. I think in terms of just kind of going forward... so I'm currently reading this book called The Some of Us by Heather McGee. It's because I really just didn't understand this phenomenon of why white people would hurt themselves to prevent other people of color like It tries minorities to get more rights. It just didn't make sense to me. For example, like, Medicaid expansion. Why would people be so against that when actually white uninsured people would benefit the most from that. It's just really crazy for me, but I think what this book really shows is that it's just this idea of perpetuating white supremacy and control. People would rather hurt themselves than give other people access and that's the part that I feel like we all need to come to terms with. Or recognize and be like, "hey, this is what's going on and it's not a zero-sum game. It's really all of us." I'm taking this introduction to U.S. healthcare class system and I'm just like, damn I'm a doctor and I literally worked in the healthcare field and I don't know any of this stuff for U.S. Healthcare. I really recognized that later. I was like, wow, I understand now like what the Affordable Care Act was trying to do and I understand how historically before the Affordable Care Act people would literally go bankrupt for having like a freak emergency and their life would be ruined. So, there's just so much misinformation. I'm just very intrigued through my writing job with ABC News to understand health communication in general. Like I don't know how to convince you, but I think it's way more nuanced than we ever talked about.

01:02:23.400 - 01:07:13.600

Absolutely. Absolutely. So one thing that back at the beginning of the interview when we were talking about your experiences engaging in the medical field when you were younger, you mentioned that your family always sought out Indian doctors and that was a big like source of comfort for you. So according to the American Association- and we've just been talking about, you know, this distrust in the medical community and just all of this misinformation. So, according to the American Association of Medical Colleges, only five percent of doctors currently practicing in the U.S. identify as African American. I guess, do you think that that right there is kind of the crux of our- or just a big contributor to this the aspect that a lot of African-American communities don't really trust the medical profession is because they don't see themselves within it? So, some of my research in derm was a lot about like race concordance in terms of patient-provider, and it definitely has been shown to make a huge difference. But at the same time, to become a doctor in the United States, especially to be a person of color and especially to be a black person or Alaska native or Native American person, the environment to be a doctor is so incredibly toxic. It's so toxic. Like there's so many barriers and it's just like- I think about all the hoops that I had to jump through and like the mental hurdles that I had to overcome, and it's just so much worse for African Americans and Indigenous populations. It's just horrible. So, I do think, you know, yes, would it be nice to have your race concordant doctor? Of course. Absolutely. I think that is incredibly important and I believe in pipeline programs. I heard this metaphor once at this transgender panel about making sure you get the house ready before you put the welcome mat out. That metaphor has just really stuck with me for a lot of the social justice stuff that I'd be kidding for because people, you know, they want to increase diversity and they want more people of color and all these things. And I'm just like, what are you going to do to support them? This is horrible experience. This whole system is set against them. Like, for example, when I was telling you about my classmate Ohenoah and they are such a phenomenal force. They identify as a black person and they ended up leaving the med school. So I think this distrust, it's definitely multifactorial. I have my opinion, obviously. Black people are not a monolith and I can't really speak to this really complex topic, but I think it's multiple things. I wish my vision for the future is that we would live in a world where it wouldn't be so hard. It's not even just med school. Think about someone who's making it all the way till college and all these barriers. It's just our society has so many barriers. Racism is like from the womb on and I really commend all p.o.c doctors who are going through so much. Absolutely. No, thank you. I mean that is kind of what I was getting at that, as we've talked about, it's not for lack of Interest or lack of effort. It truly is like a structural issue within society and the medical field. If you were going to name like- or no that's kind of- Wait, can I add one more thing?

01:07:13.600 - 01:10:23.920

Yes, of course. Please. please. Yeah. So, the other thing that I want to add is that the onus for race concordance it doesn't fall obviously on black people or indigenous people. I think that we as a society and we as a medical community need to be better at addressing the needs of everyone. We are taught to cater to a white population, but that's not- that's not okay. We need to wake up from that. That's kind of what why I was so passionate about like my skin of color research that because you can't be misdiagnosing things just because of different skin color. So, I think that you know, in patients that might not the race concordance- like for example, I speak Spanish and I want my Latinae patients to feel comfortable with me. Like sure, I'm not Latina, but I can understand- like I can empathize and they know that I've tried really hard to like learn the language. I think what I'm just trying to say is that you don't have to be the same race to really try and have genuine curiosity to build trust. Yeah, absolutely. Absolutely. I think that's a really powerful statement. So, we are kind of I guess approaching the end of the interview. I know it's running a little long. So, I guess one kind of question that I want to ask to wrap up a lot of things that we've talked about- because we've talked about your background, we've talked about your experience during Covid-19, we've talked about this passion for really promoting diversity and inclusion in the medical field, addressing racial disparities within medicine- what would you say is your mission statement for your medical career given all of these things that we've discussed and your perspectives on them? Well, I think I would like to contextualize it a little bit. Because from trying to apply into derm and trying to be a diversity candidate, like somebody whose is trying to push things forward. I realized that it is so hard to kind of combine your social justice interests with your livelihood. I feel like I was punished for it multiple times and kind of discriminated against. It's really scary to be like, dang this, my job. For example, dermatology is a very, very small community, like dangerously small. So I kind of realized- like one of the reasons why I want to do anesthesia is because I realized I can't be burnt out at twenty-six.

01:10:25.300 - 01:13:20.700

Absolutely. I literally am planning on working for the next 50 years. I need to like save some of this. So I think for me, my mission statement is pushing for social justice and change but in a sustainable way that's true to me. At the end of the day, there's no point in doing any of this stuff if it consumes me at the end. I have definitely felt consumed and like super depressed, super low, but I think it's just finding a balance and realizing I can't do it alone. It's definitely a group effort. But I also can't carry the weight of it on my shoulders. So that's sort of why I'm really excited for anesthesia because I will have time to like- I really want to go back to the Boys and Girls Club and volunteer and kind of just be in my community as opposed to like- you not necessarily changing it within the O.R. setting or the hospital, but kind of knowing me I feel like I probably will. But I just want to have energy. I just want to protect protect my light. That's yeah. That's my mission statement. Protect my light, advance change. Yeah, that's a really lovely statement. So I guess before we stopped the interview, I want to make sure that you've gotten to talk about everything you would like to. So is there anything else that you would like to talk about? Or is there anything else that you think I should have asked you? I think one thing that I would like to share because some of the med students that I worked with in intern year, they were impacted during their core clinical years. I think we're going to start seeing this very noticeable impact in physician performance in the upcoming classes. Because what I noticed was the med students that I would see on the wards, they would be extraordinarily behind on being able to communicate like presentations and think of diagnosis. I hope that people are really able to catch up, but I think we're going to have to come up with some way to support the people who were truly in the Zoom phase or else I think we're going to start seeing poor health outcomes. I think that's something to be on the lookout for.

01:13:20.800 - 01:14:35.100

Yeah. Absolutely. Absolutely. Well, okay, that no- thank you. I really appreciate that. That's a really- that's another really important and interesting point. Again, I want to thank you so much for meeting with me today. This interview has been incredibly informative and I just really appreciate getting to talk to you about this because I think it's really- experiences of people early on in their medical career aren't getting talked about and so I really appreciate getting the opportunity. So thank you. Yeah. Oh, well actually now that I'm talking about it- Okay, one other thing, hazard pay. So, as an intern we literally are the most exposed. Much more exposed than an attending supervisor. We're the ones literally super exposed, making less than minimum wage. Working eight hours a week and I think that sort of exploitation definitely also really needs to be talked about. So yeah, but eventually the union did decide on hazard pay. We got five hundred dollars extra, but I'm like, you could- Absolutely, absolutely. Okay. That's everything.

01:14:35.300 - 01:14:39.900

Okay. I'm gonna be a stop recording button. Okay sounds good.