Dear readers,
I truly hope you had a magical summer. My children returned to school recently, giving me the time to reconnect with you all. I am very happy to be back in this virtual safe space, writing about important equity topics that mean something to me. This month’s topic is one I’ve been bookmarking for many months now, allowing the idea to crystalize in my mind. I am hoping it resonates with many of you, as I feel it’s a universal topic for those of us whose personal identity cannot be limited to just one culture or racial group and instead crosses over invisible boundaries to convene at their intersection.
I am the combination of two (seemingly) very different worlds—my mother is originally from El Salvador and Catholic and my father is from Pakistan and Muslim. My parents are true original trailblazers in my mind, creating a life together despite the unsure gaze of their respective families who really questioned the durability of their relationship, largely because they had never experienced one like theirs before. As a child and into adulthood, I felt most comfortable floating in the liminal space between both cultures, religions and languages. For as long as I can remember, I have had to balance feelings of never belonging to just one demographic and the resultant heaviness of proving to anyone who questioned that I was “enough” to claim my birthright within each one.
These feelings surprisingly surfaced again when I started practicing outpatient pediatrics. Many of the first patients that I encountered were confused—I fielded many well-meaning questions from Latinx patients wondering why I spoke such great Spanish. The receptionists at our clinic confessed to me that patients were discussing amongst themselves, “take your kids to see the new Hindu doctor that speaks great Spanish” (me). On the flip side, I received many startled looks and inquiries when I entered the clinic exam room for the first time with my Muslim patients, especially those from Pakistan. “You’re Dr Amna Khan?!”. I could not help but feel their initial astonishment and confusion when I walked in the door and struggled with how to process what I interpreted as their disappointment.
At the same time, I realized a pattern that slowly had started to develop in myself with learning the tricks and trades of my new job. In order to prioritize speed and efficiency within the clinical exam room space as a very green, junior physician, I found myself generalizing behaviors, personality traits and values to the different communities that I served. I minimized asking for their perspective into what mattered most to them and instead made fast faced generalizations and assumptions. Making this my practice boxed families into stereotypes that I depended on to keep things “easier”. I paused once I made this realization, drawing parallels with my experience of patients making superficial inferences about my own personal history. I did not want my primary care patients to experience the same discomfort that I felt in those situations. I committed to finding ways to offer families the space to express their values, beliefs and priorities with raising their children. I do this by asking them these questions directly. I ask in order to see them more clearly and completely just as I wanted patient families to see me for who I really am at my core—not a half, but a double of the identities I feel so privileged to call my own.
I’m very happy to say that what initially caused me discomfort and felt laborious, I now see as an opportunity to share with my patients my all-inclusive narrative that they had never been exposed to before. With love and patience, I explain when, where and to whom I was born. I am from a Muslim family, not a Hindu one, and there is a difference, I explain. I owe my wonderful Spanish speaking skills to my mother, who gifted me her natal tongue, so I will be sure to pass along your compliments. Actually, I am Dr Amna Khan and my family is from Pakistan. Where are you originally from? In my experience, sharing these moments are greatly appreciated by all.
Simultaneously, I am getting better at recognizing when I am not giving families the same grace to express who they are—what cultures, religions, languages they subscribe to, along with their most cherished family values, hopes and dreams. With more detailed information about each patient family, I am reminded of how we are much more similar than different but those differences are what make us beautiful. These differences should be celebrated, not feared. And that truly is the gift that my parents bestowed upon me through their loving example.
As we know better, we can always choose to do better. Within our Pedi POWER anti-racism work, we are amplifying this principle to an even higher level, with hopes of establishing a Family Advisory Council to hear the collective voice of the community that we serve. Enough with the incredibly paternalistic notion that because we are medical providers, we always know what is best for everyone, all the time. What I know for sure: the answers to what we seek to remedy are always held within the community that is most affected by it.
Please enjoy our recommendations this month—all things I have intentionally placed aside to share with you, dear readers.
May you be healthy
May you be peaceful
May you make space for yourself and for others
Amna
