6:59 p.m. New York City — It begins with a man drumming a wooden spoon to his pan. The sound reverberates through the crevices of the surrounding buildings. He smirks; he started a minute early, but he couldn’t help himself. And then, a cheer. Applause. A symphony of “Woos” and “Yeahs”. Outside the hospital, the FDNY and NYPD blare their sirens, lights flashing as hospital staff trickle out, peeling off their respirators to reveal wide grins accentuated by mask imprints and tired eyes. There is no higher honor. I take off my own N95 in exchange for a surgical mask as I find myself immersed in the new sounds of the city. As an ER doctor who moved here less than a year ago, it is the first time I feel like I belong.
7:04 p.m. — The 7 p.m. roar dies down to a grumble making way once again for the hum of buses and taxis. The man with a pan has closed his window. I start my walk home from the hospital. The bridge of my nose burns from the tight seal of my N95 mask; my scrubs smell of dried sweat from the Tyvek coverall I wore for the last 12 hours.
A man stands on the sidewalk smoking a cigarette and chatting with his friend. As I cross the street, he mutters, “Here comes one, now.” and moves his friend in from the sidewalk. When I walk by, he stands tall and pushes his chest out. Then he sneers. I look around to see what’s upset him, but there’s no one else on the street. I pass him. “F*cking ch*nk”. I get it now. I suddenly feel exposed with my back to him — to this day I don’t know if I was expecting a punch to the head or a full-on tackle. I clench my coffee mug a little tighter and keep walking. I arrive at my apartment and remove my surgical mask.
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Considering the violent assaults and public humiliation of the Asian community that has been making the news recently, I’ve been lucky. But any sense of belonging I carried from the hospital now feels like a distant memory.
I call my parents in California to tell them about my day. Between the countless intubations and rounds of CPR, there was also a miraculous recovery of a patient I didn’t think would make it. I tell them about the 7 p.m. cheer; I promise a recording one of these days. They are happy to hear it. I end my conversation by asking them to stay safe and indoors, citing both COVID-19 and the increase of abuse and violence towards the Asian community. They ask if anything happened. I lie. “No, just wanted to give you a heads up.” They have enough to worry about.
This is nothing new. My parents fled Vietnam over 45 years ago after the fall of Saigon. My father found himself stateside in Austin and my mother in Paris. They learned English. They completed college. They moved to California. They each had their own fulfilling careers. And they raised two sons, instilling in us the idea that a proper education and the ability to speak English without an accent would be our keys to success. Even then, we still met challenges.
In elementary school, my peers called me “China Boy.” It was a name concocted by my neighbor and, admittedly, my friend. At 6 years old I was confused. I told him I was Vietnamese. My parents told me I was Vietnamese-American. But the name stuck. As I got older, “China Boy” evolved to curse words, which evolved into racial slurs…ironically enough never once with the accurate ethnicity.
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My parents told me to ignore them. My parents told me to avoid confrontation. My parents told me to focus on school. We hid behind the mask of “Model Minorities” until educational achievement and professional success could not hide us anymore. We largely ignored racism and its effects on other minorities until the racism was directed at us.
Now, in light of the COVID-19 pandemic we are reminded what it is like to be a target. Asian-operated businesses find themselves with a dearth of customers and Asian hate crimes are on the rise globally. In New York City alone, there have been 14 Asian-motivated hate crimes this year. Compared to the three that took place in 2019, this represents a more than 450 percent increase. And there is reason to believe this, as most hate crimes go, is an underreported number.
How we talk about a disease — in particular, how we name it — goes a long way in forming our core perceptions about it. The “Spanish Influenza” (H1N1 virus) was named so because news coverage of the disease began there (despite the first known case being in Kansas). The 2009 “Swine Flu” (also H1N1 Virus) led to the slaughtering of pigs and even cessation of pork imports in some countries despite not being spread via swine. HIV/AIDS, then referred to as “gay-related immune deficiency,” undoubtedly stigmatized a population and hampered both local and global efforts at disease prevention, containment, and cure.
Naming is so much so an issue of perception that in May 2015 the World Health Organization (WHO) released a statement on best practices for the naming of diseases. It stated, “Terms that should be avoided in disease names include geographic locations (e.g. Middle East Respiratory Syndrome, Spanish Flu, Rift Valley fever), people’s names (e.g. Creutzfeldt-Jakob disease, Chagas disease), species of animal or food (e.g. swine flu, bird flu, monkeypox), cultural, population, industry or occupational references (e.g. legionnaires), and terms that incite undue fear (e.g. unknown, fatal, epidemic).” The statement concluded that the International Classification of Disease (ICD) will be used for the official naming of diseases.
On Feb. 11, 2020, in accordance with the ICD, the WHO officially renamed “2019 novel coronavirus,” identifying both the disease and the precipitating virus respectively as coronavirus disease (COVID-19) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2.)
On March 16, 2020, President Trump used the term “Chinese Virus” to refer to SARS-CoV-2. Over the next two weeks he used the same moniker over 20 times.
By March 26, 2020, the U.S. led the world in the number of COVID-19 cases. In other words, by March 26 the most likely nationality of a patient with COVID-19 was American.
When unforeseen circumstances threaten to impact our lives it is easy to want to point a finger. Through the repeated use of the words “Chinese Virus,” President Trump capitalizes on our collective fear and desperation. However subconsciously, this rhetoric plants the seeds of xenophobia in the minds of people across the country, alienating Asian Americans like myself.
Over the last few months I’ve looked after my patients in the hospital and after my own back on the walk home. I’ve FaceTimed with patients’ families while I’ve worried about my own. And I’ve donned the mask of a health care hero at work, only to doff it as the villain outside. In those moments of in-between I am reminded of how society chooses when and how it sees me. I am reminded of how a few city blocks have the power to change my perceived societal contribution. I am reminded that by many I am seen only when I fit conveniently into their preconceived notions.
As cities reopen and social interactions resume, I fear the incidents of hate crimes will increase. I fear that businesses and restaurants in Chinatown will remain empty. And I fear that once the “Health care Hero” status fades, I will only be left with the bias against my skin tone and the mask I cannot take off.
Nonetheless, we quarantine. Not for ourselves, but for our community. As society arises from this pandemic, I hope the rhetoric we use moves on from the origins of the virus to the next steps in how we can heal together and rebuild our collective home. I hope we respect the vibrant diversity within our essential workforce. And I hope we stick up for others, not for ourselves but our community.
7:00 a.m. — I walk through the rotating doors of the hospital. The security guard greets me with a subtle nod as the perpetual fluorescent lighting shines down on us. I enter the emergency department. I don my N95 and feel it chafing against my still raw skin. I smile. Over my tired shoulders, I hear the sound of beeping monitors and feel the rush of adrenaline that will propel me through the next 12 hours of caring for my fellow Americans.
Alex Tran is an emergency medicine resident physician at the Mount Sinai Hospital and Elmhurst Hospital in New York City. He received his MD from Brown University. He currently lives in Manhattan.
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