Soul-Searching Thoughts about Identity in Healthcare

Setthasorn

 

Before I delve into my piece today, I think it is important for me to give readers a bit of an introduction about myself. My name is Setthasorn and I am a 3rd Year medical student at Cardiff University. I was born and raised in Malaysia, a beautiful country located in Southeast Asia. Fun fact: I am one-eighth Thai and seven-eighths Chinese. (I derived that from doing the math that my mother’s paternal grandfather was pure Thai.) Why do I feel the need to tell you about this, you may ask? Interestingly, I have always lived a life where I never quite felt that the person I am reflects the identity I am meant to have, or at least that’s what society made me feel when I was growing up. What do I mean by this? Well, for starters, I barely speak Mandarin (nor Thai, as a matter of fact).

A bit of a sidetrack: Malaysia is a country with three main races, that is, the Malays, the Chinese and the Indians. The national language is Bahasa Malaysia (i.e. Malaysian Language), but the majority of people are fluent in the English Language as well. Of course, a large proportion of people also speak their native languages such as Mandarin, Tamil, Hindi, etc.

Growing up in Malaysia, I never quite received a formal or informal education in the Mandarin language. (The reason behind that is a story for another day.) Not being able to speak, write or read the language has led to me being criticised and shamed on countless occasions. Hearing whispers under the breath of others about how I am a disgrace to the Chinese community is not uncommon. To be fair, the criticisms aren’t always subtle - sometimes, I am told right to my face as well. Sometimes, the comments are said in the Mandarin language itself, thinking that I won’t be able to understand their conversation. Thankfully (or maybe not thankfully), growing up with some friends who speak the language has allowed me to pick up the skill of listening. So while I may lack in the other 3 components, my ears hear what they’re saying just fine.

If you’re finding it hard to relate to this, perhaps try putting yourself in a position where, say, you meet a White person who has little or zero knowledge of speaking the English language.

So why do I bother bringing up this background story of mine in this blog? I wanted to paint a picture that identity, to me, has always been something which never quite came to me naturally. I often felt like I never quite “fit” the profile of a Chinese, as part of my identity. Have I tried to fit in? Yes, on many attempts. As much as I have attempted to learn the language through songs, movies, and language apps, let’s just say that I’m not the fastest learner when it comes to languages. And so, the issue remains - till today, I still feel that missing piece of me that would qualify me as a Chinese.

Disclaimer: Please don’t get me wrong - Malaysia is NOT a horrible place. What you are reading is a compilation of the bad experiences I had. I can very well flip the coin and tell you a thousand amazing things about what I love and appreciate about growing up in Malaysia.

How is this related, if at all, to professional identity in healthcare?

Well, the story doesn’t vary too much in my professional life as a medical student (though I would argue that I have been fortunate to have had a slightly kinder experience thus far). It all began when I moved from Malaysia to the UK to commence my medical school journey in 2018.

In case I have not made it apparent yet, I come from a country where almost everyone speaks at least two languages - one being their mother tongue and the other often being English. More often than not, the vocabularies of the languages overlap and a sentence spoken in a casual setting sometimes has a mixture of words from different languages. For me, I would consider myself fluent in the English and Malaysian language.

Having said that, I have always been confident about my proficiency in English. I grew up in a family where English was our first language and I have been speaking the language for as long as I can remember. In my sixth form college days, I used to join Toastmasters competitions and won several prizes for my eloquence too.

However, all of this changed when I came to the UK. During my early years at medical school, I struggled to speak fluently far more than I could imagine. In hindsight, I think this was attributed to several reasons. (Again, going into the detail of each of them would warrant a whole other blog post.) To keep it short and simple, it was a series of unfortunate events which involved a Stage 4 cancer diagnosis and a heartbreak, both only 3 days apart. 

I was depressed and dejected. I completely lost my self-esteem and I isolated myself from society at every opportunity I had. My motivation to communicate with anyone was minimal and poor. But in times when I had to, I was self-conscious that I had to "tidy up" my speech. I had to consciously make an effort to prevent incorporating phrases and terms from the other languages that I am also used to speaking.

I turned from the outgoing extroverted individual I was into a reserved introvert that I could not recognise for most of the time. I used to think it was my fault for having a "funny accent" or for unconsciously using words from a foreign language in my speech. This further affected my social skills, and subsequently my mental health, as I doubted if I would ever fit in. I had thoughts in my head where I felt that I was treated differently simply because I do not speak in the "normal" accent that everyone else seemingly understands.

With all that said, in hindsight, having gone through this journey at Cardiff is so much more of a blessing than I imagined. I am entirely grateful for the professors, medical school staff, and medical students who recognise the difficulties that international medical students like myself face throughout the course. Aside from recovering from the two said unfortunate events, I have been lucky to have received support from the school and my friends in forming a more inclusive environment for myself and students in similar positions too. I am particularly grateful for the Cardiff Healthcare International Perspective Society (CHIPS) for the senior support they have given me since I was a 1st Year student, as I quickly realised that I am not alone in facing some of these challenges. As much as I think being treated differently for having a “different accent” is a teething issue on its own, I do also believe that the negative feelings I had were amplified largely due to my haunting insecurities as well. Thankfully, I am getting better now, though still a work in progress.

So here it is. Here I am, a 3rd Year medical student, seeing patients daily as I begin my clinical years. Nowhere to hide now. In fact, I am done with running away. It is time I pick myself back up and learn to be the medical student I want to be, fashioned in my style and groove. It doesn’t matter if I can’t speak the Mandarin language or that I speak with a foreign accent. These things are what makes me, me. And if I am ever going to change myself, it will be for me and no one else.

As I near the end, I would like to quote an excerpt from a poem titled Diaspora Blues by Ijeoma Umebinyuo. These four lines below often played on repeat in my head during my early years at medical school.

“So here you are,

Too foreign for home,

Too foreign for here,

Never enough for both.”

Will I ever find it within myself to be “enough” for the people around me?

Maybe I will, maybe I won’t. Who knows? But what I know is that I can learn to be enough for myself; that would be when I can realise my true identity.

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