Introspections: Oppressed

 DEPARTMENTS   INTROSPECTIONS

Oppressed and depressed

Dikchhya Karki

Critical reflective writing holds a prominent place in the Medical Humanities curriculum at Rocky Vista University College of Osteopathic Medicine. Beginning in the first semester of Medical Ethics, students engage in critical reflection to explore their own assumptions and biases and how their values impact their practice. This submission is selected and edited by Nicole Michels, PhD, chair of the Department of Medical Humanities, and Alexis Horst, MA, writing center instructor.

Dikchhya Karki is a fourth-year medical student at Rocky Vista University College of Medicine. She was born and raised in Nepal until she was 10 years old when she moved to Longmont, Colo. Dikchhya completed her B.S in Business Administration/Pre Med at Union College in Lincoln, Neb. She loves spending time with her family and friends, experiencing new food and, if the weather permits, trying hard to not fall while hiking.

There is a saying that the most oppressed and depressed person is the eldest daughter. I wouldn’t say that is completely true in my case but comes very close to it. Being born the first daughter of a South Asian household wasn’t my choice. It comes with a lot of unspoken expectations and rules; add barriers of being a first-generation immigrant to that and it is as sticky as it gets. Belonging to a heavily patriarchal culture, I had to shine my way out of being married off by the age of 25. Daughters are still considered someone else’s property. One of the rituals in our wedding ceremonies is to give Kanyadan (kun-yea-daan), which is essentially the bride’s parents giving over their daughter to the groom’s parents and saying, "she is your responsibility now."

Trying to escape the fate of being handed off like an object, I worked my way to medical school. Now I was playing the role of a medical student, daughter, sister, mentor and a role model all while being groomed to be an “ideal” wife and daughter-in-law. It is why I began cooking when I was in the 6th grade, helping my parents with household chores and their small business, taking care of my little brother so that he didn’t have to struggle as much, and helping anyone else in the community who was also trying to go into medicine. While my responsibility was being given to my future family, I was responsible for everyone else around me.

I learned early on to put others before me but, eventually, I grew weary, felt unhappiness surrounding me, dreaded having to wake up in the morning. It wasn’t until my therapist asked me, “well what about you?” that echoed in my head for days. What about me? I was fulfilling my duties, I was doing “the right thing,” doing what I saw my mother doing, and she seemed content. It is what she learned and was teaching me. Who am I to start questioning? Why do I get a voice? My story isn’t unique; there are many others like me. The biggest lesson my third-year rotations have taught me is that everyone needs a voice and a place at the table. I was standing in the corner of the exam room when my preceptor was talking to a patient about cutting rice out of her diet if she doesn’t want to end up losing her legs due to diabetes. The preceptor left after saying that, and the patient sat there stunned and mumbled something under her breath. I asked if I could clarify anything for her, and she asked me how she was supposed to cut out rice, which is an integral part of her Filipino cuisine?

Another patient on an M1 hold was handed a list of medications, told that it would help her psychiatric condition, and left alone. She refused on multiple occasions, barely talked to anyone and just sat on the bathroom floor instead. Later, I sat down next to her on the floor and asked her why she didn’t want to take her medications. She looked at me with a surprised face and made a remark that no one had asked her why she didn’t want to take the medications. They just kept telling her she needed it and never explained why. She apprehensively shared her Haitian family culture of viewing medications as a disability, and that she was conflicted because she grew up being taught something else and felt that she was betraying her family.

It is easier to label “non-compliant,” “med student,” “diabetic” than it is to give someone the voice they need. There is usually more than what meets the eye behind every person, especially a person who lacks basic privileges. Whether it is the medical student who is standing in the corner trying to just survive given the immense burden on their shoulders, the patient who can’t give up an integral part of her culture, or the patient for whom taking medications would mean going against her own family, a voice that is heard is the first and foremost step toward more inclusive and equitable health care. ■

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