Paging Drs. Gupta, Shah, Sharma and Rao

When ER first came on TV, I remember thinking it looked completely unrealistic because it was too damned white. Now I finally have some numbers to back up my instincts:

Plenty more like her

From 1980 to 2004, the fraction of medical school graduates describing themselves as white fell from 85 percent to 64 percent. Over that same period, the percentage of Asians increased from 3 percent to 20 percent, with Indians and Chinese the two biggest ethnic groups. [Link]

S. Balasubramaniam … recently queried 50 medical schools and calculated that 12 percent of the class that entered in 2006 is of Indian heritage. The highest percentages are in California, Texas, New York, New Jersey and New England. [Link]

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p>While the article doesn’t indicate anything about Balasubramaniam’s sampling methodology, the numbers are consistent with my gut feelings about the number of brown faces I’ve seen amongst med students. When asked to explain why she went into medicine, one desi doctor said:

“We were never forced into medicine … But in the Indian community in Chicago, everyone was a professional. Everyone was a doctor or an engineer…” [Link]

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p>Although there have always been many desi doctors, the numbers of current brown medical students represent a sizeable increase over past years since roughly 5% of all doctors are of Indian origin, and many of them studied abroad:

In the US, Indians and Indian-Americans make up the largest non-Caucasian segment of the American medical community, where they account for one in every 20 practicing doctors. [Link]

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p>My thoughts at this point go off in two different directions. The first is about the clannishness of desi doctors. How many times have you heard a doctor say that nobody can understand what they go through unless they’re a doctor themselves? It’s as if they think that being a doctor is distinct from other professions, on a plane of its own, completely inaccessible to people who do other things for a living. They also love to boast about the hours they work, even though (post-residency) my doctor friends work both shorter and more predictable hours than friends who are lawyers, iBankers or programmers.

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p>I don’t understand why they feel this way though – I’ve never heard anything similar from engineers. Is it the combination of the long training and the high salaries? What’s at the root of this medical exceptionalism?

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My other thought has to do with how little the multicultural nature of the medical profession is reflected on TV. ER finally has a one desi doctor. To the best of my knowledge, none of the other medical shows do (although I don’t watch much TV so please correct me if I’m wrong).

This is part of a larger problem, namely that the America you see on the small screen is significantly whiter than reality. An analysis of the 2001 Fall Season found that:

White characters received 81 percent of screen time, while non-Hispanic whites make up about 70 percent of the population. [Link]

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p>An article I once read made the case that this was driven by audiences and advertisers, namely that white Americans felt most comfortable with shows that skewed whiter than what than realistic demographics, and therefore advertisers were willing to pay more to reach them. The article below makes a similar argument, but puts the blame more squarely on advertisers:

The FCC has collected plenty of … evidence, illustrating a range of racist assumptions about non-white customers openly cited by advertisers as reasons to pay less for ads in ethnic markets, or not to buy them at all. There’s the buyer for Ivory soap who refused to purchase time on a Latino-formatted station because “Hispanics don’t bathe as frequently as non-Hispanics.” (FCC study, “When Being No. 1 Is Not Enough: The Impact of Advertising Practices on Minority-Formatted Broadcast Stations,” 1/99) Companies have cited worries that “our pilferage will increase,” if they advertise on minority stations, or said simply, “Your station will bring too many black people to my place of business.” If that’s not racism, what is?… [Link]

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p>This is part of how we end up with TV shows like Friends that are set in New York City but which show a city which is whiter than Boise, Idaho. To me, that’s just bad television and I refuse to watch it.

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p>I do realize that because of stereotypes about Asians we’re likely to see Asian representation on TV increase soon, but I want more than just parity for yellows and brownz. And yes, I do also realize that TV shows are fantasy not reality, but that’s precisely what bothers me. If the absence of minority characters represents the fantasy world of white viewers, then what does that tell us about them?

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372 thoughts on “Paging Drs. Gupta, Shah, Sharma and Rao

  1. I graduated from high school in 1992 and my folks pressured me into the pre-med thing. My dad is a doc and all of my parents friends in our town in the middle of f’ing nowhere in Ohio were Indians. So they did not know anyone in the US who wasn’t a doc or an engineer. My parents always stressed the “medicine is the only secure job where you can earn a lot of money and other jobs like law are controlled by racist white folk” angle. Back then they (and I) wasn’t even aware of fields like investment banking. I ended up quitting pre-med because I hated it so much and eventually went to law school . Now at least kids growing up see Indians in diverse other fields; a whole new world of opportunity has unfolded. They don’t have to just go into medicine and engineering, now they can also look into investment banking and corporate law…

  2. Yes but I think in the US too doctors are like gods. My father is a doctor and when we immigrated to the US, most of our friends were doctors. I was continuously surrounded by doctor aunty and uncles and it wasn’t something I gave much thought to in elementary school until…when my young friends or teachers asked me what my parents did, and I said my father is a doctor, these kids were all wide-eyed and expressed that I must be so rich. It’s a very, very difficult school to get into to in the US, so to a certain extent I can understand why people are so in awe of them, especially also its a profession that deals with life and death.

    ps – i agree with you, to some extent. but in the us (capitalist country), i think the admiration comes more from a “you’re so rich, therefore, you’re cool” thing. in india (socialist, until recently), i feel it’s more cultural and has less to do with the financial aspect of things. if i am not mistaken, most doctors in india were not very well-off at all, prior to the “neo-liberal” reforms in the early nineties.

    nonetheless, i also agree that there is a justification to the admiration. but not to the extent that i have seen it taken by some of my doctor friends and relatives (and i have many – by virtue of my family).

  3. People want to see more of those who look like themselves on tv, but only in positive roles. Law and Order routinely takes real cases and changes the race of the defendents to white, regardless of actual race. However, I haven’t heard hue and cry about that. I guess if whites wanted to make a fuss, they could complain about being greatly over-represented on tv as rapists, murderers, etc. in places like New York. People don’t want tv to “reflect reality.” Reality is scary and uncompromising. They want it to reflect their fantasies about themselves, and those who make the most noise eventually get what they want as long as it makes a profit. TV ignores statistics–it looks at what will sell and make the loudest people least angry. Maybe Asians are too quiet and polite? Whites are watching less television. Blacks are watching more. Commercials appear to be 50% black, and usually feature black/white mixes more often than they occur in any reality I seen. I have not read studies about East Indian viewing practices, but from my observation they seem to follow socio-economic class. That is, higher education, less tv viewing. Since I rarely watch regular shows–i stick to a few cable channels and PBS–I am not able to give personal impressions. However, I have read the studies. Blacks are over-represented when it comes to certain professional characters. East Asians–as under-represented as South Asians. The average age of females on the big screen is about 25, and on the little one, maybe 30. Beautiful female lawyers are absurdly over-represented from my experience. Plain ones, of any race, under-represented. Males average considerably older than reality as romantic leads. Anyone looking in from another planet would make interesting assumptions about our demographics. It seems to be a rule that any given show will feature black and/or female judges (a favorite irony I guess), doctors and authority figures, way out of proportion to reality even in a place like D.C. Meanwhile, desis are vastly under-represented in medical shows. I don’t know of any shows featuring engineers. But when you are talking about “accurate” portrayal on the little screen, you really do have to look at all the aspects–there’s more than a little hypocracy in all this. Desis want more desi doctors on tv, but not more motel owners, convenience store clerks or, perhaps, geologists and teachers. If we keep beating the drum, we’ll see more brown faces on tv. But be prepared for the “reality” drum. My granma always said, be careful of what you ask for, because you might just get it.

  4. Yes luna, most crimes in NY are committed by blacks and hispanics, and yet on Law & Order most criminals seem to bee rich Manhattanites.

  5. How many times have you heard a doctor say that nobody can understand what they go through unless they’re a doctor themselves? It’s as if they think that being a doctor is distinct from other professions, on a plane of its own, completely inaccessible to people who do other things for a living. They also love to boast about the hours they work, even though (post-residency) my doctor friends work both shorter and more predictable hours than friends who are lawyers, iBankers or programmers.

    Umm…maybe because it is distinct from other professions in that most doctors deal with life and death issues on a daily basis, and nearly every decision they make can impact whether someone lives or dies? So yes, from that perspective no one really gets what we go through. That doesn’t make us “special”, but it does have a huge impact on our lives. I generally don’t say this to other people, so I’m sorry your friends boast about it; perhaps you should find new friends. But they are right. You have to either be a doctor, work closely with one, or be married to one to really get what it’s all about. There are other professions that this is probably true of–the military or firefighters for example. I love how any post about medicine turns into an excuse to bash desi doctors and suggest that we all did it for the money/stability and that we are boring and ill-informed about the world in general.

  6. Great post Ennis, a few comments:

    Have any of you seen Grey’s Anatomy? 3 of the head doctors on that show are Black, so that stat flies a bit in the face of the statistic you raised.

    With regards to doctors, I think it’s natural for people to congregate together who are in the same fields. When I meet someone in public health like myself, I naturally find myself gravitating towards them, asking them what they do, where they went to school, so on and so forth. Admittedly I don’t exclusively hang out with people who are just in public health, but there is going to be a bond there because we both chose to go into the same field.

  7. Of course if the makers of Law and Order were to actually reflect the criminal population of NY in a realistic manner, then they’d be called racists, Ennis-the-resentful would probably be first in line. So it’s a straight question Ennis – do you think Law and Order should reflect demographic fact as well?

  8. Ennis: “how little the multicultural nature of the medical profession is reflected on TV.”

    TV is lagging behind reality. What about the South Indian and Filipino nurses? Between the nurses and doctors, an average US hospital has a healthy dollop of brown.

    Ennis: “It’s as if they think that being a doctor is distinct from other professions, on a plane of its own, completely inaccessible to people who do other things for a living. They also love to boast about the hours they work, “

    Given my advanced age (54), my physician friends are usually not the bragging upstarts of the medical profession but the seasoned pros who, after decades of losing patients, have accepted the reality that they have little power over human life. They are now resigned to the fact that they are not omnipotent. On the financial front, they are painfully aware that they are still hourly workers, with incomes directly tied to labor input, as compared to successful entrepreneurs or business executives whose earnings depend on creating outcomes through aggregating other people and resources. This harsh reality of medicine may be a non-issue among the younger set, but a 60-year old surgeon standing on his or her feet for six hours straight is understandly modest about the working conditions of medicine. My physician friends do not boast about the physicality of their job, the hours they work and their ridiculously long weeks and short vacations.

    However, there is one quality that physicians seem to enjoy even in their later years and that is a love for their profession. I don’t know any 50-plus burnt-out doctors. I know many 50-plus burnt-out business executives and professors.

  9. a few points.

    http://www.im.org/AAIM/PublicPolicy/Docs/AAMCMIM05.pdf

    20% of med students are Asian American. 36% of applicants who are Asian are Indian or Pakistani. Assuming similar acceptance rates that means 7% of medical students in the United States are brown. so 7% is probably a good lowbound (i think that is more realistic for all medical schools).

    also, browns immigrant doctors have disproportionately been concentrated where native born doctors did not want to practice. for example, chicago (too cold), other declining midwestern cities (they’re declining remember) and rural areas. so the 5% who are immigrant brown doctors are not distributed equally across america. in fact, one of the reasons the USA recruited brown doctors was to fill spots in rural areas that natives were abandoning.

    in regards to the doctors. the average doctor makes a lot of money, look here:

    http://www.bls.gov/oco/ocos074.htm

    130-250 K for median income depending on specialization is pretty phat (though malpractice for some specialties, like obstretics, means you have to discount tens of thousands off it before taxes). engineers don’t make that much. they also don’t go to 4 years of professional school (yes, one can become a ph.d. engineer, but most engineers don’t have ph.d.s, look the rates who go to graduate the year after getting a undergrad from MIT, a minority, and this is a school where everyone could go to grad school if they wanted). and ennis is right that doctors get where they are based on hard work and and brain skills. now, most of my academic friends complain that doctors tend to have a self-inflated image of their own intelligence because they spend their days ministering to “normal” people, but part of this is jealously because of the disparate compensation.

  10. I don’t know, HMF. Friends would’ve been more realistic, if they lived in say, Iowa, rather than NYC. In ten years, these six white characters only ran into basically an average of a minority character per season, per 1 to 2 episodes.

    That’s kinda my point, I was saying although the show was set in NYC, they rarely acknowledged that in the show. NYC wasn’t really a ‘character’, certainly not as much as say Seinfeld (episodes about Chinese Food Delivery, Handsome Cab Rides in Central Park, owning cars in New York City, Puerto Rican Day Parade, George working for NY Yankees, etc..) So it might as well have been in Iowa. But I don’t know the show that well. i’d say Seinfeld is more indictable for misrepresenting NYC.

    Just as an aside, can people stop bringing up places like Iowa as the example of a place that is lily white and/or socially segregated?

    Hema, What places should people bring up then? Are you saying taken as an aggregate the midwest is as socially aware, and as multiculturaled as the coasts (in particular, NY, LA, SF?) No, this doesn’t make the coasts perfect… but when I was in the midwest and had a 80 yr old woman ask me, “Are you going away for Easter?” assuming I was Christian, I knew that was more likely to happen in the midwest rather than not.

  11. a few points. http://www.im.org/AAIM/PublicPolicy/Docs/AAMCMIM05.pdf 20% of med students are Asian American. 36% of applicants who are Asian are Indian or Pakistani. Assuming similar acceptance rates that means 7% of medical students in the United States are brown. so 7% is probably a good lowbound (i think that is more realistic for all medical schools). also, browns immigrant doctors have disproportionately been concentrated where native born doctors did not want to practice. for example, chicago (too cold), other declining midwestern cities (they’re declining remember) and rural areas. so the 5% who are immigrant brown doctors are not distributed equally across america. in fact, one of the reasons the USA recruited brown doctors was to fill spots in rural areas that natives were abandoning. in regards to the doctors. the average doctor makes a lot of money, look here: http://www.bls.gov/oco/ocos074.htm 130-250 K for median income depending on specialization is pretty phat (though malpractice for some specialties, like obstretics, means you have to discount tens of thousands off it before taxes). engineers don’t make that much. they also don’t go to 4 years of professional school (yes, one can become a ph.d. engineer, but most engineers don’t have ph.d.s, look the rates who go to graduate the year after getting a undergrad from MIT, a minority, and this is a school where everyone could go to grad school if they wanted). and ennis is right that doctors get where they are based on hard work and and brain skills. now, most of my academic friends complain that doctors tend to have a self-inflated image of their own intelligence because they spend their days ministering to “normal” people, but part of this is jealously because of the disparate compensation.

    medicine is a fine profession. no problem with doctors. i did pre-med for my undergrad. didnt want to go to med school for purely financial reasons. didnt seem like a positive npv decision. seemed like the money was lame.

  12. You have to either be a doctor, work closely with one, or be married to one to really get what it’s all about.

    I think this is true, and generally speaking, I agree with you. I think physicians do have it tough, and if it’s not a question of life or death, there’s always the threat of a lawsuit lurking somewhere in the background.

    However, even being married to a physician, I still get the sense that at least some physicians have a fairly healty “god” complex, or at least sincerely believe that what they do is more important than what anybody else does. This may be true in some instances, but it’s not true for every doctor all the time.

  13. Hema, I agree with you that some physicians have a “god” complex, but so do some other successful males (and sometimes females)–ibankers and MBAs for instance. It may very well be worse in medicine, though.

  14. Agreed that its difficult for non-medicos to understand what Doctors go through.However that is no excuse for the “God complex” that some doctors develop.

    It’s as if they think that being a doctor is distinct from other professions, on a plane of its own, completely inaccessible to people who do other things for a living. They also love to boast about the hours they work,

    Ennis kind of nailed it – but this is true of doctors in India too.

    My brother-in-law and sister-in-law are doctors and for the first few months after I got married I had to grit my teeth as every dinner table conversation was about how hard they worked ( as if the rest of us were sitting in hammocks, lazing away the days !!) and how no other profession comes close to medicine.Granted that medicine is a noble profession but everyone’s contribution to society is important.

    Looking back, its amusing how much this bothered me then:-)

  15. Are you saying taken as an aggregate the midwest is as socially aware, and as multiculturaled as the coasts (in particular, NY, LA, SF?)

    No, I’m not really saying that, although I do think this notion that the Midwest is filled with a bunch of racist hicks who don’t know the difference between an Arab and an Indian is seriously overstated…as is the view that you can’t find any semblance of cosmopolitan behavior, social awareness or racial acceptance anywhere outside of the East and West coasts.

    I think my view is that there’s no doubt that places like NYC or LA are more diverse than the Midwest, on the average. But I think diversity and social awareness are distinct issues. For example, my own anecdotal experience is that while New York is much more diverse than, say, Minneapolis, New Yorkers are also more “color conscious” than the vast majority of people in Minneapolis. (This is just an anecdotal example, of course…it may be that the statistics indicate exactly the opposite).

    That is, it is possible to just become another average Joe in Iowa or Wisconsin over time even whether a person is brown or black, but in New York, a person is much more closely identified with their ethnic or racial background. In one sense, it’s a case of diversity working against people, I guess.

  16. i am a lawyer, and i concur to some extent with how doctors feel. though, i will say i felt this much more when i was in law school than now as a practising lawyer. the training itself, particularly in the first year, was both intellectually and emotionally challenging in a way that none of us were prepared for. and whenever i tried to explain it to my friends, nobody understood, except other lawyers/law students. so i just stopped talking about it. now, however, i think people relate more easily to being a lawyer because of media exposure, whereas what is taught in law school is not at all discussed in general public fora. but even though law school was grueling, i still think medical school, residency etc is far harder. so i completely understand when doctors say such a thing – how can others understand something that requires almost 10 years of training? i don’t hold doctors on a pedestal, but i do think you have to acknowledge the more complicated nature of a profession that requires so much training before you can even begin to practise. though in no way does that mean non-doctors do not work harder – e.g. entrepreneurs. and often doctors make up with their initial long hours by having much more relaxed schedules later on. it’s just different, i suppose, though no better or worse.

  17. Back in the desh, being a doctor or engineer meant not having to worry about where your next meal came from.

    But BarristerBetty, wouldn’t having the [congenital] financial means and cultural capital to one day become a doctor or engineer buffer you from that in the first place? I don’t know many doctors or engineers in India who came from truly hardscrabble beginnings. Let me qualify that a little: My father was an engineering professor who grew up in a tiny one-room shack [thatched roof and all], which certainly didn’t match the middle-class or richer backgrounds of his American colleagues later in life. Yet the neighborhood in which he grew up, shacks and all, was considered upper middle class in 50s-era Madras [poverty can be comparative, after all]. He had parents who were educated, who bought him books and could afford school fees, and he never had to worry about where his next meal came from. Most [if not all] of his peers at school, who later became doctors and engineers in India and abroad, were in the same boat.

    This is just conjecture on my part, but I think the practice of South Asian parents in the States pushing their kids to be doctors and engineers reflects the fact that most South Asians who come over here are wealthier or better connected in the first place than most of their fellow citizens. Wealthy parents all over the world push their kids towards careers that guarantee wealth and the “stability” that you mentioned.

    [More conjecture] As for South Asian immigrants who weren’t as well off back home as they are here, who might push their kids in a similar fashion, I think it’s that they recognize that the social infrastructure in the States is more conducive to careers gained through meritocracy, and this more conducive to upward social mobility–pulling yourself up by your bootstraps, and all that jazz.

  18. but not to the extent that i have seen it taken by some of my doctor friends and relatives

    Yes, I know what you mean…Sometimes there are docs I meet who do think they’re god…and it’s sad b/c the medical profession should work hand-in-hand with social workers and others and I feel a lot of time, doctors don’t heed the advice of social scientists and this only hurts the patient.

    And then there are those docs, who treat a child who doesn’t want to be a doc, like they are nothing…I speak from experience. My sis is a doc and no one ever wanted to hear about what I was doing in my work or what I was studying in college, but to my sister they gave her such acclaim. The aunties and uncles gave my sister and any other of the “youngsters” that were in med school, all the attention.

    Nothing was respected except medicine – engineering was looked down on and don’t let me get into law.

    Maybe cause I wasn’t a strong enuff person when I was younger, it made me go into some sort of depression, where I felt the only thing I could do would be to get married. It’s amazing to me now, to think that is how i felt. There’s just so many other things out there to do. You have to go with what works for you and have pride in it. Medicine is a great profession but it isn’t for everyone and I wish more desi parents wouldn’t disregard other ambitions their children may have.

  19. there used to be a desi guy on grey’s – but even though they showed him frequently in the first season, i don’t recall seeing him at any point after that. re the 3 african american doctors – the creator of the show is african-american – so perhaps it is from her point of view – i.e. even non-white people can fail to be diverse vis-a-vis other minorities.

  20. But I think diversity and social awareness are distinct issues.

    They can’t be completely distinct, for a certain degree of diversity is needed to become socially aware.

    That is, it is possible to just become another average Joe in Iowa or Wisconsin over time even whether a person is brown or black, but in New York, a person is much more closely identified with their ethnic or racial background. In one sense, it’s a case of diversity working against people, I guess.

    Sure, but this doesn’t mean the “brownness” is accepted, it just means it’s ignored. Whitefolks in the midwest (predominantly) might accept a “brown” person, but just classify them as another white person with a really good tan (the thought process is : “they watch American Idol, they eat pizza, they go to the mall, they’re ‘normal’, just like us”). And that’s not social awareness.

    I think what you should be saying is, social acceptance and social awareness are two distinct issues.

    Either way, I see nothing wrong with pointing to places like montana, iowa, indiana, etc… as examples of homogenous places, that lack any kind of real social awareness.

  21. Sure, but this doesn’t mean the “brownness” is accepted, it just means it’s ignored

    But isn’t that ultimately a good thing? If someone can look at a brown person, and see no difference that really matters, it is a form of social acceptance.

    Either way, I see nothing wrong with pointing to places like montana, iowa, indiana, etc… as examples of homogenous places, that lack any kind of real social awareness.

    Well, I think you have to distinguish between the Indianas and the Montanas. Montana is a sparsely populated state with a very low immigrant population. That’s not really true for Indiana. The Midwest has a different cultural and social structure than the West does.

    Also, I’m not really sure what you mean by “social awareness.” Folks in the Midwest aren’t blind to racism, nor are they more accepting of racism than people on either coast. In fact, given that immigrants make up a significantly smaller percentage of state populations in the Midwest, I’d say people in these states are actually more socially aware than on the coasts (again, depending on what you mean by “social awareness”).

  22. Of course if the makers of Law and Order were to actually reflect the criminal population of NY in a realistic manner, then they’d be called racists, Ennis-the-resentful would probably be first in line. So it’s a straight question Ennis – do you think Law and Order should reflect demographic fact as well?

    Sean Hannity! I never thought we’d see you here at SM. Vanakkam.

    If Law and Order reflected reality, there would be one female criminal every 1000 shows, or something. The overwhelming majority of convicts are male. And also, if we stuck to the reality tip, SVU would have episodes in the single digits every year. Sex crimes have been declining sharply in NYC for years now.

    You appear only to want everyone’s favorite tabloid-ripoff cop drama to “reflect” whatever twisty, unpleasant views of racial hierarchy you have.

  23. But isn’t that ultimately a good thing? If someone can look at a brown person, and see no difference that really matters, it is a form of social acceptance.

    Oh no, I have to disagree on that. I believe differences should be acknowledged, for any kind of true understanding. Any notions of equality without understanding are meaningless. in particular for groups of people who have widely different histories and legacies in this country. For example, a white person cannot look at a black person and “see no difference”, they need to acknolwedge their history is vastly different from their own, and has reprecussions on the present day. Same with latino, hispanic, indian, etc…

    It’s acknowledging and accepting the difference that’s key.

    Also, I’m not really sure what you mean by “social awareness.” Folks in the Midwest aren’t blind to racism, nor are they more accepting of racism than people on either coast. In fact, given that immigrants make up a significantly smaller percentage of state populations in the Midwest, I’d say people in these states are actually more socially aware than on the coasts (again, depending on what you mean by “social awareness”).

    I mean acknowledging that there are different cultures in the world, that white Christian lifestyle is not unilateraly more “normal” or “better” I don’t see how you can make the case that, that sentiment is stronger in the midwest? I lived in Indiana, for two years, the college newspaper ran an article about “minority growth” and only commented on the black population. No mention of hispanic, latino, asian, native american, etc… I seriously cannot imagine such a thing happening in new york city or los angeles.

    In fact, given that immigrants make up a significantly smaller percentage of state populations in the Midwest, I’d say people in these states are actually more socially aware than on the coasts

    This makes no sense, given any definition of social awareness. How can you be aware of something you don’t even know exists – or only know through television?

  24. “You appear only to want everyone’s favorite tabloid-ripoff cop drama to “reflect” whatever twisty, unpleasant views of racial hierarchy you have.”

    No, I’m saying that Ennis is whining about fiction not mirroring reality when it comes to desi representation on ER, so why isn’t he complaining about the fact that Law & Order doesn’t mirror demographic reality as well? There is a greater percentage of desi doctors in the US population than is portrayed on television. Likewise there is a far, FAR greater percentage of black criminals in NY than TV portrays. I don’t care either way, but Ennis has a fixation on fiction mirroring reality when it comes to minorities, so lets take it to its logical conclusion:

    • Way less Jews on TV.
    • Way more black and hispanic criminals on TV.
    • Every TV show set in Cali should have precisely 57% of its characters as minorities.

    And on, and on, and onnnnnnnnn.

  25. Oh no, I have to disagree on that. I believe differences should be acknowledged, for any kind of true understanding.

    and how are they supposed to acknowledge differences when they can’t tell by the color of your skin and the mien of your face??? i mean, basically you’re suggesting that people shouldn’t talk to you and making polite assumptions unless you are wearing a “i am non-christian” shirt, because there are brown christians, and they are overrepresented in the american brown community. myself, i regular am assumed to be hindu, and people are polite to me on that account (one time someone offered me a vegetarian platter at a party). i know decruz (a christian) has been assumed to be a vegetarian because he looks like a hindu (that is, he’s brown). the kind of fine grained awareness you’re looking for is predicated on either two things

    a) knowing someone really well as a necessary precondition toward conversation, which will lead to a total banishment of casual contact and banter in public places where you encounter the unfamiliar

    b) a perfect correlation between outward markers and other aspects of their character. e.g., if you see a sikh dressed “like a sikh” you can make a good guess that they are sikh and to greet them in a sensitive fashion. but what about sikhs who dress in a manner totally indifferent from their hindu punjabi compatriots?

  26. TV ignores statistics–it looks at what will sell and make the loudest people least angry.

    Summarizes why to Hollywood, Neo Nazis are the still most realistic villians…

  27. because there are brown christians, and they are overrepresented in the american brown community

    This is a special case, and I still contend “brown christians” are have more cultural similarity with the 2nd generation Indian population (regardless of religion) rather than their white christian counterparts. From what little I know, Christianity as practiced in India is distinctly separate from how it’s practiced here in the States. but I may be wrong.

    the kind of fine grained awareness you’re looking for is predicated on either two things

    I wouldn’t consider the awareness as fine-grained at all. I’m not saying they should know what village I came from, that we as south indians, fast on the 3rd lunar month, where as north indians fast on the 3nd thursday, etc. Just a general acknowledgement of a salient difference. It’s not a question of people mistaking you for a Hindu, it’s people looking at you and not saying because you eat pizza, hang out at the mall, that you’re “just like them.”

  28. Oh no, I have to disagree on that. I believe differences should be acknowledged, for any kind of true understanding

    You can understand that someone is different, and still find it insignificant in your interactions with that someone. I think this is what I mean by the Midwest being “color blind” while the more diverse, more cosmopolitan coasts are so caught up in being socially aware, they can’t really dissociate the cultural differences from their social interactions.

    I mean acknowledging that there are different cultures in the world, that white Christian lifestyle is not unilateraly more “normal” or “better”

    I’ve lived in the Midwest for more than 15 years now (yes, I really am old), having lived in Canada and on the east coast before that, and I don’t get the feeling that most Midwesterners are either ignorant of other cultures, or believe that the “white Christian lifestyle” is more normal or better. Of course, my experiences are anecdotal (and limited to college towns and urban areas), but the attitude reflected in your statement above is exactly the sort of thing I’m complaining about on SM. This view just does not ring true to me, both as an Indian and a longtime Midwest resident.

  29. ps:

    You have to go with what works for you and have pride in it.

    hear, hear.

    and deshishiksa:

    …and that we are boring and ill-informed about the world in general

    you have to be a non-doctor, work closely with one or be married to one to fully understand how boring and ill-informed doctors can be… 😉

    i’m saying that completely tongue-in-cheek, of course. so please take it with a grain of salt. there are a few doctors that i know who are extremely interesting to talk to. on the other hand, there are several academics i know that are elitist, boring and ill-informed about the rest of the world…

  30. NA-

    I agree with your sentiments. I’ve heard the stories of living in snake-infected shacks in med school etc. While my parents were not wealthy, and the first in their family to go to college, you are right, everything is relative. I suppose they were better off than others, though not glamorous by any means.

    And on a more snarky note, I’m surprised that Chick Pea, aka “I’m a super cancer doctor hear me roar” has been relatively silent when it comes to her favorite subject to gloat/judge about!

  31. How many times have you heard a doctor say that nobody can understand what they go through unless they’re a doctor themselves?

    Well, Ennis, how can you expect doctors to understand a non-doctor’s point of view? After all, doctors are not non-doctors, right?

    Think about that.

  32. Of course, my experiences are anecdotal (and limited to college towns and urban areas), but the attitude reflected in your statement above is exactly the sort of thing I’m complaining about on SM.

    Well, then I guess we are at an anecdotal impasse. Because I have lived in West Lafayette Indiana, and have found that most white attitudes range from outright derision to the “you’re just like us” form of acceptance. Both of which don’t sit well with me. This was 5 years ago, so some miniscule change might have occurred, but truthfully, the people there haven’t even warmed up to the concept of a “brown” person that has lived, and grown up in the USA.

    If you’re honestly going to tell me that whites in the midwest do not have a “our way is the ‘normal’ way” attitude, moreso than the coasts, where exposure to “other ways” is clearly higher.. then I don’t know what else to say.

    Incidentally, I left Indiana 2 months before 9/11. To this day I thank Krishna, Jesus, Mohammed, Jehova, Buddha and every other god out there that I wasn’t there during that horrible event. Sure – was it perfect for me out in NYC? No, a whole lot of fat Italian pizzeria owners yelled “va fangool” in NYC, but you takes what you can gets.

  33. This is a special case, and I still contend “brown christians” are have more cultural similarity with the 2nd generation Indian population (regardless of religion) rather than their white christian counterparts. From what little I know, Christianity as practiced in India is distinctly separate from how it’s practiced here in the States. but I may be wrong.

    of course it is distinctly separate, but anna (a jacobite syrian christian by background) attended a greek eastern orthodox church as a child. so that should tell you that there are similarities. and my response was predicated on your offense to easter, as christians in india do celebrate that most central of christian holidays. but in any case, the general problem is still there: in a diverse society how do you establish a common ground of discourse with people in public places? you make assumptions about them. as an atheist of muslim familial background people commonly try to forge a tie with me by reference to hinduism (many in the local area have been over there). generally i’m just embarrassed because they get embarrassed when they find out my background, but honestly, the numbers would suggest that i would be hindu (85% of american browns are from what i can tell). so i don’t get irritated because people are trying to do their best (i do get irritated if they continue to assume i’m hindu, which has happened. or, if someone explains me why i should be hindu because i’m brown).

  34. I humbly request you unitalicise that and repost it, with some line breaks. I made it to the 3rd line and got a headache.

  35. If you’re honestly going to tell me that whites in the midwest do not have a “our way is the ‘normal’ way” attitude, moreso than the coasts, where exposure to “other ways” is clearly higher.. then I don’t know what else to say.

    I’m not saying every single white person in the Midwest is socially aware. I’m saying that the generalization that most Midwesterners are not socially aware is not correct either. I lived in the Midwest before, during and after 9/11, in a college town, and I never experienced a single instance of discrimination, and neither did my husband. I’m not saying that’s true for everyone, but that’s my experience…and it’s the broad “all Midwesterners are racist hicks” generalization that I’m objecting to anyway.

    Also, NYC is not all of New York. I’m fairly certain that the level of social awareness in Troy and Albany is much less than in NYC. Similarly, LA, SF and San Diego are not all of California, and I’m pretty sure that folks in small town CA are about as “socially aware” as people in small town Michigan.

  36. I lived in the Midwest before, during and after 9/11, in a college town, and I never experienced a single instance of discrimination,

    Well, I have. Like I said, anecdotal impasse.

    Also, NYC is not all of New York. I’m fairly certain that the level of social awareness in Troy and Albany is much less than in NYC. Similarly, LA, SF and San Diego are not all of California,

    Where did I imply that they were?

  37. it is distinct from other professions in that most doctors deal with life and death issues on a daily basis, and nearly every decision they make can impact whether someone lives or dies? So yes, from that perspective no one really gets what we go through. That doesn’t make us “special”, but it does have a huge impact on our lives. I generally don’t say this to other people, so I’m sorry your friends boast about it; perhaps you should find new friends. But they are right. You have to either be a doctor, work closely with one, or be married to one to really get what it’s all about. There are other professions that this is probably true of–the military or firefighters for example.

    Desishiksa – this is a very interesting comment. I did seriously date an ER doctor, and remember clearly when her first patient coded. On the other hand, I also got the impression that such life and death issues were far from daily. Even the patient who died was on death’s doorstep before he showed up, there was little she could do, either to help or to hurt him. I see your argument as it pertains to trauma surgeons (or surgeons in general) and oncologists and fertility specialists. But I never adequately felt like it described the daily experiences of most doctors, and certainly not eye or skin folks, those in the lifestyle specialties.

    Further, I never hear such rhetoric from my military friends, in part because most of the time they’re not dealing with life-or-death situations, most of the time they’re running a very large business.

    So I’m still looking for insight on this issue.

  38. Where did I imply that they were?

    Not that you implied this, but unless “East Coast” is just a euphemism for NYC, New Jersey and DC, saying the East Coast is more “socially aware” necessarily extends to all places on the east coast…whether NYC or Charleston, South Carolina.

    In other words, if you mean NYC, then say NYC…and if you mean BFE, Idaho, say that instead of “Midwest.”

  39. most white attitudes range from outright derision to the “you’re just like us” form of acceptance

    I’ve gotten this from black people as well. I recently had a conversation with a friend/acquaintance of mine who is black and I was disturbed by it b/c of the “you’re just like us” attitude.

    Sure, we’re all humans and I have a lot in common with many of the minorities in the US and I have a lot not in common with them. The conversation with my friend went like this –

    • We both live in DC now, but grew up in rural areas of NC
    • We were talking about our experiences growing up in rural NC
    • I said, being one of the few nonwhite and nonblack folks in my town I was amazed how people didn’t realize there were other types of people, or other countries, etc.

    • She said that she viewed all the minorities in her rural town, apparently there were a few East Asians and South Asians, as just like herself.

    • I said, really,…”but weren’t there cultural differences that you noticed?”

    • She was adament that she didn’t see cultural difference, but she saw them as just part of the black minority.

    • I told her that I often felt my own experience growing up in NC were invisible — b/c white or black people just subsumed a small minorities’ experience with their own.

    For me it is a constant struggle to want to be seen as American, but that I may have different American experiences than my friends who happen to be white or black. This doesn’t mean I want to be stared at, as I often was and am, – that’s just rude. I didn’t understand my black friend’s viewpoint and I don’t think she was being honest with herself. I just went to my Vietnamese-American friend’s family’s home and yes, I view her as American but it’s also interesting to understand her outlook as shaped or not shaped by her Vietnamese-American culture. And when I was at her family’s home I took an interest in their family’s history and also was aware that there are things that I should or shouldn’t do.

    I think to my black friend, she felt very touchy that other minorities don’t identify with African-Americans all the time and by me not feeling I was “black” (how could I?) that I was bigoted in some way to African-Americans.

    Does this make any sense?

  40. razib, why assume anything? if people knew enough about any culture – desi or not – they would realise that it is nearly impossible to make any sort of generalization. except maybe language, but in the case of india, that also does not stand. when people meet me, i expect people to not assume anything about me – because if they assumed, how would they know that i don’t practise hinduism (even though my family does)? that my parents don’t eat tandoori chicken and naan every night? that we don’t speak hindi in our house? that my parents have spent the bulk of their lives here? why not ask questions instead – to actually inform oneself. the issue is not about awareness – it is about respect for our differences – whether those may or may not be based on ethnicity.

  41. Oh c’mon, i think its obvious given the context, “coasts” refers to major urban areas, and “midwest” refers to small bible belt cities, not Chicago or even Indianapolis.

    And given you haven’t experienced any kind of racism or discrimination out there, I’d encourage you to play the lottery!

  42. Oh c’mon, i think its obvious given the context, “coasts” refers to major urban areas, and “midwest” refers to small bible belt cities, not Chicago or even Indianapolis.

    Well, that’s exactly what I’m objecting to. Why not just say “small bible belt city” rather than Midwest (considering it’s a fairly large region of the US, and encompasses three different geographic areas)?

    In fact, given current population distributions, most Midwesterners live in urban areas, not in small bible belt cities. And just FYI, the vast majority of the Midwest is the Rust/Corn belt and not the Bible Belt. People from Missouri and Kansas have almost nothing in common with people from Ohio and Michigan.

  43. why not ask questions instead – to actually inform oneself.

    is it normal where you come from to ask strangers in public places what their religion is? what their dietary habits are?

    my point is this: as americans (or whatever nationality) we have a lot of subconscious assumptions we make about people that scaffolded the path of discourse. that is a fact of human cognition, most mental processes are not reflective and the reflective conscious elements are strongly shaped by the non-conscious parts. when you meet someone you make assumptions and get information based on what they look like, how they dress, their accent, the part of the locality they are from. this is normal and human. the issue isn’t do we do it, it is the fine line we attempt to negotiate when we consciously use the data we intuit in our everyday conversation. for example, i had a friend who was poor who ended up living in a notoriously rich suburb. the reality is that her town had been administratively absorbed a few years ago and there was nothing rich about it, and they were pretty much outcasts. but anyway, she went to a ritzy high school and when people found out what high school she went to they would assume she was well off. they didn’t say “oh, you’re rich.” rather, things would happen which implied people assumed she was well off when making decisions (e.g., she was invited to an expensive sky diving trip by some people in her dorm, who never considered she couldn’t afford it).

    as for not being able to generalize, of course we can generalize. there’s a central tendency, a mean, a median, a variance, a skewness. we can characterize the errors which bound our generalizations. people say we don’t want to generalize a lot, but they only apply it to certain areas. for example, if you want to go down this route i better not hear any more generalizations of republicans. after all, they’re all different…. (yeah)

  44. If it makes you feel better, sure, I won’t use the word “midwest” anymore. However, I just prefer Jesusland. Makes life a bit easier.

  45. Good points, ennis. I suppose it’s the narrative that people tell themselves about the profession they have chosen that’s more important than the daily practice of it, much of the time. And the identity they develop of themselves as members of that profession – or ways in which they respond to and make sense of the social position of their professions. Just as it’s more reassuring to think that teaching shapes impressionable minds and being an academic means you’re producing original research (and isn’t about teaching the same boring thing year after year, or publishing slight variations on existing research), or that being in the army is about going out there to defend your nation (and not to have a good pension and because you couldn’t get a better job with your skills), it’s reassuring for doctors to think that the stressful long hours they put in, particularly in training, are meant to prepare them for emergencies, rather than simply being a sign that they are low on the totem pole and no-one else wanted that shift, or a reflection of the artificial shortage of doctors in the US. Similarly, doctors express anxiety about and justify high pay in terms of the possibility of lawsuits, whereas in reality only a tiny percentage have to face that possibility.

  46. that we don’t speak hindi in our house?

    Heh. This reminds me that Indians often generalize about other Indians as well. In college, one of my roommates was an IBD graduate student, and she signed up for one of those international calling plans with AT&T. One day, as part of a promotional deal, she got a call from someone at AT&T who began the conversation with “Hello, main AT&T ke taraf se Iqbal bol raha hoon.” She was so offended that AT&T assumed she knew Hindi just because she was Indian that she promptly hung up, canceled her AT&T service and switched to MCI!

  47. ?Clannishness? Hey multicultis, I thought that was called solidarity? Never can keep up with the progressive mindset….

    I’ve never noticed this clannishness, but I suppose it is my age (late thirties, really late thirties, and you can just shut it Ennis and razib 🙂 ) and the fact that I grew up in, and work in areas, without too many desi docs. Well, that’s not true. Grew up in Iowa, trained/worked in California, Illinois, New Mexico, and Massachusetts. So, you know, I’ve been around. And, hey, I don’t mean it that way!

    Desi docs are not a heterogenous group; there are people who grew up here and trained here, people who grew up in India and trained there, and various combinations of the two. Medicine is in a pretty weird state right now and there is a lot of bitterness in the profession, whether desi or not, so I think it comes out in different ways. Complaining is my personal favorite.

    Forming desi physician groups probably started for those who trained abroad and felt abused, or confused, or whatever, by the system, and now the younger types are just continuing it as a multicultural or solidarity excercise? Or, cause, it seems like the right thing to do? I am just surmising, I’m an outlier by virtue of having grown up in Iowa, quite happily, and without too much angst in later years, although plenty as a teen. Oh, why or why can’t I go to the prom and date? Anyway, being a teen pretty much sucks for white kids, desi kids, whatever kids. That was one advantage of growing up the way I did, out in flyover in the 70s and 80s; I never did idolize the majority, meaning, I didn’t assume that life would automatically be prettier if I grew up in a place where I was like everyone else. It might be, but it might not. Whatever.

    Desi docs can be full of themselves and it’s a pain in the you know what. But, from my vantage point in this particular East Coast Medical Industrial complex, lots of docs can be full of themselves. I wonder if the profession attracts people who need the kind of stoking of the ego a profession like medicine can provide? And, then, after admission to med school, become frustrated, when, hey! It’s hard, guys. It’s hard and you have a lot of responsibility and it’s not all about you and your CV and your Lexus, kiddo. You will make mistakes, you will get sued, you will have to think about things most people would rather just forget. Think I give many lectures to the ‘kids’?

    Well, most of the docs I know are pretty nice, actually the ‘full of themselves’ types are just the loudest and so get the most attention. Too bad.

  48. One day, as part of a promotional deal, she got a call from someone at AT&T who began the conversation with “Hello, main AT&T ke taraf se Iqbal bol raha hoon.” She was so offended that AT&T assumed she knew Hindi just because she was Indian that she promptly hung up, canceled her AT&T service and switched to MCI!

    a vietnamese american friend had the same experience (he hung up). i did too, though i didn’t hang up on the person. he was a nice enough indian immigrant who i chatted with for a while, and he felt really crappy about what he was doing. a large number of american brownz he was calling had no idea what he was saying because so many were from non-hindi speaking families. now, one thing that happens to me in large cities is that sometimes brown service personnel tentatively say things in hindi (or urdu for cabbies) to me to see if i know what they’re saying. obviously they aren’t sure i’ll understand, but they figure they’d try anyhow. it’s not usually a big deal, people are trying, not assuming.

    there’s a difference.

  49. p.s. i recall once in NYC a bangladeshi cab driver picking me up and talking loudly about all sorts of serious personal issues in bengali which i could hear and understand. that was awkward!