Bigotry in medicine: facing conflict with empathy

Editor’s note: This story contains a racial slur crucial to the writer’s story.

Life has a funny tendency of unexpectedly throwing things your way. We, physicians, deal with this regularly. You never know what’s lurking about to put a huge dent in your day. Particularly vexing are ugly circumstances that rock your core. And few strike such a nerve as bigotry.

When encountering a confrontational individual, our natural response — via human nature — is to counter-argue. This is doomed to fail, for an adversary who has told his opinion is wrong will never concede and understand your point. Instead, put yourself in his shoes first, respond from his perspective, and allow him to eventually see for himself the error of his ways. This is easier said than done. But doing so might win him to your way of thinking or at least save you a broken nose. I learned this early in my medical training.

I was a newbie, a first-year otolaryngology resident in 1991 when I met one unhappy patient in our clinic. I introduced myself and extended my hand. He would not take it. He just stared at me.

“I used to shoot people like you,” he finally said. I withdrew my hand and did something with it, perhaps straightening my tie or nervously biting my nails. I forget the details.

I should’ve been outraged by this remark, I suppose. Instead, I merely stood there, panic-stricken.

“It’s because of you people — I was wounded.” He leaned forward. “But I shot and killed a bunch of you!”

“Holy cow!” cried in my head. I remained confounded, entirely at a loss for what to do or say.

“What do you say about that?” he eventually asked.

It dawned on me he was a Vietnam vet. I’m not Vietnamese, but I figured arguing from that perspective wouldn’t matter. He still saw an Asian guy. I knew I’d encounter patients like this in one form or another as a doctor. But reality has a funny way of bringing to light the direness of frightful circumstances since it is so … real and far greater than once imagined. And this threw me for a loop.

I reckoned I should perhaps stand my ground, knowing he could knock me out cold. The one positive consequence was that if I were injured really bad, the senior resident wouldn’t make me take call that night.

“I don’t understand,” I finally muttered. “You shot other Americans?” This was the best response my brain could assemble on the spot. I surmised pointing out our similarities rather than our differences was the best approach.

“No! I used to shoot people like YOU!” He was one scary vet. “People who came from where YOU came from!” he pointed a gnarled finger at me. My eyes focused on that finger, a deformed appendage unable to extend itself completely, but just as ominous as the fellow possessing it. I figured he could whack me upside the head with that finger and send me flying through the window into the garbage dumpster below. With no other recourse, I stuck to my guns, so to speak.

“You mean, you shot people from California?” Provoking him was not my intention, and I honestly was not trying to be a wise-ass.

“Are you being a wise-ass, boy?” I held my ground not from courage, but instead from paralysis by fear.

“No, sir. I’m from California,” I replied meekly. Then I stupidly added, “Uh, aren’t Californians Americans as well?”

“No, no!” he shouted. “I mean, yeah! You know what I mean! I shot gooks like you in Vietnam!”

I was stuck. Then a possible counter-strategy of sorts came upon me, one that might succeed or completely backfire and land me with a black eye and a bunch of missing teeth. I was already in pretty deep with this guy, so I took the risk.

“I was born in California. I’m half-Japanese,” I added, “I thought we are allies with the Japanese.”

“Half Jap?” he inquired. “What’s the other half?

“Uh, Chinese. Weren’t we allies with the Chinese during World War II? I know they’re a bunch of Commies now, but that’s not my fault. Both of my parents were born in California. My grandmother was born in Los Angeles of all places. And this is the farthest I’ve been from home. Never been to any Asian countries, let alone Vietnam.”

“Oh yeah?”

“Yep. Never been outside the U.S. Well, I did go to Tijuana, Mexico once. It’s just across the border, south of San Diego. You probably know that. The border patrol almost wouldn’t let me come back — thought I was a Mexican or something. Or maybe they thought I was a Chinese Communist trying to sneak into the country through Mexico. I really don’t know, never went back to ask. I was just glad to be back home. Never went to Tijuana again.”

Oddly, his attitude slowly changed. He chuckled. We talked a little more, and he eventually allowed me to examine him. As it turned out, the poor guy had cancer.

We got along splendidly afterward. At his follow-up appointments, he’d shout, “Where the hell is Fong? He’s my doc!” Now and then he talked a little about Vietnam, where he lost a friend during combat, blown to pieces by a grenade. I understood how his hatred for people who looked like me came to be, but this eventually softened. Looking back, I like to think we both were better people having met one another. My only regret is that I’ve forgotten his name.

The lesson? I diffused a near-explosive engagement and created — with a bit of dumb luck — one that benefitted us both. It’s easy to react by countering like with like, an approach that will not convince your adversary to see your point of view. You can choose how to respond to any conflict. The power lies in your hands. It’s another application of empathy, that time-honored quality we doctors are supposed to possess.

Understanding another’s mindset and tailoring your approach from this perspective can make all the difference.

Randall S. Fong is an otolaryngologist.

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