14 Aug Asian values kept doctor who found herself in an emergency room from speaking up about the quality of her care
Note: As the Asian American Journalists Association AARP Fellow, I’ve been writing articles for the AARP.org website about AAPI themes but mostly work within the AARP AAPI Community’s social media platforms on Facebook and Twitter. I’m starting to write profiles of AARP’s AAPI volunteers and staff and post them to the AARP AAPI Community Facebook Page. This is the first profile I’ve posted, and because it’s such a compelling story that I’ve decided to repurpose it here. If you find the story is valuable, please LIKE the Facebook page!
When Dr. Charlotte Yeh wrote a powerful article earlier this year in the Washington Post about shortcomings in emergency care, she subtly hinted at the conflicting cultural values that affected her that night two and a half years ago when she was hit by a car as she crossed a street.
She was taken to a nearby hospital’s emergency department, but wasn’t given the level of customer care she would have liked. And she’s an expert on the subject: Trained in surgery, Dr. Yeh was an emergency department physician and experienced healthcare administrator.
But she didn’t complain or raise questions with the doctors and nurses giving her care that night. Instead, she wrote in her Post column recalling that night that she wanted to be the “good patient.”
“The good patient in me wanted to please the doctor and saunter out of the room, but the real person in me was scared,” she wrote, even though in fact she wasn’t sure she could even stand and walk at all.
That phrase, “good patient,” comes up three times in her article, and is an echo of a deeply-felt Asian value that affects many immigrants in the United States, as well as generations of Asian Americans.
AAPIs are tagged with the “model minority” myth in part because of the cultural values of respect for authority, respect for expertise and respect for elders that have been handed down over centuries. AAPIs are supposed to be “good” sons and daughters, students, workers, and, apparently, patients.
It’s not like Dr. Yeh, who is the Chief Medical Officer for AARP Services, Inc., was raised to be meek and mild. Her parents helped to found the Pittsburgh chapter of OCA, the Oragnization of Chinese Americans, an Asian American civil rights organization. But, she says, “Like many immigrant communities, I was raised by the community,” with Chinese traditions and values. There are plenty of “pictures of me dancing in folk festivals,” she says, chuckling.
Dr. Yeh agrees that her Asian instincts kicked in when she was struck by the car and found herself in an emergency room, but thinks there’s more than just the model minority myth. “I think there are complex things that go into the expression of ‘the good patient,’” she says. “We don’t want to bring attention and challenge superiors, but I was hit by a car and just wanted to be a patient and not be a doctor. I didn’t want to challenge my care.
“It was a combination of how I was raised and not wanting to stick out. When you’re under stress you return to your roots. It was both.”
In the end Yeh was treated but needed a wheelchair, and then a walker to get around. Even today she needs a cane. But in a twist that combines both her Asian value of making the best of a situation and a very American drive to publicly show off a creative streak, she decorates her cane with symbols like a bunny for Easter, or seasonal artificial flowers including a red, white and blue bouquet for Fourth of July.
She says her customized canes have helped her self-image because before, people expressed pity for her, but now that she celebrates her disability, the cane is an upbeat conversation starter. It’s hard to imagine all Asians being willing to put flowers on a cane, though.
Yeh is on a personal path to recovery, but she notes that there are definitely challenges that face Asians in situations such as healthcare, because of language and cultural differences. She’s seen healthcare providers unwittingly fail to connect with Asian patients. “If someone talks to you, you nod your head because you’re listening, NOT because you understand or agree. Asian patients were too polite to ask you to explain what you’re saying.
“It is challenging. It’s a subtle thing about cultural differences.”
Yeh didn’t let cultural stereotypes keep her from pursuing the career of her dreams. She went to medical school to be a surgeon at a time when women were just 10% of the student population, and few women held the knife in surgeries.
“My whole life has been one of change and being a change agent,” she says.
Her next change was in the emergency department, an area of expertise she was drawn to. “One reason I loved the emergency department is that it’s egalitarian. We treat everyone from the homeless to the President of the United States. It’s by medical need, not by status. It’s an opportunity to create order out of chaos.”
At the time, emergency medicine wasn’t a specialty offered in medical schools, but she saw its importance. “The emergency department was an incredible social barometer for what worked and what didn’t, in real time,” she says. “I became an activist for things like seat belt legislation and the guaranteed right to be seen because of what I saw every day in the emergency department.”
Those experiences, and the fact that she grew up a baby boomer, in the midst of enormous societal evolution, taught her the power of social change. As an administrator, Yeh instituted major changes to emergency procedures, and also helped roll out the Massachusetts healthcare regime that became a blueprint for President Obama’s Affordable Care Act.
After 30-some years at the front lines of healthcare, though, “I felt I was not learning as much,” she says. “What used to be a challenge was now the norm.”
Because of her experience as a provider of care, payer of care and a bureaucrat, she knew of AARP’s work in healthcare. For Yeh, it was the best job of all, healthcare transformation through the experience of the consumer. The core mission is improving the care for 50+ and 60+ patients. She’s worked for AARP for six years.
And, she understands, especially given her experience as an emergency department patient herself, the challenges that Asians and Asian Americans face, and how she has become a very visible spokeswoman for the community.
“Growing up I never thought about my Asian culture besides explaining the food when I brought it to school.” Now, there are so few public spokespeople who are Asian, that she’s treated like a celebrity when she speaks to Asian audiences.
She chuckles, “Gee, did I just become an Asian rock star?”
No, just an Asian who deserves the utmost respect from all good Asians and everyone else too.