Diversity and Inclusion: A Daily Effort

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DIVERSITY RELFECTIONS

We Indians do not even have a name in the United States, so how can I have a defined identity? I am Indian, not Native Indian. Yes, I am Asian but not Chinese or Korean. I am South Asian but not Pakistani or Bangladeshi. As an ‘Indian Indian,’ am I a hybrid first generation, second generation, or fresh out of boat, or an honorary white? I am still figuring that out.

Handling a contrasted self-conception which leads to compartmentalization of personal and professional life makes my life ‘hybridly’ normal. I am an Indian woman and no it is not a norm to do well professionally or have a leadership position. I work as a program director where I get invited to do acculturation and diversity workshops on bias and micro- and macroaggressions. I learn and grow every day on these topics. To know where I am today, I must share my journey.

Unity in diversity is the norm in which I grew up in India. Born in a Hindu household, I lived in a Muslim city and studied for 12 years in strict Catholic school. On top of that, my home was in the military area called Cantonment. My dad’s dream was to be a member at the country club there, which was open only to British individuals and high-ranking military. In front of the club was the notice that said, ‘No Indians and dogs allowed inside.’ My dad did become a member there after independence and I, his only daughter, got married on the lawns of the club.

That does not mean there was no odd moments for me. It was evident everyday as I was an ordinary looking girl in a very patriarchal society with several Indian stereotypes. My value in the arranged marriage market was not very high due to my relatively darker skin color and looks, and I was reminded of this routinely with snide comments like, ‘at least she is smart and good in studies.’ India—while it struggles with colorism, elitism, sexism, and castesism—is still the world’s largest secular democracy and I had fun and celebrated all Hindu, Muslim, and Christian festivals with equal enthusiasm.

Straight after completing medical school, I moved to England after marrying an Indian man raised in England and free from any bias. Some different discrimination was obvious when I moved out of India. During my psychiatry residency in the UK, older folks would tell me stories of the British empire in India and how they had affairs with Indian women. They glorified their good old days and implied it was because of them that India made any progress, I knew how to speak English well, and I could come to their great country. My psychiatry training was good, but I never got selected for any leadership positions, research or community outreach opportunities, or promotions. I was advised to compromise and just give in to staying as a junior staff psychiatrist and never becoming a consultant, as that was an honor for the local medical graduates. I was also advised by my own psychiatry mentor to dress very smart and speak with a local ‘Brummy’ accent, otherwise locals might assume I was an uneducated immigrant taxi driver and not a doctor. I was never one to compromise, so from here my grit continued to grow.

As luck would have it, Y2K happened and my husband was offered a job in New Jersey and we moved here. My first visit to the grocery store was memorable as I asked for a trolley and they laughed at me. Apparently, there is a big difference in the Queen’s English and American English. I have now learnt to call it shopping cart! New Jersey is known to have a lot of first generation Indians who are shopkeepers and stay in certain neighborhoods (eg, an area called ‘Little India’). It was a mind-blowing culture shock for me, and for the first time, I met Patels, South Indians, and Assamese and Bengali individuals. Let me inform you that since I grew up in North India, I had never ever met a single Patel or Reddy, or met Indians who could not speak either English or Hindi.

I was 6 months pregnant and interviewing for psychiatry residency. Well, New Jersey does not even entertain the option of providing visas for foreign graduates. New York was better in that aspect—until they saw I was pregnant. During one interview, I was openly asked if I lived in joint family like other Indians, when I planned to have a second child, and if it was true that Indian husbands are not very supportive in household chores. How would I manage residency, they asked.

I was an educated doctor, I did know how to multitask, and my husband was and is super supportive. I finally got residency in Philadelphia and life moved on. I will never forget a particular attending who decided to make my life very difficult and ensure that my residency was going to be full of hurdles—perhaps because I was not white and timid. That cost me my chiefship during residency, and I left the program with a determination to help trainees have a better experience during their residency if possible and to help with education, acceptance, and awareness of diversity to those like this particular attending.

Seven years ago, we moved to Atlanta for its diversity and warm climate. The nuances of the south and its diverse immigrant population have their pros and cons. Here, we learnt that some Indians marginalize based on their religion, state of origin, language, caste, and income. There was segregation based on first, second, and third generation. However, the aforementioned experiences have made me more relaxed and I find them easier to deal with. When faced with a challenging moment, I use it as an educative moment for the other individual or myself. I was elected the president of IAPA Georgia chapter and apparently it was the first time that a north Indian was selected and not a Gujrati speaking professional. Since then, we have had one Punjabi and now a South Indian as the president. Sensitive topics of discussion include culture bias and ways to improve dealings with immigrant patients who can sometimes be assuming and time consuming. IAPA and GPPA are great platforms to learn and teach.

At my job, I was an active supervisor for students and residents of Emory and also an active member of the women faculty subcommittee. Somehow, I got chosen to start a new residency program in northeast Georgia and was successfully able to implement that in spite of COVID-19, in spite of being a woman of color, and in spite of being relatively new to Georgia. I made it a point to implement diversity, equity, and inclusion but story does not end there. What I was not prepared for was reverse racism. Some assumed that I would automatically favor applicants of Indian origin. It was a shock for my PC to get a call from an applicant enquiring why he had not received an interview with us and was upfront in saying that he had seen the photos of the PD and assumes that she only wants girls in long skirts with dots on their forehead and men with turbans! Northeast Hospital System and Emory both have fantastic committees on DEI which help with making great ripples for this effort.

In the meantime, I am thoroughly enjoying Atlanta and what it has to offer and dream of a place where diversity and inclusion is a norm and not a daily effort. However, how will it become a norm unless it is a daily effort?

Dr Prasad is a board-certified psychiatrist, the program director of psychiatry residency in the Northeast Georgia Health System, an APA Distinguished Fellow, and adjunct assistant professor at Emory School of Medicine.