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±áạ: Hi. It is a lovely rainy day right now. And you might be going, "Wow. This voice sounds a lot different than what I'm used to." Well, I'm Ha, and I am one of the new voices joining the "Bundle of Hers" podcast. So just wanted to say hi to everyone, and welcome to the second episode of "Bundle of Hers."

As I mentioned, I'm her. My pronouns are she/hers. I'm a third-year medical student at the University of Utah School of Medicine. It's very nerve-racking to be speaking here, but I am so, so excited because I have a very special guest with me for this episode, and I will let them introduce themselves.

Meet the Guest: Xian Mao

Xian: Thanks, Ha. So my name is Xian Mao. I am also a third-year medical student, although I'm on the other side of the country in also rainy Maryland. I'm at Johns Hopkins University, and Ha and I have been friends since the third grade.

±áạ: It's kind of wild to think that we've known each other for this long.

Xian: Yeah. So like Ha, I grew up in Salt Lake City and we were in the same kind of small-ish private elementary school growing up.

±áạ: You came from Chicago, Illinois, first if I remember correctly, right, Xian?

Xian: Yeah. I am not a Chicagoan at all, though. I was born in Chicago, lived in China for half a year, then lived in Minnesota for another year, and then made that drive down to Salt Lake City where I was until I left for college.

Reflections on Childhood and Friendship

±áạ: When I think about our friendship, thinking about how we met each other in the third grade, and I think it was very funny how we all like fell into our friendship because it was kind of . . . Well, maybe you want to describe the situation a bit better, Xian.

Xian: I think we were kind of a triumvirate of sorts. So you and our other friend already knew each other, and then my first day of school, I was waiting outside the classroom, I see you, and I'm like, "Oh, my God, another Asian child. I must befriend this child." It's the desire to see someone similar and seeing you as somebody safe. And I was like, "Okay, must befriend." And in the end, we became like a trio of the weird kids who all lived with our single moms and come from immigrant backgrounds.

±áạ: It was weird because when I reflect on it, for a while as a little kid, I thought that our backgrounds were pretty much the norm because it was all that I really knew being friends with you all and we just had so many similar backgrounds, similar . . . We just had this shared understanding with each other.

And it took kind of a few years. I might also have just been a bit not the most observant child in the world, but it took a few years for me to realize that, "No, our experiences are very different comparatively to maybe the majority of the country."

The Asian-American Identity and Expression

And I guess that then comes into why I wanted to have you here today, Xian, in this first episode that's part of the introduction to the new cast members of the "Bundle of Hers," and also part of a continuation of the Identity Series that Margaux, Harjit, Leen, and Bushra had done when they were about to graduate from medical school.

And the reason why is that, Xian, I feel like we have gone through the same journey together for a really long time. We went to the same elementary school, as we've established. We then went to the same middle school, the same high school, flew across the country to the Northeast to do our undergrad education, took two gap years to do research and to also figure out what we really wanted to do with medicine, and then now we're both in medical school going about our clinical rotations.

And it really means a lot to me that you've been the one that I've been able to have this similar journey together with. But another thing that I think a lot about is even though our journeys look so similar on paper, we're so vastly different. And I feel like you helped me grow a lot and you helped me understand myself a lot based on how your journey has been.

The topic that I really want to talk about, I think about it as one word, and it's called expression. And the reason why I've chosen the topic of expression is because I feel that, especially as Asian Americans growing up in Salt Lake City, I feel that sometimes we get stereotyped into a group a lot. There's a lot of we all look the same, we all have the same interests, we all follow the same rules, and beliefs, and all of that.

And in a way, I feel like becoming an Asian American in medicine I sometimes fall into that stereotype of what a lot of people believe we are. But I think that even if we're very similar on paper, how we express ourselves can be so vastly different and nuanced and how we respond to our situations brings in so much depth and breadth to our diaspora.

Xian: I do agree that initially it seems like being Asian American going into medicine, there's this kind of idea that there's already a set path or that whenever I say, "Oh, I am a first generation of Asian American in medical school," there's already kind of a stereotype or there's already a set narrative of like, "Oh, your parents wanted you to be a doctor. Oh, congratulations, you're doing it. You must have been a nerd and a good Asian-American kid in high school. You made your parents proud and honored their legacy," etc.

Whereas I think it is hard because then it's hard to escape from that breadth. And I think that one thing that I really dislike about this narrative is that it's all wrapped up in the idea of personal or familial success and more of being a doctor is kind of the end goal of the "American dream."

Whereas I think for me and I think for the both of us, when we've talked about why we personally want to go into medicine, it does not take into account the feeling aspect and the ways in which being a physician can help other people and also address social issues.

Cultural and Familial Pressures

±áạ: I completely agree with that. It is weird because in a way I do feel that pressure. Coming from a single-parent household and being an only child too, I recognize that at the end of the day I am the one who is going to be able to care for my mom in her old age. And I am the one who has to honor a lot of the sacrifices that she had to make, deciding to come here to America and all of the issues that she had to go through, both as a child growing up during the Vietnam War and getting to the point where she ended up here.

I do feel that pressure, but it's a very different pressure than what a lot of people think it is. I sometimes feel like a lot of people think it's kind of like the glory, the bragging rights.

Xian: It's complicated for me. I do recognize that it's because I do have a certain level of privilege in my background. Since my mom is also in the medical field, I've had more exposure to medicine and people in medicine. It is really complicated.

And at least for me, what's important is having the ability to care for my family when they grow old, to have that kind of financial stability. But then for me, the issue of being the first generation and also an only child, it comes to an idea that there were so many sacrifices that were made on the part of my mom and so many things that she had to endure and had to pay for me to get the best chance that I could. What's expected then is that I am grateful for her efforts and that I repay her back.

What's hard, though, is when I am so grateful for what she has done, but then my dreams of success and my dreams of what I think going into medicine and being a successful doctor are kind of different than what she expects.

Tension Between Social Justice and Family Expectations

±áạ: Yeah. I think a lot of times, and it's not just even my mom, it's the rest of my extended family because I am the first in my whole family to go into medicine. When my family thinks about me being a doctor, they want me to have a good livelihood and they want me to have all the information available to answer any of their medical questions, which is impossible to do, and we are slowly working on getting them to understand that.

And then the other thing is they just want me to lay low and to just do my job and get that livelihood and get that stable life and live that American dream that they sacrificed everything for and be that poster child for the American dream.

But I think we get into a lot of conflicts because when I think about, "Yeah, I want to do that clinical care," but that clinical care is so intertwined with all these social issues, it makes me really angry and it makes me want to sometimes raise hell and bring up the concerns and kind of bring up more conflicts and not lay low in the way that they want me to. And I think that's when it gets really, really hard, because I don't think that's what they imagined I would be as a doctor.

And I understand why they get scared about it, because at least for my family, growing up after the Vietnam War, laying low was a way of protection. Then going to here in the U.S. where it's so unfamiliar and they felt like a lot of times they were never going to be a part of the U.S., like they could be on paper an American citizen, but never really belong, laying low has always been safety for them. And so that's kind of what they were hoping for me. And I'm not doing that sometimes and I think it scares them a lot.

Xian: My parents have kind of a similar background. My mom grew up in the communist revolution of China. She wasn't at the protest at Tiananmen Square, but she was there for the aftermath. And I think that's really affected her in thinking about what are the consequences of being an active agitator and being politically active and calling for revolution and change.

I definitely agree that there's this idea that you stay as far away from political involvement as possible, or you try to be apolitical. My mom definitely, whenever I try and talk about social issues, has definitely said the whole, "There's both sides to every argument. Listen to both sides."

It's also very difficult coming from first-generation immigrant families, at least in my experience, to really talk about solidarity and the shared experiences and the shared oppressions that POCs should be working together to fight against when being labeled a person of color or a minority are new experiences for her.

Intersections of Religion and Social Justice

±áạ: Yeah. Similarly with my family, also, I think, sometimes with the model minority myth, my family likes to kind of fall back on that. Even though we on paper look like we're following the American dream and that on paper we seem to be doing a lot better, it is all interconnected and it all creates oppression.

And then I think another thing about them, and I don't know if that comes up with you too, is a lot of times when I bring up concerns about social justice, we bring up a lot of ideas of Buddhism with karma.

For the listeners who don't know, Buddhism, one of the big concepts is that we are all reincarnated beings and the reincarnation, where we end up where we're reincarnated. So our social standing, even our race, and all of that is a result of karma from past lives.

And so a lot of the belief about it is that we have this suffering as a part of our human existence and this suffering is due to karma from past lives. And the way to move forward is to just really let go of all of those things that make us angry and really hold us back.

For me, it's something that has always been really hard for me to reconcile as someone who was raised pretty devoutly Buddhist and I still associate and feel that I am still very devoutly Buddhist.

It's hard for me because a lot of what drives me into medicine and keeps me in medicine when the going gets really tough is this rage in a way and also a lot of this motivation and passion against injustices. And I'm typically told, "Oh, you just need to let it go. You just need to accept it as what it is because this is our reality and this is a part of the karma and everything of human existence."

Xian: I think that first on how anger is demonized and kind of used as a gotcha of, "Oh, you're just saying these things because you're angry and you should calm down," has been used historically to silence women, to silence people of color.

There's a lot of value, I think, in anger when used right, but it's a hard emotion to kind of cultivate though because it's also a very exhausting emotion. And I think that's where Buddhism is useful, for me at least. When I need peace, it's a good way of feeling small in the good way that there are things larger than myself that will continue on and to know that my existence is only one small piece in it.

But it is then hard when applying that to social justice and talking about important issues that have also gone on for generations and need generations to heal. And it's hard to then say, "Well, this is all out of my hands. I was born into this body with this background. I guess I'll just wait until the next cycle." I think that is really hard when the ideas of karma and peace are almost weaponized to silence others and their grievances for wanting things to be better in their lifetime and the life that they are currently living.

This makes me also think about it's kind of hard to have this idea going forward into medicine when a lot of times what we're trying to do is improve not only just somebody's longevity or general wellbeing, but also make sure that they are able to do things that they enjoy. I'm curious to know what you think.

Harm Reduction and Compassion in Medicine

±áạ: It's so peculiar. I do think there's a piece that I do get a lot of times from being able to kind of let go, especially since I err to be a pretty anxious person. But it's hard because I feel that sometimes it's so disconnected with reality of what a lot of people are experiencing.

And it's kind of weird for me trying to navigate having that mindset that I was raised in as a Buddhist, being able to disengage from that and recognize that it is not the reality, that that mindset is not the reality for a lot of my patients, and my big goal is to get patient-centered care and to empower my patients to live the lives that they live.

I don't talk about Buddhism with a lot of people because I think Buddhism lives in a lot of contradictions. One of the things I like about it is it is a community religion and it sees us as all really interconnected with each other, but it is also this religion that's very focused on your personal betterment. And I feel that when done right, it doesn't pass judgment onto other people and their decisions. And that's what I really love about it.

But then that becomes this weird conflict because I go, "Well, I don't pass judgment into how people live their lives and what they choose as brings them joy," but also part of it says that we should live in this zero sum area space. And that's not really what a lot of people's goals are.

I'm currently in family medicine right now for my rotation, and a lot of our motivational interviewing is finding what makes people happy and what motivates them and using that to drive them to make changes for their health.

And so that's kind of where Buddhism is a bit tricky for me, but I would love to hear your thoughts, Xian, about it with harm reduction because I know you've thought about that a lot.

Xian: For those of you who are not familiar, harm reduction is the idea of meeting people where they are at. So this especially concerns high-risk behaviors such as . . . drug use and sexual practices generally are the ones where you have the most harm reduction systems set up. So, for example, needle exchange programs, providing free condoms.

Kind of the idea that we're never going to be able to fully eliminate "dangerous behaviors" or behaviors that put people at risk for various preventable diseases, but what we can do is to lower that risk by making sure that when people choose to engage in these activities, they are safe.

I think, Ha, you used a great word, that Buddhism is full of contradictions. A central tenet is charity and also being kind of nonjudgmental in how we provide care, I think, is very important.

But then I think it's kind of dicey that when you think of it as, "If everybody is Buddhist, then there's obviously . . . it's a negative thing to be pursuing pleasures." The Buddha meditating under the tree, the first tenet he realized was that the source of all suffering is desire, so then the pursuit of our various bodily desires produces more pain.

So it's hard, I think, to balance those things with any religion. It can be useful for some people and not for others. And I know not to apply my own religion to other people's experiences and I know that not everybody is Buddhist. Not everybody, even if they are Buddhists, will interpret it the same way.

Breaking Stereotypes: Beyond the Model Minority Myth

±áạ: I think that's a very great way to sum it up. I think what you were saying with religion and with being a Buddhist can really apply to being Asian American, or being a minority, and all of that. I think a lot of times people do put people into groups and see that people should perceive or navigate the world in a certain way just because of the identities that they say that they possess.

And I think that's a great reminder about how we should approach patients and people in general, is to recognize and appreciate their identities, but then also not infringe our assumptions, our belief sets onto people. And that's how we can elevate and amplify voices.

Xian: Going back to your theme of expression and the narratives that are forced upon us, you see within the model minority story a lot of external pain and maybe the child protesting against all those pressures, but you don't see the child having any kind of identity or any kind of dreams or really aspirations outside of what's placed upon them.

The one thing that is different is we also both wrote a lot of stories as little kids. That's something that connects us, but really you don't see in the model minority myth or you don't see the fact that we both got really into musicals and we saw "Wicked" together with seats at the very back of the theater. I think it was eighth grade.

±áạ: Yes. It was still a magical experience. I'm just going to say that.

Xian: Yeah. There's so much humanity in our shared experiences that just fade away when you only look at what we are on paper or what the model minority myth chooses to put down.

And I think that there's a very similar feeling of isolation being a member of the LGBT community, just feeling like the narratives that I am constantly hearing about my experiences, feeling like they don't apply or feeling that I don't exist or my experiences are non-existent, which is why I'm very glad that things are changing. We are hopefully getting a more diverse cohort of doctors and we're learning to use gender-neutral language and to not make any assumptions.

I had the pleasure of seeing an adorable 1-year old with two moms. We had one mom present and then another mom over the phone. I was very glad that during that experience I didn't make any assumptions on who the other partner was.

This also wraps back to the fact that both of us grew up in a single-parent household and how important it is to just not make any assumptions about what a family structure looks like.

The Power of Personal Expression and Nourishing Identity

±áạ: Something that I sometimes struggle with is that I do sometimes feel, especially as a story writer, a person who really likes writing stories, I sometimes accidentally place myself into those very general narratives that people create for me, and I kind of wear them like a very, very heavy backpack that I have to carry around with me.

And sometimes it's hard for me to think about, especially in medicine where sometimes I am just running and just trying to get through each day and not really having that space to nourish that depth of myself that you were talking about with loving musicals or loving to watch . . . Well, I don't really like watching . . . what is it? Those long Furby things that you send me. But I just mean enjoying my TikTok videos. Sometimes I don't have that time to nourish it, and then I get caught in that narrative about who I'm supposed . . . that very general narrative.

And so, for me, when I do nourish it by writing poetry or things like that, just banging out "Phantom of the Opera" on the piano, or going on a nice run outside and just listening to K-pop, that's how I nourish myself and find my expression for myself to break away from all of those generalized narratives. I'm curious how do you express yourself?

Xian: I can't believe you called me out on my Furbys. Yes, it's mostly a Tumblr trend of taking Furbys and longifying them into weird sausage bodies. I find them delightful. I have my own longified Furby. His name is Dubious Bird Meat. He is terrible, and I love him.

But the most valuable thing that kind of helped me figure out a way of nourishing myself versus just keeping on the medical school treadmill was just the two years that I had off and just realizing that this is work and this is play, and all work with no play makes Jack a dull boy. But I think it's just knowing that the time I spend taking care of myself and having fun is as important to me as a human being.

The Starfish Story: Making a Difference

Despite believing in reincarnation, I still only have this one lifetime, this one moment where my memories and my experiences are connected in this way. I've come to a place where I really value the fact that I am still alive and able to have these experiences, and I want to just continue having them, continue making connections, leaving things better than they were. One of the stories that I hold on to, the starfish story. Do you know that one, Ha?

±áạ: No, I don't.

Xian: I think it's told in a lot of different ways, but it's just a short story about a low tide on the beach and there's just a bunch of starfish that are stranded and drying up in the sun. An old man comes across them as he's taking a walk and he's staring at all the starfish and feeling like, "Ah, this is so sad. Look at how lives end."

He sees a little child just picking up starfish one by one and throwing them back in the water and he's like, "Hey there, little kid, you know that there's nothing much you can do. You're not going to save all these starfish. What you do doesn't matter." And then the child just kind of smiles, picks up a starfish, and throws it back in the water, and says, "Well, it mattered to that one."

±áạ: That's a really beautiful story. Also thinking about that connection and things like that, that is a thing I also really like about Buddhism, is just feeling that you're so intertwined with the rest of the world. And similarly, Asian, a lot of our culture based on ancestors and things like that, we're just so intertwined.

That's one of my things for expression, is community, making connections with people. And that's how I found a lot of healing. And so that's why it's exciting to be a part of this podcast and to get to share people's voices and help uplift them.

Is there anything else that you want to end with before we wrap up?

Xian: I think maybe just looking into motivational interviewing. And Google "long Furby" and thank me for the nightmares.

±áạ: If you have always found Furbys creepy, I would negate that plug and say do not Google long Furbys. Thank you very much. But thank you for . . . Actually, Chloe, I don't know how we usually close things.

Xian: Like, subscribe, reblog, retweet.

±áạ: Yes. That's good. With all of that, I would say thank you so much to our listeners for listening and for also giving me this chance to try this podcasting thing.

I hope that our conversation today about expression, and about narratives, and about family and Buddhism has been meaningful or gotten some thinking, some thoughts running about your own narratives and also about your connections to the world and your communities. I really much appreciate the chance to have the mic.

So that is it for this episode this week. Tune in next week for the next part in the Identity Series. And keep on listening and supporting us on our Instagram, wherever you listen to podcasts, and we'll see you next week. Thank you.