Author: Maria Yang, MD

Categories
Homelessness Observations Reading

The Guest Who Has No Place to Live.

Inspired by this tweet (“This book is viscerally upsetting, lol. What the fuck”), I read The Guest by Emma Cline.

The inside flap offers an accurate description of the story: Alex makes a “misstep at a dinner party” and ends up wandering around Long Island. She has “few resources and a waterlogged phone, but [is] gifted with an ability to navigate the desires of others.” She is indeed “propelled by desperation and a mutable sense of morality” and “a cipher leaving destruction in her wake.”

And, yes, the book is viscerally upsetting.

Is the story about status and hierarchies? Yes. Is it about appearances and identity? Yes. Is it about the transactional roles young women play in American society? Yes.

Is it about a young woman who has nowhere to live? Yes: Alex is homeless.

This is not the reason why I chose to read this book. (Honestly, the only thing I knew about the book was from that tweet. We can wonder together why I wanted to read something “viscerally upsetting”).

It’s not Alex’s status as a homeless person that turns the stomach. (I don’t even know how many readers use the frame of homelessness while reading this story.) It’s the odious nature of her choices, how unsettling her behavior is. She is not endearing. (Kudos to Cline for creating a character who is unlikeable yet compelling.) We readers get caught up in the appearances of luxury and decadence that we forget that Alex is trying to find a stable place to live.

We never learn Alex’s backstory; we don’t know where she is from, what happened to her in the more distant past, or how she came to behave this way. Part of the point of the novel, I think, is that we can never know: Appearances are what matter. You can tell any story you want to get your needs met.

For readers who want to make their lives more difficult (…), this book introduces uncomfortable questions related to homelessness:

  • If a young woman is despicable, does she deserve to be homeless?
  • What do we want to happen to young women we don’t like? Do we want them to suffer? Is homelessness a sufficient punishment?
  • Do we therefore assume that all people who are homeless must have done terrible things?

Then there’s the question of redemption. The events of The Guest unfold over the course of one week. Do we think Alex could ever redeem herself? What if it takes a year? or five?

Should people who are unlikeable be homeless until they redeem themselves?

Maybe Alex is a cipher, but, more importantly, she has no place to live. That’s why she’s “propelled by desperation and a mutable sense of morality”. Perhaps we take comfort in the idea that Alex is a character, that this is a novel.

  • Would we make similar choices if we were in Alex’s situation?
  • Could we also do such unlikeable things if we were homeless?

What if the homeless young women we encounter aren’t anything like Alex? Might we want to make different choices ourselves?

(And, yes, to be clear, I do recommend The Guest.)

Categories
Medicine Observations Systems

On Who People Think You Are.

The author wearing a black face mask while holding a soft serve cone. The wall behind her features a cone that looks like a fish that has green soft serve in it.
A photo of yours truly wearing a mask. Photo credit to Amy L.

There were two patients in the hospital room. Both were elderly East Asian males, each reclining in his bed. The curtain that divided the room in half was pulled forward, offering the illusion of privacy. Sound still travels through cloth.

Outside the hospital room I rubbed sanitizer onto my hands. The only size of blue plastic gowns offered was extra-large. My arms swam through the enormous sleeves as I pulled the gown over my yellow sweatshirt. The only gloves available were size large, which I slid onto my hands before putting goggles on my face. I was already wearing an N95 mask. Only my black track pants and black sneakers emerged from my blue contact precautions.

My dad had alerted me that, overnight, he was moved from a private isolation room into a shared room. His roommate, though ethnically Chinese, spent much of his life in a different country in Asia. He spoke limited English. They quickly discerned that they both speak Chinese.

Within a few minutes, I pushed the curtain back so the divided room became whole. Chinese conversation flowed among the three of us, punctuated by occasional wet coughs rattling through the torsos of the two men.

If I looked right, I could see through the window in the door. Sometimes staff walked by, paused, and waved. One was a man in his fifties who, at one point, opened the door and said to me, “We’re thinking we might discharge him today.” He gave me a thumbs up sign and shut the door before I could respond. He wasn’t my father’s doctor.

Later, my father’s nurse walked in and asked who I was. “Oh,” she commented, “I thought you were the interpreter.”

The other man’s nurse walked in minutes after that and asked who I was. “Oh,” she said, “I thought you were a physical therapist.”

Later, in the hallway, the man who appeared to be in his fifties waved me down. He was wearing a long white coat and there was a red label on his ID badge that said “Doctor”. His eyes smiled at me as he asked, “How is your dad doing?”

I paused before asking, “May I ask who you think my dad is?”

“Mr. Other Guy,” he said effortlessly.

“That’s not my dad.”

“Oh?”

“The other Asian man is my dad.”

“Oh.” He was anchored in awkwardness.

“Thanks for taking care of Mr. Other Guy,” I said before walking away, releasing the anchor. He waited a beat before veering off in the other direction.

Categories
Blogosphere Lessons Nonfiction Reading Reflection

Time Millionaires, etc.

A cartoon illustration of a father and son aging together, from birth to the grave.
Artwork by Pascal Campion

Since my last post, I have recovered from illness, though spasms of coughing still occasionally overtake me. Other circumstances have changed, too, that have highlighted to me the importance of spending time with people we love. American culture often focuses on becoming financial millionaires when becoming time millionaires is vastly more important.

Here are some things I read while recuperating that may be of interest to you:

What My Father’s Martial Arts Classes Taught Me about Fighting Racism. “Self-defence means to protect yourself, to protect others around you, and to protect your opponent from committing a crime.”

The Politics of Paying Real Rent Duwamish. This is of greatest interest to people who live in the Seattle-King County area. After reading this article I stopped paying Real Rent. The tagline is accurate: “Why a simple act belies a complicated history.”

“A 1996 Super Mario 64 manga suggests that 1-Up Mushrooms grow from the bodies of dead Marios, perpetuating the cycle of life and death.” The image is what drew me in.

What It Felt Like to Almost Die. “My near-death experience taught me not to fear those final moments.” I hope that this is true for us all.

Generation Connie. I am a bit older than the cohort of Asian American women who were named Connie (and my father said that my parents never considered the name Connie for me), though I definitely remember seeing Connie Chung with Dan Rather when I was growing up. Fun photos in the article.

A Killing on the F Train. Of all the writing I’ve read about Jordan Neely, the man experiencing homelessness and psychiatric symptoms in NYC who died when another subway passenger restrained him (via chokehold), this piece by John McWhorter resonates the most with me. His perspective is kind, nuanced, and empathic. Highly recommended.

Categories
COVID-19 Nonfiction

A Plan = A Thought.

Since the onset of the pandemic, I have taken many steps to keep myself healthy. This was all in the service of making sure I didn’t give Covid to my elderly father.

(“Making sure.” The arrogance of that statement!)

The grand irony is that I ended up getting Covid from my father.

The universe reminds me again that a plan is just a thought.

Categories
Consult-Liaison Observations Systems

Demoralization and Status.

This TikTok video provides an accurate (and shouty) summary of the National Guard member who leaked classified military documents. In short, it appears that the Airman shared these documents in an effort to elevate his status within an online cohort. (Someone on the internet opined something like, “This was a cosmic level of stepping on a rake that hits you in the face.” Correct.)

We all have engaged in behaviors to heighten our position in relation to others. Depending on who you ask, some argue that we are constantly adjusting our behaviors to communicate and maximize our status.

Our perception of our own status is not always accurate. It seems that we sometimes exert tremendous effort to demonstrate high status to make ourselves feel better, rather than to assert that we have higher rank than others. (Much research has been done to show how humans assess and react to status.)

Maybe it’s a stretch to link demoralization and status to each other, though this is what has come to my mind over the past few weeks. Demoralization is usually framed as an individual process, whereas status involves groups of people.

Merriam-Webster provides the following definitions:

  • demoralization: weakened morale; to be discouraged or dispirited
  • status: position or rank in relation to others

I’ve written about demoralization before, though it was more in reference to individuals experiencing medical illness. The paper I reference in that post offers this definition of demoralization:

the “various degrees of helplessness, hopelessness, confusion, and subjective incompetence” that people feel when sensing that they are failing their own or others’ expectations for coping with life’s adversities. Rather than coping, they struggle to survive.

This is where I might be speaking out of turn: Is it fair to apply principles usually applied to a single person, particularly one’s intrapsychic processes, to groups of people? (Would I be a true psychiatrist if I didn’t use the word “intrapsychic“?)

But let’s consider this together. I’m starting with the Airman, but that isn’t actually the point of this post.

What if that Airman was feeling demoralized? Within his Discord group, he may have been able to rely on his age to maintain high status. What teenager doesn’t think a 21 year-old person is cool? But what if group dynamics shifted and, suddenly, the Airman was no longer the proverbial “alpha”, but had been demoted to a “beta”?

In an effort to restore his status, he might have employed any one of the strategies to reduce his vulnerability:

The sharing of classified military documents isn’t a demonstration of resilience, but it is a display of power that produces postures of coherence, agency, and courage. In sharing classified papers that only he has access to, he is dissolving any confusion he or anyone else may have about his “rightful” status. To combat feelings of helplessness, he demonstrated agency to provide evidence of his power. It takes some flavor of courage (…) to share sensitive information. By sharing these documents with his Discord cohort, he facilitated communion, established a purpose for himself, and got to bask in the gratitude of his friends. What a way to escape the isolation that accompanies a degradation of status!

So let’s consider other things that are happening in the nation that might be reactions to demoralization and efforts to reinstate high status: states banning TikTok, banning abortions at six weeks, protecting access to transgender care.

Again, is it fair to apply individual, intrapsychic processes to groups of people, particularly groups of people in politics? (But aren’t political groups comprised of individual people?)

The passage of laws—something that feels real and concrete—brings coherence and fosters communion! It brings hope and purpose! Doing something—exhibiting agency—summons courage and generates gratitude! Your rank in relation to others feels like it is rising. Even though there are people who will view your actions as further erosion of your status, it doesn’t matter: You feel better. You feel more power.

The passage of laws reduces confusion, despair, and helplessness. Instead of feeling isolated, people can channel their feelings of helplessness and resentment into doing something, which makes cowardice evaporate. You may already possess high status—all the other people around you may already defer to you because they view themselves as having lower status. And, yet, if you feel demoralized, the positive regard from others may be insufficient to elevate your own status in your own eyes.

We can never get away from ourselves.