I am Neil Chang, an upcoming first year student at National Yang Ming University in Taiwan.
“Between my finger and my thumb
The squat pen rests; snug as a gun.”
What are the medical schools like in the countries represented by the VIA program? How can grassroots be used to improve public perception of stigma-related diseases? When I embarked on this 3-week learning journey at Stanford, these questions were just a small part of the many queries that focussed on comparing healthcare systems and policies in Japan, Taiwan, China and the US. The answers were surprising at times, while relatable in others. As the days passed, it got me thinking about my approach to searching for answers. Did I understand what was talked in the lectures, or did I know what was taught? What if I had to first understand the motivations and attitudes behind the individuals who make up these healthcare systems, in order to obtain the full meaning behind the knowledge I learned?
As the week flew by and I got to participate in various learning opportunities at Stanford, an inexplicable yet tangible quality that I’ve noticed running through the faculty and students at Stanford crystallized into a unique trait. A characteristic that seems to be associated with the numerous accounts of success for both their students and alumni. I began to realize how it was the sense of uninhibited curiosity in these diverse individuals that results in them proactively participating in research, constantly challenging of the conventions within their field and most of all enjoying what they do as doctors and inquirers. It was an ethos emphasized in Dr. Chacko’s design thinking session, where we were introduced to the simple yet significant idea that our brain is meant to engage the world so we survive by constantly moving.
I began to associate the idea of ‘moving’ with the process of continual discovery using our minds. Yet I 
also pondered about how open curiosity can be actualized in the world of medicine to effect positive change. This idea took on further shape at the Stanford Anatomy Lab, where I encountered carefully preserved, brown, misshapen organs that were dissected and sectioned in all the ways possible; hardly a palatable experience if I had toured the lab alone. What made the experience memorable was the lab tour guide, whose excitement was palpable and infectious as he introduced us to each organ, identifying each blood vessel, nerve and tendon. Even though he probably would have had introduced the lab hundreds of times, the guide still took us through each organ with such novelty, creating an atmosphere of learning that was both persuasive and engaging. A valuable lesson that I learnt at that point was that curiosity is contagious, where perhaps it is instrumental for us to be openly curious in order to effect change. After all, like-minded individuals united in tackling the same issue using with their own unique perspectives can possibly generate a synergy that can change the world.
My attempts to understand social issues and what it meant to be a doctor thus began to shift as I became more proactive in seeking out different perspectives from fellow Japanese and Chinese participants, in addition to reflecting upon my experiences in Stanford and San Francisco.
I knew that organizations such as the STRUT clinic were instrumental in serving the healthcare needs of the LGBTQ+ community in the US. However, did I understand the emotional or social needs of LGBTQ+ patients in both the US and in Taiwan? In truth, I knew nothing specific about their hopes, dreams or ambitions. Whenever the topic of LGBTQ+ come up in conversation with my friends, there is always an uncomfortable silence that ensue. It was a topic that we were aware of but rarely broach due to the social conventions in place that isn’t conducive to the discussion of LGBTQ+ rights. I realized despite my prior experience serving in an HIV hospice, I had missed many important nuances in the health topic of HIV/AIDs because I had yet to find opportunities of empathy.
Behind the discrimination often lies a complex mix of anger, confusion, shame, fear and self-resentment within many members of the community. These feelings often impede any outreach efforts by NGOs due to the patients themselves, who don’t seek help in fear of being outed and shamed. The importance of addressing the issue of discrimination should therefore go beyond public awareness, by also serving the psychological needs of the patients themselves who often struggle with revealing their sexual orientation or gender identity. This realization is linked to the particular emphasis on a patient-centered approach when it came to chief examination.
Dr. Oshimi’s clinical English lessons was therefore instrumental in shaping my intention to become a more people-centered doctor. Asking ICE questions that oriented the diagnosis around the patient’s physical and emotional needs was something that really astounded me and changed my previous perception of doctors being required to remain ‘clinical’ by maintaining a professional distance. Dr. Emma Li also enforced this concept in her medical case study session when she described patient examination as constructing a narrative about both patient and the condition. A good physician is ultimately one who is willing to look beyond the surface of the condition, unearthing qualities and traits that made gives humanity to the patient besides his/her illness.
“Between my finger and my thumb
The squat pen rests.
I’ll dig with it.”
– Digging, Seamus Heaney
