Code Switching: Gravel Against Stone

Editor’s Note: This piece was awarded an honorable mention in the Pulse writing contest, “On Being Different.”

As a medical student, I have a habit of lowering my voice an extra octave when I speak with patients, preceptors or even my own primary-care physician. I like to imagine my voice as gravel grinding against stone, my raspy “whiskey voice” melting away any hint of my queer identity.

In these moments, I’m keenly aware of the way I walk and stand, the firmness of my handshake and the content of the small talk I make. There are no lights, no curtains or stage, but I am nonetheless performing.

I also have a habit of over-enunciating words that begin with R, F, Th, V and Z, such as radial, fistula and thalassemia–words with phonetics not included in my native Korean language. When speaking these words, I imagine my lips performing acrobatics on gently sloping hills made of velvet. I visualize the swoops and dives required to roll the Rs (to make them sound different from Ls) and the softening of the edges in saying Vs (to make them sound different from Bs).

Growing up in the suburbs of Georgia as a queer East Asian student who was still mastering English as a second language, I tried everything within my power to fit in. Maybe you are familiar with this repertoire: immigrant children working to melt away accents and to culturally assimilate into white, Anglo-Saxon, suburban America; queer men deepening their voices when they enter barbershops. Fretting over “feminine” high tones and “proper” pronunciations is common among queer men and ethnic-minority populations in this country.

There’s not much that I can do about my appearance, the number of melanocytes painting my skin; I am already different at first glance. My voice, however, can be controlled. When I was growing up, to be different was to be marked as “other,” so I learned to command the lilt and rhythms of my speech to fit the mold.

After achieving the coveted native fluency in English and growing more comfortable with being a queer cis-male, I’d hoped that I would outgrow my reservations about projecting my natural voice. In clinical or medical-education settings, however, I’ve found myself carrying the same anxieties, feeling the same knot in the pit of my stomach that I’d felt in childhood.

In probing into why I feel this way, I’ve come up with two main reasons.

One, the emotional labor of being a medical student, and constantly being evaluated, has simply repackaged my childhood desire to fit in. Now I desire to be evaluated as a competent medical student and future physician.

But what exactly makes a competent physician? This leads to reason two: I have yet to meet a physician like me—queer and East Asian. I am, therefore, reflexively using straight white masculinity as a benchmark for medical professionalism. I lower my voice and over-enunciate certain consonants because, like many medical students, I want to be evaluated favorably. I am still carrying the heavy weight of my childhood notion that to be different is to be singled out as “other”—and I fear that it may impact the outcome of my medical education.

These vocal habits are a form of self-preservation. But when I reflect on my childhood, and my lack of exposure to queer-physician role models, I fear that I will be perpetuating the problem.

I remember being hesitant, as a teen, to discuss queer sexual health with my primary-care provider. Unfortunately, my public high-school curriculum advocated for abstinence and taught sexual health only within the framework of heterosexual relationships. How I wished, even at that age, to have a physician who was more like me; someone who could help me to navigate queer interpersonal relationships, affection, body image and the like.

Now, despite knowing what it’s like not to have visibly queer physician role models, I still find myself trying hard to perform my existence as the most stereotypically masculine version of myself.

I believe that being different as a queer physician of color will only be a boon to my future clinical practice. My cultural sensitivity to my future patients, and our shared lived experiences, will undoubtedly help to build rapport. However, to stand in my truth, I recognize that I have much internal work to do.

In putting these thoughts into words, I hope to take the first of many steps toward embracing the differences that make me valuable as a clinician and as a person.