The following is a journal entry from my first year of college: 

3/28/19: Cancer

“Hi khue DR. Joe Nguyen called mommy and let her know she has breast cancer. We will see the cancer specialist decides what to do we will update the news later ok pray for mommy ok. I was in an extracurricular meeting when I read the words off of my laptop. It was 7:22 pm. We were discussing our biotech startup company and there was a lull in conversation when I decided to check my messages. One of the first things I did when I found out my mom had breast cancer was to aimlessly scroll on Facebook. I texted my boyfriend and best friend that were in the meeting with me that I was leaving, and promptly left. I initially thought I would be able to stay and tough it out but I really couldn’t so I left. Down the elevator I went and down the tears slipped. I immediately thought of how cruel life and the world is. Money is power, money is freedom and money is treatment. My first thoughts were oh god I hope she hasn’t progressed that far because oh god we can’t afford it. How can a family, whose source of income solely rests on one parent, a son’s job where he works on school breaks, and a first-generation, low-income student’s excess scholarship money afford to pay for all of this? The irony about all this is I’m taking a freshman seminar about cancer. I know the causes — the point mutations, the genetics, the telomere length, the downstream signaling, etc. I know all the treatments too — the inhibitors like Gleevec, etc. Yet, what am I supposed to do with all of that knowledge when I can’t be helping my mom? Out I left that building, clutching tightly onto my boyfriend’s hand. I couldn’t formulate words but could formulate a waterfall of tears. We went to my dorm and I laid in bed with him and cried. I had just got back from California and piercing my ears — something that could have gone to her cancer treatment. I was thinking my brother was an asshole for rejecting my call but he was so overwhelmed himself. It was the first time in I don’t know how long that I heard him cry and break down. It felt so familiar but also broke me. He kept on asking what my mom and dad were like because I was FaceTiming them states away. He wanted to make sure that dad was strong. He wanted to also remind me to stay strong for my mom and he wouldn’t FaceTime her until tomorrow, when he was strong enough not to cry. He also said he would take a year off of pharmacy school to take care of her and drive her for treatments, and told me that I shouldn’t be taking any time off but to focus on graduating Yale. Isn’t that ironic that both my brother and my parents mentioned Yale — the American Dream. The place where dreams manifest for little poor yellow girls like me. The place that would secure the security and the success for my lineage and for the Tran family. We ended the call with him repeating that I shouldn’t be alone tonight.”

I distinctly remember the following months after I wrote that journal entry. I remember spending any break I had in between classes and homework being on the phone with insurance companies, being transferred and passed around to different people that didn’t want to deal with this: us. My family and I were a burden to insurance companies and hospitals solely due to our uncertainity in how we would pay for treatment. Throughout the many phone calls, I became better at reciting a script in my head about my mom’s diagnosis while remembering how to maintain a calm, even tone in order to not convey hysteria at the risk of being hung up on. After my mom’s visit with an English-speaking doctor, who didn’t allow me to video call into the visit and didn’t check if my mom understood her diagnosis and treatment plan, I was put on hold again with the doctor’s office. He emailed me a multitude of sheets with long names of drugs, chemical structures, and complex diagrams. I attended office hours with my professor, who was teaching a class I was taking called Topics in Cancer Biology. We poured over the papers together and he made sure I was able to articulate my mom’s diagnosis to him in order for me to translate complex scientific terms in Vietnamese with her. However, I was still states away. I couldn’t hold my mom’s hand when it was painful, wipe the sweat from her forehead as she nervously waited in the waiting room, or reassure her when she was surrounded by strangers yielding strange medical tools and devices. And I couldn’t expect hospitals and doctors to provide any sense of this relief or comfort.

My mom is now cancer free and I am thankful that hospitals and doctors provided her treatment. But it was undeniable that my mom entered each treatment session and doctor visit scared to death because of the uncertainty that plagues our healthcare system, as seen in a lack of communication and exorbitant costs. In my example alone, hospitals and insurance companies constructed racial hierachies through the intersection of race and class and race and linguistics. There were many places where the story could have ended differently if the scales hadn’t tipped in our favor that lay at the intersections of these identities. What if my mom missed her yearly check-up because we couldn’t afford it this year and we didn’t catch the cancer in time? What if I didn’t have my professor who told me that cancer was actually in Stage 3 and needed to be treated aggressively for the best chances of remission? Would the healthcare system even want to save my mother in the first place if it weren’t for my persistence to stick through hours of being put on hold and advocating for her case in English, when they refused to have translators where she could advocate for herself in Vietnamese? Beyond the physical structure of the hospital, the structural inequities of the healthcare system creates racial disparities. In the apathetic attitudes that were displayed through the hospital, it is evident that the ideal patient is one that can pay, one that can speak English. It is implied that this ideal patient is typically white. And it is implied that patients that lay outside of these identities are the “other,” who will inevitably face difficulties in treatment provided by an “objective,” yet largely apathetic institution of the hospital.