Your Six-Foot Radius.
I don't think I was that mouthy during my medical training.
Some East Asian women are shy, deferential, and taciturn. It’s no wonder some people were surprised when critical comments came out of the mouth that is attached to my face.
Advocacy comes in different flavors. My initial attempts were salty.
While I didn’t occupy the lowest rung on the neurology service (that honor went to the medical students), I was but an intern. Furthermore, I wasn’t even an neurology intern. I was training to become a psychiatrist.
The attending neurologist, who looked like those doctors exalted in enormous oil paintings that adorn the hallways of hospitals, had too many letters after his name. He also riffed on too many subjects unrelated to neurology during our morning rounds.
Rounds in academic medical centers serve two main purposes: To organize care for patients, and to educate trainees. The team, under the guidance of the attending physician, executes the plan of care for each patient following rounds.
One autumn morning we stood in a circle outside of a patient’s room. Rounds were just starting. Patients—and a whole lotta work—awaited us.
"It's the season for soup," the attending neurologist opened, smiling. "Chief Resident, what is your favorite kind of soup?"
I couldn't restrain myself.
"Can we not talk about soup? There are patients waiting and work we need to do," I snapped. My fellow intern, a future emergency physician and more accepting of reality than me, didn't stifle his laughter in time. Both the chief resident and frowning attending physician shot me a look. "I know you're focused on getting work done, Dr. Yang,” the chief resident chided, “but there is time to talk about other things.”
My cheeks burned. But no one spoke more of soup. We started talking about the patient waiting in the room.
Three years later, I myself became a chief resident. Junior residents shared with me that one of the attending psychiatrists, another decorated physician considered a national expert in his field, wasn’t meeting with them for supervision. This was one of his responsibilities. Esteemed professors were supposed to spend time with us trainees so we could learn from them. He wasn't doing his job.
Chief residents have some responsibility to advocate for junior residents. Annoyed, I asked to meet with him. This flavor of advocacy was spicy.
He didn't ask for an agenda ahead of time and I didn't think to provide one. After sharing with him what residents told me, I said, "It is your responsibility to meet with residents for supervision. Why isn't this happening?"
Well, you can imagine how that went. He became shouty, waved his arms, and wondered how I, a mere resident, had the audacity to talk to him that way.
My cheeks burned again. However, he didn't deny the allegation.
My program director was dismayed—maybe embarrassed on my behalf?—when I told her what happened. "You didn't need to tell him yourself!” she exclaimed. "You could have told me and I could have spoken with him."
The junior residents told me later that he had reached out to schedule regular supervision with them all.
With additional experience (read: missteps and errors), my advocacy is now more mellow. I've learned to ask more questions, orient people ahead of time, and be more mindful of power and status. When all else fails, be direct.
The word “advocacy” often conjures political images: chanting slogans at rallies or calling elected officials.
But those aren’t the only ways to advocate for ideas you value. Effective advocacy can happen within our six-foot radius. It’s asking questions or making statements. Sometimes, it only takes a short conversation to start shifting long-held assumptions:
"Quite frankly, I wish the president would give us a purge [of homeless people]. Because we do need to purge these people.”
“I wonder if what the parents and friends of homeless people would think of that plan. What hopes and dreams do you think they had as kids? Surely they didn’t aspire to be homeless.”
"Every time I find one of these lunatics, I take away their visas.”
“When you say ‘lunatic’, what does that mean? What is the process for applying for a visa, anyway? It’s following the law, right?”
“The probability of a trans person being violent appears to be vastly higher than non-trans.”
“I don’t think that’s true, but let’s look at the data together. Where can we look to learn accurate information?
Advocacy can look like curiosity. At its sweetest, advocacy illuminates the humanity of others. Such reminders can take just a few seconds.
To be clear, this doesn’t mean talking to anyone and everyone who enters your six-foot radius. A small minority of people are not curious and not interested in dialogue. They seek targets for their frustration and anger. If you’ve tried to make a connection in good faith, but the effort is not reciprocated, stop. Sometimes, quitting is the best option.
In times—these times—when problems feel too big for us to understand or solve, when we feel like nothing we do makes a difference, speaking up still matters. Your statements (or silence!) affects other people.
Advocacy doesn’t have to involve bullhorns or giant signs. Do not obey in advance. Have faith in what you can accomplish within your six-foot radius.