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Photo Credit: Jason Henry via Heinz Awards

Dr. Abraham Verghese is a physician, best-selling author and professor of medicine at Stanford University of Medicine. Verghese is known for work with bedside medicine and the benefits of providing patients with physical examinations. In a 2011 TEDTalk, Verghese said “Too often these days, rounds look very much like this, where the discussion is taking place in a room far away from the patient. The discussion is all about images on the computer, data. The one critical piece missing is that of the patient.” (Verghese, 2011) Verghese is also known for his creative writing career and has published two nonfiction books and two fiction novels. He believes physicians should read more than scholarly or nonfiction texts, saying “I preach to my medical students that to fully imagine their patients’ lives they must read fiction, because fiction is the great lie that tells the truth (to paraphrase Camus).” (Clarke, 2023)

Dr. Abraham Verghese was born in 1955 in Addis Ababa, Ethiopia to two Indian parents. His parents worked as educators in Ethiopia and he first began his medical education in the country. In an article from the New York Times, Verghese credits W. Somerset Maugham’s book Of Human Bondage as influencing his decision to become a physician: 

“Somehow, when I read those words as an underachieving student in high school, it suggested to me that anyone with a curiosity and empathy for their fellow human beings and a willingness to work hard could be a good physician and be rewarded by work that has great meaning.” (Clarke, 2023)

Unfortunately, political unrest interrupted Verghese’ medical education. In the 1970s, the Ethiopian emperor and government were overthrown and a civil war broke out across the country. Verghese, along with his parents and siblings, left Ethiopia for the United States. While living in the U.S. Verghese worked as an orderly. He continued to pursue a career in medicine. He attended Madras Medical College in India and graduated in 1980. He pursued a residency program in Johnson City, Tennessee. In 1983, after completing his residency, he was selected for a fellowship at Boston College School of Medicine. During his time in Boston, he witnessed the HIV outbreak that hit urban areas such as Boston and other major cities. Verghese returned to Johnson City, Tennessee and once again was face to face with the impacts of HIV/AIDS, this time in a rural setting. 

When reflecting on that time, Verghese said “I first toyed with the idea of writing because I was so affected by what I witnessed as an infectious diseases specialist during the early years of the AIDS epidemic, taking care of dying men (mostly) who were my age.” (Clarke, 2023) He later wrote about his experiences in his first book My Own Country: A Doctor’s Story of A Town and Its People in the Age of AIDS.

Verghese took a break from practicing medicine and attended the Iowa Writers Workshop at the University of Iowa. He earned his Masters of Fine Arts in 1991. He served as a Professor of Medicine and Chief of the Division of Infectious Diseases at Texas Tech Health Sciences Center. Then in 2007, Verghese moved from Texas to California to work as a professor at Stanford University School of Medicine, a position he still holds. 

Dr. Verghese also maintains a successful writing practice and career. Besides his first book, My Own Country, Verghese has also published The Tennis Partner: A Story of Friendship and Loss, Cutting for Stone and most recently The Covenant of Water which is an Oprah Book Club selection. The Covenant of Water has received high praise from reviewers. An NPR review stated “Ever the skillful surgeon, Verghese threads meaningful connections between macrocosmic and microcosmic details so elegantly that they are often barely noticeable at first.” (Bhatt, 2023) The reviewer also noted that “Whether describing the spice craze sweeping across Europe, Kerala’s breathtaking coastal views, the overpowering Madras evening breeze, or the lively Anglo-Indian enclaves, Verghese tends to be lyrical. But he writes with such singular detail and restrained precision that it is a pleasure to be swept along and immerse deeper.” (Bhatt, 2023) If you are interested in hearing Dr. Abraham Verghese speak or want to learn more about his latest release, please see this upcoming Politics and Prose event!

If you would like to learn about Dr. Verghese’s experiences as a physician or his clinical research interests, read his recent publications such as “Medicine is Not Gender-Neutral–She is Male,” “Practices to Foster Physician Presence and Connection With Patients in the Clinical Encounter” or watch his 2011 TEDTalk “A Doctor’s Touch.” 

Works Cited:

Photo Credit: Rawpixel.com via Nappy.co

In an effort to remain accountable to communities who have been negatively impacted by past and present medical injustices, the staff at Himmelfarb Library is committed to the work of maintaining an anti-discriminatory practice. We will uplift and highlight diverse stories throughout the year and not shy away from difficult conversations necessary for health sciences education. To help fulfill this mission, today’s blog post will highlight data disaggregation and how it can address health disparities within the Asian-American, Native Hawaiin and Pacific Islander communities. 

As health researchers and medical professionals, data collection and management is necessary for discovering emerging health trends and understanding how behavioral changes can impact a patient's quality of life. But the way data is collected and interpreted can generate misleading information for certain communities. 

When filling out surveys or federal documents, for example new patient intake forms, job applications, or the U.S. Census survey, there’s a section that asks for race and ethnicity. There are typically a minimum of five selections for race : American Indian or Alaska Native, Black or African American, Asian, Native Hawaiian or Other Pacific Islands, and White. These categories are the minimum requirement as established by the Office of Management and Budget’s (OMB) 1997 ‘Revisions to the Standards for Classification of Federal Data on Race and Ethnicity.’ According to the standards, “Data were needed to monitor equal access in housing, education, employment, and other areas, for populations that historically had experienced discrimination and differential treatment because of their race or ethnicity. The standards are used not only in the decennial census…but also in household surveys, on administrative forms (e.g., school registration and mortgage lending applications), and in medical and other research.” (Office of Management and Budget (OMB), 1997, p. 58782) Within health sciences research, these racial categories allow researchers to understand health concerns within specific communities and can lead to preventative health measures that are tailored to a community’s concerns. But many researchers are pushing for data disaggregation which can highlight disparities that are otherwise overlooked when using broad racial categories such as ‘Asian’ or ‘Pacific Islander.’ 

“Asia consists of over forty countries, and the Pacific Islands are grouped by three subregions of Oceania (including Native Hawaiians); both have a diaspora spread across the globe. Due to differences in social, economic, and environmental factors, it is erroneous to assume that health disparities for this population do not exist.” (Bhakta, 2022, p. 133)

Adia et. al examined the results of a California Health Interview Survey (CHIS) conducted from 2011-2017 and found that while the aggregated data suggested Asian Americans in the state appeared healthier than non-Hispanic Whites, when the data was broken into specific subgroups that fall under the Asian category many health disparities, such as high blood pressure, diabetes or asthma, were uncovered. For example, when examining the rates of high blood pressure among survey responders, 31.0% of Non-Hispanic White respondents reported having high blood pressure compared to 22.9% of All Asian respondents. But when examining specific subgroups, the researchers found that 32.3% of Filipino and Japanese respondents reported having high blood pressure. (Adia et al., 2020) “Overall, these findings support further data disaggregation in other large-scale research efforts to support interventions tailored specifically to Asian subpopulations in need…Disaggregation showed that each Asian subgroup faced disparities in health condition, outcomes, and service access that would have been masked.” (Adia et al., 2020, p. 525) When health data is disaggregated, researchers may be alert to concerning medical trends in specific communities and can work with local community partners to implement preventative screenings or devise treatment plans that allow patients to receive the best care possible. Adia et al. also noted that their findings are not applicable to Asian and Pacific Islander populations in other parts of the United States as the makeup of these populations will differ from state to state, which further highlights the need to conduct research in other communities across the country. 

In order to gather accurate data and combat health inequities within the Asian American and Pacific Islander communities, researchers will need to partner with local community members and find solutions that prevent people from accessing proper care. In a 2020 article for Cronkite News, Laura Makaroff, Senior Vice President for Prevention and Early Detection at the American Cancer Society, said,  “To make a big difference and seriously impact and reduce health inequities in Asian American populations…we need to address language access, be culturally competent, really support and engage partnerships and collaborations, include communities and people in all of research, and really be responsive and accountable to all of the different Asian American communities we serve…We need to begin and end with the community.”(Gu, 2020) Like other communities of color in the country, some sections of the Asian American and Pacific Islander communities do not fully trust the medical community. To bridge that divide, researchers will need to partner with local leaders and trusted institutions, such as religious centers, community centers, public libraries or cultural organizations, who are embedded in these communities and have a deep understanding of community members’ concerns. There are numerous ways to conduct medical research that is accessible and the local leaders and institutions can provide valuable insight to researchers. 

To learn more about data disaggregation as it relates to the Asian American and Pacific Islander communities, please read any of the works cited in this article or listed in the reference section below. The importance of data disaggregation is an ongoing conversation and we hope this article will encourage you to think critically about this topic and share your ideas and solutions with your colleagues. 

References

Gu, Y. (2020, September 8). ‘A lot of differences’: Experts address health disparities among Asian American subgroups. Cronkite News|Arizona PBS. https://cronkitenews.azpbs.org/2020/09/28/experts-address-health-disparities-among-asian-americans/

Yeung, D. & Dong, L. (2021, December 13). The health of Asian Americans depends on not grouping communities under the catch-all term. NBC News|Think. https://www.nbcnews.com/think/opinion/health-asian-americans-depends-not-grouping-communities-under-catch-all-ncna1285849

 Yi, S.S. (2020). Taking Action to Improve Asian American Health. American Journal of Public Health (1971), 110(4), 435–437. https://doi.org/10.2105/AJPH.2020.305596

 Le, Cha, L., Han, H.-R., & Tseng, W. (2020). Anti-Asian Xenophobia and Asian American COVID-19 Disparities. American Journal of Public Health (1971), 110(9), 1371–1373. https://doi.org/10.2105/AJPH.2020.305846

Adia, Nazareno, J., Operario, D., & Ponce, N. A. (2020). Health Conditions, Outcomes, and Service Access Among Filipino, Vietnamese, Chinese, Japanese, and Korean Adults in California, 2011-2017. American Journal of Public Health (1971), 110(4), 520–526. https://doi.org/10.2105/AJPH.2019.305523

Bhakta, S. (2022). Data disaggregation: the case of Asian and Pacific Islander data and the role of health sciences librarians. Journal of the Medical Library Association, 110(1), 133–138. https://doi.org/10.5195/jmla.2022.1372

Panapasa, Jackson, J., Caldwell, C. H., Heeringa, S., McNally, J. W., Williams, D. R., Coral, D., Taumoepeau, L., Young, L., Young, S., & Fa’asisila, S. (2012). Community-Based Participatory Research Approach to Evidence-Based Research: Lessons From the Pacific Islander American Health Study. Progress in Community Health Partnerships, 6(1), 53–58. https://doi.org/10.1353/cpr.2012.0013

Executive Office of the President, Office of Management and Budget (OMB), Office of Information and Regulatory Affairs. (1997). Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity. https://www.govinfo.gov/content/pkg/FR-1997-10-30/pdf/97-28653.pdf