Joan Is Okay

by Weike Wang

My childhood dreams consisted of stone castles made only out of turrets and colorful fluttering flags, me flying high above them, over moats and green pastures filled with white specks of sheep. Once I finished college and the yearlong marches through physics, chemistry, biology, and math, these dreams stopped. Then, as new doctors, we were warned that medical training would flatten us. The learning curve was relentless, akin to drinking from a fire hydrant or the fattening of ducks to make foie gras. I’d never tasted foie gras before nor did I want to be a duck, so the open fire hydrant analogy it was. A person sits eye level with the barrel and grapples it. She is pounded in the face by knowledge while her facial features are erased.

Pulmonary hypertension is said to develop gradually, to only worsen with time, but can possibly onset quickly and without warning, like when speaking to one’s mother.

Certain Americans could be two-faced. Acquaintances and other parents from our school made their implications about us clear. You must be so proud of your children. But how had your son really gotten into Yale? Because Yale looks out for minorities. They save a certain percentage of seats for them. How had your daughter really gotten into Harvard? Because Harvard is even easier on minorities and on women too. Settling the question that I’d always had then. No success of mine had anything to do with me, my work ethic, or my brain.

Once I passed thirty, many things had, according to some, become my surrogate child. If I bent down to admire a dog around Tami, it became my child. If I stared too long at a clock, it became my biological clock. Once I passed thirty-five, the frequency of child references doubled.

Different is good, he said, shifting in his chair that was actually too small for him and creaking a lot from new weight. Some people try their whole lives to be different and never achieve it in any significant way. Some people make it look effortless. I frowned some more though Mark didn’t seem to notice and continued to inspect my empty room aloud. His words started to echo so I stopped paying attention to them. Who really wanted to be different? I wondered. And to be treated differently for things about them that couldn’t be changed. Most people who were different just wanted to be the same. —

He seemed caught off guard to hear me say that. He explained he was using “woman” in the abstract, he didn’t mean me specifically. Oh, I said, and he continued to talk about this abstract woman as if I had no skin in the game. A woman biologically is able to reproduce, he said, and should she choose to, her legacy would be secure, without concerns for what else she can offer the world since she has already given it a human being. But a man can’t get pregnant on his own. A man must forge his own legacies and create something out of nothing. I tried to act surprised by his statements, to lift my eyebrows a little and show that I hadn’t realized this before, that Reese, being a male, didn’t have ovaries that released one egg each month to be fertilized, and if this egg isn’t fertilized by one sperm out of an onslaught, the sixteen-millimeter-thick uterine lining that had readied itself to support the fertilized egg, the zygote, would shred, each month, bit by bit, and come out the uterus like a vine of ripe tomatoes put through the blender. I said while I didn’t know this abstract woman personally, I imagined that once she met her abstract man, she would probably tell him to fuck right off. Fuck right off? he asked. Yeah, like that. Perplexed but not necessarily offended, he said it seemed too early in the day for swear words and he didn’t quite know what I meant.

Berating is love, and here I was at thirty-six, still being loved.

Doctors complained to each other all the time and to anyone else who would listen. The system is broken. Referring mostly to bureaucracy, insurance, the skyrocketing cost of care, Big Pharma’s focus on only lucrative drugs, the cost of medical training itself plus licensing, and the exorbitant salaries of some specialties like oncology. But who could have broken our own system if not us? And the system wasn’t so much broken as it was circuitous, self-blaming, and operating under false pretenses. A hospital is a business, and businesses like to make money whether that profit came from goods or the extension of human lives.

Much of medicine is built on hindsight, but hindsight usually means that in exchange for knowledge a lot of people first have to die. I said whatever happened, demand could not exceed supply. I thought I was speaking calmly, until Mark pointed out that I was not. Hey, he said. Hey what? Our health systems are built for this stuff. I said they really weren’t.

The name they had given me was Jiu-an, the simplest Chinese equivalent to Joan. I knew of another Asian Joan in the hospital, many Jessicas, Emilys, and Lindas. Only Asians outside of Asia chose names for themselves that took into account the convenience of others or smoothed out their foreign names to be less offensive to the ear.

China’s China, said Madeline. But what about Western countries, those with more liberties, diversity, and an entrenched sense of the self?

I might’ve permanently lost my sense of taste and smell. And they passed me a packet of hot sauce. A challenge that some of them were doing, the portion that had been sick and recovered. How many packets could you take? Five? Seven? One nurse could take seven and previously had no tolerance for spice. All this to show that we were strong, made stronger, instead of admitting to what we really were, numb.