S3E9: The Power of Reading

Harjit: Oh, okay.

Margaux: It's like Air Drop.

Harjit: Oh, I . . . okay. But I'm going to back up because eventually I have to do it at some point in my life. So I'm just doing it today. Almost done.

Margaux: I'm so excited. Okay. So, ready?

Hey, everybody. It's Margaux and Harjit here in the studio again. Yes, Leen and Bushra are still away on their away rotations.

Harjit: Boo. I say that every time.

Margaux: We miss them. It makes us both very sad. However, we are going to call Leen today because we haven't heard her voice in forever. Well, I have. No, but we are going to call Leen today because we're missing her voice on the air.

Harjit: Oh, definitely. She has such a regal voice on "Bundle of Hers."

Margaux: I know, 100%. She's got the radio queen voice. So let's call her up.

Harjit: Oh, yeah.

Margaux: I can't hear anything. Hello?

Harjit: Hello? Oh, I love this ring tone.

Leen: Hi.

Margaux: Hey, Leen. How are you?

Leen: Good. How is everyone back at the studio?

Margaux: Good. Harjit and I are just holding down the fort over here.

Harjit: I know.

Leen: Nice.

Harjit: Trying to live our best life.

Leen: Holding down the fort while half of us are gone.

Margaux: Yeah. It's been difficult. We definitely miss your wonderful radio voice on the air.

Leen: Aw. Thanks.

Harjit: Yeah. And I think the listeners will be happy to hear another voice rather than mine and Margaux's.

Leen: I miss recording with everyone.

Margaux: Yeah. When you get back, we'll have to get you in the studio. But how's your away rotation going?

Leen: Away rotation is going good. Traveling across the country. I was in West Virginia last month. Now I'm here in Stanford. It's just interesting to see how emergency medicine varies from place to place.

Margaux: For sure.

Leen: So it's cool. It's good.

Harjit: That's so awesome, Leen, going from the east to west, and you're a Utah girl. Look at you exploring the world.

Leen: Right? Yeah, I know. I'm always like, "Oh, my gosh. I miss the small town vibes," and then . . . it's all good. Everywhere is really interesting and everywhere is exciting.

Harjit: Yeah, getting those differences. I'm actually really proud of you, Leen. I think it takes a lot of courage and being brave to, you know, go on these solo trips, in a way, to two different places. And then we're going to maybe stay here, maybe move to residency. No one knows what our future holds, but I'm proud of you.

Leen: It also takes a lot of money.

Margaux: That's true.

Harjit: This is a good point.

Margaux: All of fourth year is money drained.

Leen: Oh, my goodness, yeah.

Harjit: And I was looking at my bank and I was like, "Oh."

Margaux: Yeah, I was booking some hotels and flights today or yesterday and, yeah, it's not good.

Leen: I know. It's a struggle, but we're almost there.

Margaux: Are you feeling a little bit more adjusted to the new system and the new ED? I don't know if they use a different EMR than ours, but how has it been adjusting?

Leen: So we use the same EMR, but just the setup is different. I think the first week is mostly adjustment week . . .

Harjit: Totally.

Leen: . . . where you'll go to the attending, the supervising doctor, and you'll say, "Okay, I want these labs." And they'll say, "Oh, we don't do those labs here." Things like that is a little bit more adjusting. And then also getting used to the patient population, I think, takes a little longer. In West Virginia, we had a lot of rural cases. We had the strangest cases come in at 3 a.m. and, you know, just very interesting kind of cases that you probably would never see in your life again.

Harjit: Really? That sounds fun.

Leen: We had a guy . . .

Margaux: That's esoteric.

Leen: Right? Getting shot in the back at 3 a.m. because they were burning a box of bullets kind of thing. And we're like,"What?"

Harjit: No way.

Leen: Versus Stanford people are very hooked into healthcare. They have very good accessibility to healthcare and availability. And so you walk in and patients are like, "Oh, yeah, I have this, this, this, and this, and this is what I need to see." And you're like, "All right. Cool. Great."

Harjit: Wow, very literate in their health education.

Leen: Yeah. I wouldn't . . . maybe literate. I would say more aware of what's out there as well. So, yeah, that is literacy, but very different case scenarios. I think in West Virginia we had something called "throw the sink at the patient," which not literally mean throw the sink, but patients will come in with no understanding of their healthcare, no background. Anybody who could provide a healthcare background is not present. So we just throw all the labs in terms of what we see in presentation, and we see what we can find and then go from there versus here at Stanford, you know, people are very much like, "Oh, yeah, I have this. So I should probably get this checked."

Margaux: So it's more directed at the specific complaints.

Leen: Yeah, exactly.

Margaux: Interesting.

Harjit: Yeah. That's cool to see those two different perspectives. How are the people and the food? I always love to ask about the food.

Leen: Oh my goodness, yeah. I mean, I try to make it a goal everywhere I go to get involved in the community or at least find what the community has. And the food here is amazing. It's pricey, but oh my goodness, it is so good.

Margaux: It's so good.

Harjit: So good?

Leen: Yeah, it's really good. And it's within walking distance.

Harjit: Awesome.

Margaux: So cool. I miss that about Austin. Utah definitely is not known for their food.

Leen: No.

Harjit: But I like some places. We've cried a lot of tears in several eating spots.

Margaux: That's true. Emotional connections, but not good quality food.

Leen: Oh my goodness, that's so sad.

Margaux: Okay. Well, Leen, we've got to hang up the phone now. But is there anything else you . . . last minute thoughts you have for us?

Leen: What are you guys recording today?

Margaux: We're going to talk about books. So you know how we all love "The Hunger Games."

Leen: Nice. I wish I was there for that conversation. It's all good.

Margaux: We have you in our spirits.

Harjit: We'll think about you. We'll talk about you.

Margaux: Also, let's watch "Hunger Games" when you get back.

Harjit: Yes.

Leen: We should.

Margaux: Okay, bye.

Harjit: Love you, Leen.

Leen: It sounds fun. Enjoy.

Harjit: Thank you.

Margaux: Have a good day. Bye.

Leen: Bye.

Harjit: It was really nice to hear from Leen today.

Margaux: Totally. I really miss her. I miss having all of us back here.

Harjit: I know.

Margaux: But like you said, I'm so proud of them for branching out and going out on both two away rotations each. I think that's so awesome of them.

Harjit: And trying something new and, you know, really exploring the world.

Margaux: Totally. Speaking of exploring the world, let's get into our episode, shall we?

Harjit: Yes.

Margaux: Harjit and I have still been off rotation . . . or off daily clinical duties. So one of the things that I've been doing a lot now that I have a lot of free time is reading. I like to read every morning when I wake up and a little bit each night before I go to bed.

Harjit: I love to read. It's my favorite thing to do. I think that the way I read though has shifted a lot, and that's maybe something we can talk about throughout the discussion today.

Margaux: Yeah. I'm super interested to hear that journey for you because I think reading has changed a lot for me, too. When I was learning to read in elementary school, I remember that our school was trying a new way to teach us to read, which was more by memorizing and looking at words rather than phonetically spelling them out. So it was kind of if you've ever seen those ads "your baby can read," where you're basically just getting the baby to memorize, associate that combination of words by memory with a picture.

Harjit: Wow, that's so fascinating.

Margaux: Yeah. I think they only did that for our year because it didn't work so well.

Harjit: It makes sense.

Margaux: So to this day, I find myself really struggling to phonetically sound out words. And I remember my dad and my mom always working with me to, like, basically get better at reading. And I kind of struggled a lot with reading, so I didn't like reading growing up.

And I remember in high school, in English, I would kind of skim through them. And I was able to kind of grasp from context of conversation in class what was going on in the chapters without having had read it. So, obviously, I was missing a lot of details. And then I would read things like SparkNotes, but I always struggled to actually get through a whole chapter. So there are a lot of books that I "read" in high school, but I actually didn't read.

Harjit: Oh, my gosh, I know. I think SparkNotes is basically . . . everyone I remember in high school would talk about it. But I had a lot of integrity with the way I wanted to read. I was like, "I read this chapter." Everyone's reading SparkNotes. And I'm like, "Oh, my God, Harjit, you're such a snob." There are some people that reading is their medium of release and some people, it's not.

Margaux: Yeah. And I think I've really had to work to make it something that I love, because in theory, I've always loved the idea of reading and wanting to read a lot, but it always took me forever to read and comprehend things.

That was really evident when I was taking the MCAT. At that time, there was that literary or English comprehension section. That was really hard for me to be able to read something quickly and then write or be able to answer the questions from that.

So I think that was my history in reading. And now, I have really worked on it and come to really love and enjoying and savoring words. However, I still hate textbooks. I will say I don't actually think I read a full textbook or a full textbook chapter for medical school.

Harjit: I don't think I've done that for medical school or undergraduate degree. I've never fully read a textbook. I loved math, so I read the full calculus textbook back in high school.

Margaux: What? Nerd.

Harjit: Yeah, I know. But that is the only textbook I think I really read.

Margaux: Yeah. And how has your journey changed in reading?

Harjit: I love to read to the point where my mom would call my name and be like, "Harjit, you've been reading for 12 hours. Put the book down. You need to get dinner." And she even was concerned one time and basically was like, "Is this normal? Is it normal to read this much? Why is her nose always in the books?"

And I think, for me, my journey for reading was actually a really important part of my growth and it also was a really important for me to be mentally sane. I would almost say, in a way, it was a therapeutic thing for me growing up.

I remember, when I read my first book, I literally was sucked into a different world, and I loved that feeling. I loved that feeling because I was like, "Oh, the world's so big. There are so many things you can dream about. There are so many things you can achieve." And it just made me transport into a different world. So, for me, reading was integral to my life. I felt like I couldn't survive without it.

So, in high school, I was reading all the books. I was in AP English, you know, super excited. And then I start my undergraduate degree. There, I think, is where my time decreased from reading. And I think it was almost in a forced way in the sense that I had to really focus on my school. I did engineering and I was literally . . . like, every time of the day, I was like, "Am I going to finish this degree? It's so hard." And so I really started focusing on that.

And when I had time off, I wanted to watch TV. This is also when I feel like devices starting coming in my life. And I, through the years, started using Facebook, Instagram. I finally was like, "Okay, I'm going to decide that now I have time off, I actually do have time. Let me start reading." And I will tell you it's been really difficult for me to get back into it.

I, like I said, would read a book from the beginning to end. Mine was a race of time, like, "I need to finish this book in one day." And now, I'm having a hard time even focusing for one or two chapters. So I think it's me building that practice of reading again.

Margaux: You mentioned that when you started college, you had less time to read. I think that's something that a lot of people experience in high school and elementary school. English is built into the curriculum and we're reading books through that, and then reading on our own plus or minus, depending on our personalities. But college, unless you're an English major or some major that focuses on reading, it's not a priority to read. Then the focus shifts to textbooks. And then that's very true for medical school as well.

However, like you said, books have the power to suck you in to a whole different world and give you a totally new perspective. And I think that is something so powerful of a teaching tool that is not utilized, especially in medical school when cultural competency is so important and so hard to teach overtly, right? You can't just teach and have a lecture about cultural competency, but I think books are a great substitute. I don't think anything can replace actually living, experiencing, and building cultural competency in that way. But books are a great medium to take that step, right?

Harjit: Because they make the world smaller. You can get these stories of millions of people. And I think my focus largely when I was younger was fictional books. And in college, one thing that was very positive is when I started discovering autobiographies and actual books on theories and, you know, the way the world works, the way systems work.

Margaux: So, for me, as a white woman growing up in a predominantly white culture with white people around me, it was super eye-opening to start reading books from different people and different cultures, so people of color and from different cultures around the world.

I think one of the first books that we actually were assigned to read here at the University of Utah was "The Spirit Catches . . ." me or you?

Harjit: "The Spirit Catches You and You Fall Down."

Margaux: A very eye-opening book about how lacking cultural competency can be very harmful to your patients. And so, after reading that, I was like, "What? What am I missing? What do I . . . I don't know anything about the world or my patients unless they look like me. And even if they look like me, I still don't know anything about them and their backgrounds. If it's not where I came from, then how do I know what their experiences are?"

And you very rarely have the time that you need to really talk to your patients and get to know them on the level that would allow you to have an in-depth knowledge, right?

And so I think also as part of the responsibility as a physician is not to rely on your patients to teach you about them, but to have a little bit of background going in about world populations, right?

It becomes emotional labor when we as physicians don't have that cultural competency. Our intentions are good in asking them about their culture, but it's still a lot of emotional labor on the patient's part when we are trying to figure out their culture and also healing them at the same time, or treating them at the same time.

So I think the more we can do to read and broaden our understanding of different cultures and populations, and people, and backgrounds, and perspectives will make navigating . . . working with different people so much easier.

Harjit: I totally agree with that, Margaux. When I was in 12th grade, I read this book called "The Kite Runner" by Khaled Hosseini. It's a fictional book, but it's about these two friends who are Afghani. And when I read the story of this man going through his life and then him moving to America, and the way his identity was shaped, I felt this deep connection because this is similar to my life.

People actually have struggles of identity. They actually, you know, have these conflicts. There are actually words that express the things that I'm feeling. In that way, that book, for me, was so important because I felt like I wasn't alone. And I really related to that.

So I know, Margaux, you just mentioned building cultural competency, but it also helps a person develop themselves, I feel like, with books.

One book that was really instrumental in that was Assata Shakur's book. It's called "Assata: The Autobiography." She basically was a part of the Black Liberation Army. And her journey through the prison system was so powerful, for me. Understanding her feelings, what she had to go through, kind of the systems that were working against her as a black woman really helped me understand a different perspective of a culture that is different than mine. But it gave me a lot of context.

And in these books, I found words and I found parts of history that were missing in mainstream history books, right? So it really opened my eyes.

I realized books are so powerful. And I think there's some quote out there that if you give a woman a book, she can change the world. And I truly believe that. I'm not sure who quoted it, but I feel like I heard this or I . . . I don't think I made this up. I've heard this somewhere. And I think that's such a true story because I feel like books really have changed my life.

Margaux: I recently read "Americana" by Chimamanda Ngozi Adichie.

Harjit: I love that book.

Margaux: If I butchered her name, please correct me on Instagram because I want to say it correctly. But it is also about someone . . .

Harjit: Who's migrating?

Margaux: I don't know if she migrated. Yeah, someone coming to the U.S. from Nigeria, and so sort of a similar navigation of different cultures and trying to understand one school system versus the other. And while that was never my experience, it was very powerful to read about it and how eloquently those struggles were illustrated for me by this book.

But then there was a section here, and I can read a quote too, that then I was able to connect on some level, too. So I'll just read the quote and she's talking about . . . her aunt is talking, who had been a doctor in Nigeria, and then immigrated to the U.S. And she was trying to become a doctor here in the U.S. And she said, "I failed my last exam. I got the result just before you came." And this is in reference to the Step One USMLE exam.

And then she says, "I've never failed an exam in my life. But they weren't testing actual knowledge. They were testing our ability to answer tricky multiple choice questions that have nothing to do with real medical knowledge." And in that, I was like, "Yes, I have been there, too, and I know that struggle of how frustrating the test is."

But then I can also understand all the other barriers and intersections that played in for this woman, in being a woman of color in an era that wasn't necessary friendly towards women or people of color in medicine, and then being an older person and learning a new language and trying to come into the medical system that way.

And so, while I could share this perspective of feeling that the USMLE Step One is totally useless and doesn't actually test your knowledge or medicine and share that sentiment, I could understand that we had different paths to come to that same point.

But when you have that connection point of feeling like, "Okay, we have one little thing that we can share," it really helps build the foundation and even opens more doors, I guess.

Harjit: I actually love that you say that because I think that's another reason why those books were so therapeutic for me. I lived in a very traditional home. I had to go to school, come back home. I really didn't get to play with my friends a ton. And I always felt like, "Oh, I have friends with these characters in a book," or, I relate to this character in a book." And now that I'm saying it, I don't know if that kind of sounds sad.

Margaux: No.

Harjit: But I'm just saying that it really helped me feel connected to people. Even though some of these characters might have been fictional, some of them might have been real, but their stories mattered to me.

Margaux: That power of community that books can bring is so awesome.

Harjit: So awesome. And on that note, I actually want to tell you a really meaningful story. So my best friend, Leen Samha, guess how we became best friends.

Margaux: Through reading?

Harjit: We both loved "Hunger Games." And I literally sent her a text and I was like, "We're going to be friends because you like a book that I like.We were relating how "The Hunger Games" and kind of . . . even though it's like this dystopian novel of some future world, we were relating kind of the systems that were going on to that to our life.

And I think that's one thing I love about books because you can really understand things in a different . . . even though it was fictional, it really gave you an understanding of our real-life situation. I credit me having read that book, me loving reading, for the reason for my friendship with Leen.

Margaux: I love that. I also love "The Hunger Games" too. So I hope I can be y'all's best friends.

Harjit: You are our best . . .

Margaux: I'm just kidding.

Harjit: What are you saying? We're all best friends.

Margaux: No, I know we are.

Harjit: I'm just saying that's a reason I became her best friend. And I literally said, "You are my best friend because you love that book."

Margaux: You love "Hunger Games." And also, in this vein of books being able to create community, books have also historically been a key part of exposing negative things of government or faults in our society, like "Silent Spring" by Rachel Carson or "The Jungle" by Upton Sinclair.

And then one that I think is relevant to medicine and us particularly going into psychiatry is "One Flew Over the Cuckoo's Nest" by Ken Kesey, which had the power to be a great expose to the public about electroshock therapy and how not so great they were doing it. Actually, not great at all, that it was being conducted from, like, the 1930s to the '60s, or whenever this book kind of exposed it. And then it was amplified by Hollywood, and the film with Jack Nicholson as the star kind of really got the public aware.

Harjit: Right.

Margaux: And so, while that was great in putting pressure to stop this very sort of negative therapy, this actually very negative therapy . . . the way they were doing it was inhumane and definitely should not have been carried out in that manner. But what it also did as a side effect was create a very negative image of psychiatry and psychiatrist as a whole. And it created a societal distrust for psychiatrists and the medications that we provide, which has continued on to this day.

Harjit: Right. And we're still trying to push the destigmatization of ECT and psychiatry overall.

Margaux: Exactly. So now that we have a very evidence-based safe way to do ECT and it's actually a very beneficial treatment for many patients who are resistant to the other therapies for depression, it's very hard to convince the public because a movie about this book and amplified through Hollywood built that fear and that distrust, and it's very hard to tear that down. So I think that's another power that books can have and that we have to be careful about what is written.

Harjit: It's so important to read several books on a certain topic to really understand, you know, the depths of an issue.

Margaux: Yeah. I think that's actually so true, Harjit. I think it is very important to gain different perspectives even on one topic because that's how the real world is, too, right? Someone may have had a bad experience with a mental health provider and then someone else may have had a very good experience. And I think it's important to know the whole spectrum and then make your own opinion based on that.

Harjit: And kind of this medical-type books, one book that I felt was really impactful for me was "The Scalpel and Silver Bear" by Dr. Alvord. She's the first Navajo woman surgeon who kind of combines western medicine and traditional healing in her practice.

And this book was so impactful for me in the sense that I, too, am a person who shares multiple identities, specifically cultural identities. It was just so powerful to hear her story and kind of her journey through medicine and how she navigated that being a person of color and specifically an indigenous woman.

Margaux: I love that book, too. And I think we could honestly talk about books that we've read and loved all day. And so, to our listeners, what Harjit and I have been wanting to do and what we're going to start after this episode is doing sort of a book club Bookstagram through our Stories on @bundleofhers Instagram account. So we'll be highlighting and sharing books that we've really loved reading and quotes from them. So stay tuned on our Stories to continue following that.

And we also reached out to you all to hear about what books you've loved reading. And Ally, one of our listeners, posted on Instagram that the book "When Helping Hurts" really made her think about how we approach serving others and how to create sustainable changes. And this book is about how Global Health Missions can actually have a detrimental or negative impact.

And Ally, we both . . . Harjit and I both love that you shared this book because we're planning an episode about Global Health and how . . .

Harjit: To decolonize it.

Margaux: Exactly. So stay tuned for that and thank you for sharing. I'm definitely interested to read that book. Also, thank you to everyone else who shared your book titles. We'll be adding them to our reading list, which, for me, is ever growing.

Harjit: I mean, that's the whole point, right? It's a gift that keeps on giving.

Margaux: Yeah. And also, I just have to put a plug out there for @readingwomen. They have highlights every month. So, this month, I think, is Latinx Book Month and they have . . . they post different Latinx authors.

Harjit: That's so cool.

Margaux: So I think it's a great way to find new books.

Harjit: Chloe, can I share a poem that I wrote specifically about reading?

Chloe: Yes.

Harjit: Okay. For the listeners who don't know, I actually write poetry. And I actually specifically wrote one about reading because it's been so integral to my life.

Margaux: I'd love to hear it.

Harjit: "They look at every book on the shelf. Their hands roll across each cover wondering if the next one would be deep enough to catch their eye, to drown the voices heard every night of people who were supposed to take care of them. Now, that book is carrying that weight, and it better a good one, a universe that you can immerse in, a universe that you can expand in, a universe that will ultimately end. The book is gone and they find another one. Take care and thank you for taking care of me. Gyan." And Gyan just means knowledge.

Margaux: I love that.

Harjit: Thank you.

Margaux: Beautiful. And I think that really nicely sums up this episode and how we both feel the power of reading to pull you in to give you different perspectives, to . . .

Harjit: To change our lives.

Margaux: To change your life, to give you a space for quiet and mental focus and meditation.

Harjit: And to dream and to escape and . . .

Margaux: So many wonderful things.

Harjit: All those beautiful things.

Margaux: So, for our listeners, we hope you keep reading, keep sharing your favorite books, and stay tuned for our Bookstagram Book Club book sharing on @bundleofhers on Instagram.

Harjit: Can I say bye in Punjabi?

Margaux: Yes.

Harjit: [Foreign language 00:27:04].

Margaux: Bye-bye.