ANA: Hey everybody. It’s Ana González, and this is Mosaic. As of 2004, the Association of American Medical Colleges has used the phrase “underrepresented in medicine” to refer to any racial and ethnic groups that are, well, underrepresented in medical professions based on their relative population in the rest of the country. Medical schools use the term “URM” to talk about diversity in their classes, but that doesn’t tell the whole story.

Today, on Mosaic, I talk with Gisel Bello, a 4th-year medical student and the child of Dominican immigrants. Her podcast, You Are Med, features stories from other medical professionals of color to breathe nuance into what it means to be underrepresented in medicine.

MUSIC UP AND OUT

ANA: I think I want to start off just with how you would introduce yourself. So could you just say your name and a little bit about who you are and what you do.

GISEL: My name is Gisel Bello, or how mami calls me: Gisel Bello. I am a fourth-year medical student, I am a first-generation graduate, I will be the first person in my family to become a physician. I’m an afro dominicana. I am loud as fuck. I sometimes am the life of the party. And overall I love to love, and I am the child of the sun.

ANA: Wow, that is the best self-introduction I’ve encountered in my line of work. So thank you for that. I think I wanna start right with what you said in that, when you said: My name is Gisel Bello, or, as mami calls me Gisel Bello. Growing up as someone from a Dominican family, was Spanish your first language?

GISEL: Yes, absolutely. I am an ESL kid. I learned English at school. And at home, you know, I would roll my eyes after learning English because I would want to use it at home and mommy would be like, “No, no, no, aquí no se habla inglés.” I'm very proud of my Dominican heritage. I'm very proud of being the child of Dominican immigrants.

ANA: When did your folks come over from the DR?

GISEL: So first, it was my grandmother who came over to the United States after a tragedy, actually, my grandpa was murdered in DR. And, you know, he left my grandmother with three children. And she needed to sort of figure out how to make ends meet and decided that she was going to come to the United States. So that was in the late 70s, early 80s. And she came first actually. And I make that distinction because my grandmother leaving was actually one of the biggest things in my mom's life that sort of caused a little bit of strife, sort of a little bit of abandonment issues, especially after having lost her dad in the way that she did. And so, first my grandmother came over and then my mom joined her five, six years later when she was around 15 years old.

ANA: Ok, wow. So you are firmly, like, Nuyo – I don’t know what the word is –Nuyo-dominicana. I know that there are so many neighborhoods that are densely Domincan or Puerto Rican or whatever. Did you grow up in one of those neighborhoods, or was it more mixed?

GISEL: So everyone that knows Dominicans in New York City always thinks of Washington Heights, right? And I remember being little so desperately wanting to actually live in the Heights because that's where all our people were. But we actually grew up in Harlem on 125th Street in the Grant housing projects. I will forever and always feel like I have to shout that location out because it actually created a really interesting dynamic where, yes, there were Dominicans, yes, there were a whole bunch of Puerto Ricans. But it was mostly African American and African community in Harlem…

And that was really cool because I think had we grew up in Washington Heights, I would have been even more Dominican, but I feel like I'm definitely Dominican. But I have different depths and sort of layers to me, because of the way that I grew up. Specifically in the projects, specifically in Harlem with that is such a cultured community.

One of the things that when I moved to Rhode Island, I really, really, really missed from New York City and where I grew up is that, you know, you would hear Spanish and different versions of Spanish, because Dominican Spanish is different from Puerto Rican Spanish is different from Colombian Spanish. And so you would hear all different kinds of Spanish, but you would also hear all different kinds of other languages. Not only African languages and dialects, but also, you know, Middle Eastern languages. Because there’s a big Middle Eastern community. It was a big, just cluster of different kinds of people. And I remember moving to Rhode Island, specifically to go to the University of Rhode Island, and being so confused, because in my little mind at the time, I was like, “Oh, the United States, like, looks like this.” You know, right?

ANA: [Laughs] Oh my goodness. What a shock you were in for!

GISEL: Such a shock. I was like, “the United States is like mad Black people, mad Dominicans, mad Puerto Ricans. Just this is what it is.” And, um, it was not that.

ANA: So, you go to URI, like the main campus. And that’s in Kingstown.

GISEL: Yeah. Kingston, yeah.

ANA: Wow, that is a difference. What is the first thing you remember –

GISEL: Girl.

ANA: – seeing that made you realize: Oh the world is not like Harlem?

GISEL: You know, it's even so ridiculous. And I'm even, like, a little bit embarrassed to even say it now. But like, I remember being like, to one of my roommates, who was like, this young white woman being like, “Oh my god, stop it. Like, I'll slap you,” or whatever. You know, like, that was just kind of like how we would talk to each other. Obviously, we would say these things to one another, but there were no slaps being handed out, you know, it was just like, “You know, like, shut up, like, I'll slap you, like, stop playing.”

We were all literally laughing. And I said that and she told the RA that I threatened her and that she wanted to get a room change and all of these things and I was like, girl Why? So, yeah, I, you know, I remember having that experience and being like, “Oh my god.” One, she took this so seriously, which like now I guess I could understand if like, no one has ever said that to you, and anytime someone has said that to you, it's an actual threat. But it's just like the ways that we used to joke and talk to one another in Harlem did not translate to Kingston. And that was one of the most immediate ways that it showed up.

But then also just like looking around. I was, in many cases, the only, you know, Latina, the only person of color in a lot of my classes. And that was weird to me. You know, in my high school, for example, we had, like all of two or three white kids in our class, and they were three brothers, and they all went to our school because the basketball coach was their dad, you know?

ANA: So you just did not have that exposure to how white –

GISEL: None.

ANA: – spaces could actually be.

GISEL: Right.

ANA: So that brings me to this question I’m really curious about: When in your life did you decide, “I’m gonna be a doctor, and this is the path for me,” and then actually enact that path? Did you see somebody in your life?

GISEL: So there's actually so many answers to this question, because I think I constantly ask myself the question, you know, why me? A lot of the girls that I grew up with a lot of the guys that I grew up with, have either gone to jail, passed away, have become pregnant earlier in their lives. And then there was like me. And yeah, there’s so many feelings that I have about that.

The like, funny cliche version of answer to this question is that I remember being seven, I remember having the flu or something. My mom took me to my pediatrician. I remember his name, still, his name is Dr. Camilo. And he let me use his stethoscope, and I listened to my mom's heart, and my brain exploded at the age of seven. I was like, “What is that? There's living things inside of our bodies? Like, what?”

And that was so freaking cool. So that was like, the first instant that I remember being like, “Oh, that's it, like, I'm going to be a doctor.” And of course, you know. And immigrants, and immigrant parent's dream is for their child to become a doctor or a lawyer or something. And so when I left there, exclaiming that my mom was like, “Ay si” like, “Yes, do that girl.” But, you know, at seven years old, I had no freaking clue what I was actually getting myself into.

And then sort of the next part of this that then I was like, “Okay, I do need to become a doctor” was when around the age of 10 12, y mom, as I mentioned earlier, you know, she lost her father. Then she had this sort of abandonment experience with my grandmother when she came to the United States. And then, after having us, every single time that she had a child, she went through a really intense postpartum depression experience. And so, I remember sort of being really sad. I think that a lot of –Ooh, I'm gonna get emotional.

A lot of things that I am very proud of in myself, a lot of the sort of characteristics that I carry, and that I'm proud of, specifically, the one that I kind of introduced myself with earlier, as just the lover of the sun, I definitely got from my mom. And so I remember being really young, and seeing her kind of basically, like, waste away in this depression. And suddenly, she wasn't this ray of sunshine that I was used to. This very, like, loud woman anymore. She was just sort of in her little cave. And that was really hard for me to see.

And so no one was talking to me about that. You know, in our communities, in Latino communities and Black communities, anything that has to do with mental health is just sort of really taboo. No one really likes to talk about it. And the other layer is that like, you know, children are to be seen and not heard. And so no one was like, “Hey, Gisel needs to know what's happening right now.” And I remember just like searching and searching and searching, trying to look up ways that I could like, help my mom find her sunshine again, you know. So then I was like, “Hey, okay, apparently, like doctors help out with this. Like, I definitely have to become a doctor so that I can help my mom be well again.”

ANA: Well, that’s so much responsibility for a kid. And it’s something that I’ve learned is called the “parentified child”.

GISEL: Yes, girl.

ANA: Right? And it happens when our parents don't know how to manage their own problems and emotions. And then you feel responsible as the child, even though, like you said, You have no idea what's going on, and you have no clue how to fix it. And it's definitely not your responsibility. But I feel that happening a lot. And I see that happening a lot in immigrant families where the first generation kids who have more access to the English speaking world and resources and know who to call, they, oftentimes, have to deal with these bigger adult problems. And that weighs on you.

GISEL: Oh, my God. I mean, I talk about it all the time in therapy. This is why I'm in therapy, because I didn't learn that phrase, the “parentified child,” until maybe, like a year or two ago, and it really resonated with me. And I was like, “Wow, there's a whole phrase and word and concept of like, my life? This is crazy.”

And I ended up going to URI because they gave me the most financial aid and also because it was far enough, but close enough. The parentified child in me was like, “I need to get out of here if I'm actually going to do anything with my life.” So I left...And you should have seen my parents. Like, when they dropped me off, you would have thought someone died, that we were on our way to a funeral. It was like a big fiasco. They've always said, “Education, education, education, education.” But I didn't understand until then that really what they meant was: family first, then education. So to them, it felt like a huge betrayal almost that I was leaving the family and was the first person to leave by myself to a state where, like, I knew nobody to get my education.

MUSIC

ANA: This is Mosaic, and my guest today is Gisel Bello, a fourth-year-medical student and the creator and host of You Are Med, a podcast about what it means to be underrepresented in medicine. Here’s a clip from an episode with surgical intern Mohammed Aref.

CLIP FROM YOU ARE MED EPISODE 3

ANA: So I want to talk about your podcast, You Are Med. And I think it deserves a lot of talk because it's a conversational podcast, but it is so impressive for a number of reasons. The first and foremost is that you have created this show by yourself while a full time medical student at Brown University's Warren Alpert Medical School. So how did this, I mean, I can kind of hear where this came from, right? Like your whole life. And you saw, like you had representations of what it meant to be a doctor, you had great mentors, you had a lot of challenges. When exactly did you say, this is time for me to start a podcast, I'm going to do it, here's my plan, and then actually do it?

GISEL: You know, I'm a first generation medical student. I took four years off before I came to med school. And that wasn't necessarily on purpose. You know, I thought I was going to take one year off to do research. And then we found out that my dad was in renal failure and had colon cancer, and my little sister got pregnant. My mom was losing her mind about all of these things. It was a lot of like, family, hands-on things that I ended up having to do while I had taken time off.

My life has always had these two sides to it, right? Like, there's the me trying to push forward and be this like, modern woman who pursues a career, and then there's always this family responsibility. Like we mentioned, the whole parentified child thing. Both of these things are really, really important to me.

ANA: Let me just ask before you continue, was that an isolating experience in college and then going into medical school? Like, did you feel like other people were living that same experience as you?

GISEL: Absolutely not. I was like, “This is the Gisel thing. You need to just figure it out.” It did not feel like there were other people out here who were both trying to strive and also being tied up in family responsibility. Yeah, it was extremely isolating and att times, you know, I would even say, like, debilitating when you have to, like do a paper. But then your mom calls you because your sister's having a mental breakdown. So it's always always been like that. And medical school requires so much of me to be able to learn all of this information, to be able to integrate it, to be able to perform, to be able to show that I can perform, that I can take care of patients, that I can think clinically, that I can speak well, that I'm like professional, all of these things. And also my family requires so much of me.

And the things that have consistently gotten me through are my friends that I've made that can also share stories with me about really difficult moments in their lives, you know, not only as med students, but just as humans. And if it were not for my friends, for my community, for my village, for the people that literally sustained me, I wouldn't be here. So I was like, “How about if I just interview people and have them tell me these really interesting, sometimes sad, sometimes really amazing experiences that they've had, because they are first gen or because they are underrepresented in medicine, and they're traversing through this really hard time in their lives?”

And so the idea came to me maybe like late, first year, early second year, but I was actually really scared. I was like, Who the hell am I to, you know, say that I can make this show that I can interview people and I sort of just like put it to the side. And eventually because I had the opportunity to work as a diversity, equity and inclusion fellow for the med school, they asked in my application for me to propose a project and I was like, “Oh, absolutely, it has to be this.”

CLIP FROM YOU ARE MED EPISODE 1

ANA: In like in the show notes of you are met, it says that. Let's see. “It's designed to breathe life into the nuances that are flattened by data points med schools use on their websites, and they enrich but go beyond medicine. And it's an ode to our thriving. It's a reaffirmation that you are med, and you belong here. So I want –

GISEL: Girl, you’re giving me goosebumps. I wrote that?

ANA: Yeah, you wrote that! So I'm wondering, like, can you talk about that term, “URM”, and where the name comes from? Because this is really interesting to me.

GISEL: Yeah. So when I was sort of, like, playing with the idea, I then was like: “Okay, if I were to do this, what would I call it? And I sort of thought to myself, like, “Oh, URM!” Which means “underrepresented in medicine,” which is sort of like the blanket term that med schools use to categorize, you know, students who are underrepresented in medicine. So Black, indigenous people of color.

A big identity of mine is that I am underrepresented in medicine. And, to me, I think that those things are strengths, right? They’re strengths, because when I walk into a patient's room, and they look at my face, and then they ask me if I speak Spanish, and then I start speaking Spanish, and then they're like, “¿Tú eres dominicana?” And it's just like an immediate connection. And then therefore, almost like an immediate trust that is built between this patient and me. And they don't know me from anywhere, right. So it is a strength to be “under represented.”

But I don't think that URM captures all of the stories that we've had, right? Even just in the few episodes that I've released, I share part of my story. I talked to Kaye-Alese Green, who talks about having a Jamaican immigrant mother and sort of her vision for the future. I talked to Mohammed Aref, who is talking about his identity and being Muslim and sort of how he's had such difficulty, especially post 9/11, being a med student.

We all are URMs. But we all took different paths to get here. And I wanted to sort of live in that intersection, like, yes, you're a medical student, but tell me where you come from, tell me the road you had to travel in order to be here, and the lessons that you learned, because I think that that is where you grow, you know, the audience grows to understand not only the challenges that we have coming to medical school, but also why it's so beautiful that we're here and what we have to contribute.

ANA: That is such a refreshing and new thing to me to view medical students and doctors in general, like beyond just education and clinical work. Do you feel that that's that sort of language and talk, how does that affect, like how you practice and how the other doctors and doctors in the making that you're talking to how they practice?

GISEL: I think it's so malignant, that everyone expects doctors to be perfect. There's a whole paternalistic practice of medicine that it's like, “Yes, doctor, whatever you say, Doctor.” I think that takes away so much of the true relationship that you could have with your patient. Right? And so that's like a secondary goal of You Are Med is to humanize doctors to say, “Oh shoot that happened to that person. They lived through this thing. That also happened to me.” And you don't even have to be a doctor or med student or any one in the healthcare field to listen to this podcast and be able to relate to the stories.

ANA: So what does the next year look like for you in terms of med school and also producing You Are Med?

GISEL: So next year, I will be doing rotations specifically in the field that I have chosen, which is OBGYN.

ANA: And why OBGYN?

GISEL: I'm so glad you asked. In a way I feel like the choice of me being an OBGYN had already been made even before I was born. When I visited the Dominican Republic, I went to go see my grandmother. And we went to el campo, the place where my grandmother grew up, where my great grandmother raised all her 14 children.

We went to La Laguna, my aunt still lives there. She, like, asks me what chicken I want to eat, which is bizarre, grabs this chicken, kills it, and then cleans it out. Turns out, there was an egg in the cloaca of the chicken. And she's like, “Ay, mira! Isn't this amazing?” And I approached her to take a look. And I'm like, “Girl, you had six children? Like, what do you think happens? You know, normally to us. And also, you should know, like, I'm going to be an OB.”

And she's like, “Ay,” you know, “mi mamá que sufrió tanto.” So like, “Oh, my mom, you know, she used to suffer so much.” And I'm like, “What are you talking about?” And she says, “Don't you know that my mom used to be a midwife?”

ANA: Wow. Is that your great grandma?

GISEL: My great grandma. And so I look over to my grandma. And I'm like, Girl, I told you that I wanted to be an OB. And your response was “Ew. Why would you want to stare at vaginas for the rest of your life?” Why wouldn't you just tell me that my great grandmother was a self trained midwife. And then I learned that about 50% of the people that still live off of this side of the mountain at La Laguna were brought Earth-side by my great grandmother.

ANA: Oh, my god.

GISEL: I know!

ANA: Wow, what an amazing thing to find while looking inside of a dead chicken.

GISEL: Right? I mean, so that was like, cosmic. For me that was like, such a confirmation. You know, I come from a long line of women. I actually have five sisters and a brother. You know, there's a lot of like, very opinionated, very loud, amazing women in my family. And I love taking care of women. And then, so, finding out that my great grandmother was a self-trained midwife. And that actually had caused her a lot of strife in her life, because my great grandpa didn't like her to go out at all times in the night to help women through labor, was such a life-affirming moment. I was like, “Oh, my God, great grandma. I got you. Like, we gon’ do this.”

ANA: What is your great grandmother's name? Do you know it?

GISEL: Ana.

ANA: Ohhhhh!

GISEL: Yeah. And so they used to call her Fina. So everyone, everyone was like, “Oh, Fina, Señora Fina.”

ANA: That's a beautiful family lineage that you've come from.

GISEL: It’s so good. You know, when I think about all the challenges that I've been through, to get to med school, and even throughout med school, I think about how all of this happened because of a tragedy, right? Like my grandpa was murdered. My grandma came to the United States. They struggled. And then actually, I am the beneficiary of their sacrifices. And that's not lost on me. And I feel constantly grateful for having the opportunity, not only to sit and think and learn, but to be able to build relationships that actually will be helpful and healing to people.

ANA: I think that's a beautiful place to stop. Yeah. Well, Gisel, thank you so much for being here today.

GISEL: Thank you so much for interviewing me. I feel so special.

ANA: You are special!

ANA: That was my interview with Gisel Bello, fourth-year medical student and creator of the You Are Med podcast. You can find every episode of You Are Med online at youaremed.com.

Mosaic is a production of The Public’s Radio. Edited By Sally Eisele. Produced by James Baumgartner. With help from Pearl Marvell. Our theme music is by Bryn Bliska. Our intern is Michelle Liu. Torey Malatia is the General manager of the Public’s Radio. I’m Ana González. Thanks for listening, see you next week.

Support for this podcast comes from the Carnegie Corporation of New York, supporting innovations in democratic engagement and international peace and security at carnegie.org.