250. Outsiders - Pooja Lakshmin
Frank Duffield, The Market (c. 1950)
I wanted to help others carry the burden of being on the outside, whether because of how their brains worked, their skin color, their gender, their identity, or a combination of these factors.
The summer of 2016, I took a month-long sabbatical to live in Rome. I had just graduated from my psychiatry residency at George Washington University and was a newly minted psychiatrist specializing in women's mental health. I rented a room in the outskirts of the city and regularly braved the heat to take an Italian language class, visit the Villa Borghese, and work on my memoir.
This happened to be that tumultuous period when Britain was withdrawing from the European Union and Donald Trump was rising to power in the United States. Every time I'd pick out a nice-ish restaurant in the hip Trastevere neighborhood and show up ready to cosplay the vita bella, I'd get turned away. I wondered whether my jean skirts and tanks were too casual. I told myself that maybe it wasn’t worth it for a restaurant to seat one person during dinner (even when I was certain I could’ve sat at the bar).
Then, towards the end of my trip, I was at a market near my Airbnb where I’d gotten to know some of the stall owners, when someone aggressively shooed me away from his fruit stand. Quickly a shopkeeper came up behind me and shouted at him, "No, no—don't worry! She's American." Afterwards, confused and shaken, I called my partner and told him what happened. “They thought you were Roma," he explained, referring to a traditionally itinerant and marginalized ethnic group who live throughout Europe. “Be careful.”
It was a light bulb moment: this was not my first time being an outsider. My mind immediately went back to my childhood, to the white, upper middle-class Philadelphia suburb where I was bullied and ostracized for my brown skin and "different" name. I felt a mix of knowing and shame—knowing that I had felt like an outsider in Rome, and shame that I had not immediately named but instead tried to explain it away, blamed myself, internalized the discrimination. After that incident, I walked around much more guarded and with a sense of sadness—for myself and for all outsiders.
After I returned to Washington DC, I had lunch with a mentor from a community psychiatry clinic where I had worked for two years. I told him about what happened and he said, “They didn't see you as a doctor. They saw you as a young brown woman.” I bristled, but I allowed myself to receive his words and felt strangely comforted. To hear it laid out so plainly and bluntly was a balm. Even in Washington DC, there were moments where being a doctor wasn't enough, like when a patient would call the intake line and say they preferred an American doctor.
All of this reminded me why I chose to become a psychiatrist in the first place. I wanted to help others carry the burden of being on the outside, whether because of how their brains worked, their skin color, their gender, their identity, or a combination of these factors. After that incident in Rome, I became more vocal (usually frowned upon in psychiatry) with my patients, advising them not to internalize systemic inequities. Instead, I tried to validate their hurt and their anger, and to commiserate too. Through my writing, my advocacy, and yes, even in my office, I could show them they weren’t alone.
- Pooja Lakshmin
