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Kuttin Kandi: Hiphop, Heart Disease, Fatphobia, and Truth-Telling

This is a guest post by Laurie and Debbie. Debbie Notkin is a body image activist, a feminist science fiction advocate, and a publishing professional. She is chair of the motherboard of the Tiptree Award and will be one of the two guests of honor at the next WisCon in May 2012. Laurie is a photographer whose photos make up the books Women En Large: Images of Fat Nudes (edited and text by Debbie Notkin) and Familiar Men: A Book of Nudes (edited by Debbie Notkin, text by Debbie Notkin and Richard F. Dutcher). Her photographs have been exhibited in many cities, including New York, Tokyo, Kyoto, Toronto, Boston, London, Shanghai and San Francisco. Her solo exhibition “Meditations on the Body” at the National Museum of Art in Osaka featured 100 photographs. Her most recent project is Women of Japan, clothed portraits of women from many cultures and backgrounds. Laurie and Debbie blog together at Body Impolitic, talking about body image, photography, art and related issues. This post originally appeared on Body Impolitic.

Debbie says:

I’m sorry to say I never heard of Kuttin Kandi (also known as Candice Custodio-Tan) before I read this article, clearly because I’ve been hiding under a rock.

The woman is a force to be reckoned with:

The first woman to reach the DMC USA Finals and a founding member of the all-female Anomolies crew, the Queens-bred Filipina turntablist has shared the stage with legends (Kool Herc, Afrika Bambaataa), big kids (MC Lyte, LL Cool J) and period contemporaries (Jay-Z, dead prez, Immortal Technique). In addition to beat juggling and competition-judging, she writes revealing poems, lectures regularly, does grassroots organizing and serves as a mentor and educator at the UC San Diego Women’s Center. She’s also spearheading a compilation album, The Womyn’s Hip-Hop Movement, co-writing a book about Filipino-Americans in hip-hop culture, and she proudly represents the 5th Platoon crew, Guerrilla Words and R.E.A.C.Hip-Hop (Representing Education, Activism & Community Through Hip Hop).

In April, she was diagnosed with a heart condition called “atrial fibrillation.” Shortly after she learned that, her heart stopped beating for seven seconds. Her medical professio nals prescribed a pacemaker and an indefinite course of blood thinners.

She’s been telling her story in a Facebook series called “Notes of a Revolutionary Patient.” I don’t read Facebook, so I’m not up with her writing there, but apparently she gets into everything from her hard childhood history to fatphobia in the medical profession. In the Colorlines interview, she’s extremely clear-sighted:

I realized I was receiving biased medical care the moment they didn’t ask me what work I have done and haven’t done to “be healthy.” The moment they told me, “You need to lose weight” without asking my personal health journey, I knew they were judging me. They didn’t look at me as though I was a person; they just looked at my pounds. If weight is the issue, okay fine—let’s discuss the weight [and] what got me here. But i think it’s more than just weight. For any patient, doctors need to know the details. I know that there’s a whole herstory about me. I’ve [suffered] a range of mostly invisible disabilities including depression, bulimia and binge-eating/compulsive disorder. In my 30s I was diagnosed with anxiety and panic disorder, agoraphobia, diabetes, hypertension, sleep apnea, bipolar disorder and severe allergies that require two shots a week for three years. I also have an Auditory Processing Disorder, which I occasionally reframe as a different learning style. Doctors need to take their time explaining things to people; many people have different learning styles.

And, the “true understatement that needs to be stated over and over” award goes to:

the simple fact that the health care industry is not [generally] educated in social justice, power, privilege and oppression is systemic racism.

I want to engrave that on a plaque and hang it in every hospital and doctor’s office in the country. Yeah, sure, I know; no one would let me. But I want to.

Everything else she says in the interview is golden: about histories of sexual violence, about working in male-dominated industries, about life/activism balance.

I’m sorry that her misfortunes brought her to my attention, but I’m so glad to know she’s in the world. And somehow I feel confident that she’s going to stick around and teach us (starting with her doctors!) for quite a while longer. Here’s her fundraising site; I sent some money. If you are in a position to, I hope you’ll consider it.

Thanks to Jan Herzog for the link on a mailing list I read.


37 thoughts on Kuttin Kandi: Hiphop, Heart Disease, Fatphobia, and Truth-Telling

  1. the simple fact that the health care industry is not [generally] educated in social justice, power, privilege and oppression is systemic racism.

    And there’s no connection between class privilege and learning about social justice, right?

  2. Because the doctors making six figures are totally all from lower class families and never had the resources to learn about oppression? Please.

    Kandi looks awesome, though! Dealing with the fatphobic medical industry is exhausting…I can’t imagine dealing with racism on top of it. I hope she’s getting the treatment she needs.

  3. I’m just gonna go ahead and say that since getting through however many years of a medical education is also linked to class privilege, it’s probably ok to expect doctors to sit through some “Don’t be a dick” lessons.

  4. You know, I’ve never really thought of doctors as teachers, but it sounds like they need to be. The first thing they teach you in teacher school is that you need know what your students already know. It sounds like Kuttin Kandi is asking doctors to do the same.

  5. I’m just gonna go ahead and say that since getting through however many years of a medical education is also linked to class privilege, it’s probably ok to expect doctors to sit through some “Don’t be a dick” lessons.

    No shit. Also, while it works to varying degrees, there are many other professions which require handling sensitive information and dealing with vulnerable people who might not be thinking clearly under the stress of requiring the professional’s aid (I’m thinking cops, teachers, counsellors, suicide hotline operators, childcare providers, poolside lifeguards, social workers, firefighters, etc etc). Most of these have sensitivity training programs, and continuing training on the job, that add up to being How Not To Be A Dick seminars.

    Why the flying fuckity fuck are doctors exempt? Did anyone look at the medical profession and go “oh, hey, it’s not like anyone seeing a doctor’s going to be under any stress or need any understanding of their situations or anything lol” ????????

  6. I know some places do have “How not to be a dick” lessons, because my uncle used to teach them. He’s a therapist, but he would sometimes teach bedside manner classes at a med school. Clearly these classes are not as widespread as they need to be, but at least there’s precedent…

  7. Nice, we got “poor folk (and by extension people of color, because apparently one must have a degree to comprehend racism) are just too ignorant to realize they’re being screwed” on the very first comment! This should be fun!

  8. Who said anything about doctors? The “healthcare industry” is made up of a whole helluva lot of people, many of them without even a four-year degree.

    Although frankly, the whole “everyone should be educated on social justice or it’s a sign of systematic oppression” stinks of privilege to me as well. Not everyone is capable of achieving a high level of comprehension of social justice issues, for whatever reason. And yes, that includes people that are marginalized in our society, it’s not all a matter of “oh, you’re privileged, and that’s why you won’t learn!”.

    But I’m sure most of you would like to pretend that being smart, and neurotypical, and well-educated doesn’t make it easier to be educated on social justice issues. And race? We know being white in our currently biased eduction system means you have more opportunities to learn about pretty much everything, not just social justice.

    But yeah, Li, let’s pretend the ‘healthcare industry’ is only doctors, the very top of the industry. I’m sure after 8 years of schooling, it would be a cakewalk for a doctor to take one ‘don’t be a dick’ class, but how about nurses? How about orderlies? How about medical receptionists? They’re just stinking of class privilege, with their two years of college or their GEDs, right?

    Not everyone in the medical industry has the time, money, intelligence, or educational background to enable them to become educated about social justice. That’s all I’m saying. My own grandmother was in the healthcare industry, and she only had an eighth-grade education. But it’s somehow a sign of racism that the health industry won’t make everyone in it understand social justice? And it’s supposed to do this by what, creating standards that would lead to a lot of marginalized people, like my grandmother, to losing their jobs in the industry?

  9. The reason I referred only to doctors is because 1. Kuttin Kandy specifically talked about her experiences with doctors and not other healthcare professionals and 2. It is doctors who need the highest level of intervention re: their social justice fails because of their institutional power within the healthcare system and the primacy and authority of their interactions with patients.

  10. Yeah, yeah, poor people just can’t help but be oppressive; they’re just not educated enough to see the error of their ways. So it’s totally OK for them to perpetuate a racist or homophobic or whatever system. I mean, so what if disenfranchised people receive substandard health care? At least nobody is placing an undue burden on your grandma.

    Bullshit. Offices and industries all over the country run sensitivity-training seminars, for one thing; plenty of people from all walks of life have to attend them as part of their jobs and ongoing training. For another, I’ve known enough working-class people and studied enough working-class history to know that not having a four-year degree does not prevent someone from understanding power dynamics, fairness, or kindness. Quite the contrary.

    Neither of my grandmothers went to college either. One of them was a raging narcissist; the other was an open-minded liberal to her last day. It’s almost as if working-class people are individuals with a variety of capabilities.

  11. Not everyone in the medical industry has the time, money, intelligence, or educational background to enable them to become educated about social justice.

    That’s what training programs are for. They aren’t just for doctors. I’m involved right now in an effort to develop, and get New York City hospitals to institute, specific standards (beyond “it’s against the law to discriminate”) to protect trans patients. You can’t institute standards like that without training programs, not just for doctors and administrators and computer people, but for everyone, including people with “8th grade educations.” I’ve had more than enough experience of being a trans patient in hospitals to know that anyone who works in a hospital, regardless of status or education or whether they’re smart enough to be a nuclear physicist, is capable of treating trans and other kinds of patients badly or well, and of learning to treat people fairly. Especially prior to GRS, and even more so before my transition when I was hospitalized under my male name but had already been on hormones for years, I’ve had doctors and medical students treat me like crap (laughing and smirking at me when they discovered my history, and, after transition, deliberately misgendering me), and orderlies and assistants and receptionists taking my information, and other staff members, be very kind and accepting, and the other way round. How much education they had doesn’t have much to do with it.

  12. I know some places do have “How not to be a dick” lessons, because my uncle used to teach them.

    My dad pushed to have them integrated in the school he taught at as well. I think there is a general move in that direction across the board, but it is slow going.

    (And at my dad’s university, they got bedside manner onto the exam. A student could rattle off all the medical knowledge in the world, if they weren’t able to show some empathy, they didn’t pass.)

  13. And none of my grandparents went to college either — two of them worked as hospital orderlies at Montefiore, in fact, after they came to the USA — and that had nothing to do with what they were like or whether they were capable of being open-minded or of being educated to follow particular standards.

  14. Not everyone in the medical industry has the time, money, intelligence, or educational background to enable them to become educated about social justice.

    Where along the line did I suggest that they have to pay to do this? Cops don’t pay for sensitivity training. Corporations don’t pay for diversity workshops. Teachers sure as fuck don’t pay for further training on the job in dealing with kids with special emotional or mental needs – and yes, kids who need help dealing with systemic racism/homophobia/sexism have special and specific emotional needs.

    I don’t see why someone earning in six figures can’t afford to shell out a few bucks if it’s so desperately difficult for them not to be a douchebag without spending that money. I also don’t see why hospitals, clinics etc can’t shell out the same few bucks to ensure that much for poorly-paid employees.

    My own grandmother was in the healthcare industry, and she only had an eighth-grade education. But it’s somehow a sign of racism that the health industry won’t make everyone in it understand social justice?

    Why isn’t the expense to give working-class people (who, believe me, are as likely as people of any other class to not be douchebags, once they’re educated on how not to be) some basic training in social justice deemed necessary? Oh I know! It starts with ‘sys’ and ends with ‘temic racism’. If you’re working with marginalised populations (and it’s funny how often healthcare professionals, especially non-doctors, are) who are experiencing massively stressful situations (as people seeking medical help tend to be), you’re damn right I think you should be educated in social justice. Not necessarily on your own dime, though.

  15. Not everyone in the medical industry has the time, money, intelligence, or educational background

    Oh and because I forgot to address the rest:

    Workshops are on paid time.
    If they’re too unintelligent to understand “hey, don’t be a douchebag” I doubt very much they could add single digits. I’ve routinely worked with special needs kids in the past and they had an exquisite grasp of how not to be douchebags, usually gleaned from experiencing others being douchebags at them. If a 8yo with autism, hearing difficulties, mutism and other physical disabilities can understand something, I expect people who are directly in charge of my bloody life to be able to.
    Educational background? I mean, EG addressed it beautifully up there, but ALL THE FUCKING LOLZ. Decency does not correlate with educational background.

  16. They do this kind of training, to varying levels — there’s a wonderful book “The Spirit Catches You and You Fall Down” that chronicles a hospital’s efforts in treating a young Hmong girl — where her family and the doctors have wildly different cultural notions of what health and medicine mean. That was 1997.

    Since then, I know friends who are doctors and nurses, and I myself (in my short legal clinical work) who have read this book as a part of their professional training, in an effort to get us to be more sensitive to cultural needs.

    This kind of training varies in its effectiveness, because I think just the nature of being in medicine takes it toll on the doctors and professional staff — you see people day in and day out, all with similar issues and they tend to blur together; you frequently have more patients than time, resulting an emphasis on fast, superficial diagnoses and the dehumanizing of patients. Most people in medicine I know become jaded real fast.

    Anyway, I think it’s possible to frame the education of social justice, (or not being a douche bag, or whatever it is) in a way that can appeal to medical professionals, and that is that — it makes you a better medical professional. As is evident from Candice’s story, ignoring the implications of social justice in medicine means that doctors are less effective at what they do. The questions that are in their textbooks aren’t necessarily the compelling questions to ask–they don’t get the kind of full medical history and narrative that is crucial in really understanding symptoms, how the medical problem arose, and making a proper diagnosis.

  17. not sure if this is relevant to the discussion but …
    http://abcnews.go.com/WNT/Health/story?id=131719&page=1

    also I’m not sure what profession was being referenced above when it was mentioned but “computer people” usually only have to get “people” training when they have to work with “end users” like IT consultants at large companies or help desk staff. Most consultants, researchers, or administration and information security staff have little to zero formal required training in such areas largely due to the fact that their jobs don’t involve dealing with non “tekkie” people for the most part.

  18. “computer people” usually only have to get “people” training when they have to work with “end users” like IT consultants at large companies or help desk staff

    The only reason that it occurred to me to mention “computer people” has nothing to do with personal interactions with patients; it’s that hospitals have been known to say things like “the computer won’t let us do it” as an excuse for things like failing and refusing to change a trans person’s name on all hospital computer systems, when they were a patient both before and after transition.

    Something similar very specifically happened to me when I was hospitalized in 2007, on an emergency basis, at a major New York hospital where I had been a patient prior to transition: I was first told, when I gave my information in the ER, and showed my drivers’ license as proof of identification, that because my social security number matched my old name in the system, they couldn’t change my name, or put my legal name on my wristband, or call me by my legal name, without a certified copy of the court order that changed my name — something I don’t exactly carry around with me, or think of taking with me as I’m being rushed to an emergency room! And then, even after the friend who came with me convinced the person at the desk to change my name in the system, by engaging in some extremely persuasive double-talk, something about how my old first name was my married name, but I had since been divorced (!), there were still horrible problems because the hospital had more than one computer system and they couldn’t figure out how to change my name on all of them, or the system wouldn’t let them, or whatever the excuse was. So that when I was taken for X-rays, the technician realized in the middle of the process — my hospital gown was half off and my IV bag had been unhooked from the pole — that the name on my wristband (Donna) didn’t match the name on the computer system to which he had access, which resulted in his leaving me lying on the cot in the X-ray room for more than half an hour, half-naked and in great pain with the IV bag lying there next to me so that it filled completely with blood, while I could hear him through the wall discussing my situation with his colleague (including quite a bit of laughter). Not fun; a physician finally happened by and put me back together.

    So, yes, computer people have to be trained too in some way, I think. In addition to everyone else.

  19. “the simple fact that the health care industry is not [generally] educated in social justice, power, privilege and oppression is systemic racism.”

    And systemic sexism.

  20. Some medical (and other health-professions) schools have added required classes at the very beginning of medical training to teach students about professionalism, social responsibility, the doctor/patient relationship, and sociological impacts on patient care. They’d observed that a lot of their students had no concept of their own privilege and the fact that many–if not most–of their patients would be coming from different backgrounds and socioeconomic circumstances.

    The students just would have no empathy with a patient who, for instance, had be incapable of following the instructions given at the last visit, or whose medical condition had different personal implications than it might for another patient, or who had followed the instructions given at the last visit but they hadn’t produced the intended results. Now the schools are delivering instruction on actually, f’rinstance, listening to their patients and not automatically assuming they’re lying. And on appreciating the influences on health care that are out of the patient’s control. And on figuring out how to tailor health-care delivery to the individual patient. And on not being a dick.

    This kind of training is being seen as kind of revolutionary, because it’s something that schools hadn’t bothered paying attention to before.

  21. @Donna L

    FYI, problems like that in medical software are typically the result of a failure to keep up with upgrades. Something like the ability to change a name or have more than one SSN attached to a person seems very much like an original programing error and not one that is specifically related to LGBT stuff. After all, there are several reasons why a cis gendered person might have issues with the same computer system (perhaps they were victims of identity theft and had to change their SSN, perhaps they have only recently become a citizen and are in the “system” as a tax ID number and not an SSN, etc). Obviously I cant say for certian but it sounds to me like the hospital failed to stay current with the software patches available for the system they bought, sadly this is common in pretty much every industry, because a) some times the patches cost money and b) nobody wants to change anything in the system once it’s deployed because they “don’t wanna risk messing something up”

    FYI, there actually are HIPAA and PCI DSS compliance standards that hospitals have to meet in order to stay in business and both of those standards have stipulations about staying up to date with software upgrades for a whole HOST of reasons (including stuff like what you mentioned, but also because of security upgrades and stuff like Y2K) so I realize its a long shot but the next time you want to yell at somebody who says “well we can’t do that cus ZOMG TEH PUTER” you can say something like “uhh when the heck was that system last updated, is that up to compliance standards?!”

    Obviously the root of the issue is that the hospital staff are apparently such slaves to the computer system that they are incapable of doing their jobs unless the computer tells them to. Which is not to say the software flaw is not exactly that, a FLAW but the excuse of “well I can’t make the computer do what I want so I guess I just can’t do it” is pretty lame.

    I bet you if the cash register system had gone down they would have “improvised” a solution to get paid <_<

    oh, and for the record, most companies that produce medical technology do get regular training on things like patient experiences in order to make products that make things more comfortable for them. In fact, with most of the med tech firm's that I've worked with, most of the product architects are women 😉

  22. This kind of training varies in its effectiveness, because I think just the nature of being in medicine takes it toll on the doctors and professional staff — you see people day in and day out, all with similar issues and they tend to blur together; you frequently have more patients than time, resulting an emphasis on fast, superficial diagnoses and the dehumanizing of patients. Most people in medicine I know become jaded real fast.

    The process of becoming a doctor seems to 1) select for douches and 2) create douches of those who weren’t before. That’s one of the reasons that the training needs to be altered, not just the individuals blamed. (Not to mention they are usually dealing with the public at its doucheyist, which I’m sure doesn’t make doctors behave any better — not much positive reinforcement for going out of your way to improve.)

    We (the public) have a higher standard for people like doctors, but currently its an unrealistic standard thanks to much larger circumstances than just “oh, Dr. Y is a dickweasel and Dr. X is a saint.” Before blaming doctors I think the circumstances must be changed.

  23. “the simple fact that the health care industry is not [generally] educated in social justice, power, privilege and oppression is systemic racism.”

    And systemic sexism.

    And ableism, obviously.

  24. @DonnaL

    You are absolutely right about computer people. I remember sitting in my Java class and my professor writing out an outline for a Person class on the board:

    “So what data type would we use to represent gender?”

    Me, under my breath: “Don’t say boolean, don’t say boolean, don’t say boolean”

    “A boolean!”

    I sent a nice note to him afterward, and he was understanding, and hopefully changed that lecture. There was also an instance this year where I attempted to get the input for gender in a study given to all statistics students changed from a binary input to an open ended one. Even though everyone at every level was amenable to the idea, it still took many meetings to finally find the person who could change it.

    What some people in this thread seem to fail to understand is that when you encode heterosexism and associated oppressive gender constructs into a computer system, it acts to oppress all non-conforming individuals who have to interface with it even if that wasn’t the programmer’s intention.

    That’s why we call it “systemic”.

  25. As a former military policeman, I’m thankful that the army had mandatory how not to be a dick training (regardless of how effective it was), simply because it took away any excuse to be a douche. At least someone warned you.

  26. What some people in this thread seem to fail to understand is that when you encode heterosexism and associated oppressive gender constructs into a computer system, it acts to oppress all non-conforming individuals who have to interface with it even if that wasn’t the programmer’s intention.

    I’m going to assume you mean me…

    for the record a) I mentioned a very specific subset of programers who do get training in order to avoid such mishaps and b) there are a lot of “computer people” who are not responsible for writing applications at any level that are for consumer use, and as such do not typically require such training.

  27. the next time you want to yell at somebody who says “well we can’t do that cus ZOMG TEH PUTER” you can say something like “uhh when the heck was that system last updated, is that up to compliance standards?!

    The problem is that it’s too late by then. People who have to go to the hospital on an emergency basis are generally in no position to start interrogating people about the computer system, or otherwise advocate for themselves. And they don’t always have a friend with them, like the friend I was lucky to have with me back in 2007.

    Which is one of the reasons that we’re trying to have hospitals have a system where there’s someone on call — an ombudsperson trained in LGBT and specifically trans issues — to advocate for patients, with the authority to get things done.

  28. I guess in short, I would agree, but I would also say the issue of “my medical professional refuses to disobey a computer program” is a massive problem and can or does lead to not only LGBT problems but problems for everybody period.

  29. Whether it’s bullying or computer systems, God forbid we ever acknowledge that something generally bad might hurt LGBT people more, because then we might have to actually deal with the reality of systemic discrimination.

  30. Absolutely, dead. The training we’ve been talking about should — at least in theory — help all marginalized populations, including all the issues Kuttin Kandi talks about. I didn’t mean to suggest that it’s only for LGBT people; that’s just the focus of the committee I happen to be on.

  31. While I agree with the general idea that further education/training is needed for all health care workers, I really wish we could have discussions about health care that do not devolve into how doctors are all asshole douches who make tons of money.

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