7-Opinion
I
almost drowned at a birthday
party when I was five years old.
Upon arrival at Water Country,
New England’s “safest and friendliest”
waterpark, I had raced into a crowded pool
of seemingly-still water. Little did I know,
this was the Wave Pool: a 700,000-gallon
tank of water that mimicked the nearby
Atlantic ocean.
The
wave-generating
machine
operated on a timer, thus creating
waves that rapidly increased in size. I
progressively struggled to keep my head
above water. Each time I would return to
the surface, gasping for breath, another
monstrous wave would topple me over.
Underwater, I managed to cling
onto something — swimming trunks.
In an attempt to stay afloat, I pulled on
them, hard. So hard that they fully came
off of their occupant. But my efforts to
surmount the wave tank were to no
avail.
Five
minutes
later,
I
was
unconscious, submerged at the bottom
of the pool. There was a seemingly-
excessive number of guards on duty
— over a dozen of them — perched in
gleaming red chairs that lined the tank’s
perimeter as if they were spectators in
an amphitheater. Yet not a single guard
noticed until a swimmer found me,
horrified, and called for help.
The next thing I knew, I was reclined
in a poolside lounge chair, breathing
through an oxygen mask and flanked by
paramedics and concerned swimmers.
When I came to, the large audience that
had gathered anxiously stood up and
applauded.
I was fine. Everything was fine.
Being diagnosed with attention
deficit hyperactivity disorder at 20
years old was cathartic; everything
finally made sense. But I couldn’t stop
thinking of that day at the water park,
and I grew angry. Just as I had displayed
signs of being a distressed swimmer, my
ADHD symptoms had clearly presented
themselves throughout my childhood.
In both cases, the people who were
supposed to protect me had failed to do
so. I had slipped through the cracks.
My memories of ADHD symptoms
trace back to early elementary school.
With time these symptoms worsened,
but my teachers reinforced that I was
simply “ditzy” or that it was “just my
personality.” When I communicated
my symptoms to my doctors, they
reassured me not to worry; it was “just”
my anxiety disorder. I had mentioned
my suspicions of ADHD to my therapist,
who would laugh and respond, “Marina,
if you had something, you would’ve
been diagnosed in kindergarten.”
In reality, girls with ADHD are
underdiagnosed and undertreated for
numerous reasons, including gender
bias in research. According to the
American Psychological Association,
girls with undiagnosed ADHD will
“most likely carry their problems
into their adulthood, and if it is left
untreated, their lives often fall apart.”
I initially felt that my healthcare
professionals had wronged me. Part of me
felt grateful, though; my missed diagnosis
had only decreased my quality of life — it
was not life-threatening or fatal.
Nonetheless, diagnostic errors are
often fatal and are not discussed enough.
While policy change and structural
reform are necessary, patients can gain
more autonomy in their health outcomes
by making changes in how they interact
with their providers.
Diagnostic errors include diagnoses
that are initially “missed, wrong, or
delayed.” John Hopkins researchers
found that diagnostic errors represented
the “largest fraction of (malpractice)
claims, the most severe patient harm,
and the highest total of penalty payouts.”
In the United States, 12 million people
face medical diagnostic errors every year,
and it’s estimated that 40,000 to 80,000
of these people die due to complications
of misdiagnoses. Despite the prevalence
of these mistakes, diagnostic errors are
understudied.
They are frequently “underreported
or poorly reported” as oftentimes
patients don’t self-report errors — experts
downplay the full extent of them and
most hospitals don’t even track diagnostic
errors. The rate of errors to “accurate”
diagnoses is estimated to be about 5%,
implying that these errors affect at least
1 in 20 U.S. adults, while other research
estimates that “10-20% of all diagnoses
are inaccurate” in the U.S.
Furthermore,
this
rate
of
diagnostic error may be much higher
for certain populations. Numerous
existing disparities in diagnosis are
thought to particularly concern race/
ethnicity, age and sex. A high rate
of patients who have experienced
diagnostic error reported perceiving
the visible factors of being African
American, female and a young adult
as a contributing variable to their
diagnostic error for even the most
serious cases, such as strokes or heart
attacks. The maternal mortality rate,
which is disproportionately higher for
Black, American Indian and Alaska
Native women and increases with age,
has also been associated with missed
or delayed diagnosis.
How can we learn to trust our
providers, our hospitals and the health
care system as a whole? According
to the National Academy of Medicine,
systemic racism and institutional bias
have been shown to “(manifest) in lower-
quality healthcare.” Additionally, the
U.S. has an extensive history of medical
racism and malpractice exploiting Black
Americans, Native Americans and Puerto
Ricans, so it is understandable that
minorities tend to have higher levels of
physician distrust.
There has been an increase in interest
and understanding in the complexity of
diagnostic error over the past few years,
and the ECRI Institute has even labeled
it as “the #1 patient safety problem
in healthcare today.” The Society to
Improve Diagnosis in Medicine and
over 60 other health care organizations
are collaborating to reduce both health
disparities and diagnostic error. But
individuals,
especially
members
of
communities that have been historically
abused through medicine, may reasonably
remain skeptical of their health care
providers and feel powerless to the health
care system.
As patients, we are often instructed to
be “consumers” of medicine, but no one
ever seems to tell us what that means. Self-
advocacy is the key to gaining agency in
your diagnosis and health care treatment,
and here is what that looks like.
Use differential diagnosis to confirm
your diagnosis: Think like a detective,
eliminating clues to reach a conclusion.
When you receive a diagnosis, ask your
doctor for their steps in reaching the
diagnosis. Ask for all of the possible
diagnoses that your doctor considered
and why each one was eliminated. In this
process, you could realize that a potential
diagnosis was falsely eliminated.
Don’t be afraid to take notes. Write
down the names of the rejected diagnoses
and any other information you find
important. In case you later suspect a
misdiagnosis, you’ll have a backup plan.
Prepare for your appointments like
you would for an exam. Come with an
idea of your expectations, any boundaries
you want to have and questions. You have
the right to decide what your treatment
plan is. If you’re not comfortable with a
proposed plan, ask for more information
or other options.
Ultimately, trust yourself and your
body. If something doesn’t feel right,
vocalize it to your provider or someone
who you trust that will help you take the
next steps. Additionally, don’t be afraid
to get a second opinion. You deserve to
feel respected and comfortable with your
provider. Sometimes it takes many tries to
find the right person.
While
you
probably
cannot
singlehandedly resolve the “diagnosis
crisis,” you can learn how to consume
health care to your advantage. The cracks
in the system may be, in reality, gaping
holes, waiting for an unlucky soul to
stumble upon one of them. You might find
these cracks in waterpark wave pools, in
doctors’ offices and other places where
you least expect them to arise. And once
you learn how to navigate these spaces,
you might gradually rebuild your trust
in them. Medicine is one of humanity’s
most important creations, so it must be
equitable and accessible to all.
N
ames
have
power.
They
can
both
recognize
and
infuriate a person. Take the
case of legendary Indiana University
basketball coach Bob Knight. He was
under a zero-tolerance policy after
multiple disciplinary issues in 2000.
Then in September 2000, a student
reportedly referred to him as “Knight,”
not his preferred “Coach Knight” or
“Mr. Knight.” That minor detail sparked
a confrontation that ended up being the
straw that broke the camel’s back: Coach
Knight had to leave.
The power of names, however, goes
far beyond just a single person. We just
had to search for a more lasting tribute
for truly exceptional personalities, and
we found one — naming monuments
and places after people. What better way
to permanently etch their names and
legacies into history, right? Whether we
should name anything after a person is
a futile discussion. We’re long past any
reasonable point of return on that subject.
As soon as we added value to naming
places after people, everyone started
queuing up for a piece of the pie. With
politicians, comedians and well-off
college alumni, you have diverse pools
of people willing to pay to get their
name memorialized. Meanwhile, other
groups have another motive for jumping
into the name game — control. The
Lost Cause of the Confederacy, which
attempts to falsely portray the racist
actions of the Confederates as a noble
effort in defense of states’ rights against
Northern aggression, did precisely that.
They erected multiple statues and fought
aggressively to rename places after
Confederate figures to control history
and intimidate those who would oppose
them. This occurred in earnest around
World War I, with military bases named
after Confederate figures along with a
flurry of statues, novels and plays meant
to perpetuate these false ideas.
This situation leaves us with a mixed
bag of personalities among those who
share this originally exclusive honor of
receiving a monument in your namesake.
Quite a few of them end up being
unsavory characters; maybe a name
has colonial or oppressive origins. The
obvious step is to rename. For example, it
is ridiculous to have military bases named
after Confederate generals that fought
against the nation. However, there’s one
issue that we run into quite quickly —
emotional attachment.
Why does this happen? While we’re
usually adept at recognizing the flaws in
the people around us, we develop blind
spots when it comes to our idols. We deify
some personalities, deeming them heroes
capable of no wrong. That is setting
ourselves up for failure. When faced
with the inevitable flaws in a hero, we
have two choices: accept them and grow
disillusioned or cling ever tighter to their
mythical image.
Hence, we see opposition to renaming
efforts, even in the case of military bases.
There can be justifiable criticism towards
the right for naming military bases
after Confederates using ill-formulated,
emotional arguments. At the same time,
renaming in itself indicates a diminishing
of one’s honor — removing someone’s
name indicates that they don’t deserve
to be honored or remembered. Here
is where those who’d like to remove
memorializations of controversial figures
wrongly assume that all cases should
be as cut-and-dry as the Confederate
name case. Renaming can cause massive
division and confusion, as evidenced by
the San Francisco school renaming fiasco.
Before delving into the school
renaming proposals, let’s explore our
perception of Mohandas Karamchand
Gandhi, better known as Mahatma
Gandhi. Maybe the mention of Gandhi
reminds you of Ben Kingsley’s portrayal
with iconic quotes like, “An eye for an
eye will make the whole world blind.”
(Incidentally, this quote is misattributed
to Gandhi.) Or perhaps you think of his
inspiring impact on leaders like Martin
Luther King, Jr. to pursue non-violent
protests.
As a person of Indian origin, Gandhi
holds mythical status as a hero of the
Indian independence movement and a
source of pride. However, Gandhi is also a
man who espoused racist stereotypes and
supported segregation during his time in
South Africa, participated in a twisted
celibacy test by sleeping with naked
women about 60 years younger than him
and treated his wife Kasturba dreadfully.
He has a complicated legacy that isn’t
reflected in his public image. One might
contend that he shouldn’t be celebrated
and honored, but that is perhaps an
oversimplified view.
Opinion
Wednesday, March 17, 2021 — 11
The Michigan Daily — michigandaily.com
BRITTANY BOWMAN
Managing Editor
Stanford Lipsey Student Publications Building
420 Maynard St.
Ann Arbor, MI 48109
tothedaily@michigandaily.com
Edited and managed by students at the University of Michigan since 1890.
CLAIRE HAO
Editor in Chief
ELIZABETH COOK
AND JOEL WEINER
Editorial Page Editors
Unsigned editorials reflect the official position of The Daily’s Editorial Board.
All other signed articles and illustrations represent solely the views of their authors.
Julian Barnard
Zack Blumberg
Brittany Bowman
Emily Considine
Elizabeth Cook
Brandon Cowit
Jess D’Agostino
Andrew Gerace
Krystal Hur
Min Soo Kim
Jessie Mitchell
Zoe Phillips
Mary Rolfes
Gabrijela Skoko
Elayna Swift
Jack Tumpowsky
Joel Weiner
Erin White
EDITORIAL BOARD MEMBERS
Read more at
MichiganDaily.com
SIDDHARTH PARMAR | COLUMNIST
MARINA WAGNER | COLUMNIST
THEODORA VORIAS | COLUMNIST
Siddharth Parmar can be reached at
sidpar@umich.edu.
Marina Wagner can be reached at
mwagnerr@umich.edu.
Theodora Vorias can be reached at
tvorias@umich.edu.
T
ake a short walk across the
University
of
Michigan’s
campus and you will see no
shortage of Canada Goose jackets,
Hermès bracelets or Gucci sneakers.
These aren’t objects that the average
college student — let alone the average
adult in the United States — can easily
afford, but based on our campus, you’d
think they were. Wearing designer
clothes isn’t an issue in and of itself, but
it does become an issue when it is the
result of unchecked privilege. Mar. 12,
2021, will mark two years since the news
broke of “Operation Varsity Blues” — the
infamous college admissions scandal
which brought to light the lengths
America’s elite will go to ensure their kids
get into the country’s most prestigious
universities. It galvanized the public
and sent shock waves through college
campuses across the country. To this day,
scrolling through social media comments
of those involved will show you people
are still upset. While the anger and
frustration toward the guilty are valid
and understandable, years later we have
still failed to recognize that the problem
is so much more than cheating your way
into college.
While attending the University of
Michigan, where 66% of students come
from households in the top 20% of the
income distribution, I have witnessed
first-hand how deep elitism runs on
college campuses. It’s easy to point our
fingers at those who cheated their way
into elite universities and call out their
moral failure. It is a lot more difficult to
call out the systems of privilege that get
under-qualified students into colleges,
even when they don’t pose as a star athlete
or pay someone to take the ACT for them.
Students who grow up in higher-income
households live in their own world of
privilege that gives them all the resources
they need to not only get into top colleges
but then rack up achievements not
accessible to those in lower family income
brackets.
What the media failed to recognize
in the whole college admissions scandal
was that the college admissions process
is based on much more than just grades.
Even if grades and test scores were the
only criteria, students coming from
high-earning households have access to
resources such as tutors and fancy pre-
college programs that aren’t available to
low-income students. Those resources
can help increase test scores and fluff-up
applications. Extracurriculars, school
prestige and legacy status all factor into
admissions as well.
As for extracurriculars, attending
private or better-funded public schools
gives students more opportunities to
participate in prestigious clubs — such
as the debate team or Model UN — or
in sports — like crew and fencing — that
aren’t offered at less well-off schools.
Even outside of school, families that can
afford to pay for private piano lessons
or sailing lessons help ensure their kids
stand out to college recruiters.
A student’s ties to a university are a
big contributor to getting rich kids into
schools that they otherwise wouldn’t be
able to. In recent years, legacy students
— those who have a family member that
attended the university they are applying
to — have been disturbingly more likely
than the average applicant to get into
top schools. At universities like Harvard
and Princeton, legacy students are four
to five times more likely to get admitted
than those who don’t have family ties to
the school. Of course, a “philanthropic”
donation to a university before your child
applies could easily do the trick as well.
Students who don’t have to worry
about the cost of tuition also have a
powerful
thing
that
lower-income
students don’t have: options. To be able
to choose where you’ll spend four years
of your life and to handpick a school that
is the perfect match is a privilege that is
often overlooked. For many low-income
students, just being able to attend college,
whether it be a community college or a
state school, is a blessing. We often forget
how inaccessible college education has
become for so many students. Nearly
70% of 2019 graduates had to take out
student loans. This barrier to entry,
exemplified by the staggering difference
in matriculation rates among students
from high-income families and low-
income families, is something you don’t
hear well-off students complaining about.
The college admissions scandal
shouldn’t only have taught us about how
unjust the college admissions process is.
The way students spend time outside of
class in college are vastly different and
are often perpetrated by family income.
While some students are getting initiated
into elite secret societies on campus or
spending spring break partying on the
yacht of a chairman for their school’s
board of trustees, lower-income students
are often working low-paying jobs just
to make rent for the month. If you’re
fortunate enough to have your family
cover your tuition and living expenses,
the opportunities available to you
drastically increase, whether they be fun
extracurriculars or unpaid internships.
Prestigious universities that gate-
keep lower-income students create an
environment that allows many rich
students to be blind to their privilege.
The University of Michigan is all too
familiar with this issue. It has been widely
criticized for its lack of socioeconomic
diversity. It’s apparent from campus that
the University is not your average state
school. I will never forget a conversation
between two students I overheard during
my first week on campus. One student
complained about not knowing how to
do her own laundry because her maid
had always done it for her. Her conclusion
was to hire a maid service at school
because she simply couldn’t be bothered
to do her own chores. The other student
complained about her father not booking
her a first-class seat for her flight home
for Thanksgiving. I was shocked. Though
those may be normal conversations on
campus, they are problems most people
could only wish to have. The worst part
was how oblivious the students were of
their privilege.
The elitism of students at the
University of Michigan and at so
many other top universities is perhaps
more apparent than ever. The college
admissions
scandal
brought
the
conversation of elitism among students
from high-earning families to the
national stage. However, the conversation
didn’t go far enough. There is much more
progress that can be made in identifying
the systems that allow students from
high-income families to get ahead. It
starts with admissions counselors and
university administrators making a
concerted effort to place equal value
on prospective students despite their
socioeconomic status.
What the college admissions scandal
didn’t teach us about privilege
I slipped through the cracks in the health care system. You could too.
What’s in a name?
W
hen I first started watching
the 2017 Netflix original
series “Girlboss” a few years
ago, I fell in love with Sofia Marlowe’s
entrepreneurial spirit and fearless way
of living. Despite discouragement from
her father, a man at a consignment shop
and seemingly everyone else on her
path, Sophia successfully launches her
own business, Nasty Gal, an online retail
store which upcycles and resells old
clothes. Against the odds, she believes in
herself, stays true to her vision and never
compromises her style because of others’
judgements.
When I reached the end of the
first season and discovered the show
had been canceled, I was dismayed. I
had discovered a new role model who
inspired me during a time when I felt
so much pressure and competition from
academia. I was disappointed in Netflix
and its viewers for not seeing more value
in a show with such a uniquely strong
female lead. Sophia Marlowe’s fictional
story, based on company founder Sophia
Amoruso’s path to founding Nasty
Gal, is exactly what the business world
needs more of: inspiring tales of unlikely
leaders pursuing their dreams.
On one hand, being a girl or woman in
entrepreneurship is amazing. In a world
that is always telling you what to wear,
how to do your makeup and how to act in
the presence of men, entrepreneurship
provides a unique space to make your
own decisions. It’s one of the few places
where women can be free to define for
themselves how to do business. With that
said, being a woman in entrepreneurship
also comes with unique challenges.
When women do find the courage to
follow our dreams, we face both external
and internal sexism. And while the
experience differs for everyone based
on their identity, it’s something that no
woman should have to deal with.
Liisbeth,
an
“indie,
feminist
‘zine
about
post-capitalist
entrepreneurship,”
published
an
article in 2019 called, “Gaslighting:
The Silent Killer of Women’s Startups.”
Gaslighting, as described by The
Guardian, is a form of “psychological
manipulation intended to make the
victim question their sanity.” The term
was coined from Patrick Hamilton’s
1938
play,
“Gaslight,”
in
which
the husband, Jack Manningham,
convinces his wife Bella that she is
going mad by secretly turning the
lights on and off in the house. The
idea is that if you think you’re going
mad, you’re more likely to trust the
manipulator’s judgment calls more
than your own. In entrepreneurship,
this can look like seemingly innocuous
phrases such as, “Are you sure that
actually happened?” and “It was just a
joke,” according to Liisbeth.
Although gaslighting is an issue both
in personal relationships and in the
workplace, I would argue that an equally
measurable problem is internalized
misogyny. How often do we think
subconsciously to ourselves, “Because I
am a woman, I need permission from a
man to have an original idea?”
Even at the University of Michigan,
women are undervalued in the hiring
process. In the undergraduate Center
for Entrepreneurship, women represent
just 26% of the faculty. Only 42% of
American businesses are run by women.
While hiring more women to hold these
positions is absolutely necessary, these
roles are not going to change overnight.
To quote Sophia Amoruso, “You don’t
get taken seriously by asking someone to
take you seriously. You’ve got to show up
and own it. If this is a man’s world, who
cares? I’m still really glad to be a girl in
it.”
At least part of the challenge of
the modern woman entrepreneur is
to pursue her own ambitions without
regard to others’ judgments –– to create
for herself, not for the critics. By focusing
on her own empowerment while
understanding how sexism is ingrained
in the culture, she gives herself a more
immediate chance of achieving her
goals. While men must be held to higher
standards, at this point, we can’t count
on them.
Going into International Women’s
Month, what I want women and girls to
know is that you don’t need permission
from anybody to follow your dreams.
Your ideas are brilliant and there are
people who will support you, even if
there are times along the way when you
are the only one who believes in your
vision.
LILY CESARIO
| COLUMNIST
Lily Cesario can be reached at
lcesario@umich.edu.
Sexism in entrepreneurship