I wrote the following e-mail to one of my mentors:

"The second thing I wanted to just tell you about is an incident involving a white classmate. This classmate is involved in RAP sessions (Real Answers from Peers), which is a panel of MS2's giving advice to MS1's about studying; this is for all MS1's. LMSA and SNMA* are holding their own RAP session for the MS1's who are interested in LMSA and SNMA. And this white classmate said, "I don't like segregated privilege." I haven't said anything to him and don't know if I will. His comment brings me back to our summer institute. And now I have this internal conflict about saying something or not, and disappointment in myself for fearing confrontation. =T"

*LMSA is Latino Medical Student Association and SNMA is Student National Medical Association, which is focused on the needs and concerns of medical students of color.

And this was her response:

"Finally, I get it about the dilemma about what to say. What do you think he meant? That it's a privilege to be only one of a few whatevers....women, LGBTQ, African Americans, Latinos, children of immigrants, etc. and these groups need to get out of the "majority' group's session whatever support they can, but not have the opportunity to receive from their own gathering things that might be distinct for that particular dimension of identity that is salient to them? Does that mean there should be no AMWA, no AMSA, because there is an AMA? Does he mean that he is not allowed to come to the Latino or African American presentations?

I can't tell you what to say and if to say it. I feel the weight of your calculus, as I have had that decision to make so many times.

What is it you fear in saying something to him? Is that thing worth it to you to not say anything?

Will it be useful to say something, or will it make it worse? Will it be worse only for a time, but worth it in the long run?

Will this person receive the feedback, or is he just toxic?

Is there a way to voice for these impressionable students and classmates that YOU believe there is a place for groups where people feel comfortable, that recognizes that some issues may be distinct to some identity dimensions?

For you personally, Jenny, with your work and whatever emotional load in your life you are carrying, is it worth remediating someone else and the energy that takes? I'll tell you, I should have energy to have conversations with strangers and acquaintances about "the Help" book and movie, but I can't right now.....I just don't have the energy to monitor my responses and what that person needs from me to have it be a constructive situation.

Is this someone you have a special "in" with that someone else might not, and thus he won't receive feedback in a constructive way unless you are the one to give it to him. Is he a friend?

Is he hostile about the topic, in which case, someone has to counter him and not let his daggers go un-neutralized. Someone has to be gangsta about it, just as he was so aggressive and forward...

Is he someone you can take aside and talk to in private, so that it isn't confrontational, and it isn't received confrontationally because you embarrassed him in public.

Lots of questions, Jenny. The answer is "It depends," but yes, you do have a special responsibility, given what you know, and that you are in a relatively privileged class of folks (the unfairl social construction of Asian American) who roll within the academic medical center (more so than say, LGBTQ folks, Latinos or African Americans). It would be a constructive, impactful surprise, coming from you.

As always, Jenny, so many of these things depend on timing. I have missed so many opportunities I thought I should have taken advantage of, given my relative privilege, or propensity or knowledge without privilege, within that context. Sometimes the best thing you can do is think through what you might have said or will say if the opportunity comes up again. Your heart will listen for him and anticipate his comments in similarly charged situations, believe me. Even a question like, "Can you explain more about what you mean when you say that?" is powerful. It takes the silencing power away from an act like his that's meant to silence, intimidate, or even notify others that he is struggling, perhaps seriously albeit sarcastically, with something.

Unfortunately, only you can answer these questions. Make a decision, develop a plan based on that situation, then let it go. There will be a million other times in your life, and this may be one of very few opportunities you were attuned to this dilemma and your sense of responsibility in it, yes? It is terribly important that you answer them for yourself before you are the senior resident, or Attending, or senior medical student....Remember, think developmentally, not just like you only have one chance to make a difference and this was it.

I hope this helps. It's a great question. Please feel free to call if you want to talk more. I support you and am proud of you either way. It means alot that this is on your radar."

A lot to think about. Man, I already think too much.