The Activist: Erica Li, MD

Dr. Erica Li is a pediatrician in Washington.  She went to medical school at UC Davis and trained in general pediatrics in Los Angeles.   She has been interested in Critical Race Theory since about 2017 and has summarized the implications about its application to medical practice on her website,  She also has a broad set of interests both within and outside of medicine.  In medicine, she is deeply interested in helping trainees approach clinical problems by mapping out a chain of cause-and-effect, such that each node in the chain can be examined as a potential opportunity to interrupt pathology.  Outside of medicine, she enjoys playing piano and SCUBA.

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Dr. Li’s Prescription for Success:

Number 1: You do not need to subspecialize.

Number 2: Where you match doesn’t matter. Just be pleased to match.

Number 3: Dating is very hard in medical school.

Number 4: It’s normal to have doubts about your profession.

Connect with Dr. Li

Twitter: @criticalmedtheory
YouTube: CriticalMedTheory

Notable quotes from Dr. Li’s interview:

Medical ethics as we know it and Critical Race Theory is not compatible.

Medical trainees shouldn’t assume that you have to subspecialize.

I very much embrace “small L” liberalism.

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Access the Show Transcript Here




[0:00] Before we get into Today’s show I want to tell you about a new offering from MD coaches.
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But that there is a big wide Road between saying that racism doesn’t exist anymore and that is a fundamental organizational force of the entire society and that we have to look for it,
and engage your confirmation biases wherever possible.

[1:07] Music.

[1:12] Paging dr. cook paging dr. cook dr. cook you’re wanted in the o.r. dr. cook.

[1:20] Music.

[1:42] Hello everyone and welcome to prescriptions for Success I’m dr. Randy cook your host for the podcast which is a production of MD coaches.
Providing leadership and Executive coaching for Physicians by physicians.

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Visit MD coaches on the web at my MD because you’re not in this alone.

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[2:20] Well my guest today is a pediatric hospitalist in Spokane Washington.
She has a particular interest in critical race Theory as it applies in medical practice so let’s hear my conversation with dr. Erica Lee.

[2:38] I am really excited today to be speaking with dr. Erica Lee who is out in Spokane Washington and.

[2:48] Erica welcome to the program and I’m really looking forward to our conversation thank you so much for having me because I think your origin story,
rightfully begins with your parents if you don’t mind I would really like to,
start there tell us how your,
how your parents found their way to this country and what it’s been like for you as the child of immigrant parents oh thank you very much for asking that my parents were.
She bore in the 40 East 1940s and.
Shortly after China was taken over by the communist so in 1949 I was the year that my mom was born.
And so when they were teenagers that was the height of the cultural revolution but by the time the code the cultural revolution occurred there had already been the Great Leap Forward which caused.
Total economic collapse and there was a three-year period in the 50s called the it’s labeled a natural three-year famine it’s nothing,
natural it was completely due to policy failure from the maladministration and then of course I has left a lot of.

[4:13] The satisfaction and problems and catastrophes like that tend to feel revolutionary Spirits there are scapegoating and all that kind of sentiment,
and so the cultural revolution happened,
in 1970 1967 and lasted about 10 years that was an exceedingly violent.
Time when young school children and University students were ugly radicalized and brainwashed to the point where they were.
Going to exact violence upon their own parents and grandparents and so at that time people were divided into red categories and black categories and the.
Black types of people included there were like nine categories like spies.
Capitalists industrialists so forth and the red the categories of people consisted of,
revolutionary Martyrs families and of course the martyrs are dead so their families by association to get the rent status there’s a factory workers for farmers,
revolutionary soldiers of the people’s Heroes and when you divide up a society like that based on these.

[5:34] Music.

[5:46] A lot of violence and that is what happened yeah that is what happened so that the black camera people were completely scapegoated.
Yeah my parents were children of.
Christian ministers Christian ministers were consider I guess they were considered intellectuals but also due to the Western Association as Christianity is a western Colonial,
religion according to these identity.

[6:15] Politicians and other red guards which were you know they were not police they were not military they were Sons and Daughters of regular people who have been brainwashed by commissars,
they would forcefully enter people’s homes and ransack them to find.
So-called evidence of counter-revolutionary activity and it’s a complete Witch Hunt right like they will find things like a piece of piano music oh if your into western music we want to,
without this Western culture how did your parents managed to escape well they didn’t really escape this room they stayed throughout.
I have an uncle we’re not no other particle that close to but he swam from mainland China too long.
And actually my parents were not able to immigrate but there was an opportunity for my grandmother to,
immigrated in 1980 that my parents at that time decided to send my four-year-old sister moment and we were able then able to immigrate later and reunite.

[7:42] And so were you I was not really clear from looking at your background information where you born
in China were you born in Shanghai in Shanghai okay and so how old were you when you came when you all came I was 10 years old wow that really brings up my curiosity what was the
culture shock for you like as a 10 year old and a new country it is it will be the fact that I didn’t speak any English I learned the worst and pull on the airplane bathroom doors
so my first,
first English words and then one of the things that caused me a lot of anxiety was that like my English improved
pretty rapidly over the next but it takes like two three years like people say oh you can fit in then three months that’s yes nobody can learn a new language in three months when you’re not born but it takes about 23 years to be proficient.
In the language and by the time I went to middle school.

[8:47] My English was reasonably good and then I was placed in the in the slow class because they just look at my background you’re an English learner and,
I just was inappropriately placed academically in a class that.
Was not a pro like it was too slow for me and I had like a lot of anxiety regarding how I’m not being productive and not learning as much as I could,
so you were in a public you were in a public school and and they had they had a curriculum.
That was making an attempt to help you transition to functional English but it sounds like it was really nice.

[9:39] The best am I hearing it right well I haven’t really spent a year in a the Chinese Education Center in San Francisco.
Which which helps children from Chinese speaking background to to get caught up,
was learning English but then what was high school like for you I mean my goodness high school was tough I went to lull in San Francisco and you might have heard of it in the news currently
there is like a lot of controversy about being a merit-based admission for emissions but basically you have to have the academic,
you have to prove yourself academically in order to get into law.
Any significant problems getting into Stanford where you did your undergraduate work there are very successful people who attempt to apply to Stanford and do not,
and do not get in so.

[10:35] Hey I just I guess I was lucky to have and so at what point along that trajectory were did you begin thinking about medical school the summer after junior year.

[10:48] Because I that until up until that point I didn’t really have a plan yeah I was.
I guess like all idealistic kids interested in Saving the planet,
I was kind of doing stuff with conservation conservation biology I did some internship I did like a Wildland studies for summer I was like a Environmental.
Intern for another summer and then I just realized that I didn’t really have a career plan so,
it’s like I was not pre-med up until that point and had to do all my pre-med stuff senior year who needs a plan when when
your object is to save the planet exactly so
well so in that in that junior year was there something in particular that that you can point to the sort of pointed you toward a career in medicine or it was meeting the right people
so I was like shadowing a genetic counselor I thought okay maybe I’ll,
I guess I can be a genetic counselor I have an undergrad and just just add a couple years and I be,
I will be in health care and stuff tough and then she she introduced me to her boss who was a Urology professor at UCSF.

[12:12] So that was that was kind of yeah what turned me around but then then I became like pre-med in my senior year and so I was not on track to to start medical school.

[12:23] After I immediately after I graduate I had to have a couple of years off too.
To finish all my pre-med yeah I noticed that you graduated with a ba and that would indicate that maybe there was some sort of some more science to be.
Obtained but once you got there once you got the UC Davis,
did it feel right I know a lot of I for one particularly back in the years when I was in medical school the first couple of years thought well gee this is just more College.
Did you feel like you were in the right place when you got there or did did it take a little adjusting I think so I think.
I think it would mean I was really nice but there’s a brand new Medical Campus they Davis at that time had just relocated from.
Davis the town to Sacramento where the medical center was it some point along the way you clearly made the decision that you wanted to.
Be a pediatrician did that come early or did it take a lot of thought it’s another late finding I was,
Pediatrics was my last 30 year rotation and I think it has to do with again like the people who are nice nicer.

[13:38] That and the fact that I.
I realize that there are a lot of intellectual stimulation associated with the field,
I don’t think anybody has ever put it to me that way and the tell me some more about the intellectuals that you found in the Pediatrics Department
Pediatrics is probably in terms of its problem-solving approach is closest to Internal Medicine.
But the prognosis and the patient population tend to do better than Internal Medicine patients.
That’s for sure yeah and then also I’ve realized that parents tend to know their Children’s Medical.

[14:22] Problems better than older patients who would know about themselves.

[14:28] That there is like something about like having children and take on the responsibility and being a parent that allows them to appear to be.
Generally quite invested in what is going on so you got that decision out of the way
but then you make a geographical change you’re going to do your training Los Angeles so tell us what their residency was like oh The Residency was
I really enjoyed I think that that was a much better time than Medical School medical school is kind of developmentally awkward.
As a stage 0 and I didn’t really answer your question about the intellectual stimulation.
Aspect of pediatric and there’s just there’s so much pathology that you have to you have to know it’s very it’s a very broad field of notes that the.
Like neonates are nothing like a 19 year old.

[15:29] And the differential diagnosis for any set of complaints has very very different so there’s there’s a and then you have to know a little bit of
she mons little bit of infectious disease a little bit of you know each organ specific in urology Nephrology Urology or that
well that’s kind of stuff so there is definitely a lot of material.
To master and to integrate to be effective as a pediatrician and then when I went to LA,
it’s a great Department I think the leadership is is superb and my personal academic advisor was the chair of the,
starting when I was an intern so that’s a little bit intimidating but it also shows that generally that just doesn’t happen like in most departments.
As an intern you don’t hang out with chair yeah I don’t think I’ve ever heard of that so.
That’s pretty cool and I’m was there,
a difference in the sorts of pathology that you were seeing for example between Sacramento and l.a. County.
There in Sacramento I was a medical student so I only had I don’t know like a couple of months worth of contact with Pediatrics maybe like a little more during.
During fourth year the fourth year you’re doing like you’re away so it’s not Sacramento but Lala was struck me was.

[16:59] As a pediatrician you don’t people go into Pediatrics not thinking that managing gunshot wounds will be part of their bread and butter there was a lot of gunshot like some sort of violence related.

[17:12] Emission evolving either stabbings or gunshot mostly 10 shop in the in the Adolescent population.

[17:21] Which is not why most people want to become pediatricians but that’s part of it and then the other big population that gets emitted a lot of course or the cancer.
Cancer pop.
Second call it oncology this those become you know the ones that come a lot so you actually had some exposure to those trauma patients at l.a. County I that I would I would.
I would have imagined that they would have surgical staff they are to deal with that but did you did you have a fair amount of exposure to the to the to the trauma
anybody who is under 18 I think at least has to have a pediatric consult.

[18:05] That’s just the hospital so with those types of like yeah those types of surgical cases it’s generally a co-management model,
between a primary hospitalist team and the surgical team
hi I’m Rhonda Crow founder and CEO Forum D coaches here on RX for Success we interview a lot of great medical professionals on how they grew their careers how they overcame challenges.
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[19:25] We’ll get back to our interview in just a moment but right now I want to tell you a little bit about physician Outlook
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you know in the early in the early years of my practice
as a surgeon everybody did their own intensive care but as as it got more complicated you really did have to have a love of the profound changes that I’ve seen I think I would probably rank that as
number one so but anyway the supposed to be a conversation about you let’s get back to you at some point I guess you who you were in that role.

[20:59] For three years or so and then made the decision that you wanted to move up to Spokane and become a hospitalist and,
won’t you just tell us what was behind that decision.
Los Angeles and California politics and governance making it less appealing as a place to live and raise a family.
Price of the the skyrocketing housing prices a lot of policy failures that’s
causing a lot of civil Strife well that’s a good reason really good reason to go somewhere to improve your your living conditions and and you made the decision at that point to continued in the role of a hospitalist
rather than get into,
you know the Private Practice thing that you want to tell us how you came to that decision well I think that’s really what I know how to do when I was at in,
well I counted big county yet University of Southern California I was also a hospice you’re moving into a role that you are already.

[22:07] Familiar with so sexy Yes except the it’s not a academic center so it’s more.
So it’s slightly different there are no well we supervise interns but not in Pediatrics like there are other Specialties interns and we don’t have any senior residents so.

[22:30] So it’s a very different I mean so basically we are supposed to do all the work as opposed to just look over what residents,
I want to segue from that now into what really caught our eye when we were looking for someone to interview,
and that is your interest in critical race Theory as it applies in medical practice and I have to say that I have just absolutely been fascinated by what I’ve seen on your,
website and things that you’ve written so tell us,
how this whole project came to be guess I got interested in it because of how it heightens the identity politics that,
I talked about earlier during the Chinese Cultural Revolution some of our,
most esteemed medical societies are starting to embrace it the American Medical Association straight up just says that we want to use tools from critical race theory in order to achieve equity.
And Equity is not defined as fairness it is defined the way that Ibrahim X Kennedy has described to use,
discrimination now against previously groups like racial groups that were.

[23:50] Discriminating against other groups in the past.
And that just Harkens back to what was happening during the Chinese Cultural Revolution where groups of people were,
given the category black category and systematically scapegoated.
Saying that you previously had privileged so you were seeing things that cause you to remember.
Some of the unpleasantness that you.

[24:23] Experienced in the country of your birth well I didn’t personally experience but it was it’s definitely a multi-generational.
Trauma that got passed down so it’s not something you experience but you were aware of it I think would have been a better would have been a better way for me to pose the question but.

[24:45] But something I’m interested to know from you so you you are someone who has seen this to occur to the extreme do you think that.
Human beings or sociologically wired to separate it or Cypress separate ourselves into groups,
I don’t think children do that unless someone instructs them to do it what do you think yeah that I mean that leads to a lot of Entry Intergroup violence when arbitrary when people suffer themselves based on arbitrary.
Characteristics which is why I very much Embrace like smelt small-l liberalism,
seize the universal like there are certain things that are universally true among all human beings and according to critical race Theory which has been which has a huge post-modern,
influence that posits that there is no such thing as an individual or something that’s Universal.
All politics is based on group identities,
and you clearly have done some serious study on this subject and I want to enthusiastically recommend to our audience that they check out your website which is highly instructive and.

[26:08] Maybe you can just give us a little description of what can be found at the website and while you’re doing it tell people how to find it because I think it’s a really brilliant piece of work.
So it’s critical Med critical is the word and the med Meed,
and I go through just some vignettes some of them are real almost all of them all of them are real vignettes and I.
Don’t like to tell people what to think but I go through a comparison between the values that are espoused by a critical race Theory.
Again it is our medical societies are pushing this for example according to the association of American medical colleges which all medical schools belong to they say that.
Faculty have to role model how knowledge of intersectionality informs clinical decision-making.
Or that faculty Medical Faculty should teach how systems of power privilege and oppression inform policies and practices and how to engage with systems to disrupt oppressive
practices I mean this is like straight out of some maoist or.

[27:23] So like communist book but.
I just explained how the this set of values compare and contrast with,
the medical ethics that we learned about in medical school and you decide I have some practice like discussion questions at the end that allow the reader to decide.

[27:51] Whether you want to embrace this me this value system versus that but what I do establish is that.
Medical ethics as we know it and critical race Theory or not compatible.

[28:06] What I think is most brilliant about the website in fact is exactly what you just.

[28:12] What you just were talking about in that is there are far more questions in there than they are answers and clearly that was,
the effect that you intended to bring about is that am I reading it correctly.
Yes because nobody likes to be told what to think and I do not do that on I don’t tell you what to think on this website I explore just five domains.

[28:41] Well they’re usually in pairs so the first domain is truth.
Truth and knowledge so I can his power and privilege third individual ality and agency forth Justice equity and fifth is humanism and civil rights so those are the five domains that I explore and compare and contrast
the values of critical race Theory versus,
humanism and medical ethics well you’ve done a brilliant job of addressing the subject.
On the website I’m very impressed with it but I’m interested I’m interested to know how this.

[29:21] Affects your own practice in your own way of life how how do you start a conversation on this subject,
without starting a fight well I think most people don’t know a whole lot about this subject to spite the fact that it is a national conversation,
but there is one that makes it scary from the outset,
I think most people are actually pretty curious and that I don’t try to tell them what to think I just tell them,
that these are what is critical race there how to define it well it is the belief system predicated on the idea that white supremacy is the fundamental organizing has four fundamental organizational force of society.
Do you think that’s true right like.

[30:07] We can explore whether any of its claims is true and whether there is evidence for what it claims,
and I listen to what they have to say and if they have like personal experiences of racism validate that.

[30:24] I’m not like those of us who are fighting against critical race Theory and its encroachment into Medical Practice none of us would,
ever make the claim that we are completely over racism and doesn’t exist anymore.
But that there is a big wide Road between saying that racism doesn’t exist anymore and that is a fundamental organizational force of the entire society and that we have to look for it,
and engage your confirmation biases wherever possible.
Well it’s a really incredible piece of work that you have out there and I and I truly do.
Encourage people to take a look at it do you.
On a day-to-day basis try to encourage to do you try to engage people in conversation on this subject or.

[31:15] You just sent people to the website not what I want for sensitive comes up I think that it’s really important for us to not be afraid,
to talk about it because intimidation is a is one of the tactics,
that’s used to silence people when we try to push back especially coming from my background I have parents that survived the cultural revolution.
I think that my perspective is very.

[31:46] Relevant indeed it is and I have really enjoyed this conversation up to this point but we have reached the point dr. Eric Ali where I’m going to close my mic and get out of the way,
and audience dr. Eric Ali is going to offer us her personal purse,
prescriptions for Success one of the ideas I would like to explore and and promote is that.
Medical trainees shouldn’t always assume that you have to sub-specialized during training I was pushed,
pretty hard by almost all of my mentors who I all love and respect to do a fellowship and become a subspecialist
and the reason they do that well partly because it’s that’s what they are and academic Medical Center and also because I’m perceived
to be to enjoy intellectual stimulation and explore subjects deeply.
But right now I finished a very influential book to me called the range are Ang range by David Epstein,
and she makes a great argument about how generalists are.
Some of some of the most important people that can change a field for the better and to innovate.

[33:12] So I would say that one of my advice to people who are thinking about going into medicine or or are at different.
Stages of training.
To not always assume they’re so specializing is the way to go fellowships are always out there even if you have been practicing for some time.

[33:35] You can still go back to fellowship.
But once your sub-specialized one of the things that limits you would be like where you could live because Medical Center would probably only need,
like a handful of nephrologists a handful of cardiologist but it would have a great need for a bigger need for for General
pediatricians or general surgeons or what have you I mean I also very much appreciate,
the advice or the consult I get from subspecialist so if you have a personality and a passion go for it for two sub-specialized but,
not that’s not for everybody and the sub specialization in medicine
according to dr. Jerome groopman book how doctors think the the special specialization Trend tends to give medicine a false sense of.
Certainty whereas a lot of diagnosis require you to,
to be interdisciplinary and think across different organ systems different disease categories.
In order to make an accurate diagnosis.
Other things that young people should keep in mind where you match probably doesn’t matter that much.

[34:59] Just be happy that you have matched.
And don’t don’t feel bad about yourself if you didn’t get your top choice or top two or three.
Where you where you match is where you’re meant to be and and you should celebrate that.
Also dating and trying to find a partner is can be pretty hard in medical school or residency it’s very common to break up when people can’t deal with long distance relationships,
that certainly gave me a lot of anxiety when I was in medical school and training especially as a woman,
because women generally tried to find men whore.

[35:42] Equal or higher status of but not only did I get married.
Grill a little bit late compared to the general population I’ve got married when I was 34 and still have time have time in time to have two kids most of my other,
girlfriends who were going through training cool complain about.
Not being able to find a man at the time most of them got married as well so you do have to put work into meeting people.
You can’t just like sit at home and wait for the FedEx guy or the mailman to you have to get out there and it is work but.
It also for most people does work itself out and having kids as great I do encourage you to have kids.
And not necessarily wait until you’re done with training like there is never a great.
Perfect time to have kids it’s a lot of work but children tend to distract you from all the other things that that may be happening at work or in the world,
and their Bright Smiles and Giggles they they’re really quite medicine for the soul.

[37:02] And finally it’s normal to have doubts that you pick the right profession,
being a doctor has many benefits I don’t regret going into medicine,
I know that you may hear a lot of stories about there about how everybody is burning out everybody is encountering moral injury the hyper corporate or corporatization all the.

[37:29] All the bureaucracies that is encroaching upon medicine and all of these policies getting pushed by our Medical Society especially injecting critical race Theory into medicine all those things are negatives but.
It doesn’t mean that having that relationship and taking care of patients is no longer a worthwhile Endeavor I do encourage people to consider medicine as a,
career and that I’m I’m still happy to have,
become a doctor and there are many aspects of my job that I enjoy both the interaction with the patients and the intellectual stimulation involving trying to find,
diagnosis for symptoms are there a little vague and difficult and having colleagues to to bounce ideas off of,

[38:28] It’s normal to doubt yourself but medicine is a good field and that’s my prescription for success.
Well dr. Erica Lee that is some really good advice and I have to tell you that I’m really enthusiastic about you’re putting up there in the,
forward position to don’t be afraid to be a generalist because it is very satisfying I did my training.
At a time when not everybody became a super specialist and I remained a general surgeon throughout my practice and I really really enjoy it for exactly the reasons that you outlined and I thank you so much for bringing that up,
I also thank you
I also thank you for just being here to share your story with us it’s been quite fascinating before we go I want to give you an opportunity to tell our audience.

[39:24] Where you can be found where to find your website and anything else you like.
Share whether it be email addresses or whatever so what would you like us to know so critical Med is my website against that see RIT.
I see Alm Ed the0
And my email is the same thing critical method very critical Med Theory at I’m on Twitter using the same handle.
As well and I also just started a YouTube channel with the same branding.
Well dr. Eric Ali once again thank you so much for being here it’s been very informative in a lot of fun and I appreciate you taking the time thank you so much appreciate inviting me on the show.

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