My last name “Theetha Kariyanna” has its origin from a small village Theetha and added to it is my dad’s name Kariyanna (a local folk god). Back in my school days, the name was weird to my friends as the name Kariyanna also literally translates to “black brother.” As a kid who was hesitant to loudly say his name clear and loud, I have grown up to say my name loudly with pride as I often do: “Hello there, I am Dr. Kariyanna, your heart doctor today.” I was likely hesitant to say my name loudly because of its literal translation and the fact that it easily discloses my roots in the Kuruba community — sheepherders of south India who fall into the shudra category of the caste system. The fear and hate for the caste system started very early on in my life.
Incident 1: Once a friend of mine made me meet a clinical psychologist of Indian origin who took no time to make fun of my last name. This was followed by, “If you don’t mind me asking which caste do you belong to?” The man himself “belonged” to a so-called higher caste. All I did was blank out for a few seconds, felt disgusted and answer his questions.
Incident 2: I was casually talking to an attending of Indian origin who had recently graduated from residency. Upon asking him as to how he prepared for ABIM exams, he mentioned “reading the MKSAP thoroughly”; that was expected part of the answer, but then came “well the majority of residents of Indian origin in my program belonged to a caste X. I was constantly differentiated, I wanted to show them caste has nothing to do with one’s performance and ability to be a good physician. So I really wanted to do well in exams.” I was clueless as to how I should respond.
Incident 3: It did not take a long time for a colleague of Indian origin who immigrated to the U.S. approximately 35 years to ask which caste I belonged to. When I replied with my caste, a sort of sympathetic words followed from her, “Well, you are a physician now despite being born in a lower caste. This makes you higher instantly.” I had little time to respond as I was expected to scrub in for the next procedure. But as I washed my hands, I thought, “What if I was not a physician, will that make me less of a human being based on my caste?”
Recent research has shed light on challenges faced by dalits (the “untouchables”) in United States. The trends of intolerance, violence, physical and verbal abuse towards people of lower castes are much higher and in alarming rates, all in this land of freedom and equality America. It is the right time for federal and state governments of the United States to make caste-based discrimination illegal and punishable by law. American hospitals perhaps can be role models by initiating this timely and just action first. Until then many from “lower castes and Dalits” will continue to suffer in silence.