Dr. Sun Hoo Foo
Chinatown Interview: Interviewee
Chinatown Interview: Interviewer
Chinatown Interview: Date
Chinatown Interview: Language
Chinatown Interview: Occupation
Chinatown Interview: Interview (en)
Q: Today is July 14, 2004. I am Ingrid Dudek and this is the Chinatown Documentation Project. Can we start by giving your name?
Foo: Dr. Sun-Hoo Foo.
Q: And your profession.
Foo: I'm a doctor.
Q: What I wanted to do today is talk about your personal and professional background in relation to Chinatown and Chinatown community medical needs and especially surrounding the events of 9/11. Let's start a little bit with your background.
Foo: Okay. I was trained at NYU. That was in 1976, Bellevue Hospital. I was told at that time, “if you see a Chinese patient in emergency room you are pretty sure they are very sick. They won't come up there until they are very sick”. So pay attention to them. After that I practiced -- my office was at 34th Street. And it takes a while, like a year sometimes, for patients to come there to see me for consultations. So at the end saw I should have office down here so that they can come. Now, to a lot of Chinese, “uptown is like a foreign land. It takes them years before they can go up there. Mainly because of the language problem. They don't how to get transportations. They don't know how to get there, and they're scared to go to place so they are not in Bellevue unless they are very sick.” So there was a reason of saying that. I think it's also true right now on basic care. I work very closely with Chinatown community. I'm a Director of Neurology -- I'm Director of Neurology at Downtown Hospital. I'm also on the board there, working in the hospital. We also have foundations called CCPH -- Chinese Community Partnership for Health -- that we do a lot of health screening, patient education in Chinatown area, because we know there's a problem here. Now, of this thing that we did from the CCPH, I published many articles on strokes. Now, strangely – and I'll tell you this -- if you live around Chinatown area there's official statistics that can tell you that “young stroke rate is about 50% higher than any part of the United States. By young, we mean anyone less than sixty years old”. We also look at our patients in Downtown Hospital. We found “our patient is seven years younger to have strokes compared with the [Northern] Manhattan [population]”, you know, north part -- you know, there was a study looking at different ethnicities, you know, in northern Manhattan, to see how the strokes is. And they look about -- look at them: black, Hispanic, but no Chinese. So we compare us to them and it’s seven years younger. And of the person who have strokes, many of them have brain hemorrhage. And as you know, the incidence of cerebral hemorrhage, it's about eight percent in the nation. But it’s up to 24% at Downtown. With hemorrhage in the brain you have more [physical] deficit and give you more problem. And we found that, although we cannot tell [if it’s properly] genetic whether it is so, but we know many of our patients have hypertension and it's never been treated. We also compared the data we have from the Chinese Community Partnership for Health, the screening. We have more [patent] hypertension, [and] more hypertension not treated. If they are treated they are not following up well. [We] also have a lot diabetes and hyper cholesterolemia, so we know all these are respective. And I'm very happy I could work with NYU recently. They have a grant [form the NIH to] establish [the] Asian health center to look at the health disparity among minority I think and it's starting very well. They just planning to set up a [liver] center at Bellevue, and other things will probably follow. And I hope that we can do a lot more for the communities.
Q: Obviously you have a great deal invested in the Chinatown medical community. I just want to back up a little bit and talk about what was your experience working in midtown and seeing how Chinese people related to the health care system that brought you downtown? At what point did you move your practice to Chinatown?
Foo: Well, I worked at Downtown Hospital very early on. But the offices were just like in the last six years.
Q: And you've been down here regularly for over twenty years?
Foo: Right. Right.
Q: Well, how have you seen, chronologically maybe, medical resources changing in Chinatown in terms of what's available and how people approach the medical system?
Foo: Well, I think you have to tell about the approach in two ways. One is, those who don't have insurance, [new] immigrants or those who are American citizens and works here. Now, if you know that we have a [medical] society [called] CAMS -- Chinese American Medical Society -- that started in [the] 50s. It expand now, we have about 800 members, mostly locally, and of that membership we formed something called CAIPA, so Chinese American IPA [Independent Practice Association]. We partner with Oxford -- we have a health care network of about two hundred physicians, and Dr. Tak Kwan is the president of that [CAMS]. We are one of the most successful IPA, and it's the only one that really do something for the [Chinese] community. Now, one thing that's different from us and other IPA is, our doctors work very hard. They work Saturday and Sunday, they open late, and Doctor Tak Kwan our physician, our president, sometimes he finish [work after] twelve o'clock. At night. So by doing that we are more accessible to patients. Especially a lot who do two or three jobs, and they have no time to see doctors in the working hour. They can't afford to do that. So they come on weekend and see us. So I think we are in touch with them on that wave. And also because of the culture issues, we probably knows their problem better than other -- better than our counterparts. Chinatown Clinic Health Clinic, also called Charles Wang, is doing a lot for the communities. For those who can afford and don't have insurance they really provide very good care. But Downtown Hospital, as I mentioned earlier, we have also clinic devoted for these communities. We established actually a Chinatown Partnership for Health -- sorry, wrong name, Chinese Community Partnership for Health -- that do regular screening, you know, radio shows. Health talk in different [public] places and workplace so that we get a message that, personally, and Dr. Tao and Dr. Leung and I in the office have a bi-weekly column at the World Journal that we publish regularly, the health issues in that newspaper and it is, of course, written by the staff reporter [reporter Eva Pan]. And at the end of it [the article] we do have numbers, with a hotline for patients to call, so [if] there's a problem regarding any health issue they have, or insurance, they can call. And this is staffed by CCPH of Downtown Hospital. Sometimes I get calls from Vancouver or Florida to ask for help. So this is how we try to get to the community to help them.
Q: So all of these professional networks are partially directed at getting the community to engage with their own medical. Do they also pick up the slack for people who don't have insurance?
Foo: Well, just the Chinatown Health Clinic, the Charles Wang Community Center. But from a professional standpoint there is more exciting happening. CAMS -- Chinese American Medical Society -- is not only local but national. We also form [an] international [organization]. This is something called Federation of Chinese American Medical Society, [we] partner with a physician, Chinese physicians from Toronto, Vancouver, and trying to talk about issues related to the Chinese community. We have a conference, international conference, every two years. Between here and San Francisco. This is the twelfth conference that's going to be set up on October, this year, talk about all the issues that related to Chinese patients. So the one I was talking to you about, like the strokes, is presented in that place so that everyone knows. So you go to our web site, you actually can see the abstracts of that. So we try on our part to work on the communities, try to get people interested in the issues. Because we do have problems that are not related, or are much less important for other communities, but it's important and it would be a big issue [for the nation] if it's not treated. Chinatown -- The Chinese Community Partnership for Health actually did a study not too long ago looking at hepatitis B in the school. And we really are trigger a national response of having everyone to have hepatitis B vaccine, because there's such a high prevalence of hepatitis B in our communities. So it's almost become epidemic, that you have to do something about it.
Q: Where does that come from?
Foo: The hepatitis B? Well, it's from the kids, and we found that the immigrants have high incidence than those that are born here. And it's transmitted, you know, sexually, in close contact. So if you don't treat that, it will be big health issue at the end and you can develop hepatitis B and cirrhosis and hepatoma. So we actually started it, NYU Downtown actually started that project.
Q: You had mentioned earlier that one of the assets of all of these organizations is that they're specific to the Chinese community and understand the cultural issues that are involved. I'm wondering if you could speak more on what you see the cultural issues are that are related to the Chinese medical needs.
Foo: Well, as you know that there's a Chinese traditional treatment for diseases, talking about ying and yang, talking about hot and cold. If you don't know that, it's very hard to treat them. Most of the patients don't like to go to hospital because their language is a problem and the customs are different. For example, this we have been working for a long time is when they go to the hospital they want hot water. They want warm water. They don't want to have cold water, because cold is bad for you. And you ask the staff to give you hot water, they think you're crazy. “No, we drink cold water.” I mean, that small thing will give you trouble. You know? Or when you eat you're not used to the Western food, so at Downtown do have cook that specially do thing for them so that they feel more comfortable. I mean, someone who are sick in the hospital, all these small things get very bad. The other thing is about getting blankets. When you sleep. You don't want to have too much blanket on you. But traditionally they feel very cool, they want two or three blanket. And the staff make it -- they feel that, gee, you're crazy, you want three or four blankets, it's no good for you. But however, that's how they used to. So small thing like that can make a big difference. You take care of it.
Q: I'm wondering, too -- you had mentioned that there were a number of outreach programs, like on the radio and in the papers. Are those in Chinese or how do they work?
Foo: They're in Chinese. And although this is a very small community, I think we have at least five or six newspaper, Chinese newspaper here, if not more. And most of the immigrants, when they come here, they don't have time to learn the second language. It's very hard for adult to catch the second language, especially to work three jobs and take care of the family. So all these things I'm talking about [are] in Chinese, and [we’re] trying to get to them with their language and then give them information that they need.
Q: So -- what -- I want to keep talking about the big picture in terms of, like you've been describing a very pro-active situation in terms of community and the medical institutions taking an interest in specific community needs. Do you feel that has always been the case?
Foo: I think the momentum is here now. I mean, it's coming up. I don't think it's there before. The Asian Health Center just started. From NIH, from the grant from NIH. In the past, no one cared about it. Now,
I think the reason it accumulated to this point is, a lot of people are doing the work. And the communities, the doctors, we've been trying in the past and do that. And the hospitals did their part. You know, the Downtown Hospital, sixty-five percent -- sixty-five percent of patients are Asians. And they've been trying to work hard on trying to set the committee. The Chinese Health Clinic also started like -- what? -- I guess twenty years ago. I can't tell you the exact time. All this thing accumulate to the point that we all think that, we all know that this is going to be important. And so we were very happy then, you know. Today we have more people interested in trying to do something about.
Q: So you feel like it's the demographic change that people have to respond to, the realities of the populations downtown…
Foo: Yeah. I think people are more sensitive to -- to -- to minority issue, because they are not just isolated, they're important. And they not just affect the community itself, but if is not taken care of you affect the whole country as such. So in the past when you at journal, you look at study, we're talking about big population, we're talking about white, we're talking about -- you know -- Spanish, we're talking about blacks. But not so much about Asians. But the [Asian] population [is] increasing. We have about fourteen percent [annual] increase in Asian population here, in downtown area. And they get older, too. And they get sick, they get sick, too. So I think, you know, we need to look at the issues.
Q: So prior -- so prior to, say, this moment, has the burden is mostly the burden has mostly been on informal organizations to do the outreach?
Foo: You see, there's no, really, there's no organized effort to do it. I think Asian Health Center is the first one to try to use, to organize everyone together to work on these issues. And I'm very happy -- for example, I just mentioned that the liver center is established. Right away. And so when people looking at hepatitis B, cirrhosis, hepatoma issues on it. But before we reached that stage a lot of community people are working on it, to take care of the people, and voice that, you know. Not too long ago, I think, we have this Town Hall meeting -- this is initiated by the White House -- going to different places and talk about what the [health] issue is. Downtown Hospital, Chinese American Medical Society, and our counterpart in California -- there's a Chinese hospital there -- who will study on the program, taking your elderly and pick up all the information. We all went to the Town Hall and speak about it. I don't know if that triggered it but that, I think, helps. Because everyone is interesting and could join efforts and do something about it.
Q: What about post 9/11 issues? Because I know there have been, sort of, complaints or concerns that they were toxins in the air downtown, and that there was a specific medical commissions that were directed towards the downtown community. Did that -- did that outreach make it to Chinatown community? What is your sense of post-9/11 issues?
Foo: 9/11 was a very traumatic experience. I know that first hand, because our hospital is at Ground Zero. Although no one talk about it. Because we're right there, and no reporter can say there's no electricity, there's no telephone, and we functioned, just because of the good will of the workers there they do their best. We actually used cellular phones. And we have an emergency generator. Even at that difficult time we were able to go out for the communities and give them water, take care of the medical needs of the senior center that involved with the hospital. Also, because of [the blocking of] traffic, it's even hard for our patients to reach us, and we have a van go out to the community and get them organized. So there was immediate help, but after that I think the economy suffered a lot in this area. So this will affect patients able to get health care. Because they lost their job, they don't have things to do. Now, as far as the issue they're talking about, the pulmonary system, I think NYU have a team that comes down, and I think they registered people who are here that were exposed to that to see what will happen long term-wise. I'm a neurologist, I'm not a pulmonologist, I couldn't talk too much about that. But I think they are -- people are looking at it. I'm not sure it's enough target on that. But it really takes a lot of effort, a lot of coordination budget-wise to do it. So I don't know how far we are in that. But, yes, this may come out in the next few years, whether we all will have more pulmonary consequences on the exposure. But
I think that the main thing is the economy-wise, because we do lost a lot of patients. Because of their loss of their jobs they lost their insurance. They wouldn't be able to see patients. So that could be a problem.
Q: Have there been any efforts to ameliorate that issue in terms of economic loss and its relationship to health care?
Foo: Well, I think all of us working on this are trying to get helped. For example, I work at Downtown, I work very closely with them. Because of this problem, patients couldn't get to us, there's less patients coming in, and we could not help them. So we were trying to get help from the federal and from, you know, philanthropy to help the hospital in this financially stressed time. So that we can be strong and we can serve the communities. We are asking for help. We are -- we are looking at -- a lot of people are offering help so we need more.
Q: I know you work in neurology, but I was wondering if you could speak to your general sense of how Chinatown was affected by 9/11, generally or perhaps in terms of medical needs.
Foo: Well, we have Charles Wang that, in theory, will help anyone that needs help, whether you have money or not, or insurance or not, they will be able to help you. The question is whether, because of the economy down-turn, that [the resident will] have time to look into [their health issues], and you know that. I mentioned earlier before, because “when you see them in the emergency room they are very sick, otherwise they won't come in”. So you have to -- if they have to support to put food on the table -- they don't have time to go to see doctors, you can go to Chinatown Health Clinic or you can go to the Downtown Hospital, the clinic that we have is supposed to help them if they come and ask for it. We do encourage them to come. The question is whether they can come or not, you know, because of the -- they have to work on the other side. So I think we need a lot of help there. We have to revise economy in Chinatown.
Q: A lot of the reports that have come out have fixated on whether asbestos affects the issue and whether or not [INAUDIBLE], but it's like the picture you're painting is more that the institutional structures are there but the problem really is outreach and access.
Foo: Right. I think they could come in, we will help them more. Not to say that there's no increased asthma or other problems. I think, yes, they were affected. The other thing I want to stress is that the institutions are trying to research on this [cell phone rings] and see if all this effect can be studied and we can find a better way of treating, if it affects us.
Q: So what would you anticipate then is, say, a medical issue that is so far unaddressed, that you would like to see in the future.
Foo: You’re not talking in particular about 9/11, all right? Okay. See, we have our own things. Let’s say, nasopharyngeal [NPC] cancer. If you see that, it has to be Chinese or Asian, not other races. There's a lot of things to deal with it. Stroke issues, why we have so much [cerebral] bleed. Is that just because they are more hypertension that are not treated, or genetically there's a problem in it? The health issues, I mean, all this risk factor can be modified if it change. And there's a public health issue that can we get the message to the people and help them with that? Hepatoma, hepatitis B, I mentioned earlier on, “if you see a big liver, it is Asian, it is usually a tumor”. If other races, it could be due to, you know, big liver, fatty liver. But not Chinese. If you see that. When I went to medical school I was told -- I was trained in Taiwan – “when you see a big liver in Chinese patient it has to be hepatoma, nothing else”. So that's something that we know. Infectious diseases like TB, the immigrant may have the [infected area] focus in the lung, or they may be infected and if not treated adequately it could become a problem when they get older. So all these are issues that we have to work on and find out. Now, [beeper sound] traditionally people think that Chinese are a model minorities that don't have any problem. And we always thought that we are quite good, our cholesterol is very low, but you don't get the statistic our cholesterol actually is quite high. Now maybe because the Western food that we are eating over here, but that's an issue. It's not, you are thin so you don't have cholesterol problem. We also have a lot of osteoporosis. Fractured hips and things like that. And that's because of either genetic issues or because of the environment, you know, the food we're taking, or we're not exercising enough. So there are a lot of issues there that we have. Now, one of the things that Dr. George Liu [CAIPA president] is interested in is, we don't have even the normal data on us. Osteoporosis is just for Western data, not the Asian data. We should be able to look into that. And do it. So this Asian Health Center we established is trying to encourage people to do research and get grants and study all these issues. I think, in the next few years, I think we should be able to help us by working concentrated on this [Asian health], and having people interested in this.
Q: So these are all issues that you feel can be identified uniquely to Chinese people or Chinese communities. I'm wondering maybe more specifically what kind of patients do you see, in terms of background, in terms of what age people are.
Foo: Me, myself?
Foo: Well, I see a lot of patients -- I'm an adult neurologist -- so I see adults. But [due to] the nature of neurologist, we see a lot of older people with strokes, coming with strokes, with Parkinson's Disease. The geriatric population will eventually, you know, be what I serve. I also see a lot of young people, a lot of migraine patients, a lot of patients with back pains, [beeper sound] problems like that.
Q: So from that vantage point, I wonder if you could speak about how you see your patient population having changed during your career at Downtown. In terms of immigrant populations or economic backgrounds…
Foo: Well, I think, with the insurance changes recently, with this HMO coming up, it makes a big difference as far as what I see and where I see. And, you know, and I used to see a lot of stroke patients in the hospital, and it still does, but, however, we have less patients in the hospital because we are getting them out early from the hospital, so hospital practice become less -- we have more outpatient practice. Of course, it depends on where you [work]. I see my patients come in two groups. One is young, working class, and with a stress or migraine headache and with activities, you know, back pains. So that would be that population. But for the older geriatric population, I see a lot of stroke patients, patients with Parkinson's Disease, and chronic disease.
Q: And these people most often are coming to you through HMO's or other kinds of -- ?
Foo: Yeah, because HMO or just Medicaid, just geriatric populations.
Q: I want to go back a little bit to the 9/11 issue and see if you could talk a little bit more about what went on at the hospital, and what kind of things went on immediately aftermath of 9/11.
Foo: Well, if you are there the day of 9/11 it's amazing how the workers devote themselves to do it. I was at NYU when this thing happened. I was in a meeting. Came out and saw some smoke coming out from World Trade Center. Immediately I thought that I should come down. So I went to the garage to get my car, I turn around NYU three times, I couldn't get down because everything is blocked. I mean, [the police are] very fast at blocking. And I don't know what to do. And I think a lot of people don't know what to do in that. But I was -- I went there and talked to my daughter at Columbia [University] and she told me, 'Why don't you call the police?' So I just figure I just go and talk to a policeman. I said, 'Look, I have to go down to Downtown, because I work there.' So, no problem, immediately they get me down right away. But by the time I get down it's way too late. Because the two buildings was already collapsed. Within minutes, I think, there are more than four hundred people go to the emergency room covered with dust, and it's taken care of by the hospital, for their purposes. When I was there that wait is gone, and everyone is waiting outside for ambulance to come. And we see ambulance come in, come out, but really there are no patients coming in. We see mostly injured workers, you know, firemen and policemen coming in. It was very sad. But I cannot tell you, though, everyone is trying to do their best to help, and no one is talking about anything except to help the patients. The hospital covered by dust, no electricity, no telephone service, but everyone's there waiting to serve. It was very touching to look at it.
Q: And then?
Foo: After that, I think after that, we really worked very hard, we really have a hard time, because without telephone, without electricity, it's very hard to work there. But everyone have a spirit high up, and help each one, help everyone, [we went out] to the neighborhood [to offer help]. I think Dr. Logan at that time was asking doctors and nurses to go to the surrounding senior citizens’ [homes]. Because there's no access to them. We [brought] them water and try to take care of their health needs. So I thought that was very nice. We try our best to do it with the limited [resources] that we have. And after that, it still take a while before we get electricity back in.
Q: How long did that go on?
Foo: I really don't remember. It was a while ago. I know but it takes a long time to do it. No one talk about, you know, when they get paid, or whether they sick, or it's overtime, things like that -- they would just do it. So that was very good. And you look at a lot of nice people. You are very happy about that. After that, we do suffer, because there are a lot of roadblocks. Patients could not come into the hospital because they had to walk through all these blockades -- they are even there now. So patients don't come to the hospital, so we have a problem because they couldn't come access us. But I think it works out now.
Q: How long was it before things normalized somewhat?
Foo: In the hospital?
Foo: Oh, dear --
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Foo: Oh, dear, it takes a while, and I don't think it's still normalized right now. Because it does affect our -- the -- the -- the referral from the surrounding places even now. I mean, you know that the Chatham Square is still blocking there, right, so it's very hard to get from there to the hospital from that routes. And you cannot go to the FBI where the [INAUDIBLE] school and the building is to get to there. So we have a van service that is free for patients to come from Chinatown. We take them over to the hospital. But it's still not convenient. But anyway, we try to cope. We try to cope. We do our best.
Q: What was the general feeling in Chinatown at that time?
Foo: About the 9/11?
Q: Post 9/11.
Foo: Oh, it was terrible. You know, you are here, at that time, I remember -- I never see anything closed down -- closed -- in Mott Street. And I think not too long after the 9/11, I saw two or three restaurants that are closed in Mott Street. Which never happened before. And all the garment factories -- I'm told that there may be more than a hundred factories close down around this area, because there's no way you can get the product out of the place. There's no traffic. You can not get out. And being they're in trouble already, this just kill it. I'm told that now, if you want to have office in Chinatown it's very easy, because there's a lot of space opening up in the garment factories. So it's easier to get, and therefore real estate sending the rents coming down, and all that. But I think, if you know about Chinatown, the places that are closed down in Chatham Square -- it's [where] all the buses stop there for tourists to come and buses stop there. The tourists will go from that place, Mott Street, and go around and visit Chinatown. Being no bus over there, there's no traffic. So it's very quiet. I think it's better but, at that time, I think, during 9/11 even though you come to support the restaurants you can go in and you be the only one there in the restaurant. So it affects the economy very badly. What else I can say about it?
Q: At what point were different medical institutions responding to medical needs especially in Chinatown? You talked about Charles Wang but then there are also federal and state initiatives in Chinatown. Did those hit Chinatown?
Foo: Right. I guess it's all done locally. All locally, by local community. The Charles Wang, Downtown Hospital, physicians, they would just volunteer to take care particular patients. And actually, when the plane hit here a lot of Chinese physicians at Downtown. And suddenly this community volunteer and close their shops, close the office, and go to the hospital to volunteer their time. It's very sad that we had more doctors than patients given the events, but, really, there were a lot of people going to help. Now, some of the time -- I think, at that point, when it happened, most of the office are closed. Not because the doctor don't want to come, but he just no have access. You can't come here. And patients have no access to come to see you. I was in the hospital for some time, so hospital is open all the time. Anyone who wants care can come in. So I think it's a local effort to do that. Of course, it's not like the SARS or whatever, that we had to mobilize the whole nation to it. There's no need for that. It's probably all local effort. And everybody thinks it's probably busy, about what would happen during that time. And I don't think there is any special need. My son was a medical student at that time. They went to -- what is that, on the west -- the government actually set up a whole operating place in the Chelsea place, where you have many operating tables there. But, again, there's nothing [happening] there. Everything is set up. I think the government come and respond very fast on the disaster. But there's really no patients that require their help.
Q: Not in that way.
Foo: Not in that way, right.
Q: So you're sense is that the effects may be long term or --
Foo: Right. What will happen in the future. But I think whatever emergency at that point, it happen within seconds. Nothing help after that.
Q: You mentioned the SARS scare. What was your experience with that like? How was it different?
Foo: Well, it was very bad. I think it was [sounds like] worse. Now, at that time, although we know that there's no SARS in Chinatown yet, people look at us and say, 'Well, you're Chinese, you must have SARS.' So no one come to Chinatown to restaurant to eat at that point. If anyone is here you see all Chinese there, because we say we'll support the community, we'll come in here. And there's nothing -- so people worry about catching SARS, and this may be the place that you will have it. But fortunately we don't have SARS, but unfortunately it [did] affect the economy very badly.
Q: How long will that go on?
Foo: I can't tell you the time, but it [did] go on for a long time. Yeah. I think now the economy's catching up, but I think there are more things to do. And I don't know what else. I mean, I'm doctor, I don't know economy, but I think there are a lot of things you can do to stimulate economy.
Q: I wanted to switch gears a little bit -- because you mentioned your son was in medical school, and I wanted to get a better sense of your personal history. Because you were trained in Taiwan at the National Taiwan University --
Foo: Right. Yeah.
Q: Did you grow up in Taiwan?
Q: Where --
Foo: Well, I was born in Malaysia. I was growing up in Brunei, and medical school in Taiwan. Well, I think it's -- my family's spreading all over the place. Some are in Australia, and one was in Canada. That happened when my father moved down to Malaysia [from China]. And the reason for that is because of the war. So we were sent up there.
Q: At what point did you come to the States?
Foo: Well, what happened is, is I think it's very tough to grow up in Malaysia and Brunei, because you're so afraid that you don't have the identity. Although I work very well and very friendly -- I have a lot of friends in different places. So when I was in Taiwan, actually, I have a group of friends that are very interested in trying to make medicine into Chinese. So I was at National Taiwan University. When I graduate, our CR, which is Chief Resident, that translated Harrison textbook in internal medicine to Chinese. So hopefully we can use [Chinese] as a medium and probably get to our patients much easier. So the first thing I did. And then, spinning from that, we got a publication called Medicine Today that's targeted for practicing physicians using Chinese as a medium, to familiar them with their Chinese medical terms. And also, we spin out a magazine for public, called Health [World], which is still ongoing right now. So I was very proud that we could do that. And then, at that point, America's the place where you further your medical knowledge, so my father suggested, 'Why don't you go to America and learn more about it?' So I came over here. And fortunately I went to St. Vincent's at Bridgeport, and after that I went to NYU for my neurology training. And after I finished, with my experience in Bellevue, knowing that Asians don't go to hospital unless they are very sick, I thought, well, maybe I should come down to Chinatown. Be, you know, close to them. So they start all these things.
Q: In your work in translating the medical textbooks, was it because the education system was not so standardized?
Foo: Well, at that point, because Americans is top as far as medicine is concerned, so all the advanced knowledge, newer knowledge is from [the U.S.]. And Chinese, well, don't really have access to that. So if we can translate to Chinese we can bring this to more physicians, and to more patients, it would be a good thing to do so they can do it. One of the things very interesting at that point is [psycholody], there was a psychiatrist, Dr. Tseng, [who] was trained in Hawaii, came back and started a whole thing on us -- influenced really a lot. He translated a lot of psychiatry literature, including dream interpretations from Freud -- which I was part of together with my friends. So we tried to bring that knowledge to China. Now, talking about something, we do have problems, you know, of mental health in this area [Chinatown]. I don't know if you know that the suicide rates, you know, in elderly female are very high. Because of the culture changes most of the immigrants come here, work for the family, raise the family, and the children, although are very excellent, they don't necessarily have the same culture or the same thinking as [their parents]. And therefore, when they get old, when they retire, some get lost and don't know where to go. And it's very easy to see all the Chinese patients, geriatrics, you know, and found that they have depressions. They're all very depressed because [they think] it's time for them to die. There's nothing else to do. So Dr. Chung, Henry Chung, a psychiatrist, is trying to get a grant, work on the mental health issue on the area. And I think that's very great still. Also, part of the Asian Health Center that just started, that's the main issue I think we look at. So talking about twenty-something years ago, we think there's something to work on, and we need it now.
Q: You actually brought this up earlier, kind if in a different way, in terms of making Western medicine more amenable to Chinese cultural needs. Do you feel that psychology is difficult to address as sort of a really Western practice?
Foo: Well, I think you have to look at the cultures. Chinese and Western are very, very different.
I don't even know about the -- one of the main classics in China called 'Dream of the Red Chamber'. If you look at that and the spirit tells you how the Chinese structure is, family structure is, none of us [as individuals] are very important -- the family is important. And you are important because you are important in the family. So Jia Boyi, the young man hero in it, is just an ordinary person, but because he will inherit -- you be the spokesperson for the family, so everyone try to be friend with him and make him very important. If you lost that [status], you are not there any more. So in Chinese culture all of us are part of the whole family, and not individual. It's very different from the person who [is raised in the West]. The [second generation] Chinese, the immigrants over here, adopt the cultures here. It's very different, and I think even in China, because of the world is getting smaller, everything change. So you need -- you do need to look at that. It's very hard for a Chinese to see a psychiatrist, because it's such a shame -- you know, you're “crazy”, that's why you go to see someone. But -- but, it's not true. I mean, there are things that you can not talk, and value system has changed, so I think we have to work on that and help our people.
Q: So maybe this is another need.
Foo: Oh, yeah. This is the biggest need, I think. The health, the mental health issue, is a big need that everyone ignore. Now, it's rare to see a Western psychiatrist, also, because the culture's different. And the way you express is very different. And maybe you have something to say, you cannot express in English, and he just not going to help you.
Q: Is there a large Chinese psychology movement or mental group, even?
Foo: Well, I think we are starting. Of course there are -- being, you know, there are a lot of Asians now in the United States. There are more Asians study medicine and some of them will be a psychologist.
Q: To back up again…
Q: You have said after Taiwan you came to the U.S. and that's when you got interested in the Chinese community here. Do you live in Chinatown?
Foo: I don't live in Chinatown. I live in New Jersey. I thought -- at that time, when I first started,
I was a resident. And I look at the Water tower -- there's a building there. And finally I don't have money to live there. I think I am the same as [any other] immigrant when I came here with nothing in my hands. So if I pay all my salary in renting apartment my kids wouldn't be happy, and they would be disappointed. So I decided to go to Elmhurst, and stayed, and my friends helped me to do it. And when they get older I thought that, gee, they may want to be more in the culture, in the society, so the only way I can do is go to the suburb, where they'll be happy, with many -- with a lot of rooms to grow up. So I went to New Jersey, North Jersey, and raised them there.
Q: But even so, professionally and personally, you remain engaged in the Chinese and Chinatown community obviously.
Foo: Right. Right.
Q: Is there a community in Jersey?
Q: … where you live?
Foo: Well, I live in a very small community, but my main activities in Chinatown and Elmhurst. When my kids are small I took them to Chinese school. And if you are Chinese family, you know how hard that is. I took them, you have free time on Saturday and Sunday, I took them to school. They hate you forever. I have four children. I managed to do it with [the first] two, and the other two I gave up. I gave up. Because it's really a torture. They speak English, they don't speak Chinese in school, their friends speak English. You ask them to learn a language that's very tough and hard. They wouldn't do it. But fortunate thing, the world's getting smaller. When they go to college they realize that -- there's a language they have to learn. They have to learn. So they major in Chinese in college. And that -- and that -- because of that, I set up a web site thinking that I know something and I may be able to help them to learn Chinese and also know [some things about] Chinese cultures. And not only for them. Because I'm not sure how you affect them. So I put on a web site so that anyone, or my colleagues, can see it, and anyone who would like to know something about Chinese will be able to learn it.
Q: Have your kids taken up Chinese?
Foo: Oh, yeah. They major in Chinese in college. In college. I was surprised, because, you see, I learned Chinese the traditional way -- you speak, go to school, you read it, and we know, we used to it, to learn it. So we don't use “pinyin” using the alphabet to learn it. But what I found one day, my kids can say Chinese can say Chinese, can read Chinese, and find all the words. And I thought that they could not do it. So I found out -- I went to Internet using “pinyin”, typing “pinyin”, and they can found the Chinese words. And they can write it down. So it triggered me and motivated me to learn that. So by using that tool [“pinyin”], I said, oh, maybe I can tell them what I want to tell them, which I was not successful when they were younger. So [I] try to do that. One of the things I'm very interested in doing is [to teach them] to learn Chinese from painting. And when you look at a lot of Chinese painting, you love them, it looks good, but the -- you know, the words, the calligraphy of some really doesn't make sense to you. You don't know what it is. It looks good, but you don't know what it is. It's very important if you know what they're saying. Because that is part of the painting. One example I tell them, you can see my site, is lotus. Now, you may be surprised why there are so many lotus in Chinese painting. There is something like that. But there -- there's essay -- there was a essay reading on Lotus, and give you a lot of meanings to it. There's a lot of symbolic things that we do that. Well, on the site, I cite the calligraphy, I cite where it come from, I put down the whole essay. But there are a few things that are very important, I think, that they want to learn. Just a few words. It not only help them to build their vocabularies, [but] know the Chinese culture at the same time. So, why Lotus? Lotus is grown from a very dirty, muddy pond. But the flowers are very beautiful. The fragrance is very delight[ful]. It symbolizes the gentleman. You don't have to come from wealthy family. Not to say that's bad. But you can come from any ordinary circumstance. Even from the mud. But you can be a gentleman, and be very good, if you take care of yourself and learn about it. So that's what it is.
Q: I'm sorry. Just to back up to Chinatown. As an immigrant coming over, I was wondering if you could talk a little bit about how you've seen Chinatown change.
Foo: You see, there are two type of immigrants, the Chinese -- I'm in the fortunate one. Because I'm professional. At that time, during the Korean war, there's a need for physicians. So everything is helping me to establish my -- oh, I'm sorry, Vietnam war -- everything is there to help a doctor establish a practice and help me to raise my family over here. So I don't have to go to a restaurant and be a waiter, or try to get things. I've got my job immediately when I come here. All I need to do is polish up my English, get medical training. But financially, I'm okay. It's different from those who have to change their professions, who have no means of doing what they do well in their countries, to start from nothing. Without language, without place, crammed in Chinatown. The only thing you can do is either go to garment factories, or go to a restaurant and work as a waiter. There's no other jobs for you to do. So it's very miserable for a professor to come here and do that. And in fact one of my teacher came here, stay for two weeks and then went home. Because he could not stand it. I mean, it's very degrading, a principal of a school coming here to be a waiter. So very different things. I'm very fortunate I can be on this side. But for immigrants, a big struggle. Not only that you've changed but you don't have enough money, you have to raise the children, you have to wait from the tables. A lot of times they actually have to work two or three jobs to do that. So they're not taking care of themselves, health-wise or education-wise. So it's very, very sad. But I think you can say that for any immigrants. Not just Chinese, but --
Q: Would you say that's still the case for Chinatown?
Foo: Yeah. I mean, those who come over here, unless they're professional, they go to college, study, and do that, yes, they have to struggle for the same thing. That's why garment factories, restaurants is very important for them. With the economy downturn, I think, it's very bad for these immigrants to come here. Now, you go to Chinatown, you go to where they live, you'll be amazed at some -- how small the space is, how they crowd in a place. And how they have to work to make ends meet.
Q: Chinatown has such a long history of different waves of immigration, and it seems like there's always kind of a struggle to maintain a community identity, because once an immigrant, say, by second generation, has a bit of success, they're likely to move. Do you have any sense of how that's changed over the years? Do people come back more often now invest as in a way you have in services to the community and to Chinatown?
Foo: Well, I guess people who grew up from China had to go out, right? You can't just keep everyone over here. So, especially, you're doing something they are not, limited to local activities. So a lot of people could help. But I wish a lot more Chinese that are successful out there would come back and help [the community]. For example, we have tried to raise money for the hospital, because we have sixty-five percent of population are Chinese. It's hard to have successful Chinese come up from the Chinatown or come here to give us money so they can do more works for the communities. They're happy to give money to Columbia, to Harvard, because there's a prestige in doing it. To help a local community hospital may not be in their mind. But I wish they'd change their mind and help us more, so they can help more people here.
Q: Can the hospital appeal to the state or the government, or is it all philanthropy?
Foo: Oh yeah, yeah, of course, you know it must be the federal to help us. And if you know, in the last few years we even have Hong Kong -- Hong Kong stars to come and help us to raise money for this Chinese Community Partnership for Health. We have a concert every two years, and we have a lot of community help to help us to do that. So we do have people that want to help us, but we need more.
Q: Do you feel like medical institutions like your hospital are, in that sense, insufficiently recognized as important to the community?
Foo: No, I think people recognize it's important. The question is whether people will say, 'Okay, I will help you' more -- because you can't have people give you money to spend to use it with a -- with coming up with of the 9/11, and what happened to hospital is -- is we have less fund coming in for us. Now, give you example, right? Let's say, if their operating budget is a hundred million dollars. If your HMO cut down your reimbursement ten percent, well you lost ten million dollars. Everything else is the same. What if your [number of] patients drop, okay, [then] expenses goes up. We're only talking about small money. So we really have to do a lot to try to make the budget meet. But, you know, we do need people to help with that. We need people to help out with -- with the equipments, with things so that we can better service the community. I'm not saying that we don't have, but we need more.
Q: So the economic downturn affects everybody.
Q: Then what would you -- what would you like to see for the future of Chinatown? How do you see the future in Chinatown?
Foo: Well, Chinese people are very industrious. They work very hard. They complain not that much.
I think, you know, I want the Chinatown to prosper. What I can see there is that unless the economy change, it's maybe hard, now. We rely on garment factories, restaurants, tourists to this place. We have [a lot of] problem after 9/11. So it would be hard for us to do things. With new immigrants coming in they probably will concentrate in this area because the language issues, so we need more people working on that, giving them resources. Now, things that I mentioned earlier about the Asian Health Center establish, and we can do a lot more things for the community. This will help them help us to identify the problem, and help their health needs. The other thing I'd like to do is let more people interested in Chinese culture. I think it's very important. If you talk to people and people interested in your culture know what you are, it's a way of communicating. And that's why I put some of my efforts in “learning Chinese”. Not to say Chinese is superior than any other language, but it's a kind of culture for the last 5,000 years. There's something that's there that we can help other people to understand. So language is a problem. But you make it easy, which the computer that we have, and the new software that we have, other people will understand us more, and it will be great for America because we have a multi-culture society and it all works together, we know each other well, we can probably make this country a better place.
Q: Thank you.
Q: Is there anything you would like to say before we finish?
Foo: I’d like to work with the museum [Laughter] I was thinking about the -- giving more for the museum standpoint -- is giving more about the Chinese culture. It's one of the things I think, that I come across, is about the last name, surname thing. My father is very interesting, gave me about twenty volumes of the Foo genealogy that's published in different times. From that I can trace by my ancestor -- direct ancestor -- up to the first one. And even more than that. So I think that's very important, is how we trace our ancestors. How in the world you can know that. There are generation poem that we have. So, you know, most of the Chinese have three names, right? We don't have last name, we have surname. The surname is the first one. And the last one actually is your own name. In the middle is a generation name. You get your generation name from a generation poem. So if we both had the same surname, if I tell you what my middle name is you know my rank in the family. We sort of lost that nowadays, but I think it's something that might be interesting people to understand, our Chinese culture, how it comes. So I want to talk to the museum about that.
Q: So there's a cultural history there that is -- as you were saying, it's so much more than just Chinatown as
a tourist spot.
Foo: Right. Right. Right. It's important for people to understand how Chinese functions, how Chinese structure is, yes. So there's what’s in reading of name. Actually there’s a lot of classics, too, look at my site. I'm working on that.
Q: All right. Thank you so much.
Foo: Okay. Nice to talk to you. Anything I can do, let me know.
[END OF INTERVIEW]
Chinatown Interview: Interview (zh)
<p>FOO：好的。我是在紐約大學讀的醫學院。那是在1976年，Bellevue醫院。那個時候別人跟我講，“如果你在急診室裏看到中國病人，他們應該是已經病得很重了。如果他們的病不重，他們不會來看醫生的。”因此，要多注意一下他們。在那之後，我在---我的辦公室在34街。過了很長一段時間，差不多是一年之後，才有病人到那裏看病。因此，我後來在這裏租了間辦公室，方便他們就醫。現在，對於很多中國人來講，“上城就像是國外一樣。很長時間之後他們才會去那裏。主要是語言上的障礙。他們不知道怎麽去。他們不知道怎麽去，他們怕去陌生的地方。因此除非他們病得很重，否則他們是不會去Bellevue的。”看來，這種說法是有一定根據的。我想在基礎醫療方面現狀也依然如此。我的工作與唐人街社區的關係十分密切。我是神經科主任---我是市醫院神經科的主任。我也是院裏董事會的成員。我們還有一個基金會，叫做CCPH---華人社區醫療健康合作基金會（Chinese Community Partnership for Health）---我們在唐人街地區做很多醫療檢查和健康教育，因爲我們知道這裏存在這些問題。在CCPH從事的衆多工作裏面包括<br>
FOO：我想這要從兩個方面來講。一個是那些沒有保險的人，新移民，和那些在這裏工作的美國公民。你要知道我們有一個醫學團體叫作CAMS---美籍華人醫學協會---是從50年代開始創立的。現在越搞越大，我們有大約800個會員，大多是本地的。在這些會員中，我們又成立了CAIPA，美籍華人IPA[獨立執業協會]。我們與牛津合作---我們有一個由大約兩百名醫生組成的健康醫療系統，Kwan Tak博士是這個CAMS的主席。我們是最成功的IPA之一，而且是唯一一個面向華人社區的。現在，我們跟其他IPA不同的地方之一就是我們的醫生工作非常努力。他們星期六和星期日也在工作，很晚才關門。我們的醫生，我們的主席Kwan Tak博士有時工作到淩晨十二點。這樣，我們同病人有更多的交流。尤其是那些打兩份或三份工的病人，他們在工作時間不方便看醫生。工作對於他們來講要更加重要。因此，他們周末的時候來這裏看病。因此，我想，從這個方面來講，我們跟他們一直都有聯繫。而且因爲文化方面的因素，我們可能比其他人更加瞭解他們的問題---跟其他醫生相比。唐人街健康診所，也叫作Charles Wang，爲社區做了很多事情。對於那些沒有保險但負擔得起醫療費用的病人，他們的確提供了非常好的服務。但下城醫院，如我剛才提到，我們有專門爲這些社區提供服務的診所。我們設立了唐人街醫療健康合作基金會---抱歉，不是這個名字，華人社區醫療健康合作基金會---負責定期的檢查工作，無線電透視。在不同的公衆場所和醫院診所做健康宣傳，我和我們辦公室的Tao博士、Leung博士要在世界日報上刊登一個半月刊的健康欄目，由編輯部記者[Eva Pan]撰稿。在文章末印有我們的熱線電話號碼，方便病人同我們聯繫。因此，如果他們有任何關於健康方面的問題，或者醫療保險問題，都能夠打電話跟我們聯繫。這是由下城醫院CCPH人員負責的。有時，我會收到從溫哥華或佛羅里達打來的求助電話。我們就是這樣爲社區提供服務幫助他們的。</p>
全國性的機構。我們也設立了一個國際性組織，叫作美籍華人醫學協會聯盟（Federation of Chinese American Medical Society），我們與多倫多、溫哥華的中國醫生合作，探討華人社區的一些問題。我們每兩年舉行一次會議，國際會議，在這裏和舊金山。今年十月將是第十二次會議，探討中國患者的問題。我剛才跟你提到的，比如中風問題，要在那裏提出來，這樣大家都會知道。你會在我們的網站上看到相關的摘要。因此，我們盡力爲社區服務，儘量使人們對這些問題産生興趣。因爲我們確實有一些不相關的，或是其他社區的一些不重要的問題。但是這很重要，不解決的話，會成爲全國性的大問題。唐人街---華人社區醫療健康合作基金會不久前做了一項關於學校乙肝的調查。我們得到全國的回應，大家都去接種乙肝疫苗，因爲在我們社區乙肝非常流行。幾乎變成流行病，你不得不去治療。</p>