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The Rules of the Asian Body in America

On my wife’s battle with cancer during a fraught time for healthcare and immigration

Matthew Salesses
Apr 3, 2018 · 21 min read

What are the rules we expect the body to follow?

When my wife, Cathreen, had our second child, on Thanksgiving Day 2016, we expected her body to return to its pre-pregnant state. For nearly the entire nine months, Cathreen had horrible morning sickness and could barely eat. She threw up constantly. She was dizzy and spent most of the day in bed. Everyone waited for the baby, and not only for the baby, but also for the end of The Sickness.

The last pregnancy had also been difficult. Cathreen had pruritic urticarial papules and plaques of pregnancy (PUPPP), which is basically an incredibly itchy hive-like rash. She couldn’t sleep for the itch. She had to take oatmeal baths and slather herself in aloe. Eventually the doctor made her go on steroids.

According to her OB doctor, about one in 100 pregnant women get PUPPP (the internet says one in 160), but they often hardly notice, as PUPPP usually comes late in the third term before the baby is born, and birth makes the symptoms disappear. For PUPPP to appear in the third month (my wife’s case), the odds were one in 100 cases of one in 100-something pregnancies — rarer than one in 10,000.

In addition to PUPPP, Cathreen had morning sickness for four and a half months, a month and a half longer than is typical. We would try to go out, and she would make it to the end of the driveway before she threw up and had to turn back.

About halfway through the pregnancy, Cathreen noticed that her body also itched in the cold. In the supermarket, if she reached for milk, her hand would break out in a rash. I had trouble believing an allergy to the cold was possible until the doctor confirmed it, to my shame.

Once Cathreen gave birth, she was so happy for her body’s old freedom that we immediately went for a walk, though this is not advised. She blames that walk for the pain that came afterward — for a year, she had postpartum fibromyalgia. Korean tradition calls for the mother to stay warm and inside for the first three months after delivery, lest the wind gets into her bones, but we had treated this as a superstition. My wife had broken the rules.

This is the rule we expected of her body: that the effects of pregnancy would disappear once she gave birth.

The one extra complication in her second pregnancy — the one that didn’t even follow pregnancy rules — was that she felt cold all the time, not hot. Later, we knew that her coldness should have alarmed us. In March, four months after our son was born, my wife couldn’t stop losing weight, was still vomiting, and could no longer even drink.

It turned out she had stage 4 stomach cancer.

Cathreen immigrated to America in 2009, the year we married. Before she left Korea, she’d built a reputation as an English tutor and was managing an English kindergarten. Cathreen had tutored several kids from the bottom of their classes to the top, and several kids from the top of their classes to citywide speaking awards and scholarships. One wealthy father wanted to build a private academy, which she would run and split the profits.

I was a young American finishing his master’s degree in fine arts, with no career prospects and a lot of debt, and who, even after his fiancée offered to buy an apartment and support him, insisted he could live only in America. He insisted because he was adopted, because Korea had sold him and America had bought him, and the price was the rules of his body.

The story of the Asian body in America is a story about rules, money, race, and imperialism.

The first Asians on what is now U.S. land (other than those who crossed over the land bridge during the last ice age) lived in a sailors’ colony in Louisiana in the 1700s. They were Filipinos who had a reputation as good sailors and were often used to crew the ships of imperial white nations (mainly Spain).

In the 1800s, thousands of Chinese, mostly men, were shipped to America for labor. Some were replacements for slaves. Writes author and activist Helen Zia:

In 1806…using the same ships that brought slaves from Africa, the flesh merchants rerouted to Asia. They indentured “coolie” labor from China and India to perform the same work, under the same conditions, as the slaves.

Many Chinese came for the Gold Rush. White men would wait for the Chinese to find gold, and then shoot them and take their claims. Many Chinese worked on the railroads, where their bodies were used as examples to keep Irish and black bodies in line. When the railroads were finished, Chinese bodies lost their use and were kept outside the frame of history — literally, as the famous photo of the final “golden spike” included none of the 11,000 Chinese who’d worked on it.

After the railroads, what the Chinese called the Driving-Out Time began. Immigration laws banned Chinese women. Chinese men were “offered” the “chance” to go home, not knowing they could not return. Chinese were lynched, shot, raped, beaten, stolen from, run off, all within or outside the rules of justice. The Chinese who continued to work in the United States mostly clustered in Chinatowns for survival and took jobs no white man wanted, like laundry. According to scholar Elaine Kim, the rate of men to women grew as lopsided as 27 to one. Chinese bodies were unruly if they had sex at all, and if they were too unruly, they were no longer human bodies, but targets.

Meanwhile, in 1825, the first-recorded Chinese American was born in New York. In 1898, a Chinese American won a landmark Supreme Court case that granted citizenship by birth to all Americans. The Supreme Court ruled on who could be a citizen, how, and why; it also ruled on who got rights and what rights white people had over bodies of color.

In 1889, the Chinese Exclusion Act (passed in 1882 and still the only U.S. law to specifically name the exclusion of a single ethnic group) was upheld by the Supreme Court, a ruling with obvious consequences today as the administration keeps adjusting the rules of West Asian bodies. With the Chinese banned, the Japanese and Koreans became the next wave of forced and/or underpaid laborers. Hawaii, especially, needed bodies. (That need created the body of Hawaii as it is today, as Dole overthrew the island’s government and Asian laborers overwhelmed the population.)

In 1907, Japan and the United States struck a “gentleman’s agreement” to end Korean immigration (Korea being under Japanese occupation), and Japanese and Indian immigration increased. Those immigrants fought for citizenship. In 1922, the Supreme Court ruled that a Japanese American could not gain citizenship because he wasn’t “Caucasian.” In 1923, an Indian American took his case to the Supreme Court, which ruled that although Indians were Caucasian, American citizens must also be “white.”

The rules of the American body changed to fit the rules of whiteness.

In 1924, the United States threw out the gentleman’s agreement and banned immigration from Japan and India. But bodies were still needed. Filipino immigration increased. In 1934, with the economy in shambles, Filipino bodies too were banned.

These facts are easily verifiable, but I first found them in Helen Zia’s Asian American Dreams, Elaine Kim’s Asian American Literature, and Lisa Lowe’s Immigrant Acts.

American wars played a huge part in these rules, in particular with Filipino immigration, and later (and perhaps most well-known in America) with Vietnamese and other Southeast Asian refugees. American wars played a huge part in my immigration. The first major wave of international adoption was a direct consequence of the so-called Korean War — the first children adopted were the half-white babies of American GIs, adopted by the Holt family, whose agency continues even now to deal in babies from around the world.

It was the rules of the body, first of all, that got these half-white babies adopted. It was the rules of the body that got them given up. Though it wasn’t built on the bodies of another race, Korea is perhaps as conversationally racist as America — and a half-white baby in the 1950s meant incredible shame, whether or not it was the product of a war crime (rape). As the American demand for “GI babies” increased and the Korean supply decreased, the comparative acceptability of Asian bodies (to black bodies in particular) meant that full-Korean babies could fill the gap and increase profits.

On the Korean side, these bodies meant money to help rebuild an economy destroyed by war. On the American side, these bodies meant a continued belief in the confusing will of God (infertility) and the valorization of white Christian guilt and its appetite for babies. Even racist Nobel Prize–winning author Pearl S. Buck started her own Korean adoption agency, Welcome House, which in her mind would bring about the end of racism.

I was among the largest wave of Korean adoption in the late 1970s and early 1980s. My adoptive parents are Catholic. (My father was on his way to becoming a priest when he married my mother.) They believed the best way to be good Christians was to erase my body from contention. According to my father, they still consider me not Asian at all, “only their son.” In order to follow the rules of family, my body had to be an exception to the rules.

It was in search of my body and its rules that I found Cathreen in 2005, when I went to Korea believing that I had no history at all. She introduced me to myself. Four years later, she immigrated to America, married me, and got her green card, putting her trust in rules that historically distrusted us.

Recently, in the middle of the night, I witnessed my wife hanging off her mother’s arms, her body jerking up and down, her face squeezed and wet with pain. She was weeping and crying out in Korean that I could understand: “I don’t want to die! I don’t want to die!” We were on our sleeping mats (our daughter slept beside her), and Cathreen had on her pajamas, a purple dress with tiny flowers all over it. Her head, shaved short and balding in spots as it grew back in, spiked into the air, then lay flat against the ground. Her arms and legs spasmed. Her mother and sister tried to keep her still, tried to keep the baby from going to her, their faces strained, telling Cathreen she wasn’t going to die. My body had stopped moving. I had stopped knowing what I was doing. I tried to pat her back, and my hand seemed to move in another time zone. My wife had left for Korea 10 months earlier, and my in-laws had seen her like this many times, but for me, who had just arrived, it was a first.

Earlier that week, I had gone with Cathreen to her cancer hospital in Seoul (her family is in Busan, on the southern coast, where, Americans always say, MacArthur made his last stand), and in the basement of the hospital, she collapsed to the floor, without any power in one leg. The doctors on break stood around us, watching coldly or maybe resignedly. Every day, my wife’s body is betraying her. Or, more accurately, it is fighting itself — it hurries toward death while it also attempts to fight death off.

America has often diagnosed Asians with The Sickness. Yellow Fever. Yellow Peril. If the national body is well, The Sickness must come from without. White supremacy is a cancer we must not admit to. The history of immigration above leads directly to concentration camps in which Japanese American bodies were quarantined during the last world war. The only difference between them and the German and Italian Americans who walked free is that the Asian body was infected with foreignness.

Today, the administration of the current president of the United States will be the one to decide whether or not Cathreen can ever reenter America. Her fate lies in the rules of a white man who has referred to those same concentration camps as the “precedent” for a Muslim registry. And he is right — precedent is that my body and my wife’s body are a matter of rules, not nature.

The first time my wife gave birth, we had insurance through Harvard and we lived in Cambridge, Massachusetts. The total cost to us of her many visits to her OB, her hospitalization, and all the care during and after delivery by doctors, nurses, and lactation consultants was nothing. Because of the complications, we visited her doctor every two weeks. Cathreen went to the ER twice, and we paid a total of $80. She gave birth in a spacious and well-equipped room overlooking the Charles River, and the baby was immediately set on her chest before it went to a machine or a stranger.

The second time my wife gave birth, we had insurance through the Affordable Care Act. We could have gotten insurance through the university where I was doing my PhD, but even though it would have cost me only about $100 per month, the cost to insure my family was more than $1,000 per month. On the ACA, we paid much less for insurance but were much more afraid to use it.

The total cost of having our second baby was more than $7,000, much of it because the hospital didn’t bill our insurance company quickly enough. We had far less control of the delivery process, and when our son was born, they whisked him away from us. When we contested the hospital bills, creditors came after us. In the end, I’m not sure what happened to them — after my wife was diagnosed with cancer, she told them to fuck off. A week later, she flew to Korea.

Treating Cathreen’s cancer in Korea was a decision we were forced into. We were in the same city as the best cancer hospital in the world, but MD Anderson had cut off all forms of Obamacare three months earlier. Korean health care covers every citizen, and my wife never gave up her green card to apply to become American.

I keep thinking about why we didn’t catch the cancer earlier. Every day, every minute, I am sick with this thought. It is only right to take responsibility. I knew the rules.

Each Sunday in Houston, my family attended a Korean church full of cancer doctors and cancer researchers who never thought Cathreen had cancer. The rule of pregnancy is pregnancy symptoms — and the rules for Korean bodies in America are not the same as the rules for Korean bodies in Korea. When my wife complained she couldn’t eat, our church friends complained about American food. When my wife complained she felt cold, they complained about American air conditioning. When my wife complained about infrequent doctor visits, they commiserated that in America mothers go months between checkups and are told that if the baby’s growing, everything is fine.

These things are true. When my wife told her OB she couldn’t eat, her doctor prescribed heartburn medicine, nausea medicine, sleeping pills. At the ER (which cost us $500 per trip), they treated only her symptoms. Her OB said they couldn’t check for anything else because Texas law prioritizes the fetus over the mother. No procedure could be done that stood the slightest chance of affecting the baby.

Still, we could have gone to a GI doctor a month after our son was born, instead of three months. Because Cathreen’s cancer is the most aggressive type, two months might have made a lot of difference.

We didn’t go because we thought it was normal to lose weight after giving birth. We didn’t go because we were afraid. We didn’t go because we had been taught by our insurance to go to the doctor only for checkups or emergencies. Of course, insurance companies claim to encourage preventative care and offer free wellness visits — once a year. But the effect of creditors and high copays and confusion over what is and is not covered is caution and fear. You doubt your authority over your body. You go to the doctor only when weighing costs and benefits shows that you are diagnosable, admittable, and cannot get better on your own.

I often think back to my wife’s offer to buy an apartment in Korea and give me time to write. It sounds better with each year that passes. It also would have saved her life. When she first came to America, my wife was used to seeing a doctor whenever she sensed anything slightly off with her body. I didn’t understand this — I avoid doctors until the moment I can’t avoid them. She didn’t yet fear the cost of being told she was healthy.

In Korea, because a doctor’s visit is about US$2, people get their bodies checked as soon as they feel sick. If my mother-in-law feels a cold coming, the first thing she does is get a shot to shorten the cold’s duration. In the week I wrote this, I went to the pediatrician three times because the doctor prescribes only two days’ dosage. With each visit, the pediatrician updated her understanding of my baby’s body and, when necessary, adjusted the treatment.

In Korea, they screen for stomach cancer.

The most commonly diagnosed cancer in America (by far) is breast cancer. It is also the most cured. This is not a coincidence. After my wife’s diagnosis, a cancer researcher friend hit himself in the face and wished Cathreen had breast cancer instead. Like all the other researchers we knew, he had come from Korea because America has the most money for cancer research — and in America, breast cancer research is king. Talented young scientists come to Houston from all over the world to work at M.D. Anderson, and there they follow the funding toward a breast cancer cure.

The most commonly diagnosed cancers in Korea are lung, liver, and stomach cancer. Of those, lung and liver cancer have obvious causes (Korea is a leading consumer of alcohol and cigarettes). When Cathreen was diagnosed, her doctor in America said most of the data on stomach cancer that gets to America comes from patients in Korea. Because stomach cancer is so common, Koreans get screened for it the way Americans get screened for breast cancer. Because my wife was in America, the rules of Korean bodies did not apply to preventative care.

Maybe if we had lived in a different state, if we had a different insurance, if we had seen a different doctor…how American that our circumstances determined what care our bodies deserved.

After my wife screamed for life in her mother’s arms, she lay weeping on the floor. That morning, we’d fought seriously for the first time since I had arrived in Korea, on leave from my professorship. We had fought because when the body turns against itself, so does the part of the body that is the mind.

We had fought because I wasn’t on the right dosage of Zoloft because when I brought my prescription to a Korean doctor, she said Americans overmedicate and all Koreans are sad with bad cholesterol and high anxiety and trouble sleeping, so what was I complaining about?

We had fought because that doctor was right (in a way): What am I complaining about, when my wife has cancer?

We had fought because of cancer.

We had fought because we both want my wife to live, but we don’t know what it means “to live” if life is the body’s way of dying.

We had fought because I couldn’t help her and felt powerless and so I wanted to make something about me.

We had fought because the stress and pain and life were all too much for her.

As my wife wept on the floor, her mother and her sister scolded me in Korean. I couldn’t understand completely, but I got the gist. I understood the word stress and I understood the word fault. I understood the words don’t and stop. I understood their expressions and the way they threw their faces at me. I understood my shame and the difference between my body and my wife’s body.

“Because of him — ,” my wife interrupted. “But also Sister.”

My shock became less desperate, but not lesser.

We were living in this sister’s apartment. The last time I had seen her was three years earlier, when we paid for her and her son to visit us in Houston, because we had missed her husband’s funeral.

Missing that funeral was against the rules of the body and of family. Worse, neither my wife’s oldest sister nor mother made it to the funeral. Everyone had real reasons, but the result was a bad feeling that still lingered. The husband died of stomach cancer just when they thought his chemo had worked and he was in remission.

What I remember most from my sister-in-law’s visit was a trip to see Inside Out. In the opening short, a lone volcano sang out for love until another volcano answered and joined the first, eruption by eruption, to make a single island. In the theater, my wife and I held hands and smiled at each other, remembering our own island-making. Then I noticed, on the other side of my wife, that my sister-in-law was weeping quietly, her mouth shrunk up in pain, doing nothing to stop her tears — and I remembered our differences and felt both grateful and ashamed.

Now it was my wife who had stomach cancer and I who was depressed, and we had burdened my sister-in-law with two unruly children.

“Because of me?” asked my sister-in-law.

I wanted time to stop, I wanted to go back, an hour, a day, a year, three years, ten.

My wife attacked in Korean, and tears immediately sprang to her sister’s face.

The next morning, my sister-in-law said my whole family needed to get out of her house by the end of the day.

Why does one body that doesn’t follow the rules make other bodies so uncomfortable?

When my sister-in-law kicked us out, she said that seeing my wife’s sickness makes her sick. It makes her sick with the past. It makes her sick with her husband’s death. When I see my wife collapse in pain, I see not her death — because how could I? I will not — but my own. I see what of course I have known: that the rules of my body are, in fact, the same as the rules of hers, which is to say, we are dying.

It is not that knowledge or even seeing it come true that makes me so upset. It is the admission (to myself? to her?) that I have no control, either over the rules of our bodies or over their exceptions.

What does that mean, though, that we have no control over our bodies? It seems obviously untrue. Perhaps what I mean is that we persist in the illusion that our minds and our bodies are separate, until the moment we cannot persist in it. We persist in the illusion of dualism, and therefore in the illusion of free will and control.

In 1980, a famous and controversial experiment by the neuroscientist Benjamin Libet revealed the time between a subject’s conscious decision to move and the body’s electrical signal for movement. His result was a full half-second (a long time in neurological terms) after the body’s signal and before the conscious decision.

Though the amount of time has been contested, many have interpreted Libet’s and subsequent results to mean that consciousness is an effect, not a cause, and therefore is not separate from the body but a function of it.

Libet, however, didn’t interpret things this way. His further experiments showed that the subject could consciously cancel the movement before the electoral signal became action.

The body can break the rules of the body, but it cannot make them. This is the admission that we sense we must make when we are in the presence of an unruly body. The imprisonment of our will despite our belief that we are free.

As a boy, I used to stand at the mirror and see a reflection that didn’t exist. A reflection whose existence was possible in the combination of my parents’ existences. What I saw was whiteness. I have known this for a long time, but I’ve only recently come to realize that I never saw my actual skin as white (of course I could not); rather, I saw whiteness for what it is: a concept, a rule. I was able to see it this way precisely because I wasn’t able to see why I could not be white.

It took me a long time to figure out how that reflection was connected to the white man on the street calling to me “Ni hao” was connected to the bitter rage and shame I felt when a white film star killed an Asian bad guy and “got the girl” was connected to the expectation that I should be good at math and how I hated myself that I was.

It took me even longer to figure out how those things were connected to history and politics, and longer still to figure out how the history was both mine and not mine, both my parents’ and not my parents’. I’ve figured out, but still cannot accept, how following the rules will never mean my body follows the rules.

The rules of the body aren’t actually followable. They aren’t made to be followed. They’re made to define.

I was 19 when I realized my body had The Sickness. It was less than a week after 9/11. I had gone to the various memorial services at the University of North Carolina, Chapel Hill. I was barely into my first semester and had never lived so far from home. I was both exhilarated and terrified, because my small white town in Connecticut had not been kind, and I was both eager to start my life and afraid for it to be the same life as before.

I was on a campus bus, invited to a party by a new, white friend, the kind of whip-smart in-state student who joins a frat and gets a business degree and becomes successful without ever leaving his comfort zone. He was Republican. (I was wrong about him — eventually.) In the back of the bus, a group of black students talked and laughed. I sat at a distance from them, probably with some bias and because they were together and I was alone. I felt lonely and uncool, and I was jealous of their ease with each other. I felt how I felt in Connecticut, but this time with black kids, not white kids, which confused me. I had come to Carolina with the idea that maybe I belonged with black people, since I had not belonged with whites.

We had gone maybe one stop, not even one, when they mentioned the attacks. Someone said “terrorist,” said “Muslim,” said “towelhead,” said “go back to your country.” My face burned. I didn’t seem to realize they were talking about me until they were talking to me. I couldn’t see how I could possibly fit that profile, especially to other people of color.

I got off the bus as soon as I could, carrying my infection with me.

I am in Korea now. I am here to be with my sick wife, who, to save her life, gets weekly injections of chemicals that kill the parts of her body that follow the rules in an attack on the parts that don’t. Each week, she dies a little more in order to live a little longer.

For my wife to return home — if she gets the miraculous results we pray for — she will face more rules of the body. American rules that first stole the bodies of people from her country, our country, then banned them from entering, then led them to fight and kill each other, then bought them to end racism. She must become an exception.

Right now, the United States is deporting Korean (and other international) adoptees, despite that their bodies are the only things they know about their destinations. That my wife held onto Korean citizenship is the reason her government now covers 90 to 95 percent of most of her medical care (she would have died if she had become an American citizen), and yet her stay in Korea breaks the rules of her visa.

We have heard stories from other immigrant friends and friends of friends and immigration lawyers; we have seen the news you have seen. These have always been the rules of the Asian body in America: Yellow Fever. Yellow Peril. These have always been the terms: white supremacist capitalism. What do we have to complain about, then, if in the end all bodies follow the same one rule: They die. What we have to complain about is not how we die, but how we live.

Illustration: Audrey Lee. Creative art direction: Anagraph.

Gay Mag

A new magazine from Roxane Gay offering some of the most…

Matthew Salesses

Written by

Author of The Hundred-Year Flood & I’m Not Saying, I’m Just Saying. Forthcoming are The Murder of the Doppelganger & Own Story: Essays

Gay Mag

A new magazine from Roxane Gay offering some of the most interesting and thoughtful cultural criticism to be found on the Web. Our first quarterly is coming in June 2019. We value deep explorations, timelessness, and challenging conventional thinking without being cheap and lazy.

Matthew Salesses

Written by

Author of The Hundred-Year Flood & I’m Not Saying, I’m Just Saying. Forthcoming are The Murder of the Doppelganger & Own Story: Essays

Gay Mag

A new magazine from Roxane Gay offering some of the most interesting and thoughtful cultural criticism to be found on the Web. Our first quarterly is coming in June 2019. We value deep explorations, timelessness, and challenging conventional thinking without being cheap and lazy.

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