Joan Is Okay

Content Warning: This section of the guide describes and discusses the source text’s depiction of anti-Asian discrimination and hate crimes.

When Joan considers people, she thinks about size, about how much space they take up in a room. Joan herself is diminutive in stature at just under five feet tall. A recent patient at the hospital where Joan works told her that she looked like a mouse and questioned her medical credentials. Wryly, Joan replied that her diplomas are large and framed and, as such, are not portable. Joan added that the man was welcome to leave and return later, but she would probably still be on shift.

Joan’s father has just died. A workaholic who owned his own construction firm, he suffered a fatal stroke while in a meeting at work. He’d recently complained of headaches and eye pressure, but although Joan had encouraged him to see a doctor about his symptoms, she knew that he would not. At the very end, after he’d lost consciousness, Joan’s mother had called her and put the phone up to his ear, which let Joan briefly speak to her father before he died. Joan had known as she spoke that hearing is the last sense to go and that her father’s death was imminent. Sure enough, news of his death arrived at work; Joan’s colleagues Reese and Madeline noticed because Joan turned away from her computer monitor for longer than usual. When Joan explained that her father had just died and she needed her weekend shift covered so that she could fly to China, they both agreed. Reese and Madeline were sympathetic, but Joan noticed that neither asked where in China she was going.

Joan meets her brother, Fang, at the airport. He is eight years her senior and, although she is 36, still treats her like a much younger sibling. Because Fang arranged the travel, the two fly first class. Fang seems pleased with the amenities. He explains to Joan that once she flies first class, travel will never be the same for her. Although her seat reclines completely and becomes a small bed, Joan is unable to sleep. When they arrive, Joan is struck by how crowded China is. Her mother meets them at the airport, and they proceed to their hotel.

Her father’s funeral is well attended, and afterward, there is a dinner in the private room of an upscale restaurant. In talking with several people there, Joan learns that China has developed markedly within the last decade and that many Chinese people now consider their country to be more advanced than the United States. Joan stays only two days in Shanghai, and neither her mother nor Fang objects to the shortness of her visit. They understand that her job has come to “define her” and that there is very little for her to do in China. Fang, who spent the first few years of his life there, has closer ties to the country and will remain in Shanghai after Joan returns. At the airport, Joan exchanges her first-class ticket for a seat in coach, much to the confusion of the ticket agent. In coach, she sleeps soundly, though she misses both meal services and has to make do with a small bag of grainy apple slices.

Joan works in an Intensive Care Unit. Many people confuse intensive care with emergency medicine, but the two are actually quite different. Emergency medicine is chaotic and loud, and its facilities are often located on the first floor of a hospital, near the ambulance entrance. Intensive care is quieter, with most of the patients hooked up to machines. Joan enjoys the “purity” of this setup. She finds machines easier to understand than people, and she does well at work. She is an attending physician, which means that she both teaches and supervises less experienced doctors. She enjoys that aspect of her job as well.

Back at the hospital, Reese asks about her trip. She tells him that China has changed. It is more developed and wealthier. When Reese clarifies that he had been asking about her family, Joan is at a loss for words. Reese wonders aloud if there had been “cultural differences” between Joan and her father, and Joan explains that her father had actually been quite supportive of her life choices. Reese asks if Joan has ever had a boyfriend, and she tells him that she has not. He tells her that she is quite beautiful, so he doesn’t think dating should be so difficult for her.

Each ICU has its own character, and although Joan finds both the cardiac and surgical ICUs interesting, she prefers her own, the medical ICU. It contains her favorite machine, ECMO (extracorporeal membrane oxygenation). She is struck by the similarity between its acronym and the Muppet Elmo, and she wants to put googly eye stickers onto ECMO. Attendings work in blocks of time. During their “on” blocks, they are always on call. Joan struggles in her off time, uncertain how to fill the long hours away from work. Madeline suggests going for walks since Joan enjoys being busy and being on her feet for long hours. Joan does indeed enjoy the walk, chagrined only when she has to return due to rain and speak with her doorman. He is overly friendly while Joan is quiet and solitary, and she wishes that he would talk to her less frequently. He informs her that a new tenant is moving in across the hall from her and asks if she would like to know more about the man. Joan replies that she is not interested.

The previous tenants were a couple who invited Joan over for dinner once. The man had said that he knew a few Chinese characters because he had studied Mandarin in school. Joan had informed him that a few characters would not be particularly helpful to him if he wanted to communicate. The couple had not invited her back, and after having two children and seeming to fall into marital difficulties, they had moved to New Jersey.

The new tenant is a man named Mark who strikes Joan as unremarkable. Their initial meetings are not positive. She comments on his poor technique in breaking down boxes and has to help him try to fit a large item of furniture into a too-small elevator. Mark’s response to their first few encounters is to bake Joan a pie and leave it, along with a note apologizing for having gotten off on the “wrong foot,” on her doorstep. After that, their interactions improve. She learns that Mark enjoys cooking and hosting parties. Mark used to work in publishing but quit because he didn’t enjoy corporate life. Initially, after moving in, he complains of having too many possessions, and he gives away much of what he has accumulated over the years to their neighbors. However, he soon begins to order new objects, which Joan notices as packages continually arrive at his doorstep.

Joan enjoys work, and the harder the workday, the happier she is. Her director comes to visit her to make sure that she does not need more time off, and when she replies that she does not, he asks about her family and China. She is unable to provide him with much information about either. When she ponders her family alone during quiet moments, she recalls the Chinese saying “hitting is love” (40) and remembers her parents berating her for childhood mistakes (40). They did not physically abuse Joan, but they were not warm or “loving” either. Life had been difficult for them as immigrants, and her father had never managed to start a successful business in the United States. Her mother, too, had been unhappy, and Joan assumes that they were relieved when she graduated high school and the pair were able to return to China.

Just as Joan is performing a final examination on a man who died that night, her mother calls. She is in Connecticut to stay with Fang and wants to chat with Joan because she has jet lag and cannot sleep. Joan looks at her watch. It is 2:30 in the morning. Her mother is so talkative that Joan assumes she must be grieving, that the death of Joan’s father has changed her typically taciturn personality.

Joan recalls her childhood. Joan had been a solitary girl, and although she had been academically gifted, her teachers had always said that they struggled to get to know her. Joan often felt that, because she had so little to say, it would be best to distill her ideas into their most succinct form. Still, she had confused people. Joan had gone to Harvard and enjoyed her years there, although she spent most of her time studying rather than enjoying the many social activities available.