There is a scene that repeats itself in clinics across the world, in SF, NYC, in Leicester, in Dubai, in Bangalore, so often that it has become almost invisible. A South Asian man, let us call him Raj, sits on an examination table. The paper beneath him crinkles. The fluorescent light hums. The doctor, who is usually kind, usually competent, usually pressed for time, glances at a chart and delivers the verdict: BMI of 24, blood pressure acceptable, cholesterol within range. “You’re healthy,” the doctor says. “Keep doing what you’re doing.”
Raj buttons his shirt. He feels relieved. He should not.
A little over a year ago, I started this blog to understand what I was seeing in my own family.
An uncle who was on top of his health, yet, had a heart attack way too young. A family history littered with cardiovascular disease, stroke, early diabetes among those athletic and active. As a physician, it made little sense to me, until I started reading…and then it made even less sense. The literature rarely covered us. The studies weren’t designed for us. The answers I was looking for didn’t exist.
So I went looking myself. And what I found was an area somewhat undiscovered, but rarely addressed, especially for those of us in the diaspora, where the compounding effects of ancestry and environment collide in ways no one is tracking.
One in four.
That is how many of us there are. South Asians constitute roughly a quarter of the world’s population. We are not a minority in any meaningful sense. We are, by sheer arithmetic, one of the largest coherent biological populations on Earth.
And yet the medicine we receive was not built for us.
The reference ranges on our lab work, the BMI charts on clinic walls, the dosing guidelines in pharmaceutical inserts, all calibrated on bodies in Western nations.
When these protocols are applied to us, they do not merely underperform. They mislead. They harm. They kill, sometimes, while telling us we are fine.