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Susie Matsuda

Susan Marie “Susie” Matsuda was a mixed-race Japanese American and White physician from Pasadena, California. She was the eldest child of educational-psychology professor Greg Matsuda and disability-services advocate Ellen Matsuda and the older sister of Cody, Pattie, and Joey. She entered Stanford University in 1995 and later practiced disability-competent medicine and held a medical leadership role. Susie was autistic and received a formal diagnosis in the 2000s, after years of concealing her difficulties through academic achievement, social performance, and extensive caregiving.

Early Life and Background

Susie was born on August 12, 1977, and grew up in Pasadena as the eldest of four children. She belonged to the fourth generation of the Moore family’s progressive advocacy tradition. Her maternal grandparents, Bill and Dorothy Moore, had refused advice to institutionalize their youngest daughter, Heather Moore, in 1968. Susie grew up with Heather included in holidays, birthdays, and ordinary family gatherings, with accessible space, patient communication, and care treated as parts of family life.

Susie helped her parents care for her siblings from around age five or six. She changed diapers, gave bottles, and rocked the younger children to sleep as she grew old enough to help. She was nine when Joey was born on June 20, 1987, and became his “second mom,” later reading to him at bedtime, helping with homework, and making time to play even when she had work of her own. Her closeness with each sibling differed: she shared Cody’s academic interests, translated Pattie’s intentions to adults, and gave Joey reassurance and predictable companionship.

Greg taught Susie through patient, logical explanation. He broke complicated ideas into steps, took her questions seriously, and valued curiosity more than social popularity. Susie could do homework beside him while he graded papers without either needing to fill the silence. Ellen taught her to challenge injustice and use family resources to protect others. Susie absorbed both parents’ commitment to service, but she also learned to equate being useful with being good and to treat her own needs as less urgent than everyone else’s.

The extended family supplied several different examples of professional advocacy. Uncle Mark Moore practiced civil-rights law, Aunt Annie Moore provided disability-competent medical care, and Uncle Richard Moore worked in teaching and inclusion. Susie admired Annie’s willingness to listen to patients and believe what they reported about their bodies. Ellen worked in regional-center quality assurance and client rights and served as interim administrator of Harmony House, later renamed Rosewood Community Home, during 1994 and 1995. Greg’s educational-psychology work and doctorate from Stanford supplied another model of intellectual work with practical consequences for other people.

Cody’s 1995 Crisis

Main article: Susie Matsuda and Cody Matsuda

Susie was seventeen when Cody attempted suicide in spring 1995. She had watched him endure exhaustion, bullying, and medical dismissal and had helped him with schoolwork when he could not sustain the required energy. His attempt intensified her anger at the doctors who had dismissed his symptoms and her guilt about not anticipating how desperate he had become. Ellen’s scream and the sight of Cody in intensive care remained part of Susie’s memory of the crisis.

Susie held seven-year-old Joey and tried to keep him calm while fearing that Cody would die. When Joey asked, “Is Cody going to die?” she did not know the answer. She protected him from the worst of the crisis, answered what she could, and concealed much of her own terror until she was alone. Watching Ellen become frightened and vulnerable unsettled Susie’s belief that her mother could always protect the family; Susie felt that somebody had to remain capable if Ellen could not.

Cody survived an anoxic brain injury with acquired motor apraxia of speech and became nonspeaking. Susie grieved the loss of his familiar spoken voice without treating him as less intelligent or less himself. She learned American Sign Language with the family, became fluent, helped Joey learn signs, and supported Cody’s use of augmentative and alternative communication. She did not rush his typed responses, finish his sentences, or speak over his device. The pauses also gave both siblings time to process their conversations.

Education

High School and the Stanford Transition

Susie earned strong grades in high school, graduated in spring 1995, and planned to pursue medicine before Cody’s crisis. She was well-liked, popular, and regarded as pretty; her feminine presentation and apparent social success helped conceal how much anxiety and effort she experienced. Being liked did not make every interaction easy. She turned down invitations when she needed recovery time, struggled when plans changed unexpectedly, and worried about being seen as rigid or no fun.

She hyperfocused on academic work, especially science, and used extensive preparation to manage her fear of mistakes. She organized notes and binders by color, planned study schedules weeks ahead, and kept lists for daily tasks, longer-term goals, and social obligations. Even when she thought she knew an answer, she preferred to keep her hand down rather than risk being wrong in front of the class. Losing participation credit felt safer than public error. Her perfectionism was driven substantially by anxiety and the wish to avoid disappointing people.

During her 1994–1995 senior year, Susie’s meltdowns became more frequent. College conversations could make her burst into tears; she asked her parents not to discuss the subject and sometimes sat behind her closed bedroom door rocking and sobbing. At other times she shut down, spoke little, lay staring at the ceiling, and could not engage with schoolwork or her family. These difficulties began before Cody’s suicide attempt.

After Stanford accepted her, Susie felt unable to tell the people congratulating her that she was frightened rather than excited. In April, her assigned roommate, Jessica from San Diego, sent an enthusiastic email about decorating their room, going to parties, and joining sororities. Susie stared at it for twenty minutes before composing a polite reply. Sharing a bedroom with a stranger, coordinating showers in communal bathrooms, enduring late-night music, and having people drift in and out of rooms threatened the privacy and predictability she relied on at home. The packet’s hall meetings, mixers, and shared kitchens suggested constant interaction with no reliable place to recover.

Susie worried about academic competition, but the fear she struggled most to explain concerned living and functioning in that environment. She knew she could handle coursework; she feared being exposed as unable to tolerate noise, spontaneity, or somebody moving her things. Ellen’s reassurance, “Oh, everyone’s nervous at first! But you’ll make friends so quickly. You’re so good with people,” reflected the capable presentation Ellen saw. Susie experienced that presentation as continuous work, and she feared having to sustain it around a roommate without an escape.

After Cody’s attempt, Susie proposed deferring Stanford for a year. She approached Greg with the explanation that the family needed her. His questions brought out the fear that had preceded the crisis, including her uncertainty about who she was without siblings to protect. The possibility of staying brought relief, and feeling that relief in the aftermath of Cody’s attempt brought shame. Her love and concern for Cody were real; so was the attraction of an acceptable reason not to leave.

Greg told her, “You need to go. You need to learn who you are when you’re not everyone’s caretaker.” He understood her need for quiet, routine, and careful processing while refusing to treat permanent caregiving as the only life available to her. Susie left for Stanford in fall 1995 after turning eighteen, still frightened and guilty. Joey begged her to stay, Pattie hugged her despite trying to appear unaffected, and Cody encouraged her to go and learn. Susie cried as she drove away.

Stanford Years

Susie maintained excellent grades at Stanford while finding social interaction and crowded settings exhausting. Science and medicine remained sustained interests, but achievement did not remove her need for substantial time alone. Establishing routines in the dorm environment took work. She also had to learn to trust her parents and siblings to care for one another without her daily management.

She remained homesick and concerned about the family. Weekly calls became daily as her homesickness intensified, and she kept every letter Joey sent with Ellen’s help, including his drawings and “I miss you Susie” messages. Cody sent AAC messages asking, “HOW IS SCHOOL. ARE YOU LEARNING GOOD DOCTOR STUFF.” Their interest mattered to her alongside her continuing fear that pursuing her own education meant leaving them without enough support.

Susie was a senior in fall 1998. After spending the summer supporting Pattie through pregnancy, she returned to Stanford on August 28. At Thanksgiving she was still anxious about medical-school competitiveness despite her strong grades and MCAT scores. Her conversation with Michael Smalls gave her space to discuss those fears with someone who was neither a parent nor a sibling depending on her.

Career

Susie became a physician committed to disability-competent care and eventually held a medical leadership role. Cody’s years of medical dismissal strengthened her determination to believe patients about symptoms that other people could not see. Annie Moore’s practice supplied a positive example, and Heather’s experience taught her that communication differences and support needs did not diminish a patient’s intelligence or authority concerning their own body.

Her approach included patient explanations, time for alternative communication, respect for autonomy, and advocacy for accommodations. She took chronic illness seriously and resisted the equation of exhaustion with laziness or depression with weakness. Her commitment to accuracy also extended to correcting medical misinformation. She wanted to serve chronically ill people and others whose symptoms or disabilities had been dismissed, without requiring them to perform illness in an expected way before being believed.

Medical training increased the cost of maintaining her social performance while caring for others. Susie encountered practitioners who talked over disabled patients, doubted their reports, or treated assistive technology as a failure. She compared those encounters with what she knew of Heather and Cody and resisted reproducing them in her own work. Her later autism diagnosis also changed her understanding of accommodations from help she advocated for others to needs she could recognize in herself.

Susie trained younger doctors in disability-competent care, supplied medical expertise for Joey’s disability-rights cases, and supported Cody’s advocacy with medical knowledge. She remained part of the Moore family’s professional support network. Her work also required learning limits: fear of error, the impulse to please everyone, and responsibility for other people’s wellbeing could not be managed indefinitely through more preparation and self-sacrifice.

Personality

Susie was gentle, soft-spoken, and deeply nurturing. She noticed distress and anticipated needs, often understanding her siblings’ moods before they asked for help. Her attention to people and systems was analytical as well as emotional; she observed patterns, translated between family members, and used careful explanations to make confusing situations more manageable. She usually tried to comfort rather than control, although her determination to prevent harm could make her caretaking feel like management to Pattie.

Being “the responsible one” was both an identity and a burden. Susie genuinely wanted to care for her family, and helping also gave her a sense of stability and earned approval. She said yes when she wanted to say no, apologized for things outside her control, and felt responsible when somebody else was unhappy. She rarely asked for help. Resentment accumulated alongside love, but she was ashamed to admit that resentment and feared that setting a boundary would make her selfish.

Susie’s self-sacrifice could become a form of martyrdom: being needed reassured her that she mattered, while rest or personal ambition felt like a withdrawal of love. Her greatest fears concerned failing the people she loved, becoming a doctor who could not help Cody, leaving Joey feeling abandoned, or being absent when Pattie was hurt. She could continue functioning for other people while feeling close to collapse herself.

Her emotional sensitivity did not make her indifferent to accuracy. Misinformation bothered her strongly, and she corrected it quickly, sometimes overriding her usual reluctance to interrupt. She could be polite and insistent at the same time. With Greg and Cody, her literal thinking and preference for substantive discussion often made communication easier; in other contexts she could miss sarcasm or spend considerable effort working out what somebody meant.

Through college and adulthood, Susie learned that loving her family did not require remaining constantly available. She worked on asking for help, setting limits, accepting that she could not repair every problem, and forgiving herself for being imperfect. These changes allowed her to develop an identity beyond caregiving without giving up her closeness with her siblings or her commitment to medicine.

Cultural Identity and Heritage

Main article: Japanese American History and Community in the United States

Susie was a mixed-race, or hapa, woman whose Japanese American heritage came through Greg and whose White heritage came through Ellen and the Moore family. She grew up with Greg’s quiet devotion to scholarship, routine, and family responsibility alongside Ellen’s outward-facing political advocacy. In Susie’s understanding of those family traditions, perseverance and responsibility could become difficult to distinguish from enduring distress without complaint. The value of ‘’gaman’‘, or perseverance with dignity, reinforced her existing tendency to put her own needs last.

The Moore family’s insistence on challenging injustice gave Susie language for defending other people, but she found it harder to apply that language to herself. She associated the family’s legacy with professional service and resistance to harmful systems. A private need for rest could feel less legitimate than somebody else’s urgent need for advocacy. Her parentification was shaped by the particular demands and expectations of the Matsuda household, not simply by the family’s stated progressive values.

At Stanford and in medical education, Susie encountered expectations associated with the model-minority stereotype: academic success, quiet compliance, and deference to institutional hierarchy. Those expectations reinforced her masking and made requesting accommodations harder. She also experienced uncertainty about racial belonging, feeling too Asian to assume uncomplicated White acceptance and too White to enter Asian American affinity spaces without questioning whether she belonged. Her exhaustion with social expectations complicated both experiences.

Susie drew on both sides of her family in medicine. She understood that a person might endure pain without drawing attention to it, and she believed clinicians had to listen rather than take silence as evidence that nothing was wrong. From the Moores she carried the conviction that believing people about their suffering was a basic obligation. Recognizing her own autism gradually helped her extend that obligation to herself.

Speech and Communication Patterns

Susie spoke softly and clearly, choosing words with care and allowing time to understand an answer. Her explanations reflected Greg’s patient, step-by-step approach. She generally listened without interruption and rarely raised her voice, although she could intervene firmly when correcting misinformation. With Joey she used reassurance and gentle negotiation; with Cody she offered unhurried support; with Pattie her frustration coexisted with affection.

She used spoken English and fluent ASL. With Cody, communication through signing or his AAC device preserved the depth of their discussions. Susie respected the time he needed to compose a response rather than treating the pause as an invitation to speak for him. Her patience with Heather similarly meant waiting through speech-motor planning and listening to a complete answer.

With her parents, Susie often sought approval or help understanding a concept. She asked Greg, “Dad, can you help me understand this concept?” and trusted him to provide patient intellectual support. Her internal processing was more self-critical than her reassuring speech to her siblings: she repeatedly examined her decisions, worried about what she had missed, and planned how to do better.

Health and Disabilities

Main article: Autism Spectrum

Susie was autistic but undiagnosed throughout childhood and adolescence. Her academic success, popularity, femininity, and competence at caring for others obscured her support needs. Adults understood her as sensitive, quiet, helpful, or exceptionally organized rather than recognizing the labor behind those qualities. Growing up among other neurodivergent family members also made some of her patterns familiar, while the family’s direct communication reduced certain social demands.

Her autistic experience included literal thinking, strong pattern recognition, sustained interests in science and medicine, sensory sensitivity, reliance on predictable routines, and exhaustion after social interaction. Empathy could be overwhelming rather than absent. She maintained a convincing social presentation through preparation and observation, then needed time alone to recover. Her difficulty asking for help made the cost of that presentation less visible.

During the transition to Stanford, disruptions to familiar space and routines could produce tears, rocking, shutdown, and intense bodily anxiety. The prospect of shared living brought a tight chest, nausea, and the sensation of her throat closing. These reactions coexisted with real intellectual ability and the outward impression that she was ready for college.

Greg received his autism diagnosis in the late 1990s. His recognition gave Susie a family example and language for similarities they had always shared. When she recognized herself in descriptions of autism, she spoke with him; his response included, “I wondered,” and “You remind me of me.” Susie received a formal diagnosis in the 2000s. The diagnosis brought relief and explanation, helped her understand her need for sensory regulation, and informed how she approached both her own care and medical practice.

Relationship to Her Body

Susie enjoyed feminine presentation and the care involved in dressing, makeup, and having her hair done. That pleasure coexisted with a tendency to ignore fatigue and other needs when somebody else required her attention. Looking composed did not mean that she felt comfortable or had energy left to spare.

Before she understood her autism, Susie often experienced her need for quiet and predictability as evidence that something was wrong with her. Anticipating communal bathrooms and an unfamiliar roommate could feel physically impossible, while her own room gave her familiarity and control. She feared other people seeing a meltdown and discovering how much effort ordinary-looking competence required. Her later diagnosis helped her understand these experiences as needs for accommodation rather than proof of personal inadequacy.

Physical Characteristics

Susie moved gently and gave warm hugs that Joey particularly sought out. Her posture could remain steady when she felt exhausted, and her eyes looked tired during periods of heavy caregiving. Her approachable presentation and quiet speech made it easy for others to underestimate that strain.

Personal Style and Presentation

Susie was regarded as pretty and presented herself in a traditionally feminine style. She loved dresses, makeup, and having her hair done. Pattie thought of Susie as “the beautiful one” and contrasted Susie’s presentation with her own more physical, less conventionally feminine self-image.

Habits, Routines, and Daily Life

Order was a source of comfort for Susie. In her bedroom, the bed faced the window at a familiar angle, books were organized by subject and then alphabetically by author, and her desk had the lamp on the left, pencil holder on the right, and open planner in the center. She knew which floorboards creaked, which drawer stuck, and how the afternoon light crossed the blinds. Familiar placement let her predict her surroundings without spending additional effort on them.

Her home study-day routine included waking at 6:30, showering and dressing, breakfast at 7:15, and studying from 7:45 until noon with a 10:00 tea break. Color-coded materials, schedules, and lists gave her control, but maintaining those systems also required energy. She found it difficult to relax when relaxing seemed to risk everything becoming disorganized.

Academics and caregiving occupied much of her daily life. She read bedtime stories to Joey, helped her siblings with homework, and fitted her own schoolwork around their needs. Science offered sustained interest and the comfort of information she could investigate systematically.

At Stanford, Susie worked to establish routines in a less controllable environment. Calls home and Joey’s letters supplied continuity with the people she missed. She kept the letters rather than treating them as temporary updates and needed private recovery time even when her grades and social presentation gave others little reason to notice that need.

Personal Philosophy or Beliefs

Susie believed intelligence should be used for justice rather than status and that family members had an obligation to show up for one another. Heather’s place in the family taught her that accommodation was an expression of love, not evidence of weakness. The family’s rejection of “that’s just how things are” as an answer to injustice informed her refusal to accept medical dismissal as inevitable.

She believed patients were experts on their own experiences and deserved to be heard without having to demonstrate conventional speech, visible illness, or effortless independence. Chronic illness warranted attention rather than blame. Her own development required confronting the gap between those beliefs and the harsher standard she applied to herself: she could support someone else’s need for help while still feeling selfish for expressing her own.

Family and Core Relationships

Ellen and Greg Matsuda

Main article: Susie Matsuda and Ellen Matsuda

Main article: Susie Matsuda and Greg Matsuda

Susie loved and admired Ellen but was intimidated by the reputation and intensity of “the Dragon,” fearing that her own gentler approach could never measure up. Ellen’s pride was genuine, yet her reliance on Susie’s capability sometimes concealed the cost of the role she expected her eldest daughter to fill. Greg offered quieter recognition through shared thinking, parallel work, and practical explanations; he saw both Susie’s ability and the effort she spent appearing comfortable. His insistence that she leave for Stanford became an important intervention in her tendency to disappear into caregiving.

Cody Matsuda

Main article: Susie Matsuda and Cody Matsuda

Susie defended Cody against bullying and dismissal, helped break schoolwork into manageable steps, and believed him about his exhaustion. After his suicide attempt she carried anger, grief, and guilt while remaining committed to his communication and autonomy. Watching him fall in love with Andy Davis in summer 1995 brought relief and renewed hope, including greater confidence that he could have a happy life without her constant monitoring. Cody’s encouragement to pursue Stanford helped change their relationship from daily caregiving to support maintained across distance.

Patricia Matsuda

Main article: Susie Matsuda and Patricia Matsuda

Susie was exasperated by Pattie’s impulsive fighting and defended her to outsiders while privately trying to redirect her behavior. She also envied Pattie’s apparent freedom to be loud, visible, and unconcerned with approval, even as she worried about the punishment and injuries her sister faced. During summer 1998, Susie held Pattie’s hair while she vomited, brought water and crackers, listened to her frustrations, and offered reassurance about motherhood without the parent-child dynamic of Ellen’s care. Their separation on August 28 was painful for both; Pattie later honored Susie by giving Lila Marie Hayes her middle name.

Joey Matsuda

Susie was Joey’s safe person and a second mother, with bedtime stories, homework help, play, and warm physical reassurance forming part of their ordinary relationship. During Cody’s crisis she tried to make the frightening events comprehensible and bearable for him while concealing her own fear. Leaving for Stanford meant losing that daily closeness: Joey asked who would read to him, and Susie promised calls, visits, and letters. She saved everything he sent and learned to trust that he could adjust to her absence without losing her love.

Heather Moore and the Moore Family

Main article: Heather Moore and Susie Matsuda

Susie learned patient listening and presumed competence through Heather’s participation in family life. The two shared quiet observation and attention to patterns, while Heather recognized both Susie’s capacity to nurture and the danger that caregiving could consume her. Heather’s welcome of Andy, including their connection over cerebral palsy, reinforced Susie’s hope for Cody’s future and her understanding of disabled community. Annie Moore’s medical practice, Mark’s civil-rights work, and Richard’s inclusive teaching provided distinct professional examples within the same family network.

Romantic and Significant Relationships

Michael Smalls

Susie knew Michael Smalls peripherally through high school and Stanford. Their first meaningful conversation occurred during the Wallace family’s Thanksgiving gathering in 1998, when Michael noticed that the crowd was overwhelming her and offered her a quieter place on the deck. She discussed medical-school competitiveness despite her strong grades and MCAT scores, and his description of her as “smart as hell” felt like genuine encouragement rather than another expectation to meet.

Michael sensitively asked about her difficult senior year of high school, and Susie told him about Cody’s suicide attempt and the family crisis surrounding it. He understood family pressure and academic expectations without requiring her to become his caregiver. The conversation gave Susie a peer connection based on mutual respect and shared values, with room for her own vulnerability. Susie and Michael eventually became partners.

Memorable Quotes

“It’s okay, sweetheart. I’m here. Tell me what’s wrong.” (Comforting Joey.)

“Let’s read one more chapter, and then bedtime. Deal?” (Negotiating bedtime with Joey.)

“I know you’re scared. But Cody’s strong. He’s going to be okay.” (Reassuring Joey during Cody’s crisis, despite her own uncertainty.)

“I’ll help you with the homework. Let’s take it slow.” (Offering Cody unhurried help.)

“You don’t have to explain. I understand.” (To Cody.)

“The doctors were wrong about you. They should have listened.” (To Cody about medical dismissal.)

“Pattie, you can’t just punch people when you’re mad!” (Responding to Pattie’s impulsive fighting.)

“I know you’re trying to protect him, but there are other ways.” (To Pattie about defending Cody.)

“I love you. Even when you drive me crazy.” (To Pattie.)

“Mom, I got accepted to Stanford. Pre-med track.” (Telling Ellen about her acceptance.)

“I want to be like Aunt Annie. A doctor who actually listens.” (Describing her professional aspiration.)

“You’re already doing it. You go to appointments. You take care of yourself. That’s strength.” (Reassuring Pattie during her pregnancy.)

“No one knows how to be a mom. You figure it out as you go.” (To Pattie about her fear of motherhood.)

Characters Supporting Characters Living Characters Mixed Race Characters Mixed Heritage Characters Japanese-American Characters White Characters Disabled Characters Neurodivergent Characters Autistic Characters ASL Users Doctors Physicians Medical Professionals Matsuda Family