The Throwaway and the Orphan

As salaam alaikum,

I'm currently in Kansas City (arrived safely, alhamdulillah) taking a break from my second day of this family medicine conference, and man, I am more than overwhelmed right now. I have all of this in front of me and I'm not sure what it all means...the sky's the limit, basically, and it's always been, really, but even so, I know this is what I want to do. This feels like what I was made to do, really. But I find myself in an interesting place...

One thing will be the topic of another entry, but I'm realizing this spiritual revival from within myself and by the grace of Allah (swt). It's bubbling up within me, and overwhelming me with a sense of peace, low key. It's nice, and I hope it only continues as I go forward.

The other thing is...I feel media aislada, haha, is the first way that I thought about describing it. It's not really big fish in a little pond...I feel more like a bird trying to swim in the ocean, is more like it.

They refer to us Harvard medical students as "orphans"...that is, we don't have family medicine programs affiliated with our university. And it's true. HMS does not have a family medicine program and probably will not have a department for a little bit, if ever. It's just the kind of place that HMS is. It's very much geared toward the specialties. They give lip service to primary care because I guess that's hot right now (at least that's the way I feel about the administration...[don't get me wrong, there are plenty of folks at the med school that are very passionate about primary care and do a lot of work to make Harvard not an entirely hostile place for primary care-leaning individuals to train]), but for them, academics, leadership and scholarship are their goals.

Serving your community and addressing that community's needs, not so much...

The way that I view family medicine is two-fold. Yes, there are skill sets that you are interested in and a knowledge base that you want to expand upon (for example, I'm all about maternal/child health), but a lot of where you choose to train and where you ultimately end up working depends on what community you want to serve, what challenges you want to face and tackle as a physician that exist with your patients and your community...things like that. I feel as if sub-specializing in other specialties are more about skill sets than community.

I love young families. I love their potential. I am particularly interested in maternal/child health, early childhood development and health education. I am interested in promoting the health of the family unit where it counts, which, for many if not most families, rests with mom. I'm also interested in how children develop in their first few years and how it relates to the health, health education and literacy of mom. I can focus on that through family medicine like no other specialty.

Another thing that family medicine is great for that no other specialty can quite touch...educating pregnant teenage mothers. If I can find an opportunity to do something like that in Boston during my public health year, I'd actually really look forward to that. Pregnant teenage mothers and young teen moms, helping them with contraception/family planning, their own sexual and reproductive health, their health otherwise, the best choices for their babies, and working within the challenges within their community. Like, what are their barriers to breastfeeding? Things like that.


Sometimes I wonder if, when I sat in that lecture hall during Alliance Weekend, the weekend for minority students accepted to Harvard Medical School, crying because I knew that I loved what I heard from the program here while knowing that I would lose an aspect of the way of life that I was making for myself...sometimes I wonder if I actually made a mistake by coming to Harvard. I love my education, the experience, the boundless opportunities to do whatever I see fit...but at the same time, more than just not having a family medicine department, you do feel like an orphan.

You feel like the child of the trauma surgeon and the pediatric intensivist who came of age never seeing either parent. Your parents work, but actually, they're old money, too (Harvard is old money...okay, we'll see if this analogy doesn't get out of hand). It's like, there's a lot of funds, the world is yours, the sky is the limit, you are of the most privileged people on this planet...but there's just something to be said about not being raised by your own parents.

...my family bent is obvious in this analogy.

So you feel like the orphan, though you're not. Far from it. You just wish your parents had more hand in your raising, is all. And here you are, your parents specialized, and now you want to go into family medicine, and they don't support that. Why?

Because they see family medicine as an outcast, a reject...a throwaway specialty, if you will.

Family medicine, from a distance, does seem like a catch-all. You can basically practice whatever you want, do whatever you want, go almost anywhere you want, accepting that community's limitations. It is a job description that carries little prestige with your colleagues at the US News Top 10 programs across the country, little prestige among the sub-specialties. But people in family medicine are people who really don't care about prestige. You care about finding a community, a patient population, whatever, and being the best doctor you can for that population. I digress a little bit.

I've had people tell me that I didn't go to Harvard to become a family medicine doc.

Reference "My Indian Auntie." Yeah, it's totally narcissistic of me to block quote my own writing from not that long ago, but whatever...

Then randomly, after Sarah or Sofie [my best friend's sisters] asked me what I wanted to go into, and I responded "OB/GYN or family medicine," one of her random, pregnant aunts, I think one of her uncles' wi[ves], came out of nowhere and said, "Family medicine? No, I see you as an OB/GYN. You exude OB/GYN. Look at you! You go to Harvard Medical School. You don't go to Harvard Medical School and then go into family medicine. Do OB/GYN." - March 6, 2010

The thing about it is, some people in my institution will not respect my decision to go into family medicine, think that a Harvard degree (or two, as the case is, insha'Allah) to go into family medicine is overkill, whatever. I've known this, and this conference didn't teach me that.

Three years ago when I started medical school, I had some idea but at the same time little idea what I really wanted to do with my medical degree. I've grown in experience, still have a lot more growing to do, but based on all that I've learned about the field and myself, I'm ready. I know more now what I want out of the career and what I want to be as a physician.

Family medicine is in line with my values. It's implicit in everything about me. The fact that I place so much importance on the family unit for the health of entire societies, not limited to my own, the fact that I asked myself what type of doctor would I want to be if a family member came with a problem. I'd want to be their primary care doctor, I'd want to help manage their health, I'd want to be there when their kids are born and help them establish healthy families. I'd want to be there for the young women in my family who have children in their teens. It's implicit in my values.

It's implicit in the fact that--more important than my own career is the formation of my own family, and the importance of their health, and the importance of the raising of my own children.

I came to Harvard because I didn't know what type of physician I wanted to be and I wanted the opportunity to be anything that I wanted and do anything I wanted. There are few limitations that I face domestically or abroad because of the Harvard name, unfortunately...unfortunately, because I don't like riding the H, at all. It will probably help me get A Rose Much Desired published, maybe, but oh well. I digress.

But I guess this is the fair limitation that I face...a program without a family medicine department and with several members of the faculty not respecting the specialty. I guess it makes me feel a little bit like...my striving to be Muslim with a Christian father who doesn't really support my life trajectory. It makes things harder only emotionally, and otherwise is not that great of a hardship at all.

At 22-years-old, wearing that white coat, I had no idea that I'd be going into family medicine...even less as I applied to programs that didn't particularly support it. I may have been mature but I was incredibly immature in so many ways, I'm realizing. I'm just growing up over the past two years, really, growing up from ways that I was still an overgrown child...

I didn't know what I wanted from medicine yet. Now I do. I happen to be in a place that's not the friendliest for it. Sees it as a throwaway. And it's okay, because people on the outside see me as an orphan but I'm not. I've got fam. I've got fam in all the Harvard kids that are with me on this conference today, were with me yesterday, sleep across from me.

And of course, there is always the wonderful Kathe Miller, the family medicine doctor who was my primary preceptor in the rotation that I did at Cambridge. She's my adoptive mother.

As I wrote in one of my first entries, I've found a love like Wilson Pickett. It's nice to fall into something that makes the most sense in the world, accept it for it's shortcomings, accept the challenges that you potentially face and accept there will be challenges that you can't anticipate, but go forward lovingly anyway... That's what I want marriage to be like for me.


...now, step two is to find the residency programs that are right for me. Thank God I have another year to sort all of that out! Alhamdulillah for public health school!

Wasalaam.

My Father

As salaam alaikum,

Today, insha'Allah I'm on my way to Kansas City for a Family Medicine conference. I'm praying for a safe and comfortable flight.

Speaking of dreams, I think I had a dream I was married last night. I don't remember any of it, therefore, I don't remember who I was married to or anything. I also had a dream about sprinklers running in Boston after the rain. I'm not sure where in Boston the sprinklers were running. The only dream I really remember was that I got my Step 2 CK score back, and I had failed, meaning I'd have to reschedule it and take it over. It took me a while upon waking to realize that it wasn't true...badness.


My mother suggested the other day that I should go to church with my father one of these Sundays, that "it would mean a lot to him." This made me angry...not because I absolutely refuse to attend church with my father, but that I couldn't have done this of my own volition without her getting that motherly look on her face and being an interloper in my relationship with my father.

When I argue with my father, she always gets nervous and wants to go somewhere else, even if it's just good-natured joking between us.

I didn't appreciate her telling me what to do that would "mean a lot" to my father. I don't feel like I owe it to him to go to church, and...ugh, she put the mother guilt trip on me with the "it'll mean a lot to him." It's like, can't I cook him something? That would mean a lot to him...if I learned to cook soup.

But her request did give me pause.


I spend so much time worrying about how my father wants me to embrace Christianity and how not to insult him because of my Islam, that maybe in the process our relationship is dissolving and I'm not being a good enough daughter. It's hard to tell.

My mother said that she thought it wasn't fair of me to say that my father doesn't respect my choice of religion and/or Islam. I didn't argue with her too much, because I think that this is a delusion she keeps up that helps their marriage make sense. There are degrees of respect. No, my father would never defile a Qur'an, and honestly, I'm not sure where he stands on Islam. I don't know if he thinks it's completely a false religion or if it's not the right way, I don't know.

Nor does he really know how I stand, how I stand on Christianity. I think we've both been avoiding that topic not to offend each other, but it's kind of essential for us to move forward.

In essence, I don't feel like I'm being unfair to him by saying that he doesn't respect my choice in Islam. I feel like that's entirely accurate. It's accurate in the way that he thinks he's going to come along, after I've made my decision after 23 years of not exposing me to Christianity and here I am, now 25, and he thinks if I listen to his pastor and read Romans and other things in the Bible, I'll be like, "Oh, Christianity..."

My mother herself says that he thinks I'm easily influenced, that the reason that I'm Muslim is because of my best friend, who is Muslim.

At which point I realize...my father doesn't really know me. My journey to practicing Islam was my own. Not even MQ had a hand in that. That was me, myself and Allah (swt).

At the same time...I have to make sure I'm not biting the hand that feeds me and thereafter shooting myself in the foot. Although I am frustrated with his efforts to convert me, he is my father, and I owe him love and respect, first and foremost. I need to remember that. My love and respect for my father is more important than any self-righteousness I may feel as a Muslim, which I shouldn't feel anyway. Like my father, I will answer to God at the end of this all, and kindness to my parents is one of the things, the easy things, that I'm supposed to do...so let me not forget that.

"And [God says:] ‘We have enjoined upon man goodness towards his parents: his mother bore him by bearing strain upon strain, and his utter dependence on her lasted two years: [hence, O man,] be grateful towards Me and towards thy parents, [and remember that] with Me is all journeys’ end. [Revere thy parents;] yet should they endeavour to make thee ascribe divinity, side by side with Me, to something which thy mind cannot accept [as divine], obey them not; but [even then] bear them company in this world’s life with kindness, and follow the path of those who turn towards Me. In the end, unto Me you all must return; and thereupon I shall make you [truly] understand all that you were doing [in life]." (Qur'an, 31:14-15)

Insha'Allah...

Wasalaam.

The Child of my Dreams

Salaam,

Heh, I guess I've watched, "I Didn't Know I Was Pregnant" one too many times.

I had a dream that I gave birth to a baby boy last night...while still in medical school. I was in the middle of my public health year, and I went to the hospital and gave birth to a 7lb 6oz baby boy. I don't recall knowing I was pregnant before then.

In fact, as relatives and friends began to visit me to see the baby, I began to wonder...who the father was? By the end of the dream, I hadn't really figured that out, but I figured out that I'd conceived as a result of one interaction that I barely remembered.

I went through the first few days of motherhood in the dream. I was so excited! I was like, yes, I succeeded in having a child before 30 (I don't know...as a child, I always wanted to have a child before the age of 30, because that was the age at which my mother had her first child). I had a child, as I was worried that I may never have children of my own. But then I was like...crap, I have no job, I have no income, I have no way of supporting a child right now. I must have had the child during break or something, because I wasn't worried about missing classes or anything.

As I went to the kitchen to prepare to feed my child (I was, like, holding him the entire time during the dream), I was like, "Oh crap...I haven't named this child yet!" I thought about it, and I decided to give him maybe 1-2 middle names. Before I woke up, I first thought about it...at first I wanted to name him Hassan, but then I regretted that I hadn't had twins to name them Hassan and Hasna, or Thais and Thiago, and then I decided, oh well...and I named him Thiago Hassan...

Then I transitioned into another dream.

When I woke up, I was relieved that I hadn't, in fact, had a child. I had been thinking in my dream, well, I guess this is one of those things in life that doesn't go your way, or as planned...but that mess kind of would have to have been the immaculate conception, because it's kind of hard to conceive a child...without ever having had sex...hahaha!

But Thiago Hassan, huh? I like it! I may save that for my first son.

Thiago, of course, pronounced the Brazilian Portuguese way...CHI-ah-goo.

What does this dream mean? No idea.

It was fun to have a kid in a dream, though. That hasn't really happened since college, and I've never gotten to name them before...with, like, names I've actually considered.

Sei lá...

Sadness to Fondness

As salaam alaikum,

Today was the first day I'd walked on campus in a while.

I don't think I'd been on Michigan's campus since 2008, probably on St. Patrick's day, so whenever in March that was. Then, less than a year back, I walked the diag as a student.

Now it's been three years, and as I passed by places I'd been with friends, I was overwhelmed with...sadness.

Thinking back to my undergrad years right now just makes me sad. And it's not only about the man, though it kind of is. I wish I had an experience in college that wasn't so colored by him, at first by liking and longing for him, and then for wanting someone like him in my life.

I wish I could look back to college and not feel regrets. Because that's what I feel now...regret. Regret that I wasted so much time hoping and praying for him, that I didn't make some of the connections I perhaps could have, that I spent most of college confused about my identity, entering medical school more fragmented than I was solid...

And I mean, that's had a big impact on who I've become, my goals in life, what I work for...the way that I felt I had to give up my former identity entirely to be here, at Harvard Medical School, in the end for what?

Nothing makes sense of that whole thing. I wish it did. This is the first thing that has happened in my life that I can't make sense out of, and it drives me crazy.

I walked past the Chemistry building on campus, and looked toward it wistfully. Here was a reality I left behind soon after I packed my belongings and headed to Boston for medical school, and here it was, in my face again.

It sucks when the other person gets on with their life before you do. Like, married...and he'll probably have his first child before there's even a prospect on the horizon for me, and I'm sorry if it's nonsensical, but it makes me feel like a loser.

As I walked on the campus of the University of Michigan, though I graduated with distinction and went on to Harvard, I still feel like a failure. A failure at life.

I never wanted to go to Harvard. And this is not me crapping on my blessings. I'm very thankful for all I have. And when I acknowledge that I am in a group of the most privileged women in the world because of my unique position to be able to choose my life's path...my husband, my livelihood, all of that, that still remains.

But college for me reminds me of a time that...I faltered, stumbled through a part of my life and fell flat on my face. I'm over the man but I am not over the failure that the whole period was for me, in terms of my life.

I have no prospects, at all. And really, I don't need and I don't want the plural. I just wish I had the faith that it will happen for me, but I don't. I think it's just my nature to kind of be a disbeliever in this way, I don't know.

I feel like I just don't make enough sense in this world for anyone to actually fit with me...I don't know.

But, at the end of the day, what can you do? Nothing. You can pray, but it's that same prayer you've been praying for the last 13 years, in variations, and you feel no closer to the answer. So that's done, and it doesn't matter, so it seems. Life goes on in a big way. Life goes on, you'll wake up tomorrow, and you won't meet anyone, not the man of your dreams, not even anyone interesting. And you'll wake up tomorrow, and the next day, and the next, and it will be the same story. Weeks, months, years will pass, and the same story. Nothing. This has been my reality, I know.

You can do nothing about it. I just pray...I guess I need to start praying that it doesn't hurt so badly, and that one day I'll actually be able to look back at my college years as not so much of a failure at life, and I'll be able to look back at everything, not just the summer of 2004, with fondness, not sadness.

Because that...that I actually may have control over...

Nightmares

Salaam,

Yes, I deleted my last post. It's something rare, but I really wasn't feeling it anymore immediately after I wrote it. Go figure.

But you know what I realized? Pretty much since I started third year, I have not really had nightmares.

I usually say du'as right before going to sleep (even though I sometimes go to sleep on them...oops), and I usually pray not to have any nightmares. It may seem like a silly thing to pray for, but I have very vivid dreams.

Whoa...for example, last night, I had a dream that I was a 12-year-old boy who liked this 12-year-old girl. Hahaha, that's never happened before...I've never been someone else in a dream before. At one point, we were sitting on this wire thing situated high above our middle school building, and we were going to retreat to solid ground and I got startled and screamed like a girl, and the guys wouldn't let me hear the end of it!

Weird...

So I have very vivid dreams. I can eat in the dreams and I have all five senses. That means I can feel pain. So, any nightmare has the potential to be a horrible experience that I'll never forget, so I try to avoid them.

Anyway, I realized...except for that one dream that I mentioned about the mall earlier, I don't think I've had a nightmare since I've been in this apartment. It's all the grace of Allah (swt), really, but even in times (for example, during third year) where I got bad at remembering my evening du'as...

Could it be because I have a Qur'an at the head of my bed in my nightstand? It's actually a Qur'an I rarely read because it's a Yusuf Ali translation, the one I grew up with...in my living room, I have Muhammad Asad, which is what I read these days. I have both...just because. The Asad is mine, the Ali I lifted from my house. My mother had two, one that was really worn, falling apart...she rarely uses this one, so it's crisp.

Could it be that my bed is facing Qibla? I didn't do it purposefully...it's just so so it gives me more carpeted room on the floor for salat if I positioned the bed this way.

Could it be that third year warped my brain so that I can only think about non-traumatic things since plenty of trauma happens in the hospital?

I don't know. I welcome this new state.

Haha, I can't believe I was a 12-year-old boy in my dream! That's really never happened before...no idea where that came from. I think it's from reading all of these books from children's perspectives...

Good People

[deleted]

Desilusão, desilusão!

Dança da Solidão - Marisa Monte feat. Paulinho da Viola

Translation below:

Solitude is lava
That covers everything
Bitterness in my mouth
I smiled it's leaden teeth

Solitude, word
Burrowed in my heart
Resigned and mute
With the beat of disillusion

See!
Disillusion, disillusion
I dance, you dance
The dance of solitude

Camélia became a widow
Joana fell in love
Maria attempted suicide
Because of her lover

My father always told me
My son, be careful
When I think of my future
I don't forget my past

Oh,
Disillusion, disillusion
I dance, you dance
In the dance of solitude

See!
Disillusion, disillusion
I dance, you dance
In the dance of solitude

When the early morning comes
My thoughts meander
I run my fingers over my guitar
Contemplating the full moon

In spite of it all, there exists
A fountain of pure water
Whoever drinks that water
Won't have anymore bitterness

Oh,
Disillusion, disillusion
I dance, you dance
The dance of solitude

See!
Disillusion, disillusion
I dance, you dance
The dance of solitude...

Beautiful song!