The Tyranny of Now

As salaam alaikum,

I almost have no words for this time. I'm so happy that I got to marry before the storm, in a time of relative tranquility, in the time of the first President I voted for that I was proud to call mine, flawed and polemic as some of his policies were. I was a black woman marrying a white man in the era of our first black president, born of black and white. We wed in the waning time of hope and progress. We spend our first married weeks in a time of turmoil.

My husband, bless his heart, doesn't want me to worry. My husband, accordingly, is used to compartmentalizing himself away from fear when certain things do not directly affect him. We are both citizens. We will be provided good insurance from our employers. If I want long-acting birth control, I can afford to pay $800 for it out-of-pocket, and we have no pre-existing conditions. He is not from a country on the current travel ban. If public schools go to hell, insha'Allah we'll be able to afford to get our kids into private school. We live on a literal hill, above it all, protected from flood and tsunami, protected in a way that we can be at all times blissfully unaware, if we so chose, to what is happening below.

I am not used to ignoring those things that do not apply to me. Everything applies to us all, as long as we are all human. More than any one group of people in my life, the executive actions of this administration so far has and will affect the people I trained to serve--my patients. My patients are low-income, immigrant and refugee. They are documented and undocumented. Thirty percent of them are insured by my state's Medicaid expansion under the ACA.

When I heard the election results, I curled up in a ball and cried for these people who I've dedicated this big part of my life to, for all of the rights and necessities that would be stripped away from them. In that sorrowful way, I have not been disappointed.

I hurt for my patients. I am trying to find the best ways to be active, but recognize at the same time that I am newly married and have this relationship to nurture. When my colleagues were protesting at SeaTac airport the recent Muslim ban, I was present for a business meeting my husband had at our home. I balance the desire to start a family right away with the reality that I will bring children into. Are we headed for a coup? Will the US see its first dictator? Do I want to wait (even longer than we've already waited) for things to become more stable?

I don't know.

He doesn't want me to worry. This is a man who lived in a communist country, protested as a child, lived as an undocumented immigrant in another country, immigrated legally to North America and forged a gradual road to citizenship. He has seen a lot, probably a lot worse. I respect his perspective.

But I will not sit idly by just because I, personally, will be alright. Because those who I serve will not, and to the extent that I empathize with every patient that enters my exam rooms, I will not be alright.

And this is not to speak of the friends and family members who are more directly impacted.

And this is not to speak of how, with any given tomorrow, this could be any one of us. My new Muslim surname, my old Muslim self, the daughter of an immigrant, the wife of an immigrant...anything.

It's reached the point where most happiness is hollow.

If I Were Single

Salaam,

Insha'Allah, my fiance and I are to be married in less than a month and a half. While I make the final preparations for this stage of the wedding (a larger reception with family and friends will be held later), I also make preparations for the rest of our lives together.

Will I continue to take medicine call? Will I take OB call, even? How many hours will I work? It'll be perfect to transition out of doing urgent care during maternity leave if we try for babies soon, insha'Allah...

I also have begun to lament the things I have lost. I'm no longer singing as much and I haven't written seriously nor thought about my novel in many months. Part of me doesn't even feel like a writer anymore, and it's startling.

I've started to question everything else about my life, including my career choice, while I bring my family life into focus. I'm afraid I'm losing myself.

I don't want to.

There are things that used to be meaningful to me, and probably still are, but I haven't had time to explore them. And necessarily, we change with time, I do believe, but...in the case that, God forbid, I'm left to my own devices again, I want to make sure that I am true to myself and make time for the (other) things in my life that bring me joy.

So I wonder--what would I be doing right now if I were still single? What would I be planning, in contrast with what I'm doing now? And don't get me wrong, I don't wish to be single. As a perpetually single woman in my 20s, I did long for companionship and I've been happier than I've ever been in my adult life once I attained it. It just happened that the advent of this companionship coincided with the final stage of my medical training, so there are a lot of confounders at play.

For example, I perceive I have less time for myself in my relationship, but is it perhaps that I had less time for myself as a busy resident and as a first-year attending? I feel like I have changed, but is that perhaps because now I am a practicing physician, and before the relationship, I was not?

Anyway, life would be different, if I were single:

• I'd still be living in Seattle proper, instead of living in the suburbs to be closer to my fiance. Our family home is purchased, has 5 bedrooms and 3 bathrooms, and insha'Allah after marriage I will add my name and it will be our home. I'll be a sudden home owner. But for now, I commute 20 miles to work, which is 40 minutes at best during rush hour and paying 75 cents on the express toll lanes. In my old apartment, the hospital was a 7 minute walk away and my clinic was a 3 minute drive, about 1.5 miles away. 
• Obstetrics call would be easier. I'm on OB call this weekend, and I'm dreading it. The last time I was on OB call, I managed two labors and attended one delivery. I had to leave clinic a little early and ended up sleeping in one of the uncomfortable call rooms (beds aren't so comfortable for me anymore, after having lost a bunch of weight).  If I had been living 7 minutes away from the hospital like I used to, I would have gone home after the 11pm delivery and slept in my own bed for a while. But since my own bed is now 20 miles away, I often make the decision to sleep in the hospital if I'm uncertain of someone's labor course. On OB call weekends, that means that I'm potentially spending 48 hours in the hospital. It means that I could drop whatever I'm doing over the weekend with my fiance to drive into the city just to potentially miss a delivery. There's also the stress of his disappointment of not seeing me over the weekend because of my call schedule.
• I would make more of my own continuity deliveries. Two of my patients delivered over the weekend. One I wouldn't have made anyway, because it was precipitous. The other one, I could have made. It was on a weekend night. Again, if I were 7 minutes away from the hospital and single, I would make an effort to make more of my patient's deliveries. But my fiance and I had a bit of an argument a few months ago when I told him all weekend that one of my patients was in labor and that I wanted to go be there for her during delivery but he still ended up feeling like I was sacrificing our time. I was already on call enough, then I would sacrifice our time together when I wasn't even on call to be there for my patient? "All of your patients are special to you," he shot back when I argued that this patient was special. So when a patient goes into labor, I have to take him into consideration as to whether I'll go in for the delivery...which is fair. One day, insha'Allah, I'll also have babies to take into consideration, so maybe I'll stop giving my patients the impression that I'll be in for their deliveries. ...but if I were single, I would be all about dropping everything to make my patient's deliveries.
• I might be singing more. There is a family medicine band that invited me to sing with them, but they have practice on Thursday nights. Because I work late on Wednesday nights (until 9pm or 10pm or sometimes later, depending on urgent care), I usually do not want to spend any more time in the city than I have to, and I rush back on Thursday nights. I would like to sing with them eventually, but not with this schedule.
• I might hang out with Seattle people more. Again, not living in Seattle makes meeting up with Seattle people challenging at times. I factor the commute in prior to every get together now.
• I may go back to dancing samba. I still may check out the Monday night class at some point, insha'Allah in the New Year, but it'd be something to fill my time with.
• I might be planning a trip to Nigeria with my Dad in the upcoming year. My Dad got to travel to Nigeria after an over 30-year absence this year. I would love to travel with him, but not only are there the concerns of who will then be my husband, insha'Allah, but also, if I am pregnant or with small children, I definitely won't be able to travel for some time.
• I might be planning a trip to Salvador. I love Brazil and it's been 8 years since I've been (incredibly!). I would go with my new husband, insha'Allah, but...zika. Cases of microcephaly have happened more in the Northeast of the country. And even if I don't get a zika infection, I don't want to have to worry about that 8 week period in which he could carry it in his semen for family planning...

The rest are all big maybes. I don't know if I'd be writing more if I were single, if I'd get back to drawing, if I would be reading more or keeping up with medical literature more. There are also some potential negatives, like I may not have embarked in this body-transforming fitness journey (I've lost 40 pounds!), I may not have started running races, I may not be cooking nutritious food for myself--I may not have been taking such good care of my emotional, mental and physical health as well as I have been relating to someone else.

It is true that I'm not working as many hours as I imagined and minding my hobbies as much as I used to, but that's not a bad thing. I'm also taking care of myself much better than I ever have in my adult life. And those hobbies are not going away. I just came to a critical moment in which I am reassessing what I want to be in medicine, and my practice may change in a way such that I have more time to be all the other things that I want to be in medicine.

Mainly, now that insha'Allah I can now start planning a family, I realize how much this has always been a top priority for me that was for much of my life out of reach and how much I want to prioritize it now. It's more important than my career. I find myself putting some of those medical aspirations aside for a moment, thinking about the women who have said, "You can have it all...just not all at the same time."

But now that I am marrying, there are things that I want to bring back into my life. I want to bring writing back into my life first, and fiction-reading. This year, I have been reading only non-fiction. Literally, I have not read one piece of fiction this year, which is odd for me. I wanted to be a physician and a writer on the side, but I'm finding that I'm also a person who wants to do all of her jobs well, and I can't be a good physician right now with the hours that I'm working and also write on the side, and I'll be a horrible writer if I'm only writing on the side and not devoting more time to it.

I already don't feel like a writer anymore, and that's devastating for me.

And it's hard to to do either of those things well while making a family.

But I can have it all, but not all at once. Right now, the thing that I put on hold is writing. For years, what I put on hold (in theory) was family life. Next, what I'll put on hold is medicine.

That is the topic for a later entry.

A Trump Presidency

As salaam alaikum,

I need to be doing some charting this morning, but after cruising the pain on my Facebook newsfeed and not feeling able to limit my thoughts to my status box, I decided to come back here, my nearly completely neglected blog with, so it seems, zero readership at this point, to put some of my thoughts down.

When I saw the polls take that critical turn toward Trump last night and saw my own home state had turned red for the first time since Reagan in 1988, I curled upon myself and cried. I cried for my patients, who I've grown with and come to learn from, who will no longer have insurance when the ACA is repealed. That's 30% of the people at our clinic that didn't ave insurance 2-3 years ago who now do. I cried for what that would mean, acutely, for our clinic, and the sudden struggle.

Of course that is where my mind would go first. Of course I would think of my patients. They are the people I spend most of my waking hours with, every week. These are the people who challenge me and sometimes traumatize me with their own stories of trauma. I empathize with them, even in 10-20 minute visits, I get in their space, 20 times a day I get into another person's space. It is emotionally taxing, but it was made easier by the fact that my patients had more resources because they had insurance through the ACA and Washington state's Medicaid expansion.

I was not among those who didn't believe it could happen. I saw it happen with the Republicans, and I hoped Trump antagonists were calculated enough to vote accordingly. We were not. There was hubris, and now there is nemesis.

I slept fitfully, having to pray before I could drift off and acknowledge all that I was grateful for, and all I'd rather have than avoiding a Trump presidency.

I am not of the most privileged in this country, but I am privileged. In January, I marry my long-time fiance, who is (now) a citizen and who is a white man. I will reap the benefits of his white privilege, including our living situation. Insha'Allah, we'll live and I'll co-own a home he bought for us last year, with five bedrooms, enough for our future children.

After my crying fit last night, I briefly wondered if this is a world I want to bring my children into, the children that I've been praying about more as of late, as family planning becomes acute for us.

I talked to my fiance about it. He calmed my fears. He's lived in a communist Albania. He's lived as an illegal immigrant in Greece, fearing for deportation at every turn. He's been an immigrant engineering student in Canada, he's earned citizenship there and, this year, here in the US. He's experienced that trauma. I still hurt for my patients, especially the undocumented immigrants and the refugees among them. I hurt for the babies that got invested in this election and are now are afraid for their well-being.

Insha'Allah, when Trump is inaugurated, I'll be sitting with my husband in our house on the hill with a relative position of privilege. The perfect position to affect change.

Don't get it twisted. LBJ knew Kennedy was going to be assassinated and gleefully took over as POTUS. This was a man who bragged about the size of his penis. It was not going to be him alone who signed into law the Civil Rights Act or the Voting Rights Act. My people mobilized to affect change. They mobilized. There were no submitting of demands. They gave their bodies to the cause. They worked to affect the change they wanted to see, they saw that change with their bodies. In effect, they were the change they hoped to see in the world.

My point in all this is that LBJ was hardly the charismatic and hopeful Kennedy, but he was the president under which these critical laws were passed because of the people. Will things be harder with a "Republican" (I think?) president and Republican majority in the House and Senate? For many of us, yes. Are we less likely to see the change we want to see under this president, even if we work hard to realize it? Yes. But the movements before us also didn't happen overnight.

One can muster all the memes that they like, craft all the hashtags they want--that has never been, nor never will be what is real. Although it will be painful, I will shower, dress, and be present for my patients this afternoon and evening because that is why I am here. I moved to this state from the comfort of Massachusetts' health care plan to learn how to provide care for a resource-poor, underserved community without a robust health safety net. The ACA happened, and I was overjoyed. It may be taken away, but my mission still stands. I will be there for my patients. I will use my position of comfort and privilege and muster up all the strength and smarts I can to be there for my patients.

And insha'Allah, I'll still bring babies into the world...but that's a topic for another time, another entry.

I don't believe this is a signal of end times. God knows, as always, and we don't. I also believe that this is (hopefully) the last hurrah for a dwindling majority in this nation. I will divert my energies into praying for us all, that God keep us in spite of political and financial twists and turns. I pray for my patients, my overwhelmingly black, Latino, and East African immigrant/refugee patients. I pray for my safety and the safety of all of my black and brown brothers and sisters in the face of police brutality, racism, Islamophobia and xenophobia. I pray for the scared babies and their future. I pray for those abroad who bear the brunt of our foreign policy. I pray that all of my loved-ones survive the next 4-8 years, as we did Bush...

...as we did Obama, who has the blood upon blood on his hands, who played the game, who wasn't the president we all hoped he could be, who didn't affect the change we wanted to see, sometimes because he couldn't and sometimes because he didn't try. Let's be honest.

At times like these I remember my purpose in this life, our purpose in life--to help each other through it. This is why I'm here, and forward I go.

Also, inna lillahi wa inna ilayhi raji'oon. One of my cousins passed away yesterday. Please join me in prayers for my auntie and uncle who lost another child just 4 months ago. Yesterday was also my grandmother's birthday. She would have been 88 years old. Please join me as I continue to pray for God's mercies and that God grant her peace and paradise.

I'm honestly thankful that my grandparents lived to see the first black president elected, for all that it was worth, and that neither lived to see the resurgence of the hatred that they felt so acutely when they lived in 1920s to 40s Arkansas.

No longer a resident

As salaam alaikum,

I've been busy but not busy, if that makes any sense. I've been mentally and emotionally busy, preparing myself for graduation for residency. This included taking (and passing, alhamdulillah) my boards, getting my work schedule arranged for when I start my new job in September, tidying things up for my patients before I hand them off to the new resident, moving...

Ya girl's been busy.

There is also a lot of background noise right now, honestly, that has gone on for the last three years. My faith has been challenged in a very specific way that I have not shared on this blog, because it is a moment in progress. When this metamorphosis of sorts is complete, I will speak more openly and frankly about it. For now, sorry, you just get tidbits.

But alhamdulillah, I have completed residency and I am now a family physician practicing family medicine with obstetrics. This morning, getting up and not going to clinic, I felt starkly naked in a way I never have before in my life. I said at first that I felt naked because I was no longer a resident, but in truth, I've been a resident for only 3 years. It seems like nothing and it seems like forever at the same time.

I gaze at pictures of my co-residents and feel like I miss them already and that I never truly got to know them at the same time. They are a group of 11 people that I love and with whom I have experienced something unique that will not replicate. I feel like I've known them forever and for not that long at the same time. They are excellent people and I hope we continue our road to excellence.

I went in three years from being an insecure medical school graduate, not ready to embrace myself as a physician, to a board certified family physician with no insecurities about my capabilities. Again, alhamdulillah.

This moment, however, reminds me of a song Elis Regina sang, called, "20 Anos Blues."

Ontem de manhã quando acordei / olhei a vida e me espantei. / Eu tenho mais que vinte anos. / Eu tenho mais que mil perguntas sem respostas. / Estou ligada a um futuro blue.

Yesterday morning when I woke up, I looked at life and I startled myself. I am more than 20 years old. I have more than a thousand questions without answers. I'm tied to a blue future.

And while I do not believe I'm tied to a blue future, there were all of those ways, over the past few years, that I realized that I was not my 20 year old self. I am not who I was when I began this journey to be a physician, to be a better Muslimah, to make my own contribution to social justice.

I'm not 20 years old anymore. My grandfather is not on this earth anymore and my brother is an adult with autism who is unemployed, unskilled for most vocations and lives at home with my aging parents. I am a family physician continuing a very separate life on the West Coast, away from my aging parents and away from my brother. My personal life bears harsh realities that I did acknowledge, in a highly dramatized form at 20 years old, but that are more eminent now, as I begin to make plans for marriage and a family of my own.

At the same time, I'm not 20 years old anymore and I don't look for ways to save the world at every turn, in every crevice and with every issue. I'm looking for very specific ways I can make an impact in matters that I care most about and that I know most about.

I'm not 20 and I'm not premed, I'm a family physician. I don't love a man absently who I have no access to, I love one who is here, on earth, with me, who is not a character I created but a real man who doesn't always follow the ideal script for our lives but who is here regardless. I don't look outward for my Muslim identity, I look inward.

So I begin this two months off before starting work period resuming Ramadan (Ramadan Mubarak to all) after the Feminine Interruption. I return to focusing on The Compassionate.

Unconditional Love

As salaam alaikum,

As I said a short prayer to myself before walking into colposcopy clinic this afternoon, I suddenly realized why people over time have been pulled to pray to their ancestors.



One of my friends, who is Christian, once told me that she equally regards most faiths, including Islam, and including worship of ancestors. As a Muslim who acknowledges my own faith to be the one right path for me and not necessarily for everyone else, I could intellectually understand where she was coming from, but did find the view to be peculiar. The way I understood it was that the bounds of her faith would allow for a syncretic existence in which ancestors would be revered close to God for consult and comfort. I couldn't imagine that for myself.

And I still cannot imagine that for myself, but I understand it a little bit more now. And now that I understand it a little bit more, it's making me rethink my imagining of God.

I understand it a little bit more since my grandfather died. As I heard the news of his passing last year, July 16 and shed my first tears, I was instantly filled with hope, calm and reassurance. That was from God. I knew that Grandfather was with God. I knew that he had gone to the Good Place. I had no doubt, and I grieved easier.

In fact, I was so reassured that I struggled to pray for my grandfather in the way that we're supposed to when someone passed because, in a way, I was like, "God's got this." And for the weeks following his passing, I felt him very present with me, as I felt that he had now come to know the truth of all things, and his soul was set at ease for all of the things he despaired about in this world. I also felt like he was getting to see me, all of me, in a way he'd never imagined me as a granddaughter.

That feeling slowly passed with the noor of Ramadan as the month ended, but since then, I've struggled to relate with that closeness. Grandfather's absent in this realm but very much present spiritually for me. My aunt says she talks to him sometimes. She has talked to deceased relatives all of her life. I don't do that. I took issue to that because I figure who better to talk to, effectively pray to, than God. So I pray for my grandfather but I don't talk to him.

But as I walked to clinic today, I thought about how proud Grandfather probably is of me, now that he knows everything about me and exactly what it takes to be a physician and what I've done, probably more than he understood when he was on earth. And then I faced the thought that always deters me from spending too much time in this paradigm: Grandfather also knows my sins. If Grandfather knows the truth of all things and is privy to the current happenings of this world, Grandfather knows all that I've done wrong. Not only that, but knowing the truth of all things, he knows better than me the cumulative consequences of my wrongs.

And that gave me very brief pause. I knew I wouldn't be upsetting a man who is basking in his life's reward, but I wondered if Grandfather's disappointment in those things that I had done wrong outweighed his pride for the things I'd done right. And while I was still in this slippery paradigm, I though, well, Grandfather would love me, anyway.

And I stopped there, and turned to God in prayer.

I realized at that moment that I saw my Grandfather as unconditionally loving, whereas my conception of God is not that, at all. Of course my memory of Grandfather, which is not at all the representation of the whole man that he was, is of an unconditionally loving patriarch. If Grandfather on this earth knew everything there was to know about me, of course he'd love me anyway. It would balance out. I project that to whatever form his soul has taken/will take/had taken in the outside realm.

But while God is Merciful (in that way that, at times, is so difficult for us to grasp), God's love is not unconditional in my conception of God.

I came of age believing in a God who loved charity, service, kindness and good matters and hated all that was evil, from murder to the sometimes vague perversion. So if I committed evil, I would not be loved by God. That is the condition.

Whereas for Grandfather, we'd have to be pretty shitty people before he no longer loved us, for God it seemed sometimes uncertain how much any particular good or bad weighed.

When put before an omniscient, inconceivable but reportedly merciful and just Being and your loving Grandfather, it would be way less intimidating, if it were an option, to go to your grandfather for guidance.

But as a Muslim, I believe that no one can help me or hurt me but God. And by extension, I also believe that God can and would hurt me, if indicated.

Grandfather wouldn't.

But without belaboring that point, whenever I find myself in that space, I extract myself and return to God. Grandfather, insha'Allah, I'll see on the other side and I can learn about the man I'd come to love in his 60s, in the latter years of his life. I look forward to that day but will complete my term in this world gladly, day by day, year by year, and prayerfully with many more.

But God is Greater. And maybe my imagining of God doesn't do justice to God's mercy and love. Not that I'm going to reduce God to a big grandfather in the sky or anything, but...

If I were too intimidated to come to God, who could I really go to?

I know why it is. It's the language of our Book. A God that doesn't need our prayers or reverence. A God that can replace us with beings that are better than us. God doesn't need us, but we think of people who love us as needing us a little bit.

So I understand how it would be nice to worship a center of unconditional love, but that's just not the way I believe.

2014 Retrospective

As salaam alaikum,

As predicted, residency (and life) swallowed me in a way that did not allow me to post (or even write) that often, but that is soon going to be history! I am now a third year resident, and in six months time, I'll be graduating and taking a 3 month break before I start working for real. What I do in those three months are dependent on how much money I save up moonlighting in the next year, but that's another story.

Anyway, for me, the year is hardly over, as my SO is flying down tomorrow to meet my parents, which will get a little notch in my year-in-review, but I figure I may be pretty busy the end of this year so I'd better get in my retrospective now while I'm ahead.

So, this was my 2014, roughly, and maybe not exactly chronologically, but in order of things that stand out to me.

Grandfather: The last time I saw my grandfather fully lucid in this realm was around Christmas of 2013. There was a big ice storm in Flint and surrounding northern communities and it resulted in a prolonged black out. My grandparents were staying at my Uncle Maurice's place because the power was out in their house. My grandfather talked about how much he appreciated what we did for him, an old man, and he started crying. Early this year, he likely had another stroke and went into a fast decline that almost ended in his death in March of this year but ultimately ended in his death early in the morning, July 16, peacefully in his sleep. I love that man with all of my heart and I eagerly but patiently await the day when I hear the rest of his stories in Jannah, iA.

Auntie and Uncle: I met my Nigerian Aunt and Uncle for the first time this year. My uncle, who my father had not seen in over 30 years, and his wife traveled to the United States for the first time and stayed with my family. I cried when I saw the brothers together, reunited. They stayed for four months and I visited with them two weeks out of those four months. I would love to travel with my father to Nigeria one day and visit with the rest of the family. I could say much more about this visit, but that will have to be for another venue.

Sayulita, Nayarit: I still feel like we totally pulled a coup in our residency by taking this trip. For our second-year retreat, instead of the usual long weekend in Leavenworth, we took five days in Mexico with our favorite faculty member in March. It was a coup because those five days did not count towards our paid time off, it was "conference/educational time." So we were paid for five days in which we did maybe 4 hours a day of therapeutic small groups (which were excellent!) and spent the rest of the time as beach bums, wandering around this semi-hidden jewel resort town. I actually got sunburned on this trip. Yes, black people can sunburn. Skin peeled from every exposed surface over the next couple of weeks and I felt like I was molting. So those times I wore sunscreen in the Dominican Republic were not in vain. The 12 of us and our faculty member spent 5 glorious days sharing a house on the hill that overlooked the beach. It was definitely a second bonding point for my classmates and I fell in love with them again.

Jamaica: I had never been to Jamaica, and at first felt conflicting going there to attend a wedding in July, not only of people I had never met before (my SO was best man, and I was his date), but also as the only black person in the party. Yes, I felt conflicted going to a majority black country with a group of white people. This was only the second international trip (Sayulita was the first) that I've made that was not part of a service project. And then to go to a resort where I felt like I may be inherently exploiting the people who work there? It was challenging until I got there and realized that over half of the patrons at this particular resort were black, many of them Jamaican, having conferences or spending a relaxing weekend at the resort. There were also a lot of African Americans there. And I realize that supporting tourism in a country like Jamaica is probably more productive than any of the service projects I carried out in other countries the past, though I still found it polemic. At some point, I finally just let myself relax. I was welcomed by my SO's friend and his wife warmly into their wedding party and was pulled in to do some Serbian dances during the reception (courtesy of the groom's family). Minus the sand flies biting the left side of my body, it was a good time. This is another place I have to go back to. I love going to countries with majority black people!

Stevie Wonder: I attended Stevie Wonder's "Songs in the Key of Life" concert as he toured the country. He actually made a stop in Seattle on December 3. So many performers and performances skip Seattle (like Motown, the Musical), but he came by. I was chief on Family Medicine Service at the time, and though I tried to switch my call days, I ended up on call on the day that our service went from tame to crazy. After that day, we would continue to admit patients and eventually cap out our service. My call days usually saw me staying at least until 8:30pm most days, and this day was no exception...exactly why I wanted to switch my call day so I could make the concert! In the end, I'm glad I didn't switch my call day because Friday (the day I was going to trade out) ended up to be a busier day. The concert started at 8pm, I got out of the hospital at 8:30pm and made it to the concert by 9pm. The people next to me lamented that I had missed "so much," though I got there as he did "Pastime Paradise," and knew that he had much of the album left, though I had missed "Sir Duke." I had heard from my cousins, who went to the concert in Detroit, that it went on for three hours. And Stevie did not disappoint. Our concert went on for four hours, which means I got to jam with Stevie for a full three hours after sliding in an hour late, until midnight! And, after four hours of sleep, I got in to work the next day, saw a full set of patients during my half day in clinic, and realized that age really is just a number. I thought that my days of staying up that late and then being fully functional the next day (without coffee) were behind me. At 29, I surprised myself with the stamina of a 19 year old while working full time. And Stevie, of course, was awesome. He sang each song from the album exactly as it was in the album. And his daughter Aisha Morris was one of his backup singers! And I could go on, but it definitely made my life to see my favorite artist in concert.

Nephew: My best friend from medical school had a baby boy in September, and I got to visit him in November when he was 6 weeks old. I've never witnessed someone I'm that close to have a baby, during those very new periods, someone that I knew before she met her husband when we were both very much single young women. And now seeing her as a mother, watching the transformation she and her husband have made...all I can say is, it's real. It's the only thing that gave my baby fever a pause. Not because of the job they were doing...no, they were doing excellently. It's just that I see that the struggle is real, there is no magical transformation. I was watching them as they were learning and adapting with a newborn. That is how life is, and that is how my life will be when, one day, iA, I have one of my own. Hopefully a girl. I already have some names picked out. Okay, so baby fever was on pause, did not completely go away.

Babies, babies, babies: This was the year of the babies. I think I delivered more than 20 babies this year, most of them being my own patients'. I just delivered one a few days ago, my patient's gorgeous baby girl. I have three more of my own patients due and then my residency adviser cut me off from deliveries. It's just as well. I've more than exceeded the number of continuities I need for graduation. My poor SO is tired of me talking about labor and delivery, and babies. He states that he could probably deliver a baby at this point from my descriptions of it.

Licensed Physician: I took (and passed) Step 3 earlier this year, officially completing USMLE and becoming a licensed physician. Seriously, exam taking in medicine feels like the "Song that Doesn't End." I started medical school and heard about the boards, and then learned about what would be the hardest exam I'd take in my life, disconcertingly named "Step 1." Disconcerting because if there is a step 1, there is probably a step 2, and maybe it goes on. Each year, I learned a little bit more about the exams I was going to be in for. Depending on one's specialty and if they go on to fellowship, there are a whole list of exams besides the USMLE steps that one had to pass to become not only licensed, but also board-certified. As I've chosen family medicine, I have an every-10-year board exam that I will have to pass and certain amount of Continuing Medical Education (CME) credits that I have to keep up with to maintain board certification. The family medicine boards through the ABFM is the last exam I'll take in residency, and the last exam I'll take in life (unless I lose my mind and go for more education or more board certification). But, in February of this year, I took and passed step 3, making me a licensed physician, able to practice independently (thus, moonlighting).

That Full Circle Moment: A couple of weeks ago in clinic, I had one of my first full-circle moments in family medicine. I went into the clinic counseling a pregnant woman on some cramping that she was having. She planned to do her prenatal care elsewhere, so it was going to be a simple visit. As I entered the room and began talking to her, I noticed there were tears in her eyes. She then told me that I was the doctor that told her that her grandfather was dying. Back in my intern year, when I was completing a night float rotation, I led a family meeting at 1am for a family whose beloved grandfather, who I had admitted hours earlier, was passing. It was the defining moment of my residency. I laid myself bare for that family as they looked to me to prognosticate what I couldn't with numbers. People were rolling on the floor, crying. I myself felt completely spent and cried after that interaction. I had never put so much of myself into a patient interaction in residency, and that was a great transition point for me. I actually didn't remember that woman in the sea of family members that were there, but she remembered me. Together, in the exam room, after I reassured her that there was no threat to her pregnancy at present, we remembered her grandfather. I shared with her that my grandfather had also passed that year, so I understood what it felt like to lose someone who had lived a long, complete life but who was still very beloved. We shared that moment and that continuity in a 15 minute visit. And so at the beginning of residency I saw the end of one life I was there at the beginning of another in the same family.

Saturday Thanksgiving: The last three Thanksgivings, I have been working. The first year, I was on the Family Medicine Service and served on a skeleton team that included my seniors and the chief and rounded on all of the patients of the day. My second year, I was on maternal child and covered the team's OB service. This past year, I was again on FMS, this time as chief, and I covered for my interns so they could all have the day off and me and one of the second years covered service for them. My first year, I wanted to prepare a turkey, so I made a full Thanksgiving meal on the day that I had off--Saturday. Since then, I've made Saturday Thanksgiving a small tradition for my residency class. This past year included one of the newest additions to our residency family, one of my co-resident's baby girls.

Death of a Cousin: In January, one of my second cousins lost his life senselessly. He was an anesthesia tec in his hometown in Ohio and he was paged in to work to help with a transplant. His car was in the shop so he couldn't drive there so he walked to catch a bus early in the morning and was robbed and shot dead, in cold blood, his body left in front of the bus stop where it was found shortly thereafter. This Christmas, my cousin, his father, a pastor, is celebrating his life and mourning his only son, the father of his two grandchildren.

A lot more happened this year on the smaller scale that is more tedious to recount. Overall, it was a good year, a year of challenge, growth and transition. And here I find myself.

And here I am.

Unassuming

As salaam alaikum,


One of the last things about my grandfather that he lost in the months leading up to his death was his personality. Or, I'm unsure if it was his personality per se or more his unassuming nature. I'm not sure the two are the same. They could be. I'm not sure how much of this is an artifact of my grandfather's upbringing, in a small, Southern Baptist family in the South, how much has to do with growing up during Jim Crow and having to choose deference to white people or face certain death, and how much was just his gentle nature. But my grandfather, in the time I knew him, was very unassuming.

"Oh, don't worry about me, baby." "You don't have to do that." "When you're not busy, could you..." "I'm sorry to bother you, but..."

So while my grandmother, in her heyday, would absolutely dominate all conversation in the room, my grandfather was often silent. Even after his death, my grandmother confided in my mother that she worries that he won't speak up for himself on Judgement Day.

When I learned of grandfather's death, I immediately cried but instantaneously felt a nur that could only come from God, and I was blessed to feel his presence. I knew he was not far, and that he was not suffering, and that he was with God, and it was fine. And it's been fine. And though I missed him at the family gathering after the funeral, the chair that he would occupy inside the house during such gatherings empty, I felt his presence in all of us, his offspring.

And one of the things I either got from him or learned from him is how to be unassuming.

Because I am unassuming in my daily comings and goings. I sometimes don't advocate for myself. I think more than that, I purposefully don't try to stand out in certain situations. Sometimes I feel that I do the spiritual equivalent of shrinking myself as small into a corner as I can. And I don't know how much of this was left-over, learned Muslimah jeito from college, but I try not to be too loud (though I have a naturally resonant voice), too boisterous. I try not to take up too much space, consume too much energy around me.

As a result, I feel as if sometimes, people don't really know me, or that the traits they do know me for are artifacts of the unassuming nature.

Then I worry if I'm not really nice, understanding and a good listener.

I've thought about this more as I've begun to speak up more for myself, let my opinions be known, speak before getting a chance to pour over the intent of my words so much. Sometimes, I don't feel myself when I do this, although it is certainly necessary when assuming an authoritative role, like senior resident, recruitment chief, or later, attending.

I've been thinking about this as I've contemplated my career and the various leadership roles I'd like to take, and as I see that if I don't advocate for myself, few people will. People are ready to assume mediocrity, perhaps in part because my unassuming nature. People are ready to dismiss me or consider me someone not worth knowing.

I'm not bland. I'm not boring. I'm just different. And if I spoke of my interests with as much fervor and pride as some of my friends do, as if all of our base interests are universal or at the least theirs are the ones worth sharing, then I'd be in no way dismissed, ever.

But there's something to be said about humility.

I think there's a balance. One can advocate for themselves and influence their own environment while still being humble and kind. I just have to make sure that when I'm unassuming, it's not to my own detriment while being of little benefit to those around me I'm trying not to offend.

All I Want to Be

Salaam,

As another Ramadan approaches, I'm starting to become more reflective and introspective at a time that my incoming rotation will not allow me to be. I'll be on a surgery inpatient service for the duration of Ramadan. I just have to get in enough calories and hydrate enough during suhoor and before I begin my shifts at 5am, and I think I'll be fine, iA.

But also, as another Ramadan approaches, I reflect on all of the things I've wanted to be over the years, all of the things I want to be, and all of the things that I've tucked away, at least temporarily. One of them is a better Muslim. That definition has shifted over time and looks a bit different than it did 11 years ago when I fasted my first full Ramadan outside of my parent's home as an 18-year-old college freshman.

It looks different than it did when I was a new, 21-year-old hijabi.

It looks different than it did when I was a 24-year-old medical student, struggling with the fear that my first Muslim brother-crush, who was marrying someone else, was maybe the best, the last and the only chance I'd ever get at love.

It looks different than I did when I was 27, newly disillusioned with love and certain aspects of my religion and moving from east to west coast with hopes to realize my dream career.

I think that, more than any time in my life, my self-definition is fluid. That sounds wishy-washy. I mean that I realize that parts of who I am are continually evolving as I grow and learn. I do not expect to reach my destination and still have life left to live.

In essence, I will not attain "better Muslim" at once and then sit pretty for the rest of the time. It will be one of those life goals I will work toward until the end, whether that is the end of my life or the terminal decline of my cognition.

And while one could say that my Islam is all-encompassing of the most important things of my life, I also have other aspects of my life for which I recognize that I will not reach a destination before the end. These identities of mine are constantly growing and changing, and I thank God for that. It means I'm very much alive.

It also means I can't close my eyes and see where I want to be at any given time. I used to be able to close my eyes and see such vivid detail, from the color of my clothes to the height of my husband, to how many kids we'd have at our sides. With maturity these details have necessarily become more vague or are now nonexistent, replaced with an intangible placeholder named insha'Allah.

Because I couldn't have made up the last two years of my life when I was an 18-year-old freshman or a 21-year-old hijabi or a 24-year-old medical student.

And that removes the pressure I feel to be all that I want to be. I no longer feel pressure to be all of these things soon, as if it would never happen otherwise. I no longer feel pressure to be all of the things I want to be at once.

I no longer feel the urgency of being all the things I want to be. It's all insha'Allah, and for the first time in a couple of years, insha'Allah doesn't feel daunting to me.

I guess this is what it means to Submit.

There's so much that I am that I want to be as much of my life as I can, but I cannot, because of the earthly limits of space and time. I want to be all of these things, including a writer, an artist, a singer, a musician - a family physician, a public health practitioner, possibly a medical director - a mother, a wife, a daughter-in-law--while carrying with the things I already am--a Muslim, a daughter, a sister, a cousin, a friend, the list probably goes on. I want to be all of these things at once because I enjoy each of them, in each of them I find meaning and purpose, in each of them I express a little of myself, and to several of them I aspire absolutely.

And for the first time, I'm okay with the fact that there may be some things that I'll never be. I'm not despairing right now with the possibility of never bearing my own children, but maybe I'll adopt or foster. I may never publish a fiction piece, but I'll keep writing. I may never marry, but I'll love and nurture those who are in my life. Not saying that they would not be hard to come to terms with, but I'm accepting.

Whereas when I was a teen, when I saw the future, I saw black, bleak, dark--whereas when I was in my early 20s, I saw future as a series of detailed ideals with a backdrop of grave anxiety--I can't see the future now, as I never was able to, really, and I'm placing my trust in God, the best of planners, while moving forward prayerfully with my own purposeful plans in the meantime.

By God's grace, I will be able to be all I want to be.

The Other Side of the Storm

Salaam,

I'm waking up on the other side of the storm. I just completed 5 weeks of inpatient medicine where I was a senior on service. It was great - I learned a ton, I taught a ton, and I have so much more to learn. I passed Step 3, I'm completely done with the USMLE and I'm one step closer to being a sho' nuff doctor. I'm coasting through the rest of second year with all outpatient rotations after being fairly front-loaded.

And my life around me is a bit of a mess.

I'm sure I have some rotting food in my fridge that I'll soon be obligated to touch to throw out, my bathroom is the nastiest I've ever let a bathroom get (I have a low tolerance for bathroom mess), I have one load of laundry left to do, a bunch of clean laundry to hang and a whole new bunch of laundry piling up in my hamper. I have weeks of eating hospital food catching up with me and I'm off my wellness game. I have evaluations to complete, procedures to log, continuities to track, all sorts of things. I basically have my work cut out for me right now.

But...I'm going to take it one step at a time. Tonight, laundry will go unwashed, the tub will keep it's ring, the rotting food that is now frozen in time in my freezer will freeze another day. After clinic, I will go to the gym, I will come back and do a hot oil treatment, shower and shampoo, and then chill the rest of the evening.

Early spring cleaning? I'll save that for Friday after the gym.

I admittedly let myself go during this last block in favor of being a present, active, senior. I had a bunch of awesome interns that made my job easy. And I think I did the right thing. In order to be as fully committed to service as possible as a resident, you have to siphon some energy from other parts of your life sometimes. The part that I didn't want to sacrifice were relationships. So I kept relationships up and running, maintained the bare minimum personal hygiene, and pushed forward on service.

Last night leaving was relatively cathartic. But residency goes on.

Now what? I have a full day of clinic, then I begin our behavioral health block. I look forward to hanging out with my second year class and sorting out the untidiness in my life and faith right now.


On a slightly unrelated note, I only have nightmares when I sleep on my back. Last night, I had a disturbing dream that the world around me was being destroyed by huge bombs. Already, several people had died and the world was left in a state of anarchy and uncertainty. I was back at home, and it was only my mother and I at home at the time. I don't know where my father and brother were. I was sitting at the table, eating a breakfast of mixed fruit (which was dream fruit so it didn't look like real fruit) that I think was good. My mother and I were having a good morning, shrouded in the fact that we were living each moment like we could get killed the next. It was so scary, but I was a full physician at this time and I had to drive out to work. The problem was, I didn't know which route to take. There was a freeway exchange in my dreams (way back...I'm reaching back, now, because I hadn't had a dream about that exit in a while) that I usually avoided taking when leaving Ann Arbor but that I'd have to take because my other route had recently been destroyed.

And although we knew that we could get killed at any moment, our moments were filled with constant prayer and we had faith in God that we would be seen through. And with all of this on my mind, I ate the fruit plate before me and chatted with my mother about the state of the world as the sun shone more brightly than it usually does in Michigan and as the deceptively tranquil day was before us with blue skies.

I woke up, fearing for my life, sleeping on my back with my head to the side, looking at my open closet. Not sure why I only have nightmares when sleeping on my back.

The Business of Being Born

Salaam,

I'm following along with my cousin's induction at a distance. She was excited to go into the hospital yesterday, but I knew all too well what a nightmare inductions from 0 dilation can be. I've been following along, step by step, and now, more than 24 hours into her induction, she is finally getting into a more active labor pattern (wouldn't call her being in active labor yet!).

When she and her mother began to get discouraged when she was 1cm after 12 hours of misoprostol, I assured her that I had managed some women who were inducing over the course of 4 days (I didn't include that some of these women were so tired by the end that they opted for c-section).

To which her mother, my cousin, said, "They were in labor for 4 days?"

To which I answered, "Yes and no." Putting misoprostol in the cervix is not the start of labor. The start of labor is regular, painful contractions and cervical change. So some of those women were not even in latent labor for more than 24 hours after the first cervical maturing agents were given.

My poor cousin, who did a lot of talk on Facebook and elsewhere about her moment, how no one was going to ruin it or force her to take medications...asked for an epidural after the first hour of contractions at 2cm dilated.

Can't say I didn't see that coming...but anyway.

When my time comes in the next 5 years insha'Allah, I will not turn my nose up at an epidural, I'll say that right now! It'll be nice to try natural, but I'm for safe delivery of babies first, and I'm not sure I'd tolerate a foley balloon, either.

Anyway, all of this bustle around the third great-great-grandbaby of my grandparents (my cousin's first granddaughter, my newest first cousin twice removed, hehe) has gotten me excited about my own childbearing prospects.

So I'm just going to say it, categorically, once and for all.

I love babies. I love babies, always have, always have wanted more than I'll perhaps be able to handle, and always looked forward to the day of being a mommy. And ever since the first time that I witnessed childbirth, I've wanted to experience that as well. Yes, the moment that make most women cringe as they watch the head pop out of the introitus, sometimes destroying the perineum in its wake and gushing forth with blood and poop made me say...I want to do that!

I'm continuously bitten by the bug of seeing women around me pregnant and birthing babies. From one of my attendings, one of the former residents of my program, who had glamor shots after she had a successful vaginal delivery of her 6 pound beauty, to my co-resident who recently went to c-section to deliver her surprisingly plump 12-pounder. From the plans of one of my attendings to conceive in the next year to the current 21 week pregnancy of one of my classmate's wives. Not to mention the oodles and oodles of babies my med school classmates have been having.

I can wait my turn!

That is not a typo, haha. I certainly can wait my turn, but it doesn't make me any less excited! I don't feel any less privileged to take part in the birthing process for all of the families that I've delivered, even as that number builds up. Every time I get to deliver a baby is still exciting, though in different ways than it was initially as I build up experience. But I've seen enough people on the other side of things to know that starting a family is no joke in a way I cannot appreciate until I'm there.

So I'll just keep training for now, work on getting married first, and then will make an actual five-year plan...

In the meantime, my cousin just dilated to 5. I have to go to work in an hour in which I will be managing our maternal child service in the afternoon. So I'll be surrounded by all things baby soon enough. For now, this morning, I have to focus on my medicine patients.

But, rest assured, I've been excited about having my own children for years now. I think about having my own children seriously every day, from what they'll look like (with my current SO as the combination) to what I'll name...the girls. Boys names are tough for me.

And having experienced, through friends and patients, the joys and traumas of the conception process, from miscarriages in the second trimester, fetal demises in the third trimester, preterm deliveries, complications, and infertility...I'm ready for parenthood in any form, whether they are my own children or whether I am adopting. Insha'Allah, I'm ready...

...to wait!

We Do It, Too

Salaam,

When I was a younger Muslimah, starting college and finding my way, I once scoffed at a non-Muslim friend who asked about Muslim male dating habits.

"We don't date," I explained to him. Or, at least, I tried to, before he got angry at me for "pushing" my religion on him. Whatever.

He was taken aback that I could have liked a Pakistani man over a black man. Rather, he wouldn't admit it, but even though we were "just friends," he wanted me to be attracted to him as he was not so secretly attracted to me. Oh well.

He didn't want to hear the explanation because every time I explained how I was Muslim, that was less of a chance for him to make his way into my life. We didn't date, I would have explained to him, and I would have described some of the more halal methods of courtship, as I had only recently come to understand them. We didn't date and we didn't have sex before marriage. That way, we could use birth control sparingly, while married, and then we would bring forth what God willed. And what better way to bring forth what God wills than in a marriage approached prayerfully and for His sake?

So even though I liked this brother, I would never be truly heartbroken because I wouldn't have gotten unnecessarily physical with a man who I was not bound to marry, because I would not get physical with a man I had not married. My non-Muslim friend thought I was being a prude. Whatever on him.

And I thought that was the way it was with all Muslims.


Fast forward 9 years. In that time, I graduated from college, from medical school, from public health school and have been a resident physician for 1.5 years. I have lived my life and I have lived alongside many challenging and beautiful patients who have taught me valuable lessons as I learn along with them and attempt to be a healer. Here in the Pacific Northwest, I have been blessed to work with a large population of Muslim patients, more than I had the privilege of working with while a med student in Boston. And although it did not take this experience to make this realization, it did give me real stories and real faces to put with what had just developed as anecdotes.

We do it, too.

We do what? Whatever you may say, "Muslim(ah)s don't do." We do it, too.

We have sex before marriage. We get pregnant as teenagers. We have babies, still unmarried. We get abortions for unplanned pregnancies when we're unmarried. We get drunk and use drugs.

I think what some Muslims do, and I say this because I once did it, is consider these Muslims somehow other. They are either "so-called Muslims," they are "nominal Muslims," they are "not practicing Muslims," they are "actually disbelievers," or at best they are "not striving." Perhaps struggling, later to find their way. Maybe they were born to Muslim families and have not actually taken their shahadah or taken it seriously. But they are not considered properly Muslims.

Then one feels comfortable falling back on "Muslim(ah)s don't do."

While protecting the privacy of my patients, I will say that the majority of the families impacted by issues above are actively practicing the five pillars and are visibly practicing with hijab, jilbab and beard.

And I do all of this not to noise about "evil," because I don't believe in that. That's not my point.

I used to believe that "real Muslims" didn't do certain things, that because of our approximation of the perfect faith, we were immune to certain life mistakes, missteps and choices. And I believed that anyone who made those certain choices were no longer real Muslims and therefore not part of my imagining of the ummah. At best, those who participated in those activities had strayed and, God being merciful, they would probably find their way back, someday.

But imagining the ummah this way creates a lot of instances of "not my problem," that should be our problem. They should be taken into our consideration. They should be made part of causes that we champion in our communities. These are not things that simply happen to somebody else.

It reminds me of my father's church. As many of you know, my father is Christian. His pastor and his wife were unmarried when they got pregnant and they were quite young when they married as a result. Because of this, the pastor understood the importance of having a ministry for single mothers, recalling the challenges he and his own wife faced. The proposal was met with a lot of resistance from other Protestant pastors who felt like having a ministry for single mothers was enabling and encouraging premarital sex.

So I suppose they would sooner not support these women, part as punishment and part as "encouragement" for them to form an acceptable family unit soon.

Even if that were the primary goal of the ministry, how do you expect single woman to form "acceptable" family units if they are believing woman shunned from congregations?

I applaud the pastor for forming the ministry and recognize that this point of contention exists across conservative faiths.


Real Muslims, in my practice, face many of the same problems that all of my patients face, if at a smaller volume for some. We do all of these things, but ultimately (and most importantly), it is possible for us to do okay on the other side. We recover. I have seen married women who had terminations prior to marriage now happily married to men who respect their wives and are eager to start their families with her. Men who do not hold this over her head. Men who are not emasculated by his wife's prior sexual experience. I have seen loving parents standing by the side of their teenagers struggling with early addictions to find the best health care. Parents who do not cast these young people out. Parents who are just as frustrated and scared for their children as non-Muslim parents.

My practice in medicine has always been consistent, regardless of religion, orientation, gender, ethnicity, etc, but I believe what I've learned as a clinician has impacted my worldview. I think of us Muslims less monolithically now.

Can I Choose You?

Salaam,

I posted this back June 27, 2012, and removed it for various reasons. I decided to repost it because here, a year and change later, having worked with G for several rotations, the while forming a relationship with someone else...I still feel this way when I'm around him.

I think it's just that he has a beautiful spirit...

Can I Choose You? (Repost)

As salaam alaikum,

This stage of my life is amazing and I don't have all of the words to describe it. There are so many things happening, and I'm learning so many things about myself. At the same time, I'm on the cusp of another challenging phase of my life, of many more challenging and rewarding phases to come. I'm drastically changing philosophies that I've held at one time in favor of more organic, realistic and practical ways of living my life, love and faith.

And man, it's not easy.

But in the midst of all of this, I want to say I've fallen in love. I actually haven't. I just have a crush. One like I've never had before, one that was immediate, some enchanted evening, love at first sight, across a crowded room type deals.

We'll call him G.

It's time for me to get ready for work so I don't have a ton to say, except...there's something different about this one, and I can't tell if it's destiny or desire to make it destiny, strong enough, that uncontrollable thing that people always talk about, you can't help who you like.

Because you want to make strong feelings destiny.

You want to believe that there is an eternal meaning for your emotions, that it's part of God's plan, that the strong pull you're feeling towards another human being is God guiding you down the straight path, the path He intends for you. Like, snap out of it, girl, this is it. This is the it you've always wanted.

And the first time I looked into G's eyes, that's what I felt. And I've never felt that way about any living human being before. It wasn't just the striking pale green of his eyes offset by the olive of his skin and his dark brown hair. Because I've seen attractive men before but never been so drawn before...

So, as I prepare for work for the day and other things, I'm deciding what I'm going to do with this. And praying on it, because really, what I want is him. It sounds silly and crazy for someone who lived through an MTQ, but I feel like we're meant to be, and yeah. I want to lock that, secure that in any way I can.

Is it okay if I choose you, G?

Two AM Insomniac

Salaam,

I just got off of a pediatric emergency department rotation that ended with a week of night shifts ranging from 5am-2am, 2pm-2am and 7pm-7am. As a result, for the past few days, I have been very awake at 2am and 3am. Yesterday, I was only able to get back to sleep at 3am. This is also fueled by the expectation I have for a patient who is in early latent labor right now and could go into labor at any minute...or in several days. Also fueled by being very worried about a patient that I picked up and hoping she survives the night...for several reasons.

So now I'm awake. And I could have just sat in bed and reflected and tried to go back to sleep for hours, but I guess I've already slept four hours and I have until 8am to get up, so what better to do when having insomnia than to get up in front of a screen for a few minutes?

...actually, no, bad. Screen time is not the way to go back to sleep, and this doctor knows that. The fact that I do most of my major activities in this bed these days (including working, eating some meals, leisure time, practicing my clarinet and sleeping) also doesn't help.

The bed is very comfortable, though.

I had a fitful time getting to sleep, too, with all sorts of pre-sleep hallucinations about being awaken shortly after taking melatonin to go attend to a delivery. If it weren't for the whole continuity delivery thing, second year would be easier than first year. I'm going to have to find a way to deal with that.

That, and my plans for an elective are currently up in the air because I've just been so busy with inpatient rotations I haven't had time to adequately prepare and plan. That, and it is so hard to get to faculty to help me out in the matter.

The past few weeks have been filled with a mix of excitement, sadness and challenges. There have been bachelorette parties and weddings, conferences and night floats, a very isolated Ramadan again without being able to attend Eid prayer because of work, Trayvon Martin and The New Jim Crow. It has been an emotional roller coaster and the fact that I'm waking up afraid for my patient's life, unsure about this rotation and, indeed, unsure about my future, make the perfect recipe for my insomnia.

I just lay on my stomach and prayed desperately for a while. The place of prayer in my life has morphed over the last several months.

I also wonder about this relationship I'm in, with a man that I'm pretty sure no person whose ever known me would imagine for me or may not even want for me. I made the decision a while ago that this didn't matter. However, it does make certain aspects of life more isolating.

I think this is a road, no matter what the outcome, that I must travel, though. It is a lesson for me and it will inspire humility. After years of being disappointed that MTQ couldn't see past our racial and ethnic differences to try to make something out of our mutual attraction--I now see how hard that is when you face your loving family's disapproval.

I don't have the strength right now to deal with the "you could do better" and "what's wrong with black men?"

In all, life is really hard, it's an uphill battle and a slippery slope. The feeling of God wavers from familiar to distant and more things are subjective than I'm comfortable with. So boo.

Sad

Salaam,

Today, I am sad. I sat before an old friend of mine and I became sad. I feel like I've finally come to terms with so many things that I've given up on that maybe I shouldn't have, so many ways that I've lost faith in things that maybe I shouldn't have, at least not this early.

The world for me became a much more jagged, ugly place for me more rapidly than it ever has been before. The fact that I could read The New Jim Crow and not become enraged tells me that I am disaffected. It could be worse. I could want to do nothing about it.

But it's not as bad as it could be. It's more like the opposite. I want to do everything about it.

But I don't know where to begin.

No Compulsion

Salaam,

I never quite recovered from my period of dissociation.

Quite the contrary. It was a long time in coming. It was about time that I put myself so much into patient care and residency that I felt as if I'd lost myself. I felt that way plenty of times as a student and through much of residency kept myself just outside of that space while dancing dangerously close. Every day, I was simply grateful to be a part of these patients' lives, even if they wouldn't take my advice, maintained their distrust of doctors or suffered from the health sequelae of their own choices. It was fine, because I was honored to be a doctor.

Until I had the painful, 45 minute meeting with a family telling them their grandfather was going to die, them rapidly cycling through denial and grief. And went up to speak to them about an hour later to clarify the conversation, lying myself bare before them, as I said before, at 3am, like I've rarely done for anyone else. I stopped existing for myself in those moments. I was not Chinyere. I was a doctor, I was only their grandfather's doctor, I was the young black doctor to tell this black family what I knew, laying it down. I had no where else to be but with them. I had no other identity. I put away thoughts of my own grandparents, my own extended family, what they'd do in a similar situation, if I'd have say, as the only physician in the family.

And it was hard to get myself back from that. It's hard to do something like that, over and over, because it's part of the job, we do it over and over, and feel invisible. No one else is there to really see you.

But it was a long time in coming not just because I had to hit that sweet spot in my patient care. It was because I made choices this past year that rapidly changed who I am and a lot of what I stand for. In that patient encounter, I was away from myself for long enough to take a good look at myself from the outside. I look exactly the same, but I'm so different inside.

Part of it is becoming a physician. Another part is giving up on marrying a Muslim man.

I gave up a year ago and I haven't looked back. It was not an easy decision. And it was one that I perhaps could have made with more prayer, but I'm tired. In every interaction, I realize that I was trying to hard to be what I thought such men would want, instead of being myself and being what I want for myself.

And this is not just me saying this. My SO was raised Muslim but does not practice. He believes in God but practices nothing. And I do not seek to convert him.

And with that went so many other things that were depressing to me. And with that went the feeling of hopelessness, that I'd always be alone, that no one would love me, that so many men were missing out on who would be an awesome wife.

I broke free of that, and I don't look at myself the same way. I don't look at love and relationships the same way. And yet, I carry myself the same, my face looks the same...it's just the way that I interact with the world is different. It's easier. I feel like I can relate to my surroundings. I'm not in it but not of it, to paraphrase Stevie. I'm not painfully separate.

Is it perfect? No. But nothing on this earth is.

Are my plans for myself perfect? No. But none are that we come up with.

And I'm sick of my parents suddenly trying to tell me about God like I didn't just go through a long, hard, lonely spiritual journey of my own, learning to connect with God with little help from them and their own religious bickering over the years. Could have used that when I was younger and searching. I do not want to hear your novel discovering now like I haven't thought of them before, meditated on them, took them to prayer, wrote essays in my journal about them.

I think I've also become more cynical.

Dissociation

Salaam,

Dissociation. It's a funny looking word when you stare at it almost immediately. It's that feeling one gets when they've sacrificed themselves entirely to something or someone not themselves and have little self left for his or herself at the end. It's the feeling I used to get after long days as a third year medical student, caring for patients, trying to figure out what was expected of me and comply with that, living for compassion and living for a grade.

I hadn't had that feeling in residency so much until this last night shift. I woke up, tossing and turning, unable to sleep more than three hours after the last shift in which I was absolutely exhausted. I keep thinking about the last patient we admitted. I keep thinking about the family meetings, his grandchildren sprawled out on the floor crying, running out of the room intermittently, bowing their heads, trying to understand, in an instance, death that they apparently did not see looming.

I was tempted to log into the computer to see if he's still alive. If I keep thinking about him, I'll have to. He may not be. I wish I could close the loop with the family and debrief. I wish I could be there, in spite of my lack of sleep.

I couldn't turn in my bed but for dreaming I was in the hospital. So I just had to sit up. And purposeless tears flowed down my face. I did not start them nor stop them. They came on their own.

I think I'm tired, too. Last night, I started losing my sense of self. I felt isolated, I felt apart, I felt different. I feel alien. I feel like I'm different from everyone else. I feel like no one can relate to me, not my classmates, not anyone in my program, not my SO. I felt alien in the music that I like, my sensibilities, the way I dress, the way I think, the way I am.

I think it's all happening because last night was a rough night, I put too much of myself into that family meeting, that patient encounter, gently touching the man who may be dying and speaking to him softly so he wouldn't feel discouraged as his granddaughter, not understanding the gravity of his illness, told me how his legs had been becoming cold before he was admitted. It was hard and I had to be strong. It was hard when I had to be strong because I'm in this position right now because I was inappropriately weak. I can't be weak now.

I think it's all happening because I'm also in transition, a transition that's been long in coming. A transition in my faith, a transition that is not complete but that will be long. I've lost elements of my life that used to give it meaning. My life still has meaning, of course, but in some ways it's so different I barely recognize myself.

I'm in the same in the mirror, and that I'm so the same in the mirror despite how different I sometimes feel inside feels incongruent.

It doesn't make sense that I look the same. I should look different.

I feel like dropping off the face of the earth. Not really. I feel like disappearing for sometime, into myself, away from everyone else, like I used to have the luxury to, to listen to the music that I like that no one else cares for, to dance my samba in peace. I feel like taking long walks alone, reflecting alone, being by myself. I feel like being present only in a professional sense.

And now the tears are purposeful.

Sometime in the course of last night, I completed a turn of dissociation.

I can't be someone I'm not, and I can't play like every way that I've changed since I've started this residency isn't a big deal.

[uncensored]: It's Time for me to Wake Up

As salaam alaikum,

It's early morning, I don't have any clinical or community medicine project responsibilities this morning other than putting together an outline to email to my adviser early this afternoon. Applicants will be submitting their rank lists soon and after a busy application season, I suddenly feel ambitious like I never have before.

Maybe this is what happens after you read Christopher Dorner's manifesto first thing in the morning.

I began to think of the state of black people, and specifically black men, in this society. Do not read me wrong, I am not condoning Dorner's actions. The manifesto was completely crazy-pants and any salient points he made about dysfunction and corruption in the LAPD are virtually muted by the fact that his solution is a murderous rampage. I think the whole thing is an unfortunate mess that will not bring about an overhaul of the LAPD or any similarly-functioning police departments but has the potential to result in the death of innocent black or black-looking people who may or may not look like Dorner, as well as whatever other innocent victims Dorner may target in the coming days.

He said a lot in his manifesto about clearing his name. Talk about the opposite of clearing your name, but anyway. That got me thinking about men and the importance of power and position for them. It got me to thinking about what an affront and how emasculating it must be for men to lose position, face, title, influence, whatever the mode of power they feel like they've earned or were otherwise entitled to.

Is it always emasculating? I feel like I'm making a grand gender generalization.

Anyway, this briefly reminded me of an undercurrent in many black families and in parts of the black community that black women have a duty to relate only to black men, and vice versa in a slightly different context. I wasn't raised with this notion but I do feel a special duty to black children, especially black boys, so it almost feels like abandonment sometimes that I am not wedded to marrying a black man.

But that's another topic altogether.

I started thinking about the U.S. penal system and how I won't even dignify it by calling it corrections. Because correcting what? Correcting nothing save by the wills of individual incarcerated souls that may be self-reformed and freed or may otherwise write and reach out to others to right wrongs, to speak out against injustice or to call upon them to not repeat their same mistakes. I opened up a documentary on the war of drugs that speaks a little bit about the U.S. prison complex, but I believe there's a new documentary out there that talks specifically about black men in prison. Anytime 1 out of 4 of the population of black men will spend some time incarcerated, there's a problem on some level, whether its the moral failings of a mass of unrelated individuals, the moral failings of a community or the moral failings of a society translated into law and so-called justice.

I thought about a lot of things. It all came to a head as I was reading the SNMA email newsletter and the first story (but not the newletter headliner) was titled "Black Males Not Applying to Medical School." The article pointed out that black male matriculation in medical school has only increased 36% since the late-70s, whereas males (and females) of other ethnic groups had tripled (Latinos) or even grew to nearly 10 times their 1970s demographic (Asians). Black females in medical school, much like undergraduate school, outnumber their male counterparts by 2:1.

The solution suggestion in the article? Strengthening the pipeline.

This speaks to a lot more than the college-to-medical-school pipeline and to whatever all is behind the fact that our men are so many times more likely to end up behind bars than any professional career.

In between reading this all this morning and drafting my community medicine project outline and thinking about match day and how we had no black male applicants to our program this year and that I've seen two total black residents in family medicine and how so few of my black classmates went into primary care and how I don't know of too many black medical students who aspire to primary care and how I could do a study on that and maybe if I have time during residency I should do a study on this because I think I know some of the reasons why...

...I woke up.

I'm sitting here in my bed, at my computer, lying in what I slept in, living room window open to a cloudy day and a cluttered living space, and I woke up.

I've been awake for three hours but I woke up to what is reality for me, what a lot of people see in me but I hadn't yet seen in me because I've spent so much time trying to be as inconspicuous as possible. There's a lot that needs to be done, and I was born to be one of the agents.

I am blessed to be able to be one of the agents. I was born on a platter of privilege, in upper middle class family and was raised in relatively safe neighborhoods, far from the realities of governmental corruption and economic stagnation of my father's country and far from the realities of senseless violence and economic dilapidation of my mother's home town. I was born and raised as a privileged, young black American-Nigerian American little girl who was allowed to be fat and cute and happy.

I entered the academic world with an unfortunate inferiority complex that sneaks up on me when I'm feeling the most vulnerable. You probably don't have a high IQ but you work hard, a guidance counselor told me in the 8th grade as he reflected on how I had all As. And I hate to admit it, but sometimes I believe that instead of taking responsibility for when I haven't read or haven't studied and haven't felt prepared.

I've let myself be dominated by this and other insecurities and have live a life where I haven't fully realized my privileges and blessings and instead am listening to nay-saying spirits that really have nothing to do with me. Old, warn-out, hackneyed narratives used generically to destabilize, even unintentionally, so powerfully interwoven into the fabric of our society that if anyone did it intentionally, they'd be genius, Nobel-prize level genius if the effort were at all worthy.

I don't even see what I've been blessed to accomplish, who I am...a dual-degree medical school graduate embarking on my career. I am the only black person in my residency program. I am one of four black physicians I've seen at my hospital. There may be a fifth somewhere. Sure, I've been scratching and surviving as an intern and I will continue to do so. However, I can't be who I am and have gotten to where I am and not do something about the fact that black men are more likely to go to prison than to pursue a professional career.

I'm not going to go through this residency with my tail between my legs. We all have a right to be individuals outside of our race or ethnicity but it's not in my blood to be an individual ignorant of these realities.

I am in medicine. This was my chosen path because of my Islam, because of my spirituality, because of my potential to serve. There are many causes and I have many dreams on many levels but I was privileged to not be a victim of racism and I will not think myself a victim of anything ever again, because I'm not. As I said previously, I am my own liable limitation.

I will not envision myself a hero but as an agent to a movement that's already happening. My men, our men, men who have melanin in their skin like I do and kinky hair like I do who grew up in homes like mine and homes very much unlike mine are feeling emasculated in a society that historically views them as less of a man, has made fetish of their sexuality, and in so many other ways has undermined their existence and vital purpose in our society. And again, I hope I'm not generalizing, but I think this is devastating to the psyche.

That article talked about how the waning numbers of black men going into medicine could effect numbers going into primary care with the thought that black people best serve black people and maybe we could get a handle on disparities if there were more black people in the field, at least 13%, so we could be representative of our U.S. population.

My point is, there's some deep-rooted shit that's the reason that so few black men are going into medicine or any other professional field, and why so many are in prison, and why states have historically looked at their third-graders to determine prison enrollment. And we all can't be physicians or professionals, but really, who has to be in jail?

It's time for me to stop being a victim of my own mind, of my own insecurities and fears holding me back from being what I need to be.

It's time for me to start becoming the strong, intelligent black female physician of today because of alhamdulillah all I've been given.