by Reshma Rao
I gave Reshma a book by a Vietnamese doctor, Last Night I Dreamed of Peace: The Diary of Dang Thuy Tram. After she read it, she sent me the following letter.
I guess I fell in love with you just like everyone else…I guess you know that you’re really close to someone when no words feel like they are ever good enough to express what you feel for that person. Oh Thuy! I could name off a thousand adjectives to describe you but one particular one comes to mind – human. You are one of the most human individuals I have ever come across in my life.”
Mark, you told me to write you a reflection of Thuy – it is hard for these words to come out. Thuy is someone who does not allow you to praise her in words because her genuineness, her powerful determination, and her eternal love are expressed so thoroughly through her actions. It forces me to remain silent, but my mind has thought about her a million times since my lips have first said her name. Every time I feel like closing my heart to someone, Thuy’s name comes to mind and I think twice about it.
I can’t imagine Thuy’s pain. Courageous and determined are merely enough to describe her. She fully immersed herself in the war, its tragedies, within each person affected by the war, and therefore her pain was multiplied by millions.
Thuy’s story, as much as it inspires me to have a big heart, truly, also makes me feel like the angriest person in the world. I am angry with everything, most of all with the medical school for not teaching us about this. I am livid at the medical field and the people in it; those that have turned it into nothing but a hungry, money-grabbing, deceitful privatized system of exploiting nature, like so many other of our systems. But hey, it fits in perfectly with capitalism. And I’m livid with those that do not do anything to stop it but make their life’s goal to climb the highest ladders of this monstrous injustice. And most of all I’m livid at this so-called God that I stopped believing in.
As I sit it here in the medical school library, I think about all that my privatized university has done to make the world a worse place, contributed to numerous wars, taken part in the suicides of farmers in India, cleared the area of all homeless and poor directly around the university and most especially around the damned arena.
Thinking of Thuy, I think of all the other Vietnams taking place as I write this – Palestine, Congo, Bosnia, Darfur, Rwanda, practically all of Latin America, Poland, India, China, Somalia…and the list goes on…and we cannot forget the very genocide that our country is based on. And I wonder how many other unheard of Thuys there have been in the world and how many more there will be…they are perhaps the only reason I am still here…
I look forward to you going to the Middle East:
Wherever I look, there you are
No matter where you are, there you are
If I look at the leaves swirling, there you are
If I look at the curious eighteen-year-old student, there you are
If I look at the crinkled, inked up manuscript, there you are
If I look at the sun partially hidden by the clouds, there you are
If I look at my left hand, there you are
Go in peace to the Middle East
(How else could you go?)
I’ll be here with you
First of all I want to say thank you for proposing this. My first thoughts when I flipped through Steve Brouwer’s Revolutionary Doctors, not even having started it, was sadness. To be perfectly honest, my dream of being a “revolutionary doctor” seems farther and farther away from from me. I can’t seem to get out of this web of paperwork, liability, vanity, family drama, panty hose, weight loss, 5 hours of sleep, and feeling inadequate.
Once again, thinking of you, your messages, your letters, your well wishes grounds me. For that, I couldn’t repay you in one hundred lifetimes.
On the first five pages…
Yes, the first paragraph was brutally honest in its account of US involvement in Guatemala. I often forget that Che felt so strongly about his doctor responsibilities.
First sentence of next paragraph … , you asked, “Isn’t this your vision, given your keener interest in your Public Health Master’s than residency rigmarole?”
– Yes, I suppose it is now, I don’t think it started out that way. I think I was primarily interested in the creation of a just society, not sure how I felt about the humanitarian work…a wise person once told me however to “bloom where you’re planted.” I’ve been planted in medicine 🙂
Page 14, quotation at top of page: you asked, “Have your superiors and attendings (past and present) encouraged more questions? This is how we learn. You can never ask too many questions.”
The only person who has ever encouraged me to do this has been you.
Snail Mail Scribble for Srimatiji
“My deep dream is to be
An invisible bodhisattva
No web-site with bells and whistles
No 2,000 friends on Facebook
Fame or melodrama
But with the Jedi power to disappear
For the ego to disappear that is
(Even for 14 seconds
A bodhisattva made up
Of non-bodhisattva elements–
Mustard, milk crates, Carmex,
Hill Street Blues, cracked sidewalks, Beverly Hills Cop—
A satyagrahi with 20/20 spiritual vision
The cashier hasn’t a clue who intervened in the nick of time
The best friend of stray dogs
The listener to the loneliest people on the planet
The accompanier of alienated residents
And resident aliens
The ennobler of all social workers
Bereft even of a memory of self-care
The flesh and blood answer to the one who sings
‘Show me the meaning of the word!’
(Gravitating to the Gloria Gaynors
Who can’t ever believe they’ll survive)
Rider on our equivalent of trains but 4th class
Common as the air
Plain as chapatti
A bodhisattva with compassion for all goofy-eyed groupies
A grandfather you wouldn’t even notice at the corner of Fourth and Fellini
One with the Way
Befriender of the Flow
Who doesn’t disparage a single soul
For who knows what nightmare she’s living out
A bodhisattva unfazed
By the tornado there on the horizon
A beginner bodhisattva
Who only writes down this deep dream
For Srimatjii who is so far away
And to himself as a reminder
I remember walking up and down the street where Grand Pyramids Hotel was located a million times.
I remember the smell of El-Kahera, el habibi, Cairo.
I remember being surprised at how many young people were going to Gaza.
I remember feeling like I would lose it if I had to stay in this hotel one more day.
I remember feeling hurt about all the Cairo-bashing from those who spent no more than nine days in the land of the Nile.
I remember the first moment of getting on the minibus, thinking that I would reach Gaza two days later.
I remember the feeling of my heart sinking when we were stopped at the checkpoint at Suez and it was 30, 60, 120 minutes later.
I remember spending the night at the Suez Canal.
I remember my exact heart palpitations when the two young Palestinian-American boys tried to hit the Egyptian officials.
I remember thinking of torture when they called the Riot Police.
I remember my chest tightening when I saw 2 boxed black vans pull up with Egyptian Army men sitting in the back.
I remember sitting in front of the minibus the following morning with Ameliano and the girls from Jersey talking about which protest experience was the scariest for us…
I remember thinking this has been my scariest one and then remember wondering why people thought protesting somehow made you a hero and remember thinking we definitely need to re-think stuff.
I remember talking with Rheem when he came with me to buy toilet paper in Cairo and I learned that his parents were revolutionaries in the Eritrean Independence war.
I remember ordering lamb curry with Ahmed, Rheem and Khouri and watching Ahmed slowly fall asleep.
I remember on the way to Suez Ameliano telling me “I thought you were just some do-gooder doctor chick that just wanted to help, I didn’t know you were all into social justice and economics, that’s pretty cool”
I remember how he never looked at me the same way.
I remember thinking “Man, I hope I don’t come off like that to everyone.”
I remember peeing twice in a toilet full of shit at the Suez check point.
I remember entering the gates at the Rafah checkpoint and remembering why I came.
I remember my first step on Gazan soil.
I remember feeling like it was all unreal.
I remember big buildings with big holes
I remember chicken and rice at every meal.
I remember being on the balcony staring at the sea, feeling waves of peace and turmoil crash within me.
I remember thinking 24 hours is not enough.
I remember the press conference with Hamas.
I remember Hamas officials not letting us pay for anything.
I remember children waving in piles of rubble, men waving from tiny shops, boys holding pens in the air and notebooks.
I remember seeing tents with people praying, temporary masjids built on ruins.
I remember thinking “what God” do these people pray to?
I remember feeling exhausted always.
I remember hunger pangs.
I remember walking with the beautiful dark-haired-dark-eyed Palestinian-American lawyer, who, when I told her I was a medical student looked straight in my eyes and said so genuinely “good for you,” I remember the empty look in her eyes when she spoke of law.
I remember the “Free Gaza” banner falling slightly from one of our AID trucks.
I remember wondering if I was really helping the Palestinians by being here.
I remember the smell of the garden herb a Gazan woman handed to me when I stepped off the bus.
I remember flocks of media- none of it was American.
I remember standing around Galloway listening to his speech.
I remember feeling greasy and dirty.
I remember feeling like I’ve never been so sleep-deprived in my entire life.
I remember thinking I can’t even begin to comprehend what the Gazans went through even though I’m here.
I remember the gut-wrenching feeling of emptiness I feel when I miss Cairo.
I remember the guilt I felt leaving Gaza.
I remember how there were never any tears, that I had been waiting for all this time.
So what if David Harvey’s Marxist analysis is verified by each day’s dispiriting news?
“Full effort is full victory.”
So what if the interlocking system of oppressions appears stronger with each passing month?
“Be here now.”
So what if the work feels crushingly overwhelming and gratitude for the work is depressingly underwhelming?
“You have the right to work, but never to the fruit of work.”
So what if samadhi often feels like a million years away?
“Concentration is consecration.”
So what if the daily grind is wearing down our faith and kicking our hope into the gutter?
“Love is the strongest medicine. It is more powerful than electricity.”
So what if you are 750 miles away and I only get to see you twice a year?
“You and I aren’t ‘we’; you and I are One.”
Line 2: Mohandas Gandhi
Line 4: Title of Ram Dass’s 1971 spiritual manual
Line 6: Bhagavad Gita, chapter 2, verse 47
Line 8: Last words of Sri Anandamayi Ma
Line 10: Sri Eknath Easwaran
Line 12: Neem Karoli Baba
Line 14: Meher Baba
I am a former student and friend of Mark. I’m writing this letter to you because Mark asked me to, and because I think the two of us are on a common journey. I write this letter to you, in the hopes of offering some support for what you are going through. They are, by no means, words of wisdom 🙂
Rachel, let me first say that from what Mark has told me you are a remarkable individual. All that you have accomplished, most people don’t do in a lifetime. I would love to hear more about your international travels and life experiences.
I’ll share some background about myself that you may find relevant. I tried to drop out of medical school twice, and both times I was unsuccessful. Prior to starting medical school I had spent 6 months in Cairo, Egypt studying Arabic. I came back and dove straight into human anatomy. I was miserable, and I felt each day that there was no way I could get through this. I felt out of touch with what I really cared about, isolated, missed Cairo, and quite honestly, felt lost. I had no idea what I would do with medicine, as it did not seem to fit in with what I was passionate about.
Finally I just decided I no longer wanted to be that straight A student we are so used to being and made medical school pass/fail for myself. I decided to study less medicine and spend more time on the readings that I wanted to do, like Paulo Freire, Paul Farmer, Eduardo Galeano, Zinn and Chomsky. These books became my best friends, kept me alive through medical school.
I also began searching for a physician who did international work and ended up shadowing a psychiatrist who worked on PTSD with refugees. Ironically I never considered psychiatry before, but after working with her for two years, I decided it was the right field for me. That’s how I ended up in psychiatry and am now a second year resident.
Anyway, I don’t want to bore you with my long story…what I really wanted to comment on is this. You said to Mark, “I thought, ‘Nope, this isn’t what I will do when I grow up’, so I’m back to not knowing”. Rachel, I think that’s perfectly OK, to not know…I feel like this all the time, and I’m in my residency! You can plan and plan, but I think if you stay passionate about justice, what you’re “supposed to do” will find you.
Medicine is exhausting and unfortunately there is not enough room for social justice in medicine because medicine is run so much like a business these days. But the good news is, you can carve out space for yourself. Although there’s no set path for people like us, there is a way to create it. It may take different shapes for different people. Keep talking with people, making connections outside of medicine, and don’t give up. Take risks, talk about the issues you want wherever you want, and prove they are relevant to medicine. This will re-energize you.
On feeling exhausted…yes, always! Trying to fight for justice in medicine will always be tiring. Some days you may feel jaded, hopeless, guilty, and even feel like giving up. Some days I get up in the mornings and want to go right back to bed. Some days I feel myself getting irritated with a patient, which I swore to myself I’d never do. But I promise you, it’s worth the fight. The more you look, the more hope you’ll find. For me it’s come in the form of getting my masters in public health where I’m finding more like-minded people, and staying involved with community organizations working on urban violence, racism, and neoliberal policies. And of course, from my patients.
It seems to me, from the little information I have about you that you are pushing yourself too hard. I think its pointless in me telling you not to because people told me the same thing when I was your age, but it didn’t stop me from doing so. I think people like us will always overextend ourself, but I think there’s room in there for slowing down. I learned this primarily from Mark Chmiel. Continue to reach out to Mark, Rachel, he’ll be the best friend/ mentor/ teacher you’ll ever have. Mark taught me the importance of the present moment, of practicing mindfulness, and it has helped me tremendously.
The bottom line Rachel, is, and I know this will sound corny, but the world needs you! There really aren’t enough physicians who care the way you do, and I promise you, you’ll find your own way in medicine. Don’t give up on it. To be a physician is a privilege and you have so much to offer to people. The opportunities to do what you want get better once you’re out of medical school. I have been meeting with tons of community organizations and getting more involved in public health. In fact on Tuesday I give a presentation in class on structural violence, poverty, and infectious disease. So I promise you, you will find a way to do what you want in medicine.
Think of these next few years as an investment into that future, and if all you have time to do is go to class, study, take a shower, eat and go to bed, do it and take time for yourself! In your heart sit all of those people you have come across in your travels. Let those memories and the people you love rejuvenate you, and know that each exam you take, each class you attend, is working towards your ultimate purpose. And of course, you may never know what that purpose is, but you’ll see bits and pieces of it in your life around you. It may be your reaction to a homeless man outside, a friend in need, family, your patients, or a simple walk in the park.
I hope this letter helped even a bit, and hopefully, I wasn’t completely off on interpreting what your struggles are in med school. Mark says he hopes we can meet one day. I would love that. If I can ever help with anything, call anytime.
The Affordable Care Act Won’t Help Me Here
I have three doctor specialist appointments–
In the next two weeks
But there’s no doctor I can see about missing you
This page is part of my book, Dear Love of Comrades, which you can read here.