Honored to have represented my program at the ACP Doctor’s Dilemma competition. Looking forward to be back with my team in the fall for the next round!
@FLACPchapter
@AdventHealthCFL
Go all in. Because half in is actually all out. Even 90% gets you nowhere. There’s magic in that last little bit. New levels unlocked. Simply because so few have the courage to go there.
Lately, I’ve found myself thinking about the countless business dinners and social meals my parents attended during their early years in America.
Before ordering, my mother would invariably tell the server: “We are strictly vegetarian. No meat, no chicken, no fish, no eggs.”
She might then remind them—no beef stock, no gelatin…and list all the ways in which meat might be hidden in our food.
As a child, I often felt a twinge of embarrassment when she said it. I worried that we were making things difficult, creating extra work for the wait staff, drawing attention to ourselves in a way I wished we wouldn’t.
What I didn’t appreciate then was how much courage that simple sentence required. Especially when social pressures and convention would invite conformity. Instead they were often forced to answer a set of uncomfortable, sometimes ignorant questions:
“Have you always been a vegetarian?”
“How do you get protein?”
“Have you ever tried meat?”
“Don’t you know you’re missing out?”
And then they quietly would use the moment to share our belief system.
My parents arrived in a country where fitting in would have been easier than standing apart.
They could have quietly relaxed their commitments.
They could have decided that some traditions were not worth carrying across an ocean.
Instead, they held fast to a faith and culture rooted in nonviolence, one that called them to remain strictly vegetarian even when it was inconvenient, awkward, or misunderstood.
I don’t judge those who made different choices.
Every immigrant family navigates these questions in its own way.
But looking back, I see that what embarrassed me as a child was actually an expression of conviction.
Every child of immigrants, I suspect, wants their parents to adapt a little more, to blend in a little better.
We feel the friction when they don’t.
Yet now, whenever my wife and I sit down with friends or colleagues and hear ourselves say, “We are strictly vegetarian. No meat, no chicken, no fish, no eggs,” I feel something entirely different.
I feel gratitude.
What once sounded to me like a dietary restriction now sounds like an inheritance.
A small sentence.
A quiet act of conviction.
A reminder that my parents carried more than suitcases when they came to this country—they carried their beliefs.
And they had the courage to keep carrying them.
Dear physician,
The reward for being an altruistic, conscientious, hardworking achiever is more work.
The system knows this.
That’s why it constantly gives you more responsibilities but never takes any away.
It knows that you will find a way even if it means sacrificing yourself.
The solution is not to abandon who you are.
The solution is to recognize you are being exploited and advocate for yourself.
Set your boundaries.
Officially 1 month since I switched to a flip phone.
- Everyone is more severely addicted to their smartphones than I thought. Once you have a dumbphone, you'll frequently find yourself as the only person in the room not on their phone. It's not just teenagers, it's parents and adults of all ages. It's like everyone is stuck in a trance. 75+ year olds might be the only exception.
- All the objections I previously had for getting a dumbphone have turned out to be overblown and/or solvable. My iPhone addiction had fed my brain excuses to not do this earlier. If you really want to make the switch, you can.
- I've felt embarrassed to pull out my flip phone in public at times, for fear of being different or drawing too much attention to myself. But I have learned to just own up to it. Most people end up saying something like "Oh, I probably should do that too."
- I am using my brain more. Even though my flip phone has Waze, I find myself memorizing maps and roads. I'm more bored and get lost in my thoughts. I'm using paper and pen more. Increased desire for tangible things > digital things.
Overall, it has been a great experience and I plan on never going back.
As President, I would read 10 letters a day sent to me by ordinary Americans. At the Obama Presidential Center, we’ll have some of the letters I read — and responded to — every night. I still get emotional reading them, and it’s one of my favorite exhibits.
The number of people who think mothers should be expected to fully care for a newborn without help immediately after a C-section is honestly insane.
A C-section is major abdominal surgery.
A 4–6 inch incision through multiple layers of abdominal wall and tissue…while simultaneously recovering from pregnancy, sleep deprivation, hormonal shifts, bleeding, pain, and trying to feed and care for a newborn.
Are we applying this same logic to literally any other surgery?
Would you expect someone after a hernia repair or abdominal surgery to immediately become the primary caretaker of another human 24/7 with minimal recovery time or support?
And no, C-sections are not always a “choice.”
Sometimes they are medically necessary.
Sometimes they are emergencies.
Sometimes they save lives.
And even if someone did choose pregnancy, that does not suddenly make them undeserving of rest, recovery, pain control, or support afterward.
I’ve seen women talking about going back to work before they’ve even properly healed because they literally cannot afford unpaid leave.
That should disturb all of us.
The way society minimizes postpartum recovery, especially after C-sections, says a lot about how little we value women’s health and caregiving labor.
The most powerful medicine is at the end of your fork, not at the bottom of your pill bottle. Food is more powerful than anything you will find in your medicine cabinet.
Saw a patient today with a hemoglobin of 1.9 g/dL. For context, a level that low is almost incompatible with normal consciousness, but she walked right into the clinic on her own feet.
For three long years, she lived with crushing weakness and since last 6 months breathlessness from just walking across a room. Why didn’t she get help sooner? At first, it was because the kids had crucial school exams and later her husband was reluctant to deal with the hassle of a hospital admission.
Her health was treated as a background inconvenience.
When we dug deeper, it got worse. A year ago, her Hb was 6.4 g/dL. A doctor explicitly told them she needed immediate admission. The family refused, walked out with a basic strip of iron tablets, she took them for two weeks, forgot about them, and nobody in the house ever bothered to check on her or remind her.
She didn't even come to the hospital today because of the air hunger. She came because her periods had completely stopped for months. Her body was so profoundly starved of iron and oxygen that it literally shut down her reproductive axis just to divert what little blood she had left to her heart and brain.
It’s completely heartbreaking. A woman will literally bleed her body dry, gasp for air for years and keep working silently, only to be brought to a doctor when her normal functioning stops.
Please check on the women in your homes. Stop letting them normalize chronic exhaustion.
As you get older you’ll learn that 30 minutes a day spent exercising is going to impact your surgical career more than spending those 30 minutes on the computer.
Buy whatever equipment, membership, or clothes you have to buy for it. Tell your spouse or partner I said so. 🏃♂️🚴♀️
I remember a quote from one of the Caliphs in Islam: “I am the one to be held accountable if even a stray animal in my caliphate sleeps thirsty at night.”
The principle of leadership is: I don’t shine if you don’t shine.
@jasonryanmd 3. I see a lot of discussion about burnout and perfectionism in physicians and ways to navigate and prevent them. In my opinion, good starting points would be humane expectations and workload, allowing margin of error and an unbiased/fair (6)