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Archive for October, 2012

Najim Mohammady, now 3rd year Medical student in the rigorous and innovative UCSF/Berkeley Joint Medical Program had me at “I was a child refugee from war-torn Afghanistan” when he spoke at the the 2008 Network of Ethnic Physicians Organizations (NEPO) Leadership Summit on the student panel.  Afterwards, in-between sessions, he and I spoke briefly and instantly, our friendship was sealed when he so insightfully proclaimed, “you and I are refugee immigrants…I don’t have to explain myself to you…we just get each other!”

And that is how it’s been over the last 4 years: our paths would intersect in organic and easy ways.  We would meet up in San Francisco, Oakland, or Garden Grove and Anaheim–at various CMA (California Medical Association) or NEPO events.  I like to think we have such good karma to connect in seemingly happenstance ways.  Whether at Yoshi’s Jazz club in Oakland by impromptu invitation of our iconic mentor, Dr. Frank Staggers, after an Ethnic Health Institute lecture for a cocktail and live music; or on a yacht in San Francisco marina circa Christmas 2011, at the invitation of my former patient and medical practice consultant guru to high profile CMA members, Debra Phairas–my professional mentorship and my personal friendship with this dynamic, young physician-in-training is now a cherished part of my life.

[Najim & Dr. Mai-Phuong Nguyen at 2012 XL Spring Mixer at OCMA (Orange Co. Medical Association) in Irvine, CA]

Our profound connectedness and ‘ease of just being’ whenever our lives would intersect fuel my passion for growing and ensuring the sustainability of the nascent CMA/EMOS eXchange Learning (XL) Mentorship Program.  Because every time we reconnect, Najim shares with me his hopes, his dreams and his ongoing struggles with the contemporary medical educational system that is still plagued with disparities and lack of support or guidance, not unlike the one I endured 20 years earlier.  Truth be told, it was in hearing the testimonials of students like Najim and now Dr. Brenda Oiyemhonlan (USC-Class of 2012 and fellow XL 2009 cohort who was profiled earlier in the Summer NEPO newsletter) –both of whom I met in leadership conferences sponsored by CMA Foundation and CMA–that inspired me to found XL Mentorship Program in 2009.

For clearly, their resounding pleas were that, as first generation immigrants or children of first generation immigrants, most of us did not have anyone to help guide us on the path to gaining elitist entrance into medical school, let alone how to navigate our way to success upon earning our coveted medical school admissions.  As minority medical students with less access to resources and clinical mentors, we are constantly confronted with socioeconomic and healthcare disparities throughout our lives and careers.  And as such, our medical training experiences are markedly different from those of our colleagues for whom poverty and displacement issues are just abstract, distant concepts and ideas, not deeply personal–oft-times deeply painful–realities.

In Najim’s case, the fact that this brilliant young man was accepted to one of the most competitive medical and masters in public health programs in the world, is indeed a miracle.  Because as a 6 months old infant, Najim’s parents, maternal grandparents and paternal aunt and uncle fled on foot over the mountains of Afghanistan (with Najim and his older sister, Freshta, in tow), through Jalalabad, to end up in Peshawar, Pakistan, during the Soviet occupation of Afghanistan in 1982.  With the assistance of ‘coyote’ guides, his grandfather (who was a former mayor of a rural province outside of Kabul and well educated at Kabul University) was able to arrange for his family’s escape during this tumultuous time of war.

It is suspected that the coyote guides contrived to split Najim’s mother and grandmother from the rest of the family during the trek, in the dark of night for more ransom money.  For 2 days they were separated until Najim’s grandfather promised to pay the coyotes more money, which they were to get from Najim’s maternal family back in Kabul.  Eventually, his family would reunite and they would live in exile in  Pakistan for 3 years.  By 1985, a different paternal uncle living in the US (and a Fulbright scholar) sponsored his family to California.  Najim is not clear of many of the details of his childhood nor of his migration story.  When asked why he doesn’t just ask his grandfather or mother for the details, he plainly answered, “We just don’t talk about it!  We just don’t talk…period.”

Najim’s immigrant-American story parallels that  of my family’s chaotic escape out of Vietnam on April 29, 1975.  As a foreign press translator for the President, my father knew ahead of time, that the end to the war in Vietnam was imminent, but no one anticipated just how imminent.  During our abrupt and improvised evacuation out of Vietnam with Operation Frequent Wind when the US troops withdrew “out of ‘Nam”, in the chaos, my mother and 2 sisters were pushed onto a different ship and they eventually landed on the Pacific Island of Wake.  My father, older brother and I were pushed onto the famous USS Midway, and we arrived to Guam.  It wasn’t for several months later that all 6 of us would be reunited on Guam, thanks to the auspices of my father’s “Australian brother”, my gringo godfather, Tony Paul, an award-winning Indochinese war correspondent who was then the Editor-in-Chief of the Reader’s Digest in the Pacific Rim.

Najim and I share so many uncanny parallels in our personal journeys in search of identity, purpose and home.  Recently I learned that Najim’s very first childhood memory doesn’t begin until he was 11 years old, as a 5th grader at Rancho Alamitos High School in Garden Grove.  (In comparison, my first, techno-color, high definition memory was the day we escaped Vietnam, in all its hyper acoustic and frightful details at the young age of 6.)  We suspect that this late age ‘beginnings’ of Najim’s childhood memories is due in part to deeply suppressed childhood trauma, on so many levels.

Knowing this makes me even more appreciative of this young man’s resilience and tenacity.  To know that he is the compassionate and eloquent man and scholar that he is today, despite being a byproduct of war in a homeland often villainized here in the West, makes me respect and admire Najim all that more. The fact that Najim is so viscerally committed to serving the Afghan-American community and upholding his ethnic culture, language and identity, despite not knowing his homeland nor ever having revisited it as a conscient adult, is truly remarkable.

Earlier this year in February, he defended his Master’s thesis at Berkeley School of Public Health elucidating the Physical and Mental Health of Afghan Refugees in the San Francisco Bay Area.  Through health surveys exploring diasporic first generation Afghan-Americans’ self-reported assessments of their mental and physical health, he documented the overwhelming correlation between his Afghan-American communities’ collective traumas living in war-torn Afghanistan, their subsequent traumas in their arduous journeys to freedom, plus, the added traumas of living in exile in first asylum countries like Pakistan and India  and finally, compounded by the traumas of assimilation (or lack thereof) in final asylum countries like the US.

Najim’s landmark research is only beginning to scratch the surface of the PTSD, depression and anxieties that run rampant in our ethnic communities, arising from very complex histories of war and displacement.  More so, he is helping the healthcare profession identify and define cultural competencies on how to interpret his people’s expressions of pain and physical ailments, not well explained by the usual pathophysiology and mechanisms of action in Western textbooks taught in allopathic medical schools and residencies.

As a fellow war-child refugee, just ½ a generation his senior from war-torn Vietnam, I can relate all too well to young Najim’s search for identity, purpose and healing.  This summer I launched a mental health series on Viet Nam California Radio (VNCR) 106.3FM here in Little Saigon, Orange County (home to the largest population of overseas Vietnamese, outside of Vietnam).  Beyond FM radio broadcast, VNCR reaches over 100,000 overseas Vietnamese in the diaspora via its online webcast: www.radiovncr.com.

My bilingual (Viet-English) program, Sức Khỏe và Bạn (To Your Health, Friend!) has been well received by Overseas Vietnamese who are ever grateful for a forum to express their fears, hopes and concerns.  More than 3 decades after the North Vietnamese tanks rolled into Saigon, marking the ‘end’ of the Viet-American War, the overseas Vietnamese people are just now starting to open up dialogues about their post-traumatic stress disorders (PTSD), domestic violence, traumatic refugee experiences, sexual traumas, etc.  We are only beginning to unravel our well-kept family secrets that have gotten in the way of  our “Model Minority” mythic image and pursuit of comprehensive, lasting wellness here in the U.S.  I launched this program with the strong belief that only by effectively healing our deep-seated wounds of war, can we in refugee minority communities, truly find “health, happiness” and “thrive” in future generations .

As for me and Najim, we reconnected at this year’s 2012 NEPO Summit in Los Angeles in early September.  After enduring a 48-hours shift in general surgery rotation, he caught a flight down to LAX-Westin to support the latest 2012 cohort of eXchange Learning (XL) mentees.  Najim couldn’t stay for the special Wells Fargo sponsored dinner the second night of the summit because he had to rush off to Orange County, to tend to his beloved 94 year-old grandfather whom we lovingly call Baba.

Since early 2012, Baba has been in and out of hospitals suffering the natural consequences of a very harsh life.  Recently, he underwent lower extremity grafts for his peripheral arterial diseases.  While rehabilitating in the local nursing home, Baba suffered complications like hospital acquired and aspiration pneumonias.  Not even graduated from medical school yet, Najim already is functioning as a sophisticated caregiver and healthcare consultant to his mother and extended family, advising on difficult End-of-Life issues and explaining foreign Advanced Directives.  So while we NEPO doctors enjoyed a decadent dinner, Najim texted me this wonderful photo of him and his Baba.  From the photograph, it appears, they were serving up enchiladas mojadas con arroz y frijoles and the family brought in Persian yogurt (ahhh…cultural competent multi-culti East Meets West cuisines! 🙂

Najim tending to his Baba at Garden Grove Hospital, September 2012 during NEPO Summit

I first met Baba this past summer, at Najim’s Master’s graduation party in a local Indian restaurant in Garden Grove, the Rupee Room.  In Dari (considered the Shakespearean  equivalent and erudite dialect of Farsi spoken in Afghanistan), Baba (aka Mohammad Taher Hatef) recited a poem he wrote the day Najim was born.  While I didn’t understand a word of Dari, there was no mistaking the palpable love and hope that this war survivor had for his precious grandson, on that most proud day of Najim’s Master’s graduation and 30th birthday.

Mohammad “Hatef” aka Baba reciting poetry dedicated to his grandson, Najim

Recently, I had the pleasure of hearing grandfather Hatef’s poetry in translation on a Youtube video of Najim’s dissertation defense at UC-Berkeley:

NOTE:  At about minute 9:19, one can hear Najim recite his grandfather Hatef’s profound poem, The Unbound Kingdom.  For us refugee immigrants, this poem resonates so deeply our elusive longing for a place to call home.  Again, Najim teaches me more than I feel I have counseled him as XL mentor.  Indeed ours is an ongoing cross-cultural, inter-generational eXchange Learning sort of  kinship and unspoken connectedness, far beyond that of student-mentee and physician-mentor.

I look forward to bearing witness to the amazing unbound kingdoms to which this young Afghan-American physician-leader–the grandson and bright hope of grandfather Hatef– will soar, in the years to come!

An Unbound Kingdom
–A poem about exile written by Najim’s grandfather, Mohammad Taher Hatef
(His pen name: Hatef, means sound from the unseen)

Abridged, entitled and translated by Omid Sanjideh

When I search for flowers, springtime in my country comes to mind.
Scenes of blood splattered on its arable land comes to mind.

The only beautiful jewel inside a shell to see,
My country of Afghanistan inside of central Asia comes to mind.

All that I see here in exile, appear either similar or different,
From each the wretched and incomplete story of my country comes to mind.

The nightingale sings intoxicating songs in the meadow,
The wailing cries of my home comes to mind.

When a tune strikes the lyre in the corner of my heart,
Nothing can silence the Dari or Lugerian composer that comes to mind.

I enlist forgetfulness to throw the load of grief behind me,
But my heart makes sure that it again comes to mind.

Refusal to talk about it brings me to the precipice of time,
As soon as I utter Vatan [homeland], my heaven and paradise comes to mind.

I, Hatef [the sound from the unseen], became an unbound kingdom,
So sayeth the poet, Bidel, “Any dot, chosen from amongst my poetry, is what comes to mind.”

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