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Sara H. Rahman

"Mr. Douglas?" I call out into the waiting room. A short, grey-haired man in his sixties staggers towards me, bracing his back with his hands. Despite his pain, he gives me a warm smile, which I return.

As I help him onto the exam-room table, he winces, squeezing my hand.

"I'm a medical student," I begin. "If you wouldn't mind, I'd like to examine you before Dr. Smith sees you."

He nods. "Go ahead, you can learn on me--just don't break my leg!"

We chuckle, and then I check his vitals, review his medications and ask him about his back pain.

"It's been getting worse for the past couple of months," he says. "I've been under a lot of stress with my business. And there's so much else going on--I've been feeling angry a lot lately...."

"You've been feeling angry? Why?" I ask.

"It's the news," Mr. Douglas says. "ISIS and those Muslims." His nostrils flare; his hands clench. "These Muslims think they can blow up our country!"

Heat crawls up my neck. I am a Muslim-American. My parents immigrated from Pakistan nearly thirty years ago. I was born and raised in a small rural town in western Maryland.

"I want to take care of them for good and send them all packing," Mr. Douglas continues. "They aren't welcome here!"

He gives me an expectant look, waiting for me to nod in agreement. His sentiments are shared by many in the town my clinic serves. Outwardly, I don't "look" Muslim, as I don't wear a hijab. Because of my dark skin, I'm more often mistaken for an Indian Hindu.

Growing up in my predominantly white hometown, I never really noticed any negativity from others about my race or religion--they were just a part of who I was.

On September 11, 2001, I was in sixth grade. That day, instead of continuing our normal school schedule, my teacher turned on our classroom TV so that we could watch the news, live. My classmates and I stared, mesmerized, as the smoke rose from the Twin Towers. I was so naïve, I didn't see that a small group of people had hijacked my religion, claiming it as a reason to kill thousands of innocent people. That day my race and religion stopped being simply one part of my personal identity and became a part of my political reality as well.

The tensions born that day have only intensified. Hate crimes against Muslims have surged; each time I visit my Muslim community back home, I hear another story of someone's car or store being vandalized, or of death threats received in the mail. Similar stories are shared on Facebook by Muslim communities all over the US. Some Muslims have decided to shave their beards or stop wearing hijab, crucial parts of their identity, so that they won't be "easy targets." My own mother, terrified for my safety, has made me promise to stop going on my daily morning runs alone. The fear is palpable.

Now, as I listen to Mr. Douglas, my pen slips from my fingers and falls to the floor. He keeps talking, but I can't take in his words. I need to escape…to calm down and digest this shock.

"Excuse me a moment," I mutter, blinking back tears, and walk past him, my legs heavy.

Before, when confronted with this kind of prejudice, I've known exactly what to do: speak up. I've revealed my religious identity and have tried to show that I'm "normal," in hopes of changing the person's mindset. I've done this countless times.

Most recently, while waiting for my car's oil change to be done, I watched an elderly woman struggling to help her grandson with his algebra homework.

"I should call my friend Ahmad to help me," he said.

"I told you to stop talking to him!" his grandmother snapped. "He's Arab--probably a terrorist!"

Calmly, I offered to help, and afterwards, the grandmother thanked me profusely. Heading out the door, I left a note in her hand: "Just so you know, I am a Muslim. I helped you because that's what I believe in…helping others. We aren't terrorists. Just Americans who believe in compassion and camaraderie."

But this situation is different, I tell myself. This man is my patient. He needs medical help.

Still, how can I deny the sting of his words? My mind races: As a medical student, where are my boundaries? Should I tell him that I'm Muslim? Should I tell my attending?

I decide not to share my feelings with my attending: I want to process this situation on my own.

All at once, I remember Dr. Jane, who worked in my college's Alumni Affairs department. We met at a time when I was being rejected for internships and getting threatening phone calls because of my Muslim identity. When I voiced my concerns to non-Muslim students and advisers, no one listened--except for Dr. Jane. Instead of staying safely on the sidelines, she became the Muslim students' strongest ally. She helped me to establish the college's Muslim Cultural Center, a safe haven where we could tackle the issues that we, as Muslim-Americans, were facing in the post-9/11 world.

Few people knew what I knew: that Dr. Jane's husband had been killed in the 9/11 attacks. Despite this horrific loss, she never faltered in her support for the Muslim students. Time and again, she chose love and acceptance over hatred and revenge.

Recalling her support and generosity of spirit, I feel a surge of gratitude.

A thought arises: Maybe I can act as Dr. Jane did. As wounded as I feel by Mr. Douglas's harsh words, I can respond to them--and him--with kindness and care.

In leaving the room, I reflect, I let my reactions to Mr. Douglas's words override my duty to care for him. I don't have to let that happen--I can choose to transcend the barriers that divide us.

Can I do it? Well...let me try.

Minutes later, I head back with Dr. Smith to complete Mr. Douglas's exam. I remain cordial with him: I make sure that he understands his treatment instructions, help him set up his next appointment and walk him out of the office.

"Good luck! See you at your next visit," I say, smiling and waving goodbye.

Later, sharing this experience with my trusted professors, colleagues and Muslim role models, I get conflicting responses. Some believe that I was right to remain quiet; others, that I should have spoken up.

I think about the future: What if one day a patient directly attacks me for my Muslim identity? What if a colleague or an attending does?

If a colleague or an attending disrespects my beliefs and heritage, I have my response ready. I'll be respectful, but direct:

"I am Muslim. But I am also a doctor. I can offer you my skills to the best of my ability, regardless of how you feel about my identify. It's your decision if you're open to working with me."

If it's a patient, however, I'm less sure.

I don't have all the answers--but I do know, now, that I can keep my emotions from derailing my patients' care.

I may not have changed Mr. Douglas's perceptions of Muslims, but I fulfilled my duties as a physician-in-training. Perhaps someday he'll find out that I'm Muslim. Maybe I'll have a chance to change his opinion--and maybe I won't.

Either way, right now I don't regret my decision to respond not with wounded anger but with my best attempt at compassion.


About the author:

Sara Rahman is a medical student at the Frank H. Netter MD School of Medicine at Quinnipiac University, CT. Her interests include painting, reading, working with Syrian refugees, research and running. "I like to reflect, and I spend a lot of time journaling. I decided to write this story to highlight how the existing tensions of being Muslim in America tie into my journey as a physician-in-training."

Story editor:

Diane Guernsey

Comments   

# TIMOTHY J OLEARY 2017-05-10 09:26
Thank you for writing this. It is sad, but we live in a world whe, and where bigotry lies just below the surface, and often above it. Be guided by your faith and act in love. I have watched love overcome prejudice many times over my many years walking this planet. Do not become hardened; allow yourself to be hurt, as you were, because it reminds us that others are hurting. Then, as Steve Covey said, seek first to understand before seeking to be understood; love for your patient requires you do the former; love for others may require the latter.
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# Gary Kaplan 2017-04-25 03:33
The next step:
You were exactly right not to respond in the moment and instead to treat the patient. I have observed that after being helped many people experience a moment of openness. The next time you have treated a prejudiced person, you might try ending with two sentences such as:
Do you think that our treatment today will bring you relief?
Good, because as a Muslim it is my obligation to help bring healing to all my patients.
Then smile warmly and walk away.
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# Rasha A 2017-04-24 01:25
Hey Sara,

I read your story since it came up in a doximity email and I'm glad I did. It didn't show me a new perspective but instead offered a sense of camaraderie. As a fellow Muslim medical student born and bred in California, I was incredibly touched by this story. You are doing (and writing) wonderful things. Never fear, never falter - I can already tell your patients will be lucky to have you as their physician.

Best, RA
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# Janice Mancuso 2017-04-13 17:46
I am sad that trolling has made its way to Pulse. Within the span of approx 30 mins this afternoon one person added six comments that were accusatory, derogatory, and cynical. I've been reading Pulse for years, and this is the first time I recall this happening. The fact that these comments are in response to an essay written by an eloquent, thoughtful, and brave Muslim medical student compounds the pain I feel.

Sara, I fervently believe the vast majority of the Pulse community embraces you. I am reminded of Gandhi's words that offer comfort at this moment... "I will not let anyone walk through my mind with their dirty feet.” Stay strong and courageous, dear doctor-in-train ing.
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# uptowndebbie 2017-04-10 22:42
You definitely did the right thing and I'm so sorry that this is even an issue. We have many Muslim students at our University, and they enhance our community.
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# Karenbeth Glunz 2017-04-10 10:18
I am learning how to remain "neutral" rather than "reactive" and "witnessing" rather than adding energy to the drama in which I find myself. I think that doctors and lawyers (well, all of us} who desire to be more conscious in the moment, could practice being neutral and witnessing. I think that telling a patient in pain that you agree or disagree with his/her judgement isn't of value. Your identity is personal and better that it remains such. You aren't going to change this unconscious patient's judgement. Don't take it personally. Your job is to tend to him, period.
I am sorry that you have to put up with this kind of discrimination AND with the mingling of races, cultures, sexes, and other factors in the USA, it is unfortunately a fact of assimilation. Being the first woman in many corporations, I felt the discrimination. Defending your identity isn't wise nor helpful. Just do your job (doctoring) to the best of your ability and be neutral/witness the rest.
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# Jerome Fishkin 2017-04-09 11:23
I recommend that you also tell your patients what you now would say to a colleague or an attending. It actually helps dissipate prejudice in a lot of people who have never thought of the "other" as a human being until they are face to face with . . . you. Not always, but enough times to make a difference.

In my first five years as a lawyer, I was the only white lawyer with three more senior, Black lawyers. Sometimes a client didn't want the White Jew, other times they demanded me to go deal with "The Man." We had a consistent response like that of Ms. Bank below -- you are welcome to work with the assigned lawyer or you are welcome to go elsewhere.

But the minority person is always on display. It comes with the territory. And some will leave in a huff; so be it. We use our skills on those who stay.
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# leslie bank 2017-03-18 19:53
Patients' prejudices are not new, but sadly Muslims have now been added to the list.

In my younger years in Connecticut, a patient called me to make sure that no Jews would interact with him, and that no food he ate had a Kosher stamp on it. I never let him know I was Jewish, and to tell the truth, I tried to comply with his food request, but respectfully declined to investigate his providers' identities.

And, until my recent retirement, I could receive a call from a patient demanding that nurses "of color" keep away. One great resolution came from the Nursing Leader, an African American woman, who explained to her patient what his care consisted of, and the professional staff who would provide his care. He was always free to leave, or to permit her staff to care for him. There was no other unit in the hospital with her unit's qualifications for his needs. He chose to stay
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# Marie Shieh 2017-03-18 19:18
Thank you for your story. Recently, a patient said something similar to me. I am a GP in Australia, in a regional area - small town. A patient told me about a book he read that he enjoyed by Ayaan Hirsi Ali called Infidel. I was interested to read it and he lent it to me. Her book opened up a world unknown to me and I appreciated the insight and thanked my patient and told him I liked reading her story. I asked him what he thought about Muslims. He said, "I hate Muslims."
I was stunned by his statement because Ayaan's books had given me a full picture of what it could mean to be Muslim, from a cultural background to a deeply fundamentalist one. How could he hate all Muslims if he read her books?
I said, "We can all be swept away by religion and there have been wars perpetrated by Christians as well. When we think of ourselves as separate, we have a problem."
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# Warren Holleman 2017-02-22 12:33
Thank you for sharing your story. I’ve shared it with colleagues and, while we applaud your professionalism , we also regret that you have to deal with such bigotry. It’s heart-breaking.
If it’s any consolation, your story is confirmation of the Biblical adage that there’s nothing new under the sun. A Jewish colleague who read your story resonated with it because she has had nearly identical experiences over the years. Ditto for African-America n, Hispanic, and LGBT physicians and nurses.
Even those of us who aren’t from a minority are often privy to insensitive and disrespectful comments about minority colleagues, and we too struggle with how to respond. On the one hand we have a duty to focus on the patient’s health. But we have to balance that with professional responsibilitie s to support and treat fairly and respectfully our colleagues. And also to listen to our moral conscience as human beings. What a case study in professionalism and medical ethics!
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# B. Itani, MD 2017-02-21 14:25
Dear Sarah,
I have known your parents for over 20 years. You were just a little girl then. If I want to sum up my feelings about you and your family: I am proud that you are part of my wife's, my daughters' and of my lives. Your parents are the most loving, humble and helpful people I know.
I remember the days when your dad used to ask all Muslim kids in our area to go help him feed the hungry, regardless of their religious believes. You and them will never hesitate to help a needy person of any religion. Your article tells a lot about who they are. They have raised Sara, the pride of all of us.
I have two girls in high school. Your article is going to be an inspiration to them. Please know that your feelings and response (or no response) were just perfect.
Thank you for sharing this experience and for speaking your mind.
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# Ron Banner 2017-02-21 05:34
Dear Sarah,

Thank you for sharing your story and struggle. The many responses speak to this challenge.

It is hard to change prejudices. When major lead baseball saw how great a ball player Jackie Robinson was, more African Americans entered baseball. When the African American women in "Hidden Figures" demonstrated their expertise, they were allowed into positions from which they had been barred, and John Glen said that he would not fly until the math had been checked by the African American mathematician.

Prejudice is also changed when people get to know someone (from a group against whom they hold a prejudice) and see the humanity in them. Then, they can reexamine their prejudice.

In becoming a great / caring doctor that your patients respect, with time, you may shake up those old beliefs and prejudices and they may change.

So keep on being a great doctor; one by one you will have the chance to do a prejudiceotomy.
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# Med Student 2017-02-21 01:49
Sara,

I wanted to share Mahershala Ali's comments at the recent SAG awards. Reading your story made me think of a common theme: "We see what happens when you persecute people, they fold into themselves."

https://t.co/q9txL6fW8R
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# Margaret Fleming 2017-02-19 11:11
Thank you for telling us your thoughts as you decided to put patients first. And for daring to educate a patient kindly.

It seems many of us are always seeking a group to judge, or even one person.

You teach us as you rise above it.
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# Sara 2017-02-18 18:32
Dear Sara,
My mother's Jewish family wasn't allowed to buy a house in certain neighborhoods and she could only apply to certain colleges that would accept Jews. For years my friend was afraid to tell his coworkers that he was gay, fearful of retribution. I’m outraged at the overt racism against Muslim and Mexicans, but my mother tells me I've lived a sheltered life in a liberal city. Sadly, she is not surprised by the vitriol and racism which is more overt these days. I appreciate your courage in sharing your story.
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# Muriel Murch 2017-02-18 12:57
Dear Sara.
How wonderful - yes it is - to see all the comments and support you have on this site, from speaking out, telling your story. Congratulations and well done.
And how sad it is to see nations, religions and humanity so divided once more. And to see the fear and anger causing physical pain and suffering.
Thank you from us all, telling your story reminds us to listen and love as best we can.
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# Marc Tumerman 2017-02-18 10:00
Wonderfully written and thoughtfully shared. If I may be so bold as to state that I agree with you and that you did the right thing. That you were able to do this and at such an early stage of your development as a physician is a testament to your character and understanding of our role as physicians. Many have been in this position for many different reasons. Black, female, overweight, Jewish, tall, short, democrat, republican, socialist, - different. It is our commitment to our profession that requires us to leave this at the door upon entering an exam room. It is our commitment to our humanity that mandates us to be more vocal than ever right now in the streets.
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# Lisa Poland 2017-02-18 09:58
As a healthcare worker, I have faced many situations in which I've struggled with how to handle a patient's racist (or sexist) remarks. I too have questioned whether to stay silent or to call out egregious statements. After 30 years, I have decided to soldier on and to stay silent, but it's very difficult. I can't imagine the pain when it's your own religion or skin color being attacked.

Sara, I'm so sorry you face these issues. I have a special attachment to your story because I have known you since you were three years old. You are as American as my own daughter--your dear friend since pre school. I shared my own symptoms of anger and upset with my own physician just this week--your mom. Your family is in my mind and my heart each time I hear an anti-Muslim or anti-immigrant diatribe. You make me SO proud--proud that you'll be a wonderful physician with dignity and poise and proud that you're our dear friend (who happens to be Muslim). Stay strong--stay Sara.
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# Nereida Correa 2017-02-18 09:24
Thank you Sara for this brave story. It brought tears to my eyes and brought me back to my own childhood when being Puerto Rican in New York was so painful and filled with heartbreak for those of us who came new and did not speak English or know the norms. You are a great success in your own right and walk proud as you do for this too shall pass and most people will come to their senses, and if they don't it is their loss.
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# Mary Chris Bailey MD 2017-02-18 08:26
Great piece, I am concerned that in the current political climate the situation for Muslim Americans will only get worse. It would seem that hate speech is now codoned
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# Cynthia McCraven, MD 2017-02-18 08:07
I am so proud of you Sara. Medicine is your calling and I have found as an African American woman I have many opportunities to impact lives in the exam room and most of the time is is not on issues of health. Continue to be a beacon of hope and share yourself and ideas even when it seems difficult. Sometimes it has to be just a little bit of you and your life experience because everyone is not ready to explore and change misconceptiions right away. Maybe at the follow-up visit!
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# Janice Mancuso 2017-02-18 07:00
Can stories like this (which I shared on Facebook) change hearts and minds? Dear God, and Allah, I hope so...
************************
From the Prayer of St Francis of Assisi...
Lord, make me an instrument of your peace.
Where there is hatred, let me sow love.
Where there is injury, pardon.
Where there is doubt, faith.
Where there is despair, hope.
Where there is darkness, light.
Where there is sadness, joy.
************************
Sara, not only are you a physician-in-tr aining, you are an instrument of peace.
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# Lisa Poland 2017-02-18 10:06
Well done. Thanks for the timely reminder of this prayer.
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# Beth Ackerson M.D. 2017-02-17 21:39
I feel shame for our country's fear and hatred. Know you are respected and honored by many of us. How to educate your patients and colleagues while serving and also protecting yourself? We need to stand up with you, too. I've marched in many gatherings since the election, for peace and freedom for all, "no hate, no fear, everyone is welcome here," including with my 85 year old mother...walker s and strollers...all religions, colors, genders.
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# Christine Parkhurst 2017-02-17 19:56
Sara, I'm so sorry you encountered this painful situation. Your ability to overcome your pain and think about caring for your patient to the best of your ability shows your strong moral character, formed in part by the teachings of Islam, no doubt. Sadly, this man has learned fear and hate by being constantly bombarded by messages from certain corners of the media and the Internet. Encountering people like you, people who are caring, compassionate and Muslim, may help him to re-think what he believes.
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# Pat Kenney-Moore 2017-02-17 19:25
This breaks my heart and makes me embarrassed and sad. I apologize for the ignorance and intolerance you and so many others have experienced - and will likely continue to experience. I would like to share this on Facebook. is there a way to do that? thank you for sharing this very personal story
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# Paul Gross 2017-02-17 23:12
Pat, You are free to post a link to this story (using the URL above) on your Facebook page.
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# Pris Campbell 2017-02-17 19:10
What a difficult situation. I don't know what I would have done. I hate it that my Muslim-American friends are in this situation. My own internist is from India and is Muslim but never talks about it. Like you, his compassion for all of his patients is immense.


A comment about the haiku. A wow!
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# Sherri 2017-02-17 18:48
I am deeply saddened by your experiences and embarrassed as an American and a member of the human race. I wish you had told him what you would tell colleagues or attending because maybe it would have made him feel differently -- to see that you are a Muslim-American with compassion, and maybe open his eyes to his prejudice. I know I speak for the majority of Americans, and we must all speak up for Muslim-American s and all those being targeted by this venom spreading across our great Nation and the world,
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# Ronna Edelstein 2017-02-17 18:45
Sara, thank you for sharing your story. I am sorry that you have to deal with prejudice and discrimination. I encourage you to speak up--not just for yourself but for all individuals who are victims of people and their ignorance.
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# Michael M Meguid 2017-02-17 18:34
Well written Sara and thank you for sharing. We need to be brave. Prejudice is a poison. Islam means peace and many of our American country men need to be enlightened compassionately . Salamat.
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