fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

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His Mother’s Son

Editor’s Note: This piece was awarded an honorable mention in the Pulse writing contest, “On Being Different.”

On a crisp Saturday morning in October, I drove through the early morning fog to the salon for my regular hair-coloring appointment.

I looked forward to these appointments. The hour spent there was my “me” time, during which I enjoyed lighthearted conversations with my colorist, Tina, about movies or fashion while she did my hair. These chats, which took me to a different world—the world of normal people—were followed by a cup of rejuvenating herbal tea. After a hard week as an oncologist in a busy clinic, it was a welcome relief.

This time was different, however. I’d been late making the appointment, so Tina was booked, and Ryan was to be my colorist. I felt a little apprehensive: He’d never worked with me, and I felt bummed that we couldn’t have a hearty woman–to-woman chat.

As Ryan led me to my chair, I looked around. All of the other stylists were women, and so were their clients. I felt a wave of empathy for Ryan and wondered, Does he ever suffer from implicit bias in this all-woman world?

In my own life, as a woman doctor in a male-dominated profession, and being brown and an international medical graduate, I’ve felt the anguish of unconscious favoritism on many levels: from my colleagues, from the authorities, from my employers—and, sadly, sometimes even from my patients.

As Ryan applied color to my hair, I studied his reflection in the mirror. His curly hair fell in waves onto his shoulders, and he wore a nose ring and earrings. Before he’d put on latex gloves, I’d glimpsed deep pink polish on his nails. It was obvious that his gender expression didn’t conform to societal norms.

This took my mind back to recent events at work.

A few weeks back, a twenty-eight-year-old man named Martin had come to our emergency room, suffering severe pain from a large neck mass. His biopsy had confirmed a rare, aggressive cancer involving his right tonsil.

He needed surgery, but the surgeon advised him to have chemotherapy beforehand, both to improve his surgery outcomes and to decrease the chance that the tumor would recur.

To my dismay, Martin refused treatment. I thought he must be in denial. He was discharged, and scheduled to follow up with me within a week. I hoped that, after rethinking his initial denial, he’d agree to have chemo. Unfortunately, he didn’t keep his follow-up appointment.

A few weeks later, I saw Martin in the ER again. This time, he could barely breathe. He’d lost a lot of weight, because the tumor’s pressure on his esophagus made swallowing impossible.

To ease his symptoms, he was admitted to the hospital and had the bulk of the tumor removed surgically—but it was highly likely to grow back quickly. If Martin didn’t start chemo, my colleagues and I knew that he’d be in trouble.

During his recovery in the hospital, I saw him daily and kept up my efforts to persuade him to have chemotherapy. To my frustration, he continued to refuse, never offering any reasons why.

When I asked things like, “Are you afraid of the side effects, Martin?” he simply turned his face and stared out the window. Still, I kept hoping that he’d change his mind.

One day his mom, Clarice, visited. Hoping that she might convince Martin to get treatment, I reviewed the entire situation with them, explaining how much was at stake.

From the first, though, Clarice seemed puzzlingly detached. My glimmer of hope faded when she concluded our talk by saying, “I’ll let Martin decide for himself.”

Your son could die! my mind screamed. But I couldn’t say anything.

After his discharge, Martin visited the clinic only once, for a refill of pain medications. This time, he appeared more relaxed and approachable. As we talked, I took care to tread lightly regarding treatments.

“How is your mother doing?” I asked.

All at once, his eyes welled up with tears.

“My mother is upset with me,” he said. “That hurts the most—sometimes even more than the pain from my cancer.”

He hesitated, then said: “I want to be a woman.”

Months before receiving his cancer diagnosis, he said, he’d started the process of transitioning.

“I told my mother, and I hoped that she would support me,” he said. “But she told me that what I was doing was wrong, and that she didn’t want to see me anymore.”

Martin’s revelation was an epiphany for me. It explained everything: his mother’s indifference, his refusal of treatment. He’d declined it not for fear of the side effects but because he felt caught in a catch-22: Unable to transition, but also unable to be his true self in the body he’d been born with. He’d lost interest in living, and cancer had come to his rescue as the way out.

It had never occurred to me that gender dysphoria could be the underlying reason for Martin’s resistance to treatment. I’d noted his nail polish and earrings, but my clinical mind had been too focused on his cancer. I’d spent so much time trying to trying to reason with him about the power of treatment to prolong his life, and trying to alleviate his fears. Meanwhile, I’d been oblivious to the painful identity crisis he was suffering.

Guilt-stricken, I tried to make amends.

“I’m so sorry that your mother isn’t supportive of you,” I said gently. “I’ll gladly give you a referral to our pride program, if you wish.”

For the first time in weeks, he looked me in the eyes. In his own, I saw a gleam of hope—then it was clouded by tears. He started to walk away, then turned to face me.

“Thank you,” he said. I knew that he really meant it—and that made me feel even more helpless.

“I don’t want to do anything to upset my mother any further,” he said, before walking away.

Martin had made his choice. He would rather die of cancer than hurt the person he loved most.

This is suicide, I thought. Or is it a homicide? Homicide inflicted by a society that smothers free will out of ignorance about nature and human biology. A society unwilling to accept that we’re all made differently. A society that needs to learn that differences should be celebrated….

My stylist Ryan handed me a cup of herbal tea, interrupting my trance. Hoping that its sweet aromas of chamomile and lavender would soothe my mind, I looked out the window.

Outside, the fog had lifted. The autumn leaves looked golden in the sunlight. Nature was celebrating its transition.

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Originally from India, Minal Dhamankar completed her hematology-oncology residency and fellowship at Lankenau Medical Center in Wynnewood, PA. She now practices at Jefferson Einstein Montgomery Hospital, in East Norriton. “I love reading, creative writing and painting.”

Comments

15 thoughts on “His Mother’s Son”

  1. Thought-provoking short story, so beautifully narrated – incredibly poignant and emotionally moving. Minal is such a wonderful writer and in telling us a story of intense introspection; she has captured our hearts and awakened us to struggles the transgender community faces. The story is an eye-opener for all ages; compelling the reader to question the status quo and raising awareness and the need to be inclusive, supportive, and respectful to those who feel different, experience discrimination and don’t fit into the societal norms of gender identity.

    Minal has literally put herself in the shoes of the protagonist who feels entrapped in his own body and sadly unsupported by the people who are closest to him. In doing so, every reader identifies with times when they have faced challenging moments in isolation due to the fear of being stigmatized.

    Keep the stories coming Minal, when told through your lens; they will have a far-reaching impact in creating a society which embraces the differences in people; be it race, ethnicity, religion, or gender.

    Through your empathy and gift of narration we can leverage the humanities, break walls, and build bridges.

  2. Certainly a heartfelt and poignant story. But is Clarice the “villain” here?
    Can she not have her own opinion about Martins gender identity?
    I have an enormous amount of sympathy for Martin, but for Clarice as well.

  3. What a beautiful essay! I have learned in my seventy-six years to accept people for who they are. Your story convinces me that I have made the correct moral choice. Thank you.

  4. When the most deeply touching human experience is explored and amplified and put into words by such a talented writer, it is a gift to us all.
    Beautiful and painful story, thank you for sharing this and may it inform all of our practice and more importantly, our humanity.

  5. Superbly written Minal. Many of us, we Indians, love reading; but you can write so well too. Indeed, “the differences should be celebrated”

  6. Beautifully written. Coming from India , member of a German family and having a Homosexual son , I can understand the conflicts of mother and son.
    Minal your story brought tears to my eyes . I am happy I found my peace with my son .
    Nisha Ort from Germany

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