Then... and Now—Natural Phenomena

I moved to Massachusetts, started my family, and trained in family medicine.

I am a Bostonian. I have cared for my patients, lived their lives with them, and shared experiences with an aim to treat, heal, prevent. 

The year was 2004 and a tsunami devastated Indonesia. My patient came to my office in urban Massachusetts, a week after the incident, for travel vaccines. He needed to go home, quickly, to search for his family. They were lost in the tsunami: their home, belongings, everything swept away. He had found his nephews in a hospital but his older brother was missing—the older brother who had sacrificed an education so that my patient could go to school and immigrate to the United States. He needed to do his part and go search for his brother. He must find him; there were so many things left unsaid, so many thank you’s he needed to say. 

He has returned to Indonesia every year since 2004; he has searched relentlessly. He keeps looking in every crowd, every large gathering. His brother was never found. Could he have been swept away and washed ashore somewhere else? Maybe the brother is also looking for his family, needing to be found. My patient says that he scours every crowd, mall, gathering. He scans the newspapers of several countries and tries to watch every collection of people on TV- soccer games, football matches, parades. He is looking for a face in the crowd. The closure he needs is not there. His sleep is interrupted by dreams and thoughts of his older brother. He continues to try and concentrate on his present, for his family now, but his eyes are always scrutinizing. His family has grieved and moved on, but he is devoting his time and energy to searching. As his physician, I search with him, looking for ways to ease his discomfort.

He is waiting for a flash flood to hit him. 

She came into my office and started to cry. She had recently lost her younger brother; they had grown apart in the last few years, while she was busy raising her children, and he was trying to find his way in the world. Born 15 years apart, her younger brother would hold her hand as they walked to the school bus stop every morning. He had disappeared from a town in Cape Cod, presumed dead. All she could learn from locals and his friends was that he was last seen in a pub. He walked out toward a cranberry bog before a Nor’easter and vanished from this world without a trace. Nothing was ever found. She thinks he was targeted, but why? She told me, “I am going to go back to Cape Cod the next school vacation to search for him. We have to find something.” 

She keeps looking over her shoulder. She feels she will see him following her just like he used to. She has searched every cranberry bog in Cape Cod but has not found him. She walks these bogs, looking, asking the locals. No news, no answers. Her kids have grown and now she does not have to wait for school vacations to drive to the Cape. She goes as often as she can. She feels like she has lost control of her life, she has lost interest, she just keeps searching. She says as her family doctor, I have been the constant in her life. She keeps asking me if I will leave my practice or move. She clings to the security of my office.

She cannot leave Massachusetts.

She was a scared teen in my clinic, accompanied by her mother and sister. She had just arrived a few days ago from Haiti and was living with her aunt. They had lost everything, including her two brothers, in the earthquake and were now seeking refuge with her aunt. She said that she had not slept in the last 2 weeks as she kept hearing cries for help. She was afraid that the floor would give way under her again. She told her story with tears running down her face, in Haitian Creole, as the nurse injected her with vaccines. The interpreter, mother, and aunt reassured her over and over again. 

She has grown up and is fluent in English. She works part time and attends community college, trying to build her life. She has often been homeless as she rejected upper-level apartments and now lives in a ground-floor apartment with her mother. She misses the simple reminders of her childhood like her photographs and the toys she shared with her siblings. She is her mother’s pillar of strength, but she needs someone too. She misses her family and still hears her brothers’ cries. She continues to have nightmares and often wakes from sleep in a sweat. She takes her anxiety medications regularly and continues to search for stability, firm ground. As her doctor, I try my best to accommodate her visits, even if it sometimes means double-booking.

The world should not fall out from under her again. 

I was a new family medicine resident and had taken the Hippocratic Oath. I vowed to care for my patients and safeguard them to the best of my abilities. 

I reassured my patients honestly, listened to their stories, and acknowledged their traumas and truths. I gave them hope, confidence, and prayed with them and for them. I did not know how this would play out. 

I gave diagnoses of acute stress, acute grief, and treated insomnia, nightmares, anxiety, chronic pain and fatigue. 

I was energetic, stayed humble and offered my knowledge.

I have been in practice for decades. I have stuck to my vows and made new promises to myself regarding patient care.

I continue to listen to my patients, pray with them, and for them. I am still humble and make a conscious effort not to allow cynicism to creep in.

I, too, search for faces in a crowd and have visited the cranberry bogs of Cape Cod, but as my personal well-being intertwines with my professional wellness, I strive for stability.

I now diagnose posttraumatic stress disorder and major depressive disorder and treat symptoms with medications and counseling. I team up with my mental health colleagues and try a team-based approach. 

I try to remember that healing goes beyond creating treatment plans as I offer warmth, empathy, and a human connection.

I am a family doctor.