“Dedicated” to Mending a Broken Home

My sister often shows me this photo and points to the tree that matches her current emotion. She’s told me it’s the most accurate depiction of her life day-to-day. Photo credit: National Institute of Mental Health (2018). Full article can be accessed here: https://www.nimh.nih.gov/health/publications/bipolar-disorder/index.shtml.

I abruptly packed my entire two years of existence at an attic studio in Tradewinds in a matter of twenty-four hours. I never imagined that such an impactful chapter of my life in the most beautiful place I’ve ever lived would end in this way. Dragging my eight pieces of luggage behind me, I caught the last Air Antilles flight out of Sint Maarten to Puerto Rico before the border closed, missed my connecting flight, then managed to find Texas in a daze.

Since quarantine began in March, I have been home in Dallas for my “dedicated” Step study period. It is the longest I have been here since I left in 2012, less than a year after my sister’s second hospitalization. My older sister was diagnosed with Type 1 bipolar disorder during my freshman year of high school, and since then, my family battled through several life-altering adjustments that seem to have left my parents distraught and even more lost than they were when they first migrated to America. We come from a South Asian culture where mental health is not acknowledged or nourished, and it has been difficult for my parents to come to terms with the stigma surrounding my sister’s experience. Nearly a decade later, I am back home during the most critical period of my life, witnessing the aftermath of the war while simultaneously marching through the crossfire.

As my sister and I are usually each other’s only human interaction daily, I’ve become integral in facilitating continuity of care between doctor and therapist visits. She has taken a profound interest in our teachings from Dr. Ullal and Dr. Humphrey and is also relieved to have a supporting figure at home who is understanding of her illness. Recently, she requested that I attend her counseling session, which inspired a turning point in the fabric of our home.

“It’s so great that your sister came with you today. Maybe she’s the missing link between you and your parents. This may be the start of a positive change,” her counselor said.

The comprehensive assessment of my first two years of medical school was not Step 1 or shelves; it was healing my family using all the skills and knowledge I have acquired through all of AUC’s resources. I presented my sister’s entire chronological case history to my parents, combining my knowledge and strategies from neuroscience, pathology, behavioral science, pharmacology, physiology, ICM, and wellness counseling. I found videos and artwork to help aid their understanding of bipolar disorder like my team did for Project HELP health education sessions. Moreover, I described all the processes and connections in simple terms with intermittent Bengali translations to bridge communication gaps.

My parents were in awe as I spoke. They had seen dozens of doctors, nurses, counselors, and allied health professionals, and not once had anyone taken the time to educate my parents on bipolar disorder. Simplifying the neuroscience and integrating all the other aspects helped them understand the illness better rather than only attributing my sister’s symptoms to negligence. They asked lots of simple questions that would have helped them support my sister better throughout the years. While I was genuinely shocked at the gaps in their knowledge despite being my sister’s primary caregivers, it warmed my heart to witness how receptive they were to learning. In a culture where parents’ worth relies heavily on their children checking off boxes on a list, accepting mental illness is unheard of. 

I struggled most to answer their last question of the session, “So what’s her prognosis? What treatment will help cure her?” After ten years of ongoing treatment, two long term in-patient facility stays, and endless heartbreak, it was as if I had to deliver news they heard for the first time 

“Your child has a disease that has no cure. She will never be back to normal.”

How do you gather the strength to look your mother in the eyes and say those words? How do you stay calm when the strongest person you have ever known, your father, is instantly overcome with distress after a decade of denial and hiding his emotions? It feels strange when the patient is your family member, and you are responsible for “breaking the news” to your parents. While as a student you don’t have all the skills or confidence that is needed to lead in the clinic, your most valuable arsenal is empathy. My sister’s condition has worsened over the years, and while it is painful for a parent to acknowledge that their child’s future will be compromised, an empathetic approach can help patients and their families realize how to add value to every day.

You learn far more at AUC than just the basic sciences. You learn what it means to be a well-rounded doctor and future healthcare leader. You learn to tuck everything away and discipline your mind to perform on command despite the chaos around you. You learn resilience while confined by an endless sea of self-doubt and painful memories. You build the strength to push through the pain and FIGHT. The level of respect and precedence that this profession earns you cannot compare to anything else. As physicians, we have the power to end stigmas and make a critical difference in our patients’ lives. 

AUC gave me the tools to heal my own family, which has been long overdue. We will forever be grateful. 

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