TV came after responsibility.
Beds had to be made before leaving the house.
Lights had to be always turned off.
Sinks wiped dry,

Rooms cleaned and tidy
even the smallest things
had to be done with care within them.

Don’t let the tap drip.
Be home before dark.
Share what you have.
Greet others with respect.
Say your prayers with faith.
Do your part well.

It felt heavy then,
like I was always being corrected,
always being held back.

I promised myself
I would be softer,
looser, nothing like that kind of love.

But life has a way of circling back,
teaching us in our own handwriting.

I grew.
I became.
And I heard my own voice
echo hers, each day,

“Did you clean your room?”
“Turn off the light.”
“Don’t forget to share.”

“Did you say your prayers?”
“Take responsibility.”

And now I understand
what I once resisted.

You were not mandating rules.
You were building roots.
Not control, but wisdom and care
of a way of being in the world
with dignity, order, and intention.

And now, with my children,
and their children,
your words live on in me,
not as weight, but as wisdom.

I wish you were here
so I could tell you:

You were right
in ways I was not ready to see.
And I see it now
in every small, ordinary act,

the rituals and traditions,

a sense of belonging
has become my inheritance.

So, on this Mother’s Day,
I remember you,
and I recognize you.

And I say thank you
for every “momism”
that became
a form of love
I only understood
when I had to become it myself.

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What if I had one more day, dear Mummy—
One morning of your voice
Saying good morning as the sun stretched awake?
Would you ask, as you always did,
“What should I cook for you today?”
Then laugh and say, “Phuchne se kya faida?
Tum toh wohi khaati ho—daal palak.”
What’s the point of asking when you will always be faithful
To the comfort of spinach and lentils?

Would you remind me—again and again—
To eat, to sleep, to rest,
Not to work so hard, not to carry the world alone?
Would I say Adios as I rushed out the door,
And you, with your steady tenderness,
Would reply Bye… take care, beta (darling).
Blessings tucked into each ordinary moment.

You would remind me, as you always did,
That life unfolds for our good—
If only we pray, trust,
Be kind and keep faith.
You would still be teaching,
Simply by being—caring, loving, giving,
A life lived in service of others, a light that glowed for all.

And what would I say to you, Mummy?
I would ask what you did today—
Did you walk? Did you exercise?
I would tease you, lovingly, endlessly.
I would say sorry, for impatience,
For sharp words, for the days I wasn’t as present
As your heart deserved.

I would tell you
How much I miss you, every day, every breath,
In ways that ache, fill my eyes and soften me all at once.
I would say all the things I wish I had said then—
But somehow, I know, you knew, you know,
You are with me, with us, always.

And on this day as each day,
Your memory rises like dawn—
Quiet, glowing, a whisper in the breeze,
A blessing in the rain, a gentle touch in the night
Guiding me through shadows.
Your warmth is still mine, and your love forever.
You taught me how to live, how to serve,
How to be a daughter, a sister, a physician,
A teacher, a leader, especially a friend—
Not through lectures, but through grace
Of your everyday actions.

You taught me, the best gifts are not wrapped—
They are spoken softly: “God bless you,” “Thank you,”
From a patient, a student, a friend, a life touched.
Your wisdom—Vasudevkutumbakam, the whole world is our family,
Is timeless and guides future generations
Through the echoes of your voice.

And so today, dear Mummy,
On your birthday in heaven,
On this fourth year without you,
I celebrate the gift of you—
Your meaning, your courage, your love, your legacy.
I try, every day, to carry your light—
Into every person I meet, into every corner of our family.
I hold your lessons close for your great-grandchildren:
Amara, Leela and Jaya with their energy, smiles and curiosity,
May they grow in the glow of your grace,
May they feel the gentleness you gave us,
May your story continue through the way we live,
The way we love, the way we serve.

If I had one more day,
I would simply hold your hand
And say—thank you, Mummy.
For everything. For all that you were, for all you still are.
You remain,
Our forever blessing, our forever guide, our forever home.

Earlier Tributes to Mummy

• Remembering Mummy on this Mothers’ Day (May 11, 2024)

• What If You Had One More Day (November 23, 2022)

• In Loving Memory (November 28, 2021)

#REFLECT: I invite you to pause and reflect and reassure the affirmations received by a loved one who loves and cares for you and inspires you.

How can we lessen the stigma for physicians and all other clinicians to speak about their struggles either privately or openly—and seek help?

If you are having thoughts of suicide or self harm, please call a friend or a loved one, or call 988 or text HOME to 741741

Ever since the fateful day when I walked through the tunnel joining our office building to the parking lot and discovered the limp, lifeless form of my friend and colleague, I have wrestled with the meaning and value of our work, our lives, and our calling as physicians. (Read further… )

Today is National Physician Suicide Awareness Day. I am sharing this story over the next few days. It is from an earlier 5-part series that you can find here:

• Part One: A Personal Story of a Loss by Suicide

• Part Two

• Part Three

• Part Four

• Part Five

This story was first shared in chapter 16, The Good Physician, in my book Resilient Threads: Weaving Joy and Meaning into Well-Being.

“I care for myself while caring for others.”

#REFLECT: How do you tune into your own needs? What is one well-being practice you might share with a colleague today?

For me, it was not just the loss of a friend. It was a shattering realization that even the “good physician”—the one who notices, who listens, who carries compassion in every gesture—could be broken by the very system he served.

That moment stripped away any illusion that medicine’s sacred calling to heal could be sustained without also caring for the healer. It became a turning point in my own journey, fueling my commitment to reimagine what our oaths in medicine must mean. They cannot stop at the patient. They must include ourselves and our teams, because the cost of neglecting the care givers is measured in lives. (Here is a five-part series of earlier posts, excerpting “The Good Physician” story from my book Resilient Threads: Weaving Joy and Meaning into Well-Being.)

As we pause on Physician Suicide Awareness Day (honored September 17 annually), I carry his memory as both a wound and a call to action. His story is not his alone; it reflects the silent suffering of too many in our profession. Honoring him means breaking the silence, confronting stigma, and building systems where no physician, trainee, or caregiver feels alone in their despair.

Beyond the Hippocratic Oath

The Hippocratic Oath has guided medicine for centuries, anchoring us in our duty to patients and their families. Yet the landscape of medicine has changed. Today, our calling must extend beyond patient care alone. It must include partnership with the systems we work in, our teams, and ourselves.

Suicide among physicians and trainees remains a profound concern. The rigors of medical education and practice often leave little space for self-care, reflection, or connection—yet these are precisely the practices that protect our well-being and sustain our calling.

If we are to confront burnout, build cultures of well-being, and fully advocate for both patients and our profession, we must embrace a simple truth: well-being is a shared responsibility.

Together with my colleagues in the Collaborative for Healing and Renewal in Medicine (CHARM), Dr. Margaret C. Lo and Dr. Kevin E. O’Brien, I co-authored the Oath to Self-Care and Well-Being. This Oath unapologetically reframes care of self and team—not as an individual burden, but as a shared commitment, where systems bear the primary responsibility, in partnership with those “on the ground”, the health care teams caring and educating.

When leaders actively join with care teams to nurture the well-being of caregivers, patients and communities ultimately thrive.

From Rituals to Culture

These values are not abstract aspirations. The Oath to Self-Care and Well-Being is being introduced early to medical students, residents, faculty, and healthcare professionals across institutions.

A few examples where the oath has been pledged include:

• White Coat Ceremonies

• Graduations

• Capstone Sessions

• Resident Orientations

• National Meetings

• Well-being Champion Gatherings

Each time, it offers learners and clinicians a way to align their professional promise with personal and collective well-being. Just as we pledge to our patients, we must also pledge to ourselves and to one another, while working with leaders to create environments that foster safety, meaning, and efficiency.

Suicide Prevention and the Power of Connection

In our publication, Overview of an Emergent, Arts-Based Resiliency Curriculum to Mitigate Medical Trainee Burnout (Arts & Health, 2021), my colleagues and I demonstrated how integrating the arts can help trainees process lived experiences, foster meaning, and build resilience.

This work highlighted the transformative role of three grounding principles:

1. Rituals – Intentional practices that promote self-care so that we can be present for others. They help medical professionals live as whole people, caring for their own health and heart as they care for others. Resilience requires recognizing when we are overwhelmed and letting go of thoughts or emotions that do not serve us or others.

2. Reflections – Narrative writing, storytelling, and creative expression honor vulnerability and deepen self-awareness. Even brief, recurring moments—weekly, biweekly, or monthly—asking questions such as “What gave us meaning? What gave us hope? What surprised us?” can reconnect teams with purpose and restore perspective.

3. Trusting Relationships – Mentors, peers, and colleagues provide the safety needed to navigate uncertainty and seek help. Practices as simple as a weekly “buddy check”—sharing a positive passage or a reminder that we are there for each other—can build resilience through consistent connection.

Practical Ways to Nurture Resilience

Resilience is not a quick fix; it is a lifelong journey. Here are eight practical strategies to cultivate it in real time:

1. Ritual – Begin the day with gratitude, a smile, or a meaningful quote. Pause before entering a patient’s room with a brief acknowledgment, centering yourself. Even short mindfulness or breathing practices shape mindset.

2. Replenish – Attend to foundational needs: food, water, sleep, and exercise. Remember HALT, a reminder to pause when you are hungry, feel angry, lonely or tired. Even 60-second breaks restore mental and emotional energy.

3. Reset Expectations – Practice self-compassion and clarify expectations with others. Focus on what is within your control.

4. Reflect – Journal or reflect several times per week. Ask: What gave me hope? What inspired me? What surprised me?

5. Relate – Connect with your community—family, friends, patients, and colleagues. Relationships provide perspective and support.

6. Resonate with Patients – Explore the “why” in every patient’s story. Listening with empathy reveals meaning and deepens holistic care.

7. Reconnect with Your Why – Remember why you chose medicine. Collect, reflect on, and share your stories—they sustain passion, perseverance, and commitment.

8. Invoke Resilience – Resilience is dynamic; it is intentionally cultivated, invoked, and strengthened over the journey of medicine.

By weaving these practices into daily life, we nurture not just professional effectiveness, but human vitality, ensuring that we thrive while caring for others.

Embedding Practices into Everyday Life

As we promote self-care, it is vital to carve out space for meaningful connection during everyday gatherings—huddles, morning reports, noon conferences, or staff meetings. Simple practices, such as beginning with “what went well today” or a brief celebration story, or ending with “whose voice still needs to be heard,” can shift culture.

Equally important is establishing shared agreements or grounding principles around communication—much like the Touchstones from the Center for Courage & Renewal—crafted with input from the whole team. This fosters psychological and emotional safety while promoting belonging.

Spaces for reflection and connection—whether in huddles, team meetings, or shared storytelling—help us process moral injury and return to our “why.” Over time, these practices become more than rituals: they nurture circles of trust, belonging, and meaningful relationships. Culture changes only at the speed of trust, and trust grows when we are seen, heard, and supported.

When these practices move beyond isolated events and become embedded traditions, they cultivate cultures of compassion, meaning, and care—where well-being is not an afterthought but woven into the very fabric of medical education and clinical practice.

For more resources, explore:

• The Dr. Lorna Breen Heroes’ Foundation

• 📖 Overview of an emergent, arts-based resiliency curriculum to mitigate medical trainee burnout. PMID: 32772810

• 🔗 Learn more: Expanding Physicians’ Oath to Care to Include Personal Well-Being

• 📖 Full article: Read the journal article about the Oath to Self-Care and Well-Being published in the American Journal of Medicine, AAIM Perspectives, February 01, 2020, http://bit.ly/O2SCnWB or click to download PDF.

#HowAreYouReally #StopTheStigma #ShineTheLight #DontWorryAlone #Oath2SelfCare #MedEd #PhysicianWellBeing #ResilientThreads #Reflection #DoctorsForEquity

The morning of November 15, 2015, remains vivid in my mind. On this fateful day, I walked through the tunnel joining our office building to the parking lot and discovered the limp, lifeless form of my friend and colleague who died by suicide. My friend ended his very fruitful life in despair, having been systematically and relentlessly devalued over the years by the very career to which he had given his heart, mind, body, and soul. Ever since, I have wrestled with the meaning and value of our work, our lives, and our calling as physicians.

A feeling of sadness lingers, losing a dear friend to death by suicide, the most tragic event as a consequence of emotional exhaustion. I feel anger and frustration about how much still needs to be done within health care to address this epidemic.

However the memory also sparks different emotions, gratitude being an overpowering one. Gratitude for the opportunity to have had the friendship of a wonderful human being, gratitude for his life, and legacy of always being of service to others. A smile lights up my face as I remember our interactions, the time spent together in a doctor-patient relationship, and also as a friend where we discussed our families, kids, or his passion for orchids and golf.  I feel gratitude for his wonderful family to allow his story to be shared and be the impetus for the LifeBridge program.

Reframing and intentionally seeking some silver lining despite tragedy is a common way that I cope. I turn to gratitude for the Chattanooga-Hamilton County Medical Society and its CEO, Ms. Rae Bond, for believing and trusting in an idea. Soon after I found my dear friend’s body, I approached her in desperation and hope with a very naïve and rough proposal. I knew deep in my being that something needed to be done.

We physicians and healthcare professionals needed a space that felt safe, where we could be ourselves and take off all our masks. We needed the opportunity to be able to share our concerns and fears, even mental and behavioral issues, without fear. Without the fear of big brother or big sister watching, without the fear of retribution, without the fear of losing our job or license. I had tried to seek and create such spaces within our own organization, however there still existed fear and distrust.

I had always considered the Medical Society as a safe haven for me, and I knew many of my colleagues felt similarly. We often referred to it as the Switzerland of our community, thanks to the leadership. And thanks to them, the LifeBridge program was established less than a year later.

Personally, my involvement in LifeBridge gave me meaning, a sense of joy and connection that resonated with my purpose. I felt energized in a way that sparked my creativity, giving me the motivation to continue. I found myself more relaxed, listening with care and awareness, enjoying my walks and feeling well rested after a night’s sleep. 

This month, the LifeBridge newsletter includes my brief article about the Oath to Self-Care and Well-Being, which I co-authored for the Collaborative for Healing and Renewal in Medicine (CHARM) in 2020.

I am also grateful to organizations like the Dr. Lorna Breen Heroes’s Foundation @drbreenheroes creating a community of support for clinicians & their families #StandWithLorna #LeadForLorna #StandWithLorna #HowAreYouReally #StopTheStigma #ShineTheLight

How I wish I can say our work was done to address the problem of our fatigue, stress and burnout. It is invaluable, and yet there is more to do. 77% of physicians, 75% of residents, and 78% of medical students agree that there is stigma surrounding mental health. 

Tenet #4 of the Oath to Self-Care and Well-Being reads: We WILL COMMIT to integration and balance in our professional and personal life and seek help when we feel we ourselves or our peers are overburdened, fatigued, or less compassionate.

#REFLECT:What would help you feel comfortable seeking support from a program such as LifeBridge? What would it take to reach out to a peer if you sensed their need?

On #NPSADay and beyond, we can all make a difference in preventing physician suicide by contributing to a culture of wellbeing.

Learn more at NPSADay.org and look for &/or share more resources online with this hashtag #NPSADay.

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In quiet dawn light and setting sun,
Her memory softly glows,
Whispers of love and care.
Her faith and spirit in each breeze and raindrop flows,
A gentle touch in the dark and  night,
Guiding me through shadows,
Her warmth and love forever mine.

As a physician I have guidelines to treat various illnesses, however my guidelines on how to be a parent, a daughter, a sibling, a colleague, a physician, a teacher, a friend came from my parents, my family (biologically related and heart related) through their role modeling, their day-to-day actions and the way they lived their life.

If I had been wiser, I would have started collecting my parents’ words of wisdom at a much earlier age. There’s some truth to the words that state we must get to a certain age to realize that our parents are smarter than us. I share more about the tremendous impact they have had in my life in my latest book, Resilient Threads: Weaving Joy and Meaning into Well-Being.

Today on my mummy’s 80th birthday, I would like to share one of the meaningful lesson.

I come from a working class family, lived in a multi-generational family system and have had a comfortable life, in spite of a hand to mouth living. My parents—both academic physicians—took pride in their values, hard work ethic, and honesty.  My early teens were a time when our country and the “doctor profession” were undergoing change. Physicians were still recognized to be part of that noble profession; however, some were deviating from the path by entering their own private practice and medicine was starting to also adopt a business model.

The gifts physicians’ received changed from the freshly baked bread and cakes, home-grown vegetables, and knitted scarves to more substantive gifts of trips and cars and scooters.  Some of my friends whose parents were also physicians now rode in chauffeur-driven cars and they switched to private schools. 

Unsure of this perceived discrepancy, one day I asked Mummy in an almost undermining, condescending way, “What kind of physicians are you?  You must not be doing well. Other parents tend to do much better while we are still living in this crowded two-bedroom flat. How come you don’t get the same gifts?” 

Mummy held my hand, and said, “But of course, I do get the best gifts.”

Surprised I asked, “What do you mean?” and she said, “When the patients look at me and say ‘God bless you’ or ‘thank you’ or students that I have taught years ago recognize me in spite of my gray hair now, that’s the best gift.”

I am not sure I understood then the meaning and depth of what she shared, however that incidence has a huge impact on how I show up each day.

Mummy continues to give selflessly and sacrifice for all.

So on her 80th birthday I wanted to record her wisdom to save it for me, for the family, for the future generations. I am really grateful to Ray Bassett, host of Scenic Roots on WUTC in Chattanooga. I sent him an email, spoke with him of my intentions, and he graciously accepted to interview Mummy about the questions that I sent him.

As you reflect on your life:

• What gives you meaning? 

• How did you discern what gives you meaning?

• What would you consider one or more of your/ achievement successes? 

• What allows you to overcome any hurdles?

• What words/ advice would you like to share with your family and for future generations?

Thank you, Ray, for making my wish come true!

Here is Mummy in the audio above! And my family’s birthday wishes to their Nani.

I was honored to read an early copy and endorse David’s book, Caring for Self & Others: Transforming Burnout, Compassion Fatigue, and Soul Loss.

As physicians, we may not always acknowledge that we each have a soul. However, we are in a sacred profession that truly holds the soul of our patients. Whatever we call it, there is a place deep within us—almost the elephant in the room—that is our compass guiding us, our North Star. 

Oftentimes we get lost because we don’t care for our internal compass. That is the essence of what’s lost in healthcare today. If we have the true soulful connection with our Self, it needs to be fed first so that we can be available to everyone else.

When we make self-care and colleague care an unapologetic and unashamed priority, we can give the best care to our patients. David Kopacz invites us to reconnect to our humanity, nurturing our hearts and minds as healers and setting the stage for our systems to heal as well.

I hope you’ll consider reading and sharing David’s important book. Creative Courage Press is offering a free sample PDF—the first 33 pages HERE.

Smiles, happy conversations, hugs, laughter, tears of joy and lots of delicious food marked this recent Memorial Day at my home. More than a dozen of my past UTHSC-COM Chattanooga residents, now settled in different US states and Chattanooga, gathered for a reunion. Though we were meeting many after several years, the time that had lapsed just melted away. It felt like it was just yesterday that we were together.

I am truly humbled and grateful that this group of wonderful young physicians planned and made an effort to travel with their families, all the way to Chattanooga to gather. As their teacher, now colleague and admirer, I feel a deep sense of pride. They have accomplished so much, both personally and professionally.

Seeing them as full-fledged independent physicians, giving back to the community that they serve, seeing them as mothers, fathers, spouses, leaders and colleagues, poised with humble confidence, brought me immense joy and hope.  They each are planting the seeds and making the world a better place by being in it and fulfilling their purpose in every role.

Less than 48 hours together has given me the gift that will keep on giving many fold. I know it took a commitment; it was not easy for them to travel by air or drive half a day with young children for a short visit. In addition, they each came bearing personalized gifts, our favorite foods homemade or purchased mindful to be gluten free (to accommodate my new allergy), traditional handicrafts, flowers, and chocolates.

We also celebrated gratitude with our gratitude tree, each leaf placed by a family or an individual. In the background, a beautiful circular wooden plaque hand designed and painted by a couple with the words: “Grateful hearts gathered here” in the center, a perfect depiction of our circle of community, our circle of love and support, our circle of belonging!

I was touched when they remembered my mantra “Happy Thoughts.” This mantra was given to me and our family by my daughter in her early teens. On one of our long car rides home in the midst of a heated conversation with her friend, she invited us to have happy thoughts, an invitation that allowed us to reflect and pause and reframe our mindset. While this was almost two decades ago, since then this mantra has helped me reframe situations, especially those that are challenging or hurtful and turn to wonder and curiosity rather than judgment or defensiveness. We all donned T-shirts with “Happy Thoughts” on them, as we posed for our group picture.

We currently live and operate in a technology dominant world. Computers and robots can now build cars, drive cars, fly planes, fight wars, manage money, read X-rays, diagnose diseases like cancer, and even perform sophisticated surgery. As more and more of our cognitive skills are getting robotic, these advances in technology are placing a premium on human interactions and authentic meaningful connections and relationships. The need to be intentional to create time and space for meaningful social connections is vital.

As I reflect on how our lives have changed as technology has advanced, the image of many workplaces come to mind. The work rooms with cubbies with individual computers, the people with headphones or ear buds clicking away on the keyboards as they complete their work whether that is charting on the EHR or other administrative and clinical tasks.

I am so grateful that they opted for an in-person reunion rather than a virtual one. The joy of seeing their smiles, laughing together, hugging each other, recollecting times both joyful and challenging was an experience that I realized I missed. Young children running around chasing each other reminded me of my young granddaughters and the joy that innocent childhood brings.

As we recollected our times together aided by a PowerPoint presentation with pictures from past years together, strengthened our emotional bonds and celebrated our valued relationships, the experience was both comforting and exhilarating. As the slideshow played, interrupted by recollections of episodes prompted by the slide, I reflected on our journey and time together. I celebrated how far each one had come, beyond their educational journey.

The experience for me was one of pure joy, both humbling and empowering. Our time together provided the much-needed platform to strengthen our already strong bond, our shared history, and our mutual trust. Our time together provided us with the community we needed, the sense of belonging, a reconnection that was a morale boost and a source of comfort and pride.

The PowerPoint was titled Job we met (which means “when we met”) after a Bollywood movie and ended with the words phir milenge, for “when we meet again,” an affirmation that we will continue these reunions, a commitment to meet in November 2025. I have happy thoughts we will!

REFLECT: When have you reconnected with loved ones? Who would you like to get together with next? What changes and shared memories would you celebrate?

Happy Mothers Day Mummy!

The first verse from his poem Endymion seemed only fitting, a beautiful soul I was blessed to call mummy.

 A thing of beauty is a joy for ever:
Its loveliness increases; it will never
Pass into nothingness; but still will keep
A bower quiet for us, and a sleep
Full of sweet dreams, and health, and quiet breathing.

  -John Keats

Sharing links to my prior posts.

https://open.substack.com/pub/muktapandamd/p/happy-82nd-birthday-mummy?r=3zpcu&utm_campaign=post&utm_medium=web

·       https://open.substack.com/pub/muktapandamd/p/what-if-you-had-one-more-day-dear?r=3zpcu&utm_campaign=post&utm_medium=web

·       https://open.substack.com/pub/muktapandamd/p/lovingmemory?r=3zpcu&utm_campaign=post&utm_medium=we

Happy Mothers Day to all mothers.

Thanks for reading Resilient Reflections! Subscribe for free to receive new posts. 

I’d like to share my retirement talk from that evening in the video and text below. I’ve also pasted some group photos at the end, with gratitude for all of you who attended and those who are part of my memories of these 30 years.

Good evening and thank you all for being here! As I look around the room, I realize many of you have been with me on my journey here at the University of Tennessee College of Medicine, Chattanooga and Erlanger, a journey that started more than 30 years ago. I have been here for nearly half my life in various roles. This has been my professional home. Thank you to my UTHSC and EHS family.

As I stand here and reflect on the passage of time including the past 30 years, I see my life’s journey as a vast field filled with different foliage (large oaks with strong sturdy trunks and sheltering branches, tall, elegant evergreens, flexible yet grounded palms, flowering and fruit bearing trees, shrubs of various colors etc). The seeds within this field have been sown by many, right from the earliest days of my life. Many of the seeds have been sown here, both intentionally often but not always with love and care. Some have been sown unintentionally.

Along the journey I have had numerous supporters, who played pivotal roles as teachers and mentors, sponsors and advocates, colleagues, learners, patients, team and community members, prayers partners, shoulders to cry and lean on and friends. Few became my family away from home. These are the gardeners, they helped till and plough the soil, fertilize, and nurture it by providing sunshine, water, and nutrition. They did this through their guidance, encouragement, and wisdom and often by just being there, by their sheltering presence, prayers and support. Their belief in my abilities helped me navigate the various challenges, encouraged me and fueled my determination, pushing me to strive for excellence even in the face of adversity. In this field, however, there also are plants with thorns, and weeds and those threatening to choke the other plants. Though painful, they have kept me humble, reflective, resilient, and taught me the importance of perseverance.

Throughout my journey, I too have planted seeds. My primary focus has been on cultivating the foundational elements of who, we are, our UTHSC-COMC-EHS partnership, or in other words, two important elements:

• Nurturing an environment of healing rooted in providing excellent, efficient and effective, and empathetic patient care and education.

• Intentionally co-creating, promoting authentic and trusting relationships, the foundation and crucial for professional fulfillment and thriving.

As healthcare undergoes so much transformation at such a rapid pace, the pervasive mantra of "no margin, no mission" underscores the challenges of where we are today, a corporate entity, feeling like commodities and consumers. Amidst these pressures, I too as many of you do, grapple with the tension, the balance between our financial sustainability and core mission.

How do we prevent our focus on the margin from overshadowing our mission? As I see it, our mission is to compassionately walk alongside our patients in their most vulnerable moments, to educate and mentor our learners, the future, and to care for and collaborate with colleagues who share our journey! To prioritize the other value units RVU, EVU. These ideals are not and cannot be too lofty for the essence of our calling!

As I’ve sown these seeds, continue to do so in my new role at the ACGME, I’ve also been a student of life. Some seeds have flourished, while others have withered, some crushed, some remain to break open. Some will continue, like at the Hunter Art Museum. Through it all I have tried to remain guided by my core values. I look forward to continuing to sow seeds, I hope with collaboration when possible.

Dean, you had asked me to share what I am passionate about.

There are two seeds that I request you all present to sow and continue to nurture. When we sow a seed we plant a narrative of future possibility.

The first is the seed of trust. Ours is a vocation of relationships, with each other, our stakeholders, our team, society and, the most important, the sacred relationship with our patients. Ours is a vocation of connection yet ironically, we increasingly face loneliness. Trust is the glue that builds community with engagement working towards a common unity.

I invite you to be intentional to sow the seeds of authentic trustworthy human relationships, that speak the language of both the heart and the head!  What does that mean?

As you sow this seed, ask: Are we truly present when we interact with others? Do we engage in respectful dialogue even when we disagree? How do we navigate difficult conversations with empathy and humanity, rather than relying solely on electronic communication? Can we offer explanations face to face when unexpected events occur rather than offer silence or disengagement?

As role models, it’s essential that we prioritize human connection over convenience. It is crucial to uphold the covenant we’ve made as healthcare professionals—not just regarding how we work, how competent we are, rather who we are in our work and how we relate to others. The satisfaction and fulfillment we derive from our work stem from our relationships, which, though slow to build, are inherently fragile and require intentional nurturing. Fruitful relationships grow at the speed of trust. Trust allows us to engage authentically and have the difficult conversations grounded in a shared covenant humanely.

The other seed I ask you to plant is to make a conscious effort to perform daily acts of kindness, even beyond our professional responsibilities.

Thank you for allowing me to share my journey, this journey has been made possible by the unwavering support and love of a close-knit community—from clinical to non-clinical staff, from acquaintances to cherished friends, and most importantly, my family, both blood-related and chosen, family of trust and belonging. I express my profound gratitude to all who have enriched my life—you are my colleagues, patients, their families, team members and students/residents. You have been the blossoms in my field, teaching me invaluable lessons along the way.  Thank you UT-EHS at Chattanooga, Memphis, Knoxville, and Nashville.

From the earliest days of my life, seeds were sown within me and nurtured by my family. You are the strong oaks that anchor me and shelter me. Your unwavering support provides the most fertile ground, encouraging me to be me! it has been pure joy being your mother, even the terrible teen years, pull hair out.

And to my parents you are the ones who planted the important seeds of dreams, instilled in me the values of hard work, determination, and resilience.  My parents’ unconditional, unwavering support and actions provided the fertile ground in which my aspirations took root and began to grow. Most importantly they planted the seeds of love, faith, prayer and belief.  Especially my mother, whose legacy of prayer and faith has been my guiding light. I wish she was here to witness this moment; I know her spirit permeates every step of my journey.

Thank you for the gift that gives on and will keep on giving.

Our talk is called What Happened When One Doctor Reimagined the Hippocratic Oath by Focusing on the Well-being of Health Care Professionals. Click to listen on Buzzsprout or other podcast platforms. The show notes and transcript are there too.

Listen to this episode to learn more about:

• my “How to Live” art therapy curriculum which is used to unpack the difficult and uncomfortable emotions and conversations health care professionals experience,

• what I believes it will take to transform patient care,

• a unique technique for creating what I call “a culture of belonging” where health care professionals work and learn, and more! 

Check out the many good episodes on the FindingJoy_Podcast. The podcast was developed by a team of interprofessional education researchers from Washington State University Health Sciences Spokane. They’re promoting well-being among students, faculty, and healthcare professionals during challenging times.

As 2023 turns to autumn here, how are you tending to well-being, community and resilience? I post reflections on these themes and invite you to join in the conversation here or on Twitter or Instagram with your thoughts or what you are doing for self-care and care of others. My book explores such ideas too: Resilient Threads: Weaving Joy and Meaning into Well-Being.

Family
a bond solid
a love enduring
a care true
leaves a legacy lasting

This past weekend, all four of my children, two granddaughters, and grand dog all got together in New York City. Being young parents, each with very busy and challenging jobs, their presence took intentionality and effort. I am truly grateful and happy that they found the time to get together as a family. The pictures they shared of their time together, continue to bring me joy. Papa and I have watched them over and again with appreciation and gratitude.

Almost two decades ago, the Indian Bollywood film Hum Saath-Saath Hain (translated means we are together) was released. The storyline shares the journey of a family with its many challenges, joys, successes, failures, beliefs, traditions, rituals, shared sorrows, and suffering—all highlighting the value of a family. As we watched the movie, it was not unusual for us to get emotional and tears to fill our eyes (especially Papa).  His desire, and invitation to us, was always for the family to be together, in spite of any challenge that may arise. Mummy shared the same.

Both my parents and grandparents modeled the same. I have tried to make this invitation part of my family, parenthood and legacy. The very fact that we are living means we are going to leave a legacy. I think the important part to remember is that we have a choice in what kind of legacy we want to leave.  True, our circumstances may influence this choice; however, our intentions matter. Growing older, I am even more aware of the importance, need, and value of both family and legacy.

Many years ago, my young daughter reminded me, “Mummy family is more than blood!”

Indeed, family is love, support, and understanding. I am grateful for my family—both by blood and through trustworthy relationships—grateful for keeping me grounded, keeping me true and authentic, for their unconditional nurturing and emotional support, the continued teachings, the care and compassion, their reminder of who I am, and for giving me a sense of identity and belonging.

Leaving a legacy is an act of gratitude, an act of creating something meaningful. As I reflect on my life, I am immensely grateful to so many that have helped me in this journey of growing and understanding in many ways.

I remember a conversation with my mother regarding family and legacy in August 2020 on her 80th birthday. We recorded her thoughts that year as we could not get together as a family due to the COVID-19 lockdown. We revisited and continued this conversation in November 2020 with both my Mummy and Papa on their 60th anniversary.

In remembrance and in honor of Mummy’s birthday on August 3^rd, Papa and I had another conversation about the same in this video below. Enjoy! Blessings to you and your family.

As 2023 unfolds, how do you tend to well-being, community and resilience? I will post reflections on these themes and invite you to join in the conversation here or on Twitter or Instagram with your thoughts or what you are doing for self-care and care of others. My book explores such ideas too: Resilient Threads: Weaving Joy and Meaning into Well-Being.

In the summer of 2015, I was suffering from empty nest syndrome after both my children left for college. In an attempt to continue to stay connected, I started a conversation with them via a text message. I start my day reflecting on something positive, often a quote. I love quotes. I would send the quote and reflection prompt to my children, which was disseminated to friends and family. My son and daughter began forwarding the text to family and friends, and I too began sharing it with my parents and some friends, medical students, residents, and colleagues.

This led to a large virtual community partaking in a philosophical dialogue with my father, Shyam Kumar Parashar, and myself. We published these early conversations in our book Rhythms of our Hearts in 2017, and our conversations carried on. I am honored to collaborate with my dad and happy to say have just released a sequel titled Reflections from the Heart: An Invitation to Pause, Reflect and Renew.

While I continued my ritual of daily reflection, the act of writing and sharing became more sporadic. I was aware of my own need to pause!  The last few years have been plagued with so many uncertainties and so much change. Add to that the COVID-19 pandemic, which impacted each and every one of us in the world irrespective of status, race, gender, ethnicity, religion, or sexual orientation.

I myself feel like I am surrounded by external noises and my own internal noise, conversations of what ifs, when, how? Every time I turn on the TV or view social media, there is enough negative information coming back at me to let me know that this is not the world I want to live in. These tumultuous and uncertain times demand of us the greatest possible expression of humanism.

In spite of a deliberate attempt to not watch the news or turn on the television, I find my mind racing around so many of these complex issues.  I realized I had to unpack the difficult conversations with myself and my trusted community, lean into that discomfort, and ask myself: What is my purpose? How can I show up fully as my true human self, allowing and inviting others to do the same, in spite of these uncertainties and changes? I needed to hold on to my faith, which helps me ground and center myself and helps me renew and find hope.

I found myself thinking about my early years in the United States. My four-year old daughter was learning the piano. She practiced on a keyboard at home and as I oversaw her piano lessons, I remember reciting the music notes out loud with her.

“Do, re mi, pause,” we sang. “Pause, Natasha, there’s a rest there,” I remember pointing out to her as she tried to continue playing the music.

“Why do I have to pause?” came her reply.

“Because there’s a rest in the music,” I said, pointing to the sheet of music.

As I think about her innocent question and my literal answer, I’m reminded of the beauty in that pause, the value in the rest, the making of music in that pause. I wish I had had the wisdom to give her some more answers and maybe inculcate a practice of pausing both for her and myself.

Today’s political scene, the pandemic, tensions around racism, equality and justice, the climate-related challenges, the impact of isolation, all these issues have their lasting effects of rage, anger, and hate, perhaps a transference of the grief and the loneliness that we are feeling.

All these issues also have added to the busyness and the time poverty that we were already experiencing. We work in a world which values “busyness!”

Taking time for a pause maybe perceived as a sign of weakness. But taking a break replenishes the mental and emotional energy associated with working hard, and thus improves work performance and boosts energy. I’ve learned that turning my break into a ritual can expand my consciousness and open my heart, replenishing my spirit as well. 

A ritual is something I do with an intentionality, a purpose, an inner awareness of my own emotions. My daily morning ritual focuses on a pause and reflection on something positive, often a quote based on what my mind is thinking about. These quotes serve as a “third thing”—a good metaphor serving to evoke in me what my mind and soul need me to listen and attend to. This purposeful reflection makes me more aware on a deeper level of all my emotions, helps me name my emotions and accept them for what they are without judgment for having them. My mind often wanders, so I have learned to be kind to myself and, without judgment, center back on the ritual.

After I share the quote and reflection by text or email, my father usually responds before the day is done, offering me another opportunity for more reflection and even a deeper understanding or perhaps a reframing. We continue our reflection in solitude and community, and by sharing with the reflections in our books. Giving myself the permission to take time to pause and rest allows me to reflect, recharge and renew. They remind me of my own strength, and my trusted relationships—my healing community. Most important and valuable is that the practice of these rituals reminds me to respect and be kind to myself and others, which leaves me with Happy Thoughts!!! There indeed is immense power and beauty in taking a pause.

We hope these quotes, prompts and reflections will do the same for you. May they offer you the ability to reframe and reset your thinking, recharge and replenish yourselves, recover, and even rejoice. You can find our new book at Amazon.com.

As 2023 unfolds, how do you tend to well-being, community and resilience? I will post reflections on these themes and invite you to join in the conversation here or on Twitter or Instagram with your thoughts or what you are doing for self-care and care of others. My book explores such ideas too: Resilient Threads: Weaving Joy and Meaning into Well-Being.

The retreat was facilitated by an external facilitator with a theme of “Physician Heal Thyself.” The very title shows the foresight of our department leader. This was 1999. One of the first exercises invited us to reflect on what we would like to be written on our tombstones. This being my third residency training, I was already in my mid 30s and a mother of two young children. Yet this prompt, frankly speaking, seemed macabre—especially as an introductory session of the retreat related to physician heal thyself!

The reflection was not easy. I spent time in personal thought. We were invited to share our  reflection in groups of three. I still remember sharing how I wanted to be remembered—for being a kind, caring, helping, trusted and responsible human being.

Reflecting back on that experience years ago, I realize it planted seeds for continued introspection.  What will be my legacy?

Through introspection I have come to realize that we do not have a choice if we will leave a legacy or not, the very fact that we are born, we will. However, the important thing is that we do have a choice of what kind of legacy we want to leave.

In my post at the end of 2022, I shared my thoughts on what it means to remain relevant. For me, legacy is also related to when I feel that I am truly living a life of meaning. Living life requires me to strive each day to fulfill my purpose with an intentionality and to the best of my ability.

Identifying my purpose and pursuing it is an ongoing journey. This purpose comes with an intentional attempt to understand my own core values, what I value and how I value all my relationships, those in my inner and larger circle. I value all the many ways of being with close family and friends and then all who I come in contact with, all living and nonliving beings, humanity and mother earth as a whole.

My core values are impacted by many experiences, especially my upbringing and seeing my grandparents and parents, my teachers, close family and friends, how they conducted and lived their lives, their teachings and our conversations. 

My core values are also impacted by my own learnings, errors and experiences. I have come to accept that I am human, who will make mistakes and mess up. I need to define each day with my core values, not my desires. I need to acknowledge that all I can do is my best, learn from these mistakes and strive to do better, I am a human! 

While the focus of my core values may change with my season of life, these are foundational to who I am, how I live for and with others in this world. My core belief values reflect and impact my actions. My core values are my Dharma.

Thinking back to 1999 and still today, I would like to be remembered as a kind, caring, helping, trusted and responsible human being. I would add service, self-compassion and gratitude.  I feel most fulfilled and filled with joy when I am living for and serving others, for a greater good.

I am profoundly grateful to so many without whom I would not be who I am today. I am grateful for being invited to think about my legacy at an early season in my life. I truly believe that reflecting on what kind of legacy I want to leave has allowed me to continue to strive to live a life that aligns with what gives me meaning and purpose. It has allowed me to be intentional to co-create safe and brave spaces for others to reflect on the same.

Being intentional to live a life of meaning and purpose helps me stay relevant and will help define my legacy. 

Part of my legacy, I say with humility, is sharing my story to encourage others to think about their own, particularly for other women in healthcare. This month is the 3rd birthday of my memoir, Resilient Threads: Weaving Joy and Meaning into Well-Being, and this celebration coincides with National Women Physician’s Day. Below I’m listing a few books I recommend for the women physicians and medical students.

February 3rd is the fourth National Women Physicians Day and 200th birthday of Elizabeth Blackwell, a pioneer of medical and feminist history who became the first woman to earn an M.D. degree from an American medical school in 1849 (and one of the first in the world). Her story is told in Women in White Coats: How the First Women Doctors Changed the World of Medicine by Olivia Campbell. I also recommend:

• In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope by Rana Awdish MD

• Letter to a Young Female Physician: Thoughts on Life and Work

  Suzanne Koven

• What Patients Say, What Doctors Hear by Danielle Ofri 

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  As 2023 unfolds, how do you tend to well-being, community and resilience? I will post reflections on these themes and invite you to join in the conversation here or on Twitter or Instagram with your thoughts or what you are doing for self-care and care of others. My book explores such ideas too: Resilient Threads: Weaving Joy and Meaning into Well-Being.

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Almost a year ago, I logged onto a Zoom call. Being the chair of the meeting, I was a little early, and happy to see another member, a dear friend, had also joined early. After we greeted each other, I asked them, how are you doing? With a smile, their response was authentic, “I’m fine, trying to stay relevant!”

Not the response I had expected or ever heard before! Before I could respond or even have time to unpack their response, other members started joining and our conversation shifted. For some reason, their comment has stayed with me, prompting much thought and reflection. I have also shared it with my father and close friends.

What does it mean to be relevant? Who am I relevant to? Who determines this? Does it matter?

My reflections on these questions brought me back to another one of my strong convictions: I need to be intentional to reflect on what gives me meaning and purpose.

This realization did not come to me easily. I remember those hard days, more than a decade ago, when I was questioning my purpose, both professionally and personally. Externally to the people looking in, it might have appeared that all was well. However, that was not how I felt. I always felt inadequate. The imposter phenomenon, well, I had a bad case of it! I was irritable and snappy when I was not at work. I didn’t like who I was, and the nights were lonely and scary.

Why was I feeling like this? What were my fears? Why was I questioning my purpose, especially as an internist twenty-five years later? Why did I feel unfulfilled in my work each day, what did I need to feel fulfilled?

I had to pause to review and reflect on these very questions, ones that I had refused to surface for fear of my own answers. What really helped me was the listening of a trusted circle of family and friends and the courage to share my own fears and vulnerability. I found the courage to explore these hard questions both through self-reflection and in open, honest conversations in the safe space created by my family and friends.

I needed to remind myself of—and refocus on—my why, what gives me meaning and purpose, not just in my professional life or personal life, but for me, my core being! What was it that gave me the reason to get up and go each day? What was it that made me feel fulfilled, that gave me a feeling of self-confidence?

The answer: When I feel that I’m truly living a life of meaning, not just doing the tasks assigned by a role or influenced by the stage of life that I was in.  

Five Answers to What Gives Me Meaning

Reflecting on meaning and purpose has been and is an ongoing journey in my life, one I continue to explore, redirect, be surprised, amazed, and even humbled by. This reflection is hard because it forces me to look in the mirror, even when what I see can be often harsh and judgmental.

1. Claiming My Gifts: Through open, honest conversations, I was reminded of the importance of accepting and recognizing that each of us have gifts that we are meant to share and utilize in each of our roles. This reflection forced me to claim my birthright gifts, something that was hard because it felt selfish, self-proclaiming and prideful.

2. Being Wise Selfish: I also found my answer in a beautiful book by Sogyal Rinpoche, The Tibetan Book of Living and Dying. There is a paragraph (I paraphrase) which speaks to the innate nature of humans as one of being selfish. However, we have a choice of which kind of selfish we want to be, foolish or wise. The foolish selfish person thinks only about themselves even at the cost of harm to others, whereas the wise selfish thinks of others and themselves and works towards a greater good.

3. Acts of Service: Living a life that gives me meaning and connects me to my purpose requires when I can use my birthright gifts in service of others with humility. In other words, I must experience a deep sense of genuine care and concern for another living being, human or animal or even plants (I do not have a green thumb and accept this as my limitation) and fulfilling my roles by intentionally engaging with a greater good in the focus. This service requires me to ritualize this practice and comes with courage and sacrifice, however it feels so fulfilling.

4. Following My Thread: What also gave me meaning and purpose was revealed by a poem, “The Way It Is” by William Stafford. This poem is truly very meaningful to me and I also share this in my book, Resilient Threads. The poem speaks about a thread that goes through the journey of our life, also through the world around us, even when both our personal world and external world seem to be falling apart or changing. As long as we hold onto that thread, we are okay. For me, I realized that many threads of different textures and colors make up the tapestry of my life, and they all are rooted and connected to the strong thread of faith. This faith more importantly provides me with hope for the future! Faith in the future with hope gives me energy and enthusiasm. This allows me to act!  

5. Reigniting My Inner Flame: There have been times in my life both professionally and personally where I felt the future was dark and hopeless. I remember the feeling of disengagement and apathy, not just physical, but emotional and spiritual too, and the feeling of being so drained and depleted in every way. I am grateful for the learned ability to now have the insight to recognize and reframe when such thoughts arise, reconnect and remind myself of the meaning and purpose that is not dependent on any external force but lies within me, in my core. It is the flame that never extinguishes, yet needs intentionality and hope to be reignited!

What’s at Stake When We Lose Hope?

I remember a story that my father shared when I was a junior faculty member. After my own journey of self-discovery and in an attempt to create a safe space at work where we could all show up as our true authentic selves and build community, I had started hosting reflective sessions called RRRnR (Relaxing, Rejuvenating and Rejoicing in Residency). I personally looked forward to these and so did others. Once when my father, a practicing surgeon, was visiting, I invited him to one of these sessions.  This evening we were speaking about our experience and journey as physicians, meaningful moments, lessons or relationships, and the role of patient autonomy.

My father shared his own experience of being a junior registrar in London during his early career, soon after his surgical residency training. His consultant was on vacation and had entrusted the care of his private patients to my father. During his rounds, my father went to see a pleasant lady who had been operated a few days prior. In his conversations my father disclosed her diagnosis to her, while also reassuring her that she was okay; however he used the words breast cancer. He came back the next morning to find her bed empty, the nurse sharing with him that the patient had passed in the night. Only later did my father learn that this consultant had not shared her diagnosis with her.

My father shared with our group the lesson he learnt: how we have to be extremely mindful about our patients, their frame of mind, and most importantly make an attempt to understand the thread they hold, how they cope, what are their support systems. This allows us to be present in an authentic relationship and attentive to the needs of each individual patient.

It is not an uncommon belief in India, and other East Asian countries, that sharing bad news can lead to bad outcomes. Thus, family members and caregivers will often request physicians not to share all the prognosis or diagnosis with the patients. I too had abided by similar requests during my training outside the USA. This was contrary to the tenet of patient autonomy in the USA, which was then a new concept to me.  

Frankly speaking, I was a bit embarrassed initially when my father shared the story, fearful that he would be viewed as violating this ethical responsibility. However, only later I realized his wisdom when he shared his own vulnerability, and his regret for sharing the diagnosis and how that helped him.

Science has also proven the close connection between the state of the human mind, human courage and hope, and their effects on the immunity of our body. We are paralyzed when we have nothing to look forward to, when we lose faith and hope in our future, when we lose our connection with our meaning or purpose, when we are not valued or even allowed to fulfill this meaning and purpose. Our body, mind and spirit fall victim, we can lose the will to live, and this can even have a deadly effect. (see References below).

Indeed, a common feedback I receive from healthcare members during my listening tours is the feeling of not being seen, heard, cared for and most importantly not feeling valued. On the contrary, they expressed the feeling of being a commodity rather than a human being first with gifts and skills.

#REFLECT: What gives you a sense of meaning and purpose? How might you encourage others to reflect on their gifts in the coming year? How might we ensure we see and affirm each other as valuable human beings? How can we be intentional to maintain and provide hope?

As we ring in the New Year, let us to attempt to reflect on our why, our thread of courage, of meaning and purpose and be intentional to invite those in our circle to share theirs as we together connect to our common purpose. Let us strive to co-create safe and brave spaces, providing hope and helping each other to feel fulfilled, and to engage in a collaborative community united around our common unity, our common purpose.

We all have something innate in us that the world needs. Let’s remember this with faith and hope and spread this shared hope with faith and action!

Blessings for 2023!

References

Annick Shaw, Stephen Joseph & P. Alex Linley (2005) Religion, spirituality, and posttraumatic growth: a systematic review, Mental Health, Religion & Culture, 8:1, 1-11, DOI: 10.1080/1367467032000157981

Wagner AC, Torbit L, Jenzer T, Landy MS, Pukay-Martin ND, Macdonald A, Fredman SJ, Monson CM. The Role of Posttraumatic Growth in a Randomized Controlled Trial of Cognitive-Behavioral Conjoint Therapy for PTSD. J Trauma Stress. 2016 Aug;29(4):379-83. DOI: 10.1002/jts.22122. Epub 2016 Jul 19. PMID: 27434598; PMCID: PMC4988872.

Löffler S, Bogausch A, Knappe R, Joraschky P, Pöhlmann K. Wachstum oder Wunde? Sinnfindung und Traumabewaltigung bei Patienten mit posttraumatischer Belastungsstorung [Path to growth or open wound? The quest for meaning and coping with trauma in patients with posttraumatic stress disorder]. Z Psychosom Med Psychother. 2012;58(2):192-204. German. DOI: 10.13109/zptm.2012.58.2.192. PMID: 22786848.

Frankl, Victor E., Man’s Search for Meaning, Beacon Press (1946).

As 2023 unfolds, how do you tend to well-being, community and resilience? I will post reflections on these themes and invite you to join in the conversation here or on Twitter or Instagram with your thoughts or what you are doing for self-care and care of others. My book explores such ideas too: Resilient Threads: Weaving Joy and Meaning into Well-Being.

What if you had one more day, dear Mummy?

What would you say to me? 

Would you say good morning as we awoke each morning?

Would you ask me what to cook for me today, or would you say, “Phuchne se kya faida? Tum to wo hi khati hi, daal Palak” (what is the point of asking—you eat spinach and lentils each day)?

Would you remind me to eat, to sleep, to rest? Not to work so hard!

Would I say Adios as I left each morning and before we went to bed and you would reply bye and goodnight?

Would you remind me that all that happens in life is for our good, we just need to pray, trust, be kind to all and keep faith?

There is so much you would say and always…

You would continue to show us how to be the caring, loving, giving and gifted person you were, always in service of others! 

What would I say to you? 

I would ask you what you did during the day,  if you had your walk!

I would continue to tease you!

I would say sorry for the times I was impatient and not very polite.

I would say sorry for not being there with you more. 

I would say how much I miss you each day and how hard it is without you! 

I would say all the things

I wish I had, however I know you know and knew

You are forever with me, with us!!

P.S. This week, Papa and all the family is in your favorite city—London—celebrating you together. Your warm presence surrounds and fills us with love. As we arrived, we saw a confirmation as if you were welcoming us:

P.P.S. As promised, here is a family photo I’m happy to share—and even more happy it was possible to all be together.

This weekend I had the amazing experience to see the musical Fiddler On the Roof, which was touring in Chattanooga, Tennessee. I had seen this movie for the first time growing up as a teenager in Goa, India.

I remember enjoying it thoroughly, especially the music. However, it had a different impression on me this time. And not only because I was with my father and dear friend Maria at the theatre. This classic musical invited me to reflect and think about the word tradition.

Intrigued by how consumed I was with this thought, I wondered why now, after almost five decades! Is it because tradition was such a part of my upbringing and the culture I was surrounded by in my childhood years? Is it because I am in a season of my life as a mother, grandmother, sibling and daughter thinking about the many traditions in this world—a world that is so different today, a world that seems to be connected virtually without any boundaries? Is it because I am impacted and influenced by the different issues that are affecting our world today, economically politically, racially, socially, and in every sphere that requires us to exist as humans? Perhaps it is just that I am growing in age? Whatever the reason, this reflection was indeed meaningful?

I grew up with so many unwritten yet gracefully and intentionally role-modeled traditions ritualized each day. These are just a few of the traditions that were critical piece of my culture growing up:

• Each morning on awakening, being intentional to smile and offer a prayer of gratitude.

• Lighting a lamp and praying before we left the house.

• Lighting a lamp at night.

• Touching the feet of our elders, making sure we greeted our elders and each other with the hands folded forward in front of us with a bow of Namaste.

• Making sure to have at least one uninterrupted meal together as a family daily.

• Ensuring no visitor left our home without being offered a food or beverage.

• Greeting and acknowledging each human being with a respectful welcome, irrespective of their status as workers, juniors, house helpers or important VIPs!

I have still followed these traditions, role modeling them for my children and grandchildren.  Traditions connect me to my past, who I am today, they connect me to my family and my community and reinforces the gratitude that I feel for all the contributions they have made towards who I am today. The practice of these traditions as a ritual gives me a sense of belonging and comfort.

Traditions connect me to the faith and values that I was brought up with. I am reminded of my personal responsibility and the common teaching of respecting, honoring, and acknowledging each other as human beings irrespective of status or beliefs. Traditions bring joy and a feeling of fullness. Traditions helped to promote and create a community and culture of care, kindness, and respect.

However, as I reflect, I am invited to think about the role of traditions in the current era of seamless connections via virtual and social media, facilitated by easier opportunities for travel. What is the role of this timeless universal essence that the traditions came to embody?

Just as we evolve, our world and its culture around us has evolved and so our traditions cannot be static. They too can evolve to meet the changing contexts in the world. Because these traditions are a part of our history, we have to know and understand our history if we want to be intentional and wise in defining our future.  We need to understand the values and intent behind the practice of these traditions before dismissing, forcefully mandating, or judging them in any way.

Just as culture changes with time, traditions are not cast in stone; they too can evolve constantly to meet these changing times. However, I say this with caution as this change needs intentional introspection, community reflection, and a constant united focus on what is the common good for humanity. Any and all traditions— whether personal, professional or societal—should always value a common humanity, a culture of respect and kindness, embracing all and intended to lift and empower each other whenever possible, and always always ensuring no harm.

It is up to each one of us to decide which traditions serve us and the greater good— which need to be modified and which are possibly irrelevant. It is up to to us to practice this as a ritual with courage, compassion, and intentionality.

REFLECT: Which traditions do you value and practice? 

As 2022 comes closer to turning to a new year, how do you tend to self-care, community and resilience? I will post reflections on these themes and invite you to join in the conversation here or on Twitter or Instagram with your thoughts or what you are doing for self-care and care of others. My book explores such ideas too: Resilient Threads: Weaving Joy and Meaning into Well-Being.

Also see resources related to the Oath to Self-Care and Well-Being, a supplement to the Hippocratic Oath.

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Thank you to everyone at CommonSpirit Health for the invitation to speak at today’s plenary session, “Rebuilding Places Where Clinicians Can Thrive.”

I was so pleased to be in conversation today with Dr Stephen Beeson, founder and CEO of Practicing Excellence, and Dr. Gary Greensweig of CommonSpirit Health.

We talked about the role of the system, team and individual.

We need to be intentional to promote safe and brave spaces of belonging, promote relational trust and community, and partner with our healthcare administrators and leaders. When we make self-care and colleague care a priority, we can give the best care to our patients.

Let’s commit to connect with our head and hearts, with affirmations of each other’s skills and attributes—but more importantly, affirming each other’s humanity with respect and kindness!

Thank you, Stephen Beeson, Gary Greensweig, Thomas McGinn, Ankita Sagar, Barbara Martin, Gregory Anderson, John Kniesche, and Brooke Burgess! @hellohumankindness

As 2022 continues unfolding and begins turning to a new season, how do you tend to self-care, community and resilience? I will post reflections on these themes and invite you to join in the conversation here or on Twitter or Instagram with your thoughts or what you are doing for self-care and care of others. My book explores such ideas too: Resilient Threads: Weaving Joy and Meaning into Well-Being.

Also see resources related to the Oath to Self-Care and Well-Being, a supplement to the Hippocratic Oath.

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As a physician I have guidelines to treat various illnesses, however my guidelines on how to be a parent, a daughter, a sibling, a colleague, a physician, a teacher, a friend came from my parents, my family (biologically related and heart related) through their role modeling, their day-to-day actions and the way they lived their life.

If I had been wiser, I would have started collecting my parents’ words of wisdom at a much earlier age. There’s some truth to the words that state we must get to a certain age to realize that our parents are smarter than us. I share more about the tremendous impact they have had in my life in my latest book, Resilient Threads: Weaving Joy and Meaning into Well-Being.

Today on my mummy’s 80th birthday, I would like to share one of the meaningful lesson.

I come from a working class family, lived in a multi-generational family system and have had a comfortable life, in spite of a hand to mouth living. My parents—both academic physicians—took pride in their values, hard work ethic, and honesty.  My early teens were a time when our country and the “doctor profession” were undergoing change. Physicians were still recognized to be part of that noble profession; however, some were deviating from the path by entering their own private practice and medicine was starting to also adopt a business model.

The gifts physicians’ received changed from the freshly baked bread and cakes, home-grown vegetables, and knitted scarves to more substantive gifts of trips and cars and scooters.  Some of my friends whose parents were also physicians now rode in chauffeur-driven cars and they switched to private schools. 

Unsure of this perceived discrepancy, one day I asked Mummy in an almost undermining, condescending way, “What kind of physicians are you?  You must not be doing well. Other parents tend to do much better while we are still living in this crowded two-bedroom flat. How come you don’t get the same gifts?” 

Mummy held my hand, and said, “But of course, I do get the best gifts.”

Surprised I asked, “What do you mean?” and she said, “When the patients look at me and say ‘God bless you’ or ‘thank you’ or students that I have taught years ago recognize me in spite of my gray hair now, that’s the best gift.”

I am not sure I understood then the meaning and depth of what she shared, however that incidence has a huge impact on how I show up each day.

Mummy continues to give selflessly and sacrifice for all.

So on her 80th birthday I wanted to record her wisdom to save it for me, for the family, for the future generations. I am really grateful to Ray Bassett, host of Scenic Roots on WUTC in Chattanooga. I sent him an email, spoke with him of my intentions, and he graciously accepted to interview Mummy about the questions that I sent him.

As you reflect on your life:

• What gives you meaning? 

• How did you discern what gives you meaning?

• What would you consider one or more of your/ achievement successes? 

• What allows you to overcome any hurdles?

• What words/ advice would you like to share with your family and for future generations?

Thank you, Ray, for making my wish come true!

Here is Mummy in the audio above! And my family’s birthday wishes to their Nani.

After trying to settle in a new country by working any jobs available and simultaneously completing the requirements to retrain in the USA, they had submitted their application. The resumé spoke to their experience, excellence and expertise clinically, in scholarship and education. This, coupled with the authentic, humble personal statement, left me wanting to meet this person.

This particular applicant was applying to both the transitional and the internal medicine program. Realizing that the internal medicine program offered more certainty, I crossed the short distance from my office to the offices of the two other departmental academic leaders, application in hand, my voice and face beaming with excitement. I shared the personal statement and the resumé and my recommendation that this applicant would be an asset to the internal medicine program.

After a brief glance at the CV and the personal statement, the response was a guttural hmmm maybe followed by….“but this person’s name is difficult to pronounce and being from East Asia they will have an accent, which leads to problems being understood on the wards and by staff and patients.”

Taken aback, I think I mumbled something to the effect that we should give the person a chance as I retraced my steps to my office.

I am not sure I felt anything but shock and emptiness for a few minutes.  I came back to my office sat on my desk devoid of emotions for a brief period and then feelings of both anger and sadness. I don’t think I was angry at any particular person or thing, I was just angry that this conversation had even occurred in 2002.

That particular incident continued to bother me, although I did not discuss it with the two other academic leaders. I did not have the courage to ask their reasons or the meaning of their comments. We continued our recruiting work, but they did not bring it up again and neither did I. However, I could not let it go.

Having the decision-making prerogative for the transitional-year class, I placed the applicant high on my match list and hoped they would match. They did and excelled. They even got into their home country specialty, one of the four ROAD (radiology, ophthalmology, anesthesiology and dermatology) extremely competitive ones in the US, excelled there too and continue to give back in many ways as faculty in a leading academic center.

The experience has shaped a lot of work that I have engaged in over the years and all my roles, professionally and personally. As an academic leader, chair of the department, assistant dean, member and chair of various committees, as a mother, colleague, and friend, I have been intentional in ensuring that I advocate, role model and promote a culture that is fair, equitable and respectful of each and every individual, irrespective of gender, race, culture, country of origin, place of training, lifestyle preferences, etc.

After experiencing this incidence, I became mindful and hyper-aware of the many times discriminatory statements pervaded the daily conversations. Reviewing applications around the table, I’d hear comments like, “Now how DO you pronounce this name?” followed by a frustrated sigh or sarcastic laughter. Or “Why do they have such long names?” or “Wow, that is a weird name. WHY would someone name their child this?” It is possible that these flippant remarks were made without a second thought, or out of not knowing better or with no specific malintent, however these reasons did not justify them.

I also noticed how frequently the names were shortened without permission, especially names of the non-US graduates or non-traditional white names. And this was not occurring just at my institution. For example, Raj for Rajeshwaran, Dr P for Puroshuttom. Often this was done by the graduate themselves to “fit” and prevent embarrassment.

As I reflect back, I realize the anger I felt was more at myself about my initial silence. Why did I not speak up and advocate for what I knew was right?

Personally, I myself have arrived at the University of Tennessee—Chattanooga via India, London, Saudi Arabia, Yonkers, New York, and Dayton, Tennessee. I too have had to correct people about my own name many times. In fact, I still remember that the first lab coat that I received as an intern had my name misspelled as Mutka rather than Mukta, and this error occurred in written communications, letters of recommendations, and certificates and continues today.

Mutka (notice the t’s placement) in Hindi means a big round earthenware pot to store water and other liquids to keep them cool. Every time I see my name spelled this way, the image of this big round person looms in my mind’s eye, and it is not a pleasant one. Over the years my way of dealing with this is humor as I share and correct people.

My name Mukta, on the other hand, given to me by my parents and grandparents with a lot of love, means a pearl. I love my name and am proud of it. More importantly it reflects me with my emotions, innate gifts, and vulnerabilities. It defines my individuality, my personality and my identity as first and foremost a human being, not an IMG, or Non-US graduate, not an Indian, not a minority, not a woman in academia, but me, Mukta—a unique individual and human being!

So what is in the name? Our individual names are important. Names matter. Names are the first connection with who we are, our identity in this world. Their origin, meaning and context is fundamental to who we are. Names often have a story behind them, a story with some element of reflection by some human that cared for us.

In India, the naming ceremony is a sacred occasion. Often being called by our name as babies is the first memory that we remember, since then we are conditioned to respond to our name. Names give us our individuality and they give us our identity.

Taking time to understand and pronounce names accurately expresses our genuine authentic care and concern for the individual.  Shortening, altering and anglicizing names amounts to a form of microaggression, it demonstrates a lack of value, feels dehumanizing! We need to address this if we are to confront bias and foster meaningful relationships. Intentional respect for the names—especially for the members of our team and the patients we care—for creates a stronger work ethic, shows respect and builds trust.  Both respect and trust are the cornerstone of professionalism.

That was 2002. We are now in 2022. I often wonder how much has changed and realize how much has not changed. We are—physically and geographically speaking—a global village. Technology and transportation have made our boundaries even more blurred and yet our human connections seem so distant.

Although one should feel empowered to stand up for one’s name, the lack of emotional and psychological safety is a deterrent. For underrepresented individuals, women, and especially those challenged by the intersectionality of gender, race, ethnicity, religion, or sexual orientation, lack of emotional and psychological safety makes standing up for yourself even more difficult. Having an ethnic sounding name adds to one’s vulnerability.

What can be done to be more welcoming to people from all walks of life?

• Just ask! We should be intentional and authentic to request the correct pronunciation of one’s name.

• Demonstrate genuine curiosity to learn the story behind the name.

We used to make this practice a routine at our orientations. “Tell me the story about your name!” After an invitation to reflect in solitude we divided the members up in dyads and triads and the conversations that followed were rich, filled with lot of emotion and, more importantly, created a sense of community.

As we were intentional to recognize our team members by their proper name, it fostered mutual respect and relational trust. It sent the message “we see you, we care!” And we emphasized the importance of doing the same with our students and patients, fostering a meaningful and caring physician-patient relationship crucial for their care.

No, I will not apologize for my name! Nobody should or should have to.

As 2022 unfolds, how do you tend to self-care, community and resilience? I will post reflections on these themes and invite you to join in the conversation here or on Twitter or Instagram with your thoughts or what you are doing for self-care and care of others. My book explores such ideas too: Resilient Threads: Weaving Joy and Meaning into Well-Being.