Posted on Categories Cross-cultural Experience, My Story, Words of WisdomTags , , , ,

Doctors with Borders

By Dr. Uttara Koul

The past eight months have been a summation of the five stages of grief:

                    • Stage 1: Denial – there’s a viral outbreak? Hmm. It won’t reach us.
                    • Stage 2: Anger – why aren’t people taking the lockdown strictly? Why is everyone hoarding toilet paper?
                    • Stage 3: Bargaining – a vaccine will be released any day now, right?
                    • Stage 4: Depression – all social engagements are postponed indefinitely. So many people have lost their lives! This is heartbreaking!
                    • Stage 5: Acceptance – this is the new normal.

When you’re a doctor, several more emotions pile on: anxiety, of getting sick and infecting your loved ones. Looming stress, of long shifts and insufficient PPE. Confusion, about how to treat this life-threatening virus, and so on. Despite the emotional turmoil raging inside, we shoulder this monumental responsibility like soldiers going to war.

As an international medical graduate (IMG) physician, there is another agonizing aspect that comes into play—being away from your support system. We already have a steep learning curve when we join residency. Apart from advancing in our training, we also must adapt to the cultural differences, understand the nuances of the medical practice here, and be driven to prove ourselves in an unfamiliar world. This year has turned the whole world and our community, topsy turvy. Allow me to share my example.

Eurotrip from 2019.
Jamaica trip in January 2020, last trip before the lockdown.

I am an almost-done-but-very tired 4th year Neurology resident from India, a “strong independent woman,” living alone in a somewhat familiar city and pretending to be “just fine” this year. Just like other IMGs, I navigated the complex web of USMLE and visa hurdles to pursue a challenging field that I am passionate about and came here to build a quality life. I worked hard to strike a perfect work-life balance. To de-stress, my escape was traveling. I would meet my family back home once a year. I would fly out to meet my significant other in Canada during my off weeks. Before the pandemic, I had been to fourteen US states and six countries with him. We even had plans to get married this year. I had immersed myself in American culture, participating in “Friendsgiving” turkey and funky Halloween costumes. Socializing and exploring the city with my colleagues kept me engrossed. Even though I was alone, I was never lonely.

Last India trip, November 2018.

But with the pandemic, came border closures and travel restrictions. Social gatherings became few and far between. While healthcare professionals were exempt from the current visa entry ban, it became apparent that IMGs shouldn’t risk leaving American soil to travel to their home countries unless it was an absolute emergency. Suddenly, I felt lost. I felt stuck in a city with constant “itchy feet,” and hated being by myself in such unprecedented times. Humans are social animals, and physical distancing had left me wanting.

I am certain that many of you are in a similar or more challenging situation than mine. Albeit necessary, the frustrating uncertainty of not knowing when you will hug your loved ones takes a toll. There were a few weeks that were particularly hard. I found myself losing interest and concentration, feeling burned out at work. The excitement for my own wedding had fizzled out, and it seemed that there was nothing to look forward to after work.

Fortunately, I noted these changes in my behavior after just a short time, and I decided to take actions to help improve my well-being. I exercised consistently. I reduced my screen time on toxic social media and picked up my long-lost hobby of painting. I started taking time out to call my friends whom I had lost touch with. We reconnected to play online multiplayer games, share nostalgic high school stories, and discuss Netflix shows.

Weekend wine date!

I missed my significant other dearly, but we decided to make the best of what we had—Facetime wine dates became a weekly affair. We synced our video calls to watch travel and food shows so we wouldn’t miss our incredible vacations. We discovered common playlists on Spotify and listened to music together, sometimes dancing on our calls. I made a point to regularly catch up with family so that they wouldn’t miss me, and I cooked on video calls with my mother while being countries apart.

So here I am. It’s been nine months since I visited my significant other in Canada, and two years since I visited my family back home. It is still hard, but I have started to feel whole again. Technology has kept me connected.

It is often said that “doctors make the worst patients.” We are so driven to cater to the medical as well as psychosocial needs of our patients, that we are notoriously known to ignore our own well-being. In a public health crisis where the entire world leans on us to be the guiding light, already stretched health care providers feel even more pressured not to fail. We have perhaps never witnessed such a catastrophic disruption as the one caused by the COVID-19 pandemic. It has tested our communities’ resilience and strength.

We need to stop being so hard on ourselves and realize that it is okay to not be okay. Acknowledging that you’re struggling and finding solutions in a timely manner is what’s important. There is nothing wrong with asking for help. It is vital to pursue a vocation, and to blow off steam when you need to.

I know without a doubt that our world will survive this pandemic. Lessons will be learned, and we will wear the scars of the fight like medals. I hope we all emerge stronger than ever before, as a physician community as well as a humankind.


It is the duty and privilege of ECFMG’s Exchange Visitor Sponsorship Program (EVSP) to support the health, safety, and welfare of every exchange visitor physician during their sponsorship. If you are, or know of, an exchange visitor physician in need of well-being support, please contact us. EVSP wants to be a resource for you.