Category Archives: MEDICAL – IMMIGRATION


I understand why some people would rather keep their head in the sand and not be aware of what is happening around the world. There is only so much we can do. Does it help anyone for me personally to read details of various wars, human trafficking, environmental disasters, political prison systems, and more? Or do I just traumatize myself to the point that I cannot be as helpful in contributing my little bit to society? Does information overload make it all seem so hopeless that I get paralyzed in despair?

I used to feel obligated to know as much as I could, under an idealistic theory that “if they can live through it, I have to handle knowing about it,” and I sought out information, and really tried to understand so many situations that were so far out of my control. It gave me a certain world view that can be painful to me but keeps me more sensitive to the suffering of others, and in that way, I suppose it has served me well. I am much less likely to wound others where they are already most wounded. I have a sense of where vulnerable people’s sensitivities are.

Not everyone has embraced this process, and I do understand why they wouldn’t want to. But I wish those who work in healthcare and others who interface intimately with vulnerable populations would make some effort to have a general understanding of the people they are likely to meet. A few evenings of reading would give them enough insight to avoid reawakening deep wounds in those they are paid to serve, and they don’t need to delve in deeper than the surface if they would rather not. A few simple tips:

TORTURE: People are really tortured. Don’t give a torture example for your pain scale questions (10 is like being tortured!) And please stop joking about torture or using the term with a sarcastic laugh. It is no more appropriate than joking about rape, which is one form of torture among many. I cannot count the times nurses have joked about not being into torture, or how something is torture. It is not torture to have a blood draw. It is not torture to watch a film about transplant. Find another word. Millions of people in war zones and areas of conflict face torture as part of the power struggle. It is very real and leaves permanent scars on the body and in the psyche. Be respectful. Torture is real. Making light of it hurts.

MURDER: Most people in war zones have lost family members. Sometimes whole families are gutted. In my father’s country, they lost 10% of their population and 18% of their land in the last war. No one in that country had a family that was intact. I remember one older man telling me he didn’t dare marry his childhood sweetheart after the war, because her father had been killed, her older brother had been killed, her two uncles had been killed, her cousin was an amputee, and the farm was going to filled with widows, disabled and orphans. This still goes on. So what seems like small talk, casually asking about family members, how many kids someone has (left) can open deep wounds.

FAMILY SEPARATION: It is extremely rare for a refugee or immigrant family to arrive all at the same time, or even to all arrive. One parent or an adult child is sent here to work, or wins an immigration lottery, or makes it over the border while the rest of the family is caught and deported. Again, the small talk that is so common, how many kids do you have, where are they? Oh, dear, you haven’t seen your daughter in 8 years, that must be hard! Your wife is now with someone else after you sent money for 4 years, too bad. Your Mom died a lingering illness but you couldn’t go back and say goodbye? Oh, gee! Folks, these are not the conversations that your refugee patients need to have during blood draw, with a medical assistant, or at any other time during a routine visit. Be sensitive. Don’t pry. You can open a wound simply by asking someone if their children live nearby.

HOW CAN I BE SENSITIVE? Just remembering that the refugees you hope to serve have likely been through terrible and traumatizing situations will make you more sensitive and respectful. Understanding that their family has huge holes in it, missing people, parents they will not be able to comfort on their deathbeds, children they will not be able to raise themselves, wounds that can open at the slightest touch, will make you kinder and more careful in your speech. Focus on what you are doing with the patient, and let them bring up their families, their lives, and their experiences if they wish. If they find you compassionate, and you have the time, they may wish to have these conversations and talk about their lives, but let it be their choice and in their way. It is the least we can do.


One night when I was a teen I came home from a really hard day’s work where I was underpaid and life seemed so hard and my Mom was like, hey son, I wasn’t feeling up to cooking a real meal but if you like I can make you that marucha soup, you know, that package with the spice thing and it’s noodles, like instant.  Ramen?  Maruchan?  Something like that.

Anyway, I hope you won’t hate me when I tell you that I was such a brat.  But I was.  Just a young guy, you know, half angry and just plain irritated, and I was like, Mom, really?  Why would I want that?  Just forget it!  And I went to the couch and threw myself down on it like I meant something.  Like I deserved anything just because.  And I pouted.  What a jerk I was.

Six months later, I was crossing the border, leaving my mother.  I was in the desert with some guys and I had run out of water.  Food?  Nothing left.  Not even a cracker.  We had gotten separated and I was with a smaller group.  The coyote, you know, the guy who takes you across, he was going across the border and we were waiting somewhere in the middle of nowhere.  Honestly, I have no idea where we were, even now, when I have looked at maps and wondered.  How many bones there must be in that desert.

The hours went by and it grew dark and the stars came out.  We had no way of knowing if the coyote was coming back.  We were just kind of hanging around trying to hope against hope.  Some were leaning against their backpacks and dozing off.  Others were looking over their provisions and trying to guess about how long they had before they ran out, too.

Anyway this one older guy in the group, he had brought more food and water than me, which was smart, and he was sorry for me, and he kind of sheepishly said hey it’s not much but I have a half of one of those marucha soups in a plastic container and it’s cold I mean I can’t heat it up but you can have it if you want.  And I took it and when I started to eat it the tears just rolled down my face and I thought about my mother.  I saw her face smiling at me.

She had offered me this same food and I had turned it down impatiently.  And I will never forget the look on her face, even though I was too much of a punk to say I was sorry at the time.  I had hurt my mother’s feelings and made her feel bad.  And I didn’t even know that she was already sick.  She didn’t want us to know.  But she knew.  and I turned her food down.  And now at my lowest point, in the desert, too dried up to even go pee, sorry to mention that but that is how dried out I was, and my mom seems to come to me and offer me that same soup I turned down.  And I drank it with tears.

That’s when I decided I was going to make it across and stay clean and work hard and send her every spare cent so she could get her medicines and her treatment.  And it’s been plenty of marucha soup in the years since then but none ever tasted like that one in the desert.

My poor mom.  May she rest in peace.  I can never get her back, but now that I have a daughter, I am going to roll up everything I couldn’t do for my mother into a big, golden ball, you know what I mean?  I’m just going to roll it all up and give it to my baby girl.  Working hard.  Being kind.  Showing consideration to her and my wife.  And I hope that my mom is up in heaven, looking down on us, and I hope I can make her smile.

Sorry, mom!  I love you, mom!  I’ll see you on the other side.


We have only been here a few weeks.  That’s why we didn’t check this rash thing I got.  We figured it was because of sleeping on the cement floor in the jail.

We are fleeing violence.  We were threatened.  We had a small store, and the gangs wanted more than we could pay.  More than we brought in.  Then they said they were going to take our daughter.  She is nine.  Our only living child, besides this new one on the way.

What could we do?  We took off in the night, with what little we had.  We couldn’t pay a good coyote to cross.  We had to just take our chances.  And we got caught.  We said we want to apply for political asylum, and we told them why.

They took my husband away and they wouldn’t tell us where he was.  They held us for 12 days.  It was a warehouse I think.  Just walls and a concrete floor.  It was so cold at night.  No blankets.  I kept trying to sleep in strange positions so I could make myself into a good bed for my -nine-year-old.  She is our only living child, and the thought of losing her…

I got the rash after we were released, and I washed carefully, thinking maybe some kind of bug.  Some kind of reaction to dirt or not being able to wash.  Our daughter didn’t get it, thank God.

A week after they let us out, with orders to keep reporting in to immigration, to ICE, we found out they started separating the parents from the kids.  Not just the dads.  The kids.  The parents from the kids.

They don’t understand that most of us, almost all of us, are coming so our kids won’t get killed.  So they won’t be kidnapped.  So they won’t be – harmed.  So they won’t be taken from us and – changed.

So there is nothing worse they can do to us than to take our children.  To take them at gunpoint, just like the gang threatened us, and have them alone, and do whatever they want, and we – helpless.   The fear, the rage, when we would give our life’s blood to protect them.

One of our countrymen killed himself – yes, you can read about it.  He killed himself, because he went crazy when they took his daughter and they wouldn’t give her back or say where she was or what they were doing to her.  He came here because this was threatened.  He came here to get away from it.  And now it happened anyway, and he just lost it.

I understand him.  I think I would have gone completely crazy if they had taken my daughter.  I slept on the floor, on the concrete, and I didn’t care if it was days, weeks, months or years.  I made a bed for my daughter, and I kept her as warm as I could.  And she didn’t get a lung infection, like some of the kids.  I kept her safe.  And that’s all I want to do.  I just want her to be safe, to have a chance.

If you are a parent, you will understand my feeling.  Even if you don’t understand my whole life story, you will understand my feeling.

Now the doctors at the high risk clinic say I have this liver thing.  They say the rash is from that. They call it cholestasis, and say it can happen to anybody.  They don’t know exactly why.  But I can’t help thinking that it might be from sleeping on the floor.  Getting so cold.  Being so worried sick.  And they said the biggest risk of this liver thing is stillbirth.  Yes.  My baby can die inside of me because it.

Can you imagine?  We are still in shock about our crossing.  About getting in right before they started taking the children at gunpoint.  We are so grateful our daughter with us, and alive, and whole.  And now the doctors tell us our baby might die.  Maybe our baby will be taken from us.

Is it my fault?  Did I sleep on my liver, and make it cold, while I was trying to keep our daughter warm?  I just don’t know.  I pray to God to forgive me my sins, and to let my baby stay alive.