The most difficult question anyone has ever asked me is "Why did you become a doctor?" A new patient recently asked me that and I was dumbfounded. Like a movie on a projector, my pre-teen years flashed before my eyes. I held back my tears and responded, "let us talk about it another time."
She respected my wishes and agreed that we would defer the discussion. I wish the answer were as simple as, "My father bought me a Red Riding Hood doll when I was little, and instead of playing dress up, I gave her injections and tried to heal her imaginary ailments." I knew I wanted to be a physician; in fifth grade my conviction was reaffirmed.
A dark haze lowers over my memories when I think about October 31st, 1984. We were let out of school early, around noon, and it was announced that the Indian Prime Minister had been assassinated by her Sikh bodyguards. When I reached home, my mother hurried us to the market to stock up on food, as a curfew was anticipated. While mom was picking out essentials, the shopkeepers hastily pulled down the shutters. Thud, thud, thud, and the shops were locked up. The shop keepers folded their hands in request that we leave the plaza right away, for our own safety, as things were about to get ugly.
My father was away on business in Gurgaon, a town near New Delhi. He was in the process of relocating his business, which has been in our family for several generations. We lived in an industrial area without any other homes on the block. Workers, helpers at home, the gardener and the cleaning lady were all let out early, and there was an eerie quiet in the middle of the day as people retreated to their homes. Within hours, news traveled that there organized mobs, supported by police and government, armed with iron rods and kerosene oil, on a mission to finish off the Sikhs. They had access to the voters' lists, and Sikh homes were being targeted and marked by an "X" for easy identification.
The Sikh Code of Conduct mandates that all initiated Sikhs wear each of the articles of faith known as the 5 K's. (Sikhs who are not initiated may carry some or all of the articles of faith). The five articles are the Kara (an iron bracelet), the Kanga (a small comb), Kachera (a special, longer type of underpants), Kirpan (a small sword) and Kesh (uncut hair). Sikh men and some women wear a turban with uncut hair. The visible K's-the Kara and the turban with uncut hair-make it easy to identify a Sikh. On the main street a little further from the inroads of our home, any visible Sikhs on the street were pulled from their vehicle and beaten, doused in Kerosene and burned alive. I was not meant to hear this, but it couldn't be helped. At night, mom said we had to turn down the lights and not make any noise. No one should know that we live here.
I remember sitting curled up in a corner of our veranda, where I had decided to be on watch. A myriad of emotions took over me. I didn't know at the time, but what I was feeling was sorrow, pain and anger. Naively, I was not afraid. I felt helpless for the victims and wanted to do something. I couldn't expose myself and go to the streets, defenseless. In the sleepless night, my ears were perked for any rustling footsteps or noise indicating that the mob was headed our way.
The next morning, I saw plumes of smoke at a distance. Did I imagine it, or was it the smell of human corpses burning? Two very large trucks stopped in front of our house. Two turbaned men stepped out and stood by our iron gate, seeking shelter. I could see apprehension in my mother's eyes, as there was the risk of 19-22 foot long commercial trucks being followed to our home. My grandfather, an eco-enthusiast, had planted around 200 eucalyptus trees in the back of the house. The trees were now tall and lush. Mom allowed the trucks to be hidden in back and the trees made for an ideal camouflage. For the few days the truckers were given shelter, food and water in our home, news of crimes against Sikhs was pouring in from New Delhi and many other cities in India where Sikhs were being targeted by organized mobs.
Days went by and we didn't have any news of my dad's whereabouts. We had heard about villages where women had been raped and tortured and left with the bones and ashes of their sons, husbands and fathers. In one such town in Delhi, Tilak Vihar, the entire population of Sikh males were murdered. It is now known as "Widow Colony." For who escaped being burnt alive were beaten to a pulp. I wept alone as I didn't want mother to see me like this. In my corner, every night, I thought about what I would do if the mob came to our home. We had a shotgun, which was my only solace.
A week went by and there was no news of Dad. When people were visible on the streets again, we went to visit my history teacher, who had been forced to jump from her balcony when the mob approached her home. As a result, she fractured both her legs and pelvis. She was in bed, a full cast up to her waist, lying in bed when she shared her experience.
A friend of my mother's from Canada, visiting her family in India at the time, had also perished. My blind music teacher, a deeply spiritual man, was also murdered amongst all the other Sikhs who were being targeted on trains traveling from Amritsar to Delhi. The accounts of pain were too numerous to count. I stopped listening at some point. I knew I couldn't do anything to help. It was too late. Thousands of homes and businesses were plundered, people perished and my father was missing. We feared the worst.
About a week after the October genocide was instigated, a car pulled up in the driveway with four or five men in it. Mom approached them and they accompanied her into the house and sat in the living room, speaking quietly for several hours. Once they left, one man remained behind.
He approached me with his outstretched arms and said, "It's Dad." His eyes were swollen and his face was puffy. He didn't have his visible K's anymore. My eyes searched for the long flowing beard or the soft mustache. He didn't have his turban or his hair underneath. I refused to believe that this man was my father; I looked at him in disbelief. I didn't see the usual spark in his eyes, heavy under the weight of his tears.
He told us that when the mob lit the factory on fire, he was trapped between the choice of burning to death inside or at the hands of the bloodthirsty mob waiting outside. He didn't have anything to fight back with and he didn't want to die in vain. Sikhs trapped in the burning factory decided to remove their Ks and were able to escape. They travelled in the night and made the several-day journey home. Dad started to tell my siblings and me about his eyewitness accounts but then he stopped. He could not bring himself to speak further.
My charming, marathon-running father, my hero, the gentlest soul I have ever known, who has never raised his hand or his words against me, faded away to retreat from the world in the quite crevices of his mind. He became a reserved and a more observant man. His view of the world changed forever. Our lives were spared, while thousands of others were not. How could I live with this? My heart ached for those who died a painful death. I wanted to reach out to the victims and I wanted to help make things better. At 12 years of age, my childhood dream to become a doctor became my calling.
For months that followed, I was taunted at school and students made fun of my long hair. My brother, a visible Sikh, was no longer safe on the streets. My parents decided that it was time for us to move to a place where we could live without fear of persecution. My family packed up their entire legacy, a handful of pictures, clothes and those belongings that would fit in a suitcase, and $50 in their pockets, and we migrated to the United States.
As a middle school student in metropolitan Illinois, I struggled to forget my past and assimilate in the culture of my new homeland. I found a friend in The Diary of Anne Frank. I drew comfort from her strength. My parents worked many jobs to provide for the three of us and put us through college. As teenagers, when my sister and I would deter from a goal, my father would remind us that money and riches are transient and fluid, but education and skills will stay with us forever. He wanted us to be self-sufficient. My father's constant reminders kept me aligned with my vision of my future as a healer, and before I knew it, I graduated from medical school and was starting Residency in Family Medicine.
In my third year of residency, I felt drawn to the field of hospice, which led me to Stanford/VA Palo Alto Hospice and Palliative Medicine Fellowship. I thought the volume of dying patients, which surrounded me, would scare me. However, when I arrived at the VA hospital for my first day and I took my first step out of the elevator, I felt a certain calm. Serving the veterans, who had survived torture and war, many of them Purple Heart recipients, instilled humility and resolution. I had found my niche and I finally felt redeemed. I was home.
I now believe in the possibility of a good death. My current practice is a balance of Adult Medicine and Hospice. Visiting patients in their place of residence remains the most gratifying part of my work. I would be lying if I said that I practice medicine solely to help others. My patients have come from all walks of life and I like to get to know about their lives. I like to see the family pictures hanging on the wall and I like to listen to their stories.
I was once visiting a 90-year-old patient with severe dementia in a nursing home. I had seen her many times before; however, during this visit, I noticed a large black and white poster of a beautiful young dancer above her hospital bed. I asked one of the nurses the significance of the poster and I was pleasantly surprised to learn that she was a concentration camp survivor and a professional ballerina in her younger years. Honored by the opportunity to get to know her, I cupped her hand and told her how beautiful she looked in that poster. She gently squeezed my fingers with hers. In that moment, the noticeable odor of this nursing home was juxtaposed by the life affirming memories of people living there.
Acknowledging a person's past dignifies and humanizes them. Compassion and connection can be healing. Selfishly, it helps me become a better person and helps me provide better care to my frail patients.
I am grateful that 30 years later, in April 2015, California became the first state to recognize the anti-Sikh holocausts. (http://asmdc.org/members/a09/news-room/press-releases/california-becomes-first-state-to-recognize-the-anti-sikh-pogroms ). When Asian American for Community Involvement (AACI) in Santa Clara requested participation in a video for the New Refugee Service Program, it was eye-opening experience. I learned that while my family immigrated to the United Stated, numerous others sought refuge and asylums and continue to do so, till this day. As a physician, I recognize the cultural and linguistic barriers to delivery of health care and access to resources. The videos in English and Punjabi were created in hope that refugees from India would have more information about social and medical resources available to help them acclimate (http://cst.aaci.org/ learning-resource-center/videos/ or https://goo.gl/H4Lmo4 ).
I aspire to master both the science and the art of medicine. In the process, I have found healing, joy of serving others and gratification which are welcomed side effects of my profession. At the end of the day, when my children ask me "How was work?" I feel pride in telling them that it was a busy and a gratifying day. I am humbled to have this opportunity to be of service.
About the author
Gurpreet Kaur Padam, MD, practices adult medicine and hospice with the Permanente Medical Group. She is fellowship-trained and board-certified in hospice and palliative medicine, board-certified in family medicine, and completed a mini- fellowship in ethno-geriatrics.
She is a founding board member of the Sikh Family Center, which promotes healthy families in the Sikh American community by closing current gaps in access to resources and increasing community awareness and activism.