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S7E10: Lilly — Becoming the Doctors We Wished We Had Growing Up

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S7E10: Lilly — Becoming the Doctors We Wished We Had Growing Up

Jul 01, 2024

In the third episode of this season's IDENTITY SERIES, Lilly and Mariam share a thoughtful and honest conversation about the power and privilege of wearing the white coat that signifies a duty to serve and advocate for patients. The two talk about their lived experiences growing up brown and how it instilled a responsibility to promote change and advocate for their communities and future patients.

    This content was originally produced for audio. Certain elements such as tone, sound effects, and music, may not fully capture the intended experience in textual representation. Therefore, the following transcription has been modified for clarity. We recognize not everyone can access the audio podcast. However, for those who can, we encourage subscribing and listening to the original content for a more engaging and immersive experience.

    All thoughts and opinions expressed by hosts and guests are their own and do not necessarily reflect the views held by the institutions with which they are affiliated.

     


    Lilly: Do you know what's so funny? The other day I decided I was going to make some beef korma. I don't know. Do you ever crave a dish that your mom made and then you literally can't eat it? It's so upsetting. And you can't buy it anywhere, at least not the Afghan way. And so I made it, and then I ate it for dinner and it literally tasted like nothing.

    Mariam: What?

    Lilly: I was like, "Why does this only taste like beef and potatoes? Why doesn't it have flavor?" You know what I mean?

    Mariam: Why doesn't it have the love?

    Lilly: I know. All righty. Well, that all being said, hello and welcome, all of our lovely listeners for "Bundle of Hers." This is Lilly, one of your new hosts, telling you a little bit more about me and my story.

    I'm so excited to have Mariam on with me because she is literally my soul sister. We're cut from the same Persian rug and I feel like we have a lot of lived similarities, so I'm so excited that you're going to talk with me today.

    Mariam: Me too. I love that whole cut from the same Persian rug. I'm going to steal that. I'm taking that.

    Lilly: That's how I picture us. You know how they draw the designs and the rugs? We're just two of the girls on the rugs.

    Mariam: On the rugs. I love it. That's beautiful.

    Lilly: Hung on the ceiling like my parents do.

    Mariam: Exactly. Only way to do it.

    The Experience of Growing Up Brown

    Lilly: I feel like today I really wanted to talk a lot about growing up brown, especially in the different states that we did and just what that was like for us, and then just talking more about how that really shaped our perceptions of the medical system and our path into medicine, and how we kind of figured out that we wanted to be here and where our space was.

    I just felt like you would be the perfect person to talk about this with, because even though we grew up on opposite sides of the States, I just feel like we have a lot of things that we grew up with that were very similar. So I'm excited that you're here.

    Mariam: I'm excited to be here. Thank you for inviting me. So honored. I feel like you're probably my favorite person to have as a co-host. Maybe I shouldn't be picking favorites.

    Lilly: There are no favorites, but you are mine.

    Mariam: Yeah. There are no favorites.

    Lilly: We just talk so much anyway. It's fine.

    Mariam: I think it's because we come from similar backgrounds and it's always a really, I think, healing conversation.

    I do want to say just a caveat. Not caveat, but what's the right word? Just a little . . .

    Lilly: Disclaimer?

    Mariam: Clarification. No, clarification is the word. For our listeners, when we say growing up brown . . . Me and Lilly, we just talk like we talk with each other. We mean as brown women of color, women of Middle Eastern ancestry. That's what we mean and that's really what we're going to center on. So in case any of you were like, "What does that mean?" we're talking about just our experiences as brown women of color.

    Lilly: I love that. Good point.

    And before we dive into our conversation for today, I also did want to put out a disclaimer that all of the opinions and thoughts that we share on this episode are those of our own and they don't represent any type of institution or employer. We just wanted to share our personal experiences with you all listening at home or in the car, wherever you are right now.

    So that all being said, the biggest thing that I wanted to just start off talking about is our upbringing and our early interactions with the medical system and what that looked like. So I'd love to hear from you, Mariam, just what it was like growing up in Georgia.

    Mariam's Story: Growing Up in the Middle of Nowhere, Georgia

    Mariam: Well, I talk a lot about this on the podcast, but to quickly summarize, not great. Complicated, right? I grew up in what I call Middle of Nowhere, Georgia. It was central Georgia area. Wasn't a huge, as you can imagine, Middle Eastern population. And so I never really had a great sense of who I was unless I was at home with my family. But even then, it was confusing.

    If you guys want more clarification on that, shout out to my Identity Series episode, the assimilation episode. That one kind of goes more into my experiences growing up.

    But I will say it was really challenging because when you are from a background that's different than the rest of your community, it becomes very obvious from a very young age, and sometimes not in the most positive ways.

    And so I think growing up, there was a lot of just feeling like an outsider, feeling like I needed to fit in and kind of assimilate, which was what that whole episode was about. Yeah, it was kind of a challenging experience to say the least.

    What about for you? What was it like here in Salt Lake?

    Lilly's Experience: Childhood in Salt Lake City

    Lilly: I was one of three brown kids in my elementary school, and definitely on the lower socioeconomic status of my elementary school since we were located up in the foothills of Salt Lake. For those of you who have visited Utah, some of those houses can be very big.

    And meanwhile, I was starting kindergarten and I remember 9/11 had happened right around that time. It's weird because I was maybe 5 and I shouldn't have very vivid memories at that point, but that's something that's super etched into my mind, and I can go back to that exact moment in my head, as I think a lot of people can, and you just remember where you were and what you were doing at that time.

    I remember my mom was driving me to school and she was like, "If anyone asks you where you're from, what religion you are, don't tell them. Say you don't have one, that you grew up in Utah, that you're from Utah, that you're a Utahn. And if they ask you anything further just say, 'No, I'm from here.'"

    And it was really confusing to me because we had religious books in my home and paintings, and even in our cars we had little things that are supposed to protect you when you're driving. My mom just went through and took everything down, and I could tell that she was really afraid. I just thought it was unfair and wrong that we weren't able to be our authentic selves.

    And I remember thinking my mom was being really paranoid and I felt like she was just being an anxious mom, as many moms are, and so I went to school thinking nothing of it.

    And then in my primary class, I remember one of my classmates . . . which were literally 5 and 6 and I feel like a lot of the things we say are most likely regurgitated from our parents. He turned around to the group of students I was sitting with and he was like, "I think that we should just all bomb Afghanistan so that everyone dies, and that way this will never happen."

    I just remember being in so much shock hearing that because I grew up knowing that I had family in Afghanistan, and I grew up knowing that I had cousins who had passed away from rockets falling on their homes. And it was something that was just so upsetting to me that I was like, "There's no way that we can speak like this unless we're hearing it from our parents at home."

    And I started to feel really unsafe, which I don't know if you felt that way too, but I just felt like, "Yeah, I really have to assimilate and I have to hide who I am in fear of any type of repercussions happening to me or violence happening to me just going to school."

    Realities of Violence and Prejudice Against Brown Communities

    Mariam: Yeah, or our families honestly. Very similar. This is so funny because we're talking about how we had so much in common and I feel like I distinctly remember . . . And my mom actually just stopped doing this. People ask, "Where are you guys from?" because we look different, or at least we look different in that area of the country. I mean, they would ask all the time and I would be like 5, 6 years old.

    Really, in that post-9/11 era, especially when my parents were just so worried about our safety, my mom would just lie and just pretend like she was a different ethnicity. She would make up . . . which is questionable, odd. If anybody listening is like, "Mama Asadian, what?" But it was really a protective measure because we knew that being identified as any Muslim identity, especially Afghans, was particularly dangerous in the part of the country that we grew up in.

    And for those of you that are listening that are like, "Oh, that might be an over-exaggeration," it totally wasn't. People were being hate-crimed all over the place. Those were real experiences. Lives were lost, and my parents were so aware of that. And my parents were strong, courageous people for leaving their countries and coming and starting new here, so for them to be scared is saying something.

    Lilly: I agree. I remember my cousins in Canada, they got mugged and jumped and all these horrible things growing up, and it was because they were brown men. I felt like growing up I very much needed to just blend in with the crowd.

    And even to this day, we hear these awful news stories about Palestinians being shot in Vermont, and a lot of times I think sometimes that fear that we have people think is us just being really paranoid or fearful about a threat that doesn't actually exist.

    But even when I was in college, I remember hearing stories about people's hijabs getting ripped off, and just all these horrible things where you think, "No, this is very real, and people do get horrible violence directed towards them simply because of who we are and where we live, and that's really scary."

    Navigating a Politicized Identity

    Mariam: Yeah. We were just talking about this before the podcast, but I think it really goes down to growing up with an identity that's heavily politicized. Is that the word? Politicized? Heavily political, right?

    You're from a country that most . . . and let's just be real. Most Americans, when they hear Afghanistan, they think of war, they think of terrorists, they think of 9/11. They think of all these things. From a young age you are so super aware of that and how other people perceive you before anything else.

    Lilly: One of my friends, I showed her pictures of what Afghanistan looked like in the '70s when our moms lived there, and my mom would wear big hot pink hoop earrings and cute skirts and she had a perm in her hair. They were just walking downtown.

    And my friend was like, "Oh my gosh. I never knew that Afghanistan looked like that." We had paved roads in cities and women dressed fashionably, and I was like, "This is what my country looks like to me in my eyes." But obviously what we see today, you would never imagine that that's what it looked like once upon a time.

    Mariam: I know, and it's just beautiful. I mean, people come from all over the world to Utah to hike, and Afghanistan actually very much so resembles Utah in a lot of ways.

    Lilly: I think that too.

    Mariam: I honestly feel like a lot of the Afghans that end up here just stay here because it . . . My mom was flying in to visit me for the first time years ago and she was like, "Oh my god, bachem, the mountains. The mountains are just like Kabul."

    It was so funny because I took her on so many hikes and she was like, "This is exactly . . . this reminds me of . . ."

    Lilly: Aw.

    Mariam: Yeah. So Afghanistan is so beautiful.

    Lilly: Ugh, man.

    Mariam: This is just turning into Afghanistan Part 2.

    Childhood Medical Experiences and Identity Formation

    Lilly: I know. For real. We just love our mother country so much. But kind of going off of that, do you feel like you've ever had an experience with the medical system that really impacted your identity?

    This one is very, I feel like, kind of a silly example, but I remember it so well because I was so embarrassed. I had a bone infection. For those of you who have studied osteomyelitis, I had that when I was 12.

    Mariam: What? No way. I didn't know you had osteomyelitis. That's a serious infection.

    Lilly: I was just a problem child, but I had osteomyelitis and I remember we went to the emergency room. My ankle was killing me and I was screaming and all these awful things. And my mom, being the Middle Eastern mom she is, cracked a raw egg on my ankle, and she was like, "The yolk and all the nutrients, they're going to cure you." And I just remember being like, "Mom, what is this dripping down my ankle?"

    We hobble into the ED and the doctor's looking at my ankle and he was like, "Why is this so yellow?" And now looking back, I was like, "He probably thought I was jaundiced or something." I was so mortified and my mom was like, "Oh, it's nothing. It's nothing." And then I was like, "It's an egg."

    I just remember being so embarrassed because my mom's idea of treating my disease was doing this. And the doctor treating me was just so confused and he was wiping it off, and I think he thought we were completely deranged.

    But that was the first time that I was like, "Hmm, there's this weird lack of just representation in medicine and awareness of cultural differences that causes interaction to just be so horribly awkward and just strange."

    Mariam: Yeah. That's such a cute funny story. The ED doc is like, "Get liver labs stat. She looks jaundiced."

    Lilly: I know, literally.

    Mariam: Oh my gosh. Yeah, I feel like growing up, coming from my family, nobody in my family is in medicine. Nobody's a doctor in my family, but I think I can kind of relate to a lot of just how our family members feel about medicine and healing.

    I think my mom still does this to this day. I know that every time I have any type of physical complaint, and even to this day, I will know generally how to treat the general things, headache, stomachache, whatever, right? She has taken it upon herself every single time to always be like, "This is what you do. This is what we did back home and you are going to do it."

    Oh my gosh, I had a UTI. This is so funny. I had a UTI, and I was like, "I need to go to urgent care and get antibiotics," and she's like, "No, what you need to do actually is X, Y, and Z. Drink lots of natural herbal remedies to flush it out." I was like, "Girl, what? I need antibiotics. This is going to become pylo. I'm going to become septic."

    I think it's kind of endearing to think about it, but it also is just a really weird world that we live in coming from these two backgrounds. One, we come from our families who have their own way of thinking about health/medicine. And not to say that Afghans didn't have a medical infrastructure and hospitals and practice medicine in ways that actually were efficacious. That's not at all what we're implying.

    I think a lot of children of immigrants can kind of relate to this. The ways that our families think about health and wellness are very spiritual and very culturally-oriented and tied to the homeland. I think the practices that they grow up with are so much a part of who we are and can feel healing even if they don't cure your infections, right? They can feel very healing.

    And I think that's something that, now that I'm in medicine and I generally have a good understanding of medicine, is something I can really appreciate and I think is a really valuable perspective as a future physician.

    Lilly: I totally agree. And I also feel like maybe there just hasn't been enough science and research into these remedies. There's this certain fruit that my mom used to always pick and she would boil, and then she'd make us eat the seeds. I swear it cured all my digestive issues. And ever since I grew up as an adult and I don't know how to buy that fruit and where it is, I have so many digestive issues.

    Mariam: One hundred percent. Oh my gosh.

    Lilly: I mean, look at turmeric.

    Mariam: Yes. Turmeric is amazing. I think every community has healing practices that are efficacious, that are rooted in things that aren't just about doing something cultural. It's something that's really meaningful that can also be healing.

    The Search for Representation in Healthcare Settings

    Lilly: For me, one of the big things I think about is how every time I went into a doctor's office and I sat in that room, I would get so eager and hopeful that the door was going to open and someone was going to step in that looked like me or looked like my dad, and spoke the same language as us, and had similar cultural beliefs and experiences that we did, and they would just get it.

    They would understand we don't necessarily shake hands with the women, and they would understand all these small little cultural things.

    And each time the door opened, I just remembered my heart would sink a little and I'd feel a little disappointed just because it never looked like someone that I saw myself in.

    And so going into medical school, the biggest driver for me was that one day I wanted to open the door, walk into the patient room, and be that face and be that person for another little Afghan girl.

    I remember during my family medicine rotation, I was in a clinic who sees a lot of refugees, and I was super stoked because I felt like this was going to be the best experiences I got, is just seeing such a plethora of different identities.

    I walked into a patient room and they were Afghan refugees who had just recently come in the last eight months to America, and this was one of their first doctor's visits, and I just couldn't wait to just surprise them.

    I walked in and we didn't have an interpreter for that appointment, because not a lot of people speak Farsi. But I remember walking in and I was like, "Hi, my name is Lilly. I'm the medical student. Would you all prefer that I speak in Farsi or English?" And I said this in Farsi.

    And when I walked in, it was a husband, a wife, and their two kids, and one of them was maybe 8. She ran up to me and she was just so in awe and her eyes lit up. It was the sweetest moment because she grabbed my badge and she was like, "Speak Farsi to us." It was just the cutest thing ever, and I just felt like the whole world had come full circle and I was like, "Okay."

    And I almost felt like at that moment they felt safe and I felt safe, and the whole atmosphere in the room just came down and we all felt very much at peace, especially given the fact that this was the patient's first-ever pelvic exam that she was getting.

    I had to explain to her that, "This is the kind of exam we're going to do, which is possibly taboo in our culture, but it's important because we want to look for possible cancer," which is also a scary thing to tell someone that has never had this exam before.

    And she was just like, "Yeah, okay, that sounds fine. That's good." And then as soon as I was like, "Okay, we're going to step out so you can change and get situated and everything," she was like, "But you're coming back, right?" She was like, "You're coming back and you're staying in here when it happens?" And I was like, "Of course."

    It was just really sweet because I remember thinking how many times it would've been so nice if my mom would've had someone like that to be in the doctor's visit and have that representation and have that commonality. I was like, "This is why. This is why I went into medicine."

    Mariam: I love that. Oh my gosh, that little girl was a little Lilly. You were healing your inner child. That's so cute.

    Lilly: It was very healing. And I feel like you've probably had those experiences too, because we've talked about them.

    Mariam: The major difference between Lilly and me, I think, is that Lilly . . .

    Lilly: What?

    Mariam: No, girl, you know this. You make fun of me for this all the time. Lilly's Dari, which is the Farsi dialect, is so much better than mine.

    Lilly: No.

    Connecting with Patients Through Shared Experiences

    Mariam: I mean, it's true. First of all, I was raised very Iranian Farsi, and even that is not very good, right? And my Farsi and Dari are so bad. My mom will leave me voice messages fully in Dari and I have to slow them down. I have a hard time and my speaking is obviously worse.

    So there was actually one experience, which was with a patient, and she spoke both Pashto and Dari. Pashto is the other language of Afghanistan. And nobody in my family speaks Pashto, but she found out I was Afghan because she straight up just looked at me and she was like, "You're Afghan."

    Lilly: She smelled it on you.

    Mariam: I was like, "Yeah, I am." She was speaking to me in Dari and I was just answering in the most broken, worst Farsi. She stops and then says in English, "So do you speak Farsi or . . ." I was like, "Oh, gosh." And she was just roasting me, but it was actually kind of endearing because she was being funny about it. She was like, "Girl, you've got to start speaking Dari. You're an Afghan doctor. You have to help us. You have to treat us. You're going to be . . ."

    And then she was telling me . . . and this is actually something that really stood out to me and I think is so beautiful about our people. She said, "I'm so proud of you because you are doing it. You are going to be the doctor that we really need." I think that was so beautiful.

    Then I go home and I was like, "Oh, gosh. I really do need to start speaking Farsi." It's actually been a huge goal of mine to be comfortable with my patients, right? Instead of just the formal Farsi that I speak with my family that's not as conversational.

    But it was actually such a beautiful moment because even despite the discomfort with the language, she accepted me and she was like, "You are one of us and you are doing the thing that we need." And she was saying, "We don't have a lot of people in our community that were able to become doctors, but you were and we're so proud of you."

    And then she asked me if I was married because she was trying to match-make me, and I just thought that was so cute.

    Lilly: She was trying to find someone for you. You know she's just one of those aunties that probably grew up down the street from your family.

    Mariam: She was such an Afghan auntie. It was so cute. I was like, "Well, you're my patient, so this is inappropriate." But it was very cute and I think it was just such, again, a really beautiful experience because I felt like I was part of that community and I was actually doing something for our people. It was very cute even though I got roasted, understandably.

    Lilly: It just makes me think how privileged people are who every day or multiple times a week have these types of exchanges with their patients where they have that commonality and they have that connection with them so easily because of just the environment they grew up in and where they live, whereas for us, they're so fleeting and few that we really cling onto them.

    But it really does make a huge impact on us, I feel like. I do wish that we saw these so often that they weren't so monumental, but I digress.

    Mariam: Yeah, I know.

    Aiming for Community-Centric Approaches

    Lilly: Another big thing that ties all this together with my identity that I really want our listeners to know is just how important it is to really advocate for patients, especially patients that come from backgrounds like ours where there is that lack of representation.

    That's something that I really think about a lot, because I want to be a part of mending the system as opposed to just buying into the system.

    And as Mariam and I both navigate residency applications and going into this new step and chapter in our career, I really wanted to talk more about what we hope to build in those institutions and how we hope to promote this type of work going into these different places.

    I really feel like something that I've noticed at least just talking in residency interviews is how passionate and important it is to me to be involved with community clinics, community outreach, and free clinic work, because that's really where my community exists and that's where they are the most integrated, is getting those resources.

    When I think of medicine, I think of the real medicine that you do on the ground with patients who aren't able to afford all their medications. They don't have transportation to get to their appointments. They can't afford to get all of these expensive diagnostic tests. And when I think about those things, I think, "How do we navigate that with our patients? How do we get them those exposures?"

    And sometimes we're very sheltered being at a large institution where we order whatever tests we want and we think of whatever labs we want and we just get it. We don't really think about the cost. Although I think we are trying to be more cognizant of just how much everything costs, but it still is something that's just easily disposable to us.

    And so as I'm navigating residency, I think a lot about, "Well, what kind of exposures are you going to give to community outreach? Who are we educating on our downtime? Where are we rotating and how much integration am I going to get with those populations that I genuinely want to serve one day?"

    And that's actually become a big deal breaker for me, is, "Am I going to get that exposure and do you all support that kind of work?"

    I don't know, Mariam, what do you look for? What are you thinking about?

    The Power of Storytelling in Healing and Advocacy

    Mariam: I think similarly. I think ultimately, at the end of the day, it's really just about working with the communities, right?

    I say working with and building power with the communities because I do want to emphasize when you come from a background of people who are assumed to be health illiterate . . . just like a lot of people assumed that people in my family were health illiterate because English wasn't their first language and XYZ.

    There are a lot of assumptions that are made, and I think people will approach medicine in a way where they operate based on stereotypes. I think we all do it to some extent, but I think that's kind of the danger of medicine, and so that exposure is really important.

    But I think building power with communities is also important because you're working alongside people who come from those communities to really understand them and their stories.

    I think "Bundle of Hers" has always been about storytelling, and I think storytelling is really powerful because it brings you into the nuance and the complexity of who a person is and what an experience can be like for a person based on their identities.

    And I think that was something that was really important for me moving forward in residency. I think as we were applying to all these programs, it's so easy for programs to be like, "We work with lots of patients who come from underrepresented backgrounds," but I was really looking at programs that were in neighborhoods that were communities.

    Lilly: Actually.

    Mariam: Actually within the communities and worked within community outreach clinics and with physicians, nurses, social workers, people who came from those backgrounds, right?

    And so it's a two-sided thing. I think it's one thing we should have the patient exposure. We should work alongside these communities. But then also at the same time, I think there's something to be said about having the people from those communities have more access to our healthcare system and more opportunities to become providers, physicians, nurses, XYZ.

    At the end of the day, if you are not adequately representing the communities that you would like to serve, there's a problem.

    Lilly: Exactly.

    Mariam: It's important for us to be able to build a more robust community within medicine, not just for the patients we serve, but within medicine.

    Lilly, you have the perspectives of growing up as Afghan. You know the challenges of having parents who don't speak English or didn't speak English as their first language initially when they moved to the States, or had all these really unique traditions where they cracked a raw egg on your ankle and the yolks didn't seem to make it to your septic arthritis. But you understand that gesture came from a place of concern and care from your mom, and you understand the complexities and the nuance around that action.

    I think that's really important, because the provider that you probably had at that time or any other provider probably would've been like, "What in the world? This mom doesn't know how to take care of her kid." But you know that it's way more complex than that.

    I think these stories are really important. I think these voices are really important in medicine, and I hope that with the new generation of physicians and healthcare providers in general, we are representing who we actually are working with in the community.

    Cultural Competence and Humility in Healthcare

    Lilly: That is so beautiful. Just giving you snaps all around.

    One thing that also really fuels me is hearing other healthcare professionals say that they don't feel like their job or their responsibility or their role is to advocate for their patients. They feel like, "My job is to go to the hospital to care for those patients and then go home, and that's the extent of my job." And I think realistically when we think about doctors being these healers, even back in old history and where we all started, it was never that simple. Physicians used to go to the homes of their patients and be very close and very personal with them.

    A lot of times, I think I do want a provider who's going to treat me the way they would treat their loved one because that means that they're going to treat me to the best that they can.

    And sometimes in the world that we live in, simply going into the hospital and caring for that patient doesn't mean that you're giving them equitable care. And sometimes that means advocating for them at a larger level or being involved with the community.

    Like you said, growing those roots in those environments and with those people so they know that you're not just here to be a one-stop shop and then forget about them, and at the end of the day they're just another number in your list of people to see.

    And so I really think that the white coat privilege that we have is just naturally interwoven with the ideals of advocacy for our patients.

    At the end of the day, we have such extensive education and training into a lot of these concepts. Whether or not you were raised and born in America, medical jargon and terminology is so convoluted and complicated and the healthcare system is so difficult to navigate no matter where we come from. But it's even a thousand times harder when even knowing the basics of the language is so challenging.

    I think we're doing a disservice to our patients to not think that it's our role to advocate for our patients.

    And I think a lot of times we do a good job of talking about it but not necessarily enacting it, because that can be also pretty scary, being a thought leader and pushing the needle in that realm. That's something that I want to continue pushing myself and those around me to do, because I think we do have so much privilege in doing that.

    And so kind of just wrapping up this conversation today, I really wanted to tell the viewers at home and the listeners that we have that it's so important if you want to go into healthcare that you care about these issues, that you're passionate about your patients' stories, that you want to practice cultural humility, and really learn about your patients.

    It goes above and beyond just saying, "I want to know my patient as a whole and not just as their diagnosis." It means taking that extra time to make your clinic run late so that you have that close tie to your patient so that you get to have some type of meaningful bond to them.

    And more importantly, when it comes down to it, you're respectful of that and you're able to take whatever that cultural practice is or that belief that they have and implement it into their care.

    I think that's where we really build those ties and build that rapport with our community that you don't just get by having that stereotypical physician-patient relationship with.

    It's easy to say, but it's so much harder to practice when you're running through a long list of patients in the clinic and you know you're running late. But I want to push myself and I want to push everyone else around me to really take the time to do that and create that space to even have those conversations with your peers and call them in and call them out when you feel like a patient is being left behind.

    Any other last words, Mariam?

    Celebrating Progress and Paving the Way for Future Generations

    Mariam: That was beautiful. You're amazing. I was like, "Lilly's going to be such a good doctor."

    I can hear the humility in your voice as you talk about this because you understand how difficult and challenging, not just emotionally, mentally, all those things, it can be to be an advocate for your patients. But I think the reason why I am not worried about you being that is because you grew up with those values inherent to yourself as an Afghan woman.

    And I think that is one of the big themes of this episode, is how our identities have really shaped our values and how we're in this system and we have to mold who we are a lot of the time to fit this system.

    Let's be real. It's a challenging system to be a part of. But we also, as we get further in our training, have more knowledge, more information, and are able to kind of enact on those values a lot more and be those advocates.

    I definitely see that for you. And if I have any neuro patients, I'm going to be referring them over to you because, number one, I don't know anything about neuro, but also because you're going to be so amazing.

    Honestly, I'm very excited for your journey and for both of our journeys. I hate whenever people are like, "Give yourself a pat on the back," because it's cheesy and gross. But honestly, let's just take a moment and celebrate not just us, but the people who come from communities who didn't think they would make it in medicine.

    I don't know about you, but not a lot of people in my family really thought I would make it through this process.

    Lilly: Oh, for sure.

    Mariam: And not because they thought I was dumb or anything, but because nobody in my family has been through it before.

    Lilly: Exactly.

    Mariam: I think it's really special to be a part of that process and pave the way for future generations, so pat on the back.

    Lilly: I love that.

    Mariam: Just kidding. You don't have to give yourself a pat on the back.

    Lilly: No, but for real, when I was a pre-med student listening to "Bundles," I remember thinking how cool it was that I was seeing all these different identities speaking up in this space. But then I also kept thinking in the back of my head that, "Oh, it's going to be so impossible and challenging and hard, and I don't actually see myself in this space."

    And so it's nice to take a moment to think, "We are the doctors we wish we would've had growing up." We're going to be that, and I know the viewers that are listening to this, wherever you are, you're going to be that doctor for your community and you're going to be that person that opens the door and lights up another patient's face.

    I think it's just a ripple effect and we're going to create a more just system for our patients just by existing and caring deeply. You know what I mean?

    Mariam: Yeah. Oh my gosh. Tears.

    Lilly: Not today. But that all being said, I wanted to thank all of our awesome listeners for tuning into this episode. I wanted to thank Mariam for having this intimate conversation with me about something that's really close to me and so important how it shaped how we entered medicine.

    I really hope that you all got something out of this episode or felt like you were able to relate to anything that we were discussing. I'd love to hear more about your community and what your upbringing was like, so feel free to send us a message or DM us on Instagram.

    Otherwise, we hope you subscribe to our podcast, that you rate and review us, and that you tune in for our next episode anywhere that you podcast. Bye.

    Mariam: Bye.

    Host: Lilly Kanishka

    Guest: Mariam Asadian

    Producer: Chloé Nguyen

    Editor: Mitch Sears

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