The following manuscript was submitted to the September 2018 Women in Medicine theme issue.
Three generations — that is how long medicine has been a dominant focus of the women in my family.
In the late 1950s, my grandmother was often told, “Medicine is no place for a woman.” As a result, she went to medical school under the guise of attending a teaching college deemed appropriate by her mother. It was a difficult journey for my grandmother to gain acceptance to Yerevan State Medical University in Armenia but, once given the opportunity, she was found to have a diagnostic intuition like no other. Although offered a coveted position at the city’s largest hospital, she instead moved to address a dire need in Hrazdan, Armenia where the mortality rate among the pediatric population was 20 percent. There, she led with a passion to make a difference, pioneering life-saving approaches that were originally received with great resistance. She was the first physician to start intravenous fluid infusions using cranial veins in neonates. In the first few years of her practice at the regional clinic, the mortality rate dropped from 20 percent to 1 percent. Soon, those who opposed her began to nickname her as the “saver of all.”
Throughout her life, she set the example of what it meant to be a true doctor: an individual with selfless compassion for human life. It is a quality that cannot be taught and is often undervalued in today’s selection of physicians as the first filter of selection is focused on scores alone. My grandmother was a “C” student in medical school, but she was the first to jump at rescue efforts when a 6.8 magnitude earthquake struck the city of Spitak in 1988. To this day, she still says, “Do not be afraid, even if you see a gun pointed at your head. Don’t let fear consume you.” She survived tragedies and failures and, with each fall, she has arisen stronger to protect her family.
My mother had a different story altogether and was instead encouraged to enter the mostly male-dominated medical field. She was the top of her class and graduated with a Gold Medal of Honor from Yerevan State Medical University, the same institution where her mother completed her education. As a neonatologist and as her mother’s daughter, she expected nothing but excellence for herself in her commitment to her patients.
She was the chair of the pediatrics department at a community hospital in Khimki, Russia, a city filled with poverty and desperation. For many, the hospital was a safe haven, at least temporarily. Women would present in labor but leave their newborns behind, unable to care for them or refusing to accept their congenital ailments. My mother took the valiant effort to secure homes for babies left behind, seeking mothers who were unable to conceive and wished to adopt. Most children found homes and others were taken to foster care. Between this work and her additional jobs as a physical therapist and developmental counselor, she was also a single mother raising two children of her own. In the world of socialist medicine, working as a physician was not a career path someone took out of financial gain. Rather, it was the hunger of knowledge, the joy of making a difference in one’s life, and the commitment to help those at their most vulnerable; my mother was the epitome of all three.
Embarking on my own pursuit of inclusion in medicine, I found myself embodying these strong women with their thirst for knowledge, sense of responsibility, and fearless leaps into the unknown. I found that the heart of their stories was never about financial security or medicine’s grandiosity but rather advocacy for those at their most vulnerable. As a Russian immigrant, I entered high school in Los Angeles, California without any knowledge of the English language. The more challenges I accepted, the further doubt and scrutiny followed until I achieved a national newspaper publication at the end of my senior year and graduated as summa cum laude from University of California, Irvine. The multilingualism of Armenian, Russian, English and later Spanish allowed me reach and connect with those who felt mute in a foreign environment. I’m humbled to have been given the opportunity to attend medical school with a merit scholarship, joining my family as the third generation physician.
Starting from scratch and succeeding seemed to be our way of life. I studied and read what I loved, what my mother taught me when my school in Moscow could not afford to hire science instructors. Living in a constant flux, uncertain of the future, each of us developed the resilience to ignore pessimistic voices and move gracefully against the flow of the majority. While most may settle for survival alone, it was our collective decision to live, to seek asylum and to leap into the unknown with no language or financial support. The skepticism subsided when I became an internal medicine resident physician and my sister performed at Carnegie Hall. Yet, this is only our beginning.