Toward the end of my clinical rotations, I met Salma, a 34-year-old woman who came from Egypt with her family to the U.S. two years ago. Wearing a latte-colored hijab, she was here at the hospital to care for her father, who had a case of congestive heart failure exacerbation with pleural effusions.

When deoxygenated blood comes to the right side of the heart, it gets pumped to the lungs to get oxygenated. Then, the oxygenated blood flows to the left side of the heart to be pumped to the entire body. When the heart is weak, and the pumping mechanism is not working as it should, your heart-lung plumbing gets backed up (so to speak). And you get “water lungs.” That’s where the signs and symptoms of pleural effusions kick in: struggling to breathe at night, a suffocating sensation, requiring multiple pillows to sleep as upright as possible, fatigue, gripping chest pain, a nagging cough.

Salma’s father has been recovering over the past week or so with a diuretic. And on his last day of admission, with my attending’s permission, I took a picture of his latest chest X-ray and the one from admission. I showed the images to Salma and her father, and they both knew it was confirmation of how much better he was feeling.

“Those water pills make me go to the restroom like a horse.”

“They seemed to have done the trick, Mr. Nazari. You’ve also lost some weight too because of them. How has your cough been?”

“Oh, I don’t cough anymore. I sleep much better now too. Am I ready to go home with my daughter?”

“I believe so. PT will be by shortly so that you can walk around the floor since it’s been a while.”

“Sounds great! Thank you, Student Doctor T.J.”

After PT came by to walk Mr. Nazari around the floor, I started talking with Salma to pass the time.

“Student Doctor T.J. — I like it! Has a nice ring to it.”

“My dad’s a hoot, love him to death. What kind of doctor do you want to be?”

“Internal medicine doctor, hopefully here in Houston since this is my home.”

“That’s great! Most people in Egypt become general surgeons or pediatricians.”

“That is interesting. Why is that?”

“For the higher pay usually. Pediatricians because there is a big cultural emphasis on the family and the well-being of our children. Surgeons because of the excitement, and that they are the go-to people for emergencies.”

“That’s pretty fascinating! What originally brought you and your family here to the U.S.?”

“Better lifestyle, but just more opportunities for my boy to grow and get the best education possible. We wanted to move here much earlier back in the early 2000s, but because of 9/11 and the heavy stigma Muslims faced, we decided to wait.”

“I am so sorry to hear that. I hope your time so far here has been a great one and that your family always feels welcome.”

“Thank you, T.J. The thought of not being able to provide hot water, food on the table, a roof our heads is what I feared for the longest time when we first came to the U.S. My husband used to be a field engineer, but over time decreased his hours because of disability. So much of ourselves we sacrificed to come here, but we knew it was the best decision for us, especially for my boy. Everything I do is for him and to provide him with the very best future possible.”

“Well, your son is very lucky to have a mom like you. What’s his name?”

“Jonathan, he’s seven. He’s a ball of energy; he would have loved to meet you.”

“The feeling is mutual; I remember when I was seven. Many great memories with my parents. So, what’s Houston been like for you and your family?”

“It’s been awesome! So many things here we can’t experience back home. Like here, you can experience so many different cultures and try out new foods every day. Even delicious Mediterranean food! Fadi’s is great, even the Halal Guys.”

“Those are my favorites too! You should try Gyro King, it’s a food truck close to here, and they have the best lamb over rice.”

“I think I’ve seen the truck! We will try today when we leave the hospital. But yes, there is a lot of opportunity for career growth, great schools for my boy to learn and become maybe an engineer or even a doctor one day. I feel freer here than back home.”

“What do you miss about home?”

“Oh, a lot of things. The scenery, the people, the sense of adventure. We try to go back once every two years or so to see the rest of my family who didn’t make the trip. But, I absolutely don’t regret us making the decision to come to Houston. Really wonderful country, seems to be a melting pot of all cultures which is something you definitely don’t experience in Egypt. What’s been your experience been like here?”
“Houston has been my home for a long time, was born and raised here. I love Houston for the same reasons. People can be driven to do the things that they love, which I really appreciate. It’s never a dull moment in the city with plenty to do.”

“What are your favorite things to do around town?”

“For me, biking, exploring new food scenes, and live music concerts are some of my favorite activities. Anything that activates my senses I go for.”

“That’s really wonderful.”

“Hey, you two! Missed me?” With his Dr. House-like walking cane, Mr. Nazari pulled up like a VIP to a red carpet event.

“Love the spring in your step, sir.”

“Never lost it, Student Doctor T.J.”

“Well, it was a pleasure talking with you both and getting to know y’all these past several days.”

“Y’all? Is that proper grammar?”

“I believe so, Mr. Nazari. See y’all around,” I smiled back.

“What are you planning to do Salma when you come home?”

“My boy decides how my weekend will go.”

We both laughed and smiled as we saw the sun’s rays shine through the windows, our long shadows being cast across the floor.

Ton La, Jr. is a medical student and can be reached on LinkedIn.

Image credit: Shutterstock.com