A few months ago, I met a woman who had stopped speaking at dialysis. She had grown quiet, worn thin by the rhythm of a system that seemed to talk around her but never truly to her. When she finally spoke to me, it was not about her labs or transplant status. It was a whisper — “Do you think I’ll make it in time?”

In that moment, she wasn’t asking for statistics. She was asking for presence. And that is what I gave her. Because as a Doctor of Health Sciences, my work is not limited to operations or policy critiques — it is grounded in the practice of listening, advocating, and showing up when the system feels too big to face alone.

The invisible weight patients carry

For individuals living with end-stage kidney disease, the transplant journey is rarely linear. Behind every referral and clearance lies a maze of missed transportation, provider miscommunication, insurance delays, language barriers, and fear.

Throughout my career, I’ve tracked down missing labs, escalated unclear referrals, followed up with overwhelmed families, and ensured kits were received by transplant centers. I’ve bridged communication gaps between dialysis units and transplant programs that would otherwise leave patients in limbo.

Some patients choose not to pursue transplant at all. Not because they don’t qualify, but because they’ve been burned by the health system too many times. These are not failures of motivation. They are reflections of systemic exhaustion.

Beyond the chart: How healing really happens

The most meaningful interventions I’ve witnessed didn’t come from a dashboard or a productivity report. They happened when I paused to ask a patient what they were afraid of. When I helped someone reframe their role as a caregiver-turned-donor. When I told a patient who had missed multiple evaluations due to transit issues, “You are not the problem. The system needs to meet you halfway.”

I’ve worked with families who didn’t know where to begin. I’ve supported patients who had no idea a simple referral had expired. I’ve translated confusing timelines into clear, step-by-step plans. I’ve stepped in when patients were about to be marked as “noncompliant” simply because no one had taken the time to understand their situation.

We often think of equity as access. But equity is also how many times a patient is given the benefit of the doubt. It’s how many people are willing to call again, explain again, and wait again.

Some patients don’t make it — that too is a policy outcome

There are patients who never get listed. Others who die waiting. These moments break something inside you — and build something, too. A deeper commitment. A louder voice. A refusal to pretend that disparities are accidental.

Black and brown patients are still evaluated more slowly. Still waitlisted less often. Still more likely to die waiting. These aren’t only gaps in access — they are ethical indictments. Equity in transplant must become more than a compliance checkbox. It must become an institutional imperative.

I am not just a worker. I am a doctor of systems, strategy, and humanity.

I am often told not to “overstate” my doctorate. That it makes others uncomfortable. But my doctorate is not for decoration — it’s how I hold space with scientific grounding, systems thinking, and the power to name what’s broken without apology.

I didn’t enter this field to manage spreadsheets. I entered it to shift how care feels — and for whom it works. And I’ve done that through daily acts of advocacy that rarely show up on dashboards but always matter to patients.

Hope is built, not prescribed.

Hope is not a fluffy word. It is the treatment plan when everything else stalls. It is the thread that holds patients together when timelines slip and silence creeps in.

And the truth is: Hope doesn’t come from policy. It comes from presence.

That’s what I’ve offered again and again — not as a liaison, but as a doctoral-level health advocate who sees the full person behind the patient ID.

I’ll keep writing and speaking until our systems make space for that kind of care, for every person, every story, every dream.

Zamra Amjid is a health equity and patient access strategist.