I have delivered hundreds of babies. I have held the hands of women in their most terrifying and most joyful moments. I have spent my entire adult life becoming the kind of doctor who shows up, completely, compassionately, and without hesitation, for my patients. What I never imagined was that one day, bleeding and pregnant and alone in a call room at 21 weeks, I would be the one who needed someone to show up for me. No one did.

I grew up in Iran with a singular dream: to become an OB/GYN and help people. I worked for it relentlessly. I became board-certified. I practiced for five years as an independent OB/GYN, delivering babies, managing high-risk pregnancies, and building a reputation I was proud of. Then I made a decision that would upend everything. I wanted more. I wanted to grow, to learn, to contribute to medicine at the highest level. So I came to the United States.

I arrived as a research fellow at Yale University in 2013. I came to the U.S. with big dreams, very little money, and a lot of determination. Through hard work and persistence, I built my version of the American dream, no shortcuts, just grit and optimism. I learned a new system, a new language of medicine, a new culture, all while being thousands of miles from home. I matched into an OB/GYN residency in Michigan and completed my first and second years successfully. When that program closed, I found another position in New York. I was in my final stretch. The finish line was in sight. For me, life has been my greatest teacher. It has taught me resilience, gratitude, and how important it is to surround yourself with good people.

What I walked into was not a residency program. It was a gauntlet.

You don’t belong here

The program was brand new and disorganized, but that was the least of my problems. From the very first day, I felt it. I was not welcome. I was the only international medical graduate. Everyone else was American-born, American-trained, and they made sure I knew the difference. One colleague looked me in the eye and said, “How did you come from Iran and think you can practice medicine here? You don’t belong here.”

The exclusion was not just verbal. My colleagues would organize gatherings and deliberately not tell me. Decisions were made in rooms I was never invited into. I was professionally isolated in a way that was quiet and systematic and deliberate. I worked alongside people every day who had decided, before I ever made a single mistake, that I was lesser.

And then I became pregnant.

One embryo left

This was not a simple pregnancy. My husband and I had been married for years and desperately wanted a child. I had suffered three miscarriages. I had undergone three failed IUI procedures. My first and second rounds of IVF had failed. On my third round, I had four embryos, two of which were aneuploid. One transferred embryo ended in another miscarriage. I had one embryo left. One last chance.

When that final embryo resulted in a positive pregnancy, I was overwhelmed with a terror I cannot fully describe, not joy, not yet, but a desperate, white-knuckled hope. I was on a complex regimen of medications: progesterone injections, estradiol, enoxaparin, levothyroxine, Benadryl, doxycycline, Claritin, Pepcid, prednisone, acyclovir, tacrolimus, and ASA. Every pill, every injection, was keeping this pregnancy alive. Missing a dose was not an inconvenience. It was a risk I could not afford.

When my program found out I was pregnant, things did not improve. They got worse. They made me stressed out and made my pregnancy stressful. They made my schedule heavier.

The schedule they gave me after I disclosed my pregnancy was punishing. I was assigned six consecutive weeks of night call. I asked my program to reduce it or at least add one of the interns or junior residents to the schedule for help, given that I was carrying a high-risk pregnancy. My request was ignored. I worked those weeks of nights, pregnant, exhausted, and alone.

That word, alone, is important. In most OB/GYN residency programs, a senior resident on night call is paired with an intern or junior resident for support and safety. This is standard practice. My program knew this. And they chose, deliberately, not to follow it with me. Night after night, I covered the hospital by myself. No backup. No junior resident beside me. Just me, my pregnant body, and whatever walked through the door.

Meanwhile, I watched my American-born colleagues receive an entirely different experience. The junior residents were given outpatient rotations, lighter schedules, daytime hours, being together in hospital call. When they rotated through outpatient clinics, they were protected from night shifts. When it was my turn for the same outpatient rotation, the program scheduled me to cover the main hospital on weekends. Alone. Without help. The hierarchy that governs residency training, designed to protect both patients and physicians, was applied selectively. For them, it was followed. For me, it was discarded.

I was told earlier, before I conceived, not to get pregnant, because we were short staff, meaning not enough residents to cover calls. The program wanted to use me to cover every vacation, every sick day, every gap in the schedule. Now that I was pregnant, I was an inconvenience they had not planned for. I asked about adjusting my rotation schedule given my high-risk pregnancy. I was told I had to complete all rotations regardless. When I asked about maternity leave, I was told I had none, that I would have to use my paid time off (PTO), which for a resident is almost nothing. This, at 20 weeks pregnant, after years of loss.

My doctor’s appointments were treated as burdens. My program would schedule me for clinic and floor coverage knowing I had prenatal visits, and when I raised it, there was no accommodation, no flexibility, no acknowledgment that I was a high-risk pregnant patient who needed care. I was a resident first. A human being second, if at all.

Sixty minutes to recover

Then one day, I fainted in the operating room. I was pregnant, exhausted from nights of call, and my body gave out. I collapsed in the OR. Anyone who has ever been pregnant, anyone who has ever cared for a pregnant woman, understands what that moment means. It means the body is sending an unmistakable signal. Enough.

My program’s response was to send me to lie down in the recovery room. And then, one hour later, they called me back. Back into the OR. Back to work. A pregnant physician who had just fainted was given 60 minutes to recover and then ordered to return.

I cannot describe what it felt like to walk back into that room. To keep going when my body, and my baby, were telling me to stop. But I went back. Because I was afraid of what would happen if I didn’t. Because I had already seen what this program did to people it wanted to push out. Because I had one embryo left, growing inside me, and I needed to keep my job to keep my health insurance.

And then, at 21 weeks pregnant, they took that too. My insurance was terminated the same week I lost my position.

The night that changed everything

I was on overnight call. I had been experiencing vaginal spotting throughout my pregnancy, a constant, low-grade terror that never left me. That night, the cramping was worse. The bleeding was heavier. I was frightened in the way that only someone who has already lost pregnancies can understand, a fear that lives in your body, not just your mind.

And I realized I had run out of my medications.

I called my OB. No answer. I called again. Voicemail. I left a message. I waited. Nothing. It was a weekend. My husband was overseas. I asked the on-call attending to refill my medications. She declined. I was alone in a call room, bleeding, terrified, and unable to reach the doctor managing my pregnancy.

Earlier that same day, my attending physician had handed me her patient list and asked me, as she routinely did, to call in medication refills on her behalf for her patients. I made those calls. 23 of them. I called pharmacies, I gave her name, I refilled medications for patient after patient.

And then, desperate and alone and bleeding and out of options, I called in a refill for my own medications using her name. None of them were controlled substances or anything out of the list. I knew it was wrong the moment I did it. I was not thinking clearly. I was thinking about the baby I had fought for years to have. I was thinking about my one remaining embryo, now growing inside me, and the medications that were keeping that pregnancy viable. I was thinking about all the miscarriages. I was thinking about the fact that I had been on call for hours, that my own doctor wasn’t answering, that my program had given me no support, no flexibility, no grace, and that I was running out of time.

The pharmacy reported me. The program fired me immediately. Without a hearing. Without health insurance. Without any acknowledgment of the conditions that led to that moment. Without any recognition of how they had treated me for months.

And then they went to the press.

My name was reported publicly. The story was framed around my action, the prescription call, with none of the context. None of the discrimination. None of the isolation. None of the high-risk pregnancy being managed on overnight call without support. None of the three years of failed fertility treatments. None of the fact that I was discriminated against and retaliated against.

Now, when anyone searches my name, that is what they find. And so I cannot find a job. I am a board-certified OB/GYN with years of experience across two countries, a Yale research fellowship, and a genuine love for this specialty, and I cannot get a job interview because of what comes up in a Google search.

Liana

I have a daughter now. Her name is Liana. She is the miracle at the end of years of loss, the baby I held onto through every injection, every miscarriage, every night shift, every indignity. She does not know yet what her mother went through to bring her into the world. Someday I will tell her.

I am telling this story now because I refuse to let their version be the only one. What happened to me was not an isolated incident. International medical graduates, especially women, especially those who become pregnant during residency, are disproportionately targeted, isolated, and pushed out of programs in ways that leave no clean paper trail. The cruelty is often quiet. It is scheduling. It is exclusion from gatherings. It is being told there is no maternity leave. It is a program telling you not to get pregnant. It is the accumulation of a thousand small injuries that, over time, break something in you.

I made a mistake on the worst night of my life, under conditions my program helped create. I am not asking for absolution. I am asking for justice, for context. I am asking for the full picture. I am asking anyone reading this, a hospital administrator, a program director, a fellow IMG, a woman who has struggled to get pregnant, to consider what it means to be that alone, that desperate, that close to losing the thing you have fought the hardest for.

I am still a doctor. I am still the woman who crossed an ocean to grow, who matched twice, who survived the unsurvivable. I am Liana’s mother.

And I am a human.

Elham N. Samani is an obstetrician-gynecologist.