Having returned to the United Kingdom from a vacation back to Southeast Asia, I found myself reflecting on the meaning of being an immigrant.
I found myself intensely missing the sun and the food. The general miasma of security and comfort that comes from being home. Of having access to not one but three cars with a full driving license, which, being Malaysian, is a huge part of one’s identity. Strip the car keys away from a Malaysian adult and it is almost like stripping part of their independence away. Here in the United Kingdom, I realized I was seventeen hours, thousands of miles, and entire continents away from what I would once have called home without hesitation.
Yet during this trip, I noticed something unexpected. I sometimes referred to the United Kingdom as “home” reflexively and almost always ended up correcting myself. The U.K. is not home, I would think. Malaysia is.
Yet the U.K. is where I left my laundry behind. Where unfinished work was waiting for me. Where my current life is, painstakingly, being built.
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The confusion can be real. And that is one of the costs of leaving home. Watching family and friends share moments in their lives through pixelated moving pictures. Discovering every time you return that home has changed, whether subtly or profoundly, during your absence. Friends who once attended medical school with you now have families of their own, their toddlers whom I hold during very brief visits before returning once again to another continent.
Back in the United Kingdom, I come home each day to an empty flat and, more often than not, continue thinking about work long after I should have stopped. I mentally compose clinic letters while making dinner and replay conversations from the day. I suspect this is partly because there is no one at home to whom I can redirect my attention. Work quietly expands to fill the silence.
A friend back home who had recently become a member of the Royal College of Psychiatrists herself had initially expressed an interest in moving to the U.K. Later, when we spoke again, she told me she had changed her mind, at least for the time being. Leaving home, she said, was a huge decision and not one to be taken lightly.
The fact is, she had touched upon a very important truth. Leaving home is indeed hard.
Yet coming to the United Kingdom had always represented the culmination of my professional ambitions. Working within the National Health Service (NHS) had been a dream since medical school, and although I still have a long way to go before reaching the finish line of obtaining my Certificate of Completion of Training, I have never regretted making the move. And yet, I still have pangs of homesickness.
During my first NHS job in a London hospital, the consultant I worked with had originally come from Asia himself, specifically East Asia. Whenever we met for case discussions, he would inevitably ask me whether I was homesick. Each time I smiled and shook my head. He would smile back in a gently disbelieving way before moving on.
Shortly before I left the trust, he told me that although he had lived in the United Kingdom for more than two decades, returning to his country of birth still brought back memories of a life that once was and would never be again. For a long time, he had struggled with where he belonged. Being an immigrant, he said, could leave you suspended between two places at once, belonging to both and yet never entirely to either.
One day, shortly after he had returned from a trip to Asia, we were walking together to review a particularly complicated patient when a colleague greeted him warmly. “How was your trip back home?” He replied almost immediately.
“Home? This is home.” The reply caught her off guard. She quickly corrected herself before the conversation moved on.
That exchange stayed with me much longer than it should have. At the time, I thought he was simply correcting her choice of words. Now, I wonder if he was trying to express something far more difficult to articulate.
Medicine provides many ways of measuring professional success. Examinations are passed. Competencies are signed off. Careers progress.
Belonging is much harder to measure.
Perhaps that is one of the greatest costs of leaving home. Not merely the geographical distance, but the quiet realization that, somewhere along the way, you begin to belong to two places at once, while never feeling that you belong entirely to either.
Loshi Rajen is a psychiatrist in the United Kingdom.
