Freedom Through Sacrifice

April 28, 2020

Danny Mohama and his dog

Danny Mohama, a fourth-year medical student at the University of Minnesota, was all set to travel to Lebanon as part of the Global Medical Education and Research Program supported by the Center for Global Health and Social Responsibility. Due to the COVID-19 pandemic, all University travel and education abroad programs were suspended in early March. Though his plans are currently on pause, Danny has found other ways to work toward his goals and continue his global health work. He shares his reflections on his current situation below.

Sitting at a rectangular wooden table, my partner next to me with her dog in her lap, I am reminded of these atypical times. On a normal Wednesday, there is no reason for each of us to be home. In fact, as my plans said three months ago, I was to be 6,000 miles away at a medical rotation in Lebanon. My girlfriend was to be at the University of Minnesota for her classes, and Jack (the dog) was supposed to be, well, right where he is now.

So when posed with the question, “How is COVID-19 impacting your medical education,” it feels a bit like going from 100 to 0 mph. On this April day, my role was originally a medical clerk at the esteemed American University of Beirut Hospital on the Infectious Diseases service. I would have been part of a large team, seeing patients from all over Lebanon and likely neighboring countries. I would have seen diseases at this large academic center in the Middle East I had only read about before. I would have observed endemic rashes, blood-borne diseases, and bacterial infections. My goals to better master my family’s language while in full immersion in this Arabic-speaking country may have started yielding fruits. Bartering with local vendors, eating at local restaurants, buying from local shops, and communicating with new friends may have started becoming easier.

Yet, this recent change has brought in new opportunities amidst the chaos. David Brooks discusses freedom and sacrifice within his book, The Second Mountain. He references Tim Keller in saying that “real freedom ‘is not so much the absence of restrictions as finding the right ones.’” We are so often faced with decision fatigue as we try to maximize and choose at so many points throughout our days. We rarely take time to sit and choose among what we already have. We find new light in conducting our days with the same substrate, leading to newer and better outcomes. This pause in my medical education comes at a time where there was already to be a natural pause—the transition to residency that I had already planned to take “easy.” Yet, in all my four years of medical education, I did not know what taking it “easy” meant. I still struggle with this. I find it difficult to simply sit on the couch at 3 PM in the afternoon. Shouldn’t I be studying? Shouldn’t I be running those errands? I should at least exercise. External freedom implies we should attend to something. Yet, we lack the internal freedom to say no. While it took me a few weeks, I have been doing a lot of “nothing.” I’ve sat on the couch and read in the middle of the afternoon. I’ve gone on long walks. I’ve cooked almost daily. I’ve spent much needed time with my partner. And I’ve justified all that. I shouldn’t be doing anything else because it’s not quite safe to do so. I can’t just run errands in public all the time, and there is nothing in particular I need to study. So now, what can I really do with the time I have under these new limitations?

This is where the character formation piece comes in.

—Danny Mohama

The answer is one I am still working toward. And one may ask, what do these new habits have to do with medical education? Education, to me, involves both book learning and character formation. The book learning will always continue, and largely has. This has been a wonderful time to consolidate resources on what to read prior to residency, read headlines of regular research emails I receive, and educate myself more about the novel coronavirus. However, my “procrastination” has kept me from doing this too regularly. In fact, the physiological need for brain rest has led me to do many other things I hadn’t been doing before. It has taught me to think more about mindfulness throughout the day, and what I can do to be more comfortable with simply being. Reading in the middle of the day, going on a long walk, pursuing a regular yoga routine, and talking to my family daily has enhanced some important skills. Even more, I have volunteered to babysit for a health care professional’s child. Using my duties in ways I had not thought to do (past high school at least) has shown me again what it means to volunteer for the sake of a community—where education level or accomplishments do not matter. This is where the character formation piece comes in. At the bedside as clinicians, we gain so much by simply being with our patients. We are a witness in the journey of fear, joy, suffering, and relief. We serve as partners for our patients, and heal in ways science sometimes does not tell us to. Our own internal peace spreads to a room, to a group of people, forms a culture. That is the piece of my medical education I am working on currently.

The question I ask myself amidst these limiting and freeing times also relates to the global opportunities I have missed. How do I make up for not being in Lebanon at this time? This has forced me to reconsider why I wanted to travel in the first place. I went back to an early motive of mine—reclaiming my family’s heritage. It was recently that my desire to bolster and truly own my Arab identity came to light like a storm. I want deeply to master the Arabic language, communicate freely with my relatives, pass down important traditions, food, and customs to my children. How do I do this without daily being surrounded by those my parents grew up with? Again, these restraints create my own personal freedom. I have created daily flashcards of common Arabic words and phrases. In doing this much of my childhood communication and language skills have returned. I have been talking to relatives on the phone who speak only Arabic and have felt my own comfort increase over the past few weeks. I have listened to Arabic music, watched Arab American shows, cooked Middle Eastern food, and baked my family’s recipes. These are my global interests for now—claiming my own Arab American identity locally. And I think about travels for the future. As a healthcare professional with understanding of the language and culture within a part of the world that in many ways is under-resourced, I think about opportunities in the future where I can learn more about the medical system in countries like Lebanon and Syria. Someday, perhaps it is possible for me to provide care that is appropriate for those populations, even if it is virtual. These are opportunities I can begin to think about in my medicine residency at the University of Minnesota—an institution I know to contain a robust Global Health Department.

We must sacrifice for the greater good of our communities, even if that means forgoing important travel.

—Danny Mohama

There is no shortage of growth during this time, even if there exist limitations on what we can and cannot do. We must sacrifice for the greater good of our communities, even if that means forgoing important travel. It is a time of great sadness and fear amidst an uncertain future, morbid sickness, and death. And we must use our duties to help when we can. Sometimes that means providing health care as clinicians, and other times, it simply means staying home and avoiding interaction for the sake of others’ health. For now, I am following the latter, and soon, I will be pursuing the former. While my medical education has taken a different turn, the limitations have allowed me to work on my own character formation—being present with those I do have around, including myself. And while my global health experiences have changed, the goals have stayed the same, with opportunities that have allowed me to reach just as valuable outcomes. The future is uncertain, and yet we learn humility and ultimately, growth.

—Danny Mohama

Global Medical Education and Research Program

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