Life & Memories · 239 essays
Essays
Personal, reflective, sometimes nostalgic: the ordinary life of a physician who happened to live through extraordinary changes in medicine. 97 published and 142 forthcoming, arranged in fifteen sections from Khadur Sahib to the present. New readers can begin with one of six reading paths.
Jump to a section
- 0 · The trunk
- I · Roots
- II · Amritsar
- III · Khalsa College and the Sciences, 1994–1996
- IV · Medical School
- V · Leaving · USMLE & ECFMG
- VI · Little Rock
- VII · Fresno
- VIII · Practice
- IX · The Examination Room
- X · The Patient’s Side of the Screen
- XI · The Machine That Reads
- XII · Looking Back, Looking Forward
- XIII · Notebook
- XIV · The Human Pulse
0
The trunk
1 essay · 1 publishedI
Roots — Khadur Sahib and the Majha
12 essays · 12 published- 001Khadur Sahib: Where the Story BeginsAn ancestral town, a childhood city, and what each kind of belonging permits.
- 002The Town That Learned to WriteGurmukhi, the tailless scripts, and what a record owes the person whose words it keeps.
- 003Mata Khivi’s KitchenLangar, the workhouse, and what an institution asks of a hungry person at the door.
- 004The Wrestling GroundThe akhara, Homer’s wrestlers, Nestor’s prize, and attention to the body without judgement.
- 005A Hundred Moons, a Thousand SunsOn Ang 463, abundant light, and the difference between being informed and being oriented.
- 006Succession1539, the mantle of Elijah, and what it takes to hand a teaching on without losing it.
- 007The Majha in SummerThe season between two harvests, the loo, the canals, and a plain that keeps its own scale.
- 008What the Village Knew About IllnessNoticing, remedies, the compounder, and the care a village gave its sick.
- 009Going BackA letter to anyone returning, after years away, to the place they still call home.
- 010The Names on the Gurdwara WallWhat a wall of names records, what it leaves out, and how to read it responsibly.
- 011Punjabi as a First Language of MedicinePain, fever, ghabrahat and tension: against translating too early.
- 012Chai, Rotis, and the Family TableA roti, a cup of chāh, and the right to say enough.
II
Amritsar — Growing Up Before the Internet
14 essays · 14 published- 013Growing Up in AmritsarA hometown as the first scale against which every later place is measured.
- 014The City of the Fourth GuruCommemoration, descent, and the name a city and a medical school share.
- 015Spring Dale School and the Years Before MedicineSchool years graded on their own terms, not as the first chapter of a career.
- 016Seven Children and a SchoolHow a small beginning becomes a school that outlasts its founders.
- 017Where Knowledge Lived: Amritsar, 1995Learning before the internet, and what a scarcity of answers taught.
- 018The Encyclopedia SetThe reference shelf as a first database: arranged, signed, bounded and already dated.
- 019The Teacher Who Made Chemistry Make SenseOn the kind of teacher who explains, and why a good explanation is a gift with edges.
- 020The Library DeskLocating, remembering and understanding are three different kinds of work.
- 021Cricket, Radio, and Long AfternoonsA game with no clock, a voice from the sky, and the kind of time that needed no excuse.
- 022The Day I First Thought I Might Become a DoctorHow a vocation begins as an idea, and why the first day is usually chosen afterwards.
- 023Doctors I Saw as a ChildWhat medical authority looked like from a child’s height in an earlier Punjab.
- 024The Golden Temple at DawnSilence, water, and the discipline of beginning before the day does.
- 025Winter Fog on the Grand Trunk RoadAn old road, a winter that hides it, and the patience of driving at the speed of sight.
- 026What Amritsar Taught Me About CrowdsA city never empty, a crowd made of many purposes, and the waiting room that resembles it.
III
Khalsa College and the Sciences, 1994–1996
8 essays · 8 published- 027Khalsa College, 1995A biology student, a year still being lived, and the map that is drawn only afterward.
- 028An Institution Built in an Earlier RevolutionKhalsa College, the print revolution that built it, and the network revolution after.
- 029The Physiology TextbookHarvey’s arithmetic, Guyton’s arrows, and the moment the body becomes an explanation.
- 030Memorizing the Krebs CycleA circle learned as a list, the arrow that won a Nobel Prize, and what the names were for.
- 031The Mind as the First DatabaseWhat a trained memory is for, what it cannot carry, and when it has to be checked.
- 032The Pre-Med Year Everyone ForgetsA prefix that names a stage for what has not yet happened, and the flat part of the curve.
- 033Studying the Night Before an ExaminationPanic, borrowed confidence, stolen sleep, and the vow made somewhere around three a.m.
- 034Friends Who Became Doctors, and Friends Who Did NotA pre-medical class, the roads that parted, and why no single credential ranks the lives.
IV
Medical School — Sri Guru Ram Das Institute, 1997–2002
22 essays · 19 published- 035My First Day of Medical SchoolAn ambition ends at the gate; what begins is a register, a timetable and a promise.
- 036The Anatomy Books I Carried EverywhereThe flat page, the three-dimensional body, and the knowledge that outlasts the syllabus.
- 037The First CadaverOn learning from the dead: recognition, provenance, custom, and what gratitude owes.
- 038Learning to Use a StethoscopeWhat an instrument teaches about attention, and why the attention has to be checked.
- 039The First Patient I ExaminedFrom the body that cannot refuse to the person who can: permission, role and the lent hand.
- 040The First Time Someone Called Me DoctorOn a title that arrives before the degree, and the request folded inside it.
- 041Medical School FriendshipsThe people who share the years of becoming, and what gratitude can honestly name.
- 042The Hostel YearsCommunal student life, the independence it promises, and the labour it depends on.
- 043Tea Between ClassesThe unlabelled minutes of a medical timetable, and the ordinary friendships made in them.
- 044The Professors We Never ForgetWhat remains of a teacher in a former student’s head, and what gratitude does not oblige.
- 045Rounds in a Teaching Hospital in AmritsarWhat a ward round teaches, who is in the room, and what the patient hears.
- 046When Medicine Was Mostly MemoryQuestions that died in the room, the slow search, and what a trained memory guarded.
- 047The Handwritten Medical ChartHands, order and signatures: what a reader learned from ink, and what ink could not prove.
- 048The Smell of an Old Hospital ChartWhat old paper’s smell is made of, what it lends a record, and what it cannot vouch for.
- 049What Paper Charts Did BetterFive functions of the paper record worth keeping, each stated as a requirement and a test.
- 050What Paper Charts Did TerriblyFour ways the folder failed, and what happened to each when the paper went.
- 051The Honest GapBlanks, defaults and filled-in columns, and what makes a gap in the record honest.
- 052The Consultant’s Note on Page FortyA recommendation that exists in the record, and the four things it still needs.
- 053The Fax Machine as Medical DeviceA machine that copied marks, not meaning, and why arrival was never the end of a message.
- 054MBBS, 2002Finishing, and not yet knowing what a physician is.
- 055A Short History of Writing Things DownFrom Hippocrates’ case notes to Mayo’s single dossier and Weed’s problem list.
- 056The First Medical AI Nobody Dared to UseMYCIN, 1970s, and the three questions we are still asking.
V
Leaving — Between Two Countries: the Embassy, the USMLE and the ECFMG
19 essays · 6 published- 057Leaving IndiaAn old verb, a qissa that opens with leaving, a concrete aeroplane, a departure still open.
- 058The Examinations Between Two SystemsPreparing to practice in a country you have not yet seen.
- 059The Visa WindowA life made brief and legible, and two people on either side of the glass.
- 060Step 1, Far From HomePreparing for an American licensing examination on the other side of the world.
- 061The Standardized PatientClinical skills examinations and learning the American way of asking.
- 062The ECFMG CertificateThe document that turns a foreign graduate into a candidate for residency.
- 063Credentials Across ContinentsVerifying a medical education, one notarized copy at a time.
- 064Borrowed White CoatsObserverships, letters of recommendation, and the doors they open.
- 065Match DayApplications, interview season, and the Friday in March when the email arrives.
- 066The J-1 QuestionVisas, waivers, and the rural clinics that depend on them.
- 067One Doctor in FourInternational medical graduates and the American doctor’s office.
- 068The Doctors Who Came BeforeThe generations of Indian physicians who made the same crossing earlier.
- 069The SuitcaseBaggage arithmetic, a philosopher’s pity, late wheels, and what refuses to be packed.
- 070Landing in America as a Young DoctorExcitement and disorientation at once.
- 071Learning a Country and a Hospital at the Same TimeTwo curricula, one year: dates, floors, forms and the uneven shape of competence.
- 072The Accent in the RoomAccentedness, ease and understanding differ, and the listener shares the work.
- 073The First American WinterSmall shocks that stay with immigrants.
- 074Punjabi in ArkansasFinding, or not finding, your own community far from home.
- 075The Phone Call HomeTwo clocks, the falling price of a minute, and what a call home can and cannot carry.
VI
Little Rock — Intern Year, 2007–2008
16 essays · 5 published- 076Little Rock, 2007A river city, a first postgraduate year, and the ground changing underfoot.
- 077UAMS Before EpicElectronic medicine before the electronic record became ordinary.
- 078The PatchworkLabs in one system, films in another, paper in between.
- 079Where Does This Fact Live?The address of a fact, and the second skill every new doctor has to learn.
- 080The First Time Medicine Became Electronic to MeRealizing computers would permanently change the work.
- 081The Pager and the WorkstationTwo devices that owned an intern.
- 082The Intern Who Was Afraid to Make the Wrong CallTwo fears that sound alike, and the telephone call an intern keeps rehearsing.
- 083Three in the MorningWhy hospitals are different places at night.
- 084The Call RoomSleep that was never really sleep.
- 085The HandoffFrom the succession at Kartarpur and Khadur to the morning sign-out and the discharge.
- 086The Patient You Keep Thinking About After You Go HomeOne of medicine’s quiet burdens.
- 087When a Patient Suddenly Gets WorseThe moments that turn trainees into physicians.
- 088The First Death I Had to Face as a DoctorWhat school cannot prepare you for.
- 089Calling a Family With Bad NewsConversations that never become routine.
- 090The Longest Walk in the HospitalToward a family, knowing what you must say.
- 091The Nurse Who Told Me to Sit DownThe bedside wisdom that saves young doctors.
VII
Fresno — Residency, 2008–2010
14 essays · 2 published- 092Leaving Arkansas for CaliforniaAnother hospital, another beginning.
- 093Fresno, 2008Beginning again in the Central Valley, and learning a place by its year.
- 094Residency at UCSF FresnoExhausting years that now seem strangely short.
- 095Community Regional Through a Resident’s EyesLearning in one of the busiest places imaginable.
- 096Where Systems Matter MostPatients with the least margin for systems to fail.
- 097Ten Languages, One WardSpanish, Punjabi, Hmong, and the interpreter who was always somewhere else.
- 098The Farmworker Who Came in LateIllness, wages, and the arithmetic of a missed shift.
- 099What Residency Does to TimeWeeks that lasted forever, years that vanished.
- 100The Consultant You Were Nervous to CallA nearly universal residency memory.
- 101The Patients Who Taught Me More Than TextbooksLessons nobody formally teaches.
- 102The First Time I Felt Like a Real PhysicianNot graduation; something smaller.
- 103The Last Day of ResidencyFreedom, responsibility, and a threshold that does not end the learning.
- 104The Valley’s AirHeat, dust, tule fog, and the lungs of a region.
- 105Finding Punjab in the Central ValleyGurdwaras, farms, and a diaspora older than I knew.
VIII
Practice — California, 2010 Onward
20 essays · 6 published- 106Practicing on My OwnWhat changes when nobody stands behind you.
- 107California Medicine, 2010The beginning of an independent career.
- 108When Epic ArrivedThe 2011 transition from the physician’s side of the screen.
- 109Learning Epic One Click at a TimeA new medical language became normal.
- 110The Vocabulary of the RecordIn Basket, MyChart, SmartTools: how a company’s words became medicine’s words.
- 111When the Computer Moved Between Doctor and PatientLaennec’s paper tube, the monitor on the desk, and a room where both can see the work.
- 112The Patient Who Watches You TypeWhat the screen changed in the room.
- 113Why Doctors Keep Looking at the ComputerThe ordinary reality behind a common frustration.
- 114The Note That Grew Longer and Said LessTemplates, copy-forward, and where the reasoning lives on a page that keeps growing.
- 115A Record Repeated Is Not a Record CorroboratedHow one assertion becomes six documents, and why copies must be weighed, not counted.
- 116The Inbox That Never SleepsMessages sent on one clock and read on another, and the work a queue cannot show.
- 117The Work After the Last Patient LeavesOn leaving the interrogative mood, and how attention finds its way back to a life.
- 118Pajama TimeWhen the office follows the doctor home.
- 119The Refill Request That Is Never Just a RefillClinical decisions hiding in small messages.
- 120The Abnormal Lab at 5:01 PMModern medicine’s inconvenient timing.
- 121The Friday Afternoon ProblemWhy medicine changes before the weekend.
- 122The Prescription the Pharmacy Sent BackCoverage, cost, and the plan that unravels after the visit.
- 123Two Allergy Entries, Seven Years ApartThe contradiction nobody’s job was to fix.
- 124The Discharge Summary That Never ArrivedHandoffs across the hospital wall.
- 125An Ordinary TuesdayAn illustrative day in primary care, followed through its changes of attention.
IX
The Examination Room — Craft and Attention
28 essays · 6 publishedPatient pieces in this section are composite or hypothetical, and labelled illustrative in each evidence note.
- 126The Patient Who Says, “One More Thing…”The question that arrives at the door, and how to give it a fair hearing.
- 127The Question Patients Are Afraid to AskNoticing what is not said.
- 128The Patient Who Just Wants Someone to ListenNot every visit needs another test.
- 129The Art of Saying “I Don’t Know Yet”Four words, and what each must carry to be honest and still useful.
- 130The Art of ReassuranceWhy it takes more skill than saying everything is fine.
- 131When the Test Is Normal but the Patient Is NotMedicine beyond laboratory values.
- 132The Diagnosis You Almost MissedHow physicians learn humility.
- 133The Diagnosis You Suspected Before the Tests Came BackPattern recognition after years.
- 134Why Experienced Doctors Ask Strange QuestionsThe hidden logic of casual conversation.
- 135The Physical Examination in the Age of TechnologyAttention, explanation and dignity, whatever instrument is in the hand.
- 136What You Learn From Watching a Patient Walk InMedicine before the first question.
- 137What the Chart Cannot SeeA field guide to what is seen in the room and only partly written down.
- 138When the Spouse Finally SpeaksThe history that changes at the door.
- 139“Noncompliant”A word that usually means we have not asked the right question.
- 140Medicine or GroceriesThe patient choosing between the two.
- 141Knowing When Not to ActThe mildly abnormal result and the discipline of restraint.
- 142Stopping a MedicationSometimes the best prescription is a subtraction.
- 143The Frail Patient and the Perfect GuidelineWhen the list is correct and the plan is wrong.
- 144The Older I Get, the More I ListenExperience as a reason to leave room for surprise, not to finish the sentence.
- 145Growing Older Alongside Your PatientsWhen the doctor is no longer the young person in the room.
- 146Seeing the Children of Former PatientsContinuity and the meaning of time.
- 147The Patients Whose Names I Have Forgotten but Whose Stories I RememberMemory’s strange filing.
- 148Why Some Patients Stay With You ForeverCases that become internal history.
- 149The Thank-You Note in the Desk DrawerSmall gestures remembered for years.
- 150When a Patient Says, “You Remembered”Recognition, tact, and the shared work of keeping a person’s story continuous.
- 151A Career Measured in Ordinary TuesdaysMost of a doctor’s life is wonderfully uneventful.
- 152Things I Believed at 25 That I No Longer BelieveA conversation with a younger self.
- 153What Thirty Years Around Medicine Have Changed in MeBeyond technique and knowledge.
X
The Patient’s Side of the Screen
10 essays · 2 published- 154The Arrival of MyChartWhen patients began carrying the record with them.
- 155When Patients Started Reading Their NotesA letter to the second reader of a clinical note.
- 156The Smartphone Became a Medical Device Without Anyone NoticingPhotos, readings, and the home clinic.
- 157The Patient Who Googled EverythingHow the internet changed the conversation.
- 158Now the Patient Has a ChatbotOn the answer that arrives first, and the worry that was never typed.
- 159The Patient Will Have AI TooA guide for patients who use AI.
- 160Who Else Is Reading?Privacy, HIPAA, and the chatbot on your kitchen table.
- 161How to Read Your Own ChartWhat the abbreviations mean and what to correct early.
- 162What Your Doctor’s Inbox Looks LikeA patient’s guide to why the reply took two days.
- 163The Message Drafted by a MachineWhat California’s AB 3030 notice means when you see it.
XI
The Machine That Reads — Living Through AI
30 essays · 4 published- 164The First Time Artificial Intelligence Wrote the NoteOn reading prose in your own name that you did not compose.
- 165When the Computer Started Listening Instead of DemandingThe promise of ambient AI.
- 166The Day I Realized AI Was Different From the EHROne stores; the other begins to understand and act.
- 167From Paper Chart to Artificial Intelligence in One CareerFaster than it feels.
- 168Answering Versus ActingWhy persistence, not intelligence, is the change.
- 169When AI Starts Doing the Follow-UpThe next quiet revolution.
- 170The Doctor’s Inbox After AIMachines handle the routine; humans handle the exceptions.
- 171The Exception ConsoleWhat replaces the inbox.
- 172A Visit Without TypingAn imagined visit with the keyboard gone, tested against what attention still requires.
- 173Oriented but Not PrejudgedThe briefing before the door.
- 174Show Me WhyProvenance as the first principle of clinical AI.
- 175Wrong BeautifullyHow polish lends a sentence more certainty than its evidence can bear, and how to check it.
- 176Software Does Not TestifyResponsibility when the chain includes a machine.
- 177When the Insurance Company Has AI TooAlgorithmic friction and the patient still waiting.
- 178Automated AnxietyWhen a system that notices everything wants to act on everything.
- 179The Efficiency TrapWho decides where saved minutes go, and what a better clinic day should be measured by.
- 180Micro-Cognitive FatigueThe new tiredness of supervising machines.
- 181Langar and the AlgorithmTwo futures from the same software.
- 182Ten Languages, One ClinicLanguage access, and why AI errors are hardest to see in a language you cannot read.
- 183Will AI Give Doctors Their Patients Back?New technology repairing damage from old technology.
- 184The Patient’s Own AIWhen their assistant starts talking to mine.
- 185What I Will Never Delegate to a MachineJudgment, responsibility, and the human parts.
- 186What I Would Happily Give to a Machine TomorrowForms, duplication, searching, routing.
- 187Medicine When Information Is No Longer ScarceJudgment grows more valuable as knowledge gets cheaper.
- 188Fluency Is Not EvidenceA new reflex for physicians.
- 189A Philosophy of WorkWhat a practice needs more than an AI strategy.
- 190Epic Disappears by Becoming EverywhereThe record recedes because it grew capable.
- 191Whose Record Is It?Ambient recordings, training data, and the conditions of trust.
- 192The Patient Between AppointmentsPrimary care shifting from the visit to the person over time.
- 193The Doctor I Hope AI Allows Me to BecomeLess clerical, more present.
XII
Looking Back, Looking Forward
8 essays · 3 published- 194If I Could Speak to the Medical Student I Was in AmritsarA letter to the student in Amritsar, who is entitled to object.
- 195Two Rooms, Thirty Years ApartThe student at the table and the physician at the door.
- 196The Four Eras in One CareerPaper, patchwork, Epic, AI.
- 197What Must Not ChangeThe worried person, the person trained to help, and what should survive every new tool.
- 198The Verse I Keep Returning ToAng 463, read at fifty as I could not read it at fifteen.
- 199What My Patients Have Taught Me About PunjabDiaspora, distance, and recognition in a Fresno clinic.
- 200What Punjab Taught Me About My PatientsHospitality, dignity, and the shared floor.
- 201When I Look Back From the Next Thirty YearsAn imagined view from about 2056, and the question I would want to find there.
XIII
Notebook — Notes and Fragments
12 essays · 3 published- 202The Stethoscope in the DrawerAn object that outlived its era.
- 203Five Minutes Before the VisitA single moment, described exactly.
- 204The ClickOne sound, ten thousand times a week.
- 205Roti at 9 PMAn imagined late supper: one roti, a slow griddle, and an evening that need not be earned.
- 206The Word for WorryChintā, fikar and worry: what the words do in a sentence, and what a reply owes them.
- 207What I Miss About PaperWhat paper did that the screen still does not.
- 208What I Do Not Miss About PaperThe losses of paper no one should romanticise.
- 209The Empty Waiting Room at 7 AMAn imagined clinic before opening, and a room already full of guesses.
- 210The Portrait on the Wall of Khalsa CollegeOn the faces an institution chooses to remember.
- 211The Sound of a FaxExtinct, and not mourned.
- 212The Sign-Out SheetA folded piece of paper that held twelve lives.
- 213Ang 463, One LineOne line of Gurbani, read slowly.
XIV
The Human Pulse — What Everyone Feels in a Doctor’s Office
25 essays · 6 publishedPatient pieces in this section are composite or hypothetical, and labelled illustrative.
- 214The Waiting RoomEveryone is equal there, and everyone is afraid of something.
- 215Waiting for the ResultThree imagined days, a half-painted room, and the four waits folded inside one.
- 216“Is It Serious?”The question underneath every other question.
- 217The Cost of Being SickWages, copays, and the arithmetic no textbook teaches.
- 218When Your Parent Becomes the PatientCar keys, a folder of papers, and the authority that does not travel with them.
- 219The Last AppointmentWhat a final visit looks like when both people know.
- 220SleepThe one thing every patient and every doctor is short of.
- 221The 2 a.m. Portal MessageWorry keeps no office hours.
- 222Loneliness as a DiagnosisThe patient who comes in mostly to be seen.
- 223Grief in the Examination RoomWhat to do when a widower says he is fine.
- 224The Phone Call in the NightWhy every family fears it, and what the doctor hears on the other end.
- 225Hope, Measured CarefullyAn old code of manners, a bird that asks nothing, and a date written in pencil.
- 226The Body Keeps Its Own RecordScars, gait, and what a life writes on a person.
- 227Pain That Has No PictureWhen the scan is clean and the suffering is real.
- 228Fear of the DoctorWhy sensible people postpone the appointment for years.
- 229What a Good Death Looks LikeDignity, presence, and the conversations we avoid.
- 230The Child in the RoomWhat children notice in a clinic that adults do not.
- 231Caring for the CaregiverThe person in the second chair, the work that brought her, and what real help requires.
- 232Two Countries in One BodyA registration form, a language in two scripts, and the route no checkbox can hold.
- 233Faith at the BedsideArdaas, prayer, and what medicine can learn from them.
- 234The Patient Who Blames HimselfGuilt, illness, and the work of forgiveness.
- 235The Doctor Is Also TiredBurnout, without self-pity.
- 236Ordinary CourageThe patient who takes the pill every morning for thirty years.
- 237What Everyone Wants From a DoctorBelief, truth, company, and the person who came in wanting something else.
- 238GratitudeWhy “thank you” travels further than any note.
Nothing matches.
Patient stories are composite or hypothetical, and labelled illustrative.