Life & Memories · 239 essays
Essays
Personal, reflective, sometimes nostalgic: the ordinary life of a physician who happened to live through extraordinary changes in medicine. Two published and 237 forthcoming, arranged in fifteen sections from Khadur Sahib to the present.
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- 001Khadur Sahib: Where the Story BeginsFamily roots, place, and what remains after you leave.
- 002The Town That Learned to WriteGurmukhi at Khadur Sahib and what a faithful script has to do with a faithful chart.
- 003Mata Khivi’s KitchenLangar as the oldest equity policy I know.
- 004The Wrestling GroundThe akhara and the idea that the body deserves attention.
- 005A Hundred Moons, a Thousand SunsOne verse from Ang 463, carried from childhood to the clinic.
- 006Succession1539: what it means to hand a teaching from one person to the next without losing it.
- 007The Majha in SummerHeat, wheat, canals, and a landscape that stays in the body.
- 008What the Village Knew About IllnessFolk remedies, the compounder, and how a village cared for its sick.
- 009Going BackWhat a place of origin looks like through a physician’s eyes.
- 010The Names on the Gurdwara WallMemory as a public institution.
- 011Punjabi as a First Language of MedicineWords for pain, fever, and worry that English never quite translates.
- 012Chai, Rotis, and the Family TableFood memory and the beginning of a lifelong interest in nutrition.
II
Amritsar — Growing Up Before the Internet
14 essays- 013Growing Up in AmritsarStreets, routines, and small memories that stay for decades.
- 014The City of the Fourth GuruLiving in a place founded by the Guru whose name my medical school would carry.
- 015Spring Dale School and the Years Before MedicineTeachers, classmates, and ordinary school days.
- 016Seven Children and a SchoolHow a small experiment became the institution I attended.
- 017Where Knowledge Lived: Amritsar, 1995Studying before smartphones and instant answers.
- 018The Encyclopedia SetThe family reference shelf as a first database.
- 019The Teacher Who Made Chemistry Make SenseExplanation as an act of generosity.
- 020The Library DeskRetrieval was expensive, so memory was valuable.
- 021Cricket, Radio, and Long AfternoonsWhat a childhood contains when it is not on a screen.
- 022The Day I First Thought I Might Become a DoctorBefore the white coat, medicine as an idea.
- 023Doctors I Saw as a ChildWhat a doctor’s authority looked like to a child in an earlier era.
- 024The Golden Temple at DawnSilence, water, and the discipline of getting up early.
- 025Winter Fog on the Grand Trunk RoadWeather, roads, and the shape of a Punjabi year.
- 026What Amritsar Taught Me About CrowdsA city that is never empty, and a clinic that never is either.
III
Khalsa College and the Sciences, 1994–1996
8 essays- 027Khalsa College, 1995A young student studying biology without knowing where the road led.
- 028An Institution Built in an Earlier RevolutionKhalsa College, 1892, and the symmetry I did not notice at the time.
- 029The Physiology TextbookThe first time the body became an explanation rather than a list.
- 030Memorizing the Krebs CycleWhat rote learning gave me that I only later appreciated.
- 031The Mind as the First DatabaseWhen the physician’s head held the whole system.
- 032The Pre-Med Year Everyone ForgetsThe quiet year between ambition and admission.
- 033Studying the Night Before an ExaminationPanic, confidence, exhaustion, and promises never to repeat it.
- 034Friends Who Became Doctors, and Friends Who Did NotClassmates, and the places where roads diverge.
IV
Medical School — Sri Guru Ram Das Institute, 1997–2002
22 essays- 035My First Day of Medical SchoolWalking into SGRD and realizing medicine was no longer an ambition.
- 036The Anatomy Books I Carried EverywhereWhat we memorized and why some of it never leaves.
- 037The First CadaverAnatomy, mortality, and the strange beginning of medical education.
- 038Learning to Use a StethoscopeWhen an ordinary instrument felt almost magical.
- 039The First Patient I ExaminedThe difference between knowing medicine and touching another person.
- 040The First Time Someone Called Me DoctorWhy the title feels larger than the person carrying it.
- 041Medical School FriendshipsThe people who share the years when everyone is becoming someone.
- 042The Hostel YearsLate nights, examinations, food, friendships, and the peculiar life of a medical student.
- 043Tea Between ClassesSmall routines survive longest in memory.
- 044The Professors We Never ForgetVoices that remain in your head years later.
- 045Rounds in a Teaching Hospital in AmritsarLearning by watching where the senior physician looked.
- 046When Medicine Was Mostly MemoryPracticing before every answer was searchable.
- 047The Handwritten Medical ChartBad handwriting, thick folders, a different way of knowing a patient.
- 048The Smell of an Old Hospital ChartPaper, ink, and the physical history of an illness.
- 049What Paper Charts Did BetterNot nostalgia, just lessons worth keeping.
- 050What Paper Charts Did TerriblyLost pages, missing results, medicine before retrieval.
- 051The Honest GapWhy a visible hole in the record is safer than a hidden one.
- 052The Consultant’s Note on Page FortyThe recommendation nobody found.
- 053The Fax Machine as Medical DeviceHow information actually moved in 2002.
- 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- 057Leaving IndiaWhat it feels like to leave a familiar world for training elsewhere.
- 058The Examinations Between Two SystemsPreparing to practice in a country you have not yet seen.
- 059The Visa WindowA US Embassy interview, a folder of certificates, and a few minutes that decide a career.
- 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 SuitcaseWhat you pack when you do not know how long you are going.
- 070Landing in America as a Young DoctorExcitement and disorientation at once.
- 071Learning a Country and a Hospital at the Same TimeTwo curricula, one year.
- 072The Accent in the RoomBeing understood, and learning to listen differently.
- 073The First American WinterSmall shocks that stay with immigrants.
- 074Punjabi in ArkansasFinding, or not finding, your own community far from home.
- 075The Phone Call HomeTime zones, telephone cards, and the worry that travels in both directions.
VI
Little Rock — Intern Year, 2007–2008
16 essays · 1 published- 076Little Rock, 2007An intern year in corridors, call rooms, and long nights.
- 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 second skill every intern learned.
- 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 CallResponsibility before confidence.
- 083Three in the MorningWhy hospitals are different places at night.
- 084The Call RoomSleep that was never really sleep.
- 085The HandoffThe 7 a.m. handoff and the old question of Khadur Sahib.
- 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- 092Leaving Arkansas for CaliforniaAnother hospital, another beginning.
- 093Fresno, 2008Arriving in the Central Valley and slowly making it home.
- 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 less certainty than expected.
- 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- 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 PatientThe unintended consequence of better records.
- 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 the bloated chart.
- 115A Record Repeated Is Not a Record CorroboratedHow one error becomes six.
- 116The Inbox That Never SleepsWhat patients rarely see after the clinic closes.
- 117The Work After the Last Patient LeavesThe invisible second shift.
- 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 TuesdayA full clinic day, hour by hour, as it really is.
IX
The Examination Room — Craft and Attention
28 essaysPatient pieces in this section are composite and labelled illustrative in each evidence note.
- 126The Patient Who Says, “One More Thing…”Often the most important part of the visit.
- 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”Uncertainty as honesty.
- 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 TechnologyWhat hands, eyes, and ears still tell us.
- 136What You Learn From Watching a Patient Walk InMedicine before the first question.
- 137What the Chart Cannot SeeThe gait, the pause, the daughter who looks away.
- 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 ListenHow practice changes the physician.
- 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”Continuity in a fragmented system.
- 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- 154The Arrival of MyChartWhen patients began carrying the record with them.
- 155When Patients Started Reading Their NotesA subtle, profound change in the relationship.
- 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 ChatbotWhat happens when everyone arrives with a second opinion.
- 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- 164The First Time Artificial Intelligence Wrote the NoteA physician’s reaction to ambient documentation.
- 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 TypingThe examination room when the screen disappears.
- 173Oriented but Not PrejudgedThe briefing before the door.
- 174Show Me WhyProvenance as the first principle of clinical AI.
- 175Wrong BeautifullyThe danger of the elegant machine error.
- 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 TrapIf AI gives us twenty minutes, we do not have to sell them.
- 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- 194If I Could Speak to the Medical Student I Was in AmritsarWhat I would tell the young man with the heavy books.
- 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 and the person trained to help.
- 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 YearsPunjab, America, patients, technology, and what I hope endures.
XIII
Notebook — Notes and Fragments
12 essays- 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 PMDinner after pajama time.
- 206The Word for WorryOne Punjabi word and its English shadows.
- 207What I Miss About PaperTwo paragraphs, no more.
- 208What I Do Not Miss About PaperTwo paragraphs, no more.
- 209The Empty Waiting Room at 7 AMBefore the day begins.
- 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 LineThe shortest essay on the site.
XIV
The Human Pulse — What Everyone Feels in a Doctor’s Office
25 essaysPatient pieces in this section are composite and labelled illustrative.
- 214The Waiting RoomEveryone is equal there, and everyone is afraid of something.
- 215Waiting for the ResultThe three days between the test and the phone call.
- 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 PatientRole reversal, and the daughter who now does the driving.
- 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 CarefullyNeither false comfort nor cold facts.
- 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 who brings the patient and never books herself.
- 232Two Countries in One BodyImmigrant health, and the histories a chart cannot 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 DoctorTo be believed, to be told the truth, and not to be alone with it.
- 238GratitudeWhy “thank you” travels further than any note.
Nothing matches.
Patient stories are composite and labelled illustrative.