This is for anyone going back after a long time away. It could be to Amritsar, or to a village outside Jalandhar, or to a town in Kerala or in Michoacán; the particulars matter less than the gap. It is especially for those who left to study or to train, and who are going back carrying a profession that has taught them to notice things. Read it on the plane, if you like, somewhere between the second meal and the landing card. It is longer than a letter should be, which is the privilege of letters addressed to people who are about to have fourteen hours with nothing to do.
I should say plainly what kind of letter it is. My family’s roots are in Khadur Sahib, in the Majha. I grew up in Amritsar and studied medicine there; I trained in Little Rock and then in Fresno, and I have practised in California since 2010. Those facts fit into a few lines of a biography. They do not add up to an account of any particular return, and I am not going to invent one. What I can offer is a set of considerations I would want to hear before such a visit: what a person is asking of a place when he wants it to feel familiar, what he owes the people who went on living there, and what he should do with the eyes his training has given him.
English makes the whole thing sound like a direction. Going back: a ticket, a destination, a line drawn on the map over an earlier line, in reverse. Punjabi is more candid about the geometry. The ordinary verb is ਮੁੜਨਾ, muṛnā, which means to turn, as a road turns or a person turns his head, and also to return; and its close relation ਮੁੜ, muṛ, is an everyday word for again. In that vocabulary a return is a turning, and a turn is never a retracing. You come round to a place from a side you have not stood on before. The road behind you has been resurfaced since you left, and so, in ways you are the last to notice, have you.
The Date on the Place #
The first thing to know is that the place you are carrying has a date stamped on it, and the date is the year you left. Without quite meaning to, you will have kept it there: the shops on the corner, the prices, the way people paid, the songs on the radio, the road that was always under repair. A departure fixes a place the way a photograph fixes a face, accurately for one instant and with increasing inaccuracy for the rest of its life. The place did not agree to this arrangement. It went on being a place.
V. S. Naipaul wrote a whole book about the error that follows. The Enigma of Arrival (1987) is narrated by a writer from Trinidad who lives for ten years in a cottage on the grounds of a declining manor in Wiltshire. He arrives with an England already assembled from books, and he takes the countryside to be finished: a perfection that centuries have completed, which he has come to behold. Then he watches it. A neighbour named Jack, whose life and garden had seemed to the narrator emblems of an old and settled England, dies, and the land passes to new managers who modernise it. Other people leave and die; buildings and fences come and go. His first instinct is to read all this as decay, a falling away from the completed thing he had come to see. Slowly, and the slowness is the book, he comes to see flux instead: the constant ordinary changing of a place that was never finished, which he had merely happened to arrive in at one moment of. The decay had been in the idea, not in the land.
I think of that novel whenever I hear someone say that a place has been ruined. Sometimes it has. More often the speaker has a completed version in mind and is measuring the present against it, and the completed version is simply the one that existed on the day he stopped watching. The people who stayed have no such version. For them there was no before and after; there were only weeks. The road was widened during an ordinary year in which they also paid school fees, sat with someone in a hospital, argued about a wedding and bought a new pressure cooker. Change that arrives as a single shock to the returner arrived to them in instalments, mixed in with everything else, and most of it was never experienced as change at all. It was just Tuesday.
Some of it can be dated. India’s Unified Payments Interface was launched in 2016, and in the years since, paying by scanning a printed code has become ordinary at counters that once dealt only in notes and coins; a Ministry of Finance account from 2024 mentions the small voice boxes at snack carts and tea stalls that announce each payment aloud as it arrives. In Amritsar the approach to the Golden Temple was remade the same year: a kilometre of street running from the old Town Hall past Jallianwala Bagh was refaced and relit, and the Town Hall itself became a museum of Partition, both inaugurated in October 2016. Anyone who left the city before then carries a different street, and will walk the new one with the faint sense of having been edited out of a conversation that everyone else finished long ago.
Expect something of that kind: a small, ordinary change that the residents stopped noticing years ago, and that unsettles you more than seems reasonable. Part of the surprise will be about the place. A larger part will be about how firmly you had frozen it, and how little right you had to.
Distance also makes comparisons very quickly. You will have an opinion about the traffic within an hour of landing and a theory of the economy by the second day. Understanding takes longer, and it arrives mostly by asking. A visitor can pick out the features of two countries that suit his preferred argument, an American pharmacy here, an Indian street there, and set them against each other like exhibits in a case he has already decided. The resident has to live with the whole arrangement, including the parts that never come up in the argument. Even a sincere comparison goes shallow when it forgets who is able to leave the conditions being compared. Before deciding what has changed, it is worth asking what you failed to see the first time; before explaining anything, whose account you are relying on, and whether the person in front of you has a better one. The place has its own intelligence, its own arguments and its own vocabulary for what matters. More education ought to enlarge your capacity to listen to it. It confers no standing right to explain.
You will also catch yourself converting prices into dollars. Everyone does it. Try not to do it aloud.
What the Mouth Remembers #
Your language has a date stamped on it too, though the stamp is fainter than emigrants fear. Research on adults who leave has generally found that they keep their first language; what shifts can be measured, but it is subtle. When Monika Schmid and Merel Keijzer compared older German and Dutch emigrants in Canada and the Netherlands with speakers who had stayed at home, the emigrants named fewer animals and vegetables in a timed minute and used a somewhat narrower range of words when retelling a short film. The language was intact. It was a little slower to hand.
That is milder than the fear, and it points somewhere else. The more noticeable change is not in the emigrant at all. Speech at home has moved while he was away. New words have arrived, many of them English words naturalised beyond recognition; old idioms have aged; whole generations of slang have come and gone without him. The Punjabi he kept carefully abroad, like good clothes saved for occasions, may sound faintly formal to a teenager or a shopkeeper, as though he had turned up on a weekday in a wedding suit. That is not disloyalty. A language carried abroad is preserved. A language left at home is used, and use is what changes things.
Seamus Heaney has a short poem in Wintering Out (1972) called “Broagh,” after a townland in County Derry whose name comes from the Irish for a riverbank. The poem dwells on the sounds of the place, the rain in a heel-mark, the black O in the name, and it ends on the name’s last guttural consonant, “that last / gh the strangers found / difficult to manage.” A place-name is a small border, and you cross it by saying it properly. Heaney’s poem is about belonging and dispossession in Ulster, and I do not want to borrow more than it can lend. But I recognise in it the returner’s particular dread: that his own mouth has drifted to the strangers’ side, that he will say the name of his own town, or of the village his family comes from, with a flattened vowel, and that someone will notice.
Let them notice. If someone smiles at the way you say a word, you are hearing the language go on without you, which is what living languages do. And it may console you that officialdom has its own difficulty with people like you. It sorts returners into acronyms, defining them by where they do not live. There is little point in being more exacting about your accent than the government is about your address.
Two Versions of the Same Afternoon #
Memory is the returner’s capital, and he tends to spend it as though it were the only currency in circulation. I remember when this was a field. I remember when the bus stopped here. I remember when you could buy that for two rupees. All true, very likely. But remembering is a contribution to a conversation, not ownership of its conclusion.
A return brings several versions of the past into one room. A house that one person remembers as a refuge may have been, for another person, a place of exhausting work, because someone had to keep it in the condition that made it a refuge. A move that seemed to a child the beginning of a larger life may have been, for the adults arranging it, one difficult year among several, paid for in ways nobody mentioned at the time. These are possibilities, not accounts of any family’s history, and they illustrate a general difficulty: recognition does not guarantee agreement. Two people can both remember the same afternoon and remember different afternoons.
The temptation is to insist on one’s own. It is a mild temptation, usually, a matter of correcting a date or a detail, and it can be resisted with a little curiosity. What the returner may find, if he listens, is the part of the past that was outside his view, and it can be uncomfortable to learn that a cherished memory depended on someone else’s effort remaining invisible. Learning about that effort need not spoil the memory. It changes what gratitude requires.
Photographs and records help with some of these disagreements and not with others. They establish a date, a cast, the order of events. They cannot say what the day meant to each person in it, and a smiling picture settles nothing about the hour before it was taken. We can check a fact without dismissing a feeling, and we can honour a feeling without pretending that it settles a disputed fact. Held that way, a shared past becomes larger rather than more contested. The version I carry need not disappear. It takes its place among other accounts, and the pleasure of recognition comes to include the possibility that someone familiar has something new to tell me about a day I thought I knew.
The Songs of Those Who Stayed #
Punjabi has a large literature of departure, much of it sung, and what strikes me about it is how much is sung from the side of the one who stayed. The ਪਰਦੇਸੀ, pardesī, the one living in a foreign land, is the occasion of the songs, but the singer is usually somebody else, at a threshold or a well or a spinning wheel, waiting.
One of the old figures of that waiting is the crow, ਕਾਂ, kāṅ. In a belief recorded among Punjabi- and Urdu-speaking families, a crow that settles near the house and caws is announcing a visitor, and in the music of the region the crow has long served as a messenger between separated lovers. Baba Farid, whose couplets are among the oldest Punjabi poetry that survives and some of which are preserved in the Guru Granth Sahib, gives the crow its darkest appearance. In one couplet the crow has searched the skeleton and eaten all its flesh, and it is asked to leave the two eyes alone, because they still hope to see the beloved. Farid’s beloved is God, and the couplet concerns the soul’s separation, not a husband working overseas. But its posture is the posture of every waiting figure in the folk songs: the body consumed by the interval, the eyes kept back for an arrival.
The modern poets kept the posture and changed the messengers. Surjit Patar, who died in 2024, spent part of his childhood while his father worked in Kenya, and he wrote of the separations that migration makes in poems such as “Khattan di Udeek,” the waiting for letters. A crow, a letter, a telephone at an odd hour: the instruments change, and someone is still waiting by them. The waiting, though, has contents: a life, with its own work and its own seasons, which the person waiting has been living all along.
That changes what a return is. To the returner it is the climax of a story he has been telling himself for months: the flight, the arrival hall, the faces. To the people receiving him it is an event in their story, possibly an important one, scheduled between other important ones. They will have cleaned a room, bought what he used to like, rearranged a week. They have also had years in which he did not figure very much, and that is as it should be. A return goes better when the traveller arrives curious about those years rather than expecting to be the principal item of news.
Amrita Pritam’s most famous poem runs in the opposite direction from a homecoming, and it repays being read with this in mind. She wrote “Ajj Aakhan Waris Shah Nu” in 1947, after Partition had uprooted her from Lahore; by her own account it took shape on a train at night, with Waris Shah’s words about the dead and the parted in her head. Its title is its first line, ajj ākhāṅ Wāris Shāh nūṅ, which I would render: today I call on Waris Shah. She asks the poet of Heer, dead by then for a century and a half, to speak from his grave and turn a new page in the book of love. Once, she reminds him, a single daughter of Punjab wept and he wrote a whole epic for her; now a multitude of daughters are weeping. Look at Punjab, she tells him: the corpses in the fields, the Chenab running with blood.
No family visit resembles 1947, and I do not offer the poem as a comparison of griefs. I offer it for its grammar. Pritam does not ask Waris Shah to bring back the Punjab of Heer. She asks him to come into the present and look at it. She wants a new page written, not the old one recited. That is a harder thing to ask of a returner than nostalgia, and a better one. It asks him to bring his memory into the present as a witness, where it can be useful, rather than as a standard, against which the present will always fail.
Greeting Before Interpreting #
Now the harder part, which concerns the eyes your training has given you. A physician’s attention does not switch off at the arrivals gate. You will notice how people climb stairs, and who pauses on the landing. You will hear a cough across a room and find yourself estimating how long it has been there. You will see a row of medicine strips on a shelf and want, very badly, to read the labels. The habit is not a vice. It has probably helped someone in the place where you now work, and there may be a moment on this visit when it is truly needed. But it can turn every room into a clinic and every relative into a case, and that is a poor way to be received after years away.
People do not need to be interpreted before they can be greeted. That sentence is the whole of this section; the rest is commentary.
It helps to separate three things that feel alike from the inside. There is concern, which anyone who loves someone feels on seeing them tired. There is assessment, which is what a clinician does with concern: turns it into possibilities, weighs them, proposes a plan. And there is invitation, which is the other person’s decision that they want your assessment at all. Concern is yours to feel. Assessment is yours to perform only after the invitation has been given. The professional habit is to jump straight from the first to the second, because in a clinic the invitation is implied by the appointment. At a dinner there is no appointment.
The American Medical Association’s Code of Medical Ethics has an opinion on physicians treating themselves and members of their own families. Its general rule is that they should not, with exceptions for emergencies, for isolated settings where no other qualified physician is available, and for short-term minor problems. Its reasons are worth more than its rule. Feeling can cloud judgment; a physician may skip the awkward question or the intimate examination; and a family member may hesitate to decline a recommendation, or to ask for another doctor, for fear of giving offence.
That last observation is the one a returner should carry in his pocket. A remark from the visiting doctor of the family weighs more than his remarks at work. In a clinic, a patient who disagrees can say so and remain a patient. At home, disagreeing with the relative who came back a doctor can feel like ingratitude, so people often do not disagree. They nod, and later they do something about it, or nothing, or they quietly stop the medicine their own doctor prescribed because the visitor raised an eyebrow at it.
There is a mismatch here that a physician ought to feel in his bones. A licence to practise medicine is granted by a jurisdiction, and its authority ends at that jurisdiction’s border. The prestige of the profession recognises no such limit. It travels in the hand luggage and arrives fresh. A returning physician therefore carries across a border an authority that his responsibility cannot follow: he can be believed in a place where he cannot follow up. That is precisely the situation in which a careful person should say less, and say it more carefully.
What the Doctor Down the Road Knows #
Somewhere near the house you are visiting there is very likely a doctor who has looked after these people for years. You may never meet them. You will hear about them in passing, perhaps unflatteringly, because people speak frankly about their doctors to visitors. Treat that doctor’s judgment as you would want a visitor to treat yours.
Consider a hypothetical case, invented for the purpose. An older man in the household takes a blood-pressure tablet that a visiting physician from California would not have chosen; there is another he prescribes routinely. The visitor sees the strip on the shelf and has an opinion before he has a question. What he does not know is nearly everything that matters. Perhaps the alternative costs several times as much here, or is not reliably stocked by the pharmacy the man can walk to. Perhaps he tried something like it years ago and it disagreed with him. Perhaps his doctor went through three options over two years before settling on this one, for reasons recorded in a clinic the visitor will never see. Perhaps someone in the house has at last got him taking it every morning, and the routine is now a large part of the treatment. A sentence at dinner, we don’t really use that one any more, can undo two years of that work in a fortnight, and the visitor will be on a plane when the consequences arrive.
What the local doctor has is real expertise, and medicine has been slow to call it by that name. John Berger’s A Fortunate Man (1967), made with the photographer Jean Mohr, is a portrait of a country doctor in the Forest of Dean, and much of it is an account of what a doctor comes to know by staying: the histories behind the histories, the families, the work people do and the ways they speak of pain, gathered over years into an understanding that no single consultation could supply. Berger was writing about one man in one valley, and he did not pretend that such service came cheaply. But the knowledge he described is exactly what a returning physician lacks, however good his training. Continuity is a form of evidence. The visitor has the newer textbook. The doctor down the road has the patient.
So if you are asked, ask back. What did your doctor say it was for? How long have you taken it? Has anything changed? If a concern survives those questions, the respectful route runs through the local doctor rather than around them. Offer to write down what worries you, so that it can be taken to the next appointment; or, with the person’s permission, offer to speak with whoever is looking after them. A good local physician will usually welcome a colleague’s question asked as a question. Hardly anyone welcomes a verdict delivered by proxy.
The Case Against Restraint #
All of this can go wrong in the other direction. Restraint is not automatically a virtue. A physician who sees something dangerous and says nothing, out of politeness or out of a fashionable modesty about his own knowledge, has not been respectful. He has been negligent with good manners. The breathlessness on the stairs may be nothing, or it may be the thing itself. Tact that is really the fear of an awkward evening is not tact.
There is also a kind of return staged so carefully that nothing difficult is allowed into the frame: the reunion lit from its best side, every inconvenient question left at the door with the shoes. That protects affection by refusing to look, and it distorts as surely as the clinician’s appraising eye does. Honest attachment has room for gratitude and discomfort together. You may find changes you think are mistakes, decline you suspect was avoidable, losses nobody mentions. You are allowed to see them. Affection is precisely what licenses disagreement; strangers have no standing to be disappointed.
The way through, I think, is to distinguish by urgency and by kind. Some things cannot wait for an invitation and should not. If what you notice could do serious harm before anyone else is in a position to act, say so plainly, that day, and help the person reach local care. That is the emergency the ethics opinion itself sets apart, and it applies with special force to someone who will shortly be gone. Most of what a returning physician notices is not of that kind. It is elective commentary, on a diet, a habit, a choice of medicine, the way a household manages an illness it has been managing for years. For that, the rule of the guest applies. Say it once, if you must, in private, as a question, with your uncertainty showing. Then let it go, and leave the people who will be there next month to decide what to do with it.
Remember, too, the asymmetry of the calendar. A visit has an end date, and that is one of its great privileges. The visitor can say a hard thing and then board a plane; the household lives with the aftermath. A concern raised by someone who is leaving should be raised in a form that can be lived with after he has gone: specific, modest, attached to someone local who can carry it forward. Anything else is not candour. It is a parcel left on the doorstep with no return address.
The same arithmetic applies to money. Travel takes resources, and a returner usually arrives with more of them than the people receiving him, or is assumed to. A gift, an offer to pay, a contribution to some household need may be welcome and may be exactly right. It can also alter the terms of an encounter in ways the giver does not notice, turning hospitality into a transaction or generosity into a performance of success. The ability to help confers no ability to interpret another person’s needs without asking. The guest who asks what would actually be useful, and accepts a refusal without wounded pride, has given more than the one who decides.
The Years Lived Without You #
The story a returner tells himself is usually a success story, because that is what departures are supposed to become. School, qualification, training, practice: read backward, the sequence looks like a staircase someone was always going to climb. He is asked how he did it, and it is tempting to answer as though the route were a set of instructions. Advice has its uses. But a path can be real without being reproducible, and the honest account of most careers includes contingency, timing, and the help of people who never appear in the biography.
The larger trouble with the success story is that it is too small to hold the people who stayed. Their lives are not unfinished versions of the traveller’s. They have had their own decades, with their own decisions, achievements and griefs, few of which were organised around anyone’s absence. Someone built a business from a single counter. Someone looked after an ageing parent for years without remark. Someone changed their mind about something important and paid for it. None of this appears on the returner’s map, because the map shows only the route he took. There is a particular danger, if he ever writes about it, in the tidy sentence that sorts old friends by outcome: one became this, another stayed there, a third dropped from view. The structure may be elegant. The people in it have been reduced to evidence of how far the writer travelled, and their privacy and their unfinished futures deserve better.
Naipaul’s novel ends, after all its years in Wiltshire, with a section called “The Ceremony of Farewell.” The narrator’s sister has died in Trinidad, and the last pages attend to the Hindu rites performed after her death. It is a strange ending for a book about arrival, and a truthful one. The writer who has spent hundreds of pages perfecting his perception of one landscape closes by attending to another place and to someone else’s ending, a story in which he is no longer the protagonist. I do not want to make that sentimental. I only notice how often the literature of return turns out to be like this. The traveller comes back into the middle of other people’s lives, to their weddings and examinations and illnesses and funerals, and the dignity available to him is the dignity of a good guest at someone else’s occasion.
No Purity Test #
There is a picture of identity in which the original self waits intact beneath everything acquired later. Travel adds a layer, a profession another, and the true person lies underneath, ready to re-emerge when the right landscape or the right language calls him back. I understand the comfort of that picture. I do not think it gives enough credit to the life lived after leaving.
California is not merely the place where I work while another place holds everything that matters. Little Rock and Fresno belong to my history; so do the years of practice since. Obligations and attachments formed in adulthood are not less real for having been formed later, and acknowledging them takes nothing from Khadur Sahib or Amritsar. It makes the account of a life less artificially divided. A return can bring those parts of a life into contact, and sometimes they fit and sometimes they reveal a disagreement in values or expectations. The disagreement is not evidence of betrayal. It may only be evidence that a person kept learning after he left.
I am wary of the tests that emigrants are sometimes set, and set themselves, to prove that they still belong: the right loyalties displayed, the right changes deplored, the right certainty in the right tone of voice. Such tests are hard to pass because they depend on who is administering them, and they reward performance over candour. It becomes safer to say what belonging is supposed to sound like than to describe the life one has actually built. Belonging seems to me better shown through conduct: remembering people without claiming them, keeping the small promises made on leaving, staying open to correction. None of these can be discharged in a single declaration at an arrival gate. They continue after the visit, which is where most of a relationship with a distant place is in fact conducted.
Room for Another Return #
None of this is meant to make going back sound like an examination. Most of it will be ordinary and good: food you have been missing, the language spoken all around you without effort, the strange relief of not having to spell your name. Let that be ordinary. A walk can be a walk and a meal a meal, appreciated for the work and company of that evening. A place of origin should not have to justify itself by yielding a lesson, any more than you should have to justify your visit by diagnosing somebody.
There may also be disappointment. A reunion can reveal distance; a conversation can stay awkward; someone may have less time for you, or less interest, than you had hoped. That does not make the visit a failure. It may only mean that a relationship has to be resumed from where it actually is rather than from where you kept it in memory.
The best posture for a return, I think, is to arrive with fewer conclusions than the flight has given you time to form. Go with enough affection to recognise the place and enough humility to let it surprise you. If there is one question to bring, it is the one you cannot answer before you land: what has become important here while I was away? It lets the present lead. It lets the people receiving you speak about the parts of their lives that never figured in your version, and the part you missed remains theirs to tell, in their own time and manner.
The Punjabi verb was right about the geometry. To return is to turn, and its near relation means again. A visit that goes well makes another one easier; a visit that goes badly, with a lecture or a diagnosis over dinner, makes it a little harder. What a return can offer, at its best, is a relationship that remains capable of revision, kept alive by the willingness to learn what memory cannot supply.
One practical suggestion to finish. Leave the stethoscope at home. There may be a moment when you wish you had brought it. There will be many more when you are glad to have been only a guest.
With every good wish for the visit.
Evidence and Editorial Note #
Documented findings. Public biography: family roots in Khadur Sahib; upbringing and medical education in Amritsar; training in Little Rock (UAMS, 2007–2008) and Fresno (UCSF Fresno, 2008–2010); practice in California since 2010. Muṛnā and muṛ: standard Punjabi usage. V. S. Naipaul, The Enigma of Arrival (1987): the Wiltshire cottage and manor, Jack and the modernised farm, the narrator’s movement from a sense of decay to “flux,” and the closing section “The Ceremony of Farewell” after his sister’s death in Trinidad, as summarised by EBSCO Research Starters and SuperSummary. UPI launched in 2016 by the National Payments Corporation of India, QR-code payments and the voice boxes at snack carts and tea stalls: Ministry of Finance, “UPI: Revolutionizing Digital Payments in India” (December 2024). The Amritsar heritage street from the old Town Hall past Jallianwala Bagh, and the Partition Museum in the Town Hall, inaugurated October 24, 2016: Business Standard, “Walking down heritage lane” (October 29, 2016). First-language attrition among older German and Dutch emigrants (verbal fluency and lexical diversity measures): Monika S. Schmid and Merel Keijzer, “First language attrition and reversion among older migrants” (2009). Seamus Heaney, “Broagh,” Wintering Out (1972); the name from Irish bruach, riverbank: commentary at fawbie.info. The crow cawing near a house as a sign of a coming visitor, recorded among Urdu- and Punjabi-speaking families: USC Digital Folklore Archives, “Crow Heralding Visitors.” The crow as messenger for lovers in Hindustani song, and the couplet attributed to Baba Farid of the crow and the waiting eyes: Scroll.in, “Listen: Hindustani melodies in which the crow acts as a messenger for lovers”; the couplet is described, not quoted. Surjit Patar (1945–2024), his father’s work in Kenya, and “Khattan di Udeek”: Safir Rammah, The Friday Times (June 3, 2024). Amrita Pritam’s “Ajj Aakhan Waris Shah Nu,” written in 1947 after her displacement from Lahore and composed on a train, and its content: account drawing on her autobiography The Revenue Stamp, Susegad (Substack); the English renderings are the author’s paraphrase. AMA Code of Medical Ethics Opinion 1.2.1, “Treating Self or Family.” John Berger and Jean Mohr, A Fortunate Man (1967): standard bibliographic reference, described rather than quoted. Vendor representations. None.
Recollection and tradition. The author’s places and dates are his published biography. The return addressed throughout is general and in the second person; no visit, date, airport, relative, conversation, meal or encounter of the author’s is described or implied, and the essay does not say whether or when he has returned. The man with the blood-pressure tablet is explicitly hypothetical. The folk belief about crows is cited from a recorded source as a belief, not asserted as universal Punjabi practice.
Analysis and forecast. The readings of Naipaul, Heaney, Farid, Patar and Pritam, the distinction between concern, assessment and invitation, the argument about prestige and licensure, and the advice on raising a concern are the author’s interpretation and ethical preference as of November 6, 2026, not instruction. Independence. This essay is not sponsored by any institution, company, health system or technology developer. It is personal reflection, not medical advice; readers seeking care should contact their own physician’s office.
About the Author #
Kanwar Partap Singh Gill, MD, traces his family roots to Khadur Sahib in Punjab’s Majha region and grew up in Amritsar. He attended Spring Dale School and completed pre-medical studies at Khalsa College in 1994–1996. He earned his MBBS from Sri Guru Ram Das Institute of Medical Sciences and Research in Amritsar in 2002.
He completed PGY-1 at the University of Arkansas for Medical Sciences in Little Rock in 2007–2008, and PGY-2 and PGY-3 with UCSF Fresno at Community Regional Medical Center from 2008 through 2010. He has practiced medicine in California since 2010.
His career has crossed four distinct information eras: predominantly paper-based medicine, early and fragmented electronic records, the integrated-EHR era, and the emerging age of generative and agentic artificial intelligence.