I’m spending this Ramadan in a hospital emergency room. It feels just like home.

Sabreen Akhter. Photo: The Washington Post

My last name is hard to pronounce. It’s not that it’s particularly long or polysyllabic, it’s that saying it involves parts of the tongue and throat that are not typically used in English. While the true pronunciation involves a guttural clearing of the throat, a flat tap of the tongue on the back of the front teeth, ending with a vibratory, hybrid “t” and “r” sound, most of the time I make it simpler for my patients.

“Hi, I’m Dr. Akhter,” I say to families I meet in the pediatric emergency department – my last name becoming an echo of the title before it, sounding something like “Doctor Octor.” Occasionally, a young patient I see picks up on this and laughs. “That’s really your name?” they ask. Well no, not really. My actual last name, pronounced properly, means “galaxy” in Persian. It was the last name my Indian grandfather gave to his seven children to pay homage to their young mother, whose name was Akhtari. It was a name given out of respect for women and motherhood. But I don’t go into all that.

“Yeah, that’s my real name,” I say with a smile.

The one time I take exception to the Westernized pronunciation of my name is when I’m seeing patients of South Asian heritage. Most of us can recognize a lot about a person from their last name: Khans are usually from a Muslim background, Kaurs from Sikh, Patels from Hindu, D’Souzas from Christian. (There are subdivisions of these broad generalizations, based on caste, geography, gender, histories of trade and conquest or other variables.) Akhter, or Akhtar, is a common South Asian Muslim last name.

“I’m Dr. UH-khh-tudr,” I say to my patients and families of South Asian backgrounds, as I see their eyes moving from my face to my badge. In Seattle, where I practice, most South Asian families I meet in the emergency department are first-generation Indian immigrants from Hindu backgrounds, attracted to the city by opportunities to work in the technology sector. With all the violent anti-Muslim rhetoric and turmoil in India these days, I always wonder what they think upon encountering me, an American-born Indian Muslim doctor.

In Seattle, news of the coronavirus arrived in early February, around the same time that I was becoming more aware of the escalating violence and hate-filled rhetoric toward Muslims in India. Although this kind of malice has existed for a long time in India, it has found particular clarity since Prime Minister Narendra Modi came to power, and it’s gotten much more severe in recent months. My extended family all over the world were following the news closely. As the disaster leaders at my hospital started putting coronavirus plans in place almost immediately, and the situation on the ground seemed to be changing minute-by-minute, I struggled to keep up with the information coming from my hospital and the news about India coming by way of my family.

It’s a strange thing, being Indian and Muslim and American all at once: Trying to reconcile who to consider a part of your community and who may look upon you with contempt, as you transit this world in its various spheres, is a constantly shifting exercise. It has been unnerving in my life in America to be lumped into the same rubric as everyone else on the subcontinent under the label South Asian, or worse, just Asian. When I was a child, I was acutely aware from an early age just how my family was different from the Hindu kids at my school. But that we didn’t share the same holidays, foods, rituals or names meant little to my white classmates. I was still, according to them, destined to marry Rahul, my Hindu neighbor two doors down, and the only Indian American boy in my grade, because, obviously. We were similar in the ways that our mothers made us do extra workbooks on weekends and classes during summers, but I knew, in the granular way that children do, that we were different.

Even with that primal knowledge, I have always been friends with other subcontinent immigrants and their children – some of my deepest friendships are with people from Hindu, or Buddhist or Jain backgrounds. In my life in the United States, I rarely consider someone’s religious background before putting my trust in them. I have celebrated Diwali and Holi with Hindu friends, and they have celebrated Eid with me. This has been the wild success of the indiscriminate aggregation of all of us South Asian brown people in America – this coerced mash-up in a new place, where finding your brethren forces a kind of reconciliation, though imperfect, of your differences. That so many of my South Asian American friends and acquaintances from every faith and cultural background have been activists and allies for each other’s causes has always felt completely natural to me. I have never questioned what the parents or grandparents of my friends might have felt about me in the quiet of their own homes, though I have had many hints along the way.

But now, everything feels different.

In India, during my last visit this past summer, my interactions felt tense. Unease was palpable everywhere – at the airport in the line for immigration, in the malls, in the chai shops, on the streets. It had been seven years since I had last set foot on Indian soil, and I had always looked forward to these visits as a kind of anchor. But this time, a constant sense of worry made it feel as though my every step was on unsure footing, like I could never rid myself of my sea legs. Now, WhatsApp messages from family members across the world are constantly rolling in, sharing news and reports of mob violence against Muslims and pogroms, all this under the blind eye of the police, backed by the ruling party, who in some cases have helped to foment it. My cousins in India send word that my nonagenarian grandmother is safe and does not need to leave her house for anything. I wonder whether they are referring to the virus or the violence.

This is the Muslim holy month of Ramadan. Although this is traditionally a time of great communion for Muslims around the world through the sharing of special meals and prayers, as well as a time of great compassion and charity, this year is different. This Ramadan, across the world, we are observing in isolation. Every Muslim I know is sad about this in some way. All the mosques are closed, all the late-night feasts and festivities are canceled, and all of us are figuring out how to build and gather community in the smallest ways wherever we can find it.

In Seattle, where daylight lasts almost 16 hours, I am fasting from dawn until sunset, as I usually do. During my night shifts in the pediatric emergency department, I try to find time to nourish and hydrate myself, making sure that I consume enough before sunlight begins to peek in the sky, somewhere around 4 a.m., all while trying to make sure my hands and face are clear from the invisible enemy that I am trying to protect my patients, myself and my family from.

The coronavirus has been described by some as “the great equalizer” – a uniquely savage illness that affects all of us equally, no matter our backgrounds. We are increasingly understanding the falsity of this narrative, especially as it relates to race and ethnicity, poverty and disability. But where there is disparity in the demographics of the disease, there is a rare kind of parity, of vulnerability, really, between patient and caregiver. That my young patient’s cough may become the vehicle for my own eventual illness, in ways more pernicious than previous viruses have, lends a kind of inevitable communion between us. I and all my colleagues fear the idea of getting sick from our patients, and we take great precautions. But if we do fall ill, we would experience the most essential kind of empathy, one that would lay bare any pretense of expertise, giving us the experience of the suffering our patients endure. This fear, and its companion, this empathy, are making us all better doctors.

As a physician, I think of all of this when I think of India, where the hashtags #CoronaJihad and #BioJihad are trending. I think of the Muslims in India who are suffering, who are sick, who are being asked to prove they are not infected by the virus before being allowed care, who are being segregated if they are allowed care, or worse, who are being denied care altogether. I think about the kind of covenant I enter with a patient and their family each time I become their doctor, the small bond that develops between us, and all the ways that we can either bolster or weaken that bond.

This Ramadan, I am finding ways to connect with my community from afar, through virtual fast-opening iftars and through delivering special foods and gifts on my loved ones’ doorsteps. I will spend this Ramadan, as I have in years past, talking to my young children about compassion and justice and perseverance, captivating them through the old stories of elephants and earthquakes and burning bushes. I will continue to worry and pray for many communities around the world, especially for the community that my family is a part of in India, and for all the communities suffering everywhere from the impact of coronavirus.

And because my only real, physical community outside of my home is with my patients and co-workers at the hospital, I am finding ways to deepen those relationships, too. Even behind face shields and masks, I am seeking greater connection with the families I care for, with the sick children and their worried caregivers. Ramadan is a month of many themes, though food is a central one – how we prepare it, how we share it, how we teach it to our children, how we give it to those in need. Though my visits with the families I care for may be more brief, sometimes behind layers of plastic and glass, I am finding ways to be more intentional in our moments of conversation – asking more about the food that they will eat on this day and bringing it to them if it seems there is not enough. I am doing this as much for myself as for them. Through these quiet, tender moments of kinship with each other, in twos and threes, we will all try to build our small assemblages of community together in this new world.

(Sabreen Akhter is a pediatric emergency physician who practices in Seattle.)



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