 
Being Authentic

a memoir

Morhaf Al Achkar, MD, PhD
Copyright © 2020 Morhaf Al Achkar

All rights reserved.
Dedication:

To mom
Table of Contents

Introduction

Part One: In Syria

Part Two: In the United States

Final Remarks 
Anyone who systematically deceives himself about himself behaves irrationally. But one who is capable of letting himself be enlightened about his irrationality possesses not only the rationality of a subject who is competent to judge facts and who acts in a purposive-rational way, who is morally judicious and practically reliable, who evaluates with sensitivity and is aesthetically open-minded; he also possesses the power to behave reflectively in relation to his subjectivity and to see through the irrational limitations to which his cognitive, moral-practical, and aesthetic-practical expressions are subject.

Jurgen Habermas

"The Theory of Communicative Action"
Introduction

Our existence is fragile. I learned that in many intricate ways, long before the COVID-19 pandemic, so I do not take today for granted. I do not know what tomorrow will bring. I do not even know if tomorrow will come.

On the eve of Thanksgiving 2016, I received the diagnosis of stage 4 lung cancer. Patients with cancer can have progressions of their disease after periods of stability. They also die from infections as their cancer weakens their immune system. Next to dying, I fear the spread of cancer to my brain and losing my ability to think, speak, or write. This loss would be devastating to me. I do not assume that I will be here in a few months, let alone in a few years. COVID-19 made that fear even more salient in my mind. I know that my existence is finite.

The fragility of our life and my awareness of my finitude made me aspire to be authentic. I write this memoir to be authentic—we become our true selves when we author our story. With writing my narrative, I have an opportunity to view it, reflect on it, and edit it. By doing so, I also invite others to write theirs.

Rare are the spaces in which we can look inwardly at who we are. There is no horizon to do so more intimately than writing one's biography. I write my story so I can reflect on what I am and who I am. I seek to know what is fundamental to me as a subject and what is superfluous.

What constitutes my core self?

What should that be?

I know as I write these words that my answers are never fixed and will likely never be. The question of what constitutes my identity is pertinent, even if the answer will not last. Writing in this context comes to provide some guidance. The goal is not only to summarize the life I've lived; it is also to investigate the future. Writing is not a story of becoming. Instead, writing is becoming.

Authenticity, in the end, is not a task that gets done once and for all. Authenticity is a fragile experience. We become our real selves for a restless moment, and we can lose authenticity completely in an instant if we do not keep our sights on it.

As I become, and as I live my story, I have the eagerness to share it. Rare are the times when all humanity is tuned in to an equalizing existential threat.

After the outbreak of COVID-19, folks understand it better when I say, I do not wish to complete my project and publish it posthumously. While some issues are easier to deal with by not dealing with them in one's lifetime, I aspire to tell my story as I live it.

I hope to describe my life to others. I also wish to explore my consciousness with others in mind. I won't only give the summary of my path. I will relive the experience by walking again on what were rough terrains. I also intend to stop at what I had once quickly passed by so that I can take a stance. I will make amends and apologize for errors I did not call out in a hurried period. Most importantly, I will affirm my story again to own my narrative.

—

I complete this book with an aspiration to participate more authentically in the project we call humanity. As a human, I wish to contribute to our enterprise. And I invite others to contribute, as well.

I will continue to contribute, affirming my view that we humans can do good. I participate by sharing, so that this project, which consists merely of our stories, continues. I do not necessarily dream to make sense of the project's entirety, nor do I think that is attainable. Yet, I still have the view that we humans are writing oeuvres together, the whole of which constitutes our history. Yes, our history has not always been glorious, and it was on many occasions hideous. But the project is not yet complete.

I have encountered numerous individuals to whom I said, "You should write your story!" I thought, as I do this same work, that the best way to encourage others to write is for me to tell my own story. I do not aspire to set an example. If anything, I hope to attract a dialogue and spur reflection. With COVID-19, we live a heightened awareness of our existence and consciousness. No one is immune from the worst outcomes, and uncertainty is looming. Now is the time to bring more of these reflections and dialogues.

I have been most indebted to those who shared parts of their lives and opened their souls to me. We all have a subjective world to which only we have privileged access. If someone allows another human into their world, they give the other a precious gift.

I am writing this book four months after publishing my first one, Roads to Meaning and Resilience with Cancer. I am satisfied with the work I did.

In Roads to Meaning and Resilience with Cancer, the work was noteworthy in opening space for others to share about how they lived despite cancer. It was worthwhile to me and I hope to those who read it. After writing that book where I told stories about others, I wanted to do something different. Plenty of researchers with enough sophistication and training would have been able to complete the work I did. The only project no one else can do the way I would is the writing of my own biography. That is why, as I keep on living with an existential cognizance of mortality, I have the urgency to do it and do it now.

I am afraid of being forgotten. Death does frighten me. But more than dying, I am scared of having no one remember me or, even worse, of being recognized differently from who I was. At the same time, I have never thought that I was entitled to ask others not to forget me. But, not to be forgotten is precisely what I yearn for. We forget and life goes on. To imagine or to aspire not to vanish from someone's memory is a delusion. Still, that is what I aspire to.

I tell my story so those who wish to remember me can have it. I make it available for them to know me as who I am. I have lost many, and it troubles me how easily we can forget. We have lost thousands of people every day to this pandemic, and it agonizes me that they may be forgotten. I hope we can keep their memory alive, and I worry about letting them die again if their stories are not told. Perhaps writing is my way of defying death.

—

Only I can write my biography with access to my memory, my intentions, and my desires. Others can describe my life from the outside and try to explain why I did certain things in specific manners. But no one can share my life encounters as I lived them, describe the joys I had, or the struggles.

I have an urgency to complete this project. My cancer can spread at any time. I've become apprehensive about any bodily symptoms that could indicate disease progression. I have become overly aware of my body, and at times, even subtle symptoms disturb my peace. A bad headache, twitching in the muscles on my face, a lingering cough, or chest pain are not the same for me as they are for a non-cancer patient. I have found myself doing neurological exams to test my sensation or checking the symmetry of my face to ensure my brain is still intact. It is not until I receive the scan showing "no cancer recurrence," that I feel relieved. I welcome the news as a temporary pass and say, "Phew, we survived this time!"

Since COVID-19 came to Seattle, I have been on almost complete lockdown staying home alone with my dog. Fortunately, I was able to provide patient care through telemedicine. I also continue to read, write, and participate in public discourse. I am still alive; I have a voice and can contribute.

Science has made it possible for patients like me, with advanced lung cancer, to survive beyond a few months. Of course, the risk of dying from the virus, if I get it, is higher with my cancer. But if I get through this pandemic, my hope is to live for several more years.

Even in writing my biography today, I would also like to have the chance to write it again later! This writing of my narrative will make me whole. If I continue to live, I will transcend what I become at the end of this writing exercise. Is not this the essence of living another life?

While it would be too much greed to seek to write two biographies, I hope to live a rich and meaningful life and to write more about it.

I put this work out so that my life can become more meaningful to me and others. Sharing my story will let others know me at a deeper level and save us the time of breaking the ice. While, I do not expect to send a copy of this book to every new person I meet, writing my biography will make salient to me who I am. It will refine my voice bringing me more depth and better clarity.

—

In Being Authentic, I have the other in my mind. I am writing for someone other than myself to read. I am writing to every human. Is that a lofty goal? Yes. But what if I have no other chance to speak to my readers after this? Put yourself in my position and tell me if you would not say everything in your mind to everyone who can read it. What if this is your one and only opportunity?

Because of my fear of being forgotten, I write to invite as many people as imaginable to know me. I also mean to tell as much as I can about myself. While doing that, I transcend the focus on myself to find matters about which others can be curious. But neither will I fixate only on my error, nor this book is an attempt to redeem myself from my mistakes. I have not omitted the mistakes, and I have opened ample space to reflect on what was not consistent with who I thought I was. I leverage this space to relate to those who err every day. They are the brave among us who choose to continue to act. I, like these people, hope to keep on doing things, and that means to err more.

While I write for the other, I am simultaneously writing for myself. I am one of the readers and will judge the subject as it gets written. My criteria are stricter. I need to say, "This is my narrative."

Morhaf Al Achkar

Seattle, May 06, 2020
Part One:   
In Syria
Mom

I was born, in 1983. The youngest of nine children, we kept our mother busy. Being the youngest comes with exemptions and limitations. I spent a considerable amount of time with my mother in the early part of my life. But I competed for distinction even earlier in life, and I have continued to do so.

When my mom would visit her relatives, I'd be her companion. Mom's family was kind to me, because I looked like my uncles when they were little. I often enjoyed accompanying her, except when the visits lasted too long or when my mom would spend thirty minutes by the door "saying goodbye" to our hosts.

I gained my self-assurance from my mom, Souad, eternal happiness. In the photo I keep of her, she is wearing a white jacket with a brown collar. I still remember that jacket from my childhood. She has a white scarf that covers most of her brown hair. She gazes forward not exactly to the camera but beyond it as if she sees through the eye of the onlooker. She has a faint smile in her lips and eyes, not that of joy but one of confidence. My mom was always self-assured and projected a sense of warmth, trust, and authority. She raised me to have these attributes, too.

Everyone in the community respected my mother and being the young man who accompanied her meant I received recognition as well. Folks knew that I was my mother's son and, at times, even would call me by my name. It satisfied my desire to be distinguished as an individual.

I owe my scholastic achievements to mom. She valued education more than anything else. She married my dad because she found it attractive that he had the ambition to pursue college and beyond. She was seventeen when they married, and he was nineteen. She required her children to burn the midnight oil and had strict expectations. Playing was allowed once I finished my homework, not before. Even when I was in college, she would make clear her disappointment if I spent too much time on the internet. Nothing should come before education, not chasing after girls, organizing political activities, not even family time. Education, for mom, was a secured path to a good life.

—

Doing what's right was essential for mom, too. She had seen enough of what she considered kids doing terrible things. She did not accept her children misbehaving in any way.

She had her way of enforcing good conduct. An expression on her face was enough to shut down silly behavior. She did not need to say the command twice, and at times, not even once. I did not always get the point behind what she considered right or good or proper. But, when you have nine children, you may not have enough time for critical dialogue and reflection with every single one. She was masterful at efficient discipline, and she did it with care and love.

One time, when I was seven, we were visiting with family friends who had children of my age. The hosts offered snacks consisting of nuts and sunflower seeds, but we were supposed to say no. This 'no' showed politeness. Not saying 'no' and taking the offered food could indicate we had no food at home, which was not a good impression to give.

I grabbed a handful of snacks and went to play. I shared them with the rest of the kids. The snack was so tasty that I went back for another round and then a third. The hosts offered to give me the whole plate. I realized that I might have crossed a line, but it was too late, so I took the plate to the embarrassment of my parents. The car ride home was intense. My mom made it clear she was disappointed, and I felt it. It did not help me much that I was sharing the food with the rest of the kids nor the excuse that they were so good! I do not recall misbehaving like that again, after the incident.

Her punishments did not always make sense to my younger self. There was one occasion when I felt mercy should have been called for. I was probably five and had a new car toy that my dad got for me. My cousins visited us. One of the kids broke the car. He felt bad and gave me a nicely shaped wooden stick. I forgave him quickly and we carried on playing. When I explained what happened to mom, after they left, she was mad at me for letting the kid break the toy. "You should not have let him play with it and break it," my mom said with a stern voice and a frown. I became resentful of my cousin then and felt cheated.

I may see the moral mom conveyed, which was to be protective of my valuables. Still, I did not then understand her response. What had amazed me with mom was that she'd be patient and forgiving when someone breaks a plate or a glass. That was a frequent occurrence with nine children. My siblings and I would break one or two objects a day. She'd say, "انكسر الشر," which means "the evil broke." Further, she taught me that I need to share and be generous in giving.

That incident confused me. I shared my toy, and it broke like anything else; it happened. The resentfulness came to me as I felt blamed not for my own doing but for that of someone else. Mom might have wanted me to be vigilant, accounting for other people's mistakes and not only mine. This lesson was beyond my comprehension then. At that time, it only enforced mom's authority over my conscience.

—

Mom taught me how to participate and care for the living, and how to bury the dead. She was the spirit of any group and the one who brought the whole family together. She was present at every joyful event. Even with losses and deaths, she was there for and with others. She wanted us to be there, too. As her little buddy, I went to almost all the weddings on her side of the family.

The weddings back home were incredible events for families to get together. They often lasted for a couple of nights. There were usually two weddings, one for the men, and one for the women. But toward the end of the night, the men and women from the immediate families joined. There were always beautiful young women I would notice, and my mom did not discourage me. Maybe she thought that if I were hitched to a relative of hers, I wouldn't go far away.

I was shy at first, but you could not be shy when accompanying my mom. She pushed me to take my first steps on the dance floor. After a few weddings, my feet became more coordinated, and I loved participating in the group's festivities.

Members of families in Syria also stepped in to attend for the elders or care for the ill. In my early teens, my grandmother became very sick. Mom and her sisters were her caregivers. While my aunt Qamar (her name means "moon") took on the lion's share of the duties, her sisters also helped. Aunt Qamar did not get married and lived with my grandparents until they passed. She was the loveliest soul. My mom always felt a deep gratitude toward Aunt Qamar, and so did I.

My mom was living the furthest away, in Aleppo, about two hours north of Rastan, my hometown. She had children in school, which made it harder for her to leave them all the time. But toward the end, she did get to spend time with her mother, and she was grateful to have been by her side when my grandmother died.

I was in Aleppo when we learned that Grandma had passed. So, we went there to see Mom and to lay eyes on Grandma for the last time. I was eleven or twelve. Mom gave me hugs and kisses when I arrived. I didn't know how she was doing, given that Mom was a strong woman and always appeared solid. She had clearly cried, but she maintained her image as a strong woman.

Grandma's dead body was in the room where my mom walked me through what I needed to do: "Go there and kiss Grandma's forehead." I did as I was told, feeling like it was nothing unusual, and I was grateful that I was able to do that. This memory became a guide for me later in life as I reconciled with death and dying.

—

In terms of her beliefs, my mom was a practicing Muslim. She prayed, fasted, and went to Mecca for the pilgrimage. But she believed that Islam was about a person's character and about doing good to others. She was skeptical of those who claimed to be religious yet lied or cheated. She was not fond of populous religious clergies either. Instead, she valued scientific facts. She would quote "studies" she read, often to support a recommendation she would make about diet or lifestyle.

She raised her family in a moderately conservative Muslim society. She would expect us to fast and be present on Iftar (breaking the fast). Eid (the holiday after Ramadan and pilgrimage) was a special occasion, but more of a family and social event than anything else. She would encourage me to pray, but she was not strict about it. As I matured in my teens and adulthood, when we disagreed, she would say, "االله يهديك," which means, "may God show you the right path." She would say that with patience and care.

My mom was fond of her father and drew several of her ideals and philosophical positions from him, although she was also independent. He would ask her opinion and trusted her to run his tobacco trade business when she was just a teen. They both believed it was a meritocratic world, and a person needed to work hard in it.

My grandfather also had his views on people's character. But when it came to me, she did not think that he got it right. He would ask her jokingly (or not), "From where did you get this child? He is قشق (meaning useless)! You should just get him a little farm and let him dig it up!"

Grandpa's opinion was not unfounded. My favorite hobby at that time was digging holes in the dirt. There wasn't more exciting stuff to do, and at times I had mischievous intentions. I made some of the holes into traps. But as the Arabic saying goes, "who digs holes for their brother falls in them," occasionally, I was the one tumbling into my traps. I also dug with the hope of finding utensils made of gold or jars filled with silver coins. I uncovered nothing but crud. Grandpa died when I was eleven or so, without necessarily changing his opinion of me.

When I entered medical school, years later, my mom was delighted. The decision was important to her. She would reminisce about her father's statements and say, "I wish he were alive to see how my son is doing!" Her words made me proud. Maybe she also needed to show her dad that she had done something distinguished. She bragged the most about her children's education. Among the nine of us, we held ten doctorates—six MDs and four PhDs. I was the one who got one of each.
Dad

Dad was a busy man doing honorable work. That made the time we spent together growing up precious to me. He taught me important things in my life.

He taught me how to swim. And he did that in a lake! As I think about it now, I'm not terribly confident that it was the safest choice. The lake in Rastan was an artificial one formed behind a dam. It was not the cleanest, and there were probably holes and fishing nets. Thank goodness, we all survived. His method was straightforward, sink or swim. I had to float.

My dad also taught me how to ride my bicycle using a similar method of teaching me to swim: ride or fall. I had a tiny red bike that I first shared with and then inherited from my sister and brother. I fell a few times, but in the end, I rode. I would receive a push, and I had to steer to stay on the bike, or suddenly, the two wheels would be on top of me. To be fair, the first time I rode my bike, it had a third wheel on it. I went home proud of my bike riding, but I had a sense that there were subtexts when my siblings would say, "He rode his bike today (well, with three wheels)!"

Dad also taught me how to drive. His method of teaching had evolved a bit as I became a teenager. Since he was by my side as I sat at the wheel, there was no drive or crash option. He was methodical and gave clear instructions. The right foot is for the gas and brake, the left is for the clutch. You drive carefully in the city. You accelerate fast when you are on the highway to not clog the road. They were sound principles and arguing his principles would not take me anywhere. But I still wanted to do my own thing.

One day I used my left foot for the brake. My dad reminded me to use the right for gas and brake with a stern voice.

"The car would stall if you don't have your left foot on the clutch!"

I argued, "But would you rather it hit the next car or just stall?"

Dad was quick to end my chatter, "Do not philosophize! Just do as I say!"

Maybe that was one of the most important lessons he taught me; I should not philosophize when the matter is clear–just do it right.

—

I relished the long-distance trips we took between Rastan, my hometown, and Aleppo, where we lived for most of the year. That was where he worked at the university, and it was where I received all my education. At times, he would visit Damascus, Syria's capital, for his work meetings, and I would accompany him just to drive. A bonus was the conversations we would have.

While Dad never said too many words to me when I was a teen, I'd try to get him to explain economic and social theories to me. He was an economist who had finished his Ph.D. in communist USSR and his postdoctoral work in the capitalist United States. Moving between and dialoguing with colleagues at the cold war two poles led him to take some novel positions.

Dad was a free-market economist—skeptical of the centrally administered economy and society. However, he recognized social inequities and their detrimental effects on individuals and families. He was an advocate of small-business projects, especially for women and in rural areas. He worked also on programs related to the census and was a proponent of family planning, although he liked having his nine children.

Dad was from a generation of scholars who came home in the 1970s to lay the foundations for higher education in Syria. Until thirty years prior, the country had been a French colony and then was riddled with political coups. My father was the founding dean of the Faculty of Law at Aleppo University. He then moved to the Faculty of Economics to be its dean as well.

Dad taught all kinds of courses from macro to microeconomics and from statistics to population economics. I was always fascinated by what he did, and I thought I would be thrilled to be an economist, too. His perseverance, however, was his most remarkable trait. If he got his mind set on doing something, he would give it his all and wouldn't stop until he got it done.

Besides his work in academia, Dad took pride in being a farmer. He inherited a farm from his dad and acquired a piece of land near it. My earliest memory of the farm was of the peach trees. My family sold the perfectly shaped fruits. The peaches we got to take home were small, overripe, and funny-looking. Still, they were juicy and would make my mouth water. Then cold years came, and the trees did not survive the frost. After that, Dad began to plant wheat, soybeans, and other grains. He taught me very little about the farm, and I had only little curiosity. I was satisfied to dig holes in the backyard at home.

Dad was an innovator. He introduced a piece of farming equipment to the area that looked like a cultivator back in the 1980s. Soon afterward, the farmers modified the tool by attaching a trailer to it. Those mini tractors then became the primary mode of transportation for humans and their animals. They were anything but quiet or safe. So, whenever the noise became intolerable, or the safety concern arises, Dad expressed his pride in being first!

In his spare time, Dad would write textbooks. He sat for hours and hours writing nonstop. I remember him sitting by the computer, wearing his reading glasses, the warm coat he wore at home, and his headscarf. Being a mathematician by training and holding his Ph.D. in economics, he wrote textbooks for econometrics and statistics. He would finish up one project only to initiate another right away.

I took on Dad's habit of working hard and relentlessly. If I worried about spending long hours on projects, I remembered Dad and kept going. He recently shared with me, after I published my first book, that he enjoyed authoring books and found it fulfilling. "You leave your mark," he said.

—

Faith was fundamental to Dad. He held a strong religious foundation as a devout Muslim. He memorized the entire Quran, and he prayed every day, still does. From his faith, he upholds not only the daily practice of the rituals but also the charitable act of giving, particularly to those who most need it.

Dad was a generous person who valued giving, and he would tell us that we should give ,سراً وعلانيةً ,which means announced or unannounced. He believed that if we could give, then we should. That included not only the poor but also relatives and friends. To him, however, genuine giving meant the giving that was directed outside of the family, one area where he and Mom had different opinions. My mom's priority was the family. While generous in giving to his children, my dad's preference had always been to give those in need.

He also cared for all his immediate family, including his sisters, with no ifs, ands, or buts. He treated my aunts as if they had some of the soul of his mother, whom he lost as a child. He respected them and visited them whenever it was feasible. Visiting the relatives, especially his sisters, was integral to him.

Dad was a man of integrity, and this was another manifestation of his faith. He always did what was right and demanded holding oneself and others accountable for what needed to be done. For him, it was about character. You mean what you said, and you said what you meant. You should only tell the truth.

He hated those who lied. He also hated those who refused to take a stand and stick with it or, even worse, those who changed their stance to better suit their interests. It was from Dad that I learned to take a stand and speak truth to power.

—

While we lived in Aleppo most of the year, my dad's heart stayed in our hometown, Rastan. We'd visit each week or two. We also spent the summer there. Whenever we were in Rastan, crowds would come and visit Dad; more frequently, when he was working at the university.

Was there a drop in people's curiosity after he left his administrative positions? Maybe. At times I felt some folks would come only to ask for a favor. Dad would offer his support. One can see this as lending leverage to someone, which bothered me. But I saw that it was also helping others in need and not those of reach or status that benefited in maximizing influence. They were people who needed a job at a factory or a struggling person who got caught in the cogs of the system. My dad would seek to put in a good word or speak to the person who was in a position of authority.

It used to bother me, and it still does, that there existed these civil networks of power that were unrestricted to some but not others. What also used to trouble me was the strategic nature of these social interactions; scratch my back, and I'll scratch yours. The curiosity was not about the person but for his leverage and connections. I was too young to make sense of these interactions, but I felt the lack of authenticity.

Was I even any better? I don't know. My family had many privileges. Dad was respected in town and well-known to generations of graduates. I identified myself as his child, saying, "I am the son of Ahmad Alachkar." I'd often add his job title as leverage. "I am the son of Ahmad Alachkar, the dean of the Faculty of Economics." It seemed like it would take me places. I was little when I did that. But this issue still sits in my conscience.

There was a shortage of bread in my hometown. The store would not have enough, and if you were late, that meant no bread for the day. The quality of the bread was better if you got it directly from the public bakery, where my cousin worked. Mom would send me to get bread. I'd tell the gatekeeper my secret words, and he would let me in.

I leveraged family prerogatives to get access to bread that was not available for needy families or children. It didn't make a difference whether the gatekeeper let me in because he appreciated my dad's status or because my cousin worked there.

To make it even more interesting, the word "dean" in Arabic is the same as "Brigadier General." It is entirely plausible that the gatekeeper barely knew how to read and write, so dean of a school would mean nothing at all to him. Although my dad, as the single male child in his family, spent zero days in the army, a reference to the military was probably what got the gatekeeper's attention. This interpretation doubles the weight on my conscience.

In Syria, and since Ba'ath Party seizure of power in the 1963 coup, corruption was rampant. The policemen would stop a driver arbitrarily and demand a bribe. If you applied for what required a government stamp, the paperwork sat for days and weeks so that individuals would pay an "incentive" for staff to sign off. It was as if the corrupt regime let everyone be venal to establish a network of power and money for its sustenance. Citizens' lives were made miserable, so they had no choice but to take part.

My family strived to alienate ourselves from this system. Maintaining purity was important. For example, I took pride that I never engaged in a corrupt act to attain gain. But when I think of leveraging my dad's status to get bread, I feel troubled. I can think of a few other occasions where the family name might have helped me attain what other folks may not have had access to.

Getting a passport was a lengthy process that could take days or weeks. But with my connections, it was a matter of hours. Also, getting my driver's license was a one-day errand. I passed the test, and I didn't cheat. But my family connections were like having an express pass. I avoided standing in long lines, and I did not have to wade through unnecessary hurdles.

My family connections probably made my life more bearable than countless others back home. I did not live in a lavish sphere, by any means. If anything, my family prerogatives made my life closer to how any person should be living. Without the same privileges, many had to either struggle or resort to other means, such as bribing a corrupt staff.

Did I maintain my "moral purity" because I was connected to the network of power and status? I am not sure. On the other hand, was there a way to disentangle oneself? I am also not certain to whom someone in my position should submit their apology or if they should. How much responsibility should be placed on children who are simply picking up bread for their family?

I may not be able to answer these questions yet.

—

When dad got visitors, my parents pushed me and my brothers to sit in. They nudged us oftentimes to be social, to be present and friendly. So, my brothers and I would sit in the guest room when visitors were there. My dad would do the talking. We did the nodding.

Once in a blue moon, there would be a debate in which we were actual participants. It wasn't clear to me how listening to other men talk would teach me how to talk. The general chatter and shooting the breeze did not interest me. My dad would praise a younger son of his friend's for orating with polite and kind words. In my lingo, I did not have "May God give you health and prosperity, uncle!" "I am grateful for what God granted me of blessings" also felt fake coming from a child. Dad praised the kids as if I should be speaking like that, but I could not. It felt inauthentic.

There was little space left to say what was truly on my mind. Because of that, I and my siblings were more talkative with friends or in the classroom than we were at home. Then there came days in my adolescence when those gatherings interested me less and less. Reading was more amusing, and studying was more relevant.

Dad liked to tell stories. I hoped that he would one day write an autobiography. I would read it, and I trust that others would find it meaningful. I'm especially curious to hear his reconstructions of his father's stories. My grandfather, his dad, died eighteen years before I was born. He came to the Americas in the 1930s and worked hard to sustain life for his family.

Other children would speak about their grandfathers with admiration, or how they'd get mad at their stubbornness. I wish I'd had more of that in my life.

One story my dad and mom used to tell about his dad took place before their wedding. My mom had been engaged to a gentleman who was not kind, and she decided to end their engagement. Because the guy was capable of evil, he announced that he would harm anyone who would try to marry my mom.

My dad knew the risks, but he treasured my mom enough to take them. My grandfather's stance was remarkable. With a tribal frame of reference, he announced, "We would go to war for this young lady, even if all of my tribe would get killed!"

Thanks to the wisdom of the young couple, my mom managed to make it to her new home under the cover of darkness. There was no bloodshed, but the memory of fear and bravery has lasted.
The Nine Children

My parents had their oldest child a year after their wedding. They had the rest of us one to two years apart. There were, however, a couple of breaks in between, which meant the children wound up grouped in four, two, and three. Another way of arranging us was the oldest brother, six sisters, then two young brothers.

My two oldest siblings had already left the house by the time of my earliest awareness. They moved to France for education or after getting married. I still remember how, once or twice a year, we would go to the airport to wait for the whole day in expectation of their precious visitations. Those visits were almost my sole source of new clothes and toys. The rest of my stuff was inherited from other siblings.

More than my parents, my oldest brother set the standard for what was highly rated in the hierarchy of knowledge. Mathematics, logic, and philosophy were way up there. Poetry? Not so much.

My mom delegated home chores and taking care of the younger ones to the girls. My older sisters did most of my caring duties. I was always reminded. I even called a couple of them mothers, at times. The middle two were teenagers when I was a child. Growing up, I was not always the youngest in the house. My nephews and nieces were also there. I became an uncle when I was five.

All my siblings did well in school. Although some made better achievements than others. For example, when I was a young child, Hana, my second-oldest sister, sounded so gifted that it was nearly impossible to surpass her. Her teacher would quiz her in a class filled with older students to show off her talents. She ranked in the top two nationally on the high school exam. In medicine, Hana maintained the top first or second place. She finished her pediatrics training in the UK. After years of practice, she decided to train again as an immunologist. The rest of us knew it was not just the work of genius. Hana was very bright, and she worked hard.

Hana's story is an example of what Mom had appreciated and distilled in us. We all internalized the placement of a high appraisal for education. Mom would share how a teacher of two of her other daughters told her how the two were exceptional. But my mom would say something along the lines of, "All of my kids are exceptional!"

The word exceptional was meant to depict the mental picture of a pupil dressed neatly, working hard, and was polite. The word had a righteous ring to it, and that image was what came to my imagination when I thought of all my eight siblings growing up.

—

Most of my early childhood memories involve the youngest three. We were one and a half to two years apart and were often inseparable. The three of us would play outside with neighborhood children. We had to stay very close to home though and return before dark. Because my sister was with us, we would play outside as young children should, boys and girls all together.

Usually though, neighbors who had girls imposed further rules. Back then, I didn't understand why some of the young girls would stop coming outside, and it would sadden me. They would stop playing with us when they got a little older. Many girls in my hometown did not necessarily drop out of school (some did to stay home or get married). Still, it felt as if they would mature to join the adult world quite quickly.

When I think about it now, it troubles me that the space was open for boys to be out doing their thing, while it was very constricting for girls. Today, I find that to be disturbing.

When I think of the three of us siblings, the young ones, one memory readily comes to mind. It was summer, and my parents took the older kids to the farm to work on whatever seasonal crops were growing. We stayed at home, about six miles from the farm; the oldest was ten or so. We did everything we knew to entertain ourselves, including eating unripe grapes with salt, playing hide and seek, and acting out parts in my sister's imaginary dollhouse.

The family was late returning from the farm. We were worried about them, and someone suggested that we go fetch them, so we locked the house and began walking. We shuffled our sandals along the side of the highway for what felt like hours to our tiny feet. It just so happened that our family was driving back at the same time, and my mom noticed us. "Those are my kids! What are my kids doing on the side of the road?" They crammed us in the car, which was already crowded with my siblings and aunt and a few of her children. It was not unusual to have twelve heads in my dad's car.

I saw the relief on my mom's face. But what I noticed, most distinctly, was a mix of fear and guilt. The reality of finding her children without knowing they were lost and realizing that she could have lost them forever consumed her.

—

One sibling has always had a special place in my life—Mustafa, my brother. We are a little over two years apart, but he is multifold wiser. Mom always treated him as if he were the mature one, and while that was true in comparison to me, it still bothered me.

It also irked me was that he was stronger. Up until our teens, if we had a fight, he won. We had a habit of going to our parents after each meal to show with pride how we'd grown. We would flex our arms, showing off our biceps. Mine got bigger after eating more than my brothers on a few occasions, but other than those rare occurrences, he always won.

Nonetheless, we were very close, and in my mind, we were conjoined. One time, I had just woken up and hurried to the phone to speak to my oldest brother, who was calling from France. When I picked up the phone, my obtunded mind, not able to identify who I was in the medley of my many siblings, announced, "Hi, how are you? I am Mustafa!!" That moment stuck with me, and correcting the slip was something I worked on for years afterward.

We went to different elementary and middle schools, but I followed in his footsteps for high school and college. As we had several of the same teachers, the association of the two of us was profound.

He was, and I still think he is, the brighter one of us in the sense of wit and turn of phrase. He had a head start with language. The family always remembered him singing real songs at a crazy young age, like nine months or something, but I was not there to know.

One way of viewing my life's course was through finding my distinguished path and not living in the shadows of my eight siblings, but especially my brother.

He wrote beautiful poetry because he was always genuine and original. He spoke his mind, and at times, he had gotten into trouble doing it. He is a psychiatrist. While he may not always declare his opinion about others' character, he has maintained engagement in public discourse and kept his empowered voice.

I struggled to detach my narrative from his when I was in high school. And when I started to perform poorly in medicine, I felt as if it was my destiny to have a similar life course to his. I became apprehensive of this prospect, I aspired to move my life on a different path. One unique escape I found was in philosophy.

I'd lock myself in a room and read books that no one else cared for. I differentiated myself. My dad gave me the title of "philosopher of the family," and, thankfully, no one cared to compete with me for it. It took me years to appreciate that a conversation in which we connect was far more meaningful to me than sounding different or sophisticated. Now, my brother and I share quotes we've read and gift favorite books to one another. 
Hometown; The House and The Neighbors

My family came from a smaller town called Rastan. It had a population of about 60,000 when I was younger. Rastan was spread over a hilly area, and that lent itself to the city being divided into an upper town and a lower town. My mom's family was on the lower side of the city and around the lake. My dad's family were on the upper side and closer to the top part of the hill. Still, when my parents built their house, they chose a location far away from their families.

I believe that was intentional, and I imagine now that Mom preferred some distance. She had plans for her kids' upbringing and education that couldn't be fulfilled without strictly regulating outside influences.

In Rastan, we had a two-story house, and there was a relatively large guest room on the first floor that could seat twenty. The kitchen and living room were also on the first floor. The guest room was for Dad's guests and, occasionally, for Mom's if the children fancied to have the living room space for themselves. Some of our visitors would stay for a couple of hours, and some for a lot longer.

Our kitchen was simple. We had a little stove with three burners, two of them were functional. A tiny refrigerator for many years sat at the corner, but we got an upgrade later. My mom did most of the cooking with help from my sisters. Peeling and crushing the garlic was my responsibility.

The living room was a decent size and had a couple of brown-color sofas in addition to the floor seating area. In the winter, we had a heater that worked on diesel. It would get removed in the summer when it is warm outside. We also had a color TV. I don't remember the black and white TV we had before, but I do remember the day when that color TV arrived. We had an antenna but no satellite or cable, so we watched the only two Syrian channels. Television was filled with the regime's propaganda, trivial news about the president, and boring shows.

The bedrooms were on the second floor, connected to the living room by a set of stairs. Countless times in my dreams, I'd jump from the top of the stairs down to the bottom. Those dreams were scary as I'd be jumping down with no control, unlike the more pleasant ones in which I would ride my bicycle and then fly away with no wings. The bedrooms were also decent sized. One was for the eight younger children; my oldest brother had his own, and my parents shared one.

The backyard was enormous, or so I thought when I was little. It was where I dug my holes and where, at times, I was assigned the task of watering our many trees. When I visited years later, as an adult, it seemed as if the yard had shrunk.

Our pomegranate trees were memorable because they were of terrible quality, unlike our neighbors' trees. One anecdote that comes to my mind happened when I was six. I got excited about a pomegranate that was hanging out of the neighbor's property and onto our side. I couldn't resist it. So, I went to the kitchen and grabbed a knife.

I stole the fruit and ate it. While doing it, my heart had raced, but I felt terrible afterward. I was afraid of getting caught, and I felt awful for doing what I wasn't supposed to do. Not bad enough to stop me from plucking the fruit, but bad enough to stop me from enjoying it and thus from stealing again.

I still feel like I owe my neighbors an apology and a pomegranate. One day, I will pay it back. This incident taught me to feel humble and recognize my capacity to do evil. I certainly empathize with the people who do what they are not supposed to do. I empathize, not in the sense that it is ok to do harm to others, but that no one is righteously immune from wickedness.

—

In my hometown, neighbors were kind to each other, but they treasured their family first and foremost. Thus, marriages among close relatives were quite common. If there was someone with quality attributes, their extended family would quickly snatch them up. Those associations made the close closer and created tribalism.

We were surrounded by relatives from two separate branches of the same family. Because they were cousins to each other on both sides, I felt like I was not exactly one of them. We still played together, but I would never be as close to them, not like their cousins were. That's probably where my sense of being an outsider was rooted.

I had a few friends that I still remember very well. We played soccer and rode our bicycles around. We also relished just sitting in the shade doing nothing.

In my childhood, I took certain matters for granted that were not attainable for everyone my age. For instance, I thought all children should pursue education. It disheartened me that some kids dropped out of school to find jobs, help on their farms, or, for the girls, get married.

A next-door neighbor boy, for example, dropped out at the age of fifteen to work in a mechanic's shop. We maintained our friendship, and I would hang out at his shop, but I thought he deserved a better chance for formal schooling. It was the viewpoint I had regarding every young person.

Completing high school was a rarity in the little town, and that is why my mom shielded us. For us, not completing school was unthinkable. I sometimes wonder if Mom took offense when her dad advised her to have me drop out at a young age. She respected her father and acted like she considered it a joke. But she remembered it several years later, which makes me think she was somewhat offended.

There was a fine line that Mom insisted we walk. She would tell us, "You are a friend, and you should be kind to every soul. But your school expectations are not something to question." She also advised us to stay away from the "bad or dirty kids." If you asked me to define "dirty kids," I would have said, those who spent their days on the streets and those who used profanity.

—

Another thing bad people did is commit acts of violence. My mom had reasons to worry about that. My little conscience was troubled by a conflict between brothers who were second cousins to us on my dad's side. They had a dispute over the land they had inherited from their father.

People had witnessed one of the brothers bragging about his plan to kill his brother, but no one had thought they had the heart for such atrocity. Two of them joined forces and shot their third brother dead.

In a culture with hypertrophied masculinity, men boast of foolish things that they prove incapable of doing. You'd hear statements about shooting someone or beating another everywhere. They were often said in the past tense and told in a way that made you wonder if they held any truth. Yet, in that case, these two brothers not only said they were going to kill their brother, they did it. Because that crime was close to home, I realized the tragic fact; we, humans, could slay one another, and with ease.

But did I have the aptness for such an abhorrent deed? My mom would certainly protest, in every way that she could, saying no, her children were different!

A few years after that incident, a fight broke out between my mom's cousins and another family. That family feud left over five dead bodies, and there was a threat of endlessly back and forth revenges. The inciting event was a trivial teenagers' fight.

Because my uncles were known by virtue of their status and proximity to the scene, my mom was fearful they also could get hurt. Thankfully, the conflict was curbed, but it left the city with worry that it could explode again at any time.

Those events were, indeed, rare in the sense that they did not happen every week or even every year. However, the arbitrariness of death, its violent presence, and the fragility of our existence were all palpable in the atmosphere.

Mom did all that she could to keep her family at a distance from violence. But maybe I was only spared by a mere caprice. One of the neighbor's kids was teasing me once. I felt he was bullying me. What started with words became a physical quarrel.

I had purchased a little pocketknife. I thought if I swung it at his face, I would deter him. When I got my knife out, the boy, to my surprise, pulled out his knife too. A year older and a few times more talented in knife-fights, he quickly twisted my arm, and my little knife fell.

His knife was rusty and bigger than my cute and shiny one. With a knife right to my jugular, I learned not to initiate a fight by pulling a knife. I walked home with shame. My brother was kind to not tell our mom about the incident.

I was lucky that the incident did not end with the shed of my blood or his. Our little "trial to death" ended up with me submitting and taking home a lesson that would repeat over and over. I was quite lousy at those trials by death. And I was not an exception when it came to doing dumb things or resorting to violence. But I mostly kept my foolishness in check.
Elementary School

In 1988, no one asked me if I was ready for school, and I did not like my first day. There is no preschool. I was five then, which is the age when most of my siblings also entered first grade. My brother Mustafa, however, began at the age of four, and he was always ahead of his peers.

The first day felt weird. The school was enormous, and the hallways were very long. It was like a void that could emerge and swallow you whole. The crowds of other kids didn't make it less void-like, either; rather, it was like being lost and having to search to find yourself among the students. But I had a kind teacher who made the classroom bearable.

My teacher's name was Rabiaa, which meant youthful. She was an older lady, very kind and warm. She had met my mother on a few occasions, and that made her particularly dear to me. Unlike some of my peers' parents, my mom did not come to my school that often, so the fact that she connected with Rabiaa was quite a rare thing. My mom thought the school would do their job. Furthermore, her children knew what they needed to do to succeed there.

I struggled considerably to fit in with my peers. I was a kid from a village in a city among other children who also had no mercy. One of the issues I grappled with throughout my life, but especially early on, was speaking with an accent. In our villages, we pronounced letters a certain way. I tried to talk like the kids from the city. But a slip of my tongue meant countless days of teasing.

Children were mean. I do not think they were malicious, but my peers and I did not always have the sophistication to be kind or considerate of others.

I also had some groovy memories from that time. Recess was great. We would play around and kick cans. Other than our own, we had no balls to play with, so we would crush a can of coke until it was flat and kick it around. We had a few luxurious days in elementary school when we had real soccer balls. I stood near the goal and gave the ball the final kick in. The "achievement" felt elating, but little did others celebrate with me. We all wanted to have that last touch, and not much emphasis was there for the team effort.

The snacks we were served in school was another thing I remember being delighted with. However, I didn't have them often as I saved my allowance (two Syrian pounds per day) for the small cakes that I would buy on the way home.

I was a student in good standing—I did my homework and got reputable grades. I was particularly efficient. My mom would complain that I would only sit and study for a short time before I got up and went out to play. Still, the outcome was adequate, and I progressed as expected, performing well in a class of sixty students.

It was not always easy to get attention in a class of that size, which was the case from first grade until the twelfth grade. In such a large class, you got attention in one of two ways, either you were the troublemaker receiving the teachers' punishment, or you were the excellent student receiving the praise.

Obviously, I was forbidden to be the "bad student." I was also strongly discouraged from being one of the students who were not noticed. I was left with only one option.

—

Many teachers in public schools have given their best, guiding generations of learners with limited resources in crowded classrooms. Like many students, I owe some of my teachers a lot of gratitude. But beside education, schools also served another role in Syria. They were factories for discipline through regimented practices, punishments, and rewards.

After taking control of Syria in the 1960s, and especially after Hafiz Assad's coup in 1970, The Ba'ath Party redesigned the school system. Time and again, you learned not knowledge but fear.

Every morning, students got into long lines organized by height, the shortest first, before going into classes. We had to stand there and be steady, with no movement, right or left, and with no talking to our friends. During these gatherings, students repeated the regime's slogans. The activity was in the form of a shout from the principal or a high-status student, and then it was echoed back by the rest of us:

Our eternal leader: The president comrade Hafiz Assad.

Our mission: unity, freedom, and socialism.

Our commitment: to push back against imperialism, Zionism, and retrograde and crush their criminal tool, the Islamic Brotherhood.

Be ready to build the United Arab socialist community and defend it: I am always ready.

Besides repeating the slogans, the other purpose of these gatherings was the public punishment of pupils. Certain "high crimes" would mean a kid would receive embarrassing battering in front of the entire school. There was also ample opportunity for the principal to slap this child or hit because they were taking their time to get into the line. School was an exercise in humiliation.

The reward system was quite powerful, as well. Take, for example, the pupil who led the chanting of the slogans. That was usually someone being groomed to be a little "leader." Generally, they had distinguished themselves by performing well academically or by tethering to the network of power or corruption. At some point later, in middle school, I became that person. I had gained my good standing by performing well academically and not causing much trouble. I was disciplined, from the early days.

On a positive note, we had countless examples of resilience. I had a friend in third grade who was the recipient of the teachers' beatings all the time. His name was Saleh, which meant "the righteous soul." Saleh, periodically, did not do his homework. I vaguely remember his stressful home situation. He had a half-brother in the same class.

I felt terrible for him every time he got punished, and I wished there were a way to help him. Saleh had great pride and hated pity. He would say that he painted his skin with oil before class so that the slapping of the wooden ruler on his little hand didn't hurt as much.

I don't remember if I believed him then, and I don't know if it worked. I saw him squirm in pain, and there would often be a few tears in his eyes. But he was a proud young man.

There were also the kids who would not cooperate in repeating the slogans. They'd move their lips without saying anything. At times, they would say nonsensical words just to show their mouths moving. Often though, they laughed at their own silliness, got caught, and received punishment. It was not until high school when I began doing the same. Not participating in the slogans was an option that became available to me, and I wish I had exercised it earlier.

—

Numerous humbling encounters taught me that I did not lack the capacity to do evil. They also taught me that I could change and grow.

There was a child who sought my friendship. He said that his mom and my dad worked together. When I asked him to explain more, he said that his mom worked in environmental services. I went around telling everyone that his mother was a cleaning lady working for my dad. The child was hurt—deeply hurt. After seeing his reaction, it occurred to me that I had done something wrong.

The following day, his mom came to the school and spoke to the teacher, requesting to see me. In a kind and caring voice, she asked me to be her son's friend. Then, she gave me five Syrian pounds and gave the same to her son so that we could buy a juice or a snack. I did savor the fruit juice we drank together.

She had also mentioned it to my dad, and Dad had a talk with me that day. He was caring, but stern, and it was clear that what I'd done was not OK. Having finally learned my lesson, I apologized to my new friend. I don't know if my apology redeemed what I had done to him.

I hope that he was proud of his mother, who had his back. She was a wonderful woman whom I still look up to with admiration—she protected her son from a bully (me!), yet she also showed me care and love. After what I'd done, I didn't deserve either from her.

I still remember when his mom asked to see me. I wondered what kind of harsh words I'd hear that would all be well deserved. Instead, she gave me a hug! My dad was also kind to me and noted that he was also appreciative for the work she did at his office. Both showed me another path of redemption.

Not very far off from this story was another incident that left a mark in my consciousness. In elementary school, we had a scarcity of books, and students would regularly reuse old books that were in decent shape. That year, the new books arrived late, and the teacher handed me an old book that was in decent shape to complete a set of new books that I had also received. Other students similarly got mixes of new and old books.

When the new books arrived for that subject, I felt envious of those who got the new ones. So, I reached out to the teacher and asked if I could get a new one instead. She replied, "No, you have one already!" I argued that it was old, and my preference was to have a whole new set. I asked if she could give my old book to another student and give me their new one. She thought that was absurd, and the initial little no turned into a big NO with an order to go back to my seat, which I did.

These memories are stuck in my mind and will likely be forever. I've told these anecdotes before and found ways toward forgiveness. Yet, they shaped who I became and defined how I view myself. Because of these incidents, I've come to believe that we are all equal. I am not entitled to the good stuff any more than anyone else is.

My academic performance did not make me more worthy of the new schoolbook than anyone else. A claim that I could use it better would be false because the text was the same as in the used book. My desire to have a perfect matched set was not without problems, either. Objects did not have to be shiny, new, and perfect to be effective.

I've grown to a better moral position because I had the chance to make these mistakes. I am grateful to the teacher who taught me a lesson. Had that teacher submitted to my childish desires, I would have missed the opportunity to share this story. I would possibly have missed a chance to question my entitlements—I want it; thus, I should be given it. She was clear with her denial and that was good.

I also wish to have self-compassion when I reflect at this event from afar. I had struggled in elementary school with a feeling of not fitting in. When all that I yearned was to belong, other kids teasing, whether for speaking with an accent or for being a studious child, left me feeling estranged. I did not feel I was a popular child. There were the children who were loud and superior at getting the group's attention.

Bullying a child in front of peers to appear "cool" or having a perfect set of books to "feel perfect" were two manifestations of the same struggle. There was a sense of inadequacy, leaving me with the desire to be exceptional as opposed to weird.

While I may be projecting today's self-understanding onto my past, I can tell I have changed. What has changed quite dramatically was the direction of my punches. I am less keen today to punch the vulnerable. Instead, I direct my rage at the ones with power who are oppressing them. I am less worried about assimilating and more curious about my authenticity.

—

My family spent most of the year in Aleppo and went to Rastan in the summer. Several of my buddies were classmates, especially those who lived in the neighborhood. Besides my classmates, there were the neighbor kids I played soccer with. All my friends in Aleppo were boys.

Boys were rough at times and would pick fights with one another. Mom tried to shelter me, and I avoided quarrels with my friends or strangers. Avoiding quarrels did not mean others would not initiate. I remember a friend's little brother; an unhinged kid who would pick fights with everyone. In today's language, he'd probably be called oppositional defiant.

One day, he was throwing rocks at us, and a large one landed in the middle of my forehead. It hurt, and I bled. He had a mighty arm for a little kid, and he knew just how to throw rocks like projectiles, so they landed with speed and power.

I wonder now why I didn't try to avoid the rock by moving one step to the right or left when I saw it coming straight at my face. Did I think a bad outcome wouldn't happen to me? It was as if I had the innocence to believe that only favorable things should happen and that I deserved the best outcome. Well, the rock knocked that idea out of my head.

I didn't have any friends who were girls throughout my school years. I noticed a few classmates I thought were kind and sweet, but I could not talk to them. I don't blame my family for all my awkwardness. Well, I blame them for some. My natural reaction around girls was to feel shy and self-conscious when confused and not knowing what to do or what to say.

One day when I was probably seven, a cute little girl who was my classmate found me in a bookstore and started chatting about little things. She made suggestions about some prime rulers or erasers that smelled nice or something of that kind.

While my mom and my sister, who accompanied me were nice to the girl, they immediately teased me nonstop. "You like her!" and "She likes you!" I did exactly what little kids do—I denied it fiercely.

I felt a little shame, and I was not telling the truth, exactly. When I think about this incident and similar ones, I wish I were just left alone to do what ordinary children do.

Some of this little shame came back to haunt me when it was apparent that I did like girls. If the adults had then coached me to be kind to others, regardless of their gender, and not make it into a big deal, I would have probably had a smoother transition into adulthood later. But I guess everyone tries with what they have or know, and they do what they can do, so there may be only a little utility to my wish here.

—

The rules were clear for me when it came to playing outside. I had to get home before dark. I rarely broke that rule. Because while there was no physical punishment for me to be worried about, my mom's frown was profoundly penetrating. In addition to not staying out late, another expectation was that I would not go far from home.

I did expand that perimeter slowly as I grew up, but I had reason to not wander far away. I felt fear. We lived in Aleppo about 1000 feet from a highway that I was not allowed to get close to by myself or with friends.

I have an image in my memory of a child hit by a car and killed on that highway. Whether I saw the child or not, I don't recall. In the image, bright red blood stained a little person's back and chest. On a separate occasion, my mom was the one to call the ambulance after someone had been hit. That time it was the body of an older man.

This highway separated two massively dense residential areas. Yet, there was no pedestrian designated crossing area. Being away from home could be very dangerous there.

The other reason for not going too far away was a pervasive feeling that the neighborhood was not safe. At night, the electricity would sometimes go off for hours. There were a couple of times when my sisters were chased and harassed on their way home from college after dark. I felt their fear and internalized my mom's and sisters' worries.

I didn't believe the tales about kidnapped children and was sure they were fictional. But when I had to leave the apartment to go downstairs in the dark, trusting in the fictionality of these stories didn't help.

In Aleppo, we lived in a small three-bedroom apartment. My parents had one room, and the seven siblings split the other two. The line for the bathroom was always long. The apartment was on the third floor. If it was my turn to take out the trash, I would walk down the stairs at a slower pace and run as fast as I could up the stairs. I was afraid of what happened in the dark.

Boundaries were drawn for me. I was supposed to be either in front or back of the apartment so that if my mom went out on the balcony, she would be able to see me. During the day, and especially with my childhood friends, I had desires to go beyond those limits set by my mom.

That slowly expanded, and over time I got to where I could say, "We're going to this little yard down the road," and that was good enough. Riding my bicycle was freeing.

I would flirt with the boundaries of space by getting further and further every time. But there was always a sense that there were limits that I could not go beyond.

I wonder if my desire to get away—far away—like to the United States, and even in the United States, to go to Seattle, where I am the farthest from family, might be traced back to those constraints. The crowded apartment may have something to do with it, too.
Middle School

A peak of my self-efficacy was in the eighth grade. I was cracking the books and doing fine in my schoolwork. I especially liked math, Arabic, and biology. English was okay.

I got a taste of teaching as well. The teachers would, at times, ask their students to prep and lead the delivery of a lesson. The instruction design, not sophisticated in any way, included memorizing the facts and then sharing the highlights. Diagrams and maps were items I used as teaching aids. I did enjoy standing in front of the class to talk about topics, and I felt gratified when working out mathematical problems on the blackboard.

When it came to English, I felt I was satisfactory at grammar and reading but lousy at speaking. I was self-conscious. Some of my peers had private tutoring and were more effective. That made me even more tentative. My parents never believed in after-school programs to develop English proficiency. Learning languages was not a priority at that time.

Still, I always felt I needed to participate in class and felt some discomfort if I had nothing to say. I was not the kind of student who would talk over my peers, but I enjoyed participating. The word for that in Arabic is يشارك, which implies not only taking part but also giving.

With the system that we had instituted at home for studying and doing homework, mastering subjects at my class level was easy. It was an expectation that I did not need to think about much. I went home and did my assignments. I also prepped for the next class. Time for studying was protected, and we did not have other activities at home that would compete with schoolwork. We also had stable home conditions.

I reflect on those conditions today, and I recognize that they were what made it easier for me to engage in something important, my education. Learning became an indispensable part of who I was as a person, and I've carried that outlook with me through today. I put effort toward and valued education.

I would assist other students in their classwork, but I would not cheat or help others cheat. Cheating on exams was something I despised, although it was rampant. My friends knew that well.

I remember one day reading over the exam questions during a test and exclaiming aloud about one issue I thought strange. At my exclamation, a peer whispered the answer. I didn't write it, and I received a reduced score, to the surprise of the teacher and my friends who witnessed the incident. There is no doubt that I could have solved the problem by the end of the exam, so in that sense, the peer who disclosed the answer took away my opportunity to try. I couldn't convince myself that I would have known the answer had I not heard it.

I had a high sense of moral integrity and aspired to maintain it. For me, it was an identity claim. I did not cheat. This meant I did not cheat, and that was that. Had I accepted the answer, then I would not be entitled to that claim. I would then have to say, "I do not cheat, except when I do not know the question and exclaim something about it, and a peer gives me a hint!" This assertion is too lengthy for my little brain to handle. So, it was easier for me to be morally consistent and not cheat—ever. It took less energy, and I maintained my purity.

I was clearly able to afford to be pure from this standpoint. I was doing well academically, and the one or two points of grade lost would not have ruined my reputation. For that, I am grateful.

—

At the time, I might have been a bit underdeveloped and either hadn't yet hit puberty or was just about to. However, some of my precocious classmates were very curious about gender and sex matters.

We had a little library at the school, and I was a frequent visitor. The available books needed attention, though. Not all of them were necessarily appropriate. I was particularly interested in an Egyptian writer. I won't mention his name to avoid giving him recognition he does not deserve. He wrote heavily moralistic tales, and I was obsessed with his work.

The teacher had made it a habit to encourage students to pick up books from the library and share their reading. So, I'd read this author's awful books about the dangers of men and women interacting casually with each other. Then, I would summarize what I'd read and present it to my fellow students.

On one occasion, I shared an extramarital affair story the author attributed to not maintaining a strict separation between genders. He took a deep dive into the gritty details in a graphic manner. As an eighth grader, I, like the author himself, was probably secretly enjoying the story. But we were both able to get a secondary gain of maintaining our higher moral ground. I finished telling the story and was ready to share another of the same kind when the embarrassed teacher said, "I think we can stop here; no need for more."

The students dug the story and were thirsty for more. One of them came to me and said, "You're really naughty! I thought you were innocent! Looks can be deceiving, can't they?" I did think I was innocent then, but who knows. It's not only appearances that can be deceiving to others; our self-understanding sometimes misleads us.

If I look back now, I can admit that I was curious about gender and sexual matters. I wished I had better guidance in that. These issues were not talked about openly in our society. When they were spoken of, it was typically in a distorted way. The first person who asked me if I had hit puberty was a taxi driver when I was fourteen. "Do you have wet dreams? Do you masturbate?" The comment came from out of nowhere, and I didn't know what to say. I stayed silent and could not wait to get out of the car. I wish school had taught me what was going on in my body, how to name it, and how to set boundaries.

—

When you were a good student, you got attention from the teacher, and you got delegated tasks. In schools designed not to primarily teach education but discipline, it could get bewildering quickly.

There was, for example, the task of a class representative. The representative was a student selected by their peers or by a teacher. However, they were chosen not to "represent" their classmates but rather to ensure compliance with the rules. They got the class in order before the teacher came in. If the teacher left the classroom, the representative was to be the watchful eye. At times, that person provided the teacher with a list of names of those who were misbehaving.

With shame, I confess that I had taken on that role and provided names to teachers and principals. Some students, as a result, received corporal punishment.

I hit an even lower point in middle school. I took little administrative roles at the school. I was part of what you could call a student leadership committee. Students had recently been asked to donate money for whatever needs the school had, and a few hundred Syrian pounds were left. We had a meeting with the director to discuss what to do with the leftover money. I had to think on my feet to come up with something creative, and those two things were not my strongest suits then. I suggested buying decorative material and framing the president's photo to hang on the wall. The director shot down the idea, thankfully. I was left with humiliation that I still carry today.

These memories left me with intense shame. I had the capacity to be corrupted. Telling on other kids who were just being kids was appalling. I clearly had the ability to utter inauthentic opinions to amuse someone else. Still, to appeal to no one after being inauthentic is like being swallowed by a black hole. I wish I had picked up how to extricate myself.

Dealing with these memories is agonizing. I wish there were a way to undo some of what was done. I wish I could say sorry to the students who were punished. People in Syria, especially the children, deserved then and still deserve better. It is a shame that we all were entangled in systems of torment and subjugation.

I also wish I could say sorry to myself for being in the places and situations I was in. But as many years passed and because of these specific scenes, I came to accept that I do not need to make stupid remarks just to satisfy the need to speak. I do not need to partake in evil. I can instead just be quiet or leave.

—

The most difficult memory for me to relate here, took place when I was in eighth grade, and that traumatic event haunted me for several years. I was severely beaten by the physical education teacher.

It was a bright day, and I was in a cheery mood. Attending PE sessions while not wearing exercising attire was customary for students. Often, those sessions were for students to roam around in unstructured activities. That specific day, the teacher decided that everyone should get in on the exercise routine he had planned. So, the group of students who had shown up not wearing their sports gear lined up to the side.

The teacher walked around eating sunflower seeds. The form of punishment he chose was to throw a seed down the throat of each student who did not play. Standing in line, a few of my peers opened their mouths and swallowed the seed. But I was afraid it might go down my airway or that I might choke on it, so I refused to open my mouth and said no.

He stubbornly insisted that I open my mouth, and I continued to refuse. He hit me with his hands, and his legs. He smacked my face until I couldn't hear. I felt like the world was spinning. I tried to run, but he gave chase, continuing to kick me in the back and my bottom until, I guess, he got his fix.

I was afraid, humiliated, and broken. I was also in physical pain from the beating and had difficulty walking. My hearing was muffled, and my face was numb.

Two of my friends who had also been in the line came to console me. I don't recall if they had swallowed the seeds themselves, or if their turns had not come up yet. They were very kind, but I failed to say thank you, although their care meant the world to me. I simply could not speak to anyone. I wished the earth had swallowed me up. When I think about it now, I realize those caring hands of my friends were crucial to my healing. I cried in class for the rest of the day and could not make eye contact with anyone.

I went home and cried again upon my arrival. I was barely able to tell my parents what had happened, doing so only by saying a few words in between my deep sighs and my sobs.

My mom was furious. I received no physical punishment at home, and for Mom it was infuriating that someone would hit her child. My dad was calmer. Back then, I thought he was too calm. I was hurt and humiliated and needed someone to protect me. I'd hoped he would express more anger. In the end, both my parents went to the school separately and talked to the principal and the director.

The principal was defensive and put the blame on me for provoking the teacher, but the director was responsive and expressed his support. The PE teacher was gone for a few weeks but then he came back. I avoided him.

I don't recall the exact outcome. What I do recall is how my parents dealt with the situation differently. My mom demanded justice and an apology. To her, there were no ifs, ands, or buts. What had been done to her son was wrong and needed to be undone. My dad's response was a bit different. When he went to the school, he met with the PE teacher as well as the director. He expressed his concerns. Reporting back to us, Dad made the case that the PE teacher was a "poor man in rugged exercising clothes," as if what my perpetrator deserved was sympathy rather than rage. I didn't get it then. I get that better now, as I've developed a language to make sense of the incident.

What happened to me then was part of a systemic practice. The arbitrariness of punishment applied in school in Syria was a stylized routine meant to crush the soul. Everyone needed to be ready to be punished for no reason and in a random fashion.

The self-worth of a person and the integrity of their body were all contingent on the whims of those with power. The system of punishment was not external to the society. That incident occurred in the school, which was supposed to be a safe place. It was perpetrated by a teacher, assumed to be trusted to support my education. Yet, what took place crushed my trust and left me with a sense of worthlessness and of being less than a human.

Part of me wonders what happened to that PE teacher, especially after the Syrian Revolution in 2011. This revolution erupted exactly to restore the dignity of the human being in every one of us. Did he join the Shabeeha? The group of thugs who early in the revolution would dress in civilian clothes, and armed with knives and metal bars attacked protesters. I feel like that role would fit him well. Knowing the strength of his fists and the power of his kicks, he would do a superb job hurting people.

Did he perhaps join the rebels? Countless folks changed their life course. He might have been killed in an airstrike. My dad, the economist, judged that he had little wealth. I could guess that he lived in the parts of Aleppo that were liberated in 2012 and then subdued by the regime a couple years later. It is entirely possible that he was a martyr.

I moved on in my life, and I am lucky to be reflecting on this incident from Seattle. I wish I could speak to him and tell him how he wronged me. He owes me an apology. I want him to know that I forgive him. But, for years it hurt.

—

In the summer, before starting my ninth-grade year (ninth grade was part of middle school in Syria), my parents gathered us all and shared that Dad was considering a job in Jordan. If he had taken the position, dad and mom would move to a city about seven hours from Aleppo.

My mom was worried that in the following year, I would have the middle school final year exam, and my brother would have his high school exam. They gauged our thoughts and whether we would be okay with such a move. It was an onerous decision. My dad was burned out at his job. While he was leaving an impact, it had been a toilsome work. And the pay was minimal. He had reached the highest rank he could as a professor and a dean, yet he only made about $400 a month. The income was barely enough for his large family.

Even then, it was fascinating to us how Jordan, a country with much fewer resources than Syria, were able to pay their academicians incomes that were five times of those in Syria.

We assured them that we would be all right. My parents sought a better life for us, so they moved. But it was quite difficult.

They visited us every two to four weeks, and we missed them dearly in between. We talked on the phone about twice a week. The children would each take a turn so that every one of us could speak to each parent. It was heartwarming, and when the call ended, we would all sigh sadly.

In their absence, to make it less burdensome on them, it was crucial for each of us to perform as if our parents were there. This meant we had to be all right, we did well in school, and we abided by the norms they set for us. We needed to not disappoint them, and our emotions were rarely expressed. We worried about their feelings and did not want them to feel guilty about their choice.

Then my siblings and I managed to negotiate our interpersonal relationships, not always smoothly. But we did what we could. We had written rules, and we edited them periodically.

We settled our conflicts and attempted to adapt our lives to be considerate of others. For example, we enforced the rule of eating dinner together and washing our own dishes afterward. Not using hardcore swear words at home also applied. We allowed some soft dirty words that my mom may not have approved of, but only if they were not directed at one another.

My parents' move to Jordan introduced the family to a more relaxed lifestyle as we became more comfortable financially. My allowances got bigger.

My parents introduced us to fruits we had not seen before and were quite the delicacy, like guavas. They also brought abundance of what we had a craving for, but never got enough of in Syria, like bananas. They also introduced us to what I had not seen before and did not like afterward, like Corn Flakes.

But something was missing; something deeply emotional or even existential. The move was hard for me, especially during final exams. At times, I needed emotional support. What my siblings provided as a substitute for mom's was not enough.

I had many tear-filled moments and countless others when I kept my tears inside. My siblings were around, but they were going to school, too, and the house would be quiet and cold. At times, I would come home, and Mom was not there, nor was anyone else. So, I would do my homework and busy myself with whatever a teenager can busy themselves with.

Mom also missed us too. Dad had his job commitment, so it was not an option for him to just come and hang out with us. But my mom craved spending time with the kids, which meant Dad would be left alone. These feelings were expressed occasionally but suppressed oftentimes.

They visited, but you knew they'd be leaving again soon. We could barely savor the moments because their trip would quickly end just a few days after they had arrived.

Over time, those mixed emotions were turning into more of an annoyance or inconvenience.

The tension between who I was and what I needed to be, as defined by my parents, was getting stronger. And no bananas or guavas would help bridge the gaps.

As the years passed, I almost forgot how to deal with my parents as parents. My oldest five siblings were out by then and the younger ones, including me, had grown more independent, and we did our own things.

Comments about doing this or not doing that seemed more like interference. In addition, I was by then an adolescent and becoming an adult. I had gotten used to doing things in a particular way all the time, so why would I change it just because a parent visited for a couple of days?

Besides, when they were gone, I took their bedroom, and then they'd come and take it back. I tried to keep it tidy, but if you spent twenty-eight days out of the month in your parents' room, it basically became yours. My stuff was everywhere, and the room was a mess. That was only a problem when my parents would visit.

When they came back to live with us in 2002, I was in my third year of college. Negotiating living together again was as painful for me, as it was for them.
High School

When I try to remember high school, my mind quickly goes to the Baccalaureate exam. This national exam was considered the "ultimate test" in someone's life.

The number of nightmares I had about it throughout my adulthood speaks to that perception. Your score determined whether you could enter a college of your choice. If you did not perform well, you could choose to go to a college you do not like, or you could retake the test, sometimes again and again.

I worked hard that year and attempted to study seven to eight hours a day, in addition to going to classes. I stopped watching TV and was either studying or resting so I could study again. I measured my labor by the volume of scrap papers I compiled. It felt as if I had to show the amount of work externally. If I could measure the number of hours at the end of the day, if I could confirm that my pile of papers was getting bigger, then I was doing what I needed to do. And I mostly did that with little external help.

My performance was solid in the end. But I was not the top student in the school, as I had hoped to be. I was more like the fourth. Since the top three students were classmates, I was not even first in my own class. I shared the fourth position with three other students. All the winners were my friends, but not being the best left a sour taste in my mouth.

One of the friends who performed better was kind to me. I pretended I was content and happy for them. Recognizing that our rivalry had been going for years, he remarked that he still considered me an equally intelligent peer. "That's easy for you to say when you are the one who scored higher!" I thought to myself.

Exams had for, a long time, I believed, told of what I could and could not do. My performance summarized my ability. What's more, the exams felt as if they were tests of my moral character. If I wasn't performing well, then others may think I did not work hard. I tried to show my effort by compiling papers and counting hours, but maybe my friends piled more paper scraps. They probably slept less.

Back then, I protected my pride by saying that the private tutoring everyone else had received gave them an edge. I had no coaching. That defense was probably valid to some extent. I belittled private tutoring as only teaching to the test. But I could not deny that my peers also were engaged; it was not all cramming of information. My attempt to belittle their success was vain.

I laugh now as I look back at those memories. After many more important exams and after cancer, I find those little wins trivial. But when I was younger, they meant a lot to me. I was competitive, and it hurt to not get the final recognition I thought I deserved. I am hesitant to say that I wish I had not been so competitive. And I am reluctant to accept that this competitiveness might have harmed me.

I think that rivalry had pushed my friends and me to work harder and to distinguish ourselves. We were growing together, and we were never malicious to one another. We debated, and internally, everyone probably sought to prove that they were the hardest working or even the smartest.

We did not compete for who could do the most wicked thing to other children or who would score best with girls. We exercised our minds in the good stuff: math, physics, biology, and, for some of us, humanities. Certain competitions were settled quickly and peacefully. A close friend was the best in English, another in poetry. I liked philosophy most, but it was not a subject on the final exam for me to show my talents.

When it came to math and physics, everyone needed to put their nose to the grindstone to win the game. Was that bad? Nah. We were just fine. That group of friends I had then were all hardworking, and I still appreciate them, even though they beat me in the high school exam with little or no remorse.

—

My taste in reading evolved in high school. I no longer read moralistic stories. Instead, I fancied philosophy, and I still do today.

I believe it was my oldest brother, who bought the book The Story of Philosophy by Will Durant, which became my companion in my late teens. It was a good read, although it was merely a summary of philosophical works. I used it as guide to find some of the original texts. I read them with varying levels of comprehension.

Plato's Republic provoked my curiosity intensely. With Plato, I had my first exploration of the notion of justice. My curiosity for this concept then may have stemmed from my Syrian context. For Plato, in a just society, citizens would do what they are talented at doing. The state would be governed by the rational. Everything has its right place. It was a beautiful idea, to my 16 years old mind. In Syria, of course, none of that was happening.

Over the years, my conception of justice has evolved beyond what I picked up from Plato. Yet, what I've kept from the Republic is the belief in the authority of the better reason. Thoughts are debated, and the final word is for what is the rational.

Another philosopher that interested me then was Descartes. Reading Descartes was my earliest exploration with critique. It was about the radical doubt and about thinking on my own.

The cogito, "I think; therefore, I am," took on a different meaning for me than what was probably intended by Descartes himself. Known for his Cartesian doubt, Descartes tried to establish ontological proof of existence starting from the position of the subject. He doubted everything, but he thought that because he doubted and was therefore thinking, he could not doubt that he was thinking. And because he was thinking, he argued that he existed.

The cogito is a propositional statement. "I am" is meant in the ontological sense as a true statement. For me, however, it took a normative turn. I interpreted the sentence to mean thinking was the fundamental constituent of who we were. We should think. Otherwise, we would not be. Choosing not to think was synonymous with not existing. That was not necessarily the intention of Descartes's claim, but it suited me well, so I kept it.

I contemplated cosmological matters and had my critical doubts when I was a teen. I knew that I should not take as fact all that was given as such. I took the stance that we should not consider as valid a position just because it was asserted by someone with authority. I had difficulty submitting to authorities and sought to examine ideas on my own.

I could not do the Cartesian doubt, though. It was too nihilistically difficult. I could not genuinely say, yes, I doubted everything. I could not traverse the path Descartes described. I still remembered being troubled by that. "Well, I cannot truly doubt in the same way Descartes doubted, so what is wrong with me?" I asked my oldest brother. I am sure he explained it to me well, but I did not get what he was saying, either. I took his explanation to mean, do it, it is doable, keep trying! I could not do it then.

I had friends to hang out with, but only one or two to share about my philosophical endeavors. Philosophy gave me a community of thoughts when I could not find a community of individuals with whom to dialogue.

I was raised Muslim, and my doubts were creeping in high school. When it came to choose between religious or philosophical frameworks, I went with philosophy.

Ahmad, my best friend, was my go-to guy for debates. He was then religious, and we would debate religion versus philosophy. I cherished our intense debates, and although then he had a radical position, Ahmad was thoughtful in his arguments. He converted into a fierce advocate for secularization, over the years.

It was twenty years after, when I was diagnosed with cancer, however, when I had genuine doubt, and the guide was Hegel. I read about Hegel only haltingly in high school but investigated in-depth years later. He considered Descartes's "doubt" as shillyshallying around with superficial hesitations that quickly dissipated, and a person returned to their starting point. In other words, he considered it a farce.

The real doubt, for Hegel, was existential, one that got a person into a state of despair. One of the ways to despair was by facing death in a life struggle where the individual stakes were everything. I had that, and I experienced a fear that shook me to my core and gave rise to uncertainty about all that I thought was unshakable.

—

I might have matured a little later than my peers, and that left me with some discontentedness with what other kids were doing. The actions of those who were curious about girls did not make sense to me, at first. I was either innocent or hid my curiosity that was accompanied by shame.

I was a shy kid and probably hadn't talked to a girl outside of my extended family since elementary school. The same person who read lurid moralistic novels in middle school now expressed disappointment with high school friends skilled at talking to girls. The door was closed on the subject of girls for me, because in my family, يجهل, which means to follow one's desires and passions, was censured as a terrible thing.

Further, Islamic instructions, to my ears, were filled with statements like, "sex is forbidden outside the marriage," "talking to a woman is HARAM," "masturbating is bad." There was something particularly troubling there. You have an adolescent who was going through changes in their body that they barely understood. They grappled with desires they could not control and urges they did not even have words for. Then, you have the others with moral authority tagging any expression of those desires with condemnation.

As the subjective world of the individual began to flourish, with passions and feelings and intentions to act following those affections, others force their way in to name as wrong or scornful whatever I was thinking or desiring. A teenager drowns in cycles of frustration, masturbation, and guilt—and the cycle repeats. There was no language for my feelings but those of shame, and because it all occurred in my body, there was no one else to blame but myself.

I already had quite a sophisticated rationalizing machine working for me at that time. My mind would find ways to conceal my desires. But, how could I conceal an endless craving with no space to express or sublimate it?

Reading Freud was useful, later, for language regarding libido and repression. Still, even that reading, while available to me in high school, was as if written about some other person. It was not about me therefore it did not apply to me, my mind would say.

I latched onto my image as "innocent," even at the cost of having a rift with close friends. Instead of the group of friends I had for a few years, then I sought a buddy I hoped would be less mature. My buddy was much shorter than me then, and I assumed he must be innocent, too. It turned out when I was in high school that there was no one left with any "purity."

I'd often claim that when I saw a girl, my curiosity was simply for the beauty that "God has given us." I asked him once, "What do you notice first in a girl who comes your way?" He exclaimed, "Her breasts, of course!" I was shocked. I asserted that I only saw her face and did not notice anything else. That was probably not true.

If I could go to the rescue of my younger self, I would say, "Morhaf, you were technically not a big liar!" I was making an identity claim that was quite bewildered and bewildering. I was asserting how I wanted to be and what "I was" in the sense of "I should be." I'd say, "I do" in the sense of "I should be doing" and "I try to do." The normative part of my identity dominated. I had not read Kant then nor mastered his distinction between "ought" and "is." I might have realized inconsistencies, but I overlooked them. I avoided taking notice of a few misses and did not include them in who I identify myself to be.

I did not allow space to explore who I was. I did not have words for my urges or desires. I did not have the language to engage with my subjective world in any meaningful manner. I, as someone who felt, as someone who desired, as someone who wished, found all those aspects reduced in relevance or concealed from my mind. To borrow the notion of colonization from Habermas, the normative world had invaded my subjective world and colonized it. That was the real picture.

Whenever I had an urge, desire, or what I could express with words like, "I have a desire for this girl!" A more powerful voice would come to say, "You ought not have that!" or, "You are a scandalous boy for thinking about it." I would quickly shut down and not act. To an observer, I was a shy kid. But it was literally because I'd just been humiliated by my moralistic and repressive mind.

The language of the superego from Freud could be fruitful here as well, I think. For me, it was an internalized normative position that constituted a gripping conscience. Its tools were the voices of my parents. The scene was like the space of a schoolyard where I would receive humiliation. The audience was, well, my siblings for sure but also countless other people. In the audience were all the kids I had scorned with my high moral stance. Now they had come to not only look at my beating but to call me phony for judging them claiming the higher moral position.

I wish someone were there for me to tell me that I would be ok. I wish I had a space to explore my true feelings and desires.

—

I might have channeled into the classroom some of my repressed emotions and conflicts, whether with my parents being away or my struggle as an adolescent. While working to maintain harmony at home among the siblings, I found a space to be defiant with teachers.

My philosophical readings and my reflections were shaping my positions on topics. I would argue for my opinions and defend them if they were challenged. I picked from grappling with abstract ideas and conversing with universal audience that no power is greater than that of truth or justice. Truth and justice have an authority that is beyond the influence of any person.

In the absence of the parents at home, the authority of teachers became the target. I would argue and argue. But just like my mother, who had nine kids and needed efficient strategies for regulating the chaos, the teachers who had fifty pupils were left with little energy to debate with one stubborn teenager.

No one taught me that I could make my opinion clear without going to war. I did not know how to back off and hear the subtle clues that it was best to suspend the discourse. I would throw my one rock, two rocks, and ten rocks until the other person would make me stop.

My Arabic teacher did not like my rock throwing. So, he punched back where it would hurt me the most, my competitive relationship with my brother. I had gone back and forth on the debate until he was fed up. He had taught my extremely bright brother before.

"What is wrong with you? Your brother was not like that!" the teacher exclaimed, and that burned.

After the class, I followed him and said, "I am Morhaf. I am not my brother; never again compare me to him. We are two different people!"

My teacher was taken aback by my defense. But I was not satisfied with his appeal, which was along the lines of, "You have the potential to be smarter" or something similar. With his statement, he had disarmed me, while kept comparing me to my brother. I think about it now, and I wish I could go back and say, "STOP comparing me to my brother, really STOP!"

My interaction with the math teacher was not much better. He did not teach my brother, so that was a plus. But my back and forth arguments pushed him to the end of his rope, and he blurted out, "Stop arguing; you are rude!"

I defensively stopped participating for the rest of his class and for weeks after that. Did I hold grudges for longer than I should? Probably.

While my action in those two incidents was the same, and the responses of the teachers were also similar, the outcome was very different. I reconciled with the teacher in the first incident, but I kept hurt feelings and annoyance that did not heal after the second. Was the drive a genuine desire to come to an agreement or merely to win the debate?

After several bad debates, I figured out what grown-ups meant when they said, "Let's agree to disagree." That became clear to me especially after my health and energy declined, years later. I've learned to set boundaries primarily to protect myself from exhaustion, but mostly to spend the energy I had left on what mattered the most.

I have further grown to cherish relationships. It was no longer about winning an argument or even about coming to a better truth. I have accepted that I could compromise with less than an ideal truth to save a meaningful connection. We could resume the intercourse later, or may never do so, and that was all right. Most importantly, I'd get the assent to debate from the person or else simply abstain.

Have I reconciled with the fact that someone I respected may think I was rude while I thought of myself as a fine gentleman? I am still working on that.
College

I remember the first moments of walking through the gate onto campus at Aleppo University in September of 2000. My ears were greeted with Vangelis's "Conquest of Paradise" from the movie 1492. It felt good, and it was a special moment. If I were to do it again, I think maybe a song from a different film would be better. Something from the Disney movie Monsters University would have probably been preferable.

I thought I was entering what would be glorious and transformative. The college would be wonderful and open doors to my mysterious, but guaranteed to be bright, future. My journey then was not always glorified. It didn't take me too long to figure that out. In college, I quickly discovered that the promised transformation was a delusion.

I entered the university in the same year Bashar Assad rose to power after his father's death. His message early on was about reform. The regime loosened what had been a very tight control over society for almost 40 years.

I, like many Syrians, were skeptical. At the same time, activists who were motivated to make a real change in the public sphere, took advantage of the regime loosening some grip.

I imagined the horizons of edification would be open, but the year after I joined, they literally put a fence that encircles the whole campus. You would not be able to get in and out without passing through checkpoints. Periodically security would inspect the student's ID right at the gates. You could not but think of this fence as a way to control the university and isolate it from its surroundings.

Not many years later, these fences were efficient to trap protestors inside and to close campus from those who wished to join in from the outside. The regime always had their eye on the university and made sure it was under control. To secure that control, administration buildings took a central location. In these buildings was the office of the university president, and next to it was the office of the Ba'ath Party representative. The party representative was considered to have authority equal to the president, and in some matters, it was higher. The two did not act outside the bounds of what the secret security agencies would dictate. But there was an important distinction.

The party personnel and its active members at the university served as a direct extension to the secret agencies. They would form supportive counter protests and at times would partake in beating student activists. The administration, on the other hand, focused on student affairs and education. Although dismissing activists from the university was a decision signed by administration.

A third layer was the student union, which was supposed to provide a home to all the students and advocate for them. The union had an ambiguous relationship with the Ba'ath party and with the University administration. On the one hand, they were given a voice when it came to administrative matters, like defending a student that cheated on an exam. On the other hand, because the union's leaders were vetted and approved by security agencies, they rotated in the sphere of the Party. It was simply a tool to keep another eye on students and to build tethers of connection to those with power.

Because of the colonization of the space by the regime and its extensions (security agencies, the Ba'ath Party, and the student union) you were watched at every moment. Casual remarks with peers would get quickly reported and transmitted verbatim. Reports would be written by spies you would not know, and you would not think you saw. Secret agents and their eyes wore regular clothes and walked around looking just like all the real students. And, indeed, at times, they were students. The bottom line is that you were watched, and you could trust no one except very close friends.

—

I was disenchanted in college and learning did not come easily to me. In Syria, medicine was a six year program, and not a graduate professional school the way it was in the United States. I matriculated to be a doctor at age seventeen, and that was tough. The subjects felt heavy and dense. Cell biology, botany, zoology, chemistry, biochemistry, pathology, and anatomy were all cumbersome courses from massive fields of science. Each one alone had no real beginning or end. It was never clear to me what I needed to know, and what I should focus on learning.

I was overwhelmed. When the challenge was to sink or swim, I was drowning. My siblings before me had done well or exceptionally well. And they did so seamlessly. I was not sure I knew how to learn. I was in a class of a few hundred and had no advisor or a peer-mentor to go to.

My siblings had previously been medical students, but that did not help me much. When you do well with relative ease, you can sometimes lose empathy for those who are struggling. It also can be harder to reconstruct how you solve problems simply because you have never thought about how you did it; you just did it. Having family members who had succeeded on that path, to me, was counterproductive. Then, I felt I needed to prove that I was good enough on my own, just like them. They came with an added burden.

Teaching methods in Syria which could have benefited from improvement back then, also played a role in my academic struggles. The didactic-based class teaching was lousy, especially in lecture halls that held hundreds of students on top of each other. Furthermore, while laboratory sessions were part of the curriculum, with limited resources, many of them became more comical than educational.

Take, for example, anatomy. In the United States, students got their own cadaver to dissect, or at least they watched the dissection of ones donated afresh. Well, the deltoid muscle we poked at when I was first year was probably the same one my brother's class messed with years earlier. We had plenty of bones, though.

But I should not only push the blame outside myself. In the first few years of medical school, I was not engaged enough. I disconnected and busied myself with other activities that were far more exciting. I cared very little for the content of what I was supposed to memorize.

I lost the ambitious desire to be number one that I'd had in high school. I only tried to avoid floundering. But soon, I failed pathology and had to retake the course. It was humbling, and I think it was good for me. Not that it made it easier to fail again, but it showed me that I needed to do something. That realization was in my third year of med school. But knowing that I couldn't keep on that way did not mean my path would change. It would take a few more traumas for me to begin changing my academic trajectory.

With my struggle, I had little interest in studying and more in anything non-medicine. I coped by requiring to not be defined by grades. I belittled test scores and those who cared for them: these "top students" were annoying, boring, and one-dimensional. I, on the other hand, was cultivating my character and living life. But I do not think I was true to myself then.

I was calling sour grapes what I could not taste. My capacity for rationalizing reached a new peak. Was it a self-deceit? I was not doing well and was struggling with the vanishing of a core component of my identity: being a good student.

When I reflect further now on my privileges, I feel some guilt. I was taking a college space, and early on, I was not giving it my best shot. Being accepted to college felt like entitlement I took for granted. In many ways, more hardworking students in the country did not have that opportunity and probably would have done a better job. This awareness troubles me.

At the same time, I also think that any learner deserves to be granted conditions for their success. This takes resources: excellent teachers, instruction technology, and mentoring. Students in Syria, and I was one of them, deserved more of that and didn't have it. This awareness troubles me just as much.

—

The university had other elements to offer besides grinding away in class. I cherished the intellectual space in lecture halls, book galleries, and the music festivities. However, all were few and far between. I also blossomed in one-on-one conversations with friends.

I sought to find my community and thought the university was the right place to be in a diverse one. True, there were classmates from every village and city in Syria. They also came from outside the country. But, with the scarcity of venues that brought folks to know each other, most students congregated with familiar faces from their region or city of origin. There was a group from Idlib, and one from Aljazeera (northeastern part of Syria). If you came from Homs, you associated with your people. The conservative Muslims from Aleppo had a group, and so did the Christians. I could not fit anywhere.

My parents were from Rastan (a rural town near Homs), but was born and grew up in the city of Aleppo. I was never considered from Aleppo since my parents weren't native. I did not have an Aleppo distinct accent, and I stood out.

As I did not fit into one group, I'd easily connect with outsiders. Those were the ones from a wide variety of backgrounds, often not from Aleppo, who themselves were only loosely connected to their "tribes." I had Syrian friends from almost every city. I also was curious about my Mauritanian, Yemeni, and Iranian classmates.

Those friendships with eclectic individuals did not develop into one cohesive group. They were based on values and interests shared between the other person and me, but not with everyone.

Most groups in college were separated by gender as well. Even on college trips, there would be one bus for boys and one for girls. I saw how groups of sexually frustrated individuals (like I was in high school) did not treat the other as a human but instead objectified them into things.

The misogynistic jokes and songs were troubling to me. Then the two groups would come into closer proximity to occupy the same space but have minimal interaction. The public had little space for a healthy relationship between a man and a woman. Of course, sex without marriage was Haram, yet, all the fantasies and dreams were about sex. I felt the hypocrisy was intolerable, and I could not fit.

—

My heart was filled with passion in college. There was something in me longing for connectedness and for someone to love. I probably "fell in love" too often, usually with one person at a time. Occasionally, my heart could not settle and decide its target.

One could think it was the spring or the hot summer, and those beautiful Syrian women passing by to turn on the fire in my blood. I probably called what I had "love," while it was a mixture of feelings and sensations. It was not all sensual, though; I had a curiosity about the mind just as well.

There was a desire to feel safe with someone who knew me as who I was. I also reveled in the feelings, especially to be consumed with a lover who occupied all mind and senses.

Romantic relationships were hard but not impossible for college students like me in conservative Aleppo. Lovers in Aleppo were quite creative and found ways to share moments of joy. If you were from out of town and renting an apartment, then you got your safe space. Without a space of your own, your friends could lend you a key.

The parks were also open for sweethearts to love one another. There were coffee shops as well. Lovers were creative in finding ways to get behind the walls. The burqa served as a cover for the young man sneaking in to meet his lover in the dorm. A big coat and a cap did the job for the young lady to return the visit. There were also historical sites.

Aleppo Citadel was a beautiful place for lovers to meet. Not only could you see the entire city from so high up that no one saw you, but you knew there was a history of love in every corner of this ancient building. When you were up there in the citadel, love was superior to all judgments.

There was one lover in my life that I will not forget. I was nineteen, and she was two years older. She had beautiful black straight hair and black eyes. Her scent gave me butterflies. When she laughed, my heart would race. She was full of joy and wild dreams. We'd read poetry and listened to music. I also played music for her. I would then play the same tunes again and again when I was alone and thinking about her.

We met at the peak of my activism. The passions we had were mixed with dreams, hopes, and fears. I remember one day the secret police had occupied campus to prevent protesting. I was scared, but she felt safe.

We would steal our visitations. That was all groovy until one day, her dad came into the house, and I thought, Today, I am gonna get killed!

She managed to distract him in the kitchen while I ran into the street and escaped. I was looking over my shoulder, certain he was going to come after me.

After that, I felt maybe love was too dangerous. Meeting in public places was not necessarily easier. If we went on a date, my mom would hear about us before I got home. I had no idea how she would know, but it felt like there were eyes everywhere. She disapproved of the relationship because I needed to focus on my education, and in our family, dating was not ok. My dad was open to the idea of me getting married, but I was too young and had no job.

When push came to shove and they squeezed me financially, I thought I could not continue, and we broke. Deep inside, I felt I was betraying the dearest thing I had in my life.

—

My activism in college began immediately in first year. I, my brother, and a few of his friends would have gatherings to discuss relevant issues like religion, modernity, freedoms, women's rights, and others.

I was not the main organizer, but I joined in most of the meetings. I contributed thoughts. Organizing was not my thing then, and it still isn't. But I appreciated having a space to speak and felt I had something to offer.

One of our activist friends was involved a youth scouts' organization. They let us have our gatherings at their location for a while. But they kicked us out when our group grew larger in size.

When we lost our meeting venue, we sought to move our gatherings to campus, so we could have a larger audience and impact. The way to do that was to become active in the student union.

We tried to occupy elected positions to have leverage. Hence, a few of us ran for leadership positions in the organization. We believed the union belonged in essence to the students and we should take advantage of the structure that is in place. We could then, from within, develop spaces to bring groups of students together around issues that mattered.

Our eclectic group developed an election platform with over ten items, some related to keeping campus clean and others about extracurricular activities. We had an agenda while other individuals ran for election supported by the groups that shared their areas of origin. There were groups from Idlib and surrounding rural towns, and there were those from Aljazeera. Folks from Aleppo could not have cared less about the union. Hence, it was left to people from rural areas.

We called ourselves, صرخة ثاتر, or the Cry of The Revolutionary! We got the name from a song by Marcel Khalife that says, "Here is my voice coming from the farmlands, from the mountains where kind plebeians live, and from my people's suffering. My heart left behind its nostalgia and came as a slap on the face of every slumbering conscience. I brought in all of what was in my soul and come to you as the Cry of The Revolutionary."

It was our anthem that we sang at every protest. We also had a logo that symbolized our resistance. We put that logo on our posters and flyers. We were a group of young men and women, mostly physicians, but we expanded to include peers from law school, humanities, and engineering.

We aimed to open spaces for the community to come together and fill in a gap that was intentionally left by the regime. The regime's preference was to push the public into pre-civil associations by creating structures of oppression to overlay academia and infiltrating campus with spies. The design was to shut off and kill groups and communities that worked toward forming civil relationships. The citizen was then to face the state/regime alone or within their family and tribal network.

We competed in the elections every year until a few members of our group won. A friend became president of the medical school union chapter, and that gave us significant leverage. We oversaw the whiteboard that served as a newsletter and was updated monthly. We would post articles about matters of social and political significance regarding events taking place on campus or in the region, such as in Iraq and Palestine.

That was the year when the Palestinian Intifada erupted. As a group, we led a few demonstrations on campus and took to the city streets. We viewed as a matter of justice what was happening in Palestine. The oppression was one and the same, whether the perpetrator was a dictatorship or an apartheid regime. Further, the injustices experienced in Palestine were a byproduct of the Arab dictatorships that suppressed people and prevented their potentials. We would also demand reform in Syria around the constitution, freedom of press, and right to form political parties.

We would speak about these topics whenever we had a space to rally students or an audience to listen. At a protest, we would have the same thirty or so core people, and at times, we managed to have over a few hundred protestors. We'd also "disrupt" public lectures by asking questions left unasked regarding political reform in Syria.

During the union's annual meetings, individuals from our group gave speeches at chapters in schools of medicine, engineering, law, and economics. We all delivered the same message, at the same time, with a voice that became more empowered year after year.

We would test the waters by speaking about generalities, let's say, "political and economic reform." When the response was not harsh, we went into specifics, such as removing the state of emergency imposed since the 1960s and releasing all political prisoners.

—

As our message became more focused and our capacity to bring crowds to the street increased, the stakes were getting high.

The pressure on us mounted, and it was felt by our families; mine was not exempted. In my case, dad would receive weekly phone calls and in-person remarks from officials on campus to "deter his kids". And the threat quickly became real.

One day two friends of mine and I were interrogated by the secret police. That was my third visit to a security agency. All of us were in our early to mid-twenties, two medical students, and one resident physician.

Because we declined to sign an attestation that we would not organize any future protests, we were taken to the underground jail and ordered to stand still with our faces to the wall. When a friend moved slightly to shake his weight off his legs, the agent yelled at him, "Stop moving right and left like a prostitute!"

My friend did not take that well and replied, "Do not talk to me like that!" That one statement was enough to make three or five men jump from out of nowhere and beat him with their arms and legs.

That day, I signed the paper and left for the fresh air outside. I felt I was born again, while my friend was kept for a few more days. Still, I was filled with survivor's guilt and the shame of compromise. My friend, fortunately, left jail a few days later. He did not sign.

The pressure was not only directed at me but also at my father and at my siblings. At that time, everyone else in the family made it clear that "We did not sign up for this; you could not put us all at risk!"

They did not disagree with my motivation, but the risk was undeniable. Everyone had memories of tens of thousands disappearing or dying in prisons in the 1980s. Cities, like Hama and Aleppo, were turned into ruins. The regime was known for its unpredictability.

I wanted to make my own decisions about my activism and spare my family. So, I made a vain attempt to leave the house permanently. I didn't have the means. Since limiting my access to allowances had been my parents' primary strategy to make me stop my activism, I thought I should become independent and find a job. But I had no skills. I was only a student, and no one would hire someone who was only a student.

I finally found a commission-based job. I'd go around to shops and small businesses soliciting their advertisements for a website that had, literally, no content and no visitors. It was pure spam. I went from store to store, and in a country where the internet was a couple of years old, and half the shops' owners didn't even have computers, some were like, "What is that?" I made zero money and discovered my uselessness. My attempts to be financially independent were vain.

I had no choice but to comply with my parents' demands. So, I stopped going to the group meetings and stopped participating in all political activities. Deep inside, I felt my decision to comply was morally wrong.

In one of my recurrent nightmares just recently, my parents cut off my allowance. I argued, "But you can't do that! How am I going to buy coffee and hang out with friends?" In the dream, there answer would be, "Well, you don't need to do that!"

Obviously, I was not entitled to their financial support. There was food at home that they hadn't cut me off from. They banned me from using family cars, but I could walk to school and back. It did hurt, deep inside. I felt I was coerced into giving up the core parts of who I was as a person: first the love of my life, then my commitments, and even my friends.

What made the situation way worse was that soon after, what my family was afraid of happening to me, did happen to my friends. Now the, "See, we told you! We saved you" refrain became the music of the house.

The activist group, without me, had moved their action to a new battlefront. This time, they had succeeded in organizing a major protest about a matter that was imperative to people's daily lives—their jobs.

The regime had announced that they would no longer commit to providing jobs for graduating engineers. That was a serious social matter with hundreds if not thousands impacted.

The group did a phenomenal job of orchestrating the protest with other activists and affected students. Hundreds of people were at the sit down. But that didn't fly well with the regime. Protesting about a purely domestic matter was a red line.

The university administration cracked down on the protesters suspending twenty-four of them, including some of my closest friends. Later, secret services raided a meeting some of my friends were having and took five of them to prison. Three were let go thirteen days later, but two of them wound up spending a full year locked in prison.

There had been back-to-back events that were the most tormenting experiences of my life. I was drowning with the overlying struggles: the breakup, giving up activism, leaving friends behind, watching from afar the crackdown on students who were just standing up for their rights, and living in near social isolation.

Emotionally, I was resentful of my parents, and I was feeling the guilt of a survivor, along with relief that I was not in prison or suspended.

Then, in the middle of everything, my mother died in a car accident.

My turmoil surged to a level it had never gotten to before. Her death overwhelmed my mind and senses, and I was sucked into a dark space that swallowed me for years after.

—

It was then June 2004. My family went out for a picnic trip—my parents, brother, sister, brother-in-law, and nephew. I did not go with them because I had to study for an upcoming final exam.

While everyone got to the car and were waiting for my mom, she and I saw each other for the last time. I told her to enjoy their trip. She said, "We won't enjoy it as much without you!" then she said goodbye, and so did I.

The house became empty. Two hours later, I received a phone call from my brother-in-law, asking me to drive the other family car to meet them at a local hospital. He said they had gotten into a car accident.

When I arrived at the hospital, I saw my brother first. He announced that my mom had died instantly. My dad was in critical condition, and my sister was injured but would be alright. My nephew and my brother-in-law had also gotten hurt, but not critically, and my brother had fractured his arm.

What we faced was incomprehensible and indescribable. My mother's death left me with a loss that is so immense. Something broke inside me that day fifteen years ago, and it has yet to heal.

My mom always said, "I prefer a quick death; an immediate falling to the grave!" and she was granted just that. My reaction to her loss was not as stoic as hers was to the deaths of her parents. I fell apart and cried inconsolably. I let my rage out by kicking the walls. I broke the glass top of a dresser in my parents' bedroom with my hands during my meltdown.

Sitting in the passenger seat next to my uncle, following the coffin on the way from Aleppo to Rastan, I was in dismay. I had just gone to see her dead body. Yes, this is my mom. But no, this is not her. This cold body can't be her.

The fragility of our existence was suddenly exposed, and it felt as raw and painful as it could be. Someone so vital in my life had left, just like that. It is arbitrary, as well. The course of the matter might have changed, had they left one minute earlier or later.

Had we not said the few words by the door, or had we spoken for a bit longer, could that have changed the outcome? What if I were with them? Questions like these intruded all the time, and I put them to the side as irrational. I keep her memory, though, as she lives on within me.

My mom was gone, and while I grieved her, her image was still there, trapped with no reconciliation along with all those memories. My lover, whom I'd reached out to, some years ago, shared with me about the amount of agony she had endured after our breakup. The friend who spent a year in prison, a few years later, was abducted again by the regime. He has not been released to this day, and we don't even know if he is alive or dead. The distance that grew between me and my friends was like a chasm that would not close. But my immediate response back after my mom's death was to look ahead and get on the path to move to the United States.

My mom comes to my dreams every few weeks. She is there in a space where we shared memories of our hometown, Rastan. Everything is perfect, and she announces that what happened was some sort of mistake and all is fine now. I feel her closeness and the warmth of her arms. She says that she will be here forever. Then, suddenly she is gone again, and I feel her hollow loss. Her absence comes like a void into which my heart sinks. Then I scream and cry in my sleep. I often wake up with tears on the pillows.

—

Even now, after all the years, I can barely disentangle the losses, guilt, and grief. I cannot think of my college years without an immense heaviness on my chest and clouds wrapping around my mind.

I am inclined to unravel what took place. But I am apprehensive to attempt to do so as I have tried countless times in vain. It's as if I'm climbing out of a deep hole or an old well. Whenever I come close enough to see the light, I fall back in. I fall, the well closes off, and I suffocate.

I know that if I process my tragedies, I'll be in a better place mentally and emotionally. At the same time, part of myself prevents me from healing precisely because I would be in a better place if I did. I would be in a better place while my mom is dead, my friend is in prison or dead, and the pain I caused to my lover is unforgivable. To move on would be another betrayal.

In Syria, the kingdom of fear, we had rampant corruption and a brutal dictatorship. My friends and I thought that to make a difference, the society needed to speak up. It was clear that there was risk if you poked the bear, but we thought we could move slowly and work toward gaining momentum. It was the right thing to do, and there was a call of duty.

My parents, on the other hand, while recognizing the corruption and the need for change, knew the regime better. They were around when Hama's and Aleppo's massacres occurred in the 1980s. They also saw prisoners released after, in some cases, over fifteen years in prison, only to die outside shortly thereafter.

The regime was merciless, and my parents believed that nothing changed. Talk about reform was a pure lie. The regime consisted of the same bloody group of criminals that had controlled Syria for decades. My parents had reason to worry, especially when the threat felt real. I was interrogated and they received threats. If you got taken by a security agency, there was no guarantee that you'd come out the same day or even after a year, if ever.

My love life, I believed, was my own affair. No one should have told me whom I could love or not love or whom I could date and how. Because of their cultural backgrounds, however, my parents thought their son was doing something they would not allow in their household. While the rules were lax with boys in our society, my parents, who'd had six girls, needed to be consistent. We were living in Syria, where there was little mercy for those who chose to act outside of the social expectations. "Social reform" was not my parents' battle, and Mom and Dad were both content with norms the way they were. They were entitled to their social positions.

I was entitled to my view, but I had little means to make it actual since I was living under their roofs. I made the compromise after negotiating the boundaries to their limits.

My friends felt they were making a sacrifice and I was not. They also had parents who were worried and fearful. They'd maintain that if everyone were afraid for their own well-being and that of their children, the situation in the country would never change. My friends took an admirable stance, and yes, they made sacrifices that, for some, meant years of being out of college or in prison. I didn't make that choice.

—

If I were to use the language I've developed over the years but did not have available to me back then, I would explain my position as follows.

Yes, I could have stood up for what I believed in, but I would do so only if I could stand up. In many instances, I didn't want my bones crushed or my legs broken. What I did was consistent with a position that said you needed to be able to be there to take a stance. If you died, you were making a stance once, but no more.

I knew that this position was morally ambiguous. It was the definition of compromise. When it came to core values, this position became even harder to grapple with. No one aspired to set their moral stance with a conditional "if." I would do the right things if I could, or put more explicitly, I only did what was right if the conditions were right. And likewise, I could accept not doing what was right or even doing what was wrong if I must. This position was challenging for someone who required their narrative to be consistent and true to their actual beliefs.

But if I think about this more, what I have just said is precisely true, right, and authentic. To put this more explicitly, some circumstances need to be provided for the person to act morally. Further, it is not right to demand that a human acts morally if the conditions for doing so were not given. An example of conditions necessary for acting morally is the absence of consequences that threaten the person's well-being or the well-being of their loved ones. Finally, I have a say in deciding what is considered right and ethical and even what I view as a constraint. I make the commitment to the values I choose, and I judge for myself whether the conditions for acting morally are provided or not.

I should not be pulled or pushed to do what is defined for me as right. I assent to what is right, and I decide when to abstain from pursuing what is right if I find the cost too high to pay. Of course, I do not do this moral judgment and appraisal of conditions alone; I would do it with a rational other, whether implicit or actual. This other can verify whether I am being genuinely authentic or only deceiving myself and others.

If I accepted this framework for myself and everyone else, I would disentangle my parents from the burden. They simply believed that the demand I was imposing on them to do right or to let me do right was beyond their capacity to tolerate. That is understandable, and I therefore have no real reason to be mad at them.

Similarly, I also think that my friends were not supposed to call me a coward. I set the limits I could afford to cross or not cross, and I decided when to stop. For the record, they did not call me a coward, at least not to my face. Instead, I internalized a perception that what I did was cowardly.

In terms of my relationship with my lover, you know, lovers fall in love, and they can break up. Relationships are quite complex. Any person can leave a relationship, even for no reason. I do not owe anyone anything for ending the relationship.

The fact that we hurt when someone breaks up with us absolutely sucks. I am sorry for the pain, and it hurts me to see the pain of the other person. I wish there were a way to undo that suffering. I do not think, however, that the breakup was in error. It was just someone's choice. Even though I was squeezed, it was still my choice. I made my decision and accepted the compromise to maintain my entitlements at home. I had the option to leave, but I did not. I chose my family and decided to stay on a more secure path to my future.

No, I did not say that it was an exciting and wholeheartedly amazing choice, but when in life do we ever make decisions that are that black or white? I own my decision.

—

My mom was caught in the memory in the middle of all my bewilderment. She did what she thought she should do to protect me, and she did that well. Yes, she called me names and frowned in my face. She banned me from driving the car and cut my allowance. But she pressured me in that sense to protect me, her son. If I had a son or daughter, I might do the same exact thing.

Her last words to me were, "We will not have joy without you." I have no doubt that she loved me. She did what she could, and she gave it her best. Did she not make mistakes? I am sure she did. Did she always choose the right words? With me, she was again and again at a loss for words. She would look for help from my dad and from my siblings, and all was in vain.

One day, one of my sisters said, "You killed Mom!" The whole family had known how much suffering and fear Mom lived in. I knew it, too. I would see her when I came in late at night, whether after escapades or because of my political activism. She had the same fear I noticed on her face when she saw us walking on the side of the highway. But this time, her fear was mixed with despair.

We could not communicate well. They had moved to Jordan years earlier, and they only returned when I was in the second year of college. I had become a person with my own stubborn thoughts and positions on life matters. Several of my beliefs were radically critical of not just this and that but of almost everything political, social, religious, and social. Family dynamics were not excluded.

I didn't have sophistication in language to disentangle the complexity of the situation. There were walls between us, and we could not understand one another. But I did not kill Mom. Yes, it weighed on my chest that I had resentment right up to the time she died. We had argued until the morning of that day. I had been on the internet for a "long time" while I was "supposed to be studying for exams."

I know what constitutes killing someone. To be part of what can lead to a person's death would be devastating to me. I am a physician, and my utmost priority is maintaining life and take that as my moral duty. I also know what constitutes a person's responsibility for the death of another person, and I do what I humanly can to not contribute to someone dying. Nonetheless, I am constricted in reconciling with Mom's death by where I was in relation to it. My resentment before that day has only made this a more challenging task.

Maybe I will begin exactly from where it is the hardest, my resentments. I acknowledge my resentments for mom as we disagreed on so many subjects. But in what every one of us did, there was still unconditional love for the other.

I fully meant it when I wished them an enjoyable time on the picnic. She meant it when she said with care that my absence would be noticed. I saw her joy when I'd spend more time at home, and she would express it herself. "There is nothing like seeing you around!" was something she would say to me. She had that same joy when any of us, her kids, were by her side.

Yes, we had our disagreements, but we had the love that brought us together, and that stayed always hovering in the background. She took the positions she did because of love. I made my decisions in the end also because of love. That's true, even though we did not name it.

I loved my mom dearly. I've realized how much I missed her in the past few years. As I grappled with my cancer diagnosis, I've wondered what she would feel if she were alive to see me suffering.

It has occurred to me that if she were here, she'd feel an unimaginable pain seeing her child suffer. Maybe she was spared this pain. But then I'd remember her life story and how strong she had always been. How dare I think she would not have become resilient enough to endure even the devastating loss of one of her children? I trust she would have been a shining example for other women.

Still, she had prayed that she would never be a burden on anyone. She stated that she preferred a quick death. Is it not possible that she was afraid that as time went on, she could see a child of hers die? Maybe. This idea makes me think of her more as a real human, and I like that.

I know I have not processed my mom's loss sufficiently. The dreams come more urgently to remind me of her presence but also to point me toward myself. I am curious about the dreams. I won't lie; at times, I go to sleep just so I can have them.

But my mom lives on, not only in my dreams but also in my thoughts when I am awake. I remember her, and I bring her memory into my life. My hands remind me of her distinguished ones; her long fingers were just like mine. Nothing was like my mother's warm touch.

The image that comes to mind is of me as a little child holding her fingers with my whole tiny hand while crossing a street. Her arms were always caring and loving when she pulled me closer and hugged me. Her hugs brought infinity to time.

Even when Dad and Mom chose to go to Jordan for Dad's work, when I was a teen. Of their visits, it was the hugs I remember most. Their visits to us started and ended with hugs. They were eternally good.

My mom cared for the nine of us and my dad. She did her duty well. There is no payback, and I do not know how I could say thank you now.

One thing that I can and should do is pass forward the love and care she gave me unconditionally. I will share with others and participate with care as much as I can. Reconstructing my suffering after her loss and writing about it is one way I choose to give forward.

—

As I explore my most painful memories, I realize that my struggle was small compared to countless Syrians over the past fifty years. My pain does not correspond to that of the ones who don't know if their loved ones are alive or dead.

Did I turn my head away from all the suffering to escape? I probably did.

Not unlike many folks with intellectual curiosity who couldn't do much about their reality, I took a culturalist turn. I buried myself in a world of thoughts and found space for writing in online forums.

I would share my ideas to advocate a secular view of the world, something the regime was not necessarily against. I did, however, genuinely feel constrained by society and its strict views, so my expressions were justified.

Reading continued to be my way to keep my mind busy. I read more philosophy. I gleaned frameworks for understanding that were liberating and open. On the other hand, religion was, to me, a closed system. As I perceived it, you were either in for the whole thing, or you were out. The social interpretations that put religion in action were also too narrow or foreclosed.

I was troubled by how religion sets an aprioristic judgment of how social conduct should be. Instead, I thought everyone must have a voice in how they live their lives and what they wish to do with their bodies and with their souls. People are free to believe in God or not. Individuals should be free to exercise their personal liberties. They are free to pursue what they desire with their bodies and their souls.

Instead, religion was presented to me as something that you take in and practice as rituals. You had a space for direct subjective interactions with the supreme being. The form and the content of these interactions were all set a priori. It was left then for the person only to follow instructions to encounter connectedness with the absolute and live a good life. The hope was that they would be resurrected in an afterlife and be saved.

While I appreciated the meanings condensed in the text and its history, I was not satisfied. I longed for a space to ask questions openly and take the given answers as mere attempts to be refined and, if necessary, altered altogether. I was determined to discover for myself and to inquire. I never was the one to perceive edification in the sense of opening my head as a vessel for an already constructed "knowledge." I had to experience knowing, or at least partake in constructing our understanding of truth.

One school of philosophy interested me in college: existentialism. Camus was particularly important to me. His book, The Stranger, was one of my favorites. A Frenchman in Algeria who, for some arbitrary reason, kills another man. The man's mother dies on that same day, and he deals with her death with the same numbness he felt while killing a human.

Waiting to receive the death sentence, the man held on stubbornly to his atheist stance and rejected acknowledgment from the priest offering atonement. At that time, I was a Muslim, and I reflected on my faith and its certainty taking on the perspective of a person facing death.

My faith, I discovered, was faltering. I lost my certainty. I did not have an elaborate schema to realize that the existence or nonexistence of a supreme being was not to be examined in the same structure as we perceived material objects. But that was precisely how religious beliefs were proposed. They were claims about an objectified being, or transcendent, in the Kantian sense.

I could not accept a blind belief that was not convincing to me, so I said no and stopped practicing, one day, in the middle of a prayer.

Similarly, Sartre was crucial to me, and with his language, I marked years of existential crises on the cognitive–emotional level. I was doing fine physically, and while I might have suffered from a degree of depression, it was not a clinical diagnosis. But I had profound, deep-seated feelings with no words to describe. Sartre and his existentialist friends gave me a language that I still don't know whether I've yet succeeded to rescue myself from.

Expressions like existential crisis, boredom, numbness, and nausea were used generously in my reflective writing in a problematic way. Here was an entitled middle-class brat complaining day in and day out about being existentially troubled. I had limited terminology to name my loneliness and little sophistication to detail my desire to belong.

I wish that I had used statements like, "I did not have a community," "I feel lonely," or "I am not fulfilled at school." Instead, I was going about my existential crises, being tired of this life, and getting fed up with living.

Had I been without food or shelter or had I been hungry or cold in the winter, such existential fancies would likely not have come. Had I been similarly concerned for others' well-being, especially those who were struggling, I would likely have been spared these existential whims.

But on the other hand, if I had empathy with myself then, suffering from issues related to higher needs was also valid. I needed community and purpose. I simply did not have language to understand myself and others.

Philosophy and thinking in the abstract helped me cope but also distracted me from seeing reality as it was then in my here and now. The enticing big words and phrases came to distort my vision and blinded me from seeing the simple existence as such.

I was not alone, however. I had several friends back home who were, like me in those existential moments, alienated and disengaged, nauseated, and bored.

—

Besides the books, in college, I also found a refuge in music. I had wanted to play music to express myself, even before my world crumbled. I picked up the Oud when I was eighteen.

An oud is an instrument of the lute family. It's made of wood and has six strings, just like a guitar, but more pear-shaped. My brother-in-law taught me how to play. He lent me his instrument and showed me the scales. I remember the first time I played the musical notes, do, re, mi, fa, and he cheered for me, which made me feel good. It was hard at first to coordinate between the two hands. But I got better with practice.

My mom and dad were supportive and would encourage me to play. But my oldest brother, who was more focused on the production of music said, "Why would you spend hours and hours training if you can get a software that plays any music you feed it?" I didn't know how to respond. I kept doing what I was doing.

I never became professional at playing the instrument, but I did enjoy it, especially when I had bursts of feelings, like if I was in love with someone. The oud became one way to express love. I also used it when I felt sad, which was often. Oud was associated so much with nostalgia and heartache that I thought it didn't play anything but melancholic tunes. That is not the case. Musical instruments play what you play on it.

—

After my mom's funeral, my siblings went back to their own lives. Those who were in the United States and Europe returned. Dad moved to Damascus and lived near my oldest brother.

What I had begun contemplating before my mom's death then became an urgency. I needed to leave Syria for the time being. With the losses I'd had and my isolation, it was urgent that I find another horizon.

In the middle of my struggles, I dug up a choice that was more familiar to me, being a good student. I turned more of my attention to school. My last two years studying medicine were very different from the first four.

I did not think I had clarity for my long-term plan. After all, I was twenty-one for planning my next move. If you had asked me then, I might have said something as broad as I'd like to go to a Western country to pursue a postgraduate study.

I had the option of going to Europe or to the United States. I had established siblings who could support me in both places. They had all left Syria on their own and integrated themselves in other countries. I thought The United States was a better fit for me. I believed that once you were established there, the path to progress was unlimited. Furthermore, The United States was further away.

I began to study more. The books I read elaborated on topics in a more clinically relevant way. Learning began to make sense. We reviewed this or that basic science because it related to this or that clinical topic. Aha! It clicked.

I was a bit older now. There was something strange about a seventeen-year-old child in a cadaver lab. Was I emotionally mature enough to deal with death? Was I cognitively developed enough to comprehend it? I was probably more ready in my early twenties than in my late teens.

I was studying in English. Reviewing materials in a language foreign to me meant I was spending more time on the subject. Arabic was my primary language, so to learn in English, I had to put in way more effort.

After learning in English, I appreciated the material more even when presented in Arabic. As I began to converse about medicine, I enjoyed what I was studying even more. My sense of mastery was developing, and I felt fulfilled.

Maybe, I only needed to work a bit harder and use the right tools. My performance improved, indicated by my exam scores. Most importantly, though, I understood better what doctors did in patient care. Medicine and caring for patients finally started to interest me.

Still, my learning was more knowledge-based than practical. Our medical school had mostly a hands-off learning style. It was hard to give an opportunity for 500 students to lay their 1,000 hands on a patient. Motivated students found their ways into the front seats. I was a bit timid and mostly stayed in the back.

I was not the kind of student who would poke and probe, and that came at a cost. While my knowledge of the clinical sciences was quite robust, my clinical skills were only good enough, not stellar.

—

When I thought about America, I did not have the bravery or imagination to be able to leave and cut myself off from my home country. I wanted to keep belonging to my home. The idea of being a global citizen was appealing. I could always be here and there.

I sought to become a psychiatrist. I imagined I would enjoy it a lot. I liked talking to people and wished to get to know them on a deeper level. I also wanted everyone to find their authentic selves and be content.

I had realized that mental struggle was just as devastating to the person as the physical suffering. At that time, I was physically healthy, but I had many conflicting feelings and thoughts, and I would sink into deep states of despair. I was aware of my own emotional turmoil and of others' as well.

But to get into a residency, I had to take licensing tests. So, I launched my preparation for these exams. These are tests American students and international graduates take before seeking training opportunities. Residency programs look at the scores and consider that as a surrogate for academic performance.

I studied for the tests at home most of the time. I had a quiet space. I did not lack discipline or motivation but reviewing materials for the licensing exams was not always easy. Often, it felt like a long and tiring haul.

Other students studied at the hospital library to exchange tips and be motivated by one another. I could not study there. Comparing myself to others and seeing how they study would drain too much of my energy.

Also, I did not feel I had a community there. For me, such association must be based on shared values and not strategic interactions to exchange information or externally motivate one another. I did miss out on tips and success stories.

I wonder if I had looked at it differently and had been humble enough to go there, would I have been in a better place. I needed information; it is not like I knew it all. But I also was not confident I would succeed in my plan. It was as if I would study alone at home, and that way, if I floundered, no one would notice.

I needed a visa to get to the United States, so I applied for one. The first interview did not go well. I was not prepared. I had assumed that I'd go in and say, "Give me my visa!" and they would do just that.

To my surprise, there was an interview process. The interview was in English. Who would have guessed? I had no idea that that would be the case. The interviewer asked me questions that I could not answer. I barely understood his American accent and had not prepared answers to any of his inquiries. He gave me the yellow card and declined my application because I lacked English proficiency.

My soul was crushed again. Here I was, after all my hopes that I would get the visa and travel, suddenly grounded, and the door was shut. I fell into despair. However, I did not linger in my low and got busy taking English classes. I hired a tutor to quickly improve my English proficiency and prepare myself for the second interview.

The tutor did an excellent job. In my second interview, I had answers prepared for all the questions the interviewer asked me, and I had refined my narrative by then. I explained that I needed to go to the United States so I could specialize in psychiatry. I added that I was looking at some of the top programs (I mentioned Hopkins or Harvard) and that I imagined in the future a job that would keep me going back and forth between Syria and the United States in some academic capacity.

The interviewer was impressed, and she granted me the visa. A month or so after I got my permission and only a week after my final exam for med school, I was on a plane to the United States. I said goodbye to family and friends quickly. With little capacity for the painful emotions of departure, I felt a need to leave as soon as possible.

When asked about the reason for hurrying, I would say that I was moving early so to get used to living there and be ready for the next step. I would add that it was not just to work but also to adapt to the culture, master the language, and find a community. But in truth, I was tired, and my soul just needed an escape.

My flight left Aleppo on August 10, 2006 to Milan, Italy, and then to Boston before finally arriving in Columbus, Ohio, which felt like a big achievement. After the many hours of flying, the rush of adrenaline made me so excited and astonished.

I could barely believe it when I exited the airport and met my sister. But just like Columbus himself, who was probably excited to hit dry land a few hundred years back, I had not gotten permission from the people who had already established themselves on that land.

I had followed all the rules, but as I reflect here, I still don't have an answer. What do I do with the history of colonization in this country?

After a few years in the United States and the destruction in my home country, I became an immigrant. Being an immigrant continued to be my dominant identity. How would I reconcile with being on the lands of the natives without receiving an invitation or permission?

Back then, however, I had just arrived and did not busy myself with these questions. I quickly went on my path in the next journey. I was twenty-three years old and a recently graduated physician. I wanted to move fast and be done quickly. Where did my sense of urgency come from? Was it the fragility of our existence as I had lived it through and through?

I knew that it would take a while to get integrated in a new country. I knew that—but I also knew that I had no time to waste.
Part Two:   
In the United States
Columbus

I arrived in Columbus, OH in late summer, 2006. I was on a mission—passing the licensing tests. I stayed at my sister's house. She was very kind to host me, and I had the notion that my stay was temporary. But for it to be so, I had to work hard.

I had all the conditions I needed to study. Besides a comfortable room, I was enrolled at a test prep center that provided books and videotapes as well as questions to practice for the test. I had it all, and I needed to get the work done.

The summer and fall soon ended, and it was a cold winter in Ohio. I had a thin coat for most of the time; I was freezing. I thought it was just the nature of the place, you know, the air is cold, and people get cold. It wasn't until I visited Minnesota almost two years later that I discovered thicker coats block out rough weathers. I got one and still wear it today! I wish I had found about them earlier on. Most of the time though, the support from family and the kindness of my two sisters in the United States was warming enough.

My sister and I did some fun stuff together, and we also joined social groups. With our similar mannerisms and being nearly the same height, others thought of us as twins, which I found interesting given that we are three years apart.

The study center occupied the second and third floors in a three-story building. It was not a massive space but was quiet and cozy. The kitchen was upstairs. I brought prepackaged food my sister got or meals I had cooked the day prior.

I would watch the videos at the center a couple of times each and then read the books at home. I aimed to put at least ten to fourteen hours of work every day in order to feel content with my progress. The work was gratifying yet taxing on my mind and body.

I was not the only one there in this transitional stage. Other foreign doctors were also studying at the center. I made friends and am still in touch with some of them. We coped in different ways. The hookah nights rejuvenated some of them. Playing cards cheered those who had little communities in town. Cheap drinks that reset the mood were the option for others.

Another revitalizing option was getting outside on the weekends to breathe fresh air. But mostly, maintaining connections with old communities at home while grappling to find a new one was what kept us sane.

Chatting by video or text with old friends in Syria was what I did. When I left Syria, I had a girlfriend, and we maintained a long-distance relationship for about six months. Then it got harder to feel present with her between the distance and the distraction of studying. I was spending most of my time prepping for the exam, and with few guarantees about my future, I couldn't conceptualize a life together. We broke up.

The long hours of studying, preparation using the correct materials, and mastering the techniques to answer questions all helped me get outstanding scores. That boosted my confidence, probably too much. I didn't necessarily turn arrogant or proud; the opposite was true. I was humbled to realize that achievements were doable for those who would do the work. I was privileged to have support to focus on my education.

It gave me the confidence to believe that if I set my mind on a task, I'd get it done, provided both that the conditions were favorable and that I did the right thing. But I got so focused on the numbers and the score, that I forgot to spend energy on other activities that were equally relevant. For example, I had done very little to find clinical rotations to apprentice under practicing providers and be familiar with the system. In addition, I was studying all day long. Aside from the quick interactions with those at the test prep center, I did little to improve my English skills.

When I finished my exams, I searched for opportunities to enhance my candidacy. I found a research lab position as a volunteer working on genetics research in the area of schizophrenia. That was useful and meaningful. I especially appreciated the collegiality and respect. The professor was phenomenal. His students, mostly Koreans, were very kind. They were bright too, but also spoke little English to me. If I were to do it again, I would expend more energy on getting clinical exposure.

I should have done more, but I would give myself some slack because not all these activities were within my reach. And I tried. Getting the research-assistant position where I was volunteering my efforts took probably twenty emails. Because of patient privacy regulations, most doctors from other countries received minimal entry to observe patients, let alone to interact with them clinically. I know this now, because in my capacity as a university professor, I get tons of emails of the same kind I sent back then, asking for opportunities to volunteer or to apprentice with patients.

There are no suitable mechanisms to provide such opportunities in most academic places. Schools' priorities are to give support to their own students. I paid for this gap later.
Residency Training

A year after my arrival, I applied for residency programs in a process called Residency Match.

In this process, students or recently graduated physicians compete for available training spots in the United States. I submitted applications starting in September and then went to interviews if I was invited. Later in the season (around January or February), I sent a ranked list. Programs also provided their lists of ranked applicants. The listings got "matched" nationally by a central organization. Then, residents and residency programs are informed of the results. I knew the process very well. I had taken part in it for thirteen years, first on the applicant side, and now, for the past eight years, on the programs end as a faculty member.

I sent my application to 117 programs. That number may sound extreme to an American graduate. I was apprehensive about finding a job. Where would I go back to if I could not find one?

I probably did not use the best strategy of contacting each program individually to find out if I would be a fit. I looked at some profiles online, and based on their locations, I made my choices. I knew my odds of getting a spot as a foreign graduate were slim, and it was hard to know who would invite me. In the end, I received a couple of invitations from programs in the top ten in the nation, but many lower-ranked programs didn't even bother to respond.

I interviewed well. I would prepare and rehearse my answers, having been burnt when I applied for my visa for not doing so. For every interview, I read about the program and drafted answers that were specific to the institution.

My answers were accurate and truthful. I hoped that my flexibility would help me, and every city and program had something to offer. If I interviewed in a town near the water, I'd say that I fancy spending time near the beach, which was true. If I interviewed in a program near the mountains, a similar answer was given, which was also truthful. I had no strong preference, but I preferred a supportive place. I was afraid of not finding the match.

I had my narrative entirely developed by then. I wanted to be a psychiatrist so I could take care of patients with mental illness. I also aspire to teach students and conduct research. For several of my interviewers, my answers reflected rare maturity and insight, which many explicitly acknowledged.

The post-interview communications were also encouraging. But I was torn between two university training programs. The first was highly ranked, larger in size with quite diverse trainees, but located in a Southern city. The second was smaller and located in a cozier liberal city in the Midwest.

It was January 2008, and I was grappling with how to make up my mind. I needed certainty more than anything else, so I inquired about a pre-match deal. A pre-match is an offer given to the applicant outside the matching process so that they feel secure. Programs that are worried about not filling up all their spots also got to snatch their top applicant choices before their competitors. I thought it was a win-win, maybe.

At that time, negotiating a pre-match offer was prohibited with American graduates, as many educators saw it to be coercive. Programs could still do that with international graduates! In later years, it was banned altogether.

With that security foremost in my mind, I sought a pre-match spot. The program director from the Southern city said that it was unethical for him to offer me one. The program director from the smaller town was kind enough to give me an offer, and I took it.

—

I joined the psychiatry residency program and was very excited. But I quickly struggled. When I began working as a resident, I realized that I was not prepared to do that work. As a student in Syria, I was mostly hands-off. Now, as a resident, I had to collect information, develop my assessments and plans, and work with a team. All of those were tasks I had previously done only when showing a teacher in structured settings or during a standardized test.

I asked for scaffolding, and the program kindly provided me with some backup. The chief resident would rotate with me and give me coaching. I was improving rapidly. As I had to spend time at other services, like pediatrics or family medicine, the institute could not grant the level of support I needed. That was what they said. Pediatrics was a major challenge. I was an outside resident in their service and felt estranged. The upper-level resident would give out the assignments in the morning, expecting specific tasks. But I had very little instruction on how to do them.

Even the students who had graduated from US colleges often needed a little coaching, and I felt I was not given nearly enough. Since then, I've worked with hundreds of graduates in my capacity as a residency faculty member for many years now. The level of coaching we give our new interns can be quite intense. That was not available to me.

I felt my senior did not care to talk to me about how to do better. Instead, she was only talking about me negatively to our superiors. They quickly decided that I was not doing what I needed to do.

One of their attending physicians wrote in her evaluation, "He's got the worse incompetency I have ever seen in my life!" That attending had never even met me in person. She had other obligations in the morning and provided oversight from afar; her fellow was the one rotated with us.

Four months in, I was asked to just stay home. They said they would not be renewing my contract at the end of the year, but they continued to pay my salary for the time being while I was at home. They would not let me interact with patients.

I was at a loss. For a while, I didn't know what to do. There was no going back to Syria. However, without a job, what would I do here? How would I tell my story to people? If I sought another opportunity, how would I interview again? What would my account of what happened be? Should I say, "I was kicked out of the program, please take me to yours, and I promise you I will do good?"

I wish my journey in that residency program had been different. I do take responsibility for part of what happened. As I shared earlier, being less than fully engaged as a student probably contributed to my struggle in early residency training. Had I been more hands-on in Syria, I would have probably adapted faster.

Also, I spent all my time in the first two years in the United States studying for exams rather than learning the system and getting clinical skills. Had I been exposed to what residents do and were prepared with tips; I would have been in a better place to convey confidence.

I also had been the kind of trainee that would not jump to show off what I knew. I was stumbling in English and could not gain others' trust. When you don't talk, folks assume you don't know.

Worse, I did something that many would consider more damaging than simply not talking; I asked for help when I struggled! Did my request contribute to other's perception that I was incompetent? Most students and residents combat what can be called an "imposter syndrome," which is a sense of inadequacy and fear of being called out. I was authentic. When I felt clumsy, I asked for support. I'm not sure whether other trainees were struggling significantly less than I was, but they did not make their vulnerabilities known.

I have been a residency faculty member for over seven years and just got promoted to associate professor. I have proven that I merit expertise to say what I will next.

I am deeply disappointed with what happened to me, and probably happens every day to others. Residency programs have been ascribed the task of training. Not providing conditions of support for residents is effectively failing at that task. I was failed.

Was I really the worst incompetent this attending, who had never met me in person, had ever seen? Yes. It is plausible to rank people by capacity to perform a set of tasks. When you rank individuals, there would always be a top performer and a bottom performer. I am not ashamed to be the bottom one when it comes to a task I had not done before.

I am not defensive here; I share the facts. In my pediatrics rotation, I had the chance to see probably fewer than four individual patients. I've had maybe five clinical encounters altogether. The time I spent there was very short, and the chance for me to show that I was the worst was not even given! I do not deny that I could be the worst. But I am calling into question the possibility that someone can reliably judge me as such in the limited number of opportunities I was given. There was something else involved that I left unnamed for years: it was prejudice.

International medical graduates continue to be discriminated against. If you are a non-English speaking doctor, you are immediately perceived as less qualified. This is troubling, especially with the imminent need for providers of diverse backgrounds to serve our similarly diverse communities.

Also, for God's sake, residencies are training programs. Training programs, by definition, train residents. If you expect to be a residency faculty and receive only well-prepared trainees, you are coming short on your duties. Yes, residencies need to be open to trainees of diverse backgrounds and capacities, and their job is to ensure that at graduation, everyone is excellent or at least competent.

Numerous international graduates come with skill sets not up to the level the programs required to get the job done. But with support, they performed just as well and sometimes better than their American counterparts. Better, because they have gone through hell to get to the United States and became resilient. They also have trained in a variety of clinical settings back home with limited resources, only to refine their clinical acumen. Let alone the fact that they were often the cream of the crop in their home countries.

I got into another residency eight months afterward. When I graduated, my new program director wrote an email to recruit for me an academic job. He shared with me what he wrote, and it included the statement, "He is one of the top three residents I've ever trained in my career!" This was a testament by a seasoned program director with twenty years of teaching experience our residency had recruited from a top university. I was not the worst incompetent; I was trainable.

When I was given a chance, I trained well and succeeded. But the path was not straightforward for me.

—

After I was let go from my first residency, I sought to go to the match again. It was November 2008, and I had to rush my application in. Candidates start the process in September; I was at the tail end.

Just like the first year, I applied to over a hundred programs. I got five interviews that time around. The problem I had then was my narrative. What did I tell and what did I not tell?

I chose to explain that after a few months of training, I came to realize that I needed to develop my skills in the breadth of medicine first. That was why family medicine was the right discipline for me. I kept my commitment that mental health was paramount, but so was physical health. I did not say anything about being let go. And I was given another chance.

The second residency was doable. By then, I had some amount of clinical exposure over the intense four months in the prior year. I also knew the rules and expectations better. But most importantly, where I trained in Florida, we had a diverse group of trainees. I was not the only person of color during rounds. We had trainees from all over the world, including many American graduates. I felt I belonged.

Nevertheless, I was anxious. The stakes were high, and I needed to perform well. I needed to not only know my stuff but also needed to make others see that I knew. I had to compromise my authenticity. There was no room to show weakness here. When I had announced that I didn't know how to do something, the story circled back as "incompetence."

Here, I said that I knew, and I attained the skills by doing. I was not going to be hesitant or show fear. If I felt fearful, I would just hide it. I had to deliver a baby early on in residency, and it was my very first. I ramped up my confidence and just did it. There was excellent support, too. My second-year resident was there. I did not tell anyone that I had not done a delivery before. I convinced myself that they did not need to know; I'd go and just do it. I had done deliveries in the simulation labs, and others would be around to help if needed.

—

I would never talk about my psychiatry year. If my colleagues asked (sometimes with suspicious curiosity) why I left, I would say, "to master the bread and butter of family medicine." I would then change the subject. Some were not satisfied with that response, no doubt, but it was my story, and I was entitled to share it or not share it with whomever I choose.

But since then, I have spoken about my experience with several folks. I share it with residents who are afraid of failing. I have also shared it with faculty members if I perceive them to be lacking empathy for a struggling trainee.

I wanted teachers to know that we can do a better job. Trainees should be supported and not failed, even if they are international graduates. I said it to remind myself that it was my duty to scaffold the person until they did well. If the resident is not doing well, it becomes my responsibility as an attending to work harder. I would need to do both, ensure that the patient was getting the care they needed, and the resident was developing so they can do better.

I have shared, however, only after I had proved enough that I could do it, not before.

—

My second residency was redeeming. Over the course of the three years, I recovered from the loss of my first job and my sense of inadequacy. I had to struggle to rebuild that feeling while I pulled myself up and kept moving forward.

I was appreciated by my supervisors and colleagues and became a chief resident. This role is kept for those who are showing leadership or representing their peers. Taking the role helped me better understand what is behind the thought processes of the attendings and program director. And it prepared me for my first academic position.

I had a big passion for teaching. I believed that you could make an impact if you took care of one person. But, if you teach someone to take care of others, then your influence was multiplied. I aspired to find spaces to teach my peers in residency.

They would call me "professor" even when I was only a second year. In short, there was a hint of mockery. I got the hint, but for me, it was not a mean joke to mock someone by pointing to an aspect they find dear. Yes, I aspired to be a professor. So, if you called me professor, it did not bother me.

I also enjoyed the research. My focus as a resident was on doctor–patient communication. My curiosity for the subject came from noticing that some doctors communicated better than others. The matter was beyond the techniques of asking questions and making observations. There was something about genuine dialogues and caring that appealed to me.

Communication did not come immediately or naturally to me. I had to work hard for it. I needed to not only be familiar with the language and manners but also to pick up on subtle cues. I needed to master having a conversation to exchange information, engage the person, and confer care. I wanted to investigate the subject systematically, so it became a research focus of mine.

In my research during residency, I asked my peers to audio record their interactions with patients. Then I asked them to pair and listen to the recordings together while naming the actions they performed at that point in the recording.

I used a tool granted to me by a generous professor from Johns Hopkins, Debra Roter. She was one of the most influential names in doctor–patient communication literature. I visited her lab as a resident and invited her to come to Florida to be a collaborator. It was such an honor for me that she provided mentorship. I completed this research project while in my second and third years of residency, and it was rewarding.

I also had supportive residency friends by my side, even though I maintained a stoic attitude and did not talk with anyone about my struggles. Matt was among the remarkable ones.

He became my roommate when I moved to Florida. As a Florida native, Matt had a vast network of friends. He was very social, and that kept our apartment busy. We partied often.

Matt exuded a genuineness that I was only able to put words to when he came to visit me a few years later. He came with friends, as usual, and he had bought something and paid for both himself and his friend. When the friend offered to pay him back, Matt declined and said, "Pay it forward!"

That was precisely him. He always did stuff for friends, and for me, that were not paying us back and for which he would not seek payback. He always gave forward. No wonder he had so many friends who appreciated him.

—

I was especially grateful in residency for the chance to go on medical service trips internationally.

We went to Mexico to do work around cervical cancer screening in Chiapas, which was an area with some of the highest rates of cervical cancer in the world. We worked with local gynecologists who taught us how to provide screening and treatment services, and we served a community in need. I also went to Nicaragua twice to serve a small village where our university collaborator had set up a primary care clinic that they go to three or four times a year.

I liked these projects a lot because, unlike a lot of "missionary medicine" work, we had partners on the ground. We would provide services and were humbled to be there and learn from the group.

I also went to the Dominican Republic right after residency for the same purpose. That trip was exciting because we took our students who were in their second and fourth years and were joined by students from a university there. It was fulfilling to not only provide services but also teach those who would be caring for others in the future.

With family medicine, the breadth of my skills was valuable in varied contexts. That is the realization many family doctors have when they work in rural areas or go on medical service trips. Going overseas was meaningful because I was serving human beings who desperately needed health care. The color of their skin or their socioeconomic status did not matter. I was providing care to a person who was a citizen of this universe, and that felt good. I brought this feeling back after my trips.

You don't necessarily have to go overseas to provide service to immigrant or underserved populations. Countless residency clinics, community health centers, and free clinics allow you to do that right here in the United States. That was what I had done since the beginning of my third year, working shifts at a free clinic run by residents. I do not hide that the free clinic was more fulfilling than my own clinic at the residency. I was serving communities that were in need and had little or no means of getting health services anywhere else.

The issue of serving citizens of this universe came as an answer to my guilt for not going back to Syria when the revolution erupted in 2011.

People in Syria took to the streets, demanding freedom, and dignity. The regime quickly used brutality against civilians. Doctors and health care personnel became instrumental in caring for the injured.

I ached to go. I was still in the middle of my residency training. Leaving at that point would mean losing everything. I had to pacify my conscience by serving the community where I was. Carrying on with my life path was a difficult decision I made with a tremendous guilt.

Even when I finished residency, I was torn up. I had signed up for my first academic job to start in September, two months after residency ended.

After graduation, I spent couple of weeks working several long shifts at urgent care to make money. I went on my Dominican service trip. After that, I traveled to Turkey, where I assisted a group of doctors and other medics at what could be considered a long-term acute care facility. I worked there for ten days.

The facility was like rehab, and many patients had infected wounds. I was like the hospitalist, doing rounds and managing acute or chronic diseases such as infections and diabetes. I knew my assignment there was temporary, and that left me troubled. I would be doing exactly what I hated to do on mission trips. You went there, felt better because you did something good, and then you'd leave, leaving behind an infinite amount of need and devastation.

—

There was one incident that enforced for me the limits of what I was ready to do and what I was not willing to give. It was during that same trip to Turkey in 2012. Our little care facility was near the Syrian border. One day, there was a battle not too far away on Syrian land. The group of health care workers had to go through the border to pick up a couple of men who were injured. It was a military checkpoint, not a crossing zone, but the Turkish soldiers let us pass.

The feelings were intense. It is hard for me now to describe those moments when I was first back in Syria. I walked into my home country, and technically, I was on land that was liberated from the regime. It was elating!

My elation was interrupted when we got the men. Someone on the team yelled in my ear, "Doc, are you going to open an intravenous line?" I had only started an IV two or three times in my whole life. Where I trained, nurses did that, not doctors. I poked twice and could not get the line in. I felt useless for a moment. I had trained supposedly to "save lives," and when someone needed a simple IV line, I could not do it. Fortunately, another person was able to do it.

We had to get the men back to a hospital in Turkey, but the soldiers would not let us cross back over. They pointed their automatic guns at us and ordered us not to move or we would be considered combatants.

There was one very passionate guy among us who, upon noticing that our two men were constantly bleeding, began screaming in the faces of the soldiers, "Let us in or kill us!" In my mind, I was like, "No!! Do not kill us, please; I do not want to die! I am not here to die! I have a job back in Indiana to go to."

It was a tense thirty minutes before the permission came, and we were let in. The two men survived, but one had to have an amputation later.

I did not process my experience at the Syrian border; I just closed myself off to the pain I took inside. I heard horrifying accounts of civilians who had lost everything and everyone. There was a twelve-year-old child who was alone with his cousins and uncles. His parents and two of his young siblings had been killed, but he had not yet been told. The adults who kept him under their care insisted that I did not tell him either.

The amputees were waiting for prosthetics to come and many for reconstructive surgeries that were delayed. I was somewhat useful in talking to those in distress and managing chronic illnesses. But the amount of suffering was beyond what I was able to handle myself. So, I departed and turned my head away.

I returned to the United States to my new job as a university professor. I told myself that I was serving a community there, too. I was leaving an impact. Deep inside, I knew I had turned my eyes away from an amount of pain that was indescribable and from an inconsolable suffering.

After that profound adventure, I returned to the United States. Since I had shipped my furniture and car before my trip, I went directly to Indiana. I started another chapter in my life and withdrew into my new world. 
Academia

There was an urgency to start my first academic job immediately after residency training. It was the same urge that kept me moving forward. It felt like a voice in my head telling me, "if I were not doing something really profound, I should be back home in Syria!"

I interviewed at a few places around the country. I sought a job that would let me use and build my skills in the breadth of the discipline of family medicine. I had proper obstetric training in my residency and wished to deliver babies. I also had excellent inpatient and outpatient training and preferred to keep using both. I decided to go straight to be a teacher at a residency program. In a sense, I stayed in residency, and I never left.

Indeed, the best way to learn was by teaching. If you knew how to do something, then you could explain what you could do to others so they could do it too. If you could teach it well, that would make you even better at doing it.

I realized though that my task was harder as a new graduate since I would have to pick up both the latest knowledge and how to teach it well. But that meant a potentially faster growth. Efficiency was crucial to me. Why was I in a hurry? I had always yearned for the route that would provide the most use of my time.

I practiced the full scope of family medicine from the womb to the tomb, and I thoroughly enjoyed it. It was gratifying to keep up and expand my skills. In residency, you have about 1,650 patient visits over the course of three years. When you are an independent practitioner, you see this number in eighty days of practice if you see twenty a day. With academia, as a preceptor, you could oversee up to four residents in a session. That means in a full day, you easily participate in the care of double or triple that number.

My independence grew quickly. I started as one of the most junior faculty, and I was probably the youngest in age. I needed mentors. We all need someone to give guidance on the journey and tell us how to do the tasks right. It was not easy to find the right fit, however.

My interests were quite broad. I found multiple coaches and would seek advice from one or another, depending on the matter. I explored different areas of interest, but it was harder for me to focus because I liked everything. I aspired to teach and be an excellent preceptor. And I also wanted to do research.

—

My teaching evolved over time. No one was born a teacher. At first, I was nervous. I came from a community residency program. At the university, I taught third-year residents who by then had quite the sophisticated skills. Some of them were exceptional. I was not sure how much I could add. At the same time, I knew that it was my responsibility to ensure that quality patient care was delivered. How much to trust and how much to verify were the salient questions.

To build leverage and get better at what I did, I sought to master and teach evidence-based medicine. I've had an interest in reading journals and appraising studies since I was a resident. As a junior faculty member, I had to look up answers to countless questions. But I quickly realized that looking for evidence was not a bad thing. It was actually necessary to stay current.

I challenged the notion that doctors came in knowing everything, so I would model looking for research-based answers. I also taught the skills to critically appraise journal articles and to generate research questions from practice. My role gave me leverage because now I was building an authority: I am an evidence-based guy (or geek, as some residents liked to say).

I was fresh out of residency, and throughout my life, I had complained about teachers not being aware of what their learners need. It became relevant to me to tune in with what the learner wanted and needed. It was not about me giving this or that lecture; rather, it was about what they'd get out of it.

I would inquire of residents' preferences when I prepared a lecture, saying, "Hey, what would you like to hear about?" The residents always had answers. It was paramount to focus on what was clinically relevant.

Case-based instruction was an important part I strengthened at my institute. We had a tradition in residency training across the nation called grand rounds. When it was first invented by William Osler, grand rounds were done in a hall, sometimes with a patient present. The attending would lead a discussion and expound the medical reasoning around diagnosis and management.

Over time, educators moved to using PowerPoint presentations, and the focus on the clinical context was lost. At my institute, I was ascribed rejuvenating grand rounds, by bringing case discussions back and supporting residents to teach. I modeled to the residents and coached them in leading the sessions so that it leveraged their talents as teachers to their peers.

We had a structure to follow for the group discussions. The resident teacher took on the role of facilitator for peers who participated and shared ideas. Every person brought expertise and valuable insights. The right answer was good, but the answer that was off provided an opportunity for reflection.

The most rewarding learning modality I led, however, was video reviews. We'd record videos of resident interactions with patients and bring the recordings reviewing sessions. Peers of the first, second, and third-year residents engaged in what I called "critical dialogues and reflections."

They developed competency by reflecting on what they saw in the videos and through discussions with each other. They learned not only how to do this or that activity but also how to judge their work. They further picked up how to converse with peers conveying care and support, and how to reflect on their positions.

Residents did not always find the exercise easy, but they perceived it as rewarding and insightful.

—

In addition to teaching and doing clinical work, I spent a big chunk of my time doing research. Research had always been my passion. To me, asking questions and searching for their answer was existential to who I was.

I immersed myself in educational inquiry. The topics I mentioned in teaching were also the focus of my research. I explored how to teach and master evidence-based medicine. I examined models of learning and instruction designs that engaged trainees. I shared my work and findings in national meetings. Furthermore, I did research in clinically relevant matters, especially opioid prescribing.

Opioid use was a problem throughout the United States. Prescribing was rampant, fueled by false advertisements by pharmaceutical companies and an emphasis on pain as a vital sign. An epidemic of opioid-related deaths plagued society. Medicine as a discipline was implicated. We, doctors, understood our role to be alleviating suffering. For many, that meant prescribing pain killers until the mind was numbed. Over prescribing was combined with epidemics of obesity and lack of physical activity, both of which made pain-inactivity-obesity a vicious cycle for many patients.

The federal government and several states issued rules to regulate prescribing. I was living and working in Indiana, which issued a set of criteria and functions to be followed if providers were to prescribe pain medications.

The rules were intended to change practice, but it was not easy to predict how they would work in real life. So, I assembled a team of researchers to explore the impact of those rules on opioid prescribing. We looked at the data that included the universe of all prescribed opioids in our state. We showed that there was a true decline in prescribing in association with these rules.

At first glance, this finding could be viewed favorably as something to celebrate, so to close the case. But I was concerned. In this massive database, we had no way to know who was and who was not getting these pain medications. There had been literature to suggest that managing pain had been a case study in disparity by gender, race, and socioeconomic status. Certain groups of patients were more likely to be prescribed opioids or denied a prescription they needed because of their attributes, and not the state of their suffering.

We had another reason to worry. It was clear that as the rule came out, the administrative task was quite a burden to providers. We anecdotally observed how doctors began to shirk their responsibility of managing pain.

So, we took our project in a different direction. In a qualitative study, I interviewed patients and doctors to inquire about their experiences with pain and pain management and how that shifted after the rules.

What we found was eye-opening. An already lopsided doctor-patient power dynamic became even more unbalanced with the laws that gave leverage to the doctors. Now, instead of addressing the patient with pain as someone who needs care, it became easier to shove them to the side and blame the law for the cruelty.

Hearing patients' narratives and understanding their experiences using social science qualitative methodology shifted my career path and focus, forever.

—

While I was doing the work in clinical care, teaching and research, I felt more training would be helpful. My goal was to be able to model evidence-based medicine better and conduct my inquiry methodically. So, I joined a program of study for a master's in clinical research in 2013.

For two years, I learned about how to do research in clinical settings. It was transformative to my mind and gave me tons of tools I still use today.

One mentor who was of substantial impact on my education at this period was Professor Kurt Kroenke. Dr. Kroenke was an exemplary researcher and teacher. I reflect on this now and find that I'd shaped my teaching after his work.

Just like Dr. Kroenke's instruction method, I combined online and in-class strategies so that the trainees could do some of the work at home. The teacher also would not have to repeat the same lectures over and over. Dr. Kroenke taught me and generations of scholars how to ask research questions and how to think methodically about the inquiry.

Besides the methodology courses, I took electives in education. My goal was to learn how to teach. The coursework brought me to the horizons of humanities that I had not come to appreciate enough as a formal field of study before then.

The most remarkable course was on qualitative inquiry taught by Professor Thu Suong Thi Nguyen. I came to appreciate qualitative approaches that engage with the phenomenon without reducing it to numbers. I became aware that there're several ways to do research beyond the positivistic way I picked up in medicine. You could call them paradigms.

In one paradigm, you assume there is one truth for all, while in another, you open yourself to accepting everyone's entitlement to their own "facts." Some go as far as considering believing in truth to be our biggest delusion. While in one paradigm you're concerned about objectivity regardless of the implications of your research, others are driven to research only to transform society. It is eye-opening and profoundly troubling (in a pleasant way) to realize how much we bring to the research of our own assumptions and schemas. It felt at times as if we got back from the abyss only what we'd brought into it.

My education gave me a framework I did not have available to me before. I learned about social theories. Medicine developed predominantly based on engineering problem-solving dispositions, can be viewed by some lenses as quite reductionistic. I've come to appreciate that there is a fundamental social component in our understanding. The normative part, focused on the good and right, is just as relevant as the technical aspect, occupied with effectiveness. Also, the subjective emotions and feelings are just as important as the objective physical signs.

My new awareness made me pursue more training, and I sought a program of study that was focused entirely on research and its philosophy. I joined a Ph.D. program in Inquiry Methodology in Education at Indiana University in September 2015.

—

I had various reasons to pursue a Ph.D.. I was struggling with health, which I will share about in few pages. I needed to get the Ph.D. so that I would have a plan B. I don't recall precisely how far I pushed my thoughts in expounding how my plan A (being a physician) would fizzle. But it was not hard to understand the apprehension. I was let go from a job once, could that not happen again?

I have encountered discrimination and xenophobia, and I was becoming not only more aware of both but also more intolerant of them. Would it get to where I'd be unable to live in the United States and need to start over in another country? That was a possibility. A Ph.D. would be a passport to exploring other professional identities and potentially moving to a new space. It would be my alternate strategy.

But I also had another matter in my mind. While in academia, I feared that I could face prejudice related to where I trained. I've had supervisors and colleagues say, right to my face, what belittled the education trainees had received at universities not considered "prestigious enough."

I sought to earn a terminal degree from the United States so I could shoot down remarks that might come to question my merit. Succeeding at the challenge of obtaining a Ph.D. while working full time as a professor would speak to those critics. I would also become an MD, Ph.D., a rare accomplishment that is often viewed with better recognition.

I had reasons to worry and gone through many ordeals that made me unable to trust that the other would treat me fairly, let alone as an equal.

But another part I should not forget is that learning genuinely excited me. I cherished the classroom. They were an escape from my busy, emotionally demanding days at the hospital. I had tons of fun joining delightful individuals who were still capable of dreaming and looking forward. Unlike the space of work as a "job," there was a massive privilege in being a graduate student myself.

My advisors Phil Carspecken and Barbara Dennis were a tremendous support throughout the process. Both were beyond generous in what they taught me. Phil is a philosopher and a model teacher. He always left more comments on my class assignments than I put in words myself. My answers would return to me with more questions, and reflections would continue into horizons of enlightenment.

He guided me to Hegel, which was amazing. He also made Kant accessible. Then Phil said that I would love Habermas even more than Hegel and Kant. I was skeptical at first. But he was correct. Habermas is probably one of the most sophisticated philosophers of our time. His direct impact will be noticed for generations and his name known for centuries. He's been my favorite philosopher.

As I write these words, I have three books on my desk: Kant's Critique of Pure Reason, Hegel's Phenomenology of Spirit, and Habermas's Theory of Communicative Action. These books contain not only ideas but also the frameworks for thinking about my life and its meaning. These readings and my coursework became existential to me.

Barbara ended up teaching me my main courses in critical qualitative methodology, which I employed in all my projects since then. Both Phil and Barbara taught me how to take a critical stance in refined arguments and how to synthesize. There was a vast space for authentic dialogues in their classes, with no limits to where the thoughts could go. Their caring and kindness were also limitless; learning from them was empowering.

I completed my dissertation in August 2018. I realized that without their support, I would not have been able to finish.

—

During my graduate studies at the school of education, I had space to rethink my stances and my positions. In a framework of critical theory, I became less tolerant of xenophobia and racism.

As a person who speaks with an accent and has brown skin, I was asked, "where are you from?" time and again. Even after I became an American citizen, there were those comments that made me feel as if I were not American enough. It was often easy for a debater when I called out injustices to say, "If you don't like it, just go back to Syria!"

Many colleagues of mine who were immigrants would speak of similar incidents. Innocent-appearing questions would have the subtext or be followed by words like, "Didn't they find a real American to get the job?" By "real American," the reference is to someone who was white. I stopped tolerating this nonsense, and I would call it out when I heard it. Are not we all immigrants except the natives?

I would even call out advocates for immigrant doctors who based their arguments only on the services these doctors provided to communities. It was about utility and rarely for the people, themselves.

On the other hand, I have also become aware of my own privileges; several of them were not earned. I could pass as white, and I am male. I am also a doctor and a university professor. I have had access to what was not available to many people.

Even what I had earned with hard work, like a passing test grade or getting an acceptance letter to school, I had conditions for my success not provided to others.

I have been on both ends of the outcomes. I know that many people who are far more hardworking than I am have not had the opportunity to get half of what I got. I also know that when these conditions were not provided, my hard work did not do me enough good. I don't claim all the credits to myself.

I've become particularly aware of power relations and oppression as they have historically played a part in our existence. My commitment has then been to leverage my privilege to call out power and to seek to provide conditions for the person to grow into their authentic self.

I brought my critique of power to bear in my work in medical education. I supported dialogues and reflections where residents learned in a non-hierarchical style instead of receiving instruction from a supervisor with questionable authority. I was once a powerless resident. As I became faculty, my commitment was to provide better conditions for every learner to take part in the conversation and to be authentic. To survive as a resident, I had to fake my confidence and present myself as the person who always knew. As a faculty, I wanted the learner to feel safe to not know and comfortable to ask for help.

Calling out lopsided power structures as they related to the doctor-patient relationship also became a focus of mine. I despised seeing a doctor claiming superior knowledge of what was good and right. Genuine and critical dialogue ought to be enacted in this context as well; that had become my position. The awareness of empowering the patient's voice became especially relevant when I became a patient myself.

—

My life was not always about work and school. I had fun in Indiana, too, and I traveled quite a bit. I had traveled only a little when I lived in Syria and during my early years in the United States, and I wished to do more.

It was freeing to be in a new town. New Orleans, Denver, Las Vegas, and San Francisco were favorites. Coffee in a new city always tasted better than at home, for some reason. My natural curiosity for novelty would cause me to be excited about talking with strangers. I was looking for what I did not know.

As days went by and I got busier with my Ph.D. work, I traveled less. My readings and contemplation made me realize that I had been running away from myself rather than running toward seeking something external. Since then, I had spent more time grounded, and coffee tasted the same.

I went out at night a lot. I would find the places where the party was. There were Wednesday and Thursday Latin nights in the Red Room and the Jazz Kitchen. Friday and Saturday nights, I would hop from one club to another in downtown Indianapolis. Something in that scene was liberating. The scene was beautiful. Exactly as Hegel put it, everyone danced until they were drunk. Others then came in to dance and the party continued even though the faces changed.

I enjoyed the music and dancing. I had partied a fair amount when I was in Orlando. Taking on the rigid character of the professional was quite tiring. I needed to let loose.

I could not find a community to do other kinds of adult-like activities. I was a single man in my late twenties and early thirties, while my colleagues were married and busy with their children.

I particularly dug the self-expression aspect of dancing. It was a way to meet single ladies. I especially loved the Latin dancing. There was a community of people who danced in Indianapolis. While I was not necessarily part of that group, it was nice to see familiar faces wherever I went.

I had taken salsa and bachata classes and liked it even more with coaching from a master. When dancing and being out at the revel, I was closer to my true self. I cared less about the perfection of my moves and enjoyed the company of the people I was with. It was not about the competition and more about the joy of the moment.

Meeting new people and making friends was something I sought out. But I had only little success. I didn't have a group I considered my core friends. I had met folks in school who became companions, and we would do fun stuff together. I also met ladies for dating. I was a bachelor most of the time, and I wasn't necessarily looking to change my status, although I kept open to finding someone I would change my status for. And that did happen a few times.

Dating apps made it easier for me to meet women. However, in Indiana (and Florida before), dating scenes were not that welcoming for a person with my skin color and origin. Many had prejudices and would make inappropriate or even racist remarks. There was one lady who, after a long exchange, would scream, "You're Arab, right? Why did you guys do 9/11?" That left me speechless.

At times, I would tell that story to a lady on the date to describe a lousy previous encounter, something people on first dates loved to do, for whatever reason. Over time, I built a repository of gruesome comments to add to that one. Some would say, "Yeah, really intriguing question; tell me why?!" or some would emphatically say, "Wow, that's terrible and dumb! I thought Muslims are the ones who did it, not Arabs!"

But I didn't let those incidents crush my enthusiasm and hope.

I realized that I was looking for something I couldn't find on my dates. My desire was always for what was beyond the woman I was with. It didn't help that with online dating apps, you could always hope that the next person would be "more interesting." Something was missing.

I had a deep struggle and hollowness in my heart that I did not recognize until years later. It took cancer and a journey of labor and reflection to uncover. I was searching for "love" and "human connection." I was not open to either, nor was I able to genuinely engage.

I adopted a dog to deal with the problem. Leo joined my life around that same period. I got a dog because, as I explained at the time to a friend, my eyes filling with tears, "Only a dog can love me!" That statement was not true. It was a fact that, while in Indiana, countless folks genuinely cared about and loved me. I have dated women and had friends who appreciated me for who I was and were there for me when I needed them. It was me who was not present intimately to be able to accept and reciprocate love.

I had difficulty with intimacy and would run away when a connection developed to a certain depth and became meaningful. I would say that I was looking for love and connectedness, but I would run the moment I got both. I longed for roots, so I did what would help me be grounded. Things like buying a house, for example. But soon after I would tie a connection, I'd sever it and move on. I sold my home less than three years after I bought it. It was a beautiful place. I sold it so I could be lighter in my moves. And one year after I sold the house, I moved away from Indiana.

—

I left Indiana, not only because I had an itch to leave. Living in Indiana was very difficult for someone like me.

In just the few years I was there, Mike Pence, with the support and demands of his base, signed laws and made decisions that were troubling on many levels.

In 2015, there was the religious freedom restoration act. The rule gave business owners license to refuse to serve customers based on their religious stance. It was interpreted, for example, as allowing restaurants the right to not serve people from lesbian, gay, bisexual, transgender, or queer (LGBTQ) community. Pence only backed off this heinous decision after major companies threatened to pull out of Indiana. In the end, money rather than ethics was what deterred someone who claims the higher moral ground.

Soon afterward, in 2016, there was a law that restricted women's access to abortion, limiting their freedom to make choices regarding their own bodies. Here again, we find someone's moral code claiming authority over other people's lives. It was deeply troubling and offensive.

It was my duty to protest that rule alongside groups of empowered women and men who took to the streets. Troubling to me, though, was knowing that these laws were probably supported by the majority in the community. Those fights were personal. When there is an attack on someone's right to be, express, and experience their authentic selves, it is an attack on me.

What hit most at home, though, was Pence's ruling that prevented Syrian refugee families from settling in Indiana. There were two Syrian families who went through the lengthy vetting process to escape the war in Syria and find a safe place in the United States. Exodus, the refugee organization, was helping in their case. When they arrived in 2016, they were barred from settling in Indiana, and the families had to be directed to another state.

That act was a stab at the heart of my identity. It happened during a week I was working back-to-back night shifts and was exhausted. There I was, a Syrian immigrant serving the community in Indiana by directly caring for patients and by training doctors who would do the same. At that moment, families from my home country, people who were in immense need were rejected by officials voted for by the same community I was there to help. I felt the grave insult at the root of who I was.

Why was I even there? What was I doing in that state? I did have privileges, and I was accessing many opportunities, but had I been a person in need, would this same society not spit on me?

It was hard to justify staying in Indiana after that. My rationalizing powers reached their limits. I was becoming inauthentic in a space that cared less for the person and had little regard for the vulnerable. I've had encountered ample events in my life to show me that our existence is fragile. Any person could lose everything they have in the blink of an eye. The job and status could vanish, and the person turns into what society chooses to betray. I had reasons to be fearful as I had experienced the vulnerability of illness before.

I aspired to be in a place where the community had an ethos of caring for other humans, regardless of their life choice, religion, or color.
My Health

Ayear after I arrived in the United States, I fell sick. I had awful diarrhea, pains in my stomach, and weight loss. At times, I also had joint pain and fevers. It took the doctors a while to diagnose me with Crohn's disease.

I was hospitalized in Columbus once in 2007. After a few trial-and-error attempts to find the right medication, I was put on a combination of medicines that kept the condition under check. The disease went into remission while I was in Florida, and I stopped the treatment for over two years. Coming back to the Midwest, with whatever lifestyle changes accompanied the move, my Crohn's came back, and this time around, it was intense.

I was hospitalized again in 2014 with dehydration and a Crohn's flare. It was the weekend, and a friend dropped me off at the emergency room. I got admitted to the hospital, in one of the rooms I used to admit patients to when I attended on our inpatient service.

The residents, and rightfully so, felt they should not be managing the health care of their attending. My colleagues took over providing direct care. I also had a kind GI doctor from Nigeria who was quite talented and caring.

Being hospitalized this time probably changed the course of my life. I was put on steroids and sent home to take them until I went into remission while the doctor worked on the prior authorization for an immunosuppressant called Humira.

Prednisone helped with the symptoms dramatically. It also gave me a considerable amount of energy. I would sleep about four to five hours at night, and I would write papers and grant applications all day long. Decreasing the dose would get me more fatigued, and my symptoms would flare, so I kept the higher dose, and that meant more productivity. It also meant more aggression.

I got a wake-up call when I almost had a fight in the Broad Ripple neighborhood of Indianapolis. A frat boy made a gesture that I considered inappropriate toward my two lady friends. Another Syrian man and I were walking with, an Asian woman and a Caucasian woman.

The frat boy walked up and got in our faces, and with arms extended, he attempted to grab the two women. I quickly jumped in front of him, and he almost gave me the unsolicited hug he had intended for the ladies. We exchanged words, and then he shoved me once before his friends took him away, and my friends and I kept walking.

I reflected on this event immediately. Here I was, a university professor, getting into a fight with a frat boy who was probably fourteen years younger than me over a silly gesture he'd made. I was angered because of how I saw the situation. We were two women with two men of color insulted by a white man from Indiana. It was as if he thought he could do whatever he pleased because he had a massive body, with a small brain and no filter.

I grappled with these thoughts in my mind. But it became urgent for me to come off the steroids and go back to a self I felt could be authentic but not too out of control.

Thankfully, a few months later, I stopped the steroids and was put on the immunosuppressant Adalimumab. Adalimumab is a medicine in the form of a self-administered injection. The needle hurt a little, but not too much. It was more the apprehension and anticipation of the pain that were unsettling.

The drug helped with the symptoms and got my disease under control. But because it is an immunosuppressant, which causes increased risks of infection, I was always concerned. As a physician, I am exposed to infectious pathogens everywhere at the clinic and the hospital. Many of these infections acquired at a hospital can be tough to treat.

With every injection, I would get a disturbing feeling: what's keeping me well today was probably going to kill me one day!

I had reflected in my first book Roads to Meaning and Resilience with Cancer on how the difficult decisions we make in life can come with consequences beyond imagining. I developed lung cancer less than two years after I got on Adalimumab. It was plausible that being on an immunosuppressant was part of what caused the cancer. I made the remarks that I own my decisions though. I chose to take that drug to maintain my quality of life, and there was no way to know for sure that I would get cancer. It is not something I regret.

I reflected on this matter to model self-forgiveness to those among us who make lifestyle-related choices and develop diseases attributable to them. We make decisions every moment, and some can set us on a path with devastating outcomes. In the moments of making decisions, we have no choice but to choose something, and whatever we decide will have a consequence of some sort. I choose today to look with compassion and care at my previous choices. I do not want to live with regrets.

—

In November 2016, I went to the emergency room with my X-ray results. The left side of my chest looked like it was filled with fluids or I had pneumonia. I'd felt short of breath in the week prior and finally had time in my busy clinical and teaching schedule to get the necessary tests. The diagnostic path in the ER was straightforward. I needed a CT scan to clarify what was seen on my X-ray.

Being in the emergency room showed me an inverted world as I became the patient. The image in my mind was that of the panopticon from Jeremy Bentham. The panopticon is a design for buildings that are intended to maintain perfect control of the oppressed while expending a minimal coercive energy. They are built to have an observatory in the center, which is ringed by individual cells. The person inside each cell is observed by those in the center. Hospital and clinics are designed like that. Prisons are the classic example, but at times, school rooms have been designed that way, too.

Now I was the exposed person in a cell. I had no entry to what I knew took place in the center. I knew it, because I used to be there as the doctor who took care of patients. On the other side, as a patient now, I was seen and exposed, without being able to see.

Viewing one of my interns outside did not help much. He probably felt as awkward as I did when our gazes crossed. I didn't know what to say to him. Part of me felt the need to reassure him, saying, "I'll be all right!" But I had no idea what was going to happen, and I didn't know for certain that it would be the case.

Going to the CT scan was another voyage of exposure. I had been stripped of my street clothes and wore a gown. The choice was mine, of course, to leave my underwear on. Because the short gown slid above my thighs when I moved and was semi-open from behind, it did more to expose my nakedness than to cover me.

I had walked into the ER, but once I was there, I didn't walk anywhere. Instead, the stretcher I was laying on got pushed around. Thankfully, there was a blanket, which I used to cover my face. I did not want to be seen. I did not wish for my colleagues and students to see me and come ask, "What is going on?" I felt vulnerable and receiving a caring inquiry would only add exposure to my vulnerability. I felt naked at the same hospital where I usually walked around in a suit and tie (or bowtie) or, more casually, wearing my doctor's scrubs.

The CT showed a massive pleural effusion. The left side of my chest was filled with fluids that squeezed my lungs away. No wonder I could not talk or breathe even with the least amount of exertion.

The next step was to get a sample to send for analysis. Waiting for the procedure, the rest of the day was uneventful besides my neighbor who was screaming at the top of his lungs. I could tell he did not have what I got because he was very loud. The nurse was kind to find me a quieter room.

There were about ten hours or so of waiting until the pulmonologist came. Waiting was bothersome, but not terrible. I understood that the doctor, since it was around Thanksgiving, was busy covering for other colleagues who needed time with their families. The pulmonologist, in his sixties, was working very hard that day, for which I thanked him.

However, the delay was also a symptom of the shortage of health care providers. Such a deficit will only get worse if our country keeps restricting immigrants who wish to come to the United States to train and work.

—

At the pulmonologist's office, four days later, I didn't have to wait very long before I got to see the doctor. He gave me the diagnosis slowly, although he was seemingly disturbed. He explained what we saw on the X-ray and CT scan as he presented the images. Then he told me that the pathology report showed cancer cells.

I was taken aback by the information, and it took me a moment before I cried. My first response was, "I am not an exception; now what?"

It was an awful moment in my life. I'd been grounded again after I hoped I could fly. I had spent my lifetime in efforts to distinguish myself, first from my siblings and then from others by working on my life project. The diagnosis came to remind me of my humanness. I am a person, first and foremost.

At that moment, I had no space to work to be different, but only to recognize that we all get sick. I was grateful that this position was available to me as I had encountered illness on the two sides of medicine, that of the doctor and that of the patient.

I had a moment of surrender, evidenced by my tears. It was sadness in the sense of a disappointment of hope. It was not anger what I felt, because I did not consider I had entitlement to the opposite reality. Humans do get sick, which sucks.

Was it a surprise? I did not expect cancer at that time, for sure. Yes, I had considered the fragility of my health, and the possibility of it getting worse when I had Crohn's flare-ups. When I'd take the injections, I thought it was going to kill me one day. I anticipated an adverse outcome. The cancer diagnosis did not come easily. I wondered then if that was the end of my project. Death was coming soon, and I should let go.

I immediately asked, "Now what?"

I realized that finding cancer cells in the fluids around the lungs meant stage 4. We did not have much information, but the situation seemed gruesome, to say the least.

"Now what?" was more of a question about next steps.

I did not jump on the fighting cancer bandwagon back then; that attitude was not yet available to me. I was curious about the pragmatics of the situation: "Help me think this through; what are the consequences? What can be done? What are we going to do next?"

There was a style of response I resorted to when I was under a lot of stress—I jumped forward into doing something. Moving forward to transcend the condition by action was implicit in my attitude. What could I have done instead?

Well, I could have breathed deeply and savored the feelings. I could have held onto the pain and stared down the struggle to confront it and understand it in language. Those two other modes of response I've done at different times, but they are, I would say, not my default.

I act first, then I pause to think or feel. I usually catch myself thinking before feeling. Looking forward, I remind myself to pause a little and be more attentive to my emotions.

—

Among my oncologist colleagues, I had one in mind who I sought to be my doctor. She was kind and caring. I knew her well because we shared the care of a patient with lung cancer my team had diagnosed and cared for. He was an older gentleman.

One day, the new intern inappropriately consulted the palliative and hospice team for that patient, and the oncologist was furious.

Now, substantial evidence supports the advantages of engaging palliative care to help patients with cancer. Palliative care is not about helping the person die comfortably, although they are very talented in that arena. They offer services that make living with cancer more tolerable. They also guide the person as their illness progresses to its end. I saw a palliative care team within a few months of my cancer diagnosis. The team was incredibly thoughtful.

What troubles patients about mentioning palliative care, or worse consulting them without the person's permission, is precisely the motive for that specific intern. It was like, "this person has a "terminal" illness, is older, and does not need to be in our service. Let's get palliative care to make him comfortable as he dies!!"

That patient had a team of providers around him, and on that day, the "comfortable death" was not salient nor relevant to him. I talked about this incident with the oncologist herself. I also reflected on it with the team and moved on.

I'd thought this oncologist knew her patients and treated them as persons, so I wanted her to be on the team. But she was on vacation so, instead, I got yet another colleague who was kind, but not as warm. The first appointment was on the sixth floor of the hospital building. It was November in Indiana, and the room felt cold. The room was at a regular hospital floor that was turned into an outpatient clinic.

Hospital rooms typically have a large bed or two and maybe a sofa or a few chairs, in addition to a lot of equipment. Instead, this room had a computer and a stool for the doctor, and two chairs for the patient and their caregiver; it felt empty. And it was cold.

I was by myself. I sat on the patient's chair, and my back was to the window while I faced the door. I thought, "My journey as a cancer patient has started. This is how it will be until the end!"

There was anticipation in the three to five minutes of wait. I wanted to be aware in the sense of being present in the moment and perceptive. I realized that this consciousness, if I died, was what would cease to exist. Now my awareness became precious. I could sense the oncologist standing behind the door finishing a conversation with someone, a patient, or a nurse. That moment was long. Finally, he entered the room and greeted me with a handshake. He did not say my name or ask how I was. He just sat down and dove right in.

He asked me about my Crohn's and how many years it had been since the diagnosis. By that time, the pathology report showed the malignant cells to be "adenocarcinoma." It was unconfirmed, although the suspicion was that they were from the lung.

As any doctor does, he asked questions about my medical history. He probed about the details of my health and sickness. He examined me thoroughly, too.

The first task was to determine what kind of cancer this was. Because of my history of gastrointestinal problems, the oncologist suggested we investigate a GI source for the disease. He ordered a colonoscopy to be done in a few days. We agreed to meet again after the test, and he left.

I wished he would've asked how I was doing. That was important to me. I was not doing well, and a question like that would have gone far in making me feel like a human. His failure to ask how I was struck two bruised spots. I was not a peer physician or even a person anymore.

I had for years defined my character around my work and being a health care provider. Even my personhood was linked to this identity. I am a person because I have a purpose in my life, and my purpose is to provide care to others.

When a peer recognizes me as a person or colleague, I know it myself with certainty. But as I became ill and perceived that I was dying, what died first was my purpose, the essence of my selfhood. Without a greeting or how are you, I am not a peer or a person. I am only a case of disease or a problem to probe and decide a course of treatment for. Show me the pathology, so I can fix it, not any different than the mechanic to the car or the handyman to the refrigerator. I needed to hear, "How are you?"

The next few visits were all jumbled together. I had gone back to the same old room and to other ones on the same floor. I would recognize the friendly face of the front desk staff and appreciated their kindness. They had helped me, especially when I arrived at my appointments late or when I failed to show up to a scheduled visit.

I had too much on my brain. Although I was off work and my only job was caring for myself, I was swamped. There was one day when I showed up ten minutes late, and as a result, I waited for something like ninety minutes before I was seen. I learned my lesson and showed up to appointments early after that.

—

The diagnosis of stage 4 lung cancer became the final one. The options were palliative chemotherapy and radiation unless I had an actionable mutation—a genetic variant that caused my cancer. Finding such variants could open doors to novel treatments.

I began reading about lung cancer and prognosis. It was quite harrowing, to put it mildly. With a mutation, however, there could be some hope. I got the results of the biochemical testing after about fourteen days, and I did have an actionable mutation.

When I learned that I had the Anaplastic lymphoma kinase (ALK) translocation, I cried and cried. Having ALK made me a candidate to receive treatment in the form of pills and potentially survive longer than the average patient with advanced lung cancer. I felt I'd been given another chance to live.

The doctor then initiated the prior authorization for the medicine I was supposed to get on. Before taking the treatment, however, I wanted a second opinion, so I went to Boston.

In Boston, I toured the Institute of Contemporary Art and reflected on life and death. I also visited a thoughtful and kind doctor. His name is Arabic sounding, like mine. He did not speak to me in Arabic though, and I am not sure if he spoke the language. But with him, there was a warmth that I usually feel toward the outsiders, and it came quickly. Exchanging few emails prior to the visit probably had helped as well.

After my late-day visit, I treated myself to a nice bar where I had a glass of red wine and savored some delicious oysters. Ah, those oysters were so good! They just melted in the mouth, with their saltiness and the tang of the lemon juice and the little sauce on top. I think they were some of the best oysters I'd had in my whole life.

Suddenly, I became appreciative of what would otherwise have passed by without notice. I started to have some hope, although I was still troubled by the numbers marking the prognosis and the odds of my survival.

We are talking about a sum of months I would likely live. I may live more or may live less. Six months? Ten months? Maybe over a year? It was hard to predict. But there was a time-tag now put on my life.

I became the number as well. I was one of the many with the illness, and to learn about myself, I would have to imagine a hundred people like me with no face or identity, but only the disease. I needed to then do the math and comprehend what the prognosis and odds meant. I also became the number in the sense that one day, probably soon, I would die and be forgotten, like the millions of others before me. I was reduced to a one abstract being.

I left Boston and arrived home, and at the parcel holder, a bottle of medicine was waiting for me. I grabbed the bottle and was struck that it was quite small. This was what would hopefully keep me living longer.

Time slowed.

I asked myself why I would take the medicine. I went existential on myself for a minute!

I thought the question was dumb at first, but it certainly wasn't, and I had to take it seriously. If I take the medicine, it would be to live longer or with a better quality of life. Right?

But why?

Why not do the opposite? Or to put it more accurately, why not let nature do its thing? Why should I resist dying?

Those questions were meaningful because, for years in college and afterward, I grappled with an emptiness that led me to ask those same questions. "Why am I alive?" Life was tiring, and at times, I would say, "Life is empty or boring." Well, guess what? Now I had the option to not live. It was available if I were truly authentic in my questions before.

I only needed to not take the medicine, and nature would take its course. The questions were not dumb or silly. Add to them the feelings I'd had in prior years that I was incapable of loving, and no one could love me except my dog, and you realize that the thought comes naturally, "Well, death came to you on a silver platter; just take it!"

Furthermore, you could add the vast numbers of killings happening to my people in Syria. The question, "How would I wish to stay alive while others couldn't?" became understandable.

These questions were in the back of my mind as I walked into my apartment. When I arrived, I filled a glass with water and took a sip to swallow my first pills. By taking the pills, I stopped the debate in my head. My instinct for living and my innate desire were stronger and more essential than those ideas and questions.

I took the pills without reading the instructions, and I did so on an empty stomach. I needed to get an MRI of my head to make sure, first, that I have a brain (vital for me), and second, that I did not have any metastases there (important for the doctor). The medicine I was starting would not work well if I had metastases. I was supposed to get the MRI before starting the drug, but I did not follow the doctor's advice.

Suddenly, I became extremely nauseated. I had, while walking around the hospital, to try hard to stop myself from throwing up. I realized that other passerby might have received the wrong gesture from me. It's not nice to look at someone's face and have them give you the universal gestures for "I'm going to throw up."

I was nauseous, and that was not in any way existential. If anything, my actions then told me that I was doing all that I could to keep this existence going. The nausea sign was not a political statement, either. It was true that I was discontented about the political situation where a vast majority in Indiana voted for Trump.

What happened in the US was troubling and nauseating in many ways. But that was not on my mind for a second. I was simply about to throw up.
Coming Out of The Crisis

Rethinking the course of my life was not a straightforward process. When you believe you are not going to live more than six to ten months, you do your calculations differently. But, early on, I chose the most straightforward path: stay in my lane. I had signed a contract with the University of Washington and intended to move to Seattle. I kept with the plan, although I delayed the move for three months.

I said goodbye to my Indiana friends and was on the way to take a plane to Seattle. Moving Leo was not easy. I had gotten him as a puppy when he was barely ten pounds. He was my baby and my best friend. By the time we moved to Seattle, Leo added another 100 pounds to his weight. He needed the largest, giant-sized crate. However, the crate size that fit Leo, we discovered at the last moment, did not fit in the plane flying from Indianapolis. So, we had to drive to Chicago. On top of that, instead of the direct flight, he had to go to San Francisco first and then to Seattle. I was worried about him.

The decision to move with him was difficult. In Indianapolis, I'd received help from his daycare, Tender Loving Pets. Staff there were kind enough to come in and pick him up so he could play with the other dogs, and they dropped him off at the end of the day.

The owner lady knew about my health and offered to keep Leo if something happened to me. I wanted Leo to stay with me. But now he was on some plane in the luggage compartment, probably overheated and maybe thirsty. I'd read horrifying reports about dogs not making it to their destination, and I was terrified.

I arrived in Seattle before he did, and when his plane finally landed, I picked him up in tears and then drove to our hotel. Searching for a rental apartment was not hard. I looked briefly, found one that had a beautiful view of the water in downtown Seattle, and I took it.

I'd always dreamed of living in a high rise facing the city and the sea. And that was precisely what I found. It was expensive and far from work, but at that stage of my life, I justified to myself living in a lavish place for a few months.

My new job was similar to what I'd done before, seeing patients and precepting residents. I was having wicked battles with fatigue, so I purchased a little sofa that opens into a bed and kept it in my office. I would nap there at the end of the day to let the traffic ease some before heading home.

The commute back and forth from work was draining my soul. It would take an hour to get home sometimes. I felt I did not have that much time to spare, so I left my apartment and moved closer to clinic into a tiny place with a small window. It was a sad move, but a necessary one. Even the movers were surprised by the difference, "Wow, what a big difference; your previous apartment was way nicer!"

I was not doing well physically and at times I would barely have the energy to walk around. That was clear especially during the hospital inpatient rounds. I felt I was only a notch or two less sick than the patients.

I'd had imaging studies one morning before rounds, and because my kidney function was up, my mind was on hydrating. At times, I would get warm or feverish, and with my afternoon fatigue, I would be almost obtunded. I tried to govern the economy of my body's energy. I would take naps in the call room after rounds so that I'd be able to muster the strength in case something happened, and the residents needed my help. I was exhausted very often, and efforts to try to hide it did not work. I had just switched to a newer drug, and my body was not taking it well.

It was impossible to keep my struggle to myself. I had chosen to announce my diagnosis early on, and I had told the residents about my health when I started the new job. I didn't know how long I would live, and I didn't wish to disappear suddenly and leave folks not knowing why or what happened.

One third-year resident shared her thoughts and tears with me. She explained how painful it was for her to see me around, especially at the hospital. She said that when she witnessed other patients struggling, she had learned to compartmentalize her pain and move on to provide care for the next patient. She had to look in the other direction at times so she could get her job done. But with me, she said, I was everywhere, and there was no "other direction."

Further, I reminded her of her own existential questions, and she could not deal with that while caring for patients. She then asked me what many other residents and colleagues had asked: "Why are you even here?"

When I got asked that question in the job space, and it happened again and again, I would acknowledge the constraints on my foreseen existence. Then, I would share that I aspired to live meaningfully in whatever time was left. I would say I was there for the conversations. I would clarify that when we had discussions, we allowed our consciousness to pass along. Therefore, dialogues were one way to keep ourselves alive, even when we stopped existing.

I would then invite the person to help me have a rich journey by being present and open to me. But that request was not fair in the case of this resident. This particular resident was suffering, because of me, and that made me aware of my own struggle even more. So, I asked for an accommodation.

I gave up taking calls and working inpatient. I also gave up delivering babies. I chose to work four days a week so first and foremost I could have the space to care for myself. But I also required a space to stylize my image. I did not want to project the image of the sick person that would invite other's pity. I wished to rest when tired and be out when able to engage with others wearing a smile when I could. Yes, I aspired to live authentically, but that no longer meant letting out all that was within. It meant being authentic with style.

—

I was not doing well, true. But my suffering, I realize now, was probably less than many other cancer patients. In varied ways, I had it easy. The pain was there, in the back, chest, arms, hips, and legs, but was often manageable. The pain made it harder for me to sleep, which made my fatigue (mainly a side effect from the medicine) even more awful. But over time, I was able to do probably 70 percent of what I would've done before cancer.

My stamina was reduced significantly, but I could still take walks, ride my bicycle for couple miles, even climb a flight of stairs or two.

I was also sad and probably depressed. That would have scored mostly in the mild or moderate clinical ranges if I were to take a depression questionnaire. I could still have joy with family and friends, and I would laugh at jokes.

My sense of humor became more idiosyncratic, but I always had my own quirky way of being funny. I had times when I would feel good, as if I had no health issues. I also had times when I genuinely felt that I was doomed. Between these two extremes, I carried on.

—

Because of the enjoyable moments I had, and because of the awareness of my finitude, I wanted my journey to be vibrant. That particularly included my academic path. Academia defined me. My professional identity now was not chiefly about being a doctor. I'd lost a lot of that already. I would say I am a professor who is also a physician. Being the teacher had always been salient, and maybe became more relevant as I provided less direct patient care.

I hoped to squeeze into whatever years I had left the richest academic career imaginable. That required jumping on the next milestone of growth. Even though it also meant challenging myself and seeking opportunities for advancement, with cancer.

I thought I might not live more than a few years, but those few years better be meaningful and impactful. I pursued a clinic medical director and residency program director positions. In all cases, I was hoping to move my impact to the next level.

Instead of just being a clinic provider, I sought to have a seat at the table leading conversations about how care is delivered. Instead of teaching and advising residents, I aspired to design and oversee learning. I would be expending the same amount of effort but doing work at the next level of impact. However, I was not offered any of these jobs, much to my disappointment.

Looking back now, I am grateful that I was spared. Since my failed few attempts, I have had the chance to do work in areas that are meaningful to me while I had space to take care of myself.

I understand why the opportunities were passed to others who were probably on a career trajectory that better fit those jobs. Committees judged the fitness of the candidates, and decisions were made following some criteria. The matter was not personal to me.

I believe that if I were given the opportunity and the support, just like everyone with the necessary abilities, I would have grown to be fit and do an excellent job. Fitness develops; it's not fixed. With the condition of my health, one could argue, however, that I might not have the ability to do many of these jobs.

I confess that I go back and forth on this matter. With the treatments I take, there are days I feel I could do anything, and days I feel like a dead vegetable. Accommodations, reducing my work hours, and flexibility with the workplace, including working from home, all had helped a lot.

There is still a question I grapple with as it looms over my head. I assume that others deal with it as well when considering me for a job advancement. I do worry that my illness may have made me less fit for leadership positions. Why would someone invest in a patient with stage 4 cancer?

But when I think of the several opportunities that have been available to me since then, I must remind myself that this idea may only be in my head.

—

To manage my energy better, I spread my work between Monday and Saturday. I teach residents in different settings about one day a week. I supervise them in the clinic and teach lectures on various topics, especially around research and scholarship. I do research on one day. Depending on where the funding comes, I have pursued different subjects. Lung cancer lived experience has been a central project for the past couple of years. I also work on implementation projects around mental health for one day a week. I usually see patients at the clinic on Saturdays. The day is gratifying, even though it can be very tiring. I nap after work, every day.

I like my schedule, although, like countless professors, the allocation of my time depends on funding sources. I can't wait for that day when an endowment comes to give me the flexibility to fully pursue my research work and not depend on grant funds. Maybe if my memoir sells well, I will endow myself and leave the legacy after my death.

My work in mental health has a special place for me. Obviously, I had pursued psychiatric training because I viewed mental suffering to be as relevant as physical ailment. I have the space to work in this area at my current job. I've joined a team of brilliant researchers and providers, along with energetic staff, in efforts to expand provision of mental health care. The premise of the work speaks to me dearly.

The project is about providing care where patients who struggle with mental illnesses present the most: the office of their primary care doctor. The group seeks to implement effective and sustainable frameworks to expand the capacity of primary care doctors to deliver adequate care. Now patients with mental health issues are not left to be managed by their PCPs alone. Instead, they are cared for by a team that also includes a psychiatrist and behavioral health providers.

This group is dear to me because I have a space where I can contribute perspectives. Whether at work or outside, for me, what has become crucial now, is to be present and bring insights not immediately available to others. This is one answer to having a life project that is meaningful and fulfilling.

I could go even further to say, I long for the horizons where I can add what not many others could contribute. In a sense, to me, that is the essence of offering that which is authentic. But what can that be? There is always someone else who could do the job.

That is true, and I can share a humbling moment to show that someone else will do the job. As I finished writing my book Roads to Meaning and Resilience with Cancer, I saw ads on Amazon about a book with a similar topic. I found Tough, a book written by Marquina Iliev-Piselli, who is a cancer survivor herself. She interviewed thirty-seven cancer patients and let them write their stories.

My first reaction on seeing it was disappointment. I had thought I was doing unique work, but there was another person doing exactly what I had done. But I overcame that feeling and reached out to Marquina, who is now a friend, and we had one of the best exchanges I had in a year. I was in Seattle, and she was on the other side of the country, in New York City. Yet, in the same year, we were living parallel realities and working on very similar projects. It was heartwarming.

She is a beautiful soul and told fascinating stories of brave women. Here again, I came to realize that the work I was passionate about would be done by others.

I have no worries. What I've learned from this is that someone else will finish the work. The world will be all right without me.

This may sound too obvious, but in fact, being tormented about the opposite is what perplexes many of us facing our mortality. "What will happen to others when I am gone?" is a question that comes to my mind and the mind of other cancer patients. I am sure others will miss the moments and may remember us, but they will be all right.

Yet, I am keeping the challenge for myself to cultivate a capacity to contribute what is meaningful for others and that which is not generic. I came to believe that it's part of my authentic life project to invite others to their own authentic space, as well, so they can bring that to the discourse.

Take, for example, teaching. While I promote developing capacities to provide quality care, I encourage learners to find space of genuine existence, so they'd be the doctor they aspire to be. It is not a cookie-cutter, and it is not one professional size that fits all. Learning is growth and formation we achieve as we encounter ourselves.

Also, I focus on teaching research methods so future scholars can reshape their understanding of the world and have the tools to carry their own projects. I rarely teach knowledge; everyone can do that, and many can do it better than I do. I focus now on teaching how to construct knowledge and how to come to know. I am teaching the tools for knowing ourselves and the other. That had developed into my niche.

—

Life after cancer has opened possibilities I didn't have before. I have become more reflective. Some may say too reflective. But I would reflect on that and say, "There is no such thing!" You can always reflect more.

I had to know myself faster, and I had to ensure that when I died, I would not have many regrets. At the same time, I preferred to keep on doing stuff rather than pining away in remorse or grief. With my attitude, I would be guaranteed to make mistakes, and I had to have a strategy to learn fast. Reflections are that strategy.

I have also worked harder since my illness. I indeed have less time in my day, but I became more efficient at doing what I needed to do. I had no choice. I am in the mindset of squeezing tens of years of life into just a few. I needed to push myself.

Earlier, when I was working on my Ph.D., I would recognize that I was exhausted. So, I wrote on a sticky note, "You're tired? At least you are alive to be tired!" I thought I should stop complaining about being fatigued and get on doing what I needed to do. There is no time for tiredness.

I finished things faster. I do realize that, at times, I'd compromise this or that quality to get the work done, but my better motto has been, "The perfect is the enemy of the good." I would be content with good enough! I've worked more efficiently also because I was doing what meant something to me. Writing the first book took about three months. The first draft of the memoir took 14 days.

I've narrowed the space of engagement in projects or debates that I thought irrelevant. I focus instead on what gives meaning to myself or others and on where I can contribute something useful.

I have also become free to call out my own bullshit. Clearing my conscience has become an urgency, and I realized that a few people in my life could receive my apologies. I had times when I reached out. This meant something to some, but others were not concerned or didn't even remember what I'd said or done.

Over time, I wished to not spend my mental energy looking through lists of deeds to judge whether what I'd done was wrong or could have been amended. Instead, I've chosen to be mindful and kinder to the next human I encounter.

My preference has been to not enmesh the world in my own conflicts, especially if individuals had moved on in their lives. In the end, the person may need to find ways to heal, when possible, with or without recognition. I could die before having a chance to say sorry to some people.

As I explored my deeds, I had been particularly grateful for the ones who called out my mistakes. It was the 'no' that I received to an unwelcome behavior and the demand for an apology that taught me a valuable lesson: Respect the other person's boundary.

Crossing a boundary means you owe the other person an "I am sorry," and you learn not to trespass their line again. Seeking an assent is fundamental. I confess that I learned this later in life than I should have.

When one person called me out once in my twenties, I did apologize. I did it, however, but with little remorse. It was like, "So what?" or "Sure, you want me to say sorry, so I'm gonna say sorry!" It took cancer to make me realize that I owed that friend a genuine apology, which I delivered years later along with a gratitude. I said, "I am sorry for two things: for trespassing your boundary and for not giving you a genuine apology then. I am also grateful for one thing: you taught me an important lesson." Not surprisingly, my friend remembered the moment of our first interaction, and appreciated our second one much more.

I've gained curiosity for the other and became better at empathy and at looking outside myself. I had a passion for hearing about people's lives, especially those with cancer.

If I were struggling, that means others in similar situations are also struggling. If care and love are what I needed, then there must be many others who also needed that. My observation that we live shared experience was confirmed in my research work that led to my previous book.

I was grateful for the enlightening conversations with these patients and survivors. I learned about their lives, and through that about mine. These exchanges showed me aspects of our existence that were so precious, yet often go unnoticed: suffering, living with meaning, connectedness, empowerment through community, and resilience. Engaging with people's stories gave me the bravery to look at my own and be more authentic.

—

As I realized that I was confronting death myself, the questions of what was beyond my finite existence became very salient. While I came from the middle east, the part of the world that gave us several attempts at the Absolute, I am facing death with one certainty: I do not know. I believe we cannot know surely in the sense of how we come to know objective truth. That is why I am agnostic.

The beautiful images that were developed to describe the afterlife could be true and could be false. I hold the same ambivalence regarding all religions. Some folks may consider them historical developments by the finite to reach the infinite. Others view them as attempts by the Absolute to connect with the finite. Both sides are just as eloquent at providing their arguments, and I am standing in the middle. While I confront the absolute master, death, I announce that I do not know which side is right.

I have lived a non-religious life. I intend to continue doing so in the foreseeable future. I realize that as death approaches, many humans tremble and choose to find refuge in faith. I never judge anyone who does that. I will be compassionate with myself if I go with that route as well. I intend to maintain my curiosity.

I draw the norms of my actions from the experiences and the learning we humans have achieved. I also bring the norms from the context of my day-to-day interactions and relationships with others.

I gave up my belief in one truth when I was nineteen, and I gave up my search for truth altogether when I was thirty-four. But I've continued to participate in producing and reproducing knowledge, meaning, and little truths. I am active in redefining what we consider right or good within my own context and vocal in expressing my authentic way of living.

Religions in the world, just like philosophy or poetry or art or people's stories, provide me with pre-interpreted semantics I can re-interpret in my own journey.

I hold to my entitlement to live that way, and I strive to make accessible to everyone the right to live within whatever framework of thought they choose for themselves, as long as they are not impeding others' similar rights.

—

With cancer, I have become more assertive in taking a stance. I discovered that I had an empowered and authentic voice, and I decided to use it. It was November 2016 when I was diagnosed with cancer, the same month Donald J. Trump was elected president.

I've asked myself several times which one of the two felt worse to me personally. The answer was not always unequivocal. A few months after Trump's election, he acted on his promise to ban Muslims from entering the country. Syrian refugees were banned as well.

I thought my story could be leveraged to shed light on other humans' struggles, especially those reduced to numbers and without identities or faces.

There was a rally by the airport in Indianapolis, and I prepared a talk to give but did not have the chance to share it with the crowds. So, I posted it on social media. A friend shared it with a journalist at a local newspaper, who then reported on my story. Other journals and media outlets reproduced parts of it.

As the narrative began to take different shapes, I decided to write my own account in the form of a letter to Trump. The letter was published as a Huffington Post blog, entitled, "Dear Mr. Trump, You Are Cancer and I Only Live If You Shrink!"

In the letter, I explained about living with what I had perceived then as a terminal illness. I reflected on being a doctor and a teacher, then a cancer patient. The disease awakened my sense of self as a vulnerable human. It also brought out my authentic self. As a Syrian immigrant affected by the ban on Muslims, I had fears that I might not be able to say goodbye to family. I hoped people would put a human face on the suffering because of Trump's inhumane politics. The ban on refugees had affected countless people. Often, their stories were left unheard. I shared my story to tell theirs.

I felt empowered after writing that letter in February 2017. I also thought that it helped me recreate my identity and reconstruct my narrative. It further liberated me to engage with the Syrian struggle. That was the most obvious impact for me.

For years, I'd felt that I had betrayed my community by leaving and then failing to engage in a meaningful way in our struggle. I did not think that my writing necessarily had any impact on the Syrian adversity. But it connected me through my personal equivalent of struggle with the battle of the people back home and in the countries of refuge.

Since then, I have continued to grapple with my involvement in the Syrian tragedy. I could pacify myself that I have a severe illness preventing me from going there to be near the people on the front line. I could tell myself that participating in fundraising here and there is good. I still feel there is a debt that is hard to repay.

I will always feel I owe Syria something. I do not simply imagine that the act of one person or group could change the condition of the Syrian catastrophe, but there is the feeling that something needs to be done urgently.

I have often had dreams about Syria. In most of them, I am back in the country somewhere, usually on the streets outside my house. I am trying to figure out a way to get out of the country, back to the United States. It would feel as if my attempts are all in vain, and I am be trapped. At times, I am stuck on battlefields with guns and shooting over my head. I run for my life, but with no escape. One time, the nightmare posed a challenging moral question. In the middle of these battlefields, I had the chance to be near President Assad. I thought, "I could kill him; I should do it!"

I grappled with the moral problem in my dream. I am not a violent person, and I condemn killing. But the dream posed the question of whether, if there were a way for me to kill the monster to end the suffering, I would do it. That nightmare ended without me killing anyone.

While this question was, for me, one I only dealt with while asleep, many Syrians had that same moral conflict in their daily reality. When they were faced with the brutality of the regime with the daily killing of civilians, groups of brave men took up arms to defend their families.

Many of these men were from rural towns including the one my family is from, Rastan. But with the regime's continual bloodbath, the country quickly slid into a militarized conflict. Regional forces and international players backed different local factions in the conflict. After a few bloody years, as everyone knows, the regime regained control.

Backing from Russia, Iran, Shiite Iraqi, and Lebanese militias gave the regime an advantage. The revolution that had emerged as a peaceful protest for a dignified life got militarized and then defeated.

—

The Syrian tragedy is not over yet. More than 600,000 were killed so far, and the atrocities continue. The number of those missing is larger, and countless more are displaced from their homes.

The refugee crisis is still growing (especially with COVID-19 today), and many who settled struggle with less than fair conditions. Survivors are left with wounds, traumas, and disabilities.

Buildings that used to hold our memories are no longer standing. Death did not spare the kindest among us and the most vulnerable. We lost families in their totalities, and we lost loved ones. We have so many holes in our hearts that we wonder at times if we can take another loss. Yet our bleeding has not stopped.

Only a couple months ago (in early 2020), the regime's artillery and Russian jets attacked the last pockets of rebel-controlled areas in Idlib. Civilians were fleeing. Children and older men and women were on the sides of the roads or in whatever modes of transportation they found. They were heading to safer places, and those had become scarce.

The criminal regime had taken over most of the country. Areas under their control are in profound economic devastation, let alone the rampant corruption. The revolution in its genuine form, many folks announced, has ended, but they disagree on its end date. Some say it was the day the uprising got militarized. Many say it's when the regime got their hands on our cities again: Homs, Aleppo, Duma, and Dara.

Announcing the end can mean communities could bury their dead and start the process of mourning and move on. This process may be quite laborious for us, Syrians. Tens of thousands of citizens are still in prison, and countless others we do not know if they are still alive or dead. Further, there are still groups who are fighting on the ground in whatever space is left for resistance. The war is not entirely over.

It is like cancer! The regime is cancer, winning in the battles, and taking over. We Syrians are like the weakened body inflicted with this malignant disease. Trying to keep on, we seek ways to live with whatever is left of us. At times, it feels like there isn't much left.

But dealing with this cancerous regime, Syrians have become more resilient. Many who left the country to places of refuge are working to reinvent themselves. They have stories that need to be told.

I have the privilege of having established a life, while countless Syrians lost everything. I am fortunate to feel I am contributing something meaningful for myself and for others, even after I became sick myself. I do not take this for granted. And I aspire to do more.

I will tell my story and connect with other people's stories. Maybe if we all share stories, we can rebuild our collective project. I want to participate in the project of telling Syrian stories, although I do not feel I am ready yet. I do not have the tools, but I am working on them.

—

After I finished my Ph.D. training, and with my illness, I shifted my research focus around. My qualitative research with cancer patients who were tarrying at the limits of time was dear to me. I knew the journey inwardly but did not have the words initially to explicate what it felt like nor what it meant. I live it as an existential struggle, as do many people.

However, living with the illness for long periods of time has led many of us, cancer patients, to a reflective awareness of ourselves. Recreating the narratives made it feasible to find words for complex and challenging realities. My work was meaningful to me and enlightening.

In the conversations I had with other patients, I was able to understand the other, and through that, I better understood myself. When I then shared my own stories, others said my words spoke truth to their experiences just as well! It goes both ways, I guess.

I have preferred to face the challenge head-on and not turn away. The pain was too close. It was inside me, and there was really no way not to feel it. I guess I could have numbed my feelings with what makes the pain more tolerable: drugs and alcohol. But the pain would still be there when I woke up from dulling my senses.

Instead of those vain attempts to distract myself, I decided to further my edification to rise to an understanding. If there is space for action, then I would do what I could to change my condition and lived experience.

While living with illness, I came to be aware of countless favorable circumstances that made it possible for me to be where I am now. Remarks about privileges may sound strange to a reader who sees in my story only the mere outlines: immigrant with many traumas in a previous life who escapes to a new country only to suffer from more traumas and then a terminal illness.

Well, if you put it this way, it does sound depressing! But that is not my whole story. The story I authored is that of grappling with what was given to me and doing something about it by leveraging other opportunities. I was given loads of unfortunate events and was able to wrestle with them and carry on, due in large part to many other supportive conditions. The events themselves were moments for me to refine my character and become my authentic self.

Being a person with privilege, my decision was to use my voice to share not only my story but also, and more importantly, the stories of others.

Many folks like me are doing the work and living with purpose despite their adversities. They choose to not tell their stories, and that is their prerogative. Others do not have the audience to tell their narrative, even if they want to.

The public space is occupied by celebrities; many are phony or with no soul. You hear about their trivialities once they've made it to the mainstream. Not much space is left for those forgotten on the margins who are making it day-by-day. Little is known about the victories of tarrying to live on after adversities or in unfortunate conditions.

—

Living with cancer brings questions to the forefront not only about who we are and what we do but also about the persons around us and how we relate to them. It challenges our perceptions of relationships, and at times, it strains the existing ones.

For me, it was heartwarming to reconnect with friends after I announced my illness. I have chosen to be public about my disease and shared on social media. Quickly, friends and acquaintances made the most touching and kind comments I've heard in my life.

People were surprised and, I could say, troubled by my illness. We have a framework to expect disease and death after humans live a very long life. But we have not come to take the loss of a person in their youth lightly. That is a good thing, I think.

The comments made me feel as if I was walking in on my own funeral. Folks shared memories about events that touched their lives; some I could barely remember. I was almost saying, "Wow, I was a good guy!" But part of me also wondered about all those annoying elements that I contributed to other people's lives. Well, humans tend to be kind and forget when someone is suffering. We humans can forgive.

There is also something to cope with in the journey of illness when others soon retract to their normal modes of action. The person who is ill notices that retreat. After the "state of emergency" was announced and people came from everywhere to visit, bring casserole, or say goodbye, they soon returned to their busy lives.

I felt lonely for a while. I had gotten used to love pouring in from every direction. That flood of affection became the normal, and I had a kind of withdrawal from it, when friends suddenly left to do their own thing. This withdrawal is part of the experience, I guess.

The flip side, however, is that I also felt tired as some of the love and care came to fulfill the other person's internal needs and not mine. Some people believe that being with the sick is a righteous thing to do, and they come to me in order to feel good about themselves.

There are also those who have their own struggles and connected with me as I became vulnerable, as they felt safer around me. To date, I have cherished the connectedness my illness has made available to me. I still aspire to the genuine conversation, however.

I have also mastered setting my own boundaries. I invite people to my space, but I also protect myself from being sidetracked or pulled into contexts I am not curious about. I need to be present with others, but I want them to be present, too.

It has become necessary for me to perceive the reciprocity of care and curiosity. I hope to be genuinely cared for and loved, and I need to be able to do the same for others. I do not appreciate one-sided relationships of the type that fulfills something unspoken, the person would not wish to explain, even to themselves.

—

Thinking about dating changed in the recent years, as well. I went back and forth with how I'm to live my life.

When I developed cancer, I had just started seeing a woman, and when I went to share my news, I initiated the visit by asking that we be friends from that moment on. In my mind, I was freeing her from the burden of making the decision.

She agreed to my request. But when I shared the diagnosis, she called me out for taking away her right to decide for herself. She insisted that cancer did not change what she felt for me, and she chose to stay intimately involved. I did not resist and appreciated her presence.

We dated for a short time until I asserted that I wanted to keep true to my desire to stay single and alone. After that I stayed single for a few months, then dated and got engaged and, finally, split up again in December 2019. Now, I am back to being a bachelor and keeping it that way.

I won't talk here about my relationships per se because they are not only mine. These stories are 100% the other person's, just as well.

Relationships in general are not easy. There is a certain level of vulnerability to be in one. Cancer exposes a pervasive exposure that made it harder for me, at times, to maintain a sense of self necessary to have connectedness.

Cancer has taken me into deep lows in feelings and thoughts. During these times, digging into my agony with another person can be exhausting and horrifying. It felt like jumping off a cliff without knowing what was waiting for me or how deep I would go.

It had often worked out fine in the end, though. After a buildup of tension, I finally would find the bravery to be vulnerable. It took effort—at times, a lot of effort—something I didn't feel I had the energy to endure for the long term.

Being with someone, for me, exposes a sadness that I could hide from myself. The person sees my face and asks, "Are you OK?" My answer would be, "No, I'm not OK." But the answer would mean going into a spiral of feelings that I wish I could be spared.

I didn't struggle to make myself understood by others or to have them understand me either. I had a sophisticated language to bridge the divide. Some say, you only understand the experience if you had gone through it, and I would disagree. Others did not need to have cancer to understand what I was dealing with.

To be understood, it takes commitment the person decides to have regarding spending the needed time and efforts. With cancer, however, time and energy are scarce, and the experience is difficult to explain. It's true, the more I exercised my capacity to make myself understandable to others, the better I felt. As I explained myself, I made better sense to myself too. But to do that all, I needed space for myself and some distance from people.

While currently I live alone, I still cannot live without humans and do not wish to alienate myself or be alienated. I aspire to stay in the mainstream, even though that comes with a burden. To stay in the mainstream means remaining able to engage with what others find meaningful. But, with cancer, what entertains me is often not of the same relevance to others.

The desire to be in the mainstream made me bring the margins to the center. I'm moved to tell stories in a way that is relevant to all people. I tried to connect us with those living ordinary realities, yet in a richer way.

I've pushed narratives of those living as patients, including my own, to the center. This endeavor, could be called a counter-invasion, from the margins to the mainstream. But you can simply call it inviting the other into a conversation, where all are equal.

I have had rich experiences that I refuse to undermine in order to fit in to a societal standard. I need to connect with the other in the spaces they are in and not merely in my space as they come to provide care for me while I vanish. And I've grappled for a very long time with this concept. Why would people come? Why would others stay around in a relationship with me?

As I searched for love, I made clear to my significant other that if my health declined, I did not prefer for them to be around. I didn't wish to be a burden on someone else. Particularly at my age, it felt like my partner would likely be around the same age. Would not I be wasting prime years of their lives only to die and leave them with a grief? That was an onerous burden in my mind. Choosing to die single is easier.

If I answered the question of relationships more convincingly, there was another piece of the matter to address. I am afraid that the other would not tolerate my suffering and would have the urge to leave. When I get to be at my most extreme vulnerability, as my health declines, I anticipate that it would devastate me if they left then.

To protect my heart from this potential loss, I would just shut it off and announce that I did not want the person to stay. I'd push them away, so I maintain my sense of control. I realize I'd be missing out on intimacy and care; both are only attainable with openness to vulnerability.

Meanwhile, I also reflect on my previous life and remember that I had maintained curiosity about being on the edge and finding the novel. I enjoyed the hunt for the experiences. By that, I do not mean killing an animal or scoring a date with a beautiful woman or even marking a daring thrill off my to-do list. Instead, it is about being in spaces where I feel the moment dense and new. Newness in the sense of transcending the self and being in the spirit of existing as an "I."

When I put these fears and desires together, I see how my options become quite constrained. But they do not have to be. I have learned to be myself. This attitude is critical. I have refused to pay forward to people so they can be there for me when I'd need them. That is not part of my formula of existing. I need only genuine connectedness with others.

I can see how my presence can be inviting to the other when I am authentic and seeking genuine connection. But how would I appeal to another person when I shrink to a mere being near the end, when even the music I chose for my last moments may not sound to my ears? I don't have the answer to that question yet.

—

Relationships with family is not qualitatively different, although it is worth its own reflections.

Since my youth, I have secularized the concept of family. This helped me take a critical stance and dissociate myself into a space in which I could be an individual. A blood relationship is vital. But more important is the genuine connection we have with the person as such, including those who share most of our genes. The notions of "duty to the family" have, for me, a more subtle meaning than what many would consider traditionally as a righteous obligation. For me, if you can do something good for your family, then you should—if you want to.

At the same time, I have been close to my dad and siblings, and we have quite a solid connection. That is why I shared with them first when I received the diagnosis of cancer. I did that over Skype, and seven of my siblings were there. There were tears and moments of shock.

Silence was followed by words of love and support. I ended the call with an announcement, "I need to go buy a light bulb so I can keep reading the philosophy book I've just started!" The light bulb has been out for a few days, but now I have an urgency to fix it so I can read Hegel's Phenomenology of Spirit and find truth.

Different family members visited me at different times, and they were kind and thoughtful. I was also fortunate enough to be able to visit them all: in California, Maryland, the UK, and France. It was a great time with many heartwarming memories.

I struggle with group talks, and I tend to not be able to follow all the little chitchat. In one-on-one discussions, I can give the attention that is needed, and I find it rewarding. We have a weekly meeting on Skype now on Sundays at noon. I suggested this meeting for multiple reasons.

I wanted the family to stay connected, with and without me. I thought a structured space for regular check-ins would be good. We've had different forms of periodic talks in the past, but now it's been consistent.

I also preferred an efficient type of check-in. I did cherish the intimate one-on-one communications, but I have eight siblings, and with Dad, we are ten. This way, there is less need to repeat some of the common questions like, "How are you?" and "How is your health?" The one hour of chat is enough to allow everyone to share updates. The more intimate and deep conversations can be carried out later or before.

Even before COVID-19, our weekly meetings were precious. They seemed to have become more meaningful to us all, with the little in-person connections that we have space for with the social distancing. But our video chats started way before this pandemic.

—

My world changed rapidly in the past couple months. It's totally a different place. And like everyone else, I felt the COVID 19 pandemic to have overwhelmed my capacity to think. It was a major existential challenge.

I heard about it when the news came from China, early January 2020—scary stuff. People were dying in large numbers. The situation seemed to be poorly managed, but it was hard to know what is real and what is not. The Chinese government is not famous for its transparency.

But what was obvious then was that in a tightly connected world, this fast-spreading virus was not going to stay in China. It was not surprising that the virus appeared to the US in a few weeks. The first reports were from Seattle. The COVID-19 cases were 10 miles away from where I live.

The threat, I felt, was not only grave, but it was like right outside the door. Very quickly, the hospital and clinic where I see patients braced for the worst to happen. Loads of information were coming every day, and I was doing my own research. I would look at the CDC website and periodically do a PubMed search of all that is "COVID-19." A few hundred articles would come first in early March and thousands in just a few weeks after.

Social media also blew up. Information and misinformation were coming from every direction. People were worried, understandably.

I was terrified. As a cancer patient, I could be susceptible to a worse outcome than the average person my age. I was also concerned about my dad and my siblings. But I was especially worried about my colleagues and friends who were doctors. Without enough protection, health care providers were exceptionally vulnerable.

Further, I sensed the fear in my cancer community. They were exposed to the illness. When debates about "rationalizing care" emerged, they were frightened to have become victims of society's prejudice.

As the pandemic evolved, it became clear that we were not prepared for it. The health system in several cities in the US was struggling. Marginalized communities were hit the hardest in the sense of the number of individuals acquiring the virus and dying because of it. They had to work and had limited means to protecting themselves. Because of historical health disparities, many had suffered from underlying health conditions that made them vulnerable to the worst outcomes with the virus.

The pandemic, as many said, showed the worst of us and the best of us. There were examples of mobs hoarding essentials, and a few even stocking sanitizers so they could sell at higher prices. Some mislead the public into undermining the significance of this disease by ignorance or negligence. Many stubbornly refused to adhere to public health recommendations risking their lives and those of others.

On the other hand, many staked their lives on the front lines to care for the ill. Those were the real heroes.

I longed to participate, but I did not how, at first. When the discussion came about caring for patients, my immediate inclination was that I'd like to be on the front lines like everyone else. But when I realized my personal serious risk, I decided that I could be spared.

It was not difficult for others to understand my reasons. In the end, no one really wanted me dead or in the ICU. But the decision to quarantine me and stay home was tough. I felt I had to give up a duty to care for others that is at the core of who I am.

I continued to see patients by telemedicine, and I would reach out to those who have chronic illnesses to make sure they are doing ok. It is not the same as being in the front line, but I thought I could lighten the load a little.

I thought I could also contribute in my capacity as a researcher. So, I shifted my research project to focus on the lived experiences of communities and individuals affected by this pandemic.

So far, I've interviewed about thirty individuals. I have been occupied making sense of the challenges and participating in the public discourse on the subject. I published a few articles and gave interviews to local radio and TV stations to lend a voice to the ones whose voice is not heard.

I shifted my style of research to take a more journalistic approach to the matters at hand. I felt there is an urgency. I would interview 5-8 participants about a topic, and I would write a piece to be published in a media outlet.

I intend to develop the work further to produce what I could communicate to medical readers in article forms as well as to the public in a book. Maybe that will be the topic of my next book.

I felt I needed to build my tools, as well. I had to learn fast. So, I endeavored on a program of study in philosophy and theories of social sciences. Being alone at home gave me time, and having little distraction gave me space to read and reflect.

I have been in the house quarantined for many weeks now, and I missed the human connection the most. I crave the presence of someone with me in a room. Yes, I had more intimate talks with friends, families, or lovers over Facetime, but it is not the same. I discovered how much I love the touch of the skin. I missed the scent of another human's body.
Final Remarks 
How Will I Be Authentic?

Being Authentic is what I decided to name this memoir before I drafted the first sentence. It was the working title and the mindset of writing it.

I thought about authenticity as a guiding blueprint for telling my story and living life moving forward. I wrote the book with eyes on the past, mind in the present, and heart in the future.

I've wondered from the beginning what it means to be authentic and grappled with that question along the way. I had a few attempts to explicate that.

I thought that being authentic meant to do what is measured by my own standards. In other words, to not give a shit about others' criteria. I didn't like that last sentence and thought I could find a more sophisticated way of saying it, but I left it because it is authentic. However, I didn't like the statement because it was not accurate.

If I tried again, I would define authenticity as striving for space for me and you so that I can feel whole in myself and for myself, and you can do the same. In that space, I could bid my criteria and join in thinking how to judge based on them with you, and you do the same. I need a genuine other to be authentic to myself with them and for them as well.

I further thought that being authentic would mean having my standards reflected upon (by me) and well regarded (by the other). It is not just to take them as they are given to me by others. It is also not to make them up as they occur to my mind by my own intuition. I seek my better, authentic truth to come in openness and dialogue with the other.

I need to be able to defend what I do with reason. I should be able to respond to anyone who might say, "No, you were not authentic, that isn't right, or that's not true!" I am open in my life project to this critique and must be able to answer it with reason.

I should anticipate critique, and with my action, I should account for this no and prepare arguments for it if it comes or doing what would make it not appear.

I realize that not every "no" comes with a valid reason. Humans have many psychological drivers for objecting or criticizing. To a wrongful "no," I should be prepared with my own rejection.

I further need to be able to add coherence and consistency to my narrative. I should edit some of it out, explain parts, and apologize if needed. But as I am conscious of my story, I would never let that stop me from living an experience that unfolds and from allowing myself to be renewed. 
Participating

Being authentic is meaningless if I do not act. I want to act in the sense of leaving an impact and renewing my relationship with others.

I realize that I am here in a world of conditions and contexts, and I'd like to explore how to make it better and contribute to solving some of its problems. I hope to be part of finding a better truth in cooperation with others. This is a group project, and it is paramount.

At the same time, I celebrate the relationships I have, and I'd like to renew them and create new ones. My friends, family, loved ones, community, and humans in general are present in my mind, and I have more than just curiosity. I have care for everyone.

I'd hate to be idle. Yes, I could rest when needed and will sleep when I should because sleeping and resting are necessary for my physical and mental well-being. I set boundaries to protect myself.

I realize that my life may be reduced in span, but I genuinely aspire to leave the world a better place for those who will remain after me. I want to help keep it. I also, while I am alive, need to minimize my negative impact on the world we live in.

I do have environmental consciousness, and I should probably become more sensitive to this matter as I continue to exist. Participating in the project of humanity isn't feasible if the conditions of our existence grow unfavorable due to our own selfish acts that impact the environment.

While being aware of our environment, I need to allow myself to leave my mark in the sand. I know that when I die, I may fall like a tree in a forest with no one paying attention. I am working to reconcile with that. But I aspire to have a life project that contributes to humanity in a meaningful way.

I have my words and will say them. I have my hands, and I am typing as I go so that I can be a participant. I will do what is within my power to let my story carry me to individuals who also look inward to find their authentic selves.

I want to be mindful of the other as such. I'd listen to what they're saying. My commitment is to consider their best interest without patronizing or claiming better access to their truth. Yet, if invited, I'd accept the invitation to be truthful, and that means to engage in a critical dialogue.

We are complex, yet maybe not so much. People want to simply live meaningfully. If faced with adversity, they would need conditions to cope, become resilient, and receive support to carry on. Before all that, we crave to find our authentic selves and be treated as such.

We do not like to be abandoned, and we celebrate the connectedness with loved ones, family, and community. We also long to this subtle and forceful feeling we call love. We also long to contribute something meaningful and feel mastery in our own world. It feels gratifying to do things well and be useful, and it can be discomforting to be made to feel inept.

But there are conditions to be authentic. People must first have their basic needs met. We all deserve shelter, health, education, and participation in the public space.

Not having these needs met does not mean the person is incapable of attaining higher-order meanings. But these becomes more difficult to get to. Further, not attaining basic needs could explain why someone falls short in seeking better values or get entangled in what the self or others consider evil. But if I would name the highest among the ideals and the grounding value for them all, it is justice.

I mean justice in the sense of fairness. If two humans are born today, do we have conditions to ensure they arrive at the same endpoints they set for themselves years from now? The answer to this question tells more about who we are than any other criteria, in my opinion. To be a just society is of utmost importance, and it is not an aspirational goal but instead is a project to work on today.

We all equally need to be able to promote our self-interests and live our ideals as actuality. Seeking what we choose to pursue and having space is what we all merit. We further deserve to author our narrative and shape the world after our individual images. The person should be invited to join in as an individual.

Rethinking our group identities is a must-do here. I am an outsider, and like countless folks in my position, we want to be considered in and not be left on the margins. Our innate ability to see the truth is comparable, and our right to consent to what is good is equal.

As an outsider, I invite the person "inside" to escape their entanglement and see the world from their other's perspective. From my vantage point, we all can grow if we redefine how we view ourselves within the group we are part of. We can all grow if we become immigrants or, even better, citizens of this globe.

I am an immigrant, but I invite the people "of the land" to take my position and share their story after they develop it as if they are saying it to their other. I share mine precisely for that purpose. I hope the public widely open their personal spaces, to which only they have privileged access.

I do think we can be better versions of ourselves if we share our authentic story taking the vantage point of the outsider. We may first think, "My story is boring," or "Who cares to hear it!" I would say that if you put yourself in your other's shoes, you would certainly find your story interesting!

I reflect on this I/thou and we/them as we grapple globally with a crisis of identities. Fascists and populists are leveraging this crisis to cultivate group identities that are defined by the rejection of the other. People have done that in times of scarcity and times of crisis.

But we can do better.

Humanity has achieved sophistication enough to deal with crises without dehumanizing or Satanizing other groups. What feeds the populists and fascists are elites implicated in the crises and the scarcity as they accumulate their wealth and power. Thus, it becomes essential for us, the majority, to say no.
Surviving COVID-19

The COVID-19 pandemic made us all realize that our life is fragile. We have become aware of our finitude in an urgent manner. I am not the only one thinking today that we should reconsider our answers to the big questions of our existence. The call for more authenticity is loud.

Individualistic answers were proven to fail. People are finding the need to work together for better solutions, not on their own, but as a community. There are tons of stories that are inspiring, and writing our narratives today is critical. We can edit it tomorrow. The critical dialogues and reflections are relevant here, and so is the reconstructive work. And that is the project humanity in its acute state. Many individuals today feel the urge to work on what they are talented at to contribute to our project. They have lost a loved one or came closer to conceiving their own mortality.

What COVID-19 did not do is making humans think we are too finite to dream big. Yes, many are still wary of the risks of questioning everything. True, the conditions have not been created yet for knowing what's far beyond our previous self-understanding. And there is a danger in getting lost in the big picture and getting consumed in the delusion of fixing the totality.

I am further aware that the desire to open all the questions at once can leave us with nothing but shadowy answers. But do not we miss a once in a lifetime opportunity if we abandon the desire to transcend our conditions and seek a better reality? We do. Today is the time to try.

I thought my life journey is nothing but attempts to transcend my finitude and reach beyond. Today, I feel less on the margin than ever. Billions on this planet are vigilant of their life projects as they are sensing the real threat. Being confronted with sickness and mortality brought us all into a state of confusion. Some were more prepared than others. Some of those who have confronted their own fear before might have an edge.

There is hope that we may be getting this pandemic wave under control. But we still may not have much time left to protect from another one. The devastation caused by this illness on vulnerable communities was so vast. We have an urgency to fix the damages.

We've lost countless lives, and I wish we can talk to everyone to hear their stories. I wish everyone had written their memoirs so we could anticipate what they would say as life goes on. I wrote my memoir, so I can participate in the conversation when I am gone. I regret that many have not left us their words. I know that I do not want to go. I also know that I miss those that have left, even the ones whose stories I did not come to know.

I am not reconciled yet with my early death, nor with that of others. I wish to continue as me and, better, even as an I. I wish others never leave. But if that is not attainable, let's at least keep the words.

I have talked to many people around their experience with COVID-19 as part of my current research. I hope that I have the time to share their stories. There is an urgency to make sense of our challenges on all its levels: the existential, social, psychological, political, and cultural. A lot of work needs to be done in addition to the efforts to keep people safe and maintain conditions for their sustenance.

Can I say, I feel fortunate to be alive today? I take this journey with others and will do what I can to bring those voices to the conversation. There are millions of questions we need to ask today about who we are and about what we are doing and, most importantly, about what we aspire to be. I want to participate in answering these questions. 
A Community or Communities

To participate, I need a community or communities to which I belong. And I think I have a few.

When I think of my community as a professional, I feel extraordinarily fortunate to be surrounded by folks who are doing meaningful work, and I, with them, participate.

I am with the learners, many of whom are, empowered millennials, aware of the notion of justice better than their entitled parents. They are resilient and quite capable of calling out the bullshit that existed and still exists. The youth are leading the change and pulling us forward. They deserve to be proud of their voice. I am heartened and optimistic as I see the picture of the black medical students standing by a slavery plantation asserting that they are here. I want to learn from them.

I feel also fortunate to be with colleagues in healthcare. Countless of my peers dedicate their lives to the mission. They are putting in the labor and being selfless in giving. We are becoming more and more aware that medicine is not a system with its own rules outside the society. We are not engineers and the person in front of us is not a machine. We are, instead, embedded in the heart of the living beings in the larger community.

The epidemic of opioids, the unsustainable health care costs, and the disparity in health care are all examples of medicine's failings. Attention is needed to examine the dynamics and the norms of interactions to make them more consistent with who we are and what we wish to do. Way before COVID-19, but especially with the pandemic, the questions of health equity have been salient and needed to be in the forefront of the discourse today.

But when I conceptualize my community as a person, I need to find a space in which I belong with others. I crave the dialogue, simply with everyone.

My community includes the totality of those of us who'd like to converse. I say this, and I am entitled to it as an immigrant who is still in search of a home and defines home not by geography but by the people.

This community will have to be diverse. I suffocate, like most humans do, in monochromatic societies. There ought to be space for the other, the different. I am not speaking of a little space for artists, poets, writers, dancers, and actors, although it would be fun to find where those exist. I don't particularly look for an eclectic group to belong to in separation from others. I strive to connect with the poet, artist, writer, dancer, and actor in every one of us.

—

But when I think of community, I cannot help but think of Syria. Syria was my home for the first twenty-three years of my life. When I left, I did not want it to stop being home, although I hoped to reconstruct our relationship. I had hopes that we would both change, and we did.

With our tremendous losses, everything is left to question: who are we? Can we still speak of a Syrian community anymore? I think we can. Those who still look back every now and then to celebrate a memory or to grieve a feeling are the community. Those who lost everything and do not wish to look back are also us. We have a narrative that we share, and we are writing this narrative as I speak.

A defining value and aspiration for us Syrians is justice. Justice is what we demand. The calling for justice is what we need to hold on to. The killing has continued, and that needs to stop so the criminals can be brought to a fair trial.

There is no undoing of what has been done. Yet, justice is the first step for possible healing. True, the regime is like a cancer that has spread and came on strong after crushing the whole country. Holding onto that calling is fundamental for us to continue.

Holding onto the calling for justice lets us enact other positive values without having to turn our heads away. Yes, the person who has survived the atrocious killings and lost many of their loved ones is still entitled to live. We are not betraying the dead if we choose to live.

We are resisting death by living and carrying on. While many of those we loved are absent and there are others we don't know if we will bury one day, we can choose to live and still not forget them. We can live and carry on while holding to something fundamentally us, our commitment to bringing justice and our promise not to forget.

Every human is permitted to live life to its fullest. We can keep the ones we loved alive by carrying on while savoring their memories. They are alive when we remember, with a warmth in our hearts, their quirky sides, and their silliness. I'd like to be remembered as that after I die, and I want to live when I have by not letting my loss of loved ones make me lose myself forever. I make this choice because that is what I know the ones who loved us and left want us to do. We resist their death by becoming more resilient. We resist by loving and laughing.

While we are still busy counting our dead, can we speak of a Syrian project in the positive sense of the word? I would say why not? We all have our project, and we will always do. Now the conditions are just harder on the ground, and the Syrian people are all over the map. But, hey, that is more leverage and better access to wisdom and resources.

I realize as I say this that many of us are still struggling with the basic needs of living as humans. We need to have a space for citizens to participate. This means rehabilitating the ones who were injured or damaged by the war. It also means catching up with education for the ones who were left behind because of the war.

Displaced groups need to resettle in safe places. Many of us could choose to return home when the regime becomes part of our past that has gone. Meanwhile, it is a human right to have dignified refuge when needed. We Syrians, just like any human on earth, are entitled to a space to be safe and to have access to what's considered in the civilized parts of the world as fundamental human rights. Finding humane conditions for refuge is an entitlement and not a generous act of this or that country.

Syrians have gone to the street to protest the corruption and the wrongdoing of the regime. Throughout the years of the revolution, we cultivated our authentic ideals. We enshrine freedom and dignity.

These are the essence of humanity's project since modernity. Syrians demanded to take part in this project and not live outside it. We revolted against the unfair conditions of groups treating us like their slaves and the country as their heritage.

We asserted when we took to the streets that we are all equal, and we stand for people's rights to participate in shaping their destiny. We have endured oppression, and we stood tall.

Syrians, like many people, celebrate hard work. We honor the job well and perfecting it with style. We appreciate doing what is right and working in our callings. Many are hardworking individuals in intellectual disciplines, but among us is the crafty man and the person of trade.

We have historically been open to others and lived openly with them. We are generous people, and we give even when we have little left. Many of us are brave, and we have a dignity that we do not want to compromise. We have given a lot for making things right, and we did it stubbornly as we took a stance.

More important than all this is that we are living and insisting on keeping on. We love to laugh. Our sense of humor is quite quirky but authentic, nonetheless. We do not spare any opportunity to celebrate life by dancing, and we have stupendous music and great beats. We also cook delicious food. We share our cuisine with the cultures that have lived near us; we learned from them, and we taught them. Because of our location in the world and in history, we have refined our tastes.
Being Optimistic

I had some difficult past many years, and I became resilient. The US also had a rough past few years and we are still pulling through. The world is facing COVID-19 and it has been a major challenge, but there is hope. I look beyond these dark times, and I am optimistic.

I have said it several times in this book that I am now aware of my end as an individual. I have no children, and I do not plan on having any. I cannot have biological children even if I want to. The medicine I take is teratogenic. It would be quite unethical to fulfill my desire to have a legacy in a child while not guaranteeing that they would be healthy enough. It's also not fair, for me, to bring a child into a life I'd depart before they develop language to understand their own existence or make sense of my departure.

But I am curious about all the children out there. I care for these little creatures who can be annoying on the plane and are too authentic for me to stand them for more than fifteen minutes in my office. I am optimistic about the future they will bring for humanity and hopeful that we can do the work to keep this earth livable for them.

I worry about our planet, for the children, and for the other creatures that had no say in what we humans have done or will do. The threat is real: it is getting hotter, and we see the effects. Water levels are rising, forest spaces are shrinking, species of animals are vanishing. Soon, expanses of lands that used to be livable habitats for us humans won't be so anymore. This is deeply troubling.

Indeed, we are probably more powerful than other species, and we have many advantages in our brains, but we do not own the land. We are just as much visitors as everyone else. Maybe we need to better accept this fact and stop clutching onto things as if they are going to be ours forever. It is as if upon realizing that we may not live long, we stop caring about leaving anything behind. Who cares about what is here after we're gone, anyway, right?

Well, we should care. I care, and I want others to care, too. If the other is not caring, they are impeding on my rights and on the rights of children everywhere. Because of the children and because of the others who will still be alive when I am gone, I care. If you feel you lack the capacity to empathize with what I say, meet other humans as such and come to know them as individuals.

The suffering of a human will teach you to care when you hear about it from the individual themselves. Their joy, if you are lucky to learn about it, will teach you to care. And I know how everything in our daily lives today is reducing us to numbers. We are exposed and known as objects with attributes. We can be known by tracking what we do and by observing our behavior. But that is not the whole story.

Many of us want to resist being reduced to mere things. We hold onto the claim that we are beyond what can identify us and name us from the outside. We can transcend what is made known about us because we can reflect and author our own narratives.

Indeed, others can study us and predict our behaviors. But we can learn about who we are, transcend ourselves, and defy predictions if we choose to. I do believe in our capacity for learning. With learning, we move up and in different directions. With knowledge and education, we bring hope as we see the world differently. We cope with struggles, and we reconstruct identities. We are liberated to be and to become our true selves. Can that be available for everyone? Education is a human right.

Another human right is the right to health care. I realize that I am fortunate to be alive only because of advances in science that made possible the newer treatment I am on. I hope that more will come so I can stay alive. I also hope that what is available to me is equally available to everyone else. Health is a fundamental right that cannot be alienated from the individual.

I have encountered the fragility of our existence enough to know, inwardly, that there are no guarantees. Today, I am a middle-class person. I have a job and shelter. But if I get sicker and lose my job, I will drift down rapidly and could lose everything.

Many of the homeless people we see on the streets have meaningful stories. Some of them probably have drifted one day, like we all could. It continues to trouble me that in the developed part of the world, we have the ultra-rich while the poor are suffering more and more. This is not right and needs to change. Those who take for granted their wealth while giving little credit to others' contributions may need to look further out.

We have, for centuries, established our society as the product of individuals competing with one another to pursue their own interests. Is it time to provide fair conditions for everyone to be authentic and participate? Is it time to reconsider our social contract to correct for our errors and for natural happenings?

COVID-19 taught us that the disease disproportionately affects those who have been victims of historical social oppression: the poor and the marginalized. Now, it also taught us that no one is immune, and when the ship sinks, we all go down.

A new, collective project is needed, and it should have different principles. Justice is the main one.

I realize I end this memoir meandering about myself, others, and finally, the world we live in. My aspirations are not separable from who I am as an authentic person. I won't be authentic without speaking about these concerns that transcend me as an individual while constituting my core self.

I am moved to live and to participate. Part of my participation is to take a stance. The other part is to call on others to do the same. I cannot be authentic in a world entangled with oppressions and injustices. I cannot be authentic alone.

I am writing my account so that I can participate. But in doing so, I am also inviting others to also write their stories, be authentic, and participate. And I will leave you with my demand; you should write your own memoir and be authentic.

The End

## Contents

  1. Introduction
  2. Part One: In Syria
  3. Part Two: In the United States
  4. Final Remarks

## Landmarks

  1. Cover

