“Gratitude turns what we have into enough, and more. It turns denial into acceptance, chaos into order, confusion into clarity. It makes sense of our past, brings peace for today, and creates a vision for tomorrow.”

– Melody Beattie

As an avid reader, the above quote always intrigued me, but the true meaning didn’t register until I worked as a pediatric anesthesiologist in the Middle East.

”Sabina, I got an offer to move to the Middle East for job assignment. What do you think?” My husband asked as I was trying to put our son to sleep and thinking of the long week ahead. I paused for a moment. I had to…

It had been three long years since my firstborn was diagnosed with leukemia. We were finally winning the battle and finishing chemotherapy. The art of compartmentalization I had acquired along the way had started to bear its weight on me. Having to leave my son NPO for an intrathecal procedure in the morning in a cold hospital room and driving to another hospital for work was taking a toll on my physical and mental health. “It would be worse if I was not in the United States,” I would tell myself. However, I was able to remain steady, strong, and productive, due to the tremendous support I received as a patient’s mom and a physician. Those were indeed tough times, but the unmatched care filled with love, compassion, and empathy made the difference. The people around us in our journey with my son were not related by blood. I had never seen them before and knew I may never meet them again. A gentle pat on the shoulder, being present when I didn’t have much to say, acknowledging the circumstances I was in, were what this mom needed the most.

When I first came to the U.S. in 2008 with big dreams and a new marriage, I went through all the struggles of entering residency training, caring for an IUGR baby, and having no family around. Just like many physician moms, especially immigrants, I had already beaten the odds. I was immensely fortunate to have mentors who recognized my drive and passion. One step led to another, resulting in a successful match into the anesthesiology program at the University of Arkansas for Medical Sciences (UAMS). I continued to be embraced by the most generous and beautiful people wherever I went. The training at UAMS, just like any residency, was rigorous and highly demanding. Being a level 1 trauma center, we had long working hours. Add to that the new system I had to acclimate to. My first friends in residency were nurses, who taught me that “OSH” – the hospital that would keep sending countless surgical cases every night – was an acronym for any “OutSide Hospital” and that the term “flashlight” was to be used instead of “torch” while examining patients. They were my work grandmoms.

The importance of teamwork was underscored as never before when I had my first trauma case as a first-year anesthesia resident. This woman, “GK,” with polytrauma, was brought to the OR for an exploratory laparotomy and fracture fixation. She had multiple fractures along with a liver laceration, splenic rupture, and bowel perforation. We all thought GK would not make it out of the OR alive. Our team transfused 20 units of PRBCs and FFPs along with five bags of platelets. We gave factor VII at one point as the orthopedic surgeons tried to place pelvic fixators. That night was long and full of lessons, the most crucial one being the importance of teamwork. What a wonderful attending physician we had! Everyone stuck to the roles he had assigned and worked toward a common goal – no death in the OR. This avoided any confusion with fewer chances of error. GK was taken to the ICU eight hours later in critical condition and, miraculously, walked out of the hospital three months later. GK had beaten the odds.

Toward the end of my residency, I was serving as a consultant to junior residents. I was able to identify and troubleshoot anesthesia-related issues. Intubating difficult airways, placing invasive and non-invasive lines, and doing neuraxial and basic ultrasound-guided regional blocks became easy with time. I gained the trust of my amazing attendings. “If there is one anesthesiologist you want to receive your epidural from, that’s Dr. Khan,” said my attending to a family requesting the procedure. This could only be said by someone who had faith in the training they had provided. I was awarded the best pediatric anesthesia resident award toward the end of my residency. I was elated. Gratitude was missing.

While the residency had taught me to handle difficult cases, the pediatric anesthesia fellowship fine-tuned the skills I had acquired. I learned to handle complex pediatric surgical cases, intubating babies with Pierre-Robin syndrome with flexible intubating scopes, and placing arterial lines under the drapes in craniotomies and epidurals in 3 kg babies with surgeons pacing impatiently in the background. The several role models in the program ensured that I learn what it takes to be a compassionate yet competent pediatric anesthesiologist. I was blessed with mentors who became pillars of strength for me.

“Sabina, are you listening?”

My husband’s voice echoed in my ears as I pulled myself to the present. “Yes, I am.

But I am not sure how my boss would take it. We are already short-staffed,” I spoke softly. I was thinking about my exceptionally supportive boss and how I would explain this sudden change.

However, the idea of moving to the Middle East was surely tempting. It meant being closer to my family, one thing I was missing in the U.S. That could translate into more support, and maybe the job could offer more flexible hours. My son had just come out of chemotherapy, and no one knew of my second pregnancy yet. This move could provide time for me to heal, regain my perspective, and start fresh. We decided to interview at a children’s hospital, and everything went well. My boss was extremely supportive of my decision, which helped me tremendously in taking the plunge.