Learning to Listen: A Memoir

By Vidhya Prakash

Learning to Listen is a riveting memoir, chronicling an infectious diseases physician's most impactful patient encounters amidst a backdrop of poignant and powerful experiences growing up in the United States. A fascinating journey into the world of an Indian woman, physician, U.S. Air Force veteran, and mother, Learning to Listen strikes a chord and touches the heart.

• Language: English
• Publisher: Tablo Publishing
• Release date: Nov 15, 2021
• ISBN: 9781649699855

Book preview

Whatever happened, happened for the good.

Whatever is happening, is happening for the good. 

Whatever will happen, will also happen for the good. 

Lord Krishna in the Bhagavad Gita

A single sunbeam is enough to drive away many shadows. 

St. Francis of Assisi

Mom

I paused before I knocked on the large, wooden door that separated me from my patient. Ms. K was a woman in her sixties who had suffered multiple infections of her knee, requiring numerous surgeries, countless rounds of intravenous antibiotics, at least ten hospital admissions, and an immense amount of patience and courage. She was admitted to the hospital the evening before with increased pain, swelling, and drainage from her right knee along with fever and chills, which were telltale signs of breakthrough infection. She would invariably require yet another surgery and more intravenous antibiotics. I braced myself for tears, anger, and a barrage of questions.

When I heard her weak voice utter the words come in, I walked into Ms. K’s room. She sighed as she greeted me, shaking her head. I don’t know what to say, Dr. Prakash, she said. I just can’t believe I’m here again. I sensed defeat more than the anger and despair I had anticipated. We discussed how she had been doing since her last surgery several months ago and she said she was doing fairly well until the past week, when the symptoms started and gradually worsened to the point that she was not able to walk. As she continued to describe the pain and swelling she experienced in her knee, her eyes welled and she stopped mid-sentence, taking a deep breath and clenching her fists. I just don’t know if I can keep doing this, Dr. Prakash, she gasped in between sobs. I just don’t know if I have any fight left in me.

I pictured myself in the hospital bed and imagined I was on my eleventh hospitalization, struggling with pain and swelling in my knee to the point I couldn’t walk, separated from my husband and children yet again for at least five to seven days, facing a prolonged recovery and ongoing adjustment of antibiotics, and anticipating another long journey of six to eight weeks of intravenous antibiotics, weekly blood draws, and several more doctors’ appointments. This was in addition to the high likelihood I would be hospitalized yet again because my treatment would fail. I wondered if I would have any fight left in me and struggled with my honest answer. I reached out and held Ms. K’s hand. I told her that I was inspired by her strength and her courage. I emphasized that she had made it this far, would undoubtedly get through this, and that the entire health care team was behind her to help her through the process. I know you can do this, I finished. We locked eyes and she gingerly nodded her head, her renewed sense of hope palpable as she began to smile through her tears.

Within a few days, I received a lovely message from Ms. K’s close friend. She thanked me profusely for caring for her friend and emphasized that my compassion and believing in Ms. K made all the difference in her care. The wonderfully human connection I established with Ms. K, coupled with the affirming letter I received from her friend, renewed my love and passion for my work as an infectious diseases physician. The experience solidified what I continue to learn with each patient encounter, which is that at the heart of our profession is the relationship we establish and build with our patients.

This is the story of an Indian girl born in France, raised in the United States, who was an English major in college and then joined the Air Force, who ultimately fulfilled her lifelong goal of becoming a doctor, and then married a White man with whom she is raising two bi-racial children in an ever complex universe. I read this sentence and raised my eyebrows. There are so many components of my story that are intriguing, inspiring, and impactful, but I had to ask myself one important question. What are the stories that need to be told, that must be heard? After much reflection, I realized that it was the stories of my beloved patients, with a backdrop of my experiences as an Indian girl growing up in the United States and how these very experiences played a vital role in shaping the type of physician, mother, wife, solider, and citizen I would someday become.

And so, where do I begin? I thought of starting from the very beginning in Strasbourg, France, where my father worked as a senior research scientist, where he and my mother began the first part of their journey as a married couple, and where I was born. I wondered whether I should start with anecdotes from my childhood, and my various interactions with adults and children who were fascinated by my ethnicity and perplexed by the fact that I spoke with virtually no accent as a Brown person. I also considered beginning with one of my patients themselves, as they are the soul of this story. However, I never would have successfully navigated the multiple complex experiences of my childhood, nor had the privilege of connecting with any of my patients without the beating heart of my very existence and my greatest champion. Therefore, my story begins with my mother.

I have always loved to write. A quiet and somewhat lonely child at school, my imagination was a vehicle to another world, where I was free to create fascinating creatures and characters who kept me company as I helped them navigate their curious conundrums and difficult dilemmas. When I was seven, my mother bought me a Hello Kitty spiral bound notebook with a matching eraser, pencil sharpener, set of pencils, and vinyl pencil case. I still remember the distinct smell of the notebook as I opened it each time; the woodsy, earthy scent of the pages mixed with the more artificial one that wafted from the shiny cover. I would sharpen my pencils and eagerly write about talking ducks, a pet elephant I named Fatso, a magic pencil, and a mouse that sharpened its tail. The last story was about God, who helped teach me how to ride a bike. This one was my mother’s favorite.

While the neighborhood kids were outside riding their bikes or on play dates, I would perch myself on a small, red stool in front of a little Strawberry Shortcake dresser that I used as a desk and write to my heart’s content. I was alone but far from lonely, immersed in the dramatic escapades of my colorful characters. After school and on weekend afternoons, I would keep my mother company in the kitchen. I would look up from my notebook from time to time to watch her cut vegetables and throw them into a pan of hot oil, the sizzling sound immensely satisfying. She would smile and ask me about the latest adventure of my writing and I would keep her informed, motivated by her genuine excitement and glee. She would then sit down with me and read through each story, marveling at my creativity and showering me with hugs, kisses, and encouragement to keep writing. So, I did.

My mother earned her master’s degree in English literature and language at Farook College in India. She was awarded the Gold medal, the highest honor for a graduate student at her institution. Berated by many family members for not marrying at the age of eighteen like so many of her friends and relatives, she did not oblige them, focusing on her studies instead as she recognized and honored her talent. She didn’t mind the whispers at public events, the looks of pity from concerned aunts and uncles, or the barrage of questions from numerous people about why she didn’t want to marry and have a family. My mother made the decision to focus her efforts on meeting her goals, and not the goals of others.

At the age of twenty-eight (considered very late for a girl to be married at the time), my mother received a marriage proposal. It was from a man nine years older than she was, from the same state of Kerala, who was a research scientist. He had been educated in the United States and was now working in Strasbourg, France. She was told to make a choice between this man and someone local, who worked and lived in India. She was given a brief bio of both bachelors and then presented with a picture of each. Bachelor number one, the local man, was handsome, smiling, and had kind eyes in his picture. Bachelor number two, the highly educated scientist working in France, wore oversized, black-rimmed glasses and scowled in his picture.

My mother thought about each bachelor and what her life might be with each, based on a bio and a photograph alone. The kind, happy local did not quite measure up to the scowling scientist who looked extremely intelligent in his picture. In the end, education and intelligence won and my mother married my father in India, meeting him for the first time on their wedding day. I have asked my mother and father repeatedly for details about their first conversation but both are reticent. My brother, Vivek, and I were born within a few years and my mother made the decision to focus on her children instead of her career. It wasn’t until we were teenagers that she went back to work as an academic tutor at the University of Cincinnati, where she was cherished and highly regarded by students and professors.

The road to becoming an academic tutor was not an easy one for my mother. I was about fifteen-years-old when I overheard her talking to one of her best friends, Bhargavi, at our dining room table. I called her Bhargavi Aunty, aunty a term of respect for our elders.

You should go for it, Eddo! Bhargavi Aunty said emphatically, calling her by their mutual nickname (which really had no meaning) for one another. While I couldn’t see my mother, I could certainly imagine the pained expression on her face, filled with self-doubt and shaking her head.

No, Eddo, she said. I’m out of touch. I don’t think so.

I could hear the rustling of a newspaper as the ever determined Bhargavi Aunty persisted. "It’s right here, Shylaja! Academic English tutor, University of Cincinnati" she read aloud from the paper, her frustration palpable. I can’t understand why you can’t apply!

I heard my mother get up from the table, and the sound of clinking plates and glasses as she gathered them up to take them to the kitchen. No, Eddo, was her final response.

Why was she so reluctant? Had it been a while? Of course. But she hadn’t been a wallflower during her days in college and graduate school, and she had taught English literature at the college level for several years before she got married. I wondered if I should broach the topic with her but didn’t feel it was my place. My mother and I talked about everything under the sun but I sensed this topic was a sore spot and therefore, off limits.

Bhargavi Aunty would remain persistent with phone calls and more visits to our home. I would continue to hear bits and pieces of their discussions. Bhargavi Aunty would outline my mother’s impressive credentials, my mother would immediately downplay them by mentioning the number of people in Cincinnati who were likely much more qualified then she was, and then an exasperated Bhargavi Aunty would reply, "Shylaja," and then trail off, likely giving my mother a withering look. I basked in the glorious energy of these two strong-willed, stubborn Indian women in an unending battle of wills, and began to look forward to their discussions.

One day, Bhargavi Aunty made a special delivery. It was an application for an academic tutor position at the University of Cincinnati. Today’s ping pong match of words would be replaced by a warm, comforting silence filled with understanding and compassion. Bhargavi Aunty told my mother she believed in her and while there were, indeed, many individuals with impressive resumes in the tri-state area, that she was the best and the brightest of them and clearly the top candidate for the position.

Shylaja Prakash pondered all that she had heard from her dear friend and did a little soul searching herself. Within a week, she prayed ardently to all the Gods in her prayer room and placed an envelope containing the typed application in our mailbox, triumphantly pushing up the rusted, red arrow to ensure our mail carrier would pick it up. My father, Vivek, and I did not bring this up in discussions, patiently waiting for her to mention it at which time we planned to show our ardent support. However, my mother was silent on this topic. She helped us with our homework, cooked, washed the dishes, scrubbed the kitchen floors, did laundry, held my hand through my latest social disaster, but kept mum about the application and even about the interview that followed. We did know that my mother, who owned only Indian garments, borrowed a brown dress from Bhargavi Aunty for her interview.

One day, the phone rang and my mother set her dish towel down on the kitchen counter to answer it. Her back was turned to me and I noticed her long, black hair which she would carelessly braid each morning as she tossed it behind her, slowly unraveling as it ended in a knot behind her apron strings. As she spoke, she suddenly collapsed onto the counter.

Oh my God! she cried. This is the biggest break of my life! Thank you so much! Thank you so much! Her hand clutched the phone as she shook with excitement. Shylaja Prakash had just been hired as an academic English tutor at the University of Cincinnati. Our family rejoiced and offered our congratulations. We made plans to go out to dinner that evening and my mother began to plan her schedule and determine what office items she needed for the job. She also had to make a phone call.

Eddo, my mother started in earnest. Thank you, Eddo. I wouldn’t have been able to do this without you. I couldn’t hear Bhargavi Aunty on the other end but I imagined her sharing in my mother’s happiness through her tears. We speak of allyship in equity work, in particular #HeForShe allies who take up the gender inequity burden as their own. In this case, my mother had a true #SheForShe ally in Bhargavi Aunty, a woman who saw the talent and genius in her friend and wouldn’t take no for an answer.

My mother started working as an English tutor when I was in the tenth grade. As happy as I was for her, in my heart I felt that she could clearly have been promoted to the rank of college professor as she had been an exceptional one in the past. I would ask my mother over the years why she didn’t fully pursue her career, as though the sacrifice must have left a large void. Her voice calm and her demeanor serene, she would reply that her greatest gift was her children and that for her, there was nothing more important or worthy of pursuit than our success. When I would ask if she expected the same of me she would laugh. That’s totally up to you, she would reply. It’s your choice to make. But whatever you decide, know that you will flourish. My career choices would drift with the wind over the years, but my mother took each and every one seriously. She would cut out pictures of Sandra Day O’Connor and tape them to my closet door when I thought I would become a lawyer, send me and my brother to science camps when we expressed an interest in becoming scientists like our father, and eventually bought me my first stethoscope when I solidified my decision to pursue Medicine as a career.

One day, when I was about to turn eight, my mother sat down beside me. She beamed as she presented me with a gift. It was a small booklet bound in red silk. Neatly written on the front cover in golden letters was Vidhya Prakash: My Story About God and Other Stories. I gasped in delight as I watched her eyes sparkle. Taped to the inside front cover was my photograph, followed by a table of contents, an introduction to the author, and all my stories, painstakingly transcribed from my Hello Kitty notebook to white paper by my mother. She would wait until all of us were asleep to type each story using our rickety typewriter. My mother told me how proud she was of me and of my first book. I hugged her tightly, clutching my red book while imagining what the next volume would bring.

We think of and exalt the great women who came before us; the pioneers, the trailblazers, the daring and courageous women who paved the way for us through their guts, grit, and sheer determination. I honor all these women and am grateful to them. However, none stands out more than my mother, a great spirit who defied a society that told her that her worth was measured only by her role as a wife; a selfless woman who made the conscious decision to hold true to her values as a mother by committing her life to her children, never once considering this a sacrifice; an honorable and venerable being who taught her daughter that a Hello Kitty notebook was only the beginning.

Prayer

My mother encouraged me to write, was the first person to tell me how well I did during a play or dance recital, and always told me how proud she was of me. She is not only my greatest cheerleader, but also my greatest teacher. My mother taught me and my brother how to ride bikes, how to drive, how to have difficult conversations with people, and that taking the high road would be difficult but well worth it in the long run. She taught us the importance of apologizing immediately when we were wrong and about self-respect. My mother also instilled in us the value of giving to those less fortunate.

When I was seven-years-old, we took a family trip to India. The oppressive heat, maddeningly itchy mosquito bites, and sitting in darkness when the lights went out like clockwork every evening during monsoon season marked my earliest memories of the trip. Giggling with my cousins, writing in my journal with a bejeweled pen that my beloved uncle bought me, and excursions to nearby paddy fields were among the highlights of my journey.

One morning, we decided to take a trip to a nearby town. We had stood at the railway station in the sweltering heat for what seemed like hours, waiting for our train. Accustomed to the comforts of a clean, organized, and air-conditioned airport, I whined about the heat and feeling tired and hungry to my mother who did her best to comfort me. The sight of refuse strewn about the platform, coupled with the chaos of families hurriedly trying to either catch a train or other family members, made me yearn for home.

I glanced around the station teeming with people and noticed several women sitting on the ground, leaning against a concrete wall. They were thin, forlorn figures wearing tattered and faded sarees. They would extend their hands to passersby and request some spare change, not having much luck today as they were routinely ignored. I listened in on a conversation between two well-to-do women sitting next to us. I contrasted these polished women in their colorful, silk sarees, their necks covered in gold and diamond studded earrings peering out from behind their coiffed hair, with the worn and weary beggars in their shabby attire. Shameless, they are. They bring it upon themselves, one muttered, glaring at the women. Agree, her friend chimed in. Instead of wasting away here I don’t understand why they won’t seek employment. Just no excuse. I leaned my head against my mother’s shoulder and found myself deep in thought. Where did these impoverished women grow up? Where were their partners, their children, their homes? Or, were they homeless? If they struck out at the railway station today, what were their other options?

You must always give, my mother once told me. "In this world, there are always those who are less fortunate than