Brotherhood Dharma, Destiny and the American Dream (24 page)

“Stop,” Dr. Schimmel interrupted. The fellow stopped immediately. “How do you know he required four units of blood? Maybe he actually required three, or five. What you mean to say is that he was transfused with four units of blood. Just give me the facts, please.”

Of course he was absolutely correct. The practice of medicine deals with observation and recall of facts. So from that day forward that was the way I started to think, talk, and write.

Several months later I had the opportunity to demonstrate to him how successful his lesson had been and, perhaps, to prove that I was
a worthy pupil. One of the GI fellows was presenting a patient when Eli said, “So, lack of hydrochloric acid in the stomach stimulates the release of the hormone gastrin—”

This time I interrupted him. In India, of course, I would never have dared to do something like that. In America this back-and-forth was the way we learned medicine on the wards. I guess I had become Americanized by this point.

“Eli, that’s not true,” I said. “Lack of hydrochloric acid is permissive for the release of gastrin.” Then I began a discussion of the topic.

When I had finished, Dr. Schimmel turned to the group and smiled. “Sanjiv, your thinking is so much more elegant than mine.”

I was truly humbled. A nice compliment from one of the giants of medicine.

There was so much richness about living in America that Amita and I decided to apply for green cards to stay here, if not permanently, then at least for several years. So we discarded our original plan, which was to finish our educations here and return to India.

Only immigrants to America know the world of the green card, the card originally issued by the Immigration and Naturalization Service that makes a person a legal resident, meaning they have almost all of the rights, except voting, that American citizens enjoy. Without a green card you can’t legally stay in America.

Getting a green card turns out to be a big industry. It requires a good lawyer and it can be both time-consuming and expensive. But when an immigrant finally gets it, it’s like being handed gold. It means your life is changed forever.

Amita and I both applied for our green cards as we finished our internships at Muhlenberg hospital. Time passed and we didn’t hear anything, we didn’t receive any notices, so we assumed our applications were being processed, until we received a letter from Immigration more than a year later. “This is your third and final notice,” it read. “If you don’t appear for an interview on this date we will discontinue your file.”

Third notice? We hadn’t received any notice at all. But still, we were excited. We thought this meant we were going to be given our green cards.

We went for our hearing without an attorney. It never occurred to us that this was anything but a formality. This was America, the country that welcomed immigrants. The hearing officer was named Mr. Pickering.

“So,” he began, “you’ve applied for immigration?”

“We have,” I said. “That’s why we’re here.”

He turned to Amita. “Now let me ask you independently.” He looked at me and told me not to answer for her, then asked, “You’ve applied for immigration?”

“Yes, I have,” she said.

Then he turned back to me. “And you, Dr. Sanjiv Chopra, you got your visa to come here on the explicit terms that you would train here for five years and then go back. So now you’ve both applied for immigration. You’ve proven you are liars and dishonest. You’ll be receiving a notice within two weeks explaining that you have to leave the country within a month.”

We were dumbfounded.

“What are you saying? I have accepted a fellowship at St. Elizabeth’s Hospital and Amita is going to be chief resident in pediatrics at Boston City Hospital. We’ve signed contracts. We can’t leave.”

He shrugged. “I don’t give a damn. Dismissed.”

We were devastated. What about our plans? We probably didn’t understand it at that time, but we had just entered a world familiar to so many immigrants, a world in which you feel powerless against the government, where every time you get a letter from the Immigration Service your heart starts beating faster. At first we had no idea what to do. How do you fight the government of the United States?

We had come to the States with the intention of going home when we had completed our studies. We hadn’t lied about that, this wasn’t simply some story to get us into the country. It was only after we were settled here that we began to even consider the possibility of staying. Our reaction was probably typical. When we made our decision to
stay here we were somewhat ambivalent about it. We knew what we would be giving up at home, we knew we would miss many things about India, especially the closeness with our family, but we felt we could have a better life here. After we were told that we weren’t going to be allowed to stay, staying here became the most important thing in our lives. Any doubts we might have had disappeared.

Amita called her program director at Boston City Hospital, Dr. Joel Alpert. She had completed her residency there, and he had picked her to be the first foreigner and the first woman to be chief resident of the in-patient service. It was quite an honor.

“I know somebody at Immigration,” he told us. “I’ll make sure you don’t get that letter.”

Then we were told we needed an immigration lawyer. The man who was recommended to us was Mr. O’Neal. We were told that his fees were sky-high but that he was very good. He fights for you. We met with him. He was a large, imposing figure.

“You’re fine,” he reassured us. “I’ll come with you for the next interview. Don’t worry about it. By the time we’re done I’ll have Pickering picking up peanut shells on Boylston Street.”

He went to the next meeting with us. He reassured us that the meeting had gone very well. We were asked many questions, which we answered honestly. He sat behind us, didn’t utter a word, but smiled confidently. Over the next few weeks we lived in a state of perpetual worry—until finally we got the word that we were approved for permanent residency. We were permitted to stay in the United States!

And while for many people the cost is thousands of dollars, O’Neal told us, “I didn’t have to do much. Your credentials were impeccable. My fee is four hundred dollars.” Four hundred dollars to be allowed to stay in America? That was certainly the best bargain of our lives.

We were so pleased to get our green cards that we didn’t immediately consider taking the next step, becoming American citizens. This was decades before the great immigration debates had begun in America, and, at least for educated Indians, becoming a citizen was not difficult.

I had first considered the possibility of becoming an American citizen the year we arrived, while we were at Muhlenberg, and truthfully didn’t see any obvious reason to do it. I’d spoken with Deepak about it, but he hadn’t made his own decision about that yet, either. We were living in America and we had retained our Indian citizenship; in some ways that was the best arrangement for us. We had always been proud to be Indian citizens. But several years later, we were well settled here and I was working as the assistant chief of medicine at the West Roxbury VA Medical Center. The chairman of the department, Arthur Sasahara, asked me my immigration status.

“I have a green card,” I said.

He shook his head. “You’ve got to become a U.S. citizen.”

“Why?”

“We’re part of the federal government,” he explained. “If there’s a crunch and we have to lay off employees, the first people to go are going to be temporary employees. Technically you are a temporary employee because you’re not a citizen. So please go and apply for your citizenship.”

This was a step I hadn’t considered necessary. Although by this time I had no intention of returning to India to live, I still felt loyalty. India was my country, the country that had paid for my medical education. My parents were there. My childhood memories were there. My family had written our history on scrolls in a city there.

Many of the Indian friends we’d made in medicine had applied for their American citizenship. It wasn’t an active topic of conversation in the Indian community in Boston, as it was considered very much a personal decision. But now there was a reason for me to take this step. To claim I was doing so because I believed strongly in the principles and values of America wouldn’t be true. That belief grew stronger over the years as I traveled to dozens of countries around the world. While I did believe that this is a wonderful, unique country, I also retained a love for India. India, even with all its problems, is a wonderful country. And I have to admit that there were at least some pangs of guilt. The Indian government had given me this amazing
education; I had fabulous teachers and role models in medical school. Then one day we had packed our bags and left. The way I rationalized it was that by becoming successful in America I could probably do more good for India than if I had stayed there. While in many ways that has turned out to be true, both for myself and Deepak, I can’t say that I didn’t feel some trepidation about my decision.

When I discussed this with Amita she had already made up her mind: She flatly refused. “I’m Indian,” she said. “I won’t give away my Indian citizenship.”

In Amita’s mind there was still a good chance that we would go back to India someday, and she was not ready to give up that dream. Amita has always been passionate about India and most things Indian, especially our great culture, even more so than I am.

This was a very difficult decision for us, and admittedly Amita and I had arguments about it. In that regard I’m sure we were no different than immigrants from any part of the world. This is an enormous commitment, and couples have split up over it. But for me the opportunity to do what I needed to do was here. I was adamant about it and told her flatly, “Amita, I’m not going back. And you know our kids wouldn’t want to live there. They were brought up here. They’re Americans.”

I reminded her that some of our Indian doctor friends had returned home and it hadn’t worked out at all for them. Almost inevitably they came back to the United States. While it was possible to go to India and establish a private practice there, and we could have worked with my father if we wanted to be in academic medicine, which I loved, there was less opportunity. Those classmates of ours who stayed in India had progressed inside the system, and there was little room left for people who were returning, no matter what credentials they had or how much experience they had acquired. The Indian government had created the category of “pool officer” for doctors who returned, which meant you weren’t an associate professor or even an assistant professor. It was an untenable position. There was a legendary professor of pathology at the Mayo Clinic who had
returned to India—but like so many other people who tried to make the journey, after a while he gave up trying to be successful within their system and came back to the United States.

Amita refused to apply for her citizenship, but I went ahead with it. When I went for my interview the official examined my application.

“So you’re a doctor, huh? What kind?”

“A very good one,” I told him. We both laughed, and I continued, “I’m sorry, I don’t mean to be so facetious. I’m a gastroenterologist, specializing in hepatology. Liver disease.”

Most Americans don’t know exactly what “gastroenterologist” means, except that it has something to do with the stomach. But I had gotten an official who understood all too well.

“A gastroenterologist?” he said. “My daughter has Crohn’s disease.” For the next half hour we discussed Crohn’s disease, the best treatments, and some of the exciting advances in the field. He asked me a single question—“Which president abolished slavery?”—and then said these exact words: “Welcome to America.”

The official ceremony was held in Faneuil Hall in Boston, where several of America’s founding fathers had made speeches before the Revolutionary War. You can feel the history surrounding you when you’re there, and there couldn’t be a more appropriate place to be sworn in as an American citizen.

There were approximately two hundred and fifty people there with me, and it was obvious they had come from all over the world. Many different races were represented and a few people were even wearing their native dress. The judge arrived late, but when he started the ceremony he asked, “So how many children are here?” Quite a few hands were raised. He asked them to stand up. “How many of you are going back to school after this ceremony?” Every single child raised their hand. That’s when he said, “I hereby prohibit you from going to school today. Today is a very special day in your lives. You’ve become a United States citizen. This is a day to celebrate. I’m ordering your parents to go celebrate with you.” Then he swore us all in.

The children cheered. I was so moved by the entire ceremony,
where we were, what was said, the joy on all of those faces. This is amazing, I thought, America is a beautiful place.

Amita resisted for some time after that. It wasn’t that she felt any less happy to be in America, but her love was still India. Her mind changed when we took our three children on vacation to Spain. We visited several cities before deciding to go to the Rock of Gibraltar. We drove all the way there. Because Gibraltar is still a British possession, we had to show our passports. The immigration official looked at Amita’s and Priya’s Indian passports and said, “I’m sorry, I can’t let you in. You’ve got a single entry into Spain and you’ve already entered. Coming back from Gibraltar would be a second entry; you can go but you can’t come back.” So the two of them had to wait in Spain while my other two children and I went to see the Rock of Gibraltar.

The next time we returned from abroad, Amita had to stand in the foreign nationals’ line to go through Immigration. That line is always considerably longer than the line for U.S. citizens, as the officials look extra carefully at visitors coming into the country. She found it vexing and finally said, “Okay, I’ll become a U.S. citizen, but I’m doing it as a matter of convenience.” She also went to Faneuil Hall to be sworn in. That whole experience, taking the oath in front of the American flag, sitting on long benches with immigrants from many, many different countries, really affected her. Some of her emotional ties had been severed, but her strong feelings about India remained.