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Clinical Decisions: Journey into Emergency Medicine, an Interview with Resident Tanja Zlatkovic Zanin, MD, Class of 2015

April 19, 2013
by Simone Schneegans

Tanja Zlatkovic greeted me at her front door on a sunny Friday afternoon. Her dog stayed at her side as Tanja showed me around the apartment, pointing out her favorite spot- a sitting room with a stained glass window overlooking the front lawn.

After the tour, we stood in the kitchen chatting as she prepared coffee, baguette and cheese, fresh berries. We talked about the gas bill, about adjusting to the overnight shift in the ED, about her great backyard. Tanja has a welcoming personality and a candidness that make her easy to talk to.

We moved to her dining room table and Tanja told me how she drove to a mysterious parking lot to get her dog from an animal rescue organization, how she failed a microbiology test in med school because she fell in love (the only test she ever failed), and how she quickly felt at home with New England’s blunt style of communication.

Still, getting to the heart of Tanja’s decision to go into Emergency Medicine proved an elusive task. Her story is so full twists and her telling so intimate that to jump to the end would be a dishonor to her experience. And so, the afternoon passed with stories.

Her early desire to go into political science; an international friendship that turned into her marriage; the image of her Bosnian mother exclaiming, “America is gorgeous!”– all are necessary parts of Tanja. She told each piece with enthusiasm and, in between, listened to my stories with equal interest.

Eventually, we centered on the topic of her homeland, Bosnia-Herzegovina. In 1993, when Tanja was 11, she was forced to flee Sarajevo as a refugee of the Bosnian War. Later, she wrote to me with more details:

“…things at home were increasingly chaotic. We had spent the last year hoping for peace to reach our beloved Sarajevo, only to be disappointed by the intensifying brutality. For two months we resorted to taking shelter in the small basement of our six-story apartment building... while the thunder of grenades filled the city above our heads…”

She went alone to a farm in Serbia, a radical change for a girl from Sarajevo, and was eventually joined by her family– her mother, father, and brother. In what Tanja called her “life journey from one refugee camp to the next, East to West,” she and her family moved around, Serbia to Croatia to Germany, before eventually settling in the United States.

What struck me as I read Tanja’s words was the fact that in person, she was almost hopeful when she talked about her experiences as a refugee of a war motivated by ethnic hatred. She emphasized the foolishness of hate, its tendency to stop people from developing, healing, or achieving.

“Nobody is better than you,” her mother would tell her, “and you are not better than anyone else.”

Tanja said that her parents emphasized the importance of equality between human beings and the idea that while she should nurture her own aspirations, every person deserves her attention, love, and compassion. She repeated this several times throughout the afternoon, and later expanded on the idea of people’s innate potential for goodness:

“I survived Bosnia…by the generosity of those who selflessly offered their help and guidance. I was moved by the strength, integrity, and loyalty that characterized the people I was surrounded with, and without whom I would not be alive today.”

Deeply affected by her experience, Tanja studied political science, focused on conflict resolution, and worked in Tanzania for the International Criminal Court for Rwanda. Though she loved her work, she “longed for a more intimate, tangible sense of accomplishment.”

Tanja started to volunteer more of her time at a makeshift clinic at the base of Mount Kilimanjaro, and in its dingy hallways, found what she had been longing for.

“Giving medical assistance, and hope, to people when they are at their most vulnerable gave me faith that I was doing the right thing.”

Her initial aspirations to work in conflict resolution, to support victims of genocide, to address the scar tissue, were overwhelmed by the realization that she could work to heal people in a more literal, immediate way. Tanja returned to the US, promptly entered medical school, and became Dr. Zlatkovic.

The feeling that she was meant to help the vulnerable lead Tanja to Emergency Medicine. In Emergency Medicine, physicians engage each patient, from those with the highest level of acuity to those that use the ED more like a primary care clinic.

“No other specialty has its doors wide open to the rich and the poor, the insured and uninsured alike,” she said.

“[B]eing able to provide emergency care makes me think back to my experiences in Bosnia, and to those brave doctors and nurses that worked tirelessly to heal their own communities. I cannot imagine how a country can develop, progress, and mend its social and political conflicts without first mending its actual wounds.”

Early on, Tanja worked to establish a free clinic for Native Americans at the Mattaponi Reservation and worked at inner-city clinics in the US. She worked with physicians in her hometown of Sarajevo- the same doctors that cared for people injured in the war that displaced her family and so many others. She went to rural Honduras and saw medical flexibility and creativity in the face of limited resources like electricity and running water.

Summarizing her goals, Tanja said, “[i]t starts with health, and I aspire to alleviate the suffering of those whose social, political, and especially medical circumstances make life a daily battle.”

After spending the afternoon in her home, I could see that compassion. The gracious host that offered me three different kinds of beverages and showed me her wedding album; the woman who got her dog from a rescue organization that operated more like a drug ring; the doctor who treats every ED patient equally because she may be their only access to health care– kindness practically pours out of her.

Thomas Carlyle said that a strong mind always hopes, and always has cause to hope. This seems fitting for Tanja; a woman who, through her own struggle, developed strength, optimism, and an indefatigable respect for the humanity of others.

“Somewhere along the way I decided to seek out a life in which I could honor that humanity.”

Submitted by Simone Schneegans on April 19, 2013