During my advocacy elective as a pediatric intern, I spent time with attorney Alice Rosenthal Esq., the senior staff attorney with the Center for Children’s Advocacy and the coordinator of the Medical-Legal Partnership Program at Yale New Haven Children’s Hospital. One afternoon, we spent several hours with a father and son who had immigrated from a Caribbean Island just a few years prior. The son had a very complex psychosocial and medical history. Sadly, his childhood was filled with tragedies. In his country of origin, the son’s mother had subjected him to physical and emotional abuse.
A few years after moving to the U.S. with his father and siblings, the son was diagnosed with leukemia. Fortunately, he is currently doing well but is often noncompliant with taking his medications and misses various medical appointments. He has also been diagnosed with a complex psychiatric illness but has stopped his psychiatric medications because he insists that he “feels better” and fails to attend those appointments as well.
Aside from his complex medical diagnoses, the patient had recently become involved in group violence. His father tearfully shared that he feared for his son’s life and that of his other children. Community members had been shot and killed. Overwhelmed by fear, hopelessness, and loss of control, the father was on the verge of asking his son to move out of their home.
All of this was just the surface of what were many years of hardship for this young man and family.
This is an extremely complex case with many layers to dissect. This family’s story brings to light the reality of many immigrant youth in the U.S. and further validates my own experience growing up as a daughter of Egyptian immigrant parents. Since my childhood, I was extremely involved with my Coptic Orthodox Christian church community, most of which were Egyptian immigrant families struggling to find their footing in the “land of endless opportunity,” hoping to fulfill the “American Dream”. Others were immigrants from Eritrea, Ethiopia, and Syria. I very quickly learned that most families from my church community faced endless adversities, and that youth, in particular, faced unique and challenging difficulties.
One’s youth is a time of establishing self-identity, values, and opinions. It is a time of self-discovery and building meaningful relationships. It is also a time of pursuing a sense of belonging while combating insecurities. In my church community, I witnessed various youth disconnected from their homelands and isolated in their new countries, deeply seeking any sense of acceptance. Many are left feeling alone and lost while wrestling with depression, anxiety, and various other mental health disorders.
Unfortunately, the son we met with not only had an unstable home in his country of origin, but like so many other immigrant youths, was also struggling to find a sense of “home” here in Connecticut. Perhaps his thirst for belonging was one factor which pushed him to seek a group that would accept him, even one involved in violence. Immigrant families often live in unsafe neighborhoods, as they are the most affordable locations, and experience other social stressors such as a poor education system and lack of economic opportunity. Many immigrant youth find themselves struggling to learn English, do well in school, make friends, and work jobs to help support their families – all simultaneously.
While meeting with this father and son, the father shared in tears, “Maybe if I send him back to our home country, he’ll realize how good of a life he has here.”
The reality is that the son’s life here is full of new obstacles – not necessarily fewer obstacles than before. It is often that the struggles one may try to escape in one’s homeland are only met by further, yet different, challenges. This youth’s past was met by isolation, group violence, substance abuse, and withdrawal from his high school education.
As pediatricians working with various immigrant populations, it is vital to recognize the struggles that immigrant youth face. Medical legal partnerships are uniquely positioned to help immigrant families combat the challenges related to safe and stable housing, education, and access to medical care. This partnership recognizes how social stressors must be addressed in order for families to live healthier and happier lives.
We, as pediatricians, are called to recognize immigrant families’ past experiences and empathize with them as they try to create a new home in a foreign place. The young men and women who sit on our examination tables may be physically present, but emotionally lost somewhere in the middle of their troubled past and painful present.
Demiana Joy Azmy, MD, is a first-year pediatric resident at Yale New Haven Children’s Hospital. She grew up in Connecticut but spent 8 years in Albany, NY completing the Siena College-Albany Medical College Science and Humanities Program, a joint acceptance program with a focus on ethics and service. She received her BA in Biology and Minor in Creative Arts at Siena College, followed by her MD at Albany Medical College. Outside of medicine, she enjoys painting, crafting, traveling, playing basketball and volleyball, and spending time with her loved ones.