Overcoming Cultural Barriers in Medicine

Born a son to immigrant parents, one of whom did not speak any English early on in my youth, I struggled to assimilate to American culture, to friends, and to the everyday language and vernacular during my formative years in grade school, middle school, and even high school. My mother raised my brother, sister, and me while my father worked two, and sometimes three, jobs to make ends meet. Mom did not speak any English in those days. She did not need to. She never left the house without my father. He spoke broken English with a heavy, thick Slavic accent, an accent that struck the fear of God in most people, despite his small stature and average build. To me, however, he was enormous in pride, devotion, and sacrifice for his family. I admired and adored my parents, not only for their unending love and support, but also for the sacrifices they made to move to a foreign land, to eventually learn the English language, and to provide us opportunities in life (opportunities which did not exist in their motherland, Macedonia, of the former Socialist Federal Republic of Yugoslavia).

There was one bone of contention I had with my parents, my birth name they bestowed upon me. As an impressionable young boy trying to befriend his neighbors and classmates in a perceived foreign land, I cursed my name from the beginning. I grew up in the seventies and eighties, the age of disco, Bruce Springsteen, eighties hair bands, parachute pants, and intense American pride. I, however, felt like a foreigner in my own birth country, America. And though I had friends, at least they claimed to be my friends, they were not always the nicest or sincerest of human beings. I seldom was addressed by my real name, Zoran.

I heard all the jokes, and there were many, with references to my name. I was often referred to as Zorro, Zoltar, Zorba the Greek (I am not even Greek), Zorba the Geek (a name many of my so-called friends used because I often excelled in academics while they struggled), and then later in the early 2000s, Zohan. During my internship training days, I worked with a senior resident who also struggled with my name. Then one day, while rounding in the medical intensive care unit, I prescribed an antiemetic to our mutual patient for post-extubation nausea and vomiting. That day, another badge of honor was bestowed upon me, the name Zofran. For the remaining three and one-half years of my training, I had an attending physician who always referred to me as Zofran. If only I could have collected royalties from the makers of Zofran.

There were a few names I did not mind, however. One name later bestowed upon me was “Z!” That was it, the letter Z. Every time my friends, teachers, and especially athletic coaches addressed me as “Z!,” it was always emphatic, bold, and authoritative. It made me feel important, prominent, and dignified, at least in my mind. Then there was the name Zorn, as in Jim Zorn, a prominent NFL quarterback in the late seventies to mid-eighties who played for the Seattle Seahawks, long before I developed any interest in football. Needless to say, I soon developed an affinity for the Seattle Seahawks, especially their quarterback.

As I aged and later matured, I grew tired of having to explain the ethnic roots of my name, how to spell it, how to pronounce it, and so forth. For years I wished my parents had chosen an American name for me. I just wanted to fit in.

Many years later, long after medical school and residency, I still get the proverbial “Where did you get your name from?” to which I often reply, “Mom and Dad! How about you?” Most patients laugh, but a few occasionally take offense to my sarcasm. I understand those few being offended by my comments, but I also would expect some understanding and empathy about my plight and the lifelong inquiries regarding my name, ethnic origin, and the litany of explanations I have entertained over the years.

One day, that all changed. It was not until recently, after twenty-four years of practice as an attending physician, that I grew to appreciate the name my parents granted me. Last fall, while I was sitting on my recliner after work, my wife struck up a conversation with me. She informed me that she saw a new client that day. (Note: My wife is a veterinarian and the much smarter half in my family.) She told me that this new client was a former patient of mine from my primary care and private practice days (2000 to 2008), a patient I cared for, along with her husband and children. My wife went on to highlight that her new client emphasized how much they appreciated me, how much they missed me since I left primary care to pursue hospital-based medicine. When I inquired about her client’s name or family name, my wife could not recall. She continued, however, to inform me how adorable, friendly, and inquisitive their new puppy was. She then told me how much they loved and adored their new puppy. Puzzled, I struggled to think of who her new client might be when my wife asked me to guess the name of their new puppy.

“I do not know. Why do I care what they named their puppy?” I replied.

“You should care,” she kindly scolded me. “It is a very nice and sincere name.”

“It is a puppy. Come on! What do I care?!” I retaliated.

My wife then reached for her phone, uploaded a picture of their new puppy, and then responded, “They named him Zoran. They think so highly of you, what you have done for them, and how much they appreciate and adore you, just like this puppy. So, they named him Zoran, because they have the same affection for him as they do you.”

Story and picture printed with permission of my former patient and proud owner of a puppy named Zoran.

A few weeks later, I was picking up a prescription at a local pharmacy when I ran into my former patient (my wife’s new client). It had been sixteen years since I last saw her, her husband, and their children (who were now adults), and to this day, she continued to thank me for caring for her family early on in my career. She then showed me more pictures of their new puppy named Zoran. As we were reminiscing about the past and hugging to make up for our lost time since our last encounter, I thanked her profusely for the greatest compliment I ever received as a physician.