Munish Sharma
Winters in Texas, though milder than those in northern cities of the United States, occasionally carry a distinct chill that calls for layering up. As I sifted through my closet today, preparing for an upcoming cold front, my hand brushed against a pullover I had not worn in years. A faded pullover with “Chicago” boldly emblazoned across the chest. I instantly revisited the memories of not just the city itself but of a frigid winter night eight years ago that will forever remain etched in my mind. While chasing my dream of becoming a pulmonary and critical care physician, I spent a night at Chicago’s O’Hare International Airport, stranded by circumstance but strengthened by the lessons that night imparted. Life journeys have some ephemeral moments that produce perpetual, vivid fragments of memories. These tiny fragments of memories weave themselves into garlands we cherish lifelong.
I was born and raised in Kathmandu, Nepal, into a humble middle-class family where both parents are teachers. Growing up in Kathmandu’s narrow alleys, I first dreamed of becoming a doctor. Medical school came as a reward of merit, a scholarship offering me a glimpse into the world of my dreams and my humble ambitions. Years later, those dreams carried me far beyond Nepal’s borders to the labyrinthine challenges of the United States (USA) healthcare system. Immigration has long plagued the country, and whether it is a wish or a compulsion for Nepalese remains uncertain—I was no exception. The USA beckoned as a land of opportunity but also one fraught with formidable challenges for an international medical graduate. The road to finding my place in the US healthcare system was daunting, marked by grueling hours of studying for the United States Medical Licensing Examination (USMLE), navigating cultural barriers, and enduring the uncertainty of every competitive match. The specialization I pursued—pulmonary and critical care medicine—demanded clinical precision and an understanding of the delicate balance between life and its fragility.
After completing my Internal Medicine residency in Pennsylvania, I faced a significant setback—I couldn’t secure the fellowship I had worked so hard for. Months of effort, countless applications, financial strain, and exhausting interviews seemed wasted. The rejection hit me hard, underscoring the challenges faced by international medical graduates and the gaps in my résumé. That evening, I sought solace at a nearby temple, grappling with my emotions, unable to tell my wife or meet my two-year-old daughter’s gaze without masking my disappointment. Yet, I realized rejection is part of life’s rhythm, like the ups and downs of an electrocardiogram, signaling our vitality.
On a mentor’s advice, I considered a new path: a non-accredited pulmonary hypertension fellowship in New Jersey—a niche within chest medicine. Moving my family for a modest salary and no guarantees was daunting, but it was a calculated gamble. As Albert Einstein said, “In the middle of every difficulty lies opportunity.” But Opportunities are rare and sporadic, like a flash of light, a meteor streaking across the sky, or a rainbow that briefly graces the horizon. You must sometimes take a leap of faith when you see an opportunity. Hence, I moved to New Jersey for a yearlong training to consolidate my resume for a fellowship application next year.
While living in New Jersey the following year, I awaited a vital fellowship interview at Springfield, Illinois. We were at the doorstep of winter. The air carried a subtle promise of colder days to come but lingered in an in-between, a fleeting chapter of seasonal transition. My career resembled the weather those days: It was a time of great professional and personal transition. Every step I took seemed to weigh heavily on my future. Securing a fellowship was not just a career ambition; it represented the culmination of years of hard work and the promise of a future where I could make a difference. Not to forget the risk I took of moving with my wife and little child. My wife, in particular, had to quit her job in the prior city to move to a new city. Thus, when I flew for the interview, my mind was swirling with thoughts—hope, doubt, and the persistent question of whether I could get into my chosen specialty.
The interview day was a whirlwind, full of intense conversations and long hours of trying to showcase my best self. By the end, I was exhausted, both physically and emotionally. I received encouraging feedback from the interviewers, which gave me some optimism, though many questions still lingered in my mind. Since that morning, I had felt a discomfort in my right eye, accompanied by a persistent foreign body sensation. I wondered if my aging glasses were the issue, as I hadn’t replaced them in years despite thinking about it often. The discomfort persisted, nudging at my vision, and I repeatedly rubbed my eye and cleaned my glasses, hoping for relief. Later that day, I boarded a train to O’Hare airport for a late-night flight to New Jersey. I kept rewinding the interview day in my mind throughout the train journey. My small hand carry had a snack that I kept munching. I smiled silently and intermittently as my mind tried to convince me that I did well in the interview. ” Well, the overall feedback was positive, and no one seemed to have found any flaws in my resume,” I told myself. After all, humans naturally seek validation and become joyous from praise. It reinforces our sense of self-worth. While we generally dislike criticism, constructive feedback is essential for growth, offering new perspectives and opportunities for improvement. A balance of appreciation and critique fosters both confidence and progress—though our aversion to criticism seems to be an inherent aspect of human nature.
When I arrived at the O’Hare airport in Chicago, I learned that my connecting flight had been delayed due to adverse weather conditions. The initial announcement was followed by another one to inform the passengers that the flight would leave only in the morning. What began as a minor inconvenience soon turned into an all-night ordeal. With each passing hour, the hustle of O’Hare gave way to an eerie stillness. Shops and food counters had already closed their shutters one by one, and as midnight approached, the terminals started seeming more vast, more lifeless and bitterly colder. As the seasons transitioned and winter had not yet entirely set in, the heating system at the airport was likely operating at a reduced capacity. Initially, this might have sufficed to maintain a comfortable temperature. However, as the night wore on the partially engaged heating system struggled to keep up with the plummeting cold. Then, I suddenly started realizing about my oversight!
I had checked my hand carry at the boarding gate where the airline staff had greeted me with a warm smile and an air of kindness. Staff suggested that I check my small hand-carry bag rather than keeping it with me on the flight. It was my only carry-on item—I hesitated but quickly complied with his kind demeanor. Something is compelling about kindness; when someone smiles and extends a thoughtful gesture, we are drawn to reciprocate and comply. Rudeness and abrasiveness push us away, but kindness? That invites trust. In hindsight, I should have kept that small hand-carry with me—it was the only item I had—but I was distracted. My right eye was bothering me, a constant discomfort that distracted me. Perhaps it was the distraction or kindness, but I gave in almost without thinking. At the time, it seemed like a simple decision. But without a carry-on, I lacked essentials—warm clothing, a snack, or anything to occupy my mind.
The chill kept permeating me, numbing not just my body but also my thoughts.
I wandered through the empty terminal, seeking anything that could offer a semblance of comfort. I searched in vain for a hot cup of coffee, a vending machine, or even an open kiosk where I could buy a warm layer. As the hours dragged on, I felt the chill settling deeper into my bones. A small oversight had evolved into a bigger hardship. A reminder that attention to detail and foresight can avoid challenges in life. The struggle against the cold became symbolic of my larger challenges. It mirrored my uncertainties about the future. A simple mistake quickly spiraled into self-doubt. Suddenly, everything about me felt fragile, as if built on quicksand. I generalized my failure, questioning my approach, attitude, and abilities, thinking, “If I failed here, I must have faltered in the interview too.” The confidence I once had suddenly seemed to be replaced by overwhelming insecurity. The airport became a microcosm of life—where a single unprepared moment led to long hours of introspection.
I was again rubbing my right eye, trying to clear the sight. Just when I began to think the night would never end, I stumbled upon a small, inconspicuous corner near one of the boarding gates. I felt a faint stream of warm air coming from an exhaust fan. It wasn’t much, but it was enough. That small discovery became my refuge.
I crouched by the fan and leaned into the faint warmth. As the hours passed, I dozed off. Sleep came sporadically but brought solace—a temporary escape from the biting cold. I believe when I was in the twilight, I recalled an incident my mother shared with me growing up. My father, a mathematician with high principles, quietly carried his burdens, facing challenges with stoic resolve. Though he didn’t speak much, especially in our childhood, he was vigilant and attentive to our needs. My mother was the storyteller in our family. She often told stories of my father’s youthful struggles, tales that gave me strength when I needed it. As a young man, my father left his small village in western Terai, Nepal, to study in Darjeeling, ill-prepared for the cold and economically strained. Lacking a proper jacket, he often layered shirts to shield himself from the bitter winds. My mother often said his sacrifices, born of necessity and perseverance, became the love and security he later lavished upon us. Years later, I found myself in a similar position, though on a different path. Reflecting on my father’s struggles, I realized how much greater they were, shaped by fewer resources and harsher conditions. But every struggle feels monumental within one’s own context. After all, struggle is relative to one’s lived experiences!
The meager warmth from the exhaust fan provided more than physical relief; it gave me hope. It also seemed to clear the dampness in my right eye or glasses, though I couldn’t tell if it was my eyes, aging glasses, or thoughts that cleared. My thoughts started veering toward a more hopeful path thereafter. I reminded myself how the last time I drove all day long to Detroit for an interview, my heart remained tethered to home. Manyata, my then three-year-old, was waging her own small war—a week-long battle with fever and cough. Every mile in that journey felt like moving further from where I was needed. This time, the stakes are quieter: The night at the airport was cold, but this journey was not weighed down by a sick child at home—an unexpected mercy! “Everything is relative in this world,” we often say, but nights like these unveil the full measure of that truth. As we shift from moment to moment, our thresholds and anchors evolve, reminding us that contentment is less about absolutes and more about perspective.
When morning finally broke, I felt like I had emerged from a long, arduous battle. As shops reopened and the terminal regained its bustle, I rushed to the nearest store. Among the racks, I found the pullover now hanging in my closet—a simple yet cherished item with “Chicago” emblazoned on the front. Slipping it on, I felt an almost irrational joy. Perhaps slightly teary, too. It wasn’t just about the warmth of the fabric but about a sense of triumph after a long night of adversity. That night had stripped away all distractions, forcing me to confront my own fears and shortcomings.
Months later, I got selected for a pulmonary and critical care fellowship in Corpus Christi, Texas, where I had interviewed during late winter. During my interview, I met my program director, an esteemed professor whose mentorship would go on to profoundly shape my career. One thing that struck me during my interview at Corpus Christi was that the interviewer clutched a warm cup of coffee. The gentle warmth of the vapor rising from his cup of coffee somehow reminded me of the warm air dissipated by that exhaust vent at the Chicago airport months ago. Though they could not be more different, those two separate moments seemed linked by an invisible thread. At times, two seemingly unrelated things share a theme that resonates deeply within us, linking us to a timeless sense of comfort and confidence we can’t fully define yet profoundly feel.
Working as a consultant physician at a teaching hospital in my current capacity, that night at the Chicago airport now feels distant. In the grand tapestry of life, far greater trials and tribulations command attention. Yet, these small moments of life often resurface, nudging us towards deeper reflections. The pullover, which offered warmth during a vulnerable time, symbolizes something greater. Even during times of misfortune, discomfort, and uncertainty, there’s always a way forward—and sometimes, it starts with finding the smallest source of warmth.
(Munish Sharma, originally from Lalitpur, Nepal, is currently residing in Texas, USA. He serves as an Assistant Professor of Medicine at Baylor College of Medicine and works as a Consultant Physician in Pulmonary and Critical Care Medicine.)
