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When Laurie Reyman was nine years old in South Africa, a shopkeeper waved her to the front of the line, ahead of the Black customers who had been waiting. Because she was white.

She never forgot it. Decades later, that memory sits underneath the question at the center of this episode: not what's wrong with you, but what's happened to you. Laurie Reyman, senior program manager, was there when SASIC was first designed. She was one of the people who sat down and asked how this work should look before it existed. But where the earlier episodes turn outward toward the patient, this one turns the lens around, onto the provider's own eyes. The assumptions we carry into the room, the humility the work demands, and the steady work of examining yourself before you examine anyone else.

Laurie walks through what trauma-informed care actually asks of the person providing it. How to help without re-traumatizing the patient, why slowing down and staying curious matters more than any protocol, and how to see someone as a whole human being rather than the sum of their trauma. She closes on something the news footage never showed us: the beauty of Afghanistan beyond the war image — the country, and the people, that were always more than their trauma.

This episode references war, trauma, and racism.

SASIC was funded by the federal Office of Refugee Resettlement and delivered by the International Rescue Committee in partnership with HealthPoint, Harborview Medical Center, and local community organizations serving Afghan immigrants.

Thank you to Safa Aynoor, medical student at the University of Washington School of Medicine, for editing assistance.

Produced and hosted by Dr. Duncan Reid.

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Imagine trying to treat something the person in front of you can't name — because in their language, the word for it means something closer to madness.

That's where this episode begins. Kristin Tiernan, a clinical psychologist, and Hem Acharya, a psychiatric nurse practitioner, are part of the behavioral-health team at HealthPoint. Their work starts with a problem most providers never face: in Dari and Pashto, "mental health" can translate as crazy, and a diagnosis can feel like a threat to a family's standing, safety, and future in this country.

Kristin and Hem take us through what it actually takes to help. Starting with the need to first slow down. How distress hides in the body, in headaches and dizziness and "too much thinking." 

Why a screening questionnaire can hide the truth, even when translated into the patient’s language, and how to turn the form into a conversation instead of a verdict. And why the relationship between provider and patient itself, the thing no metric can capture, turns out to be the strongest medicine.

Hem speaks with rare honesty about his own life, and about a definition of the work he's arrived at: that he'd rather not call it mental health at all. He'd call it emotional health.

This episode discusses trauma and mental illness. If you're struggling, help is available — resources are in the show notes.

SASIC was funded by the federal Office of Refugee Resettlement and delivered by the International Rescue Committee in partnership with HealthPoint and Harborview Medical Center.

Thank you to Safa Aynoor, medical student at the University of Washington School of Medicine, for editing assistance.

Hosted and produced by Dr. Duncan Reid.

If you or someone you know needs help

Call 988 or the Regional Crisis Line: 206-461-3222

Trained volunteers and mental health professionals from Crisis Connections help people on the phone, connect people to services or can send mobile crisis teams to respond in-person.

Call 911 if the mental health crisis poses a threat to life or safety. In South King County, crisis counselors in 911 call centers support people who call related to a mental health or drug or alcohol use crisis.

Get an appointment within 24 hours

You can get an appointment with a mental health or substance use provider for yourself or someone you’re helping. They can connect you to treatment and services you want. 

For appointments related to substance use: Contact the Washington Recovery Line: 866-789-1511.
For appointments related to mental health: Contact 988 or the Regional Crisis Line: 206-461-3222. 

https://kingcounty.gov/en/dept/dchs/human-social-services/behavioral-health-recovery/crisis-services

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Before they spent their days helping Afghan newcomers navigate insurance forms and bus routes and appointment texts, Hadi and Zarmina were newcomers themselves — lost in the same city they now guide others through.

The SASIC program deliberately hired case managers who were themselves Afghan, and this episode is about why that choice was both its greatest strength and its hardest problem. 

Hadi, from Herat, couldn't figure out how to cross the street his first week in America. Zarmina, a dentist from Kandahar with a public-health degree, arrived alone, eager to find a job to support her parents in Afghanistan. Both had lived the exact disorientation their clients now face — and both had to earn trust in a community that, at first, didn't want an Afghan case manager at all.

Interlacing their two interviews, this episode explores the surprising diversity of Afghanistan — the many languages, ethnicities, and "different versions" of a single country — and the humility it takes for to learn your own people. Hadi and Zarmina describe the day-to-day of the work: the morning flood of phone calls, the mismatched expectations, and mental-health support quietly folded into sewing circles and soccer games, because you can't put the words on the flyer. And they reflect on what the job gives back — why, in their experience, a short-term service so often becomes a long-term friendship.

SASIC was funded by the federal Office of Refugee Resettlement and delivered by the International Rescue Committee in partnership with HealthPoint and Harborview Medical Center.

Thank you to Zarmina Sidiq and Hadi Ebrahimi for their generosity in sharing their insights with us.

Thank you to Safa Aynoor, medical student at the University of Washington School of Medicine, for editing assistance.

Hosted and produced by Dr. Duncan Reid.

Visit EthnoMed.org for additional resources. Follow us on YouTube and Instagram @EthnoMedUW

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The Rest of the Story — Episode 1: Intro to Services for Afghan Survivors Impacted by Combat

In August 2021, the world watched Afghan families flee Kabul, crowding airfields to catch the last flights out. Within days, the world stopped watching. This series is about what happened next.

When the planes landed in the U.S., tens of thousands of Afghan newcomers arrived carrying the weight of combat-related trauma. They entered into a resettlement system that wasn't ready for them. 

The Rest of the Story follows the people whose job it became to help — through a federal program called SASIC: Services to Afghan Survivors Impacted by Combat.

In this first episode, we meet Zahida Jaffer, case management coordinator at the International Rescue Committee, who was there at the very beginning, She worked inside the tent communities on a U.S. Air Force base in 2021 and spent the years that followed helping other families rebuild. 

Family physician Dr. Shoshana Aleinikoff sets the scene from the clinic side: a system that had quietly atrophied, and the flood of calls that brought it back to life. Together they introduce the program, the community it served, and the ideas that run underneath everything to come: trauma-informed care, cultural humility, and wraparound support.

SASIC was funded by the federal Office of Refugee Resettlement and delivered by the International Rescue Committee in partnership with HealthPoint and Harborview Medical Center.

This episode references war, displacement, and trauma.

Produced and hosted by Dr. Duncan Reid, MD

About SASIC:

https://ethnomed.org/services-to-afghan-survivors-impacted-by-combat-sasic/

Featuring: 

Dr. Shoshana Aleinikoff, MD Director of Immigrant and Refugee Health at HealthPoint Clinic

Zahida Jaffer, Case Management Coordinator for the SASIC program at the International Rescue Committee

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Getting into medical school felt like the finish line. It wasn't.

In Part Two of our conversation with Dr. Ayman Youssef, Chief Resident of Quality Improvement in Internal Medicine at Harborview Medical Center, we pick up where we left off in medical school in Galveston, Texas where his sense of belonging had to be earned all over again.

Ayman takes us through the culture shock of medical school, a formative summer in Amman working with Palestinian refugees through UNRWA, and a residency match that didn't go according to plan. He wanted Stanford. He got Seattle. He's grateful.

We get into what Harborview revealed about the kind of doctor he actually wanted to be, the chronic illness he had to reckon with mid-residency, and why he's still on his own timeline — deliberately, and without apology.

And we end where the whole conversation has been pointing: information. Who has it, who doesn't, and the additional work needed to navigate medicine without the hidden curriculum that gets quietly handed to people who already belong. Ayman is honest about what he did and didn't have, what he wishes he'd known earlier, and what he tries to pass on now.

This is Part Two of a two part series. If you haven't listened to Part One (Episode 31), start there.

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What does it mean to belong somewhere when you've never quite fit anywhere?

In this episode of the Provider Pulse Series EthnoMed Podcast, we interview Dr. Ayman Youssef, Chief Resident of Quality Improvement in Internal Medicine at Harborview Medical Center in Seattle. Ayman grew up in Houston as the bicultural son of an Egyptian Muslim father and an American mother — finding he never quite fit in at his Islamic school or in public school.

His path to Harborview was anything but direct. It wound through a series of engineering majors, a grueling commute through Houston traffic, a passion for organic chemistry, and a personal statement that forced him — for the first time — to make sense of his own story.

We also get into the work that now defines much of his day: running Harborview's Morbidity and Mortality Conference, where he works to review cases of adverse outcomes while ensuring that he remains curious, humble, and human.

This is Part One of a two-part conversation. It's a story about finding potential late, earning belonging slowly, and learning to hold failure — your own and the system's — with honesty and care.

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"The medical system we have is very oppressive in this country. It doesn't primarily value humanity and the human experience and the health of human beings."

In Part 2 of our conversation with family physician Dr. Anuj Khattar, the idealism we traced in Part 1 collides with the realities of the American healthcare system. This episode isn't comfortable—it's not meant to be.

Dr. Khattar walks us through what happens when a values-driven physician enters a system designed around different priorities. From 30-hour shifts in residency to patients unable to afford care, from the loss of continuity in family medicine to the question of whether doctors are actually happy—this is a frank conversation about a physician's assessment of his path and the state of medicine.

In Part 2, we explore:

• How witnessing child abuse during pediatrics rotations sparked his passion for reproductive healthcare and patient choice
• The moral distress in residency when he realized "this isn't what I signed up for"
• The painful reality of insurance barriers preventing patients from getting necessary care
• Taking six months after fellowship to reclaim his identity beyond medicine
• The honest answer to "Do you know anyone who's really happy being a doctor?" (Spoiler: "Really happy is a stretch.")
• Why six jobs isn't just burnout—it's an intentional design for maintaining agency within system constraints
• The loss of continuity that drew him to family medicine in the first place: "I get more lost in novels these days because I want to know those things about people's lives"

This isn't a warning to avoid medicine—it's an invitation to enter with clear sight. The healthcare system has real problems. It prioritizes profit over patients. It creates barriers to care. It burns out providers who entered with the best intentions.

But Dr. Khattar hasn't given up. He's created a sustainable practice across multiple settings, refuses to stop advocating for patients, and continues teaching the next generation. He shows up—even in 15-minute appointments—and still cares.

For pre-med students: Better to question now than after medical school. Channel your anger about the system into motivation to change it.

For medical students: You're not alone in the frustration. The gap between what you hoped medicine would be and what it is—that's real, and it's okay to name it.

For anyone in healthcare: This conversation validates what many feel but don't say out loud.

Dr. Khattar's story doesn't end with easy answers. What it offers is honesty, agency within constraints, and the refusal to look away.

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What happens when an idealistic pre-med student becomes a physician and discovers the healthcare system isn't quite what they expected? In this first part of our conversation with Dr. Anuj Khattar, we trace the path from a diverse San Jose childhood to six different healthcare jobs across Seattle.

Dr. Khattar currently works as medical director at Cedar River Clinics, teaches at Swedish Family Medicine and ICHS, provides care at Planned Parenthood, runs a ketamine-assisted therapy practice, and works urgent care—a portfolio that reflects both passion and the complex realities of modern medicine.

In Part 1, we explore:

• Growing up in 1990s San Jose during the tech boom, where white students in his school were the minority and diversity was the norm
• The mobile clinic experience at UCLA that cemented his commitment to serving underserved communities and taught him to see systems of power and inequality
• Undergraduate research experience and his realization that this was not his path
• The challenging first two years of medical school at OHSU— endless exams and questioning his path
• Finding redemption in third-year clinical rotations and discovering his mentor in family medicine

This episode is essential listening for anyone considering medical school. It's honest about the challenges—the grind, the depression, the culture shock—while showing why some people persist. Anuj's story isn't a warning to stay away from medicine; it's an invitation to enter with eyes wide open.

Coming in Part 2: What happens when idealism meets the constraints of the American healthcare system.

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After her crisis of conscience in Kenya, Bayle Conrad made a decision: no more international work. But finding her place in global health wasn't that simple.

In this second part of our conversation, Bayle returns to Seattle with an MPH degree and more questions than answers. She turns down international jobs she's qualified for, takes a microfinance position that still involves those same power dynamics, and eventually stumbles into refugee resettlement work at the International Rescue Committee—a job she wasn't sure she could do.

What follows is six years of transformation. The anxious teenager who couldn't speak up becomes a caseworker handling crisis interventions. The student who questioned her right to help finds meaningful work here in Seattle. And the questions that nearly made her quit? They become her greatest asset.

This episode tackles the practical realities of refugee healthcare: Why "just pick up your prescription" isn't simple. How systemic barriers compound trauma. What happens when a care conference becomes an exercise in power dynamics. And most importantly, how providers can create space for agency rather than accidentally undermining it.

We end with Bayle's hard-won advice for students navigating uncertainty, anxiety, and the messy path toward meaningful work.

Topics covered:

• Transitioning from international to domestic work
• Refugee resettlement and casework at the IRC
• Navigating power dynamics in helping professions
• Barriers to healthcare for refugee populations
• Working with interpreters and cultural brokers
• Practical guidance for providers
• Advice for anxious, shy, or questioning students
• Finding your strengths in unexpected places

Perfect for: Healthcare providers working with refugees, public health professionals, students questioning their career path, anyone navigating the tension between helping and perpetuating harm, and those learning that their sensitivity might actually be their strength.

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What's the difference between helping and voyeurism? Between witnessing and exploiting? These are the uncomfortable questions that nearly made Bayle Conrad quit her Master of Public Health program.

In this first part of our two-part conversation, Bayle takes us from her childhood in Spokane—struggling with debilitating anxiety that made her hyper-aware of power and agency—through her undergraduate years at the University of Washington, where she learned to view global health through a critical lens.

The pivotal moment came during a summer internship in Kibera, one of Nairobi's largest informal settlements. Tasked with escorting donors on "slum tours," Bayle found herself asking: What makes me different from them? What right do I have to be here? These questions led her to write an essay titled "The Voyeurism of Global Health" and to nearly abandon her career path entirely.

This episode explores the ethical tensions inherent in cross-cultural work, the journey from crippling self-doubt to self-awareness, and why some questions are more valuable when left unresolved.

Topics covered:

• Growing up with undiagnosed anxiety disorder
• Finding mental health support in college
• Learning critical perspectives on international development
• Working in Kibera's informal settlement
• Power dynamics in global health work
• The ethics of international development

The link to Bayle Conrad's essay can be found here at the following link (pages 38-39 as listed in the pdf, or 60-61 using search tab):

https://courses.edx.org/asset-v1:BUx+GlobalHealthX+3T2018+type@asset+block/ReflectionGlobalHealthPart1.pdf

Perfect for: Pre-health students, public health professionals, anyone working across cultures, and those navigating anxiety while pursuing meaningful work.

Visit EthnoMed.org for additional resources. Follow us on YouTube and Instagram @EthnoMedUW