The alarm clock blares its relentless siren at 4:45 AM, every morning without fail. A few seconds of bleary blinking later, Yelena is out of bed and ready to begin tidying the house before leaving for her much-too-early shift at the hospital. For her, these daily sacrifices (of sleep, perhaps of sanity) are a small price to pay for the doors that she has opened for me, her thankful daughter, and all the generations to follow. After a long shift, as we begin our interview and Yelena begins cooking dinner, I ask whether she enjoys waking up early. Yelena, a seasoned New Yorker, responds with “Wake up? But New York never sleeps, New York never rests! I’ve taken that to heart.”

Yelena was in her late teens when she and her family first decided to apply for a visa to come to the United States; in 1979, when they did so, their city of Tashkent was still under the control of the Soviet Union. As she describes it, “It was difficult living under the KGB, especially for anyone who wanted to have a business and didn’t have the money to pay them off. Everyone wanted the opportunity to work and actually make a life for themselves and for their families. People were trying to leave in order to chase that dream. We all heard that America gives people a shot to actually do that.”

The time when they decided to leave was many years before they were actually granted permission to do so. “We couldn’t leave for ten years. My step-sisters were able to leave, but me and the rest of my family were stuck there for another ten years.” When they finally left in 1989, it was a time of unrest in the Soviet Union, right before the collapse of the single-handed rule of the Communist Party and before the fall of the Berlin Wall. Corruption within the police force and sheer fear in citizens’ hearts kept opportunities limited and dreams tampered. Even now, decades later, mentioning communism brings back painful memories to Yelena. Being Jewish hardly helped: “Living there [in Tashkent] was very hard. How? Not only money. National discrimination, mostly against Jewish residents. A woman once told my father that he was wearing ‘the wrong headdress’, referring to his yarmulke.”

Looking at our subpar attempt at a Passover seder, I can’t say that being Jewish has been a huge part of my upbringing. I can’t say that Yelena, the self-described “passive observer” of religious practices, was particularly affected either. She made a family tradition of decorating the Christmas tree every year and bringing home chocolate bunnies for Easter. But Judaism mattered to my grandfather, who was the victim of anti-semitism in my mother’s story and whose two daughters from a previous marriage had already made their way to America to start anew. The backlash against his heritage and against the peaceful life that Yelena was working to accomplish for her family inspired their move abroad.

While they were waiting for their visa to clear, Yelena took the initiative to pursue her career: “In those ten years, I finished medical school, I was finishing my Ph.D. (doing research on blood and bunnies and gynecology, it was so great!) before abandoning my thesis on the couch when we found out that we could come to America. I was a month away from earning a professor’s title.” She had to abandon her research and start packing immediately: another opportunity for the visa to clear would not come any time soon, if at all. “When we got the permission to come, we had to pack our bags and leave. We wouldn’t get a second chance. We didn’t have time for Ph.D. theses. We didn’t have time for anything, really.”

I ask if she regrets leaving and abandoning everything at the ripest point of her career. Having a Ph.D. in her home city would mean levels of prestige and recognition far greater than the same degree in the United States. She could never get back the years upon years of hard work that she placed into her profession. She thinks for a moment before her firm reply: “No.” I ask why she never defended her medical specialty here — even though she works as a physician, it is not in gynecology as it was back in Tashkent. She laughs a bit bitterly before sighing and looking at her lap: “I was told by my fellowship advisor that I couldn’t make it here as an OB/GYN.” I tilt my head, confused. Why? “They didn’t want to hire immigrants here.”

Yelena explains that there was suspicion among American citizens when looking at foreigners, often doubting their abilities in the fields that they have worked in for years breaking down boundaries and obstacles in her path to become respected in her field. She knew that Yelena, who had immediate needs to support her family, did not have the opportunity to do the same in a field as competitive as gynecology. Instead, she encouraged her to branch out and explore other options, leading to Yelena’s eventual (and somewhat spontaneous) decision to go into endocrinology.

However, before Yelena could even begin to think about her career prospects in America, she had to find a way to arrive here in the first place. It took nearly a decade for Yelena and her family to flee the country. Why did the immigration process take so long? “You needed a ton of paperwork and had to go through an official network of organizations to even get permission to become a traitor, as they called us. No one was allowed to leave the country and remain a Soviet citizen. They took away our passports because we were seen as traitors to the country for leaving. We became refugees and had no country to call our own.” Under the laws of the Soviet Union at the time, citizens who wanted to leave the country could not do so and retain their citizenship. Obtaining an exit visa was difficult enough, but once it was obtained, people had to relinquish their right to Soviet citizenship, which included the right to return to their home country if something goes wrong. In the years after leaving the Soviet Union but before working long enough to apply for American citizenship, people like Yelena were stateless.

Fortunately, Yelena had some family waiting for her in America, unlike countless other immigrants who had to start entirely from the bottom. “We lived with my sister, her husband, and their son (who was maybe 2 years old at the time). They had arrived a few months before us, so they had some time to get adjusted and eventually welcomed us to stay and split the rent.” All of them were desperately looking for any job that could pay for bare necessities. As refugees, Yelena and her family were unable to take any of the money they had in the Soviet Union or liquidate any of their assets, reducing them to complete poverty: I grew up hearing the story of how my mom and her sister used  the only $50 they had to buy my cousin a decent crib to sleep in. Considering the difficulty that came with finding any job for newly arrived immigrants, let alone a well-paying one, that small sacrifice became a huge setback for the first few weeks after arrival.

Yelena laughs as I ask her what she expected when she was on her way: “We heard so many stories from old friends about America having everything — it has everything! Of course it has everything! We didn’t doubt that it had everything! But we didn’t have the money to buy it. Of course there was everything here, but we came with a few dollars for the whole family. Who had the money to buy it all?”

The concern with money continued to plague their family, as well as countless others who arrived here after abandoning their previous lives. Since none of the immigrants had a right (or the language ability) to work in their specialties from their country of origin, many of these immigrants took low-paying jobs as taxi drivers, live-in nannies, or home health aides. Yelena herself became a caretaker for an elderly neighbor, spending nights there and days studying. As Yelena explains, “You start to understand that you’re no one in the eyes of the world (even if you have a diploma, even if you finished all your education, even if you worked hard your whole life): you come here, and you’re no one.”

The only hope for the majority of these people, who came to the United States (like Yelena) with various degrees and certifications from the old country, was taking an equivalency exam to establish their credentials here. The Foreign Medical Graduate Examination in the Medical Sciences (FMGEMS) was a test taken to see whether foreign medical students were equipped with the knowledge that they would have gained in medical school here. The test was broken up into three sections: basic science, clinical science, and English proficiency. And while most graduates from foreign universities had no problem mastering the medical material for the exam, knowing enough English to translate complex terminology from their native language required months, if not years, of arduous preparation. Yelena laughs again as she recalls this time period, which she claims was when she was “the most physically fit I’ve ever been. For $34 dollars ($62.30 in 2018), I bought my first American sneakers (Reebok) at Payless. They were bright, ugly red. I used them to walk to Kaplan courses for 3 miles there and back every day for half a year.”

Kaplan and other test-prep companies seemed to be the key to unlocking many candidates’ potential. With skyrocketing costs of textbooks and study materials, many hopeful doctors pooled together their money and resources to collaborate and work together towards passing the exam that could establish their future here. Impoverished immigrants, often with no English ability to speak of, were constantly compared to American graduates, all of whom were going for the same few residency slots: “All of us, former doctors, worked together and it helped us actually have a fighting chance.”

Yelena became one of the few non-native English speakers to pass her exam on the first attempt, setting her on the path to becoming a certified physician in the United States. The next six years passed in a blur. She completed her residency program and was placed into a SUNY fellowship program at the insistence of her advisor, who saw the potential in Yelena that she refused to see in herself. She opened her own clinic in 1998 a few short weeks after completing her fellowship, a mere eight years after arriving in America, and a year before she gave birth to me.

I look at her and ask if she would do it all again. All the pain, all the work, breaking down a satisfactory life just to pursue the faint possibility of a better one. “Yes.” Knowing myself, my answer would have been no. The bravery required for such a risk is beyond my capabilities. So I ask her, why? She thinks for a second, hesitates, and gathers her thoughts before decisively replying.

“America was a country of dreams, for everyone it seemed. It still shocks me that as second-generation— you call us first generation? Even though we came here sort of young? — okay, as first generation, we were able to go through what we went through and end up moderately successful. I see a lot of my colleagues, and many of them have similar backgrounds to me. I can’t tell you if the American Dream is real, but somehow things worked out for us. And if things worked out for us, then things can work out for you.  That’s why I have such high hopes for you: you’re an American graduate. There is nothing holding you back. You can make whatever life you want for yourself here. And that makes it all worth it.”

And as the sun sets behind her, its rays filtering through into her apartment on to the food she cooked for our small Passover dinner, she smiles.



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