On Motivating Difficult Patients

Snigdha Nandipati
A Case of Culture
Published in
4 min readFeb 16, 2022

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Photo by Matthias Zomer from Pexels

This book excerpt is from Chapter 7 of my debut book, A Case of Culture, now available on Amazon, Barnes & Noble, and Kobo. Learn more about the book here.

A little over fifteen years ago, Tamara Katz used to serve as a volunteer at our clinic. Though she passed away in 2004 at the age of ninety, she is remembered to this day by our clinic staff for her candid personality and the meaningful impact she had on our Russian patients. It wasn’t until I read her obituary and learned of her story as a Holocaust survivor that I realized the pain and hardship that hid behind her vivid demeanor.

Born in 1914 as Tamara Kaplinski in Lida, Poland, she learned many languages at a young age, including Polish, Russian, German, Yiddish, and Hebrew. Her language skills would prove invaluable in helping translate for the many Russian patients at our clinic. In 1937 Tamara married a fellow Pole, Abraham Dworzinski, and in 1939 they had their first son Nathan (Wall, 2004).

Two years later, the Holocaust began. Her parents and husband were shot in a mass killing of Polish Jews, leaving her widowed with her three-year-old son. Tamara always kept a few blades of grass from the mass killing site in her handkerchief as a reminder to herself to make it out at all costs.

Tamara and her son spent the next several years on the run. She was able to pass as non-Jewish because of her bright blue eyes and fluent Polish. In 1944, she met and married Abraham Katz, a fellow refugee. By the end of the war a year later, Tamara and Abraham found themselves in a displaced persons camp in Austria, where they gave birth to their daughter Ruth. Finally, the family decided to escape from it all and moved to the United States in 1951, settling in San Francisco.

Her husband passed away a few years later due to a kidney condition that began during the war. Though widowed and alone in a new country, Tamara let nothing get to her. Instead, she decided to live her dream as a bookkeeper, eventually learning the business well enough that she opened her own antiques shop. Tamara was known among family and friends for her fiercely independent attitude. “That was her greatest strength, but it was also her greatest demise, too, as she got older,” her daughter Ruth shared. “She thought she could still do things; she would forget that she wasn’t fifty anymore.”

In a way, her independent and autonomous mindset came directly out of her early life experiences. She was at death’s doorstep and managed to escape. She worked incredibly hard to get to where she got to be, and she suffered many losses along the way. Perhaps that was why she would not tolerate it when others didn’t similarly work for what they wanted, especially fellow Eastern Europeans.

Tamara began volunteering as a Russian interpreter at our clinic in the early 2000s. Many of our clinic’s patients back then were elderly Russian folks who moved to San Francisco right after the Cold War. In fact, the neighborhood surrounding our clinic had (and still has) a prominent Russian community. Living in a majority-Russian neighborhood was associated with greater retention of Russian identity and lower rates of acculturation for Russian immigrants in the US (Miller 2009). And sure enough, this was the case with our clinic’s Russian patients. Be it in the bread lines or soup kitchen queues back in Russia, they were used to fighting for their demands. If they fought hard enough, they got what they wanted. This was what worked in Soviet Russia, so patients began to use the same approach here in the clinic. They came in with exceedingly unreasonable demands, hounding the front desk staff and nurses and doctors incessantly until their demands were met.

Tamara was fed up with their behavior. Our clinic at the time was incredibly small with limited resources, yet the doctors and staff took on any and every burden in order to provide free medical care to our uninsured patients. Tamara wanted to make a point to these patients that their lack of gratitude and unruly behavior was intolerable.

“This is America,” she told them. “You need to work for what you want. You can’t just make demands.”

Because she was much older than any of the patients, they looked up to her. “Go to school. Learn the language,” she told them. “Do what you need to do, but don’t just ask for things without working for them.” Tamara not only helped the patients adjust their behavior, but she unknowingly inspired many of them to go out and get jobs and learn English. She might not have made the same impact if she was an outsider lecturing these patients about how important it was to learn English, or if she lacked familiarity with the unique cultural challenges that these Russian patients faced in emigrating to and living in the US. But because the community saw how she led by example and regarded her as one of them, Tamara was able to encourage meaningful change among our clinic’s Russian population. She transformed the community from within.

In this article series, I share excerpts and stories from my book, A Case of Culture. If you would like to learn more about what happens next, you can find the rest of the story in Chapter 7 of my book, out now on Amazon, Barnes & Noble, and Kobo. If you enjoyed this book excerpt, please consider subscribing to this weekly excerpt series and sharing it with your network. Join our virtual Book Launch Celebration with Dr. Hasan Gokal of Code Blue Radio on Sunday February 20. RSVP here. To learn more about the book, visit my website. If you would like to connect with me, you can reach me here via email at snigdha.nandipati@gmail.com or @snigdhanandiauthor on Instagram and Facebook.

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Snigdha Nandipati
A Case of Culture

I write about medicine, language, culture, faith, and philosophy.