I was a third-year medical student in Chicago, and I was more than ready for a change of scenery and a change of pace. I asked my trusted Uncle in India to organize an opportunity for study in Delhi. He wholeheartedly obliged and I set off on a near month long rotation in a residency-based institution in the city. I rounded with Internal Medicine Residents and attending physicians. And I learned untenable sums, and without a doubt, it was the highlight of my medical school experience.

I remember so many things about that rotation: the convictions of these budding physicians, the needs of these patients. And I remember the ardor of the teaching doctors. We would walk the wards and they would pepper the hours with facts and volley questions, forcing us to squeeze out our lexicon of medical knowledge. It was a superlative experience. But I remained baffled by something. I never understood why the student physicians could never walk in stride with the attendings – always careful to maintain at least two steps behind their teachers. That there was respect for their elders was beyond reproach or question. I remember asking the doctors I was fortunate enough to share time with, ‘You know we admire and honor you, but must we also keep a physical space between us as a method of deference?’  They smiled. No one had ever asked them the relevance or imperative of the behavior because it had become culturally imbedded.

Respect is a palpable experience, in addition to a physical one. I walk into my office every morning and I am usually greeted with good mornings and how are you. I never wait to be waited on with such inflections. I have no issue with initiating the questions and salutations. We are all deserving of platitudes and affection. I may ask a great deal of my assistants and nurses, but I know that I am quick to complement and express my gratitude as well. The exchanges never feel hierarchical to me. While I know they accord me with Dr. and I call them by their first name, there is no diminishing of regard or affection separating our titles.

As a child, I was always cognizant of the role of child vs. adult and the road to deference. It was heavy, and laden with spoken and unspoken expectations of the meaning of regard and respect. I also remember preparing for my future marriage. I remember being awed and possibly scared of what the relationship between child and in-law might look like. It had already been revealed by my own parents and their respective interactions with their extended families. Their patterns of engagement offered a mixture of both ease and stress, normalcy and contrived appropriateness. In short, it was one part love and many parts work.

When I reflect on the relationships I value most, they all share one commonality – comfort. I never need to question a phone call, a note, an exchange, or even a hasty goodbye. Relationships that are based in mutual love do not exact stress or discomfort. To the contrary, a relationship founded in honesty and trust feels loving and right. I have so many aunts and uncles whom I have adopted in my lifetime. Culturally, every friendship my parents have ever cultivated brought with it a new aunt or uncle. And many of those adopted family members are deeply cherished – we call on one another with mutual affection and interest.

The relationships that have demanded respect without the ease of return have proven most onerous and difficult for me. Where love or regard is demanded, rather than cultivated, where the relationship is required rather than desired – that is when I have been most uneasy. Where my parents have had to tell what is expected, rather than the feeling guide me there, those are the interactions that have felt most empty and quite often pained.

Since the loss of my father in 2018, I can count on a hand or maybe two, the numbers of individuals who have remained bonded to me. I do not keep score. For me, even one tender relationship is worth a thousand. I simply know that when love and respect are rooted in something beyond requirement and expectation, the love flows ever honestly, endlessly, and deeply.

I conclude with this offering: before you enter a relationship with expectation of respect, honor and possibly deference, ask yourself this question: are you able to offer the same? Are you able to love beyond condition, respect without boundary, and honor without pain? Because, if you are not, and if the relationship is not grounded in these tenets, and these beautiful roots, then do not expect them to bear fruit or to engender flowers that bloom.