Dr. Nandita Sriram, Physician at Kaiser Permanente
Meet Dr. Nandita Sriram, internal medicine physician at Kaiser Permanente. Nandita graduated from Weill Cornell Medical College in Manhattan in 2014 and completed her internal medicine residency training at the Ronald Reagan UCLA Medical Center in Los Angeles. Nandita has a special interest in medical education and in women’s health, and firmly believes in wellness and disease prevention through diet, exercise, and self-care strategies. Nandita is also an accomplished Carnatic vocal musician, Bharatanatyam dancer and Western violinist. She shares with us her story of finding purpose as a physician, living with intention and mindfulness, and integrating different cultures. Read on to learn more.
“I was born in Memphis, Tennessee and moved to California when I was 18 months old. I was really fortunate to have had a comfortable, charmed childhood, thanks to my parents who immigrated to the US and worked so hard to provide for us.
My older sister has cerebral palsy, but it never felt strange to me. I loved spending as much time with her as I could, and I guess I never really knew any other kind of normal. I do think that having a sister with disabilities made me more independent and mature for my age as a child.
I also had the benefit of growing up in a multi-generational household. My maternal grandparents have lived with us for the majority of my life, which is really amazing. They were super helpful in helping me connect with my culture, from ensuring that I could speak Tamil fluently to making South Indian food every single day.
A large portion of my after school hours were spent learning and performing Carnatic music, Bharatanatyam and Western violin. I also spent summers at tennis camps and swimming lessons, and I got really involved with speech and debate at my high school. My parents gave me a lot of leeway in terms of having a typical American childhood - I don’t think I ever missed a high school dance or a sleepover! We celebrated Navarathri and Diwali with as much flair as we did Halloween and Christmas!”
Starting a Career in Medicine
“I’d known for a while that I wanted to pursue something in the sciences and studied biomechanical engineering during my undergrad years at Stanford. Most of my summers were spent doing research at biomedical companies, but by my senior year, I was more drawn to the humanistic aspect of patient care.
Looking back, I think the med school application process was the hardest step of the journey - I had the same struggles with pre-med classes and the MCAT as most people do! But once I started started school, my professors helped ensure I’d be successful from there on out. I chose to go to the East Coast for med school since I’d been in California for so long and thought Manhattan would be an amazing experience.
And indeed, it was one of the best periods of my life. There is so much cultural diversity in the city, and there was always so much to do when we weren't in class. There is nothing like New York City. I met my now husband there, too. He is also from California, and thankfully we were both able to come back to the West Coast for our residency training.”
“The first year of residency was really hard. We’d get a maximum of one day off a week, but things started getting a little better in our second year. As physicians, we are always touting healthy lifestyles with our patients, but we need to remember to take care of our own health, especially since residency can be so grueling! My husband and I were very adamant about trying to cook nutritious food, and we got into a yoga practice, which continues to be our go-to wellness strategy.
Anybody who goes through med school has so many moments of self-doubt. You’re thrown into a program with a bunch of type A students, and the pressure can be overwhelming. I also expected to be successful and happy during all my rotations, but obviously that wasn’t the case, and people specialize for a reason. I had to remind myself to play to my strengths, and tell myself that it was OK not to feel at home in the operating room, or that it was OK that I didn’t feel like the ICU was for me. I realized with time that my strength was seeing patients in the office and speaking with them about how to live a healthy lifestyle. I still tell myself to focus on my strengths whenever I go down the rabbit hole of self-doubt.
Internal medicine is so interesting to me as the variety of pathology in the field is endless. My patients can walk in the door with pretty much anything. This past week, I saw a patient with appendicitis in one room and I was urgently rushing her to surgery, but in the other room, my patient wanted to see me for a simple rash. I also love developing lifelong relationships with my patients. When it comes to health and wellness, behavioral change is incremental, and it can only happen over time with trust in a physician.”
Real Talk as a Physician
“The best part of my day is when I get a message from a patient telling me that they finally feel like their normal selves again! It’s equally rewarding to have a patient say, ‘Thank you for validating my concern. I feel like you really listened to me.’
Sometimes I do grapple with the feeling of needing to prove my worth as a young woman in medicine. For example, I’ve seen patients who tell me that I can’t possibly be old enough to be a doctor. I bristle a bit when I hear things like that, and while I know that they’re likely not trying to undermine me intentionally, I can’t help but feel like they’re undercutting my work. I try really hard to not take things like this personally, and I take solace in the fact that I know I’m providing really good care. I keep telling myself that, and I politely continue to reinforce that I am indeed a doctor, I’ve gone through all the training and I am someone you can trust.
My advice to young women interested in pursuing medicine is to know that this is a long journey and not for the faint of heart. Burnout in medicine is a very real, increasingly recognized problem, which makes self care so important. I would make self care a habit early, much earlier than I started. Taking care of yourself should be as embedded in your life as is brushing your teeth.”
Health & Wellness in the South Asian Community
“A lot of my female patients are also the primary caregivers for their children, parents or in-laws. And I’ve seen time and time again that they often let their own health fall by the wayside.”
“Being in the Bay Area, I have a pretty large population of South Asian patients. These are sweeping generalizations, but I’m frequently speaking with them about the higher rates of heart disease and diabetes in South Asians and therefore about the importance of monitoring heart health from a young age. Most of my South Asian patients are extremely high achieving, which often comes at the cost of their health. I’ve seen many cases where inadequate work-life balance has led to physical aches and pains. I try not to put a band-aid on these issues by prescribing medication and instead really focus my efforts on promoting regular self-care regimens.
I also try to normalize the stigma around mental health issues. Many of my patients experience anxiety or stress, which is totally normal in high pressure environments. I remind my patients that seeking therapy or needing medication is not something to be ashamed of. I also emphasize that mental health treatment is confidential, so patients shouldn't have to worry about their parents or employers finding out that they're seeking help.
A lot of my female patients are also the primary caregivers for their children, parents or in-laws. And I’ve seen time and time again that they often let their own health fall by the wayside. I try to empower women to care for themselves within the confines of their home, whether it’s by finding short YouTube videos for exercise or by carving out five minutes each night for guided meditation apps.”
On Love and Marriage
“When it came to relationships and marriage, my parents definitely had their preferences, but they thankfully didn’t hold me to specific expectations. They were very pragmatic early on and knew what was important to me as I started building my career. So when I introduced them to Dominic, who is half-Armenian, it took some time for them to get used to the idea, but they quickly came around. They got to know him well and really embraced him with acceptance and openness (he and my mom even went to India together for pre-wedding shopping!).
It would have definitely been easier at the onset if my husband had been South Asian, but Dom is very open to my culture and strives to learn as much as he can. He comes to every kutcheri, tries endlessly to perfect his sambar, and celebrates all our festivals with as much enthusiasm as my family. I was really drawn to Dom because I could immediately sense that he wanted to be an equal partner, and he never presupposed that I would take charge of housework. We both share a strong sense of family - just as I grew up with my grandparents, Dom also grew up with his grandmother, who only spoke Armenian, so we have so many shared experiences when it comes to multi-generational households.”
“I’ve realized that once you marry somebody and you’re not under the umbrella of your immediate family anymore, ‘preserving’ your culture is dependent on how much you prioritize it. I never want to give up my love for our language, food, culture and the arts, and Dom knows how much I value those aspects. Sometimes it’s the littlest of things, like listening to Sanjay Subrahmanyan while we get ready for work in the morning.
For anyone experiencing friction with their families when it comes to relationships, I’d advise you to keep telling yourself that this is your life, after all. Ultimately, you want to choose a partner who is going to support your dreams for the rest of your life. It’s also important to determine your deal breakers, and know that those deal breakers can change over time as your values shift. And, always trust your gut!”
“I’ve had mentors at every single stage of my career, and I don’t think I could ever overstate their value. My mentors in medical school helped me choose my specialty. One of the most helpful pieces of advice they gave me was to not just focus on the subject matter of the specialty, but also to think about the kind of people in that specialty - to make sure I’d feel at home with my colleagues. My mentors today are so crucial in reminding me to look ahead at the 10- or 20-year time horizon, especially when I’m bogged down in the nitty gritty. They take note if I’m staying at work too late (it’s the slippery slope to burnout!) and push me to find my raison d’etre - that bigger sense of purpose.”
ON THE ARTS…
“The arts are so important to me. They give me immense joy and keep me balanced. I’ve never been someone who’s been married to my work. I try to keep up with Carnatic music by setting small personal goals for myself by means of performances here and there. I love that I can bring myself joy every single day when I practice singing.”
“I absolutely love yoga and practice regularly. I can actually feel a difference in my sanity level when I miss a couple weeks! I’m aiming to complete a 200-hour yoga teacher training course at some point. I’d love to one day start teaching yoga for the physical, mental, and emotional benefits it can provide. I also enjoy my TV shows, and right now I’ve got The Marvelous Mrs. Maisel and This is Us on rotation - it’s always cathartic to cry or laugh with the characters!”