Cheryl Chan

photo: Laura Dumont Photography

I Will Use My Rage for Him

Cheryl Ryan Chan is a change agent. A mom with a mission. A woman who crowd-sourced anger and used it as a tool for accountability. She figured, if the courts are going to fail to protect her son with intellectual disabilities from his abuser, then she’s going to have to just change the law. If you want something done right...

I want to preface my story by acknowledging that this is The Advocacy Issue, but it’s more of a story about identity, but I missed that issue because I was having a colossal internal argument with myself about whether to write about this because I know it is a powerful story and one that may evoke a powerful response from readers. To say I’m not ready for that doesn’t really match up with my character—with my identity. Everyone who knows me knows that I don’t walk away from a challenge. They know I am a leader, an outspoken critic who loves as deeply as I call people out.

A good friend introduced me at a conference before a speech I made and said, “You know the term ‘call a spade a spade’?  Well, Cheryl sees a spade and calls it a fucking shovel!” So, it’s weird that I hesitated to write this. My identity is inextricably entwined with this story; I have no identity without the journey I’ve had over the last 30 years as Mom to a man with severe autism, so I guess this does fit. And I’m now ready. Let’s do this.

“If anyone touched MY kid, I’d kill them!”

I always try not to roll my eyes and I just take a deep breath and nod. That kind of response is typical when they hear my story—just not very helpful.

As if I hadn’t thought of that. As if I haven’t executed the people involved in my son’s abuse in my head thousands of times.

Anyone with kids in their life gets the emotion behind that kind of statement. If you love someone who is vulnerable, you get it. Aging parents, very young children, someone with mental illness navigating the “service” and medical worlds; all of us get it at some level.

The emotion is real. BELIEVE ME. It’s rage—nothing more, nothing less, and as you’ll learn here, rage is a wonderful, powerful emotion. I live with it and I’ve learned to embrace it as a strength. I have embraced it since the day I found out Nicky, my profoundly autistic, intellectually disabled, non-verbal son, was brutally beaten by a caregiver at his adult day program while another caregiver looked on.

It was spring of 2014. I had already been told what happened with his caregiver. I knew I was going to get something in the mail from the Massachusetts Disabled Person’s Protection Commission (DPPC) with details of their investigation that a caregiver at Nicky’s day program had been found with drug paraphernalia while working with my son. I received a phone call from the provider agency that they filed the report, per the state mandate. I was prepared for that envelope. It was weird when there were 2 envelopes in the mail that day.

The first one I opened was just what I was expecting, but having never seen it in this report format I took my time reading it. Ok, there’s the investigator’s name, date, and time of the investigation. There’s the summary of the reported allegations. They’re using some acronyms I don’t know so I’ll look those up. Yep, it says drug paraphernalia was found on the guy after returning from a community trip with my son. Ok, the guy denied it but a witness testified to seeing it at the program. The investigator’s finding is that the allegation is considered “substantiated,”  meaning, it probably did happen. Ok, and at the bottom here is the recommended action: fire the accused, basically. I knew this had already happened because the agency had already done it. Ok, got it.

When I opened the second envelope, my world shattered.

The description detailed in the second report is too horrifying to repeat, and I would lose you, dear reader, to the rage you would feel. Abuse of someone you love is top among the nightmares we all list. I’m pivoting for this story because it’s about being raw; and while the details of what happened to my child are about as raw as it gets, this is supposed to be my story. Which, right now, is a story about rage and this is the moment it begins.

****
I hadn’t been told about this second report. As it turned out, the allegations of abuse came out during the drug investigation. The witness decided to spill everything she had been hiding. The provider agency didn’t even know about it (side note: they should have and they remain culpable as far as I’m concerned).

I’ll never forget holding both reports, completely in shock, still trying to figure out why I had 2 reports, not 1; and even more importantly, how could what was described have possibly happened to my son?

I remember the wind being knocked out of me as I read those papers.

I remember being unable to speak.

I remember a feeling taking over my entire body.

I was shaking.

My heart was racing.

My mind was racing.

I called DPPC because I had one question that hadn’t been answered in their report. The woman on the phone was warm and knowledgeable. She expressed her relief that these people would no longer be working with my son. That was when I asked, “Yes, but what mechanism is in place to prevent them from applying for another job in another agency and doing this again?”

That warm, authoritative voice turned into a soft, apologetic whisper.

“There is none.”

“This is where I do believe my identity began to reshape. Instead of having moments of rage, I added pure, red-hot rage to who I am. ”

I carry it.

I use it.

I’ve learned how to manage it (most of the time). I hold it down until I can’t, then I let loose—privately, using all the words and threats and describing all the pain I’d like to inflict, and screaming at all the people I think are idiots and the machinations that have taken the place of humanity.

And then I go and figure out how to change shit. It’s what I do.    

I took my newfound rage and spent about a week doing research. My thoughts sprang to the same concept of the sex offender registry; we need a way to house the names of substantiated abusers and make it mandatory that providers check it before hiring. It didn’t take me long to find that several states had “abuse registries” just like what I envisioned. I made some calls, did some interviews, and armed myself.

Then I wrote a scathing letter to a bunch of state legislators—mine, the ones representing the towns where Nicky’s house is, the ones where the abuse took place, and where the agency is based.

I gave them a front-row seat to the disgusting description of the abuse. I told them about my phone call and my question. I told them that as we speak, the people who terrorized my son are likely walking around working with other people, high on drugs. I presented my research findings on what other states were doing. I told them Massachusetts needs an abuser registry.

Within a day, I got responses. Within a month, the Arc of Massachusetts, the largest and most powerful lobbying entity for our community, was involved. Not long after, I was asked if we could call the bill they were introducing “Nicky’s Law.” After some soul-searching, my husband and I said yes.

That decision was not as easy as you might think. I knew it meant becoming the face of this thing. I knew it meant I’d be contacted by media, I’d be asked to speak, and I’d have to be ready to advocate in front of all the big leaguers on Beacon Hill. I’d need to practice deep control over my rage and yet, I needed to show it. I also knew it would bring Nicky’s face into the public eye.

And there would be haters.

Can we protect him? Mercifully, he is intellectually unable to grasp what was about to happen, but that left us responsible for all of it. We decided that if Nicky could participate in the decision-making, he would want us to go for it. To fight for him and for those like him who rely on others to be safe. This was not just about Nicky.

****

“Want to know 3 of the best things about rage? It’s easily shared, easily spread, and easily fueled!”

Once dubbed “Nicky’s Law” the bill took on its own identity. I’ve been a part of the Massachusetts disability community for decades, and I’ve built a huge network of friends, movers, and shakers. I knew I could unleash a collective fury. I knew I had to take that very seriously and plan each move I made, each word I said, carefully.

Like I said, I needed to figure out the balance between showing my rage and managing it in public. If I allowed my rage to prevail over my actions, I could quickly have been reduced to an emotional, jabbering, “maniacal mom” on the news that had real meme-potential. That would not have served the mission.

I called up the troops using social media and word of mouth; the Arc did the same and the bill became one of their legislative priorities. Very quickly we had amassed an army. I told the story of Nicky’s abuse over and over and over again. My email, Messenger, and my phone were flooded with messages from other parents pledging their support and asking how they could help. Many were parents whose children had also been abused. As happy as I was about the attention this was getting, I began to feel the weight of those horror stories. I was sent photos, DPPC reports, and voicemails I could barely make out because of the sobbing.

I met another couple who happened to be working with their own legislators on a similar bill.  We joined forces. I met 2 others whose loved ones died under the care of their providers.

About this time, something began to change in me. Something almost scarier than the rage. I began to go numb.

The more I heard, the less I could respond. I took the stories in, I hugged the families, I gave them any advice I could. I did the substantiation that many had never gotten from their investigations. I validated their rage, but I stopped feeling it.

I think there were 2 reasons for this, one healthy and one unhealthy. The healthy reason is to protect myself and not absorb so much rage that I lose control; the unhealthy reason is that my brain was in a state of overdrive and parts of it felt like it was shutting down. I could barely conjure sympathy in my voice even though I knew I should. There’s my armchair self-diagnosis, but it feels like I’m right.

I wasn’t sure what to do with this, so I decided to just let it be. I had a job to do: get Nicky’s Law passed. I also had an army to command; they were standing at attention waiting for my orders and I knew they would’ve followed me to Beacon Hill with torches if I asked them.

Once the momentum was built, I was thrust—nay, shoved—into the lobbying circuit; as predicted, I quickly became the face and voice of the bill at several legislative events, hearings, testimonials, and even now in the form of workshops to help others learn how to advocate. That was ok. I’m comfortable there and it gave me a way to channel my rage.

Except the rage raged on. For 6 years. Yep, the bill dubbed by lawmakers as a “no-brainer” still took 6 years to finally become law.

The speech that brought it all home was the one I gave at Autism Awareness Day in 2019 at the Boston Statehouse. The Great Hall was packed with families, caregivers, agencies, and supporters from around the state, as this annual event always is. I had a speech, but it was the second version; the first version I had written was deemed too rude or fiery or over the top or something—I suppose I had allowed my rage to dictate; so I was told to tone it down and had reluctantly done a rewrite. But I wasn’t really feeling it.

Just before I went up to the podium, the speaker ahead of me had given a budget update that was exciting for our community. I was a little annoyed that I was following a speech all about money and services; I was about to make a plea for something much more important in my mind. I grabbed a pen and scribbled a final line on my printed speech and headed to the podium.

I managed to not cry for the first 3 seconds, a big improvement for me. I stood there and allowed my rage to enter; that now-familiar companion that both buoyed and tried to weaken me at any given time. Five years had gone by since my son had been beaten and this fucking bill was still not passed. I wanted to call upon the rage that had been ready to leap off the page in the first version of my speech. Now I felt like a caged, gagged prisoner of war forced to read a prewritten statement to make everyone feel better about Nicky’s abuse.

But I got through it. And at the very end, I looked up and realized they couldn’t stop me now.  I glanced at my scribbled note.

“Well, ladies and gentlemen, we just heard some great news about the budget. Isn’t that exciting? It really is. But we can’t take our foot off the pedal on this abuse registry, because this is not a bill about services and supports.”

I took a giant gulp and a deep breath, and I know my rage was heard.

“THIS IS A BILL ABOUT SOULS.”

Pin-drop silence. In my mind, it lasted about 20 seconds, but I think it was probably like two.

But the standing ovation did last a long time and united everyone in front of me in a way I’m not sure we can ever replicate. I had found the words through my rage that put it into perspective for everyone that day. We are all united by our humanity, and when abuse happens, it chips away at our collective humanity. Every single one of us can connect at that level. Every single one of us can close our eyes, and imagine someone we love being terrorized; beaten, hurt, abused—every single one of us can feel that rage.

Rage won that day.

Next legislative session, the bill passed unanimously in both chambers. Governor Baker signed it in February 2020. To date, the mandatory abuse registry checks have resulted in multiple abusers being blocked from caregiving roles. Legislation is now being considered to expand the registry to more vulnerable populations beyond autism and intellectual disabilities.  Nicky’s Law is saving lives.

My life is forever altered, but it’s Nicky who carries the real scars and trauma. I’ll always have those daydreams where I walk up to his abusers and have my revenge. I think that’s normal.  If it’s not, I don’t really care. It’s my normal. I carry the rage but it doesn’t define me. What defines me is what I did with it.

I had a different identity before motherhood and my journey with my son. She was kind of a bully without a purpose. Now I identify as a leader, a guide, a mentor, a good friend, a loving woman. I love who I am. My soul is full of joy, courage, pride, and beautiful, sweet, ever-burning RAGE.

Cheryl Chan is a Community Builder, policy advocate, person-centered practitioner, trainer, and frequent public speaker on topics that affect people with disabilities and their loved ones. Her advocacy and creation of Nicky’s Law and her long-standing commitment to the autism and intellectual disability community in New England has branded her a leader and advocate recognized around the country. “My next step,” she says “Is a federal abuser registry to protect all vulnerable populations who rely on caregivers for their health and dignity of life.”

Allyson Spellman

Photo: Saray Taylor-Roman

I Will Be a Light

By Allyson Spellman

Allyson Spellman makes a career of emboldening women to use their strengths for good. The Advocacy Issue was a natural collaboration for this busy mom, actress, Telly Award winner, motivational speaker, philanthropist, JTV host, vegan, animal rights activist, and entrepreneur.

I cannot take credit for the quote that has been the underlying theme of my life. They are words that I heard Brené Brown speak in her Netflix documentary “The Call To Courage.” These words struck a chord in me because they are the catalyst to where I am today.

“Start every day by putting your feet on the floor and saying, Today I will choose courage over comfort. I can’t make any promises for tomorrow, but today I will choose to be brave.”

To follow your dreams, passion, and purpose takes courage. To step out of the safety zone where it is comfortable requires resilience and determination. To be fearless and take a leap of faith, trusting that the net will appear, is one of the bravest things we can do.

My work in the entertainment industry and my devotion to animal activism have given me a crash course in courage.

I always had the divine instinct that I was to be in front of the camera starting from a young age. I remember dressing up and singing with my hairbrush in my room like so many little girls dreaming of stardom through innocent eyes. I was very fortunate to have great opportunities at a young age to live out that dream, but what took the most courage was heading to New York City with two suitcases in my hand, knowing no one and staying with a “friend of a friend of a friend” as I started out my journey in the big city.

However, it didn’t take long for that journey to take many unexpected emotional detours. Audition after audition, I would experience the same cliché scenario. There were a hundred other hopeful actresses who looked exactly like me filling the room, all fighting for the same part. And time and time again, I was told that I was lacking something as I left that very same room. I wasn’t tall enough, I wasn’t blonde enough, I wasn’t thin enough, I wasn’t the right age, the list was never-ending. Obviously, you don’t have to be in the entertainment world to experience this kind of criticism.

During that time of my life came a great game-changing lesson that I still hold onto today. To be able to own and celebrate what makes us different takes courage—especially in a world that constantly tells us how to look, how to act, and how to live. The art of no longer seeing “flaws” but instead seeing “fabulous” is what sets us apart in a great way. They are the things that make us memorable and stand out from the crowd.

I believe comparison really is the thief of joy. Why compare yourself to others? No one in the entire world can do a better job of being you than you. No one has your DNA. No one has your fingerprints. How can you possibly compare something so one-of-a-kind with anyone else? No one can do what you do. No one can bring your unique thoughts, talents, and experience to the table like you. You are a once-in-all-of-history event. Celebrate it!

I started to embrace what others criticized in a big, bold way and no longer believed these “flaws” were holding me back but instead saw them “fabulously” thrusting me forward. This shift in my thinking helped me secure roles on several projects, and if I got a “no” I simply saw it as “Next Opportunity.” This process wasn’t overnight. It took time, tenacity, grace with myself, consistency, self-love, and most of all it took courage.

Trust me, it takes courage to step out and start living unapologetically and authentically. But once you do and you experience the freedom that comes with releasing the weight of worrying about what others think or measuring up to unrealistic standards, it is hard to ever go back and sacrifice something so sacred.

You also have to step out of your comfort zone to take a stand for the causes you are passionate about, that truly stir your soul. For as long as I can remember I have always had a connection with animals. I was that little girl always bringing stray animals home, helping the turtle cross the road quickly so it wouldn’t get hit or finding an injured bird and immediately taking it to the vet.

My desire to help animals was more than just a sentimental feeling, it was a calling. Even as life got busy and my career flourished, I never stopped doing what I could to help an animal in need that was directly in my path. I didn’t believe or recognize at that time that I could make an impact as an animal advocate on a larger scale.

No matter how busy I became or how distracted I was, the divine nudge within me served as a constant reminder to not forget my calling. The fire within me never went away—I just kept it at a comfortable flicker.

In 2001, I was flipping through a magazine at my hair salon and I saw a recognizable and beautiful actress surrounded by rescue dogs. Her name is Shannon Elizabeth and she was especially huge at the time, starring in “American Pie” and “Scary Movie.”

I went on to read how passionate she was about animal welfare and her story inspired me. To this day, I can remember how the salon looked, opening the magazine, what I was wearing, and how I felt as I was glued to every word. I felt in my gut there was something special about this article.

As I read it, I learned she started a dog and cat rescue in Los Angeles called Animal Avengers. She also talked about using her celebrity profile for good and how she used her platform to make a difference. At the time, I wasn’t sure why that article hit me the way it did, but now I do.

Over the years, I kept recalling that article that sparked something within me. I would be driving and it would pop into my mind. I would be on set and “randomly” it would yet again infiltrate my thoughts. I was so impressed Shannon used her platform for good. I wanted to “one day” do that as well, but I needed to wait for the right time to boldly take a stand for animal welfare.

But as I waited for the “right time” I realized there were those out there who did not have the luxury of time. The only time these animals had was right now to be saved and not a minute more.

Then like a light switch, it clicked for me; my purpose lit up and it hasn’t been dimmed ever since. Something was ignited in me and I knew there was no more sitting on the sidelines watching others do the work.

I shifted from the mindset of someone should do something about that, to realizing I am that somebody. I finally understood we all have a platform wherever we are today. It is our families, friends, neighbors, community, networks, co-workers, and social media. We can positively impact and influence anyone, anywhere, and at any time in our life. Never underestimate the power that passion can persuade.

It’s pretty amazing when you decide to make a wholehearted commitment and act with courage, the universe aligns the people and places to support you. I have seen this countless times.

About 10 years after I read that article, I became friends with Shannon’s cousin who connected us in NYC. I now serve on the U.S. board of the Shannon Elizabeth Foundation where we are working diligently with anti-poaching units and organizations to help save endangered animals in South Africa. She is not only one of my closest friends, she was also my mentor in animal advocacy and continues to be such a positive role model in my life.

Being devoted to activism of any kind takes courage.

“It is excruciatingly painful to see either first-hand or images of cruelty toward another being.”

Those images stay with us and emotionally haunt us. I was petrified to go there. I had to come to terms with the fact that no matter how uncomfortable, gut-wrenching, and painful it was for me to see these things, my turning away does not help the situation. It continues if I look away. Turning a blind eye because of my pain does not help those that feel the real pain.

I still struggle with the pain of witnessing cruelty. I have shed many, many tears. But I also have celebrated many, many victories.

When I became a mother my activism turned into something much larger. I began to wonder what world will my daughter know? What animals will she only know in pictures because they no longer roam the earth? Will she know oceans without pollution? How will she be taught an environmental ethic?

Rather than force my rules of living on my daughter, I decided to be an open book. I strive to lead by example. Sometimes I do it well, sometimes I fall hard flat on my face. I am a work in progress and I always will be.

Seeing connection, concern, and compassion through her eyes has given me a new perspective. Oftentimes, children say they want to be just like their parents when they grow up. Personally, I want to be just like my daughter. I also want to give her a kinder world. And, if I can’t do that, I at least want to give her the tools to challenge injustices against all beings. Sometimes our actions may seem insignificant, but a small ripple can gain momentum and build a current that is so powerful it will make a difference way beyond our lifetime. That is the legacy I want to leave.

I started this story with a quote from Brené Brown, I will also close out with one: “Only when we are brave enough to explore the darkness will we discover the infinite power of our light.”

No matter what obstacles or difficulties we encountered in the dark times of our life, we must constantly remember to shine our light boldly and unapologetically. Learn to embrace the darkness as it helps us reach our highest potential and purpose. It certainly may not be comfortable but it is so worth it!

Dr. Angela Aslami

Photos: Ariel Thomas Bates Lane Photography

I Will Treat the Whole Woman

Editors note: Our conversation with Dr. Aslami invited a raw Q&A about her heritage and her ethnicity in the middle of a discussion about her medical practice. My questions were met with grace and guidance by Dr. Aslami. As an Editor, my questions were driven by a desire to learn her full story. As a woman, my questions were driven by my desire to learn about the world “right up the road” and into which I hope to be invited.  This transcript highlights our discussion. To read the entire conversation, visit www.livingcrue.com.

Our conversation begins here:

Did you grow up in Massachusets?

Dr. Aslami: I grew up in Sturbridge, Massachusetts. We moved there when I was in 4th grade. Prior to that, for 1st and 2nd grade, my dad took a teaching job in Saudi Arabia. In Saudi Arabia, we lived in a gated community separated from Saudi society. It was nicknamed the “community of infidels” because it was the French people, the Germans, the Europeans, the Americans. All of whom were teaching at the same university. So we had our own little “community of foreigners.”  ... We came back to the U.S. when I was in 3rd grade.

Do you remember how it felt for you and your family to settle into a life in New England?

It was in 1979. That was the year the Soviets invaded Afghanistan. My parents were born and raised in Afghanistan and they had no intention of staying in the United States their whole life. When my dad came to the U.S. in 1963, he came for college. He got a PhD in 1971, which was when I was born. They planned to go back to Afghanistan, but in the early ‘70s, there was a lot of communist infiltration in Afghanistan. So his parents were telling him to let it settle down and to stay in the U.S. for a little longer. Do what you can to get an education. So, their plan was to save some money, sell the house, and go back to Afghanistan. Then the Russian invasion happened in Afghanistan in 1979. So, he took a job with Corning Glass Works in New York and they helped him become a citizen of the United States. Then he helped my mom become a citizen. But their intention was still to go back. So when we first moved to Massachusetts, I was in the mindset that this is not going to last very long. I knew nothing about Afghanistan.

My mom was the oldest and my dad was the 2nd oldest of their siblings. I didn’t know them in 1979, this whole family that we had. I didn’t really think about it that much. I went to school and I did my after-school activities, and my sister had been born in 1977. I don’t remember there ever being a conversation where they said, “We’re not going,” but instead what I remember is them constantly doing immigration paperwork, and every couple of months somebody was coming to stay with us from Afghanistan and my parents were getting them set up with life here. Sometimes they ended up in Canada or Germany or France or wherever, but they were just constantly doing immigration stuff to get people out of Afghanistan. So I don’t think we ever had that, you know, “official” we’re-not-going-back discussion. I mean, that war was from 1979 until now. Afghanistan today is 100% different than how it was when they grew up. They grew up in a relatively stable Afghanistan in the ‘50s and ‘60s. It wasn’t all chaos and war.

They had a good life?

Well, that’s an interesting way to put it. My grandfather, my mother’s father, was a political prisoner from age 6 until 21. He was released from prison right at the end of World War II ... So from 1945 and until the early ‘70s, yeah, it was stable there. My grandfather tried hard not to talk about it. The whole family tried not to talk about what they’d been through, and their kids—my parents’ generation—didn’t really know. So from my parents’ perspective, it was a decent society. But my grandfather’s generation spent 16 years in political prison. Half of his family died in prison and many of the men were executed—this would have been around 1931.

Did that make you rewrite everything you remembered about your childhood and your past?

Yeah. He actually wrote a book. It was written like a story, not a documentary. But it is a documentary. I was like, “Oh wow!” Now I understand why my grandfather speaks 5 languages and why he’s such a forgiving person and why he’s so committed to faith. I mean insanely committed to the faith. And the same with my dad’s side of the family. I didn’t really understand how people could be that committed to optimism. And committed to picking up and starting in a whole new society—Western—that’s so different from how they grew up. And to embrace it to the max degree. To be anti-communist and pro-American and anti-religious extremism. The biggest insult that will come out of my dad’s mouth is to call you communist! But they came here sponsored by the Afghan government, which was stable at the time, to get a Western education, to go back and build roads and build factories and build a society. And they never really got that chance. But they never lost hope in that either.

What were the differences in cultures here and in Afghanistan at that time?

Well, the roles of gender. Completely different, right? Women all stayed home. Most of them didn’t go to school. The expectation was they would go, they would get literate and then they would stay home and take care of their family. And that’s what they did. My mom, her sisters, and my dad’s sisters, they all graduated high school. Some of them went to college and even worked outside the home, but always with a job or career subservient to their husband’s job. There’s no rock & roll there, there’s modest dress, no dating, no sleepovers, roller skating parties, movie theatres, or kids hanging out together on the streets. As kids, you would go to school, come home and help in the house. They didn’t have washing machines and dishwashers and things like that. There’s a lot of manual labor that had to happen.

How did this reflect in your household growing up?

It’s interesting. In our home, [my mother] took care of everything including everything about the kids. My dad worked and financially supported everybody. Between his financial support and her getting thrust into having to do all the immigration work, she started to learn the whole path to citizenship. I have 2 sisters. Both of my parents were very much in favor of us getting as much education as we could. My mother, you know, taught us we need to stand on our own to get our own job. Don’t depend on anybody. My dad never said those types of things. He just said that you need to do the best you can in everything you’re doing. There were never any conversations with my dad about what would it be like if I decided to be a stay-at-home mom. Not with my sisters either. Whereas my mom was like, “Get a job, get on your own feet, don’t be dependent on other people.”

Growing up, she did not allow us to have sleepovers or boys in the house or go to birthday parties, and when some of the school activities came around, you know she was not happy about that. Dating was not allowed. I wanted to go to the prom and she just didn’t like it. I was planning to go no matter what, and so there was a lot of battling over the prom and she’s like, “Don’t let your father see your dress, don’t let him see the pictures!” My dad didn’t say anything about it one way or the other. He just buried his head in the sand and I don’t even know if he knew the prom happened. [laughing]

Tell me what it was like leaving your small town in Massachusetts.

Yeah, that’s why I picked a small college because I didn’t want a big city. I was very scared of big cities for no particular reason. But I never had a bad experience. I just didn’t want to go. But then when I did go, I didn’t want to go back to a small town. Single, no kids, lots of things to do, you know. So that was great. And then I was accepted to law school (that was my plan all along,  to go to law school). Then senior year of college I had shoulder surgery, which then resulted in a lot of physical therapy and a change in my mindset on what I wanted to do ... I took pre-med classes at North Carolina State University, met my husband there, and applied to medical school from there. I didn’t really have a clue what kind of doctor I wanted to be. I was a women’s studies minor. So OB-GYN was kind of always on my radar, but so was primary care and cardiology. But ultimately, I decided I didn’t really want to have patients who were men, and part of that was because of some of my experiences in med school with patients who were men. You know I would walk in there to take care of medical stuff and get, “Oh, you’re so pretty,” and comments on my looks and I just didn’t like that. I didn’t appreciate it, and I didn’t want to experience that in my career. One encounter that really stands out occurred in the ICU. I was a 3rd-year medical student and part of a large team comprised of other  students, residents, ICU doctors, cardiologists, anesthesiologists, pharmacists— 20-something people on this team walking in to care for a 40-year-old guy who just had a heart attack. The ICU doctor says to the guy, “We need to do a treadmill test on you. Do you think you can get on the treadmill?” And the guy looks at me and says, “Well, if that little lady will stand in a bikini at the end of the treadmill, then  I can do it.”And that was the day I said no cardiology, no male patients. I didn’t want to have any male patients.

How often since then do you experience any kind of sexism or racism, on the street or on the job?

I have not experienced sexism or racism from any of the doctors, the nurses, or the hospital administration. I am also somewhat confident, so if there were things, I probably missed some of them or didn’t really put too much stock in them. There are always a lot of people assuming Dr. Aslami must be a guy. You know, there are a lot of automatic references of doctors being “he” and not “she” and thinking I’m a nurse.

When I was looking for an OB-GYN residency around the 1998 time-frame, that’s when it was starting to be around 50-50 males and females in residency positions, and it has since become more women than men. But that was the beginning of it, and all the other fields of medicine were still heavily male-dominated. That has really changed a lot in the last 20 years. Given how recent it is that these gender ratios have flipped, it’s hard to expect society to undo the thinking that everybody in a medical building who is female is a nurse and male is a doctor. That takes a long time.

When I was in school at Wake Forest University in Winston-Salem, in the deep South, I saw racism directed at other people. We had a very high population of immigrants from Mexico, so a lot of migrant farmers and a lot of labor that was needed. They didn’t have health insurance, and so they were primarily the people that the students and the residents took care of in the hospital. So I learned Spanish because it made life a lot easier to be able to speak medical Spanish.

What were your parents thinking through all of this?

Just supportive. They were proud, you know. I was the first one in the family to become a doctor, so they were pretty proud of that. The joke is, Jennifer Lopez, JLo, and I were pregnant at the same time and that was the year of the bird flu. Flu shots were hard to come by and so I wanted my parents to get flu shots because I was going to have babies and they never get flu shots. They were like, what’s the big deal? And then my mother called me and said, “You know, I saw JLo on TV talking about how important flu shots are.” And I’m like, “Mom, seriously?! I’ve been telling you to get the shot for months!”

You were pregnant with babies, plural?

Yes. I have two sets of twins and one in the middle. At the time, I had just finished my residency, so I was in my first year of private practice. You would think as an OB-GYN I would know what pregnancy is like, but you don’t know until you know! That was rough. Then, you know, you don’t know anything about motherhood until you’re a mother. So then I was begging my mom and dad to come and live with us, too. ... So, yeah, motherhood is a whole other residency.

All 3 of [my sisters] married Americans and married Christians. We were all raised as Muslims and my parents, shockingly, rolled with it very well. They have a lot of younger siblings who raised their kids in the United States and Germany. Some of them are very conservative, and kind of gave their kids a hard time about assimilating, and some of the kids toed the line and others became very rebellious. My parents were a little more easygoing with all that. My dad has a much bigger family and I think it’s just because my mother’s father, after everything he went through in prison, was just a lot more open to other points of view and other cultural forms, and so they weren’t that dogmatic.

You married Americans, but you’re American.

You picked up on that!

Did you mean to say that? I’m curious because because I’ve met a number of people who sort of put that out there first, as if they need me to know, whereas I never assumed otherwise.

It just came out that way! Right? I was born and raised here ... I’m first-generation born here. My entire family—mother, father, and all of their siblings have married Afghans. They are all 100% Afghan, so I also feel 100% Afghan. Genetically, I am 100% Afghan. But yeah, I was born and raised here and so when I say “married an American,” I guess I mean I married, well, not the type of person my parents expected. They expected an Afghan or Iranian and Muslim, and he’s none of that. They didn’t give me a hard time about it. They told me growing up I had to marry somebody “of the book.” So, Christian, Muslim, or Jewish. My spouse had to be one of these.

You grew up Muslim, but are now Christian?

Yeah, so I started going to church in med school. My roommate was a devout Christian, so we started going together and I really liked it. My husband was also a regular church-goer. I don’t think we actually had a sit-down conversation about what religion we were going to raise our kids, but we just raised them Christian.

I think part of why I really enjoyed going to church is because the places we went were non-denominational Christian churches ... So I learned a lot, I experienced a lot of peace going there, and we definitely wanted our kids to have that foundation.

Are your kids learning about their Afghan heritage?

Most of the exposure to Afghans was really with my parents, and maybe a couple of their friends. When our kids got older, and were easier to travel with, they experienced more cultural exposure as we traveled around the country visiting family scattered from coast to coast. When we get together, we eat. The food is all homemade and it’s all very labor-intensive and it’s delicious. They’re like, “Mom! Why can’t you cook like this?” Because this takes 8 hours to cook!

You once said to me, “When we’re young, we don’t expect the older generation to change their ways.” How do those expectations translate into your profession?

I was more politically active as a younger person, marching in the streets for abortion rights, writing letters to Congress, and things like that. For most of my professional life, Roe v. Wade was the law of the land. Not so much anymore. And so all that activism has been more in the rooms, with patients, individually.

I tell them, “These are your decisions, these are your choices, these are your options, these are the places to go, and this should be your decision to make. And tune out all the noise about what you hear from various groups on TV, political or religious, predicting the impact of this decision. You’re the one that’s going to have to live with it.” With the younger kids, I’ll say, “You know, I’ve got patients who are 30 and 40 years old, who made some of these decisions, and this is how it affected them.” We discuss the pros and cons. I’ve got patients that are ages 12 to 90, they’re all women, so there’s a lot of cultural changes in that, no matter their ethnic background. I try to keep it just related to females and women and how your life goes on.

So, when I have a 17-year-old telling me, “I don’t need birth control, I don’t want to put those things in my body,” I’ll say, “Well, listen, let’s talk about what a baby in your body is going to be like for the rest of your life. And if you choose to terminate the pregnancy, let’s talk about how that would affect you. Because I’ve seen it both ways, and you have to know the pros and cons.” And so then, if they’re still opposed to birth control or whatever I’m like, “Okay, well, here’s a bunch of things I want you to read, and we’re scheduling a follow-up in 4 weeks because I’m not going to expect you to make a decision right now. But I do know that not doing anything about protecting you from pregnancy has a whole lot of implications for the rest of your life that you know you’re not thinking about right now.”

And then I have a lot of people who have all kinds of sexual dysfunction issues and they don’t want to talk about it. I bring it up and then, if they’re hesitant, then I nudge them. It’s easier to do it with long-term patients. But eventually the story comes out—of everything that’s going on in the relationship or what they feel about their own self or their own body.

This was one of the nice things about the pandemic. People learned Zoom, including myself. I had never even heard of it before. So now I’ve started putting a lot of these really sensitive conversations and educational things into these online classes that are like 4 hours long. Here are 4 hours about your sexual function, what your anatomy is, what it’s supposed to do, how it changes over time, and what treatments are available ... Some parents don’t necessarily want to talk to their kids about this kind of stuff either, and I’m like, well, you could just go on the website and they could find it out on their own. But my kids tell  me, “Don’t send my friends to your website!”

Did it make you come out of your comfort zone to have these open conversations?

The office conversations were easy because it’s what I was professionally trained in. I’ve never terminated a pregnancy, but the procedure to do it is the same as the procedure to treat a miscarriage. Because I know how to do it, I can talk to people about the procedure. We were trained on that. So that’s an easy conversation. We weren’t really trained on sexual health and sexuality and how to help people with all that. That came later, and so I grew up with my patients in this process. Having these conversations over time—and the medical profession didn’t have a lot to offer until recently—so a lot of the conversation for 10 years was, “It sucks, and there’s not much you can do.” Now there’s a lot you can do, and so it’s fun to actually talk about it. It’s easier to have those conversations in the office.

Is it because there are more women in your field and they are the ones changing the approach to your specialty?

Unfortunately, women still hear that there is nothing that can be done to improve sex lives and they hear it from men and women. They hear it from primary care and they hear it from OB-GYNs and they hear it from nurse practitioners.

And so it’s really a matter of, do you have the interest to learn it? Because even in the residency programs there are still not a lot of conversations and education about sexual dysfunction. It’s a very small lecture and you know it’s a very small component of what they teach. You have to be interested in it and then you have to go look for the material.

And the other piece of it is a lot of it isn’t covered by insurance, so they don’t really teach you and train you on things that are going to cost money. Because patients come in with the expectation that insurance is going to cover everything. And we know that’s not true, in general. But really, the insurance companies don’t care about female sexuality. So that’s a whole battle.

There have also been issues with restrictions. When I was a resident there were no work restrictions, so you could work 150 hours a week if they made you do that. Right after that, there became work hour restrictions and now residents have to learn obstetrics and gynecology and surgery and women’s health in 4 years. So things had to fall by the wayside because the working hours were restricted, and sexuality education was one of those things. As a provider, If you are interested in improving sex lives, you have to educate yourself about the available treatments, because it is not part of routine OB-GYN training. Treatments have been available for male sexual dysfunction for decades, and are even covered by insurance, but I feel like Bob Dole was the first guy who was on TV talking about that. He set the stage for the public discourse on sexuality.

JLo needs to put out a commercial about it! How has your practice evolved from the way gynecology was practiced in, say, the ‘90s?

There’s a lot more listening and educating, and treatments that are not necessarily medication based. We have a very educational website where patients can do their own research, and every time we find a new resource we add it.  We try to protect people from “Dr. Google.” And we also have the ability to communicate more efficiently, right? So they can communicate with us on HIPPA-secure platforms. But there are also a lot more certifying bodies for integrative medicine, You can find the doctors who studied it and are certified in it. And they’re not just saying, go to the dollar store and get a multivitamin. There’s actually evidence-based medicine around all these things. If you seek it out, you can get certified in and then you can offer it, and people want it. You know they want guidance on that. Usually, when you go to your regular doctor and ask about vitamins, the majority of them say it doesn’t really matter you’ll just pee it out in the toilet, don’t waste your money. But it does matter. Yes, some of them are a total waste and you will just flush it down the toilet and other vitamins are not a waste. And then the dose matters. And if you want to use natural products, or if there’s a medical condition, then it does matter which product and how many times a day and the doses and whether you’re taking it with food or not, and what other medications you’re taking or not. There’s a whole science behind it, none of which is taught in traditional medical school or nursing school. So you have to seek out a provider who has that training.

Why does it seem the onus is on women? Gender shouldn’t matter when it’s about a logical approach to health and wellness. At what point will Western medicine catch up and not require you to seek out certified doctors but make this part of medical education?

Well, there are 2 answers there. As to the first question: why is it up to women? Women are the caretakers of the whole society, we are the caretaker of our individual families, and multiply that by 100 million, and that’s the whole society. So we’re kind of hard-wired; our role as a family caretaker is a gender-defined role. There is some blurring of gender-defined roles, obviously, but for the majority of families, it’s the women who make all the healthcare decisions. So that’s just the experience I hear from lots of my patients also. The other piece of it is that women are more likely to seek care for themselves. There are a lot of guys who will not go to the doctor unless their wife or their girlfriend or their mother makes the appointment for them and takes them to it or demands that they go. They’re not going to do it spontaneously and honestly, if they do go in because there’s something bothering them, it’s usually serious. Since women seek out treatment, they also come up more frequently against treatment failures and then they look for alternatives. Women also talk. We’re more likely to go online and get in a chat group or get in a support group or ask 10 other people and then go with those recommendations.

But why medical schools don’t teach it? That’s a whole other ballgame! Residencies are funded by the Center for Medicare and Medicaid Services. So it’s sort of like having the NFL draft and there’s only x number of slots. There’s only x number of training slots across the country—for primary care, surgery, psychiatry, and so forth. So all the institutions that receive that money have to stay within the guidelines of what the government decided. But then when you go to what are they being taught, some of that is influenced by big pharma, right? So if you’re learning about cholesterol management, you can’t make money off telling people to eat the Mediterranean diet.

And you know the organic farmers are not the ones coming in and sponsoring a lunch to educate the doctors and the medical students. You know the cholesterol medication manufacturers are doing that. So there’s a sort of inherent bias in training. They have tried to limit that. I mean, there have been a lot of limitations placed on big pharma and they get around it somewhat by disguising it as education. They do educate, but it’s a little biased. Doctors learn it on their own, but they have to have the time to do that. In residency, there’s no time. And then, you graduate from residency burdened with debt, and now you’re in your late twenties or early thirties, starting a family, young children, and maybe even taking care of your older parents, and you’ve got a new job, and for the first time, you’re the primary caretaker for your patients—no one’s looking over your back and you’re not running things by them anymore—you don’t really have that time. You feel a little bit uncertain in your early career about what you’re doing. So you spend more time reinforcing what you learned to begin with, to make sure you’re sticking to the standard of care, and then later on, when you’ve had enough treatment failures, you start looking for other approaches. Some people—not all—some people, will start looking for another way.

Is that what happened to you? Did something happen specifically with failures and treatment plans that made you take the step?

Yeah, and it was, personal. I was 33 when my first kids were born, and when they went to daycare, all of a sudden I’m getting sick with everything that they got sick with, but not recovering. My husband was getting sick, too. I mean we’re both getting sick all the time, but he would recover and I would have a 6-month coughing fit that ultimately was diagnosed as asthma. It didn’t behave like asthma. We live in an area with no shortage of access to world-class medical care and I went to lots of places for 2nd, 3rd, and 4th opinions. How do I have uncontrollable asthma on 6 meds a day when I don’t smoke, I don’t have pets, I don’t have allergies, and all I have are kids? It was an ongoing problem ... I had to have my nebulizers in the office, in my car, and at home. I had to have rescue inhalers everywhere, 5 meds a day routinely, and stay away from smokers and people wearing perfume and cologne and flowers and all that stuff. It never really behaved like normal asthma. Anyway, a patient came in one day and said “You know, you should just stop eating gluten and dairy.” I had no idea what she was talking about because I didn’t have any abdominal symptoms at all. But I was pretty desperate and I was miserable. So I said, “All right, fine, I’ll try. What have I got to lose at this point?” ...  I started going to conferences on how gluten affects asthma, well, it actually affects more than asthma, it affects psoriasis, eczema, sarcoidosis, rheumatoid arthritis, inflammatory bowel disease, colitis, Hashimoto, I mean a really long list.

And so the sort of philosophy from the functional medicine world is that the gut is not functioning well and it’s triggering your immune system. And your immune system is coming down with the hammer on the wrong body part. In my case, it’s my lungs. But it might be joints or brain fog or whatever. I accidentally discovered this, honestly. I wasn’t actually looking for it, but that’s how I found it.

Did you and do you get a lot of pushback from the traditional practitioners [about practicing functional medicine]?

No, not from the doctors in my main hospital group. I didn’t get it from them. I have a lot of primary care docs who cross-refer with me. So in the beginning they were kind of like, “What do you mean? Replace your statin with fish oil?” I have to walk a line. I say to patients, “I’m not going to take you off meds that other doctors put you on. I’m going to suggest you could use this in addition to—and there are pros and cons to this, right?” If you’ve already had a heart attack or stroke or whatever, I’m not going to mess with the cardiologist’s recommendations, but I am going to say, “Yeah, the weight loss would help and you know the Mediterranean diet would really help, and eating organic would help. But I’m not going to tinker with your meds.” So this is sort of how I walked that line, because I think that if I tried to be more aggressive and say “Oh no, I don’t agree with what your doctor is doing, I think you should do it this way,” it is going to cause a lot of pushback and it could hurt people. I do have some patients coming in with unreasonable expectations. They’ll say, “You know, I had a little bit of breast cancer. It’s gone and I want you to give me hormones.” I’m like, “Well, you know what? That’s actually not the best idea for you,” and they’ll bring me research studies that say it’s okay. But it’s small numbers of people and niche studies, not the standard of care. And they don’t like my answer and they’ll say, “I thought you were a holistic doctor?” I’m like, “I am, but I know traditional and functional medicine usually can play together.” Sometimes, you really have to be on one side or the other.

Did you see yourself here?

Well, it’s interesting that you ask, because I found the essay I had to write to get into medical school and that was probably written in 1993. So it was me writing what I thought my practice was going to be like in 2010 and I was like, “Wow, I’m not that far-off from it!” I used to watch “General Hospital” back in those days—did you watch it?

Yes!

So you remember the health club where everybody hung out? I thought my practice was going to be like a medical practice in one building and the spa on the other side of it, but there was going to be a smoothie bar and dance classes and a place to hang out and socialize and aerobics classes and you know, massage tables, and all that! That’s what I thought it would be like. So I don’t have a spa. That’s next. Put it on my future to-do list.

Dr. Aslami’s practice, Horizon Health and Wellness, is in Bridgewater, Massachusetts.