A few months prior, I encountered a woman who had ceased communicating during dialysis. She had grown silent, exhausted by the cadence of a system that seemed to converse around her but never truly with her. When she eventually addressed me, it was not concerning her lab results or transplant situation. It was a faint utterance — “Do you think I’ll get there in time?”
In that instant, she wasn’t seeking data. She was yearning for connection. And that is what I provided. Because as a Doctor of Health Sciences, my role extends beyond operations or policy evaluations — it is rooted in the art of listening, advocating, and being present when the system feels overwhelmingly large to confront alone.
**The unseen burden patients bear**
For those living with advanced kidney disease, the path to transplant is seldom straightforward. Behind each referral and clearance exists a labyrinth of missed transportation, communication failures among providers, insurance holdups, language barriers, and anxiety.
Throughout my professional journey, I’ve traced down missing lab results, escalated ambiguous referrals, followed up with distressed families, and ensured kits reached transplant centers. I’ve closed communication divides between dialysis facilities and transplant programs that would typically leave patients stranded.
Some patients opt not to pursue a transplant entirely. Not due to a lack of qualification, but rather because they’ve experienced disappointments from the healthcare system too frequently. These are not instances of lost motivation. They reflect a systemic burnout.
**Beyond the records: The reality of healing**
The most impactful interventions I’ve observed didn’t arise from a monitoring tool or a productivity analysis. They occurred when I took a moment to inquire about a patient’s fears. When I assisted someone in redefining their role as a caregiver transitioning into a donor. When I reassured a patient who had missed several evaluations because of transport issues, “You are not the issue. The system needs to accommodate you.”
I’ve collaborated with families uncertain of where to start. I’ve aided patients ignorant of an expired simple referral. I’ve converted convoluted timelines into clear, actionable plans. I’ve intervened when patients were on the verge of being labeled as “noncompliant” simply because no one had invested the time to understand their circumstances.
We frequently consider equity in terms of access. However, equity also encompasses how many times a patient is extended the benefit of the doubt. It’s about how many individuals are willing to contact again, clarify again, and wait yet again.
**Some patients don’t survive — that too is a policy result**
There are patients who never make it to the list. Others pass away while waiting. These instances break something within you — and construct something as well. A deeper commitment. A more assertive voice. A determination to not act as if disparities are mere coincidences.
Patients of color continue to be assessed more slowly. They are still less frequently placed on waitlists. They are still at a higher risk of dying while waiting. These aren’t just access gaps — they are profound moral failings. Equity in transplant must evolve beyond a compliance checkbox. It must become a fundamental objective of the institution.
**I am not simply a worker. I am a doctor of systems, strategy, and humanity.**
I am frequently advised not to “exaggerate” my doctorate. That it makes some uneasy. But my doctorate serves a purpose beyond mere distinction — it is my foundation for engaging with scientific rigor, systems thinking, and the ability to identify flaws unapologetically.
I didn’t enter this arena to handle spreadsheets. I came to transform how care is experienced — and for whom it benefits. I’ve accomplished this through daily advocacy efforts that seldom appear on dashboards but consistently have a significant impact on patients.
**Hope is cultivated, not prescribed.**
Hope is not a trivial term. It forms the treatment strategy when all else stagnates. It is the thread that binds patients when schedules falter and silence envelops.
And the reality is: Hope isn’t derived from policy. It emerges from presence.
That’s what I’ve provided time and again — not as an intermediary, but as a doctoral-level health advocate who recognizes the entire individual behind the patient ID.
I will continue to write and speak until our systems create space for that kind of care, for every individual, every narrative, every aspiration.
*Zamra Amjid is a health equity and patient access strategist.*