A twice monthly nephrology journal club that meets on Twitter. Hashtag #NephJC
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The conclusion is hopeful but not simplistic. Physical safety does not erase trauma, guilt, or homesickness. Nevertheless, Salama begins to understand that surviving is not a betrayal of those who died. #NephJC
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Most immigrants are expected to assimilate into a new culture, which typically happens generationally (kids & grandkids).
Is it important to keep your culture alive in a new place or does it lead to resentment/fear?
Do you think Salama & Kenan will ever return to Syria? #NephJC
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Months later, Salama and Kenan live together in Toronto (Yeah Canada! 🇨🇦), where they preserve their Syrian identity through language, art, memories, faith, and their relationship.
Did you like this conclusion? #NephJC
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Salama ultimately chooses life without treating departure as a rejection of Syria. She and Kenan attempt the dangerous journey across the Mediterranean. Their boat encounters disaster, but they are rescued. #NephJC
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Leaving your home is never easy. Many chose to stay and die for their beliefs.
Does leaving Syria represent defeat, survival, hope, or some combination of the three? #NephJC
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Finally, some questions to ponder 🤔:
The lemon trees symbolize different things at different points in the novel. Survival, new life, hope and home are just a few ideas.
What do the lemon trees in this story mean to you? #NephJC
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We have all experienced loss in our lives/ medical practices?
We all lose family, mentors, teachers and patients?
Do these losses make you refocus on your achievements and goals or consider quitting? #NephJC
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"We will take the fragments and we will rebuild it."
Happiness after trauma may not return in its original form, but the characters can construct a meaningful life from what remains. The language of fragments acknowledges permanent loss without surrendering hope. #NephJC
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As doctors we are often asked to sacrifice time with family, mental and physical health in the name of caring for others.
Salama’s case of abandoning her post is extreme.
However, do you feel guilty when taking time for yourself (vacation, work-out, ect)? #NephJC
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"Your life is just as important as theirs."
Salama needs to recognize that self-preservation is not selfish. The line challenges her belief that caring for others requires sacrificing herself completely. #NephJC
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Have you had to make difficult decisions for the betterment of yourself or family?
Many people used to come to the US to train in medicine, seeking a better life.
Is there anywhere in the world where refugees are now welcomed? #NephJC
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"No one takes to a rickety boat on the sea if there is another choice."
This challenges dismissive attitudes toward refugees. The dangerous voyage is not an easy preference but a desperate response to the absence of safe alternatives. #NephJC
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Nephrology is unique in that we provide a life saving chronic procedure (dialysis) that sometimes involves caring for non-citizens. The policy in the US remains very fragmented & routine standard care is not the norm. Have you had to advocate for undocumented patients? #NephJC
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There is currently a lot of distrust of immigrants in the world, does this story make you more sympathetic to refugees?
Have you had the opportunity to work with, or care for, refugees or undocumented individuals in your medical practice? #NephJC
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"No country in the world will love you as yours does."
Layla's claim expresses profound attachment to home, but the novel also complicates it by showing how home can become unsafe.
Could you imagine fleeing your home? Where would you go? #NephJC
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"When I die, I'm going to tell God everything."
The simplicity of this statement makes it especially devastating. It expresses a child's trust in divine justice when human institutions have failed.
Do you believe in divine justice/karma? #NephJC
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The book also has several memorable quotes.
Do you have any personal favorites?
#NephJC
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The world has seen a lot of injustice in the last decade.
Why does Kenan feel compelled to record the revolution, and what does the novel suggest about the importance of witnessing injustice? #NephJC
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Would you risk your life, and those you cared about, to report on what you were seeing?
In a world filled with information and disinformation how would you make your viewpoint stand out?
In a world of sound-bites how do you get attention? #NephJC
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Witness & Storytelling
Kenan’s work raises questions about who controls historical narratives & what individuals owe to those whose suffering is ignored.
Do you feel like you are receiving enough (or too much) info about real ongoing worldwide conflicts? #NephJC
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