How one doctor survived family violence – and gained her Fellowship

Doug Hendrie

23/01/2019 2:27:05 PM

Dr Imaan Joshi survived eight years of abuse. Now she wants to teach junior doctors about boundaries and resilience.

Dr Imaan Joshi believes in resilience.
Dr Imaan Joshi believes in resilience.

Dr Imaan Joshi came to Australia to study medicine more than 20 years ago.
Becoming a doctor was a surprise choice for the dreamer who loved books, arts and debating.
But she found she loved it and ultimately gravitated towards obstetrics. By 2003, she had begun her specialist training.
The following year, she married. It was then that things changed for the worse.
‘I got married to a man who, it quickly became apparent, was abusive on every level,’ Dr Joshi told newsGP.
‘Due a number of factors, not least of which being cultural shame and encouragement from community leaders to “be patient”, “seek counselling” and other unhelpful suggestions, I stayed in the marriage for eight years, unable to leave.

‘Domestic violence is one of those things we as doctors don’t tend to get right. A lot of people don’t tend to understand – it’s not as simple as just leaving.   
‘It would be helpful having a peer or professional who says, “Hey I was involved, it was really difficult”. You have that gradual demoralisation and invalidation. You lose your sense of self, your confidence, what’s best for you.
‘People get frustrated: “Why didn’t you leave? Why didn’t you tell the police?” But it doesn’t necessarily work that way.’
Dr Joshi’s husband started becoming controlling soon after their wedding. He would go through the rubbish to see what she had done that day, check the dishes, inspect the laundry. Dinner had to be on the table. Everything had to be done his way. Otherwise he’d make spiteful comments.
‘I was successful – I was a doctor, I’d supported myself through med school. But he’d tell me I was so disorganised. Whatever I did was not good enough,’ Dr Joshi said.
‘Over time, having someone who’s meant to be a safe person [be abusive] – it gets in your head. Home was meant to be a safe space.’
At work, Dr Joshi would seek out extra shifts – as many as possible – to delay coming home. Home was no refuge.
‘I used to dread coming home,’ she said.
Children then started arriving – four, in quick succession. Between stints of maternity leave, Dr Joshi worked to support her family and husband.
‘After kids, it got a lot harder. I started thinking about their attachment to him,’ she said.
‘He’d threaten to take the kids and leave – and he’d do it, for an hour or two. Once when I was pregnant with the third, he took the other two and disappeared for a full week.’
It felt impossible to tell anyone. Dr Joshi’s supervisor noticed her stress and irritability, but the shame component was a strong deterrent to speaking about it.
‘I didn’t want my peers to find out, so I put on a professional face. I never wanted to feel pitied by anybody,’ she said.
‘Empathy is very different from sympathy. I never wanted people to feel sorry for me – I just wanted people to listen without giving me advice, without saying “I could never put up with that”.
Finally, in 2011, with her youngest daughter just three months old, he left. Dr Joshi then had to figure out what to do next. She went on welfare, but it didn’t seem like a long-term solution.
Dr Joshi’s specialist training had been put on hold during her marriage. As a single mother of four, it seemed impossible. So she switched career.
When her youngest was 11 months old, Dr Joshi began training full time as a GP, her eye on passing the Fellowship of the RACGP (FRACGP) exams as quickly as possible. To get time to study or work, she hired babysitters to look after the kids wherever possible, and studied alone after the kids were in bed.
‘The kids had to do long day care so I could work. It was literally just one foot in front of the other,’ she said.
‘I thought about quitting. If I’d failed [my Fellowship] exams I wouldn’t have gone on. But I passed the first time.’
Dr Joshi gained her FRACGP in 2014. She now works in Sydney, dividing her time between her clinic and aesthetic medicine. Her children are now all in school. Life is, for the first time in a decade, becoming a little easier.
So how did she keep going during those years of violence?
‘I don’t think it was ever a grand moment or decision. I think that’s why not quitting was so important and significant, because each day I had to make the decision to keep going, to not quit, some days more than others,’ she said.
‘And contemplating the alternatives – giving my kids up - was never one that I took seriously because I felt a strong sense of responsibility for them and their safety.
‘Now I look back and marvel that we got through all of that and it wasn’t any one big moment, choice or decision, but a series of milestones.
‘Every day, for years, I’d think, “I need to be here till my eldest is 18. I can’t die before then”.’
Dr Joshi cited a quote from Holocaust survivor Viktor Frankl as inspiration: ‘When we are no longer able to change a situation, we are challenged to change ourselves.’
‘Resilience, I think, is an exercise in sitting with a lot of grief, discomfort and uncertainty and making the smallest possible change some days just to keep moving forward till it becomes habitual over time,’ she said.
‘At the time, I thought my life and career were both ending, but things have a way of working out.
‘Adversity in life has given me so many opportunities to work on myself, my own awareness and on discovering, at every stage, who my real friends are and how small that circle really is.’
But Dr Joshi’s recovery is ongoing.
‘I’m sure I had some intense PTSD and depression for years that was masked by simply having to get on with it, and in helping my kids through their own trauma,’ Dr Joshi said.
‘The last few years have been about self-awareness, boundaries, recognising high-conflict people … and making a choice to disengage from such people,’ she said.
Dr Joshi has chosen to speak out about her ordeal because family violence ‘doesn’t discriminate’.
‘Despite years of abuse, I still believed that I’d asked for it on some level, and it’s a pervasive message we give women all the time as a society,’ she said. ‘So now I’m passionate about speaking up.
‘As I’ve worked on my non-existent boundaries, I’ve discovered that many people don’t like people who say no, especially men, so that’s ongoing work and something I’d like to write about, as that form of misogyny begins so early.’
Dr Joshi emphasises the need for boundaries when she speaks to trainees.  
‘I focus a lot on boundaries in my education to trainees as medicine doesn’t teach us any, interpersonally. We are often taught to be doormats and it is no wonder, I think, that we suffer from burnout, bullying among peers and even suicide. We’ve set ourselves up to fail,’ she said.
‘In your internship and residency, your boss will tell you what to prescribe – even if you don’t feel comfortable. So you come out of that into general practice and that culture is ingrained in you.
‘And doctors are so patient-centred that we can get into trouble as we don’t know when we can say no.’
It is this emphasis – personal strength and boundaries in place – that Dr Joshi wants to pass on to junior doctors and to her own children.  
‘I knew that my children were watching and that I was the only role model. I felt I had to be the best I could be,’ she said.
‘Now that I’m out of that really bad period of time and things are more settled, this is a way to pay it forward for others – especially around boundaries. If I’d had appropriate boundaries, I could have left, but I kept thinking things would get better.
‘Now I have raised children who have seen their mother as a role model, not just someone who sits back.
‘One friend said why don’t you stay on welfare? Why are you going for your Fellowship? But I remember thinking – what if I don’t keep my skills up? Is the best I can role model to my children?
‘We’ll all have tough times, but you choose what happens in the next chapter. And that’s really important.’

domestic violence family violence fellowship mental health resilience

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Gill Singleton   25/01/2019 7:08:23 AM

Thank you for sharing your story Dr Joshi, incredibly inspiring. You have shown amazing resilience and strength through your journey and it sounds as though you have a great deal to teach. Your story is a strong reminder that domestic violence can happen to anyone, regardless of education or SE status and that leaving an abusive situation is not as easy as it may sound. As GPs we are in a good position to identify and support individuals who are exposed, whatever decision they choose.

Mythily Ramanathan   25/01/2019 2:50:36 PM

What you have done is great.... domestic violence has no discrimination. All the best for a happy and prosperous future.

Judith Virag   25/01/2019 3:45:45 PM

Joshi, thank you for speaking up and ‘paying it forward’.
We are nothing without our community, and the values of that community are fluid.
The Australia I came to in the 1980’s was so much more relaxed and open than it is now. The focus is changing from support and validation to ‘resilience’ and subtle victim-blaming.
I applaud people like you, who share the reality of life for all of us, regardless of our social status, our perceived power or our perceived income.
Kudos to you for inspiring unity and hope.

siri arcot   25/01/2019 3:46:22 PM

Dr.Joshi you are a true inspiration and role model...

gregory williams   25/01/2019 3:56:14 PM

Your story is the single most grounding and inspirational thing I have read i a long time . Well done for being so courageous . You can carry that strength with you forever

Charlene Chideme   26/01/2019 8:50:58 AM

What a truly inspirational and touching story Dr Joshi! It has given me a lot of insight..I appreciate the courage it must have taken for you to speak out about this. Thank you so much.

Malinda Leary   26/01/2019 8:23:06 PM

Thankyou to Dr Joshi for being so brave in sharing her story. She is truly inspirational

Dr Jodie Louise Ralph   27/01/2019 8:22:59 AM

Thank you for sharing your story.

Elizabeth Hindmarsh   29/01/2019 4:53:18 PM

Dear Dr Joshi, congratulations - this is a great article and best wishes to you and your children

Nazareena Ebrahim   14/02/2019 11:27:40 PM

Thank you for sharing Dr epitomise courage on every level and remind us that it can happen to anyone!

Rajitha Jayasuriya   2/03/2019 6:37:17 PM

Thank you very much for sharing the story. It's inspirational. Best wishes for you and family

Theohari Gribilas   12/03/2019 1:18:07 PM

Where do workshops run in Sydney? This is such an inspiration.

Gopal Susarla   23/05/2019 9:11:27 PM

What a wonderful life you have made for yourself & your children. I know what you had been through & how you handled it. Very inspirational for everyone.