“I'm an Indian. I'm an American. I am Indian American, and I'm hoping that I've taken a bit of good from both”

Story #10

Dr. Lija Joseph, first-generation Indian-American

Interviewed & Written by Roni Deckard

Edited by Madeline Humphrey

Dr. Lija Joseph, an immigrant from Kerala, India, said at the time that she migrated (1992), “the U.S. and India did not have a very good relationship. India was more aligned with Russia, so it was really hard to come to the U.S.” 

Dr. Joseph is the Chief Pathologist at Lowell General Hospital and Adjunct Associate Professor of Pathology & Laboratory Medicine at the Boston University School of Medicine. Her journey to the United States began with her husband; however, this journey was fraught with significant challenges from the beginning of the visa application process. Despite being ranked fourth in all of India in his exam results for admission to medical school, her husband was initially denied a visa to come to the United States for an in-person interview for residency. 

Everything from the “huge iron gates” at the U.S. Consulate in India where Dr. Joseph recalled, “we had to stand in a line at four in the morning and line up outside the gate. I distinctly remember holding my son at that time, maybe eight months old or something, and covering him up so mosquitoes wouldn’t bite him, waiting outside the consulate office until the door opened.” 

After her husband’s acceptance into residency, the family—Dr. Joseph, her husband, and their child—became a part of the J-1 Visa Program. 

“We had to assure the U.S. government that there was a scarcity of doctors trained in a particular field at that time. So, the Indian Government would assure the United States that this is indeed true, and that we would have a job for him once he finishes his training, and he comes back [to India],” Dr. Joseph said. 

In 1992, after her husband spent one year in New York, Dr. Joseph and her daughter joined him in the move to Columbia, Missouri. Here, she continued to face significant challenges in her career and personal life. 

“I applied multiple times to the residency program, and they wouldn't even call me for an interview. Finally, my husband's professor said, ‘I really want to keep him in this spot in this program, so is there anything you can do to accommodate his spouse?’” she continued,  “so finally, they called me for an interview. The first sentence the program director told me was, ‘we have not admitted a foreign graduate to our program in 25 years, and we are very xenophobic.’” 

“In 15 minutes, he had completely changed his mind, and I was the first foreign graduate ever accepted in that program. And now that program has many, many, many foreign graduates, but that definitely felt unwelcoming,” Dr. Joseph said. 

In regards to hardships in her personal life, she said, “we were alone. I mean, we had our work friends and colleagues, but that's not the background we come from. We come from a background where your family is everything.” 

For Dr. Joseph, Thanksgiving was particularly difficult. “Everyone's talking about meeting family and getting together and all of that. For an immigrant, it is a very painful time because you don't have family, and everyone's celebrating family.” 

After completing residency, “we changed our mind and decided to stay in this country,” she explained, “so there is a program called J-1 Waiver program, where the U.S. will then say that there's a scarcity of people of this caliber in this country, particularly in underserved areas of the United States. They would then give you a waiver, but that requires us to work in a region of the U.S. that has scarcity of doctors. So, where we lived, where our kids grew up, a lot of that was determined by the visa journey.”

After 12 years in the United States, Dr. Joseph and her family received their green cards in 2004.

When applying for a position at Boston University, where her husband was being recruited, Dr. Joseph continued to face barriers as an immigrant woman. Despite moving from Little Rock, Arkansas to a city where living costs were up to three times higher, she said, “my salary stayed the same, and I didn't even know [how] to negotiate.”

“Then subsequently, there were some difficulties that I had to face when I was promoted. Even at BU, my salary was never equitable to what the men, the white men, in the department were making.” 

For Dr. Joseph, the most difficult part of coming to the United States was leaving behind family.

“Unlike most Americans, when they have vacation, they go to an ocean or a beach house or invest in a trip to Europe. Whatever money we could save, during residency and fellowship, we would save it all up to go home.”

Upon reflection on the experiences of immigration, she said, “I came to this country at 25 or 26. So, there was a moment when I said, ‘I have lived in this country for an equal number of years as I have lived in my own country.’ This [country] has been much more formative because I'm an adult here, whereas growing up, we were just children.”

“I'm an Indian. I'm an American. I am Indian American,” she said, “and I'm hoping that I've taken a little bit of good from both.”

For other migrants in a similar position as Dr. Joseph, she advised “to be active through the library—engage, engage, engage—don't just lock the door and sit in your room. Especially because you come from a country that gives so much value to family, when you're transplanted, it's almost like you're violently uprooted. If you feel alone, it really impacts your mental health.”

In light of the events of the past year, Dr. Joseph is currently a member of the Diversity, Equity and Inclusion committee of Lowell General Hospital. She works closely with the team to address the inequities she sees in the diverse community of Lowell. 

“I'm very energized. I know many of these things [like the inequities] have been happening for so long, but something has changed. At least it has changed in me,” she said. 

Dr. Joseph would like American-born citizens to ask themselves this question: “would you have the courage to drop everything and go build a family and a whole life in another country, learn their language, learn their culture, and learn their literature? If you would not,” she said, “then appreciate what we have done, and also appreciate the value we bring to this country.”

“I think [people born in America] need to understand how much we have given up to come to this country, and to assimilate and accommodate to realize a dream. They should embrace us and cherish us for what we bring and what we've given up.”