Before they ever arrive at our clinic, most asylum seekers have already told their story again and again. To border agents, immigration officers, legal advocates, therapists and strangers with clipboards. Each time, they are expected to recount the most painful, sometimes unspeakable, chapters of their lives to a system that is not designed for healing but for adjudication.
Over the course of my four years in medical school, I have had the privilege of volunteering with the HEAL Refugee Health & Asylum Collaborative. HEAL’s Forensic Evaluation Clinic conducts pro bono forensic physical and psychological evaluations for clients seeking asylum and other forms of humanitarian protection. As a medical student assistant, I help conduct evaluations and draft affidavits documenting the physical injuries and psychological trauma that clients have endured.
Through this experience, I have witnessed how the repetitive retelling takes its toll, even when the most trauma-informed practices are employed. Survivors of trauma must relive their deepest wounds each time, often expected to speak with precision, in a language that may not be their own, and in settings where they may not feel believed. I have seen the strain this process places on memory, how trauma can fracture and distort the past, blurring details and timelines. The act of recounting is itself a burden and yet the stakes for getting it “right” are unimaginably high. An inconsistency, a forgotten date, a reversed sequence, can jeopardize someone’s chance at safety.
If storytelling is both painful and necessary, how can we, as clinicians, advocates and supporters, lessen the burden it places on asylum seekers?
One client offered an insight that has stayed with me. After an especially painful interview, as we sat in the quiet space of our clinic’s back room, she told me something I’ve carried since. She said, “I didn’t survive because I kept telling my story. I survived when someone stopped needing the details and simply chose to be there. What saved me was community. My story wasn’t just mine to carry anymore.”
In legal and clinical contexts, the pressure to recall with exactness can be immense, turning memory into something to be scrutinized rather than held with care. But I’ve also seen how, outside these settings, the same act of storytelling can offer something different: a way to reclaim agency. In community spaces, where stories are met with compassion instead of cross-examination, speaking one’s truth can feel like reclaiming control. There, the narrative need not be flawless; it only needs to be heard.
Since that moment in clinic, I’ve started to view my role differently. Yes, our affidavits can help provide critical corroborative evidence in someone’s asylum case, enhancing their credibility and chances of being granted protection. But the truest form of healing often happens after the papers are filed: through shared meals at a church dinner, friendships formed at English classes or moments of laughter in a support group. As physicians-in-training, we may not be able to change the legal system or guarantee safety, but we can help connect our patients to resources that allow them to rebuild their lives, find community and regain a sense of dignity.
One resource I’ve seen make a profound difference for asylum seekers in the Baltimore area is the Asylee Women Enterprise (AWE). As a student health navigator, I had the privilege of working with a client who, when we first met, was withdrawn and deeply isolated. She rarely left home except for her daughter’s medical appointments, and even then, she avoided eye contact and conversation. Over the months, I watched a slow transformation. She began attending weekly programs at AWE, first just to observe, then to participate. She started forming friendships with other women who, like her, had crossed borders and carried invisible wounds. Soon, she was laughing over tea in the AWE kitchen, swapping stories with co-workers at her part-time job, and even forming a warm, trusting relationship with her daughter’s pediatric team. Witnessing that transformation reminded me that community isn’t just a support system, it’s medicine.
I’ve started asking clients not only what they’ve endured, but what brings them joy, what they hope to do, who they miss. These conversations are not incidental; they’re a starting point.
When a client tells me she used to love singing in a church choir, I can help connect her to local congregations with music ministries. If someone once taught, I look for community centers that offer volunteer tutoring. If a client lights up at the mention of cooking, we explore local food pantries that offer communal meals or cooking classes. These entry points become lifelines, ways to transform isolation into connection, and memory into momentum. In doing so, we begin to help individuals reframe their identity from victim to community member.
Because ultimately, what I have learned is that the opposite of exile is not just asylum. It’s belonging. And as physicians, it is not enough to treat illness, we must help create the conditions for that belonging to grow.
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