1. A Conversation with a Ukrainian-American UVA Physician

In this episode, I have a conversation with Dr. Katarina Egressy, a pulmonary-critical care physician at UVA who is also a Ukrainian-American. We discuss her upbringing in Ukraine and the former Soviet Bloc, her faith and spirituality, her perspective on the Russian invasion, and her upcoming plans to travel to Ukraine to provide medical aid and supplies.

Topics
- Dr. Egressy's upbringing in Ukraine (02:34)
- Overview of the history of Ukrainian-Russian relations (08:55)
- Dr. Egressy discusses family in Ukraine (21:40)
- Dr. Egressy's plans for her upcoming trip to Ukraine (23:41)

Links
- Help Dr. Egressy's efforts by contributing on her GoFundMe page: here
- Dr. Egressy's UVA Faculty Page: here
- Follow Dr. Bell on Twitter

Transcript

1. A Discussion with a Ukrainian-American UVA Physician

Intro

[00:00:00] Kat: Being able to feel that ostracization of different races or sexual minorities. It's incredibly close to me growing up of somebody who, was so culturally diverse yet never equal.

[00:00:15] Taison: 

[00:00:17] Hello, everyone! You are listening to This Medicine Life. I'm your host Taison Bell, a Critical Care and Infectious Disease physician at the University of Virginia. And, if you're like me, you may love being an academic medicine, but it's hard, y'all! The goal of this show is to make that just a little easier through the power of connection. We're interviewing medicine faculty, both inside and outside of UVA. Our goal is to connect with each other, to share our stories, our tips for success, and - together - become the best versions of ourselves in life and career.

Pre-Guest Segment

[00:00:53] Taison: I started this podcast with a goal to connect with my colleagues in a way that brings our whole selves to the conversation. And this is why I wanted to have a sit down with Dr. Kat Egressy -- in the Pulm/Critical Care Division here at UVA. And not only because of the COVID-19 crisis where we've managed patients side by side. But I later learned that she has also been carrying the emotional burden of a crisis abroad, with the Russian invasion of Ukraine. She's from the Lviv, the Western Ukrainian city recently under heavy bombardment by Russia. And she still has family in the country. Now, you would think that someone dealing with so much would hold a little back from others in order to have some reserve, but that's not what you see when you watch her work. Empathic is the best word I can use the describe her. Her interactions with the staff, with families and with colleagues. She even says on her hospital profile page, "My practice of medicine is guided by empathy science, and sincerity. Now, this is obviously a heavy conversation we're about to have, and we've met on the phone before we recorded the episode. She asked me, do you think your listeners are ready for a conversation like this? But just because a conversation may be hard or controversial, that is not a reason to shy away from it. In fact, if we are to bring our full selves to our work and personal lives, I believe that we have to lead with our whole selves. Even if, and especially if, it's rugged or raw at times. With that. I'm very honored to have Dr. Egressy on as our first guest. 

Taison/Kat Conversation

[00:02:30] Taison: Good morning Dr. Egressy, how are you? 

[00:02:32] Kat: Good. How are you, Dr. Bell? 

[00:02:34] Taison: I'm good. Thank you for coming on the show today. Why don't we go ahead and jump right in. I have some questions for you, but first, just to be sure - because I just call you Kat - but how do you actually pronounce your full first name? 

[00:02:47] Kat: So the American version of my first name is Katarina. If we talk about my full name, in Ukrainian, it's Катерина фон ланг Егреши Іцянік pronounced in Russian it's Екатерина Богдановна фон Ланг Егреши. And then the American version is Katarine von Lang Egressy. So I dropped the patronymic as well as my father's last name when I naturalized. And in some ways it's super complicated, but it definitely represents who I am and where I come from. 

[00:03:20] Taison: Yeah, it's like you carry multiple identities at once and there's no other way that personifies that then your name, something that's simple like, "what is your first name?" You have three or four different versions. And I think that that demonstrates how complex can get sometimes. 

[00:03:36] Kat: Yeah, I've... 

[00:03:38] Taison: You 

[00:03:38] Kat: It's life. 

[00:03:39] Taison: You've forgotten more languages than I've ever learned. 

[00:03:43] Kat: I don't know about that, but I think it's life, even thinking about my heritage my first and second generation of parents and grandparents have, Ukrainian, Hungarian, German, Jewish, Russian, and Romanian. And then thereafter, I'm sure that there's some Scandinavian, et cetera, et cetera. Just in the heritage alone I think I represent a very humble European mutt. A lot of people from Europe can say that they have a very mixed heritage. And in some ways, to me, metaphorically represents what Europe is. It's a relatively small continent where people really had to mix together historically to survive. Albeit with multiple conflicts and uprising, but we're all united by blood, even though our cultures are different. And our languages may be different. And so I do think of myself as a European because I was born in Europe in Ukraine. Yet I straddle multiple different cultures because my mom and I immigrated to the United States. I am exactly that story of my mom and I coming to the United States with very little English skill and literally $25 in our pocket and really no idea of the United States outside that it represented the land of opportunity. That was so scary, but also it's so humbling. And I keep that with me at all times. 

[00:05:10] Taison: And you were a teenager when you came over here.

[00:05:12] Yeah. I was 12 or 13. So I literally started high school, I think ninth grade, or maybe eighth grade or maybe middle school. Where were the places that you lived before you came to the US cause you, moved around a bunch.

[00:05:26] Kat: Yeah. just a little geography. I was born in Ukraine. The time that I was born, it was really called the Ukrainian SR or the Soviet Republic. I was born in a town called Lviv or L'vov, which is the Russian pronunciation or Lemberg, which is the Polish-German pronunciation. I lived there, until I was approximately nine or 10. And then, the next two or three years were really spent with my mom trying to get me out of Ukraine. And so we traveled various countries of the Soviet block, including former Yugoslavia and Poland and Czech Republic and we stayed there for small periods of time trying to cross the border, and then ultimately coming back to Ukraine where I continued to go to school. and then finally, around when I was 12 or 13, by that time the Berlin wall has come down. Through that, we were really able to transition, with a brief stop in east Germany, to the United States. So we started our life here when I was 13, I believe, in Richmond, Virginia. And, I went to high school in RIchmond, and have deep ties to Virginia. 

[00:06:35] Taison: Wow. So you have your mother in Richmond. 

[00:06:38] Kat: Yeah. 

[00:06:38] Taison: Which it's obviously nice to be close to her. And your family is in Montana. You travel back and forth. So you've continued this trend of having family all over and traveling. 

[00:06:51] Kat: Yeah, I think that's probably true. I have kept a bit of a nomadic soul. Not because I really want to, but because of multiple different circumstances throughout my life, I also married a person who grew up on the sailing boats and was a professional sailor and an engineer. So by marriage as well as historically and culturally, I think the two nomadic souls joined and created a union, where we moved around quite a bit, but yes, right now I live with my family in Montana and travel to UVA, which allows me to work with colleagues that I am so fortunate to have, but also on bookends to see my mom. 

[00:07:33] Taison: I'm always interested in what actually grounds people. You are a very grounded person. So what does actually ground you when physically you're God knows where during the course of the month?

[00:07:44] Kat: I think that's a, both a very difficult and an easy question to answer because for me, specifically, the things that grounds me are my spirituality and my faith. That is a deeply personal thing that I absolutely have grown into. I grew up in a relatively non-religious household. In Soviet Union, religion was not encouraged. and in fact it was practiced very secretly, and you were strongly persecuted if religion was ever connected to your name. My faith and my spirituality in some ways is something that I've discovered more as an adult. Something that I continue to discover every day. But it really grounds me and allows me to be humble and to really appreciate things for what they are. I'm naturally a very competitive person, but I think as I aged and as I've lived life, and as I've had children, it allowed me to really step back and be grateful for what I have and trying not to think about things that I cannot control. That is a difficult thing. and I try to practice that every day. and it continues to be a difficult thing. 

[00:08:55] Taison: That's the theme of intensive care. We tend to be drawn to it because of control, but it's defined by the lack of control. On that theme, the Russian invasion of Ukraine has recently dominated our headlines, but something that you had been thinking and dealing with for a while because this has been a consistent theme of the country's existence. So from your view, the information that we're getting, what is off the mark and what are we missing? 

[00:09:20] I think the first thing that we should do is really lay the foundation and talk briefly about history of Ukraine. Because, even though it's the largest country in Europe, both by surface area and square mileage, it is a country that we haven't really heard about much, in, I would say, 20 years prior to Russia's invasion. Ukraine, as an entity was first described in, 890 or so, with founding of a city called Kiev which is the current day capitol of Ukraine. Two hundred years later the Slavs of the East, which are the current day Russia, decided to annex the Eastern Slavs and created an entity called the Kievan Rus, or the Russia. And then throughout the next three or four hundred years have suffered from a lot of different invasion, including the Tartars, the Mongols, the Ottoman Empire, And then around 14 or 1500, really consolidated the majority of the area of modern Ukraine. under the Russian rule. For the last thousands of years, Ukraine has been independent only for very short periods of time. There have been various uprising however, it never truly managed to hold on to independence as a country. 

[00:10:46] Kat: It kept its language. It kept its culture. It kept its sort of nationality and sense of pride. So throughout the years it produced poets and musicians and directors and writers and composers that were Ukrainian but, because of various different occupiers, had to go by different citizenship. 

[00:11:08] Russian empire started occupation of Ukrainian territory mostly the Eastern territory around 1600s. And that really continued until the 20th century where the Bolshevik revolution really triggered yet another uprising where there was a sovereign revolution happening where people of Ukraine actually were fighting both the terrorist Russia, as well as the Bolsheviks and they lost. And so Ukraine, as part of Soviet Union, was born around 1920s and thereafter continued to assume various different forms, both politically, but also geographically. The part of Ukraine that joined the Soviet union in 1920s is not what the modern day Ukraine is. Because most of the Western Ukraine, including the town that I was born was under various different rules, including Austro-Hungarian empire, Poland, Lithuania, Romania. And to this day, a lot of different minority cultures exist within Ukraine where people speak Hungarian and they speak Romanian as a first language and they speak Polish as a first language. Ukraine is an absolute amalgam of cultures, languages, and land. Yet it's survived and continues to be its own entity. Even geographically, it is divided by our beautiful river called Dnieper or Dnipro. It divides Eastern Ukraine, where more people than not speak Russian as their first language and really have had more of the Russian culture. The Western part of Ukraine feels that it is much more European and has European influences and speak languages both of Ukranian as a first language, Polish and Romanian and Hungarian. 

[00:13:02] When I started school in Ukraine, Ukrainian as a first language was still not encouraged, by the time I reached fourth or fifth grade, Peter Poroshenko was very much in full motion. Ukrainian did become an official language. And Russian was still taught in school. Russian literature, history of communism and Leninism. But what was interesting whispers of Ukrainian independence started floating even through the school. And all of a sudden the school choir was allowed to sing Ukrainian national songs and we were allowed to. recite poetry and Ukrainian and something that was completely incomprehensible to, a fourth grader or third grader became possible. Previously the only thing that really was possible is talking about Russia and being part of Russia and really encouraged to really feel mostly Russian. In addition to that, I think that there is an overlay of my own family's cultural history where my mom and her mom and my grandma, my grandfather on my mom's side never became members of the communist party and that carried a very heavy toll for all members of my family, including, incarceration and death and deportation. But it also carried a forever fear of speaking out and speaking up. And therefore very little was really discussed when I was growing up. And so there were so many different layers of cultural repression and lack of identity and also resignation. And what I mean by that notion is that you spend so much time being repressed, you spent so much time being denied, you reach a stage of depression that really borders on resignation and you simply feel that whoever is in charge really does not matter, but your own personal life, it becomes irrelevant. 

[00:15:03] And that in itself really leads me into the conflict of Ukrainian and Russian countries as understanding that resignation in some ways leads to devaluation of human life. And the decades of Soviet repression revoked the human identity as a person, but mostly a member of the states to the point that doing something in the name of the state, including atrocities would be a very plausible thing for me to comprehend. Understanding not only have Vladimir Putin came to power, but also how the Soviet structure really functioned for the past 70 years. Just to add an historical flavor to this in 1936 and 38 Stalin, who was the leader of the communist party and the defacto leader of the Soviet Union, created a starvation in Ukraine, which he starved nearly 6 million people in Ukraine to try to repress the Ukrainian identity and really squash any whisper of wanting to be free. And even though Ukraine is considered the bread basket of Europe and crops are abundant, the Russian army encircled Ukrainian villages, and literally allowed people to starve in front of their eyes. We could go on and on and talk about Chechnya and talk about Georgia and talk about Turkmenistan, and Azerbaijan and all of the far East countries that Stalin as well as the current leader of the Russian Federation have created incredible acts of atrocities.

[00:16:43] Taison: So there's a long history of repression and conflict here. How does that lead us to the present day?

[00:16:49] Kat: If we move into the current conflict of Russia and Ukraine it really started back in 2014 where Ukraine really made the first real move towards independence that was a national uprising against the pro-Russian government. Russia felt that this was not in alignment with its own interests within Ukraine. Russia started amassing, warcraft and warfare, on the border of Ukraine and Russia of the Donbas and Luhansk, which Russia and Ukraine share a lot of kilometers of Eastern border. And since then there has been military sort of chronically slow burning conflict whereby both Ukrainian and Russian lives were lost. Some sanctions were put in force but what happened next was moreover annexation of Crimea, which was traditionally Ukrainian. But really nothing that would really stop Russia in its track and in fact, enbolden it in some ways. And so the conflict that began. two months ago really is a culmination of six or seven years of chronic disease that finally erupted as a full-on septic shock. So to say alarmingly, it just went from a small chronic conflict yet with a very determined autocrat, who has been planning this all along to a full scale military war to the point that it has displaced over 10 million people in Ukraine and has now killed thousands on both sides and created an incredible precedent of false propaganda for all of Russia and potentially for the rest of the world. 

[00:18:34] Taison: This theme of dehumanization is what seems to carry through. And it's fair to say that the Ukrainian people have a cultural identity that has existed for a long time, even if not a geopolitical identity. But fact that there's identity is that existential threat. It seems like it's been an ongoing effort to dehumanize and therefore justify the aggressions that happen. 

[00:18:59] Kat: Yeah, I would agree with that. And moreover, I think it also carries to even the Russian people within Russia. Dehumanization of the common person was used as a tool of propaganda and extending the political power. Meaning that if you were called the enemy of the state or in the enemy of the people you were immediately dehumanitized and you became not worthy of respect, life, freedom, anything. Your own neighbor was encouraged to denounce you because you were no longer considered a human being in the same league as that person. This absolute intent on propaganda and false information that goes on in Russia currently. For the average Russian citizen there is no war that is happening with Russia and Ukraine. There is only a, a liberation of sorts that is carried on by Russia and Ukraine of the Russian people. And words like neo-Nazis andlikening Ukraine to being led by Hitler and the current Ukrainian president being called Hitler. And also spreading information that all of the atrocities and the genocide that we have seen portrayed portrayed in Western media is a deep fake or something that was staged by either the Americans or the Ukrainians or somebody else. 

[00:20:24] And that to me is equally as disturbing as the unprovoked invasion in Ukraine. Not only does it allow Russia to carry on its mission and hold power of righteousness, but it also allows the Russian people to dehumanitize or remove Ukrainians from the world stage. 

[00:20:47] Kat: And, for me specifically as a Ukrainian American, that really strikes deep in my soul because I, have, even as a child had a significant difficulty thinking of myself as equal to somebody who was a member of the Communist Party or somebody who was a Russian citizen. That notion of not being equal, or being below something or somebody is really rife within the former Soviet Republics because it was used as a tool of propaganda. And I can clearly identify with that American conversation now. Of being able to feel that ostracization of different races or sexual minorities. It's incredibly close to me growing up of somebody who, was so culturally diverse yet never equal.

[00:21:39] Taison: The same themes play out in different contexts, but the theme of dehumanization and feeling like you're not equal it's really fascinating. Now you Still have family in Ukraine. How are they doing? 

[00:21:55] Kat: My father lives in the area of Ukraine called the Transcarpathian Ukraine. and it's probably the utmost west point of Ukraine that borders on Romania, Poland, and Hungary. And therefore for the most part, the area where he lives has not seen any active rocket strikes However they have had multiple air raids and what they have been seeing the most is the immigration of the displaced Ukrainian population into the Western area. And therefore my father's house. That used to house just him and his wife currently holds five extra people. Extra family members are needing a place to stay and places like hotels and gyms and YMCA's of sorts have opened their doors to refugees. They are seeing increasing prices, both of food and common articles. and more and more so lack of gasoline and lack of ability to purchase fuel. I feel in some ways incredibly guilty because I am able to get up in the morning and serve meals to my kids and go shopping and drive a car. and I feel incredible guilt that I am able to do that yet so many people of Ukraine cannot. And I struggle with that every day and really use faith and my spirituality to try to ground me. And understanding as to what I can do as a Ukrainian American to try to bring light to this conflict. And most importantly, raise voices. Because If I can elevate a voice of somebody who's actually participating in this war that's probably the most important contribution that I can do. 

[00:23:41] Taison: So you're planning on going to Ukraine in July and August. What are you planning to do? And how do you preparing for this? 

[00:23:48] Kat: Yeah, that is something that I continue to talk to my father about, because I'm trying to understand how I can be most helpful, not only to my father directly and to his family, but also to the community that he lives in. I as a person cannot carry heavy military artillery or tanks or fighter jets on me. I have, had my dad reach out to the head of the hospital in the town that he lives in and have gotten a number of medications that are in critical demand and plan on soliciting some of these medications from either the pharmaceutical companies or maybe directly from the community that I live in or the community that I work with as well as, potentially joining forces with some of the humanitarian organizations that are already on the ground. As you can imagine, there are multiple organizations that are present there, both helpful and not helpful. And although I'm trying to do something from here, I think will be most important is actually arriving there. 

[00:24:50] That being said, two things are important. One, my going to Ukraine would have not been possible without the amazing involvement of colleagues around me. My colleagues have stepped in and allowed me to take the time to travel to Ukraine. And for that, I consider myself incredibly fortunate to both live and work in the country as well as a place that allows me to do that. Second important point is that it is an active conflict. So even though I may make plans the situation may change. We could be facing a much more dangerous military conflict August than we are facing now. I don't know what is it going to be because I'm not a military analyst nor do I truly understand the mind of Vladimir Putin. The only thing that I do know he has really no way of backing down. And as his ambition grows he will continue to do anything in his power to extend influence of Russian Federation.

[00:25:53] So even if the Ukrainian conflict right now seems like a local regional conflict. I suspect that it will continue to be much more than that if Russia is allowed to go on. So my plans have to stay flexible. For now, I am planning on potentially transporting medication or necessary supplies that I can carry on myself to the either Polish or Slovakian-Ukrainian border. And then definitely going into Ukraine and hopefully helping in the small way that I can. What one person can do is simply elevate the voices of the ones that can't. And I want to believe that my voice and my actions matter and then they count and that's all I can do. 

[00:26:41] Taison: If my work with you has been any example it's that I have no doubt you can have a substantial impact. And I hope the message you've shared today, it can get out far and wide and we can assist in any way possible. I really want to wish you health and safety when you're there and I can't wait until you get back and we can talk about what what you experienced and share more. 

[00:27:01] Kat: Thank you so much for your kind words. This really means a lot. I appreciate the kindness that has been extended to me within the realm of critical care or pulmonary medicine, my colleagues, and workers, and people who surround me. but also the kindness that I tried to extend to the world. and I do believe that what comes around, goes around. So if I can pass it on and do very small part and maybe sometimes with mistakes and arrows. I will try to do what I can and I think that's where my faith and my spirituality allows me to ground myself and believe that it's possible. 

[00:27:36] Dr. Aggressi, thank you for coming on and we wish you well. 

[00:27:40] Kat: Thank you so much, Dr. Bell, it's been a pleasure. 

Post-Guest Segment

[00:27:43] Taison: Dr. Egressy is quite an amazing person, and I'm glad we were able to sit down and have this conversation. And there were really three things that resonated. The first is just the sheer burden that some of us carry. Imagine holding down a COVID-19 pandemic, but also worrying about your family abroad and the regional conflict. We don't always carry evidence of the burdens we carry on our sleeve. And so approaching interactions with kindness can really go a long way. The second is the theme of dehumanization of marginalized populations. As Dr. Egressy was describing the systemic dehumanization of the Ukrainian people. I found myself connecting that with my own history as an African-American in the United States and past the atrocities and ongoing injustices. Five thousand miles and an ocean away, the struggle has the same roots. And then the third is a power of one person. This is a massive conflict between Russia and Ukraine that not one person can solve and it can feel overwhelming. But that doesn't mean that we can't have an impact. Dr. Egressy has decided to help out by traveling to Ukraine, bringing medical supplies. She's also started a GoFundMe page that will have a link in the show notes. And I hope as you listen to this episode that you amplify this message that you contribute. And together we can show what one person can do. 

Outro

[00:29:09] Taison Bell: And that's our show! Thank you for listening to This Medicine Life. If you enjoyed the show, please subscribe, write a review, and tell a friend. We are available wherever you get your podcasts. This show was created, recorded, and edited by - me. Music is by Dr. Malcolm Lex. 

[00:29:26] Views and opinions expressed to not necessarily reflect the view of the University of Virginia or any other entity. Please send me your ideas for topics you want to hear about or guests you want to have on the show. My Twitter handle is my first and last name, Taison Bell. Please stay tuned for the next episode. Until then, I'll see you around.