I Learned English From a Teacher Who Didn’t Know What “Baa Baa Black Sheep” Meant

And I became a physician in America anyway. But some gaps never close.

I was ten years old, sitting in a classroom in Punjab, Northern India, when my English teacher taught me my first English poem.

Baa baa black sheep, have you any wool?

I repeated it dutifully, the syllables strange in my mouth. Afterward, I asked him what it meant. He smiled and said: don’t worry about the meaning. Just focus on the words. Focus on the rhyme.

I was young, but something felt off about that answer. Years later, I understood why: he didn’t know what it meant either. He had been trained in a school where English was a formality, not a living language — something you recited, not something you inhabited. He gave me the only thing he had: the sounds without the soul.

I think about that classroom a lot now. I am a third-year pulmonary and critical care fellow in the United States. English is my third language. Punjabi is the language I dreamed in as a child. Hindi is the language I learned when I left Punjab for medical school in Madhya Pradesh, in central India, far from home, far from everything familiar. English came after that — first as text in textbooks, then as conversation, then as the language I use to tell families in the ICU that their loved one is dying.

I have come a long way from that classroom. I know this. My family came from poverty. I am the first person in my family to go to medical school. When I think about the distance between that ten-year-old mouthing nursery rhymes he didn’t understand and the physician I am today, I feel something close to amazement.

And yet.

Today in clinic, I watched my attending manage a difficult family.

They weren’t difficult in the way we usually mean — not hostile, not unreasonable. They were simply people who needed someone to be present with them. Their family member was critically ill. They were frightened. They needed a physician who could enter their fear and make them feel less alone inside it.

My attending did something I have watched many times but still cannot fully explain. He mirrored them. He took their words and reflected them back, not as repetition but as understanding. He agreed with their concerns in a way that validated rather than dismissed. He became, somehow, part of their team — not just their doctor, but someone working alongside them toward the same goal. It was a combination of humility, intentionality, and a choice of words so precise and so natural that it seemed effortless.

It was not effortless. I know that. He has spent a lifetime inside this language. He grew up in it, was shaped by it, absorbed its idioms and its rhythms the way I absorbed Punjabi — not by studying it, but by living in it from the beginning.

I stood there and felt two things at once.

The first was admiration, uncomplicated and genuine.

The second was the quiet, clarifying recognition of a limit I will carry for the rest of my career: I will never be able to do exactly that.

I want to be careful here, because this is not self-pity. I am complimented regularly on my bedside manner. Patients tell me I am a good listener. Families in the ICU — the most vulnerable, frightened people I encounter — have told me they feel heard by me. I believe them. I am a good listener. I do feel what they are feeling. The empathy is real.

But empathy without language is a gift you cannot fully deliver.

There are moments — in the middle of a hard conversation, when the stakes are highest — where I know exactly what I want to say. The idea is fully formed inside me. The feeling is there. And what comes out is close, but not quite right. Not wrong enough to fail the patient. But not precise enough to be everything I wanted to give them.

It is like trying to play a piece of music you hear perfectly in your head, on an instrument you learned as an adult. The music is real. The feeling is real. But the instrument doesn’t respond the way it would for someone who has played since childhood. There is always a small gap between what you intend and what you produce.

I have accepted this. What I have not accepted — what I refuse to accept — is the idea that this makes me less of a physician.

Here is what I know about physicians like me.

We comprise roughly one quarter of the physician workforce in the United States. In underserved communities, in rural hospitals, in ICUs that would otherwise be short-staffed, that number is often higher. The American healthcare system does not merely tolerate IMGs — it depends on us. It could not function in its current form without us.

We came from everywhere. From Punjab and Karnataka, from Lagos and Lahore, from Manila and Monterrey. We learned medicine in languages that were not English, sat for licensing examinations in a language we acquired rather than inherited, and then walked into American hospitals and began caring for American patients — many of whom had never spoken to someone with our accent before.

We brought things with us that are harder to measure than language fluency. We brought the experience of having navigated systems not designed for us. We brought the particular empathy of the outsider who has always had to work twice as hard to be understood. We brought the humility that comes from knowing you are a guest in someone else’s country, trying your best, every day, to be worthy of the trust they place in you.

I am grateful to the American medical system for accepting me as a trainee. I mean that without irony.

It is not a small thing, to let someone in. To hand a frightened family over to a physician whose first language is not yours, whose accent marks him as foreign, and to trust that he will take care of your person with the same skill and compassion as anyone else. American patients do this constantly, often without thinking about it. Some of them, I am sure, notice my accent and feel a flicker of uncertainty. I understand that. I do not hold it against anyone.

What I hold onto instead is the accumulation of moments in which the uncertainty dissolved — in which the conversation went long enough, or the care was good enough, or the listening was real enough, that something like trust built between us. Those moments are the ones I carry.

My English teacher in Punjab gave me words without meaning. Somewhere between that classroom and this ICU, I found the meaning on my own.

I will never mirror a patient’s grief the way my attending did today. I have made peace with that particular limit. But I have learned to offer something else: the presence of someone who knows what it is to be far from home, to be uncertain, to be doing the best they can with the tools they were given.

In the ICU, that turns out to be worth quite a lot.