What do you think?
Rate this book
Your Heart Is the Size of Your Fist: A Doctor Reflects on Ten Years at a Refugee Clinic
Your Heart Is the Size of Your Fist draws readers into the complicated, poignant, and often-overlooked daily happenings of a busy urban medical clinic for refugees. An Iraqi journalist whose son has been been murdered develops post-traumatic stress disorder and mourns his loss of vocation. A Congolese woman refuses antiretroviral treatment for her new HIV diagnosis, and instead places her trust in Jesus. Two conservative Muslim Iraqi women are inadvertently exposed to pornography when a doctor uses Google Images to supplement a medical discussion. By turns humorous, distressing, and moving, these stories offer insight into the people seeking a new life while navigating poverty, language barriers, and neighbours who aren’t always friendly. This riveting collection of true stories from Dr. Martina Scholtens is filled with hope and humour, and together make up a deeply moving portrait of how one doctor attempts to provide quality care and advocacy for patients while remaining culturally sensitive, even as she wrestles with guilt, awareness of her own privilege, the faith she was raised with, and vicarious trauma after hearing countless stories of brutality and suffering. In the spirit of Louise Aronson and Atul Gawande, Scholtens’ writing is based on her personal experiences and explores the transformative moments in which a clinical doctor-patient relationship becomes a profound human-human connection.
215 pages, Paperback
Published October 17, 2017
9 people are currently reading
514 people want to read
Ratings & Reviews
Friends & Following
Create a free account to discover what your friends think of this book!
Community Reviews
Displaying 1 - 30 of 67 reviews
October 15, 2017
Beautifully written and engaging from start to finish. Dr.Scholtens shares her daily interactions with her patients at a medical refugee clinic providing a glimpse into their lifes both before and after immigrating to Canada. Honest, powerful, humorous at times, and deeply moving. This is a treasure to read and I would highly recommend this to anyone.
November 28, 2017
A beautifully written account of the challenges and triumphs the author faced daily while working in a refugee clinic in Vancouver. Dr. Scholtens writes honestly and openly about her personal struggles to reconcile a life of privilege to the difficulties her patients experience on a daily basis.
This book opens the reader's eyes to the horrors that many of today's refugees have had to live through before coming to Canada. And then there are the problems they encounter at every turn while they try to settle into their new surroundings. I wish every Canadian would read this book. Perhaps we can meet refugees with compassion and kindness at the very least, instead of suspicion and wariness. I am grateful to Dr. Scholtens for writing this book.
This book opens the reader's eyes to the horrors that many of today's refugees have had to live through before coming to Canada. And then there are the problems they encounter at every turn while they try to settle into their new surroundings. I wish every Canadian would read this book. Perhaps we can meet refugees with compassion and kindness at the very least, instead of suspicion and wariness. I am grateful to Dr. Scholtens for writing this book.
October 9, 2017
The primary work of patient care is not diagnosis, but compassion. This principle is made abundantly clear in Your Heart Is the Size of Your Fist: A Doctor Reflects on Ten Years at a Refugee Clinic by Martina Scholtens. I am not often brought to tears while reading, but I had to dab at my eyes a few times reading this one. Scholtens' voice is tender and uncertain, her descriptions bordering on poetry; for her patients, we are allowed a window into the trauma and confusion and lingering fears refugees bring with them, the healing that a welcoming, supportive country can offer. In particular, the various stories form a narrative arc throughout the whole story, charting Scholtens' journey into medicine and the progress of one refugee family, while interweaving the stories of scores of other patients and not a few doctors. Chapters are short, allowing easy reading for busy people that may only have five minutes to themselves at a time. But be careful. The stories are like Pringles: you'll find it hard to stop at just one.
November 27, 2017
I loved this book.
June 25, 2018
Great book. Both light and deep, endearing and enjoyable. At times I found her honesty about the disparity between her semi-charmed kinda life and those of her patients frustrating because the tension was left unresolved... but it's probably better that way since answers are difficult and not one-size-fits-all anyway. I highly recommend!
February 16, 2019
I liked this book. It addresses some issues that are relevant to working with refugees, but is also highly applicable to living in a multicultural society. Bridging gaps in communication due to language barriers and cultural differences and working towards cultural humility are important skills for physicians, but also for everyone else. The messages of reflection and self-care are also important.
I think the focus on individuals is what makes these kinds of books so compelling. The doctor is in an excellent (though not unique) position to carry hidden details of patients' lives, and so can relay messages that emphasize both the complexity of one person and the broader human and social context which affects us all. It's empathy-building. I'm reminded of the great privilege I have to take things for granted, and to not consider all the gifts I have carried since birth. Well-written and introspection-promoting.
I think the focus on individuals is what makes these kinds of books so compelling. The doctor is in an excellent (though not unique) position to carry hidden details of patients' lives, and so can relay messages that emphasize both the complexity of one person and the broader human and social context which affects us all. It's empathy-building. I'm reminded of the great privilege I have to take things for granted, and to not consider all the gifts I have carried since birth. Well-written and introspection-promoting.
May 19, 2022
What a gem of a book. Dr. Marina Scholtens works in a refugee clinic in Vancouver. She sees new Canadians from all over the world and walks us through the process of working with each refugee via a translator to identify any health issues. The anecdotes are truly riveting and the examples of how best to overcome cultural boundaries in a respectful and caring way. This book is a truly an exploration of how to be human and how to show compassion, juggle your own personal life and stay cognizant of your own privilege.
If you are interested in other cultures, the strength and resilience of refugees and immigrants or just are interested in the daily life of a thoughtful, reflective and kind doctor this is a fabulous book for you!
#Touchwood
If you are interested in other cultures, the strength and resilience of refugees and immigrants or just are interested in the daily life of a thoughtful, reflective and kind doctor this is a fabulous book for you!
#Touchwood
December 31, 2018
This is a beautifully crafted book that pulls back the curtain on the lives of some of the most invisible in our communities: the people who are here as refugees fleeing from unspeakable situations in their homelands. Dr. Scholtens shares their stories as well as her own as her family grows and she notices the contrasts between her own upbringing, her life as a parent and young physician, the lives of her patients, and the needs of the community. Highly recommended.
November 3, 2017
This was a unique and intriguing peek into the world of a family physician and her experiences caring for refugee families while balancing the emotional and psychological demands of her career and family. The stories will expand your understanding of and empathy for newcomers to Canada.
November 6, 2025
Read for grad class. Very touching recount of a doctors experience at a refugee clinic. I loved how much she clearly valued patient’s wellbeing no matter what their story was. Truly demonstrated what it means to meet your patients where they are.
March 6, 2018
Very interesting and well written book.
May 22, 2018
This was very honest and I found it thought-provoking and very inspiring.
December 31, 2025
The book throughout semester that helped me realize how my two majors go in hand, empathy is so important in healthcare!!!
October 20, 2019
Such an honest reflection on this physician's experience as a student, mother, and family physician. A truly challenging, necessary, and rewarding read.
August 9, 2018
I wasn't sure what this book would be like but I really enjoyed it. It gave great insight to her work without revealing too much about her patients but also how hard it can be but also rewarding it can be too.
March 29, 2020
I was reluctant to read this book, afraid it would be too political. I’m so happy I did. This memoir reminded me of how Medicine should be practiced; with compassion & empathy. It should be a relationship of mutual trust, not like an order at a drive through restaurant. As a daughter of a Doctor who practiced family medicine for 50 years, her stories resonated with me like the stories I still hear from my Dad’s former patients. It is also a reminder of the risks & strengths immigrants across the world take every day to give their families a better life.
February 11, 2018
This was a very moving book. I enjoyed it very much and recommend it to everyone in this age of materialism, cynicism and crass political behaviour. We are very lucky to be living in Canada and this book illustrates the things we take for granted.
January 8, 2024
I approached this book thinking that I would be able to relate; then I discovered that there is a mountain of differences between a person who immigrates to Canada and a person who arrives as a refugee. Both are given the same privilege but the journey is vastly different.
Refugees are placed under the care of a physician for one year from the date of their arrival during which time they also have to secure housing and employment. (Side note: with doctors in short supply post-pandemic it is even more difficult to realize that refugees lose their medical care at 12 months & are then left to "fend for themselves"). Immigrants arrive with identification, birth certificates, passports, medical history, mandatory proficiency in English/French, mandatory funds to secure housing, and education requirements. Often most, and sometimes all, of these documents and abilities are not available from a refugee. Of course ID's are secured in whatever refugee sponsor/camp/organization they are held until cleared for entry.
Dr. Scholtens documents her 10 years of serving these newest Canadians. She mostly served entire families; her expertise covering gynecology, pediatrics, and geriatric needs. The culture shock alone is staggering; add to that the complex medical needs that arise from coming from a war-torn country, as well as congential challenges from tribal marriage customs; and you have a road map that few could traverse easily. And yet these are the people who become our neighbour's, co-workers, and very eager Canadian citizens.
So many if them have seen family members murdered, blown up by bombs or disfigured by hand grenades. Women have been denied education and often basic human rights. Language barriers add an unexpected layer of humour as Dr. Scholtens respectfully and tenderly tells their stories. She is also has her share of trauma to process as she learns what has been endured.
Reading this book has made me more empathetic and certainly has educated me about our Canadian refugee system. It also gives me pause to consider if we are doing enough to integrate refugees into our society; 12 months is not a long time to rebuild a shattered life. A few observations left me troubled; racism works both ways, grievances between rivals are not dissolved by geography, and deeply embedded customs and thought patterns are difficult to transform. The intersection of culture and religion are a collison course, as many refugees are admitted based on religious persecution or due to civil wars based not on acquiring territory but intolerance. Perhaps the freedom Canada offers allows some to continue harmful traditions within the walls of their private homes. We can only hope that their children, who can now thrive without fear, will embrace a deeper freedom as they meet us, and open their hearts that are the size of their fists.
Beautifully written and easy to understand, highly recommend this book.
Refugees are placed under the care of a physician for one year from the date of their arrival during which time they also have to secure housing and employment. (Side note: with doctors in short supply post-pandemic it is even more difficult to realize that refugees lose their medical care at 12 months & are then left to "fend for themselves"). Immigrants arrive with identification, birth certificates, passports, medical history, mandatory proficiency in English/French, mandatory funds to secure housing, and education requirements. Often most, and sometimes all, of these documents and abilities are not available from a refugee. Of course ID's are secured in whatever refugee sponsor/camp/organization they are held until cleared for entry.
Dr. Scholtens documents her 10 years of serving these newest Canadians. She mostly served entire families; her expertise covering gynecology, pediatrics, and geriatric needs. The culture shock alone is staggering; add to that the complex medical needs that arise from coming from a war-torn country, as well as congential challenges from tribal marriage customs; and you have a road map that few could traverse easily. And yet these are the people who become our neighbour's, co-workers, and very eager Canadian citizens.
So many if them have seen family members murdered, blown up by bombs or disfigured by hand grenades. Women have been denied education and often basic human rights. Language barriers add an unexpected layer of humour as Dr. Scholtens respectfully and tenderly tells their stories. She is also has her share of trauma to process as she learns what has been endured.
Reading this book has made me more empathetic and certainly has educated me about our Canadian refugee system. It also gives me pause to consider if we are doing enough to integrate refugees into our society; 12 months is not a long time to rebuild a shattered life. A few observations left me troubled; racism works both ways, grievances between rivals are not dissolved by geography, and deeply embedded customs and thought patterns are difficult to transform. The intersection of culture and religion are a collison course, as many refugees are admitted based on religious persecution or due to civil wars based not on acquiring territory but intolerance. Perhaps the freedom Canada offers allows some to continue harmful traditions within the walls of their private homes. We can only hope that their children, who can now thrive without fear, will embrace a deeper freedom as they meet us, and open their hearts that are the size of their fists.
Beautifully written and easy to understand, highly recommend this book.
June 22, 2022
Thank you to NetGalley and Brindle Glass for access to the audiobook of Your Heart is the Size of Your Fist: A Doctor Reflects on Ten Years at the Refugee Clinic by Martina Scholtens, MD in exchange for an honest review.
CW: death, death of a child, pregnancy, infertility, miscarriage, rape, abortion, descriptions of war, racism, islamophobia, medical content, grief, see full list on StoryGraph
Scholtens is a gifted and beautiful writer. Her account of her time as a doctor in a refugee clinic engenders feelings of compassion, heartbreak, loss, and the unending hope of resilience. She carefully weaves the narratives of her patients in with discussions of what is means to be practitioner treating people under the biopsychosocial-spiritual framework. This book has implications for all people in business of caring for people (doctors, nurses, counselors, social workers, human resources personnel, etc.). Not only does Scholtens tactfully argue that trauma is an evergreen issue when interacting with patients, but also reminds readers of the utmost importance of cultural sensitivity in treatment. Stories of healing presented by Scholtens serve as a profound reminder that people are the experts of their own experience, and, though at times it seems impossible and counterproductive, a kind and listening ear can be a therapeutic agent.
My only critique is that I wish Scholtens had addressed ethical issues presented throughout the book more thoroughly and sooner than she did. Though she did circle back to some of the ethical issues at play with accepting gifts from patients, determining when referral to mental health professionals is appropriate, and how to discharge a patient from care effectively, it seemed that some of these issues came up multiple times without an immediate discussion of the ethical challenges that she encountered in her role as a refugee doctor. I was disappointed at a) the lack of regard for ethics at the forefront of conceptualizing treatment, and b) that it took so long to discuss ethics at all, which may lead lay-readers to accept some of this doctor's actions as acceptable when perhaps she should have altered her responses in certain situations.
I am a big fan of medical nonfiction, so I loved this memoir by a doctor, especially one as eloquent as Martina Scholtens. I might recommend this book to fans of true crime (though I can't exactly put my finger on why), and those who are interested in gaining more insight on cultural competence in treatment (either physical or mental).
CW: death, death of a child, pregnancy, infertility, miscarriage, rape, abortion, descriptions of war, racism, islamophobia, medical content, grief, see full list on StoryGraph
Scholtens is a gifted and beautiful writer. Her account of her time as a doctor in a refugee clinic engenders feelings of compassion, heartbreak, loss, and the unending hope of resilience. She carefully weaves the narratives of her patients in with discussions of what is means to be practitioner treating people under the biopsychosocial-spiritual framework. This book has implications for all people in business of caring for people (doctors, nurses, counselors, social workers, human resources personnel, etc.). Not only does Scholtens tactfully argue that trauma is an evergreen issue when interacting with patients, but also reminds readers of the utmost importance of cultural sensitivity in treatment. Stories of healing presented by Scholtens serve as a profound reminder that people are the experts of their own experience, and, though at times it seems impossible and counterproductive, a kind and listening ear can be a therapeutic agent.
My only critique is that I wish Scholtens had addressed ethical issues presented throughout the book more thoroughly and sooner than she did. Though she did circle back to some of the ethical issues at play with accepting gifts from patients, determining when referral to mental health professionals is appropriate, and how to discharge a patient from care effectively, it seemed that some of these issues came up multiple times without an immediate discussion of the ethical challenges that she encountered in her role as a refugee doctor. I was disappointed at a) the lack of regard for ethics at the forefront of conceptualizing treatment, and b) that it took so long to discuss ethics at all, which may lead lay-readers to accept some of this doctor's actions as acceptable when perhaps she should have altered her responses in certain situations.
I am a big fan of medical nonfiction, so I loved this memoir by a doctor, especially one as eloquent as Martina Scholtens. I might recommend this book to fans of true crime (though I can't exactly put my finger on why), and those who are interested in gaining more insight on cultural competence in treatment (either physical or mental).
December 23, 2021
This is the best book I’ve read on the subject of refugees and their often unseen needs entering Canada. Scholtens has a unique eye on the inner (and outer) struggles many refugees to Canada have to deal with when they arrive. One of the stand-out words for me in this book is her observation of maternalism, paternalism, and judgement from ‘Canadians’ toward people new to our country.
Living near Vancouver, Calgary, and Edmonton over the last 35 years, I have encountered many similar stories to the ones described by Scholtens. I’m not a doctor but I’ve volunteered, studied alongside, and worked with organizations that help new immigrants over the years. Reading these words has been both refreshing and a stern reminder to be continually mindful.
As we near the end of the book, Scholtens gives us a glimpse of her own personal mix of joy and grief without apology. It feels like a permission slip to feel both gratitude AND grief over some of life’s biggest and smallest moments.
Until now, I hadn’t ever read a book that comes so close to observing the struggles of so many new immigrants as perceptively as Your Heart is the Size of Your Fist. I highly highly recommend this read.
Living near Vancouver, Calgary, and Edmonton over the last 35 years, I have encountered many similar stories to the ones described by Scholtens. I’m not a doctor but I’ve volunteered, studied alongside, and worked with organizations that help new immigrants over the years. Reading these words has been both refreshing and a stern reminder to be continually mindful.
As we near the end of the book, Scholtens gives us a glimpse of her own personal mix of joy and grief without apology. It feels like a permission slip to feel both gratitude AND grief over some of life’s biggest and smallest moments.
Until now, I hadn’t ever read a book that comes so close to observing the struggles of so many new immigrants as perceptively as Your Heart is the Size of Your Fist. I highly highly recommend this read.
June 23, 2023
Beautiful memoir recommended to me by a colleague, shedding light on many refugees' difficult first year of adjustment after their arrival in Vancouver from the perspective of a family doctor who worked in a refugee health clinic for a decade. While I'd heard stories about refugees in the news, it was eye-opening to read this first person account. Makes me immensely proud to be Canadian and to know that my hometown welcomes these folks and provides them with the necessities to start a new life - not to be taken for granted and always in jeopardy due to federal funding cuts, but maintained partially thanks to the advocacy work of people like Dr. Scholtens. Dr. Scholtens grapples with her own privilege and struggles to reconcile the inequities between her life/upbringing with that of her patients. She also shares about the emotional and psychological toll it has taken on her to serve these patients. My favorite part was the patient stories - some are funny, some are heartbreaking, some are horrifying - it's hard to imagine having this difficult of a job, but I'm grateful there are those who shoulder this responsibility everyday. Highly recommend!
June 24, 2022
Just Beautiful.
Dr. Scholtens shares an open and honestly look at what it’s like to work in a refugee clinic in Vancouver and I cannot be more appreciative. After reading “Your heart is the size of your fist” I really had to look inward and just appreciate the privilege I have.
This book also makes me think that we need to start removing the barriers that still currently exist! I just love how Dr. Scholtens recognizes where her cultural knowledge limitations are and is willing to learn about cultural differences. That’s just what it’s all about, understanding that you do know everything, but you are willing to learn. This isn’t just an important skill for physicians, but for society as well.
I highly recommend this book if you are interested in learning about the challenges refugees and immigrants have, but also about their strength and resilience. Very eye opening and humbling. Thank you Dr. Martina Scholtens.
Thank You to Dr. Martina Scholtens Alex Finlay and TouchWood Editions, for the audio-digital ARC provided through NetGalley in exchange for an honest review!
Dr. Scholtens shares an open and honestly look at what it’s like to work in a refugee clinic in Vancouver and I cannot be more appreciative. After reading “Your heart is the size of your fist” I really had to look inward and just appreciate the privilege I have.
This book also makes me think that we need to start removing the barriers that still currently exist! I just love how Dr. Scholtens recognizes where her cultural knowledge limitations are and is willing to learn about cultural differences. That’s just what it’s all about, understanding that you do know everything, but you are willing to learn. This isn’t just an important skill for physicians, but for society as well.
I highly recommend this book if you are interested in learning about the challenges refugees and immigrants have, but also about their strength and resilience. Very eye opening and humbling. Thank you Dr. Martina Scholtens.
Thank You to Dr. Martina Scholtens Alex Finlay and TouchWood Editions, for the audio-digital ARC provided through NetGalley in exchange for an honest review!
December 18, 2017
A very readable memoir of sorts. Scholtens reflects on her life as a doctor while working in a refugee clinic in Vancouver. She revisits with one particular family throughout the book and mentions other patients as their visit reflects components of her practice. The book is more about Scholtens as a doctor and mother than about her patients. They are the foil for her reflections and introspection. I wish there had been more depth to her interactions with the patients than her personal/professional realizations, but perhaps that is a reflection of the clinician's life: they only see such small snippets of their patients that there can't be a depth to their story, because so much of it is missing. I'd recommend the book to women who are caught between a challenging profession and home life, who are seeking direction or "self-help" without wanting a self-help book. The book does give some perspective on what it must be like to be a newly arrived refugee, too.
November 22, 2017
I was hesitant about this book at first and within the first twenty pages I thought I was going to return it because I wasn't feeling it. It may have been because I thought it was written by a man so I had to readjust to that and that I thought the camp was in another country besides Canada. But I really liked it. She was honest about her reaction to certain situations which I appreciated and the way she divided it down by the different ways things needed to be treated and what you need to take into consideration. That it is not a case of infantilizing them or expecting them not to have their own requests or needs (for instance the family who asked their host family not to play basketball after 8). They're human beings and they are in a situation where they need help and no one likes that. The health cuts pissed me off so unfortunately this is happening everywhere. But it was a very good read so I recommend everyone give it a read.
This entire review has been hidden because of spoilers.
January 26, 2018
Martina really opens your heart to the refugee. You "know" all the issues and challenges in your head but sometimes have a hard time making the connection in your heart. Martina does this well, not over dramatizing it. She is honest in her own struggles wrestling with the contrast between our Western lifestyle and the worlds where her patients have come from. The things that we take completely for granted are not givens in other parts of the world. I also appreciate her discussion on the work-mother balance. Highly recommend this book! It will help you to see the plight of the refugee with much more compassion and maybe a bit more understanding. The lines between "them" and "us" are not so distinct.
January 12, 2025
A moving memoir on being a physician for humans seeking refuge. Dr. Scholtens not only shed light on refugees transitioning to life in Canada but also how to approach treating this specific patient population and the adversity that comes with them. I admired how Dr. Scholtens gave account on patient's lives while still protecting their dignity, unique situations, and values. This book was articulate and enlightening for both providers and others interested in public service/public health. Scholtens account was humble and I appreciate the glimpse given to readers on her personal life and challenges that come with being both a mother and provider.
Highly recommend reading this book if you want to be inspired and learn how to meet patients where they are at.
Highly recommend reading this book if you want to be inspired and learn how to meet patients where they are at.
January 10, 2019
Excellent excellent book. The joys, humour, and devastating things this incredible care provider experienced. As my uncle said, a must-read for anyone who provides healthcare to others whether patient is newer Canadian or long-time. Not that it is academic-heavy, but I'm going to work to remember to check my maternalism (speaking down/making assumptions about intelligence based on characteristics, being too proud about...hm, well, not sure). And a reminder of some the unspeakably awful things some refugees have gone through. Chapter 20 was really hard. I'll likely edit this review once I better summarize my learnings. Glad I read it.
December 27, 2018
A soothing, grounding read. As a family doc, I relate to her stories so much. Her accounts of doctoring the refugee population range from comedic culture-clash to grave tragedy. However, a lot of what she writes relates to the general family physician-patient relationship. Reading her words about the peculiarity of what we do refreshes my reverence for the role. The book is just beautifully written. Thanks to my true friend Nat for the gift of this book. We used to read FreshMD together back in our student days. So happy to see Dr. Scholtens use her talent to produce a longer-form piece!
May 27, 2020
Read the book for the MCW Reads group at work. Actually loved it - couldn't put it down once I was into it. Short stories about the interactions a physician has with her patients in a refugee clinic in Canada. A majority of the stories were about Yusef and Junah and their children and I was just drawn in to how things would work out for their family.
I would highly recommend this read for those who are not as familar with the refugee crisis as the author had experiences with a wide range of cultural groups and gave background information on why many of them had to flee their homelands.
I would highly recommend this read for those who are not as familar with the refugee crisis as the author had experiences with a wide range of cultural groups and gave background information on why many of them had to flee their homelands.
January 25, 2021
Interesting, well-written, and personal. Touching when you read the challenges immigrant families face, not only prior to leaving their home country, but as they assimilate in a new country and culture. As a health care professional, and a human, I found myself examining my own attitudes and biases toward people of a different culture, and hopefully this new awareness will increase thoughtfulness and care on my part. I enjoy a book like this that not only entertains, but is thought-provoking as well. 4.5 Stars!
Displaying 1 - 30 of 67 reviews