Your Heart Is the Size of Your Fist

A Doctor Reflects on Ten Years at a Refugee Clinic

By (author): Martina Scholtens
ISBN 9781927366684
Softcover | Publication Date: September 26, 2017
Book Dimensions: 5.5 in x 8.5 in
224 Pages

About the Book

An absorbing and touching read, this collection of true stories is the first book by a Canadian doctor on the topic of refugee health.

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.

About the Author(s)

Martina Scholtens, MD, MPH, CCFP worked for ten years as a family physician at Bridge Refugee Clinic in Vancouver, Canada. Her book about this work, Your Heart Is the Size of Your Fist, was published in 2017. She is a clinical instructor with the Faculty of Medicine at UBC. In addition to clinical work, she has lectured on mixing art and medicine, done extensive advocacy work around federal health insurance for refugees, and acted as a consultant when BC settled 3,000 Syrian refugees in 2016. She is a recipient of the Mimi Divinsky Award for History and Narrative in Family Medicine. She is now doing a psychiatry residency in Victoria, BC, where she lives with her husband and four kids. For more information, visit


“Both an eye-opening account for Canadians wanting to understand the challenges facing refugees and a strong argument for refugee health, including mental health, to receive dedicated treatment and funding . . . . Your Heart Is the Size of Your Fist is also about the person in the white coat: a mother trying to find balance between the personal and professional, an a doctor whose patients expand her notions of what a doctor should be.” —Jade Colbert, Globe and Mail

“Captivating . . . Several stories highlight what being a physician entails, including being a healer, advocate, and educator, and often going above and beyond for your patients. . . . I urge anyone interested in primary care or refugee health, along with anyone who would like an honest view about providing culturally sensitive health care, to give this book a read.” —Yvonne Sin, MD, British Columbia Medical Journal

“This book is all heart.” —Riaz Meghji, Breakfast Television Vancouver

Your Heart Is the Size of Your Fist is a pleasure from start to finish: timely and timeless, intimate and wise, compelling and informative. Scholtens offers an insider’s view of doctoring, powerful stories of refugees creating new lives in North America, and a personal account of balancing motherhood, medicine, and self.” —Louise Aronson, founding co-director, University of California San Francisco Medical Humanities and award-winning author of A History of the Present Illness

“Impressive—a wonderful read but also a deft exploration of multiple current concerns, from how we care for refugees to how doctors balance their professional and personal obligations and care for themselves.” —Marcia Day Childress, Ph.D., Associate Professor of Medical Education, University of Virginia School of Medicine

“Scholtens’ memoir is a transformative exploration of a brave, young doctor from a stable, nurtured environment coming of age in a healthcare system unprepared for this growing and struggling underprivileged group who arrive on Canada’s doorstep with so little in the way of material assets yet so rich in experiences. Skillfully through story, she portrays challenges refugees face when adapting to life in BC and her own frustration with how little she believes she helps them. The reader witnesses her discovery and reaction to stories of wounded survivors, from worlds she can barely conceive. Her loving family she portrays as saving her from delving too far into the trauma that she witnesses. Yet she struggles with the competing demands of motherhood and medicine as the two threaten to merge into one, as mother to mother she celebrates with them.” —Dr. Maureen Mayhew, clinical professor, University of British Columbia School of Population and Public Health

“With her decade of experience with refugees in Canada, Martina brings heart and determination to her patients, as revealed in this book. Sharing the joys and challenges of being a clinician to people whose life experiences differ so much from her own, she writes about dealing with doubts and uncertainty, and cherishing the gifts, concrete and abstract, exchanged between doctor and patient. Skilfully weaving her own story with that of her patients—describing personal loss, challenges to the values of her Dutch Christian upbringing and professional norms—Martina reflects on how she balances her personal life with the demands of her vocation, the need for flexibility in boundaries, and the importance of advocacy when working with marginalized populations. Martina draws us in with vivid stories of doctor–patient exchanges and leaves the reader with a deep appreciation of how humility, curiosity, humour, and good faith can compensate for any deficits in knowledge in cross-cultural interactions.” —Dr. Neil Arya, founder of the Kitchener Waterloo Centre for Family Medicine Refugee Health Clinic

“[Scholtens’] desire to ‘reflect, memorialize, and advocate’ as a writer-physician is fulfilled in this slim volume. A recommended and accessible read for a wide audience.” —Jenny DeGroot, Banner

“[I knew] this would be a book I’d find interesting. What I was not anticipating was that I’d be so compelled by the work as literature, for its shape as a memoir, the glimmer of its prose, and for its depth and richness as memoir. . . . To say that it’s an uplifting and breezy read should not undermine the spiritual weight of Scholtens’ story and its importance—but hopefully it will compel you to read it.” —Kerry Clare, author of Mitzi Bytes

“Personalizes and individualizes refugee journeys through the eyes of their practising physician.” —All Lit Up

“Any attender at St. John’s Vancouver would sooner or later notice a young family of six regularly file in and sit near the front on Sunday morning at 11. Your Heart takes the reader into the life of the mother of this family. From 2005-2015 she ministered as a family physician to refugees whose lives had so often been traumatized by the fist of warfare and unimaginable suffering. Scholtens recounts her story of growing up in an insular Christian Reformed community in BC, how she began university as an English major, but then took a “guided drift” into medicine with no inkling that her vocational love would be for the health and welfare of refugees. In this book we are introduced to, say, a tiny Bedouin woman patient who had grown up in a Syrian desert, or a man from a remote South Asian village with a rare congenital condition, or a Somali man whose arm had been ripped off by an explosive and who now wept at the possibility of a prosthesis. She proves herself adept as an interpreter of other cultures and adjusts her practices to the often-Muslim beliefs of her patients. The Christian reader is grateful for a believer such as Scholtens who puts her faith into practice on the front-line of a global disaster and in doing so reminds us of the commandment to love our neighbour.” —The Anglican Planet

“Recommend it to everyone . . . Working moms, doctors, therapists, immigrants, human beings. There is something here to speak to the heart of any human who lives among humans. This is a beautiful book.” —Realizing Grace blog