Dr. Hassan Hussain grew up in a small village in Uganda. Days were spent barefoot, playing soccer and climbing mango trees with children from a variety of backgrounds. There was no doctor there, just a physician's assistant who didn't know much about medicine.
School, where his dad was headmaster, came easily to the young boy. And although his dad thought his son would become a doctor, neither could envision the high-tech world of Hussain's life today as a Modesto cardiologist specializing in interventional procedures.
"I do coronary tenting. I do peripheral work, angioplasty from heart to foot," Hussain, 51, said. "I put in pacemakers, defibrillators, leads in people with failing hearts, the gamut of all this interventional therapy."
He's come far from his life in Kumi.
"You're talking about a totally carefree life where nothing mattered -- everything was OK -- to one of the most stressful positions you can be in, working on people's hearts and arteries," he said. "Clearly, it's a huge shift for me from where I grew up. I had no idea in my wildest, wildest dreams I'd be doing this stuff. My dad thought I'd become a doctor, but even he didn't foresee all of the intervention stuff that the technology allows us to do today.
Along that road from village child to highly skilled specialist, Hussain became part of African history, discovered the American dream and deepened his faith as a Muslim.
And that faith, especially during the month of Ramadan, which began Aug. 12, guides his work and his life.
From India to Africa
Hussain's family wasn't from Africa originally. "Our forefathers moved from the Indian subcontinent, which was under the British rule at the time, from the east coast of India to the east coast of Africa," he said.
They settled in Mombasa, Kenya, and then part of the family established trading posts as the British built a rail line westward.
"Our family went even further into Uganda and became merchants by trade, selling clothing and other items like that to the local natives," Hussain said. "My father went into the teaching business. He became a teacher and then the headmaster of schools."
Hussain said, with a chuckle, that his parents have told him he was "a very obedient child."
What he mostly remembers is the carefree lifestyle. "There (in Kumi), as our main entertainment, we played outside," he said. "We used to climb the mango trees and play soccer a lot. We had a beautiful childhood. It wasn't restrictive; it was fun. We interacted with all kinds of cultures."
He had African friends, many of whom lived in very poor homes. His own family, he added, was OK financially, neither rich nor poor. It didn't really matter in the village, he said. "No one had cleats and soccer shoes; we all played barefoot. That was the norm there."
Military coup disrupts life
When he was a sophomore in high school, "the big event took place," Hussain said. "Idi Amin came to power."
The dictator took over Uganda in a military coup and was later dubbed the "Butcher of Africa" for the hundreds of thousands of people he killed during his regime.
"My father felt that something was going to happen. He had an inner feeling," Hussain said. "So he decided to leave the teaching industry -- he couldn't go much further anyway -- and move to Nairobi. He went into business for himself."
The move, in July 1972, was a wise one. Just two weeks later, Amin ordered all of Uganda's Asian residents -- the majority of whom were from India, held British passports and had lived there for generations -- out of the country and took over their homes, businesses and other possessions.
Though timely, the move threw Hussain into turmoil.
"My whole life turned upside down," he said. "I was a small-town student going to a huge school. The problem was, I had missed some things that they had already done in school. I went from an excelling student to an average one because my whole career was disrupted."
He finished school and wanted to become a doctor. But at the Nairobi medical school, he said, there were only 103 spots for incoming students; of those, "only three seats were given to non-African students. All of Kenya and Uganda were competing for those."
Then Hussain found a private school, the United States International University. Its main campus was in San Diego with sister campuses in London, Paris, Nairobi and Mexico City.
"I saw a way out of Kenya," Hussain said. "I wanted to go to medical school, and the best education was felt to be in the U.S. My dad was a big proponent in getting the best education you can."
He did a year of undergraduate work in Nairobi and transferred to San Diego.
Hussain landed in New York on March 31, 1978. He was 18 years old.
"I remember that trip very well," he said. "I had my one lonely bag and I was by myself."
He had learned English in Africa.
"Our medium of instruction was always in English. Swahili was the common tongue," he said. "Transferring was not an ordeal from a communication standpoint. From a cultural standpoint, it was a great shock. It was totally a different culture, different people."
Despite the cultural challenges, Hussain completed his bachelor's degree, then did a master's program in psychology in two years.
In 1984, he went to the Medical College of Wisconsin in Milwaukee. He graduated in 1989 and returned to California to complete his residency.
In 1990, his parents and younger sisters emigrated from Kenya. Before leaving, they chose a wife for him, a woman named Fatima from Mombasa.
The arranged marriage, foreign to the Western mind-set, is common in other cultures.
"My parents' and my sisters' good sense narrowed it down," Hussain said. "They said, 'This is the partner we've chosen for you. What do you think?' We've been married 20 years. It worked out very well. We have a beautiful 2-year-old son."
After his residency, Hussain was selected for a fellowship at the University of California at Davis. "My claim to fame is that I was the first foreign fellow hired at UC Davis," he said.
After that, the cardiologist, now a U.S. citizen, worked in Yuba City and Texas before joining Stanislaus Cardiology in Modesto in July 2001.
"They were a nice bunch of guys. It has worked out very well for me," he said.
Faith deepens in years
As Hussain grew in medical knowledge, he was also growing in his faith.
"I was born as a Muslim child, but as I recall, I don't think the understanding of Islam was like it is now," Hussain said. "No one was praying five times a day except for priests or imams or mullahs. As a matter of fact, in the town where I grew up, the mosque was far away, a few miles outside of town."
When he found himself surrounded by a strange culture in San Diego, Hussain said his faith "was a way of finding myself, to discover who I was and what I wanted to be and where I was headed. In my inner core, I believed I was here for a reason and that Mohammed was the last prophet, but my daily practice wasn't committed."
That came later, he said.
"My maturity occurred probably after I got married. I was in my late 20s or early 30s when I became very, very committed," Hussain said.
"I have no anxiety in my life anymore. I do the most horrendous procedures, and it's OK. I know (Allah) will be guiding me. Whatever happens, I know I did the best I could. He is the guider. He is the sustainer. I'm not. It's definitely given me perspective. I'm not the deity that's responsible for any outcome. I'm only the means."
That perspective, he said, means "I have no airs around me. It gives you some humility in life."
His partners, he said, respect his faith. "We have a group of people of very different faiths. It works really well," he said. "I'm astounded at the respect given me as regarding my religious life."
The partners honor one another's religious convictions. For example, Hussain said, there is no alcohol at office parties, nor is it purchased for clients at holiday times.
"We don't pay for it because I cannot buy alcohol," he said. "That would be a no-no for me. We do a seasonal greeting type thing. We just send a general greeting card along with a basket (of non- alcoholic gifts)."
As a Muslim, Hussain also is prohibited from earning or paying interest.
"All my business dealings are interest-free," he said. "I don't have any bank accounts that earn interest. I don't charge my patients interest, either.
"My practice is very much aware that when we buy something, leasing is OK or buying something outright, but we won't buy any equipment in a way that would charge interest. I prefer to use a debit card when I can."
Ramadan changes his focus
Some routines change at his office during Ramadan, where fasting lasts from sun-up to sundown, and when special, additional prayers last until about 11 p.m. The combination means less food and sleep.
"My office staff tends to be concerned about me, so my load tends to be a little bit lighter," Hussain said. "Instead of my usual 20 patients that I would see in a morning or 20 in the afternoon, I would have maybe 15, 16. In the cath lab, I tend to do less cases. Obviously, you do what you have to do. But the focus is on prayer and fasting."
"(Ramadan) is a time for self-reflection. You avoid getting into an argument or reacting to what others say. It teaches you how to be more patient, more calm, more understanding. If you do this every year, you hopefully become a better individual. It spills out of you."
Along with those things, he said, the disciplines of Ramadan tend to make him more efficient. Because he gets up about 4:15 a.m. instead of his usual 5:15, he often gets to the office earlier and doesn't need to set time aside for lunch.
Ramadan includes extra prayers, called tarawih prayers, after the nightly 9:30 p.m. prayer time. These are usually recited at the local mosque with the rest of the congregation. When Hussain is working on-call, he sometimes misses those.
"The patients always come first," he said. "When you're done, you attend to your obligations as far as religious services."
In the years since the Sept. 11 attacks, Hussain said he's experienced no criticism or negative attitudes from patients or other community members regarding his faith. "Patients have come up to me and said they really appreciate what I've said and stand for. It's all been positive. I've never had anyone say, 'I don't want to see you (as a doctor) because of what you believe.'
"I believe we have a tremendous community in that area. There may be something (negative) out there somewhere; I've never experienced it myself."
Bee staff writer Sue Nowicki can be reached at firstname.lastname@example.org or 578-2012.