A Skirt Caught on Fire

Summary

Family Secrets: "A Skirt Caught on Fire"

Podcast: Family Secrets (iHeartPodcasts)
Host: Dani Shapiro
Guest: Dr. Mary Fariba Afseri
Date: July 9, 2026
Runtime: ~63 min

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Episode Overview

In this powerful season finale, host Dani Shapiro welcomes Dr. Mary Fariba Afseri, a Portland-based OBGYN and author of One Woman’s Work. The episode explores how family secrets, legacies of women's health, migration, and the struggle for autonomy echo across generations. Through Mary’s investigation into her family's hidden stories—particularly the death of her maternal grandmother—she both confronts painful inheritances and finds profound purpose in her medical vocation.

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Key Discussion Points & Insights

1. Childhood Memories and Migration

• Early years in Iran and the U.S.:

  • Mary shares fragmented childhood memories from Shiraz, Iran, despite having left as a toddler ([05:04]).
  • Her family, originally from Chicago, returned to Shiraz but left Iran in 1978 amid looming political upheaval ([08:47]).
  • Arrival in California, the challenge of being an Iranian American during the Iranian Hostage Crisis ([08:47]).

• Identity and Assimilation:

  • After incidents of anti-Iranian bullying, her parents change Mary and her brother’s names to blend into American society ([12:14]).
  • Quote:

    “To be told that we were going to be given these names that were going to allow us to fit in was really, really exciting for me. It was a relief.”
    — Mary Afseri ([12:36])

2. Parental Expectations and Following a Path

• The Pressure to Become a Doctor:

  • From a young age, Mary is expected to pursue medicine, despite her creative passions ([14:10]).
  • Quote:

    “My dad knew that about me very early on and tried really, really hard to steer the ship the other direction...It came across as, you’re going to be affirmed for doing well in the areas that he found value in and not necessarily recognized for the areas where I might have been innately drawn to.”
    — Mary Afseri ([14:12])

• Negotiating Family and Self:

  • Mary balances pre-med requirements with her interests in women's studies and creative writing ([20:30]).
  • The struggle for validation:

    “Week after week after week, it felt to me like it didn’t matter what else I was doing and what else I was achieving. My dad had an eye on a prize, which was that I was going to become a doctor. And until I achieved that, nothing else really held a lot of value or a lot of weight to him.”
    — Mary Afseri ([22:51])

  • Profound memory:

    “If you had some other big talent like Picasso, maybe I wouldn’t be so concerned. But if you were to become a doctor, it would grant you lifelong security.”
    — Mary recalling her father’s words ([24:19])

3. Family Lore and Silences

• Missing Stories:
  • Mary’s maternal grandfather was mythologized; her maternal grandmother an “angel” whose death was shrouded in silence ([16:46]).
  • She only learns her grandmother’s name, Marie/Mary, as an adult ([19:16]).
  • Discovery makes her question whether her American name was more than a simple assimilation strategy ([20:13]).

4. Finding Her Own Calling in Medicine

• Medical Training and Burnout:

  • Med school was challenging, and by year three Mary takes a break, spending time in Bolivia working in pediatrics ([29:06]).
  • Sees firsthand the impact of mothers’ lack of autonomy, which catalyzes her move from pediatrics to OB/GYN ([31:48]).
  • Quote:

    “When you care about children and you care about families, you really have to start with the mothers. And I really fell in love with the mothers and decided that that was probably the direction my career was going to go.”
    — Mary Afseri ([31:29])

• The Deeper Story at Work:

  • Mary feels her work is driven by something beyond herself, a sense of ancestral presence ([34:42]).
  • Begins to suspect her grandmother’s death was related to unsafe abortion; starts to investigate ([34:42], [39:25]).

5. Excavating the Grandmothers’ Stories

• Maternal Grandmother – The Secret Death:

  • Family had always believed her grandmother died of a pregnancy-related condition, possibly a stroke ([39:25]).
  • Mary, as an OB/GYN, questions this; her aunt shares a rumor about a drink taken to induce abortion ([43:00]).
  • Mary imaginatively reconstructs her grandmother’s last months ([43:00]):

    “I really wanted to try to imagine what was going through her mind that led her to this decision to drink a drink...In doing that, I hope I’ve given her a little bit of a story back.”
    — Mary Afseri ([44:07])

• Paternal Grandmother – Mental Health and Loss:

  • Father’s mother suffered postpartum psychosis after childbirth and was institutionalized; her father never saw her again—both parents orphaned by maternal losses related to pregnancy ([44:54]).

6. From Heritage to Activism: Building the Mobile Clinic

• The Idea Sparked by Crisis:

  • Deep unease about reproductive rights post-2015; pandemic accelerates thinking about access ([50:47]).
  • Creates a mobile OB/GYN clinic housed in an RV, stripping away the old model and meeting people where they are ([54:27]).

• Mobile Clinic Details:

  • Welcoming, trauma-informed, and designed to fit patients’ needs ([54:27]).
  • Serves urban and rural communities, trauma survivors, neurodivergent individuals, LGBTQ+ patients, and those with complex care histories ([57:31]).
  • Quote:

    “If you are aspirational and you build something aspirational, then you will attract aspirational people. And so our patients are people who actually have other choices. A lot of them do. And they choose to be a part of our community because it is what we are building. It is what is missing. We are actually building community and we’re building a new way of doing things that feels hopeful.”
    — Mary Afseri ([59:10])

7. Personal Motivation and The Power of Bodily Autonomy

• A Patient Asks Why She Does The Work:

  “My parents left their country in order to provide me with a life where my autonomy was protected, valued, supported, even encouraged. And now another version of me, the one that would still be there if my parents hadn’t left, is being shot and killed in the streets for daring to show her hair...This fight for bodily autonomy. It starts with one person, one torment, and if we do not stand for that, it spreads to all of us.”
  — Mary Afseri, reading from her memoir ([60:28])

  • “I only recently learned that my grandmother died as a result of attempting an illegal abortion...We are only as free as each other is free.”
    — Mary Afseri ([61:24])

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Notable Quotes and Moments

• On ancestral connection and purpose:

  “The work that I’ve been doing for the past 20 years as an OB/GYN... flows out of me, and that despite any reservations I might have had about getting into medicine in the past, my career has been this incredible extension of who I feel that I am...there’s not a through line there... That’s why I chose to tell their stories.”
  — Mary Afseri ([32:39])

• On imagination as survival:

  “In investigations they’ve done around burnout, one of the ways to combat burnout is the use of imagination. And I didn’t know that at the time. I just happened to be somebody who lived in my imagination.”
  — Mary Afseri ([41:14])

• On intergenerational trauma:

  “Both of my parents were in essence orphaned by their mothers due to pregnancy related conditions.”
  — Mary Afseri ([47:08])

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Timestamps for Key Segments

• [03:01] — Mary begins: Sensing grandmother’s presence
• [05:04] — Early memories of Iran & migration
• [08:47] — Iranian Hostage Crisis & name changes
• [14:10] — Parental pressure to pursue medicine
• [16:46] — Family storytelling & maternal grandmother’s mystery
• [20:13] — The discovery of her grandmother’s name
• [29:06] — Medical school burnout & Bolivia experience
• [31:48] — Epiphany: working for mothers
• [34:42] — Burnout, ancestry, and listening for family secrets
• [39:25] — Investigating her grandmother’s cause of death
• [43:00] — The likely illegal abortion: reconstructing grandmother’s final months
• [44:54] — Paternal grandmother’s postpartum psychosis and loss
• [50:47] — Arriving at reproductive health activism
• [54:27] — Building and describing the mobile clinic
• [57:31] — Who the mobile clinic serves and why it works
• [60:28] — Mary’s motivation: legacy, autonomy, and kinship

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Tone and Style

The episode weaves together narrative, investigation, and introspection, as Mary and Dani Shapiro speak with candor, warmth, and emotional depth about generational mysteries, loss and resilience, and the ongoing fight for women's agency. The tone is personal, reflective, and quietly urgent, reflecting both sorrow and hope.

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Summary

This episode artfully charts Mary Afseri’s journey from a child navigating dual cultures and expectations to a woman uncovering the silenced trauma in her family’s past and turning those revelations into action. Through medicine—and, crucially, through creative imagination—she confronts intergenerational wounds, reclaiming her grandmothers’ stories, and forging a new path for care that is rooted in empathy, activism, and hope for all women.

Key lesson:

“We are only as free as each other is free.” ([61:24])

Transcript

[Podcast Announcer]

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[Mary Afseri]

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[Kalpen (Kal Penn)]

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[Mary Afseri]

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[Kalpen (Kal Penn)]

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[Commercial Narrator]

Family Secrets is a production of iHeartRadio.

[Mary Afseri]

I see her around, I whisper, and she raises her eyebrows. I don't mention that one day I was going about my life and the next it seemed my grandmother was there. She crept into my thoughts uninvited. While on walks, I felt her drawing me into rose petals, sending me her scent, asking me to listen. When I was at work, in between patient visits, her voice entered my thoughts unexpectedly. I caught myself talking to her in the passenger seat as I drove home. In my quietest moments, the unmarked minutes between tasks, the gray space of life when we are alone with ourselves, it was like she had never left. I think she has something to tell me, I confess. I know it sounds strange, but she has something she needs me to know.

[Dani Shapiro]

That's Dr. Mary Fariba Afseri, Portland, Oregon based board certified OBGYN and author of the recent memoir One Woman's Work. Mary's is a story of a life shaped by forces both known and unknowable. And those unknowable forces, silent, waiting, secret, become the building blocks to an extraordinary undertaking which will in time shape other lives. Buckle up. This is the season finale of Family Secrets and it's an inspiring one. I'm Dani Shapiro and this is Family Secrets. The secrets that are kept from us, the secrets we keep from others, and the secrets we keep from ourselves.

[Interviewer]

Mary, tell me about the landscape of your childhood. Do you have early memories or fragments of your childhood in Iran?

[Mary Afseri]

I was really young when we were in Iran. I was only about 18 months old. We had been moved back to Shiraz after living in Chicago. So I was born in Chicago. My dad finished his medical training and fellowship with the plan of returning back to Iran with me, my brother and my mom when we were in Shiraz. I was only about a year and a half until about I was three years old when we left. And so my memories are the memories of a toddler. If we have any memories. I've confirmed a few of them with my mom. I remember taking walks to a corner store where we would buy candy. I remember having my aunties around who were teenagers when I was a toddler and so I remember playing with them. I remember a mouse coming into the house and everybody jumping up onto beds and squealing and I remember stopping on walks with my mom and talking to Friends who lived in the neighborhood, who, interestingly enough, years later followed my family to California and then lived in the same neighborhood that we did when I was growing up as a kid in California. So it was almost like a transportation of this neighborhood in Shiraz to a neighborhood in Northern California.

[Interviewer]

So interesting. Your first language was Farsi?

[Mary Afseri]

Yes, I believe so. There's a little bit of mixed messages. I know that my mom was mostly speaking Farsi when we were born. She taught herself English living in America. So I think that we were getting mixed Farsi and English just from the time we were born. But my guess is that it was primarily Farsi in the first year. Definitely Farsi when we were in Iran.

[Interviewer]

Where was your mother in the birth

[Mary Afseri]

order with the aunties? My mom is number two, and she had an older brother and a younger sister from the same mother. That's my grandmother, Mehri. There was another baby that was born who was later lost to a childhood death. And then there were a series of two more stepmothers with other children that were born to them. And so eight in total. And my mom was number two in that birth order.

[Interviewer]

And where did your parents meet?

[Mary Afseri]

So this is kind of an interesting story. My mother lost her mom when she was only four years old. And my grandfather was getting remarried for a third time to a woman who happened to be my dad's first cousin. And my dad is 12 years older than my mom, and he was a medical student in Shiraz, and his cousin was getting married to my grandfather on my mother's side. And so my dad would come over to the house at the end of his school days to visit his cousin. And over the course of a few years of that, became very close to my grandfather. And through that relationship, met my mother, who at that point was a child. I mean, she was 12 years old, 13 years old, and he was in his mid-20s, but he was really a beloved part of that family. And when my dad decided that he was going to leave Iran and go do his medical training in Baltimore, he asked for my mom's hand in marriage. And at that point, she was 16 years old.

[Interviewer]

So you and your brother and your parents leave Shiraz in 1978, is that right?

[Dani Shapiro]

Yes.

[Interviewer]

And at that point, you are how old?

[Mary Afseri]

I was 4 years old. that point, the country was under rule of the Shah of Iran, and there was a lot happening politically, and there were sort of the rumblings of an Islamic revolution. There was this knowledge and undercurrent in the country that there was going to be regime change and the knowledge of that led many, many tens of thousands of Iranians to decide to leave the country. There was just too much uncertainty. And there was a great fear that the country that they had lived in, which at that point, there were quite a lot of freedoms. When we look back at photos, it's unrecognizable in the sense of the photos that people see coming out of Iran in the last few decades. My mother was completely dressed like a regular European or American teenager, wearing short skirts and long hair. The men and the women were allowed to mingle. There was a lot of education on both sides, incredible relationships with the US as far as education goes, and science and medicine. And that's how my dad got recruited for Johns Hopkins, was through a relationship like that. So this undercurrent that that was going to go away and theocratic Islamic regime was going to take over the country. My parents, with two young children who had already lived in the United States and knew what the US had to offer us, made the decision to leave and to come back to the US with us. 1979, 1980 was a really interesting time to be Iranian American in this country. The hostage Crisis began on November 4, 1979, which I always remembered because it was my mother's birthday. And my parents, like a lot of families, had the TV turned on to the news. And so day in, day out, we were watching these scenes come out of Iran. The hostages, Americans bound and gagged. The countdown every single day of the hostage crisis. And I was a kindergartener at the time in this upper middle class suburb in California that was actually not very diverse. I was surprised that there were any other Iranians in that school. But one day when we were going out to recess, I watched as two second graders sort of hunted down a little boy named Amir, who I was just vaguely familiar with. But they pinned him to the ground and they were reenacting what they had seen on TV with the hostages, calling him their hostage. Now I went home and I told my mother the story. And my mom, for as young as she was and pretty recent to the country, was always a fierce advocate of children and of us. And she ended up going to the school. And the way that I look back on it is I don't know what the conversations were, but I know there were conversations. And I saw her speaking in Farsi with Amir's family, and I saw her being able to translate with the school what had happened. And I think it probably occurred to her at that time that her children were now being put in A similar position. We had Persian names that we had been given at birth, and that's what we were being called. And one night she and my dad sat us down to tell us that they had made a decision to change our first names.

[Dani Shapiro]

Mary's name had been Fariba, and her brother's name had been Farshid. Their mother asks them if they've heard of the American folk group Peter, Paul and Mary. These were good, solid American names. So Fariba became Mary, and Farshid would now be known as Peter.

[Mary Afseri]

I was pretty excited to have my name changed. It's a mouthful today for people to say Fariba Afseri back then to show up in kindergarten. I already felt a little bit different. We ate Persian food. We had relatives that were coming over in droves from Iran and sleeping under our piano. And I knew that our house looked very different than a lot of the houses in our town. And so to be told that we were going to be given these names that were going to allow us to fit in was really, really exciting for me. It was a relief. And I think that my brother felt the same way. I wanted to fit in as a kid, and I really believe that my parents wanted to make sure that we fit in. They had accents, so no matter how well educated they were. My dad was a physician. My mom went on to become a psychologist with a doctorate in psychology. No matter how educated they became, they also recognized that. That just by the sheer accent that they will never be able to fully shed. They were maybe viewed differently in certain situations. And it was really, really important to them that we didn't face any obstacles in terms of our ability to achieve the American dream, which is why most immigrants leave their countries and come to the United States.

[Interviewer]

And in pursuit of that American dream. How early did you get the memoir that you were supposed to grow up and become a doctor?

[Mary Afseri]

That was very early.

[Interviewer]

I had a feeling.

[Mary Afseri]

Yeah, I mean, I think that it was really clear to me because it was so not the type of kid that I was. If you want to imagine the prototype or the stereotype of a kid who grows up to do really well in sciences and then becomes a successful pre medical student and then goes on to medical school, I was not that kid. I mean, I was ahead in the clouds. I was always an imaginative, kind of writer, dreamer type. And my dad knew that about me very, very early on and tried really, really hard to steer the ship the other direction. I appreciate the fact that I had a father that was really invested in my success who believed that I could actually grow up to be anything that I wanted to be. And I have to say that over the years I've learned that's not always the case. And a lot of people find me extremely fortunate. And I agree. To have a father who spent so much time trying to make sure that I was going to do well in school. The ways that he sort of hyper emphasized my shortcomings and things like math and underemphasized the areas that I really showed talent in, such as, you know, poetry, when I was even just as young as 8 or 9 years old. So it came across as, you're going to be affirmed for doing well in the areas that he found value in and not necessarily recognized for the areas where I might have been innately drawn to. And you know, I'm a mother now and I can kind of feel the tension in that, that your kids come into this world and if you're paying attention, it's pretty clear that kids come into the world with, with different propensities. And I can see that in my two children with very, very different propensities from the time they were very young. And so the idea that the things that I loved and cared about were not necessarily valued, I found that to be a little bit painful and difficult as I started to grow older, you know, into my teenage years and my college years.

[Interviewer]

And what did you know about your parents families? What did you know about where they had come from and who their parents had been? How much was that kind of storytelling part of your lives as a family, you know, once you were here in the States?

[Mary Afseri]

I feel like there were five stories that just were on repeat my whole childhood. So there was a story about my mother's father, my grandfather, who was still alive up until I was in college. We didn't see him until I was in college. He was able to make one visit and then he passed away shortly after. But he was this larger than life, you know, landowner in Iran who wore Armani suits and drove his jeep around the property. And so it was a little bit of a two dimensional picture of this grandfatherly figure who I never had a relationship with, but who was somebody that my mother was deeply, deeply attached to and in love with and who she left in order to come to the United States. The flip side of it was that she had lost her mother as a child. She was only four years old. And my grandmother died and that story was completely unknown. So why did she die? How did she die? What were the circumstances around that? That was not something that we Ever talked about. I don't think I even asked questions about it until a certain point in my life. As a kid, my mom would refer to her mother as her fairy godmother. And that's how I grew up thinking about her. That she had this angel that was looking out for her, and weren't we lucky that she had this special angel looking out for us. And anytime anything remotely, you know, scary might happen. She had a few health scares that she came out of. It was always thanking her fairy godmother for getting her through. And that, to me, was my grandmother. She was an ethereal figure kind of floating around, keeping an eye on us, but there was really no information about her. It felt like a void. It just felt like a hole in the history of our lives. Because my dad would talk about his life, and he also had these rich, super tragic stories from his childhood around both of his parents, who he also lost pretty young as a teenager. But those stories had depth to them. Like, I could feel and see his mother and his father, and I could feel and see my maternal grandfather, but my maternal grandmother was a ghost.

[Interviewer]

Did you know her name?

[Mary Afseri]

I didn't learn her name until my late 20s. And it came as a complete surprise to me. I was back at home from living across the country, and I was going through old photos with my mom. You know, one of those moments, we're on the floor, and somebody had given her a box of pictures that they had retrieved from Iran. So these photos hadn't been seen in almost 30 years. And so we're going through all these black and whites, and then I pulled out a picture of somebody that looked like it must be her mother. It looked exactly like my mom. And so I asked about it, and my mom said, yeah, that is your grandmother Marie. And that moment just completely floored me, because up until then, I had no idea that my grandmother's name had essentially been Mary, which is what my name had been changed to.

[Interviewer]

So this was not a Peter, Paul, and Mary situation, or was it. Was your mother. Was this buried so much for your mother that. That it's possible that your mother decided to name you Mary in kindergarten without thinking about the parallel to her guardian angel?

[Mary Afseri]

Well, at the time, when I saw the picture and she said the name Mary, and I asked if that was her name, my mom said, yeah, that's why I named you Mary. I thought you knew that. So I assumed that that connection had been made when I was five. But it was never, ever explained to me. I think it's a pretty Common immigrant kid move to walk the family line and then also have side quests where you're actually pursuing things that you also want to be doing. And I will just say I did that my entire life. So I was a very good student. And then when I went to college, I took all of the pre medical undergraduate requirements just in case I decided to apply to medical school. And also probably to appease my dad. So he knew I was taking all of the classes. But I was also a women's studies major and I was also doing a lot of creative writing and I wanted to travel. There was a lot of other things that I had imagined myself being and doing, but I did complete what I needed to complete for medical school in the case that I should decide to do that. And I did well enough in those courses. I did take some time after college and I moved to Boston. I was accepted to a program, the Public Health and Communications program. And for me it's just the perfect metaphor for who I was trying to be in my life. I'm going to go to this medical school program and so maybe that'll appease my dad for a little bit. But I'm really going to study some things that I care about around public health and public relations and campaigning. And I did that. And I had this very rich experience in Boston. I did an Albert Schweitzer fellowship. I was developing programs in underserved communities. I was very serious about martial arts, getting a black belt and Shotokan karate. I mean, I was a pretty focused young person. I got a really good job after graduate school working for a nonprofit that was affiliated with Harvard and traveling and developing programs. So I felt like I was doing pretty well for, you know, a 25 year old who was still trying to decide what my sort of lifelong career was going to be. And yet there were these weekly phone calls home and week after week after week, it felt to me like it didn't matter what else I was doing and what else I was achieving. You know, my dad had an eye on a prize, which was that I was going to become a doctor. And until I achieved that, nothing else really held a lot of value or a lot of weight to him.

[Interviewer]

Was that true of your brother too?

[Mary Afseri]

Yeah, my brother had similar pressures put on him and he was similarly on a winding road in his 20s.

[Interviewer]

Also to become a doctor.

[Mary Afseri]

Also to become a doctor, yes. I'll just say, to be fair, you know, my dad absolutely loves being a physician. He has been an incredible physician, is an incredible entire life. He's 85 years old. He was forced to retire because of a medical condition just three years ago. He is an infectious disease doc who went to his office every single day during the COVID pandemic, even in the early days when we didn't know what was happening. And he was in his late 70s when he was doing that. So he was aware, and we were aware that he was putting his own health and life at risk and believed very strongly that that's what he was put here to do. So very much a man who followed his passion and his life has been an example of that. And I think he just very, very strongly believes that if that is something that you can achieve in your life, why wouldn't you? And he wanted that for me, whether or not it was the right path for me or not yet to be determined. There was a moment I flew out to meet them on a one week vacation. They were going to Paris and I was in Boston, so it was really accessible for me to go meet them. And we had this moment when I was 26 years old walking through the Picasso Museum. And we sat on a bench afterwards. And again he was asking me, what are you going to do with your life? And when are you going to get serious about your life? And all I could really think about was that I had been pretty serious about the things that I had chosen so to commit to up until that point. But what he was talking about was medical school. And he said a line that stuck with me where he said, well, you know, if you had some other big talent like Picasso, maybe I wouldn't be so concerned. But if you were to become a doctor, it would grant you lifelong security. And one of the reasons that line stuck with me, not just because it hurts for your father to think you may not have a talent or an ability to do something else, but I wanted to make sure that if I did choose to become a doctor, that I didn't do it for those reasons. So it became actually like an oppositional force in me to make sure that I made the decision based on something inside of me that felt like it was the right choice.

[Interviewer]

That makes so much sense that, in other words, it needed to become, for you, a kind of calling in the way that, you know, in a different way, but you know that you had witnessed your father experience being a physician as a calling.

[Mary Afseri]

Yes, for sure.

[Dani Shapiro]

We'll be back in a moment with more family secrets.

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[Kalpen (Kal Penn)]

hey everyone, it's Cal Penn, host of Irsay The Audible and iHeart Audiobook Club. This week on the podcast I'm sitting down with Wil Wheaton, who played Gordie Lachance in stand by me 40 years ago and now narrates Stephen King's the Body, the novella that inspired it all. We talk about what it's like to return to a story that shaped his life, channeling his memories of River Phoenix in the recording booth, and why the friendships you have at 12 might be the most important ones you'll ever have. I know Gordie Lachance. I am Gordy Lachance. Like, I mean, even when I was a little kid, I was Gordy Lachance when I didn't know it. Listen to Hearsay, the Audible and iHeart audiobook club on the iHeartradio app or wherever you get your podcasts.

[Commercial Narrator]

Hey, it's Ryan Reynolds here from Mint Mobile.

[Mary Afseri]

Now.

[Kalpen (Kal Penn)]

I was looking for fun ways to tell you that Mint's offer of unlimited premium wireless for $15 a month is back. So I thought it would be fun if we made $15 bills, but it turns out that's very illegal. So there goes my big idea for the commercial. Give it a [e-mail] switch upfront payment

[Mary Afseri]

of $45 for three months, $90 for six months or $180 for a 12 month plan required $15 per month equivalent to taxes and fees. Extra initial plan term only greater than 50 gigabytes. Me slow when network is busy, see

[Commercial Narrator]

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[Dani Shapiro]

Mary does go to medical school, and she is doing it for the right reasons. But by her third year, the wings of her free spirit are feeling a bit clipped. She's losing sight of who she is. She feels caged in.

[Mary Afseri]

There's a lot of classwork and there was a lot of studying. I was really committed to it. But by the time I got to my third year, I went to one of the deans at the school, and I pretty much was like, you need to bust me out of here for at least a month or so. Like, I kind of need to regain, like, that sense of who I am and why I am doing this in the first place. And I'm so lucky that I had somebody who supported me in that, because it wasn't really allowed at that time. But he helped me apply for a scholarship program, and when I got accepted, I was able to choose to go to a certain country and spend a month doing a rotation. And at that point, I was really interested in pediatrics. And so I chose to do a pediatrics rotation in Bolivia for one month. The thing with doing pediatrics, especially in a country like Bolivia at the time, this was in 2005, is you are just seeing 20, 30, 40, 50 mothers a day with their babies, as well as all the other children that they have to bring in tow for their appointments. And I was doing this type of work in clinics that were in the mountains as well as in the cities. We were going to orphanages. And one day we ended up in a clinic that was in the jungle. And there was a real awareness that was starting to build to me that these women did not necessarily have control over how many babies they had. And as a result, they would end up with 7, 10, 12, 15 children over the course of that many years. And there was a lack of resources. Sometimes one child would die at the age of seven because they got sick, and there was nobody to take care of that one child. So what these women were experiencing over and over again became very clear to me. And in this one hospital, that was a Catholic hospital, and so technically, we were not supposed to be providing birth control. There was an OB GYN who had taken upon it himself to actually place IUDs in women that they were buying on the black market, bringing in. In their purses, and the curtains were drawn. We never wrote a note, we never took names. And he was just putting IUDs in this woman, cutting the strings extremely short so that even their husbands may not be aware that they had had birth control placed. And that rotation, it was one week in that clinic. It really flipped the script for me, where I started to become aware that when you care about children and you care about families, you really have to start with the mothers. And I really fell in love with the mothers and decided that that was probably the direction my career was going to go.

[Kalpen (Kal Penn)]

Well.

[Interviewer]

And one of the things that I find so moving about your story is that that would be enough. I mean, that would be enough of a reason for the switch flipping. But there was also something happening that you were not conscious of, that, you know, I mean, on this podcast, we often end up talking about the secrets we keep from ourselves. This was both a secret that was kept from you and in a way, like a secret that somehow your unconscious knew, which is that there was this tremendous family history on both sides. Your grandmother Mary, and on your father's side as well, that had to do with that kind of precarious. What can happen to women who are really exactly in that situation that those women in Bolivia were in.

[Mary Afseri]

Yeah, I've never really said this out loud, but I will say that the work that I've been doing for the past 20 years as an OB GYN, which is bearing witness with women during childbirth, also being with mothers when they experience tremendous loss, and also being put in the position of potentially saving a mother's life when something goes wrong, as it can very quickly in obstetrics. The part that I think I haven't said out loud is that I was meant to do this work, that this work flows out of me, and that despite any reservations I might have had about getting into medicine in the past, my career has been this incredible extension of who I feel that I am. And it is hard to deny now that I've come to truly investigate and understand where I come from, both of my grandmothers, and what they experienced. It's hard for me to deny that there's not a through line there. And that's why I chose to tell their stories.

[Dani Shapiro]

Something else happens while Mary is in Bolivia. She meets Keith, who will eventually become her husband. She returns to the States, graduates medical school, and while still early in her career, she becomes a mother. This is a rarity in her profession. She is only permitted to take maternity leave if she'll make up the time on the other side, as these very busy, intense years tick by, characterized by harrowing work, sleep deprivation, and now two young children at home, Mary is increasingly feeling burnt out. And running parallel to this burnout is another story, a deeper story she's only just beginning to know and decipher.

[Mary Afseri]

I was about 10 years into my career, and 10 years is a point where when you've been really grinding to build a private practice, which is what I was doing, I was in a small community practice. There were just three doctors. We were seeing all the pregnant women, we were doing all the gynecologic surgeries. I was getting called in in the middle of the night to deliver babies. There's an emergency, an emergency room. And then I had my own children at home who at that time were, you know, four, six, seven years old, two of them. And trying to manage all of that, which is a pretty common story for most doctors. I was hitting a point where I could feel myself starting to what we call burnout in the physician sense. A lot of reasons for it, and I would say in mine, there was a lot of sleep deprivation and just a lot of facing patient situations where I think I thought I was going to have more control over and realizing that there are systemic obstacles to being able to do all the things that you want to do as a doctor. And so I was in a particularly challenging situation with a very young preteen patient who had become pregnant and spent almost a year taking care of her and going through her whole experience of delivery and postpartum. And as I was going through all of this, recognizing my challenges, feeling the obstacles, being sleep deprived, trying to be a mother, it dawned on me that there was some drive within me that was keeping me going that felt disproportionate to just a job. And people would ask me, they would say, like, why are you working this hard? Or what is it that keeps you going? And seeing this many patients, and why is it that you haven't taken a one week vacation? And I did sort of feel like there was something that was pushing me that felt a little bit beyond myself. And I wanted to learn to understand that because it didn't feel good. And I wanted to be able to maintain the work that I was doing, but to do it in a healthier balance. And for somebody that's sort of grounded in the medical world, I also come from a background, maybe in a heritage that also believes in probably something bigger than us that exists. And I started to feel this presence of my maternal grandmother. She just Sort of arrived in a way where I was starting to wonder about her, think about her. I had remembered that I was named for her. And it dawned on me that at one point, somebody had told me that she was pregnant when she died and was 26 years old when she died. And so at this point, 10 years into my career, I realized that if anybody could understand why she had died in the family, that person was probably me. I was the expert. I was the ob. And nobody had spoken to me or even in front of me about the fact that it was a pregnancy related death. And that's when I started to ask my family members if anybody knew how she had died. And I got few answers. My dad, who's the medical expert of the family up until that point, felt that she had probably had some condition that led to high blood pressures, that led to a stroke. And these are things that can happen. Women do develop high blood pressure. They do become preeclamptic or eclamptic. Women do die in childbirth due to these things. But it was her fifth pregnancy, and I just wasn't sure if that was exactly the reason. And we didn't have medical records, and my dad wasn't there. And so I started to realize that he probably didn't have the whole story. And so I was asking my auntie and my uncle, who were children at the time, they had lost their mother. And it was my aunt, who still lives in Iran, who had just the tiniest little bit of information that she had gleaned from the women that lived in the town, what they had shared with her. And she shared that with me. And that led me on this investigation around what I think probably actually killed her.

[Interviewer]

And was your mother a part of that search, or did you not speak to your mother about it?

[Mary Afseri]

You know, everybody was always in the room when I would ask the questions. And there seemed to be just an acceptance that something in the pregnancy had killed her. So for me, the idea that she died while she was pregnant, possibly of a stroke, possibly of high blood pressure, it's a very dramatic story. The moment that they realized that she was very sick and dying, it involved a bonfire and her skirt catching on fire and being carried away from a party. And all of those details in my mind became clinical details. So it was an investigation into how would a pregnant woman end up with a skirt caught on fire, being lifted up and carried down the driveway, which that is something my mom and her older brother did remember. That was the detail they carried forward with them.

[Interviewer]

You know what's striking me Right now, listening to you, is that it's this combination of your gifts that allowed you to actually really do that excavation. Because, yes, you had the clinical knowledge and therefore, like, knew the questions to ask. And, you know, you weren't entirely satisfied with the answers that you had received. But you also had this creative and spiritual connection to Mary, where, in a way, she became a kind of guardian angel for you, the way that your mother had described her being for your mother. And so you were filling in the pieces of her story and of what happened to her, both in a medical, forensic way and a journalistic way and also a kind of poetic way.

[Mary Afseri]

Yeah. You know, interestingly, in investigations, they've done around burnout. One of the ways to combat burnout is the use of imagination. And I didn't know that at the time. I just happened to be somebody who lived in my imagination. But at that time, Mehri became like my buddy. In this moment in time, when I felt very alone, I couldn't really relate with my peers and my friends because everybody had young children. But then I felt like I lived this double life in the hospital, sort of experiencing things that it was really hard for me to talk about on the playground later when I would go to pick up my children. And so, in some ways, I sort of bridged that gap. And this story of my grandmother came into play. And once I had an idea about how she might have died, I really started to think more and more about what might have led her to the decisions that she made in the last six months of her life. And those decisions kept me going, really thinking about what it is that women face, what happens when women don't feel like they have agency in their lives, similar to what was happening in Bolivia, similar to what's happening in other parts of the world, similar to what we were starting to feel in our own country. And so that became more and more of the fulfillment of my purpose was understanding what happens to women in those circumstances. And she was my moral conscience.

[Interviewer]

Can you talk a little bit about those last six months of her life?

[Mary Afseri]

Yeah, I talk about them realistically in the sense that the details are made up. I imagined the details. My aunt, who pulled me aside one night when I was asking my mom and my uncle and my dad what had happened, she stepped outside, she was smoking cigarettes, and we were standing on the driveway. And she told me that what she had heard is that at some point my grandmother had become pregnant again, and it was her fifth pregnancy in six years, and had drank a drink, and the drink was intended to end the pregnancy. And somewhere along the way, after drinking the drink, that is when she got tragically, you know, super, super sick, probably septic, and ended up dying. So she died, and obviously the baby she was carrying died. And what I did in trying to imagine those months leading up to her death was I really wanted to try to imagine what was going through her mind that led her to this decision to drink a drink. And how did she even know that that was an option? And what did that look like and feel like in 1950s Iran, where obviously this was illegal. And so I recreated those scenes from my mind. And I think in doing that, I hope I've given her a little bit of a story back.

[Dani Shapiro]

And then there's also the story of her paternal grandmother. Her father had always been forthcoming about the painful loss in his childhood and that he didn't grow up with his mother. But Mary learns there's more to it.

[Mary Afseri]

My father is a great storyteller, and I knew there was a pretty dramatic story of when he was 12 years old, he had had a baby sister that had just been born, and his father handed him the baby and put him in a taxi cab. And this is in Tehran at the time, this is in iran in the 1940s, and had him go to the police station and he was instructed to tell the police that he had found a baby on the sidewalk. Even though it was his baby sister, he was not allowed to tell them that. And so over the years, my dad had sort of shared bits of that story. I mean, I think he waited until we were old enough to absorb it. And it was always a very difficult story for him to tell. He would become choked up even to this day telling that story because he lost his sister that day. It wasn't until I started looking into the Mehri story that I wanted to understand the background to why it was he was given his baby sister. And what he shared with me is that his mother, after delivering that baby, she had already had signs of depression, sort of his whole childhood. It wasn't a great childhood, but she experienced very severe postpartum psychosis. And his father recognized that she was not mentally well or stable to take care of the children. And she was admitted to a psychiatric hospital right after she gave birth. And interestingly, you know, she stayed in the hospital for a while. And, you know, these stories that we hear feel like fiction. And it's actually our parents lives. His dad now had a few children that he didn't know how to take care of without a mother. And so he went and remarried rather quickly while my dad's mother was admitted and so she didn't have a home to come back to. So even once she had recovered to the point where she could leave the hospital, she never returned back to her own family and she ended up going and staying and working and being a nanny for another family. And my dad never saw his mother again. So both of my parents were in essence orphaned by their mothers due to pregnancy related conditions.

[Dani Shapiro]

We'll be right back.

[Podcast Announcer]

Nix that's Knix Leak proof underwear isn't just for one moment, it's for all the everyday moments you didn't realize leak proof underwear could make easier Maybe it's day one of your period, maybe it's a long travel day, maybe it's hot outside, you're on the move and you just want to feel fresh. Their leak proof underwear comes in a range of absorbencies from light to ultra and helps protect against periods, light leaks, sweat, and everyday surprises. And because they look and feel like real underwear, they're soft, invisible under clothes and machine washable. No extra hassle, no complicated routine, just dependable protection you can wash and rewear. See why millions have made the switch to leak proof underwear? Visit nix.com that's knix.com and use code flow15 for 15 off. That's kn I X.com code flow15

[Kalpen (Kal Penn)]

hey everyone, it's Cal Penn, host of Irsay The Audible and iHeart Audiobook Club. This week on the podcast I'm sitting down with Wil Wheaton, who played Gordie Lachance in stand by me 40 years ago and now narrates Stephen King's the Body, the novella that inspired it all. We talk about what it's like to return to a story that shaped his life, channeling his memories of River Phoenix in the recording booth and why the friendships you have at 12 might be the most important ones you'll ever have. I know Gordy Lachance. I am Gordy La Chance. Like, I mean, even when I was a little kid, I was Gordy la Chance when I didn't know it. Listen to Earsay the Audible and iHeart Audiobook Club on the iHeartradio app or wherever you get your podcasts.

[Mary Afseri]

A burst pipe, A dead water heater, The AC calling it quits. Who do you call? Homeserve is an easy way to handle unexpected home repairs with plans covering stuff basic homeowners insurance usually won't Instead of scrambling for a contractor, you make one call to get the repair process started. Join the millions of customers. Customers who trust home serve right now go to homeserve.com podcast for 50 less your first year. That's homeserve.com podcast savings compared to renewal price void in Florida. This is Bethany Frankel from Just Be with Bethany Frankel.

[Interviewer]

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[Mary Afseri]

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[Dani Shapiro]

Her grandmother Mary's story, Afsar's story. It's all beginning to make sense. Mary's calling, Mary's haunting. Her family's past and her present are moving closer together now and create a powerful need for change. Dreams, visions that result in big, bold moves require some combination of grace and grit. Mary has both.

[Mary Afseri]

I can say that those of us that work in reproductive health started becoming increasingly uncomfortable back in 2015. We could sort of see what was happening and you could predict that there were, you know, mechanisms being put into place that were going to slowly and then maybe rapidly strip away access to reproductive health care and rights and, you know, policies and laws that we took for granted. And so it was way back then that I started reimagining the way that we might have to provide care for women and for anybody that wanted reproductive health care. The idea that somebody would show up to my practice as a drug rep and just stock our shelves with birth control pills and IUDs. It dawned on me that there was a really good chance that that might go away. And I'm in Oregon and I felt more protected. But I did start to think about what would happen in other states and would there be a way for us to be able to provide women with care in areas where they weren't able to receive that kind of care. It really felt like that care was probably going to go away. And all of this careened into the pandemic and just a restructuring in general of the way that healthcare was being provided. And my desire to come up with a model where we could actually take ourselves where people needed care. Rather than asking people to follow this very old school model of go to where your doctor is, no matter where your doctor is, find a way to get There. And the pandemic sort of accelerated this notion for me of how little we are doing for people in communities that have difficulty accessing care. So even those of us in cities. Do you remember the days when you needed to get a PCR COVID test and you had to drive to a parking lot and sit in line and then get a nasal swab out of your car? And we were doing it sitting next to the sick family member and putting ourselves at increased risk to get PCR tested. And then I would look around and the Amazon trucks and the instacarts were just delivering food and toys and, you know, treats to houses all over my neighborhood. And I got this notion of, you know, what could I do to provide more mobile care? Is it possible that we can take ourselves to where people are rather than asking them to come to us? And I had this daydream of a mobile clinic, something that would house an exam room and something where I could take myself, because I know that I can provide excellent, specialized obstetric care and gynecologic care. I could take somebody that is a medical assistant who also does blood draws. I could have an ultrasound machine. We could do any kind of procedure in the back of an RV that I could do in my office. I knew that we could do that. And so the seed was planted. And I started by actually driving around and doing PCR tests in my town for people, letting them know they could come out onto their front porches and I could do the swabs, send them off to a lab, bill their insurance, and they never had to leave their homes. And then it turned into this full fledged mobile clinic that we've been running now for four years.

[Interviewer]

Can you describe the RV and this mobile clinic?

[Mary Afseri]

It's a 31 foot camper RV purchased at camping World, except that I used a hairdryer and a ladder and I peeled all those red, white and blue decals off one winter in order to then be able to put an actual name of a clinic and a logo on the outside. But for the first year we didn't have that. And these incredible patients showed up anyways and trusted that they were coming to a clinic, because that's how we advertised ourselves on social media and through our website. So the way the clinic looks now is you approach it. It's a RV that has just, you know, a little bit of signage on the outside, a little bit of instructions about waiting in your car. We'll text you when you're ready for you, because we just see one patient at a Time inside. And when you step inside, for me, it is this idealized version of how we could be providing care. We close the door behind us, we lock the door. My best friend, who's a seamstress, made the curtains on the inside. There's usually some light music playing. There's the regular couch that you see when you walk into an RV that's just still there. And our patient sits on the couch. And I like to sit on a little stool so I'm pretty low to the ground so we can be face to face. And Laura, my medical assistant, is seated at the little kitchen table and she has her computer there. We have blood draw supplies. We have a microwave to pop popcorn. We have the sterilization equipment and all of the medical equipment that I had in my normal gynecologic office. In the back of the RV where you would normally have the queen size bed, we ripped that out. And we have an exam bed and we have an ultrasound machine and we have a bathroom and we have a curtain. And so we start out into the front. And then for anybody that needs an exam, whatever it is we're doing, we move on into the back. And they get undressed and we do exams. I place IUDs, I remove IUDs, I do biopsies. We do colposcopies for abnormal pap smears. We do free ultrasounds for people in their first trimester of pregnancy so we can confirm whether or not they have a healthy first trimester pregnancy or not. And all of that is being done in this vehicle that we can pop open, close up, and drive away. And our locations can be in parking lots. One of my favorite locations is in a little bit of more of a rural community where every week we park in front of a barn. We are on a country road. If you looked it out on a map, you would think that you were literally just driving onto a field. But when you arrive, our clinic is there and we're there to greet you.

[Interviewer]

What do the patients who find you? I mean, I feel my whole body feeling relief that this exists just with us talking.

[Kohler Cast Iron Ambassador]

Right.

[Interviewer]

So how do you experience your patients differently than in the old setting? And who comes to you?

[Mary Afseri]

When I started telling people that I was going to do this, there were a lot of questions about who is going to go see their gynecologist in a parking lot in an rv. And I didn't have that same doubt about women being willing to come to a place once we established that it was a safe place and it was a place where they were going to receive care that they could trust. And so when we originally built the clinic, we made it very clear that we were providing trauma informed care, that this was a safe place for people who had possibly experienced medical trauma in a hospital or clinic setting, or for folks who had had sexual trauma where going to a doctor was excruciating, that maybe doing it in a different setting would feel safer to them. I initially thought that the point of the clinic was to get out into communities that didn't have doctors. But we are just as busy in our urban centers as, as we are in our rural centers, because folks who are neurodivergent who have a hard time accessing large facilities, we have folks who are coming out as trans and need gender affirming care. It's very uncomfortable in certain waiting rooms. If this is the first part or the early part of your process. We have a lot of women who experience infertility or maybe they're undergoing a miscarriage or they've had multiple miscarriages, and sitting in a traditional OB waiting room with expectant mothers is really difficult for them as well. So it's this alternative space where you pull up in a car and when you walk into that clinic, I have to say, the clinic becomes your clinic. It becomes what it is that you need, because we're actually there to serve that purpose. I think the fact that we are willing to create something different has inspired our patients to believe that they are a part of something that is larger than themselves. And I think that if you are aspirational and you build something aspirational, then you will attract aspirational people. And so our patients are people who actually have other choices. A lot of them do. And they choose to be a part of our community because it is what we are building. It is what is missing. We are actually building community and we're building a new way of doing things that feels hopeful.

[Dani Shapiro]

In her beautiful book, Mary describes a moment in which, regarding the work she's doing, a patient asks, do you have a personal motivation? Here's Mary reading her answer.

[Mary Afseri]

I paused.

[Interviewer]

Hmm.

[Mary Afseri]

Nobody has really asked me that before. I'm curious. They responded because there are a lot of doctors not wanting to provide this care right now. Well, I started slowly and closed my computer on my lap. I wanted to make sure I really said this correctly. Truthfully, I can't speak for anybody else, but I know this much. For me, my eyes drifted to the tattoo on my forearm. My parents left their country in order to provide me with a life where my autonomy was protected, valued, supported, even encouraged. I continued. And now another version of me, the one that would still be there if my parents hadn't left, is being shot and killed in the streets for daring to show her hair. I listened to my own voice. I had never explained this before. This fight for bodily autonomy. It starts with one person, one torment, and if we do not stand for that, it spreads to all of us. I thought for a moment, then continued. I only recently learned that my grandmother died as a ra result of attempting an illegal abortion. She left behind four young children. How different might things have been for her? For my family, we are only as free as each other is free.

[Dani Shapiro]

Family Secrets is a production of iHeartradio. Molly Zakur is the story editor and Dylan Fagan is the executive producer. If you have a family secret you'd like to share, please leave us a voicemail and your story could appear on an upcoming episode. Our number is 1-888-SECRET-0. That's the number zero. You can also find me on Instagram, Annie Writer and if you'd like to know more about the story that inspired this podcast, check out my memoir, Inheritance.

[Mary Afseri]

For more podcasts from iHeartRadio, visit the

[Commercial Narrator]

iHeartRadio app, Apple Podcasts, or wherever you

[Kalpen (Kal Penn)]

listen to your favorite shows. If you're a lineman in charge of

[Commercial Narrator]

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[Kalpen (Kal Penn)]

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[Kalpen (Kal Penn)]

Call 1-800-GRAINGER clickgrainger.com or just stop by

[Commercial Narrator]

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[Kohler Cast Iron Ambassador]

When Kohler, global design leader and luxurious kitchen and bath products, asked me to be their ambassador for timeless, elegant, durable cast iron, I said I'm in. Soon after I was in their Kohler Wisconsin foundry watching molten iron poured enamel applied by hand and the beautiful finished pieces ready to ship. Since 1883, Kohler cast iron has been crafted by incredible artisans and seeing it firsthand gave me a whole new appreciation for their craftsmanship. Now I am proud to lend my stamp of approval to my favorite Kohler cast iron products for their durability, beauty and enduring style. Shop my curated [e-mail] as the Kohler Cast Iron Ambassador, I say long live Cast iron.

[Mary Afseri]

This is Dr. Laurie Santos from the Happiness Lab and this message is brought to you by Simple Mills. Simple Mills packs nutrient dense ingredients into snacks that taste amazing like their cheesy light and airy pop' Ems or their five different delicious flavors of almond flour crackers lifting you up, never weighing you down, so you can keep shining through the day. You could say Simple Mills is the feeling of the sun in a snack. Find Simple Mills at your grocery store.

[Kalpen (Kal Penn)]

Hey everyone, it's Kel Penn. I'm inviting you to join the best sounding book club you've ever heard with my podcast, Hearsay, The Audible and iHeart Audiobook Club. Every episode, I nerd out with amazing guests and dive into the best new audiobooks available on Audible. It's the book club for your ears. Listen to Hearsay, the Audible and iHeart audiobook club on the iHeartradio app or wherever you get your podcasts.

[Dani Shapiro]

This is an iHeart podcast.

[Mary Afseri]

Guaranteed Human.