By definition, nostalgia is a wistful desire to return in thought or fact to a former time in one's life–to one's home or homeland, or to one's family and friends. It is a sentimental yearning for the happiness of a former place or time.
Perhaps this desire explains, in part, the seasonal journeys undertaken by birds of many species. Of course, they are motivated largely by weather and a quest for survival. But like clockwork, these birds return to their original habitats, often after enduring journeys fraught with danger.
We also see this trend among humans, albeit in a different way. The issues are in many ways similar, such as the search for greener pastures and economic uplift, and for better living, education, and employment. Still, the destination often proves alien, and there are many risks involved in migration.
Anthropologists have documented this trend since earlier times, when people used to migrate in large groups. Hence, the phenomenon has always been part of the human experience.
But migration often comes at a huge psychological price. After all, psychologically speaking, people who are born and raised in a particular country develop an attachment to that place, and detachment sometimes leads to emotional turmoil. I've seen this in my practice, and so have my colleagues.
The type of emotional reaction differs, depending on whether the migration is forced or not. But the transition can prove challenging just the same.
Many of our colleagues who originated from developing countries are practicing medicine in places such as the United States, Canada, Australia, New Zealand, and the United Kingdom. These international physicians left their homes for a myriad of reasons, but often because of the prospects of better training and a better life.
Many of these physicians express a desire to repatriate back to their countries of origin, and I speculate that about 90% do not go back for one reason or other. About 10% opt to return home, only to find that they would come back to their adopted countries if they could. Often, life in the home country has changed, which can make people feel alienated when they go back.
In many cases, these medical doctors form listservs with their classmates and continue exchanging e-mails remembering the old days. I receive these kinds of e-mails just about every day from former classmates from medical school. Very often, a sense of emptiness prevails within them.
I suspect that many of these doctors undergo brief periods of depression and other mood changes. However, a large number of them develop a phase of denial and a sense of pseudodetachment.
I have not been able to find anything in the literature that examines the extent to which mental health professionals can help lift the nostalgia among international physicians.
Considering our expertise, however, I'm sure that we psychiatrists have the skills to help.
This appears to be a fascinating area for research, particularly in light of the growing numbers of international medical graduates practicing in the United States, for example (N. Engl. J. Med. 2004;350:2435–7).
I wouldn't be surprised if someday we develop a nostalgia-related diagnostic entity in the psychiatric classification system.