Everything Is Relational | Kanwal Matharu

Kanwal Matharu is a cornea surgeon, Fulbright scholar, and global health educator who has spent his career building pipelines between American academic medicine and under-resourced communities around the world. He's also my friend—we met when he was a freshman at Princeton and I was working in residential life, and I've watched him navigate the distance between idealism and institutions ever since.

In this conversation, we talk about what it means to align your career with your faith, what he learned about strategy and relationships as a young trustee on Princeton's board, and why he's come to believe that "soft relations carry so much more weight" than procedural wins. We also talk about the costs of the path he's chosen—the isolation that comes with subspecialty training, a called-off engagement, and sitting cross-legged in borrowed slippers on his last day in Egypt, practicing patience after everything went sideways.

This is a conversation about service, sacrifice, and what it means to keep going when the story isn't as clean as you thought it would be.

Transcript

Episode 02: Everything Is Relational

Kanwal Singh — Cleaned Transcript

George: It's been nothing short of a joy to get to be a part of your journey and to cheer you on as you do all of these wonderful things. I'm proud to call you a friend. So to begin: Kanwal, you've been described as someone who synthesizes and communicates complex topics, but I'm curious about the person underneath the CV. For people who don't have the privilege of knowing you the way that I do, how would you describe what you're actually trying to do with your life? Or put another way—when you close the exam room door after a long day, what question are you carrying? Not a research question, but the human question that's underneath this.

Kanwal: I think what you're trying to distinguish between is my career, my vocation, and my personhood. What questions am I getting at on a day-to-day basis stems from how I identify as a human. Currently, my priorities are trying to live a life as a good Sikh, in relation to God. Next is my relationship with my parents—that's the next orbit I'm trying to take care of. Then family, friends, et cetera. And lastly, my responsibilities to my work and adventures.

This comes from a Jesuit concept about levels of happiness, where each one correlates with a level of unhappiness. Level one was your primary physical needs—joys of the flesh, physical intimacy, good food. The second level was friendship, third was family, and fourth was God. I thought that was a very good way to orient and prioritize one's life.

George: That's both compelling and succinct. What drew you to medicine originally?

Kanwal: The usual cliché answer: I was interested in science and enjoyed working with individuals. Taking a step back—Indian American, my parents, specifically my mother, vehemently told me not to go into medicine, not to be a stereotype. She said, "Do something you're actually passionate about, because we don't need more really bad doctors in the world. A bad doctor is someone who's not passionate about what they're doing, who's forced into it."

Huge credit to my mother for always exposing me to everything and encouraging me to think critically about what I want to do. In high school, I volunteered in an ER and enjoyed it. In college, I worked with the Princeton First Aid and Rescue Squad. I didn't particularly enjoy the emergent nature, but I absolutely loved being in that sacred space of healing and getting to know people individually.

As I progressed through college, I grappled with the question: I like science, I like health—do I care more about large impact, helping a million people 1%, or would I rather help one person 100%? That's how I answered the public policy versus physician question.

One of the great questions my mentors asked was, "If you just want to help people, why don't you just be a social worker?" It's a compelling question. So I had to learn to answer that with more specificity—the leadership components, the capacity for surgery, the molecular biology tie-ins.

George: What was the experience of clarity like with respect to that question? Was it something you arrived at consistently, or did it come in and out of focus?

Kanwal: My approach to these big picture questions—whether about relationships or choosing my life's work—is to go in with an intentionalist mindset as opposed to a consequentialist mindset. I try to do all my due diligence, gather all my information, and once I've made a decision, I've done my best and then I go forward. Step by step by step. As I gather data, it comes into focus and then I'm set.

One of the heads of internal medicine said something quite profound about decision making: there's a million different versions of us, and we'd probably be pretty happy in any one of them. In medicine—do you do internal medicine, ophthalmology, surgery? They all probably would have been all right. It's just the path I chose, and it's up to me to make the most of it. I think that's a pretty Buddhist concept. Some combination of those philosophies built confidence in the decision, and then I just pull the trigger and go for it.

George: I've seen that clear, engaged, move-to-the-next process in action more than once. But I wonder about the data gathering phase. The texture of what you outlined is very agent-driven, will-driven—orient attention toward X, gather information, make a balanced decision, move in that direction, course correct as indicated. But I also know you as someone who feels deeply and is deeply present.

Kanwal: You're right that the whole point is dealing with uncertainty in the decision-making process. When I was choosing a specialty, I created an algorithm for myself. I enjoyed internal medicine, surgery, neurology. I tried to break each down and analyze the elements, then prioritized.

When I was making that decision about ophthalmology, I looked at big picture quality of life issues. I get much more joy helping someone live a life full of quality as opposed to extending their life. The cost-benefit ratio, the effort involved—I get the high from helping someone see better. The science was fascinating. The opportunities for global health were interesting. I loved being in the operating room. I liked being in the clinic over the inpatient side. So there was an analytical component, an emotional component. And in my heart of hearts, I just loved looking at eyes.

But then I thought—or someone pointed it out—my aunt is also a cornea subspecialist. My mother has severe dry eye. I have significant refractive error; I'm dependent on glasses to see. My whole subconscious must have been oriented towards the subspecialty from a very young age. How much was subconscious? How much was agency? I don't know. I'm the marionette at the end of the strings.

George: Which end?

Kanwal: Which end? The one that George Laufenberg tells me to go to.

George: You were obviously deeply involved at Princeton beyond academics. The first aid squad, being an RCA—and not in a perfunctory way. I knew you as someone intensely and deeply engaged in the care of young adults in an extraordinarily high-stress environment without much encouragement for being soft and present. I watched you play a hugely important role in a lot of people's lives. Six of Princeton, PACE, the Office of Religious Life. What do you think you were working out during those years?

Kanwal: I hadn't thought about it that way. I think I was trying to find a sense of community. The residential college advisor role was a huge part of choosing medicine—appreciating being there for people, leadership.

Definitely finding community. I'm an only child. I'm a brown boy who grew up in New Orleans, a city divided on Black and white. I'm a Sikh who went to Catholic school. I'm left of the political spectrum in a Catholic school in New Orleans.

Then I got to Princeton and my race and religion weren't a negative—they were a positive. I found my homes at Forbes, at the Office of Religious Life. I was walking around campus and saw a gentleman in a turban and was like, "Yo, you're Sikh, let's go." Community building is something I've always been drawn to. Brotherhood. I recognize I've been so lucky to have really awesome mentors—yourself being one of them—people who shared their time, whose words of encouragement or guiding principles helped me get through something. I've always enjoyed paying that forward.

George: That's striking because in my experience of you, community cohering around you felt almost automatic, inevitable. It's interesting to hear how much that came in as a question. And I'm thinking about the other direction on the timeline—your time at Baylor and the absence of community.

Kanwal: For sure. And I'd argue in medicine in general. Or being an adult in general in a capitalist society which has values antithetical to a lot of what I just outlined.

Growing up is tough. It's not for the faint of heart.

My training situation at Baylor—I recognized I was going into a tough program that was extremely busy with specific values. Ostensibly those values are teamwork. But in a toxic situation where everyone is fighting for survival, everyone is fighting for their own individual survival. On one hand, brotherhood, teamwork, we're in the foxhole together. But when there's a grenade launched and everyone else can get out—peace.

Of course there was community building, dear friends and mentors who got me through. My neighbors were lifesavers, an external source saying "what you're going through is not normal." Princeton I felt very much at home. Medical training throughout—first in medical school, then residency—was very isolating. Each fellowship was more isolating. That's the nature of subspecialty training, the nature of doing something where you're alone, at the bottom of institutional hierarchies.

George: Let's go back to Princeton. Tell me about the South Africa trip. What shifted for you?

Kanwal: That was another part of the decision to do medicine. The reason I loved Princeton so much, the liberal arts way of thinking, is that it's interdisciplinary. What's celebrated is specialization, but also specialists talking across borders and finding common ground.

The South Africa trip was the Office of Religious Life bringing one person from each religious background—a Muslim, a Sikh, a Catholic, an atheist walk into a plane and fly to South Africa—to understand the role religion played in overturning apartheid. Religion as a force for good was powerful and encouraging, something we don't often reflect on.

Within that trip was one of my first exposures to health inequities. Growing up with family trips to India, poverty is everywhere. It's not hard to intellectually understand that malnutrition in India is different from malnutrition in America. But in South Africa, one of the places we visited was originally a senior living facility. Then AIDS wiped out the parent generation, so it became a facility for children being taken care of by their grandparents. It was staffed by a doctor who would barely visit once a month.

That was jaw-dropping. What are we doing here? How does this happen? Those are humans, I'm human. There's nowhere in my world where a doctor would staff an entire hospital once a month for both ends of the healthcare spectrum that need it most. That was an in-my-face healthcare disparity. I wanted to go after that.

Everyone writes in their applications that they want to do something with global health—it's the most cliché thing, value signaling, whatever. But those moments crystallized it for me. Gave me fortitude. Work has been really tough the past three to six months. When things are tough, you question what you're doing, why you're here. It calls things into uncertainty.

Then yesterday, this surgeon from Mozambique finally arrived. I was supposed to meet him Monday, today is Wednesday, it had been a ride—flight delays, miscommunications. I saw him and we talked about the work he's doing, and boom, that was the jolt I needed. That's why I'm here. It brings up all the feelings. I'm subconsciously drawing on these experiences from South Africa through the present. That's the reminder I needed.

George: You mentioned this was an Office of Religious Life trip. Can you say more about how your Sikh faith, especially practice, shapes how you think about service?

Kanwal: Sikhism's core value is equality for everyone. How do you demonstrate that you truly believe every human being is equal? Through selfless service—not egocentric but altruism-centric. The term is seva.

That's been a kind of dogmatic teaching I've received from a young age from my mother and father. You've been given so much, it's your job to give to others. Sikhism has this long, proud tradition of fighting on behalf of the less privileged—the person experiencing religious persecution, the person hungry on the street. That's a significant part of our traditions, our sense of community, our identity as a religion.

When you're constantly fighting on behalf of the little guy, that often puts you in a difficult position. In my current practice of faith, I remind myself that people who preceded me fought much harder things, and they kept in Chardi Kala—ever-rising spirit. When I'm really down and someone asks how I'm doing, I say "I'm growing and learning." I try to center that. If I ever tell you I'm growing and learning, it means I'm miserable but I'm forcibly practicing mindfulness, forcing my mentality to recognize this is where I'm at.

In terms of life orientation, I attribute that to Sikhism—service-oriented, work hard, an honest living. That underpinned my push towards medicine. And in my day-to-day mindfulness, leaning into where my spiritual practice is at age 35.

George: When you look back at the path from Forbes College to now, how much was planned and how much was discovered?

Kanwal: It was planned. Absolutely, 100% planned. On my college application essay, I wrote that I want to do global health. When I got this job, I shed many tears that I'm living the dream.

My understanding and value system for how to practice global health has centered on an education model. How could I have ended up in the fields of Iowa, a farming community? This size of town is very comfortable—my cultural heritage. In many ways I feel very much part of this community. I'm in a mission-driven group that's overly optimistic and idealistic in so many ways, and I feel very seen here.

It was planned in the sense that I was very intentional in selecting molecular biology. But discovered—every step of the way I put my full effort in. That's probably how I matched from a not-reputable medical school into a pretty reputable residency. I got good letters of recommendation because I was hustling. So yes, planned and discovered.

George: "Hustling" felt dismissive of your way of being present. That doesn't fit with my experience of you.

Kanwal: I love "intentional 100% effort." Dean Kadesch said one of the things he noticed about me is that I always give 100%. If I'm projecting that, that's something I aspire to.

Someone else pointed out the thing about synthesizing complex topics. A mentor challenged me to do that when I was in his lab in high school. When someone brought that up 16, 17, 18 years later, I thought, oh, that's a valuable skill.

George: There's a clear arc from college applications to your current position—in some ways this represents the culmination of a trajectory you mapped out years ago. Where's the crack in that? The place where it doesn't quite hold together the way it looks from the outside?

Kanwal: The personal life. How much time do you have?

But even the professional life. I'm engaging with local politics, and my value system guides me in one direction, but I'm hitting roadblocks. That's giving me major pause and uncertainty. How much time am I supposed to spend in Iowa? Maybe I've done what I was supposed to and should move on to the next challenge. That's quite an existential question.

The two principles I'm meditating on: seek to understand everyone else's perspective and why they're telling me I'm wrong. And learning where to swallow either my pride or my principles on certain things. I'm pursuing this grand mission of global health, and on specific matters of how to run my clinic, I need to yield. These are huge things I'm saying casually, but they're causing me great distress and interpersonal difficulty.

On the personal life—I've dedicated so much time and energy to this very specific, very lonely academic course involving lots of traveling and sacrifice from people I've been partnered with, from my own parents who are always distraught when I go on long-distance travels where safety is a concern.

My relationship with my parents has taken a hit. My relationship with my now ex-fiancée—which I think tells the whole story about cracks. The foundation of our relationship cracked significantly when I went to India for three months and was not available in any real way to be supportive as a partner.

Lately my algorithm has been feeding me videos about motivation, people drawing those three axes—time with family, independence, and money—usually saying pick two, pick one. There's a trade-off between feeling super lonely and having no major responsibilities to other humans. I don't have children or a partner to take care of, so I can go off to Egypt on a Fulbright, which is such a privilege at 35. But it was deeply and intensely painful as well. That's where the cracks are.

George: I want to pull on several threads there. Tell me about the Egypt trip. Set the stage.

Kanwal: I got to the University of Iowa two and a half years ago as co-director of the Global Eye Program. There are lots of ways to do global health. One way is to parachute in, do the thing, fly out. I think education is the best way. Our institution is particularly strong at that.

My goal since getting here has been to identify a strong partner institution and create a pipeline between that local institution in a low-resource setting and our institution. An academic center in America excels at subspecialty care, whereas a high-volume general ophthalmology clinic in India would be better suited for low-resource settings. In my grand plan, you have a triangle between a low-resource center in sub-Saharan Africa, an academic center in America, and what you have in South Asia.

The Fulbright Commission identified Iowa as a good partner for building a pipeline to the Research Institute of Ophthalmology in Egypt. My chair forwarded that invite, I applied. The specifics were increasing research capacity, increasing cataract surgery on high-volume outreach camps, and helping them implement electronic medical records. Research ties back to my roots at Princeton. Cataract surgery I learned during my second fellowship. Electronic medical records from lived experience as an American healthcare provider. Even though I'm junior, I felt confident my training fit the institute's needs.

I applied, discovered Iowa is a hotbed for Fulbright scholarships. We have someone dedicated to helping faculty apply. The strongest global health programs are in the Midwest. Iowa sends the most people to India. Something about Midwest culture, the Christian ethos, being away from the coasts. Uncanny.

So I get the Fulbright. Then it gets caught up in bureaucracy, international funding, USAID cuts. While that ball's in the air, I also develop relationships with Zambia as a place to work. About a year later, the Fulbright funding comes through. Let's go, take on this crazy adventure—while the Israel-Gaza war is happening. Brown boy, American passport, kind of scary.

I did the conference, connected with amazing people, international surgeons. Spent a month on the island of privilege in Cairo where the US embassies are, and in many ways just had an absolute blast.

I went into a modern-day palace that's now a museum of Islamic art—on my run, in workout clothes—and this guy gives me a free tour. Millions of experiences like that. Got to see the Citadel. Took a train to Alexandria. Almost had a private tour of the pyramids and Sphinx because the oculoplastic surgeon taking me around threw small bribes to the guards. I'm the last person there, getting a picture by myself with the Sphinx. Got to sneak into the Pharaoh Khufu's doctor's tomb.

Incredible privileges. On the flip side, absolute disaster logistically.

Day one, I get connected to a driver—Arabic speaking only, doesn't use a smartphone. They're keen to show me the history and culture. They send me to the museum where the mummies are kept. The drive was harrowing. The seatbelt didn't work. The stick shift knob would come out. Then 10 minutes in, the car dies in the middle of the road. We hop out and transition into another cab he somehow summoned.

I get to the museum, have a phenomenal time communing with the pharaohs of old, looking at how they were stabbed by some coup, how inflation shattered their economy and caused uprisings five thousand years ago. How harvests caused political uprisings. Things obviously relevant today.

Then I have to get back in the car with my guy. I'm trying to be mindful—this is how the story always starts, there's going to be this arc. Halfway through the month, he's picking me up every morning greeting me with "Hello, I have arrived," and that became endearing. By the end of the trip, he was late by two hours to pick me up for something I was super excited about, exploring the old Muslim town. The hero's arc crashed. I just took Ubers from there.

My last day: early on I realized the water heater wasn't working. My first few showers were frigid—I literally talked about this in a global health presentation, most people just can't handle cold showers abroad. Got it figured out, there's another heater. Last day, that heater breaks, floods the whole apartment. I'm in shower gear—not a lot of clothing—cleaning the apartment, opening all the windows, canceling all my meetings. Let me just follow the protocol, clean up, throw out the trash.

I discover the door locks behind you. Obviously I didn't have my keys. Thankfully I had clothes on. I go find the doorman who doesn't speak any English. Someone walks by, I use hand gestures—locked out of door. He grabs his screwdriver, a hammer, starts banging on the lock, which brings out the neighbor. I grab his phone, use Google Translate to speak Arabic, say call the Fulbright team for the spare key.

We wait half an hour. The Fulbright guy Rafeth comes, cursing because he's worried the doorman destroyed the lock. Which he had—the spare key doesn't work. We wait another hour, hour and a half. Just sitting there. The doorman breaks down the lock. Plumber comes, fixes everything. I clean up the apartment, pack, run to my meetings. That's how my last day in Egypt went. I'm on the hook for that bill too.

That's not even the story about cultural norms—first trip abroad post-calling off my engagement, brown Indian American Punjabi boy, very single in a hijabi Muslim world, trying to navigate those spaces.

Best of times, worst of times. A Tale of Two Cities, very applicable for my trip and my 35 years.

George: I'm struck by this tension between the idea of community as a function of service driving a lot of this, and the experience of isolation. That story about the driver—I could see the buddy movie in your head. The hero's arc fantasy.

Kanwal: I saw it too. And I saw it crashing. I was fuming that this guy is late—he has one job. I'm paying him double what Ubers cost, paying for my safety.

The tension between community and isolation—maybe I feel isolation more when I'm alone because I'm so drawn to community. Or because I have such high aspirations.

George: It sounded like reality interfering with your fantasy life.

Kanwal: I have an answer for you. The drive for service, to help, to push boundaries puts me in difficult situations. Now that I've traveled so much this year with Zambia and Egypt, I'm drawing strict, tight boundaries for myself—not traveling as much. My life has become much more community-centric. I finished an emergent surgery on Tuesday and got an invite to bar trivia with the wellness crew I helped start. I went immediately. I can put off the hunger to go answer bar trivia, get one drink—that's priority number one.

That's where the tension comes from. To do the hard thing necessitates one way of living. I push myself to the breaking point, then retreat very much into the communities I've built. Big swings.

George: A friend of mine once described the middle ground as a place she would swing past on the way from one extreme to the other.

Kanwal: That's great. Your line to me was—this was our lunch at the Cap, a formative moment in my life, 2013—you told me that we don't change habits even when they're destructive until something breaks. Only when it breaks do most people change.

My best friend and roommate, I always observed him doing destructive things up to a certain point. What he characterized in me is that I'm more risk averse. If I can predict something has a risk of causing destruction, I'm pretty good at avoiding it. But in my professional life, even if something is risky, if my morals or ethics aren't aligned with it, I will push until I break. That's the model that explains a lot of my actions.

George: Say more about the distinction between professional life and not.

Kanwal: Healthcare in America is broken in many ways. I will fight the system to get the best care and outcomes for my patients, even if it requires more emails, more time, sitting in the room, coming on weekends to write notes.

Personal life: many people have told me random hookups are bad, so I avoid them. I don't need to live that experience too many times. I don't need to get drunk too many times to realize this isn't how I need to live.

George: It sounds like you're willing to put yourself in risky situations in service of an external goal, but in personal terms you're depriving yourself of the fuel. What's on the other side of that when you imagine it?

Kanwal: Level one happiness, level one unhappiness—to go back to the Jesuit metric. Prioritizing joys of the flesh.

George: I buy that a little bit, but I know you. You're not just talking about joys of the flesh. Under that wittily told story about the driver in Egypt—that sounds heartbreaking to me.

Kanwal: I agree. No notes. It was. That's a representative story. It encapsulates a lot of my experiences with administrators I'm trying to work with. I've sketched out objectives, please help me execute them. Time and again, falling flat on my face, banging my head against walls of miscommunication or mis-execution.

In general, most of my problems can get solved with money, and I've been blessed that money has not been rate-limiting for me. That's the unstated part of my life of ridiculous extreme privilege. I can go into a lot of spaces that other people can't and feel safe. I can go to South Africa, Egypt, I can go, I can go.

The pro of being the last person at the Sphinx, the only person in Alexandria overlooking the Mediterranean, is that you're also the only person there trying to problem-solve a situation others haven't worked through. Which is isolating.

George: What do you do with the heartbreak?

Kanwal: I have a very clean answer. As I waited for the Fulbright guy to come with the spare key that wouldn't work, I sat in a shirt, sports shorts, boxers, borrowed the doorman's slippers, sat cross-legged and said: this is a chance for me to practice patience and acceptance. I've been hardcore focusing on that for 2026. Year 35.

Heartbreak is transient. Something Sneha, my ex-fiancée, told me when I was leaving a heartbreaking situation—when she and I were just friends—she said, "Kanwal, I respect you the most for putting yourself out there, giving yourself a shot." I hate when people say it's better to have loved and lost than never loved at all. But that is me—heart on my sleeve. If I believe something, I'm going to do it, risks be damned. The whole point is learning to deal with the outcomes.

George: What does your practice—spiritual, meditative, or otherwise—look like now?

Kanwal: I'm basically a character of myself at this point.

George: Say more.

Kanwal: I think I'm pretty much the same person you met when I was a freshman. Which has always been a sore spot. The person who lived across from me evolved so much in tangible ways—recognition of their sexuality, overweight to marathon runner, pre-med to first in anthropology graduate school. Easy to see the evolution, the butterfly.

Whereas I'm the same caterpillar that showed up at Princeton in many ways. I say this disparagingly. I always ask Sal, "Did we grow any? Did we do anything different?" I said we were gonna be doctors doing public health stuff, and you're helping homeless people, I'm doing global health. Did we really change our track? Did we grow any?

That's a riff on something I like to think about. I'm very happy with where I am.

George: Does the track have to change for there to be growth?

Kanwal: It's a sexier story.

George: It's an easier story.

Kanwal: Easier. I'd like to think all the work I've been doing is internal.

George: What would have to change for you to say "I can't keep doing this"? And what would need to stay the same for you to keep going?

Kanwal: Change would be one of those higher levels—family, parents, spouse, or God, some higher meaning telling me what I'm doing professionally isn't ideal. Sikhism teaches that the way to happiness isn't by meditating and cogitating and circling around. Humble yourself to God's will and everything else follows. Same message in 15 different ways. Get rid of your ego and put yourself on something bigger.

In my 20s, I spent a lot of time thinking, "That's great advice, but how do you discern what God's will is?" I've worked through that. So either loved ones or discerning that my trajectory is elsewhere would get me off this path.

To stay on this path: continue to find meaning in it, continue to have the energy to do it, continue to have help, financial stability, to feel supported, to feel I'm in a community that's appreciative of what I'm doing. Even if the community isn't, to have enough allies that keep me in a safe space mentally and spiritually so I can keep going. Because this is very hard at times, and I've sacrificed a lot—at least in terms of capitalism metrics and general arcs of what a straight male Indian American son is supposed to do.

All of my friends are on their first or second marriage. All of my friends are on their second or third child. It was especially rough when three exes, back to back, had children—I think four days apart. What am I doing with my life? Where am I in my timeline? What is the plan for me? That causes pretty existential dread pretty quickly.

George: "What is the plan for me"—that's interesting construction. So much of how you've talked today has been about your plan.

Kanwal: Yeah. Paragraph one, chapter one, verse one of our textbook, Guru Granth Sahib, is what I tried to tell you. Imagine India, Hindu Brahmins, priests going off into the mountains, sitting under freezing waterfalls, meditating, doing yoga, just thinking about God.

In our society we have so many preachers. My favorite Catholic school teacher said today's saints are Green Day when they release American Idiot, or the Dixie Chicks, or Margaret Atwood with The Handmaid's Tale, or Rachel Carson with Silent Spring. Those are our prophets today. So many people preaching how to live your life—good and bad, so many influencers.

I imagine the same thing back then—lots of yogis, lots of Brahmins. Guru Nanak was like, it's all BS. You don't need to sit there, you don't need to isolate yourself. You've got to live in the world, have your hands in the mud, work by the sweat of your brow. That's rule one for us. You better be hustling to make this place better.

Don't spend your time thinking—commit yourself to God's will. So my plan, ostensibly, I have aligned to what the goal mission of the big captain is, aligning my talents and gifts to whatever God's plan is for a better world. That's how I conceptualize it.

George: Beautiful and beautifully said. One more direction. Going back to the immediate post-Princeton era—serving on the board of trustees as a young trustee.

Kanwal: I felt this question coming.

George: The context from my own time at Princeton—apart from working with you and Salmaan, doing the Forbes thing, working with Dean Matt—working with the Freshman Scholars Institute was unequivocally the high watermark. Helping kids from under-resourced high schools or first-gen low-income backgrounds, watching them go from arriving on campus in a sea of entitlement, awash in imposter syndrome, to beginning to have some sense that there's a version of this that's mine, a patch of ground to stand on, to develop a critique of the institution from inside.

I watched you be deeply involved in and committed to so many things while you were there. We didn't talk as much when you were in the young trustee era. I'm curious what you learned about institutions from the inside at that altitude. Moving between living deeply in the day-to-day, informed by faith, to a more strategic register in an institution that's so change-averse.

Kanwal: Your question touches on a lot of what I learned over time. I came in hot. I came in passionate. I came in as the rebel candidate. The people I ran against were the president and vice president of student government. I was of the people, by the people—the grassroots candidate elevated because I had no student government experience. My angle as young alumni trustee was to update the dinosaurs on the board about what the current Princeton student experience is like. I was going to put that in their face because to me they were intentionally blind to it.

I very quickly realized that bringing the fire did not help anyone. Much more useful was being strategic.

During this time, in medical school, I took a trip to Ireland and spent time at the jail integral to the Irish Revolution. They had such a beautiful descriptor of the different revolutionaries—it mapped so cleanly to Malcolm X and Martin Luther King. I began to look at my role on the board from Malcolm X firebrand to MLK. I had much more grace for everyone on the spectrum and recognized that in the Indian Liberation Movement, on the Board of Trustees, on whatever—you need all the flavors of activism for something to get done.

I came in with naive understandings that some institutions are relational, some are proceduralist. In healthcare, a VA should ostensibly be proceduralist, but if you know the technician who runs the CT scanner and you really need your patient in sooner, talking directly to the technician gets your patient faster than putting in the order and following procedures. That's a relational institution.

I thought perhaps Princeton was systematic. Perhaps it is. But at the end of the day, everything is relational. Soft relations carry so much more weight. It's a lot of posturing in the big room asking the administrator a pointed gotcha question that gets you nowhere. Whereas building consensus behind the scenes, sending emails, setting up phone calls—doing the work—is more constructive and gets you closer to the ultimate goal.

On the flip side, the number of emails I sent along with the other young alumni trustee—who was much more respected because she was always more dignified and circumspect in public—we sent so many emails about Black Lives Matter and our Black students feeling unheard. It preceded the sit-in in the president's office by about two years. Never have I felt so validated in a prediction. I tried to be the canary in the coal mine. We tried to do it the right way. We still failed.

A lot of how I live my life today comes from that experience. Personally, I got to interface with the most successful people—American successful, Northeast WASPy Ivy League definitions of successful—and spend an inordinate amount of time with them on their time. I learned from them and talked about my existential questions.

About work-life balance, the head of the board said: don't think about it day-to-day, think about it in decades. You're going to sprint for 10 years, then you might need to rest for 10 years. A judge married to someone in the Obama administration explained how your partner can sprint for the first years of the marriage, then you sprint for your years, and how they balance that. I had incredible opportunities to talk about activism with the former president of Brown, about helping one person at a time versus 10 or 100.

It was an incredible, formative experience.

George: It's fascinating to hear how that continues to echo in how you're thinking about the multiple valences of your work now, how you're showing up for it.

Do you know Dorothy Day? Early 20th century Catholic social justice worker. One of my favorite quotes attributed to her—someone asked what happens when she fails to do God's will or has to say no to something. Her answer was essentially: it's a particular form of arrogance to think that if I don't do something, God won't find another way.

Kanwal: That's beautiful. I need to think about that more often. It's not all on me.

George: Last question. What's one question you wish someone would ask you?

Kanwal: Is it a generic person or a specific person?

George: And you don't have to answer it right now.

Kanwal: I wish my parents would ask me, "What should we do now?" And respect that opinion. That's a chip on my shoulder. I just can't get my parents to engage with me as an adult they respect more than as a child.

Everything else—how are you doing, what's the meaning of life, what should we do—it's old hat. I don't have anything insightful. But I'm still working on the most important relationships in my life. With my friends, my loved ones. Yeah, I like my answer.

George: That is so consistent with what has unequivocally been the theme, the central through-line of this conversation—your relentless emphasis on relationships. And I, for one, am so deeply grateful for the relationship that we've had for the last 15 years. So appreciative of your heart and your mind and your time today, my friend.

Kanwal: Thank you, Coach. Love you, George. Be well.

George: Love you too, Kanwal. Have a wonderful day. Thank you.

Kanwal: Cheers. Talk to you later.