A Calling in Care: Dr. Rafik Mughnetsyan’s Story

It was Dr. Rafik Mughnetsyan’s first week as a new resident in the Adventist Health White Memorial Internal Medicine Residency Program when he met a young patient with an aggressive, metastatic disease who was scheduled for surgery. Sadly, despite the surgical team’s best efforts, the young patient never regained consciousness post-surgery. That was when Mughnetsyan, alongside the patient’s brothers and parents, faced the heart-wrenching decision to shift from life-prolonging treatments to comfort measures with terminal extubation.

During this challenging time, Mughnetsyan was struck by the kind and meticulous care that Waafa , an Intensive Care Unit (ICU) nurse, gave to the patient and family. She ensured the patient’s room was immaculate, constantly attended to his needs and created an atmosphere of peace to ease the family’s grief. Waafa’s dedication to maintaining the patient’s dignity, even in his final moments, deeply affected Mughnetsyan. It was then he knew he had found his calling in hospice and palliative care.

Long before Mughnetsyan was a resident or knew the type of medicine he would practice, he had personally experienced numerous acts of kindness that guided him toward a medical career dedicated to compassionate care.

Mughnetsyan immigrated to the United States from Gyumri, Armenia, settling in Glendale, California with his parents and two brothers in 2007 when he was in the 7th grade. During his first week of middle school, a girl seated behind him sneezed in class. Without thinking, Mughnetsyan turned to her and said, “Arroghjut’yun.”

This phrase means “bless you” in Armenian, but to English speakers, it can sound harsh due to its distinct phonetic qualities and emphatic consonants. It certainly wouldn’t sound like someone saying bless you. Despite the unfamiliar sound, the girl understood his intent, smiled, and replied, “Thank you.”

Although seemingly insignificant, Mughnetsyan vividly remembers this moment as his introduction to Los Angeles which shaped his belief in the inherent kindness of people. Since that day in 7th grade, this belief has been reinforced repeatedly as he received unwavering support from friends and mentors throughout his journey to become a doctor.

One of those influential mentors was Dr. Cristobal Barrios, a trauma and general surgeon at UCI Medical Center. As an undergraduate at the University of California, Irvine, Mughnetsyan believed he would earn a doctorate in chemistry. His passion for science was undeniable, but he soon realized that spending entire days in a lab wasn’t for him.

Then, a rare opportunity presented itself. Barrios allowed Mughnetsyan to shadow him during his emergency department rounds, a privilege seldom extended to students not on the pre-med track. The dynamic teamwork in emergency medicine and the practical application of medical science Mughnetsyan saw ignited a new passion in him, steering him toward a medical career.

A more profound, more personal act of kindness that influenced Mughnetsyan came from his mother, Karine Mirzakhanyan RN, BSN, a dedicated nurse at Adventist Health Glendale at the onset of the COVID-19 pandemic in 2020. Despite a shortage of personal protective equipment, she remained steadfast in her nursing commitment, showing up to work when the community needed her most and keeping her family safe by staying in a hotel.

Mughnetsyan, then a medical student at Western University of Health Sciences College of Osteopathic Medicine of the Pacific in Pomona, California, supported her by delivering food to the hotel’s front desk. “Seeing my mom’s dedication to the work she did, there was zero doubt in my mind that this is where I was meant to be,” Mughnetsyan said.

Throughout his journey as a medical student and resident, Mughnetsyan especially relied on the kindness and guidance of mentors and friends. Dr. Hanriet Minasian, who completed her internal medicine residency at Adventist Health White Memorial in 2006, wrote his letter of recommendation for medical school. Dr. Sarkis Kiramijyan, an Adventist Health White Memorial cardiologist, provided invaluable advice and encouragement during his residency applications.

Equally important were his fellow residents. Dr. Fadi Tahan , whom he knew from undergraduate studies at University of California, Irvine, provided friendship. Dr. Argin Haritounian, a close friend from medical school, gave him encouragement and advice. Additionally, Dr. Anna Arakelyan and Dr. Hovik Kurghinyan, a married couple and long-time friends who transferred to Adventist Health White Memorial after their residency program in Palm Springs closed, offered unwavering support when he needed it most, strengthening his belief in the power of community and kindness.

“You don’t realize how much work you do, how emotionally you get involved and how taxing that is on you,” Mughnetsyan said about his first year as a resident. “Having multiple mentors that I knew from before, who were older than me, who were able to lead me helped make the transition so much easier.”
Now, as a new graduate of the Adventist Health White Memorial Internal Medicine Residency Program, Mughnetsyan reflects on these moments of kindness and support, acknowledging how profoundly they have shaped his life and career. These experiences have deepened his commitment to paying it forward, both as a mentor to younger doctors and as a compassionate caregiver to his patients.

The encounter with the young patient facing a terminal illness whom Mughnetsyan met in his first week as a resident set the tone for his career. Since then, he has met many more patients and their families grappling with similar challenges. The stories they shared and the raw emotions on display impressed upon him the gravity and privilege of his role.

“Every time I step out, I tell my team that this man has literally a finite amount of time left and he just gave 30 minutes to us,” Mughnetsyan said, emphasizing the deep sense of responsibility and honor he feels in his work when talking with hospice and palliative care patients. “You cannot take that for granted. You have to realize, okay, what’s the point of this job? The absolute privilege we get that people give us.”

As he embarks on his next chapter as a Hospice and Palliative Care Fellow at City of Hope, Duarte, Mughnetsyan carries with him all the compassion and kindness he experienced during his residency at Adventist Health White Memorial. He has learned to appreciate the precious time shared with his patients, understanding it as an invaluable gift. With this fellowship, he hopes to honor the countless individuals who supported and mentored him, and to continue serving with the same dedication and empathy that defined his journey.

You can help support the Adventist Health White Memorial Internal Medicine Residency Program and residents like Dr. Rafik Mughnetsyan by making a gift today. Your contributions ensure that our residents receive the training, mentorship and resources they need to provide compassionate and high-quality care to their patients. Together, we can continue to foster a community of kindness and excellence in healthcare. Make your investment today and be a part of shaping the future of medicine.