For Dr. Abishek Thatigutla, being back in the Twin Cities just seems right.

Born in Bangalore, Dr. Thatigutla spent his early years in Minneapolis before moving to New Jersey for high school. It was there that a positive experience with his family physician started him on a path that would lead him back to Minnesota, where he’s now in his final year of family medicine residency at Hennepin County Medical Center.

Dr. Thatigutla saw that family doctors were “in the middle of everything.”

“I just thought it was the best job in the world.”

The best job in the world is also unrelenting. A level-1 trauma center and a public-sector, county safety-net that serves patients who travel from across the Midwest, Hennepin demands a lot of its residents. Doctors like Dr. Thatigutla and other CIR members see patients with complex health issues inextricable from racial and economic injustice. They do so in an understaffed and underresourced environment, where there is always a logistical problem to solve.

Now, with the Trump administration’s attacks on immigrants accelerating in Minneapolis, Hennepin residents are contending with a new set of evolving and extremely high-stakes issues as they work to give their patients the best possible care. The Twin Cities are home to many immigrant communities, with people coming from across Latin America as well as Somalia, India, Laos, and elsewhere.

Dr. Thatigutla recently had a patient, a pregnant woman, who was terrified to come into the hospital to address issues in her pregnancy, or even to give birth. This widespread fear about ICE is yet another critical problem that Hennepin residents must find a way to navigate, as the state fortifies the barriers between working class patients and quality care.

Power is a good starting place. A union doesn’t solve anything on its own, but safety-net doctors have never needed one more. Quickly getting on board when his now-graduated colleague, Dr. Allyssa Jonsson first brought up the idea of unionizing at Hennepin, Dr. Thatigutla was part of the group who organized and won a union with CIR this March. To him, the most important thing a union gives doctors is a collective voice.

“Most of the time when the admin is trying to do anything, they’ll use the ‘cause,’ or the patients, or the mission [to justify it],” said Dr. Thatigutla. “It’s very clear that a lot of the time the people who are making the decisions are not the people who are on the ground floor treating patients. We need to have more input.”

Of course, Hennepin doctors were not the only housestaff who joined CIR in 2025. In a historic run for physician labor organizing, more than 5,500 new physicians unionized with CIR this year, including physicians at other essential safety-net facilities in Rhode Island, Philadelphia, and Delaware.

Across the country, union members in new and longstanding CIR hospitals are facing the Trump administration’s attacks head on, including by fighting for language protecting immigrant patients at the bargaining table.

“So much of our training, we’re told to follow the hierarchy, the rules and authority–and there’s so many things we do because it’s for the good of the patient,” said Dr. Thatigutla. “It’s very clear that medicine and health care is political now… Staying silent and doing nothing is making a choice.”

Now in bargaining for their first contract, residents at Hennepin have even more on their plate. They understand that their well-being is closely intertwined with patient care, and as a doctor who cares about people, Dr. Thatigutla notes that, in spite of residency’s seeming hostility to this fact, physicians are people too. They should have what they need at work and at home.

Dr. Thatigutla’s love of working with people drew him to medicine, and he says it’s still his love for his coworkers and patients that sustains him through all the fights.

“I’ve lived all around the world and I haven’t run into a place that’s quite like Minnesota,” said Dr. Thatigutla. “I’m really lucky to be back here.”

He said he feels at home in the Twin Cities, and he plans to practice family medicine after completing his residency this spring.

“It is true that I’m going to be done in six months and a lot of this won’t be affecting me after that,” said Dr. Thatigutla. “But I wanted to create a structure so the people who come after me can have that and build on that.”

“It won’t happen overnight or all at once. But it needs to happen.”