Breathing between the specks of time, I see the past one year reel off before my eyes; the good and the bad, the happy and the sad – all flowing together seamlessly to make me believe that it is what it is, it all happens for the best.
The familiarity of the blue of our scrubs and the beeping sound our background music. Panda eyes and dark circles telling tales of new admissions at three in the morning. The convenience of the lab-coat pockets carrying forgotten five-rupee-coins, broken earphones, crumbled masks, and a dried pen or two. The weight of the stethoscope and the weight of quick decisions proofs of our adulthood. The fear of COVID drawn into a gradual acceptance of a masked world. The comradery of fellow house officers in the homely Gynae FDR. Saturday halwa puris and a fifteen-minute Walk-At-Home video before OPD and long hours of going without food. The morning ritual of chai with the nursing staff and the dua of a sick patient. My hand-carry making night-duties bearable, helping me nurture a home everywhere I go. Trying to live it all, trying to make it a lifestyle. Trying to love what we lived and now living what I love.
These are all moments I won’t forget, moments I won’t miss.
Goodbye, intern-year. You will be missed like bitter almonds. I’m glad you came.
The Internal Medicine rotation was definitely one that I was eagerly looking forward to. An interesting mix of coughs and dizziness, it was the bitter-sweet potion that had you sliding down the ride of the minute details hidden away behind negligence and also sleep-deprivation, and the dominant signs and symptoms that brought your patient to the ER in the middle of a deadly pandemic. It was all of that and more.
Thankfully, I had a great team of fellow interns, residents, and consultants. Each one of them had their own skills and methodologies that seemed to reflect on the way they monitored their patients and mentored us. Out of this wonderful team of internists, the few I had a chance of closely working with were Dr Abdul Rahim, the Chief Resident; the Covid-warrior, Dr Darayus P. Gazder; my birthday-bro, Dr Aneel Madhwani; and the profound doctor, Dr Hina Imran. For their kindness, their mentorship,and their friendship, I will forever be grateful.
10:07 AM | 17 November 2020
what are these peaks and troughs on the ECG strip? lead I, lead II, lead III; pray, what are these? avL, avF – will they tell us stories of loss and grief? from V1 to V6, there’s just a struggle to breathe. 10 mm/mv is hope per existence. 25 mm/sec is life ebbing towards death. the QRS axis is revolving around Takatsobu and T waves are crashing by the shore of uncertainties. what are these peaks and troughs in the ECG strips? pray, what are these? there is no machine in the world that will tell you what the heart beholds and there is no pill in the world that will cure the ills of the heart and the soul. will we ever truly know? will we ever truly know?
Sunny smiles and tiny hands are not the only sights that you’ll get to see in the pediatric department of any hospital. You want to light up the ward with balloons and teddy bears but you find yourself posting Injection Vancomycin and Injection Meropenem while struggling to explain to the anxious parents that their kid will be okay. Or maybe not.
It’s worse when you see a life blooming within a happy soul that is trapped on a wheelchair and is labelled as “CP child”. It’s a little like your heart sinking because why would God do that to any parent after nine months of dreaming about their little bundle of joy? But that’s how they spell life.
Working as a young doctor (a fresh graduate) in times as unprecedented as these is a normal intern year times infinity. What do I see when I look back? The colourful walls of the general ward; the torturous UDS postings; a hard-earned “good” from the senior registrar after the morning rounds where I stepped into the rather large sized shoes of the residents; tea and more tea; some resilience and a couple of chocolate cupcakes. And faith in myself.
The golden streaks of faith have made their appearance again and I am reminded of how the toughest of times can also be the most beautiful ones.
I’m much better prepared this time. Perhaps, also much better equipped. But you know what’s tiring? That I’ll have to go through this again. All alone. Again.
Back in medical school, I’d always glamorously looked towards delivering my first CPR. The act of massaging a heart back to life; always wanting to recite one of His ninety-nine names as I give the compressions, eyeing the ECG monitor cautiously, hopefully. That’s what I had imagined. That’s what I had hoped for. But yesterday was very different. The fixed, dilated pupils stared back at me with little mercy for shattering my naive dreams. The straight ECG line left no space to fill in that blank.
If only we could read the words of the heart, lain out majestically on a piece of paper; encoding hopes, dreams, grief, and loss as stencils jumping up and down, called the QRS complex.
But let’s not be so ungrateful. Sometimes, all we need is another chance at life, another chance at being born all over again.
It’s a strange night. There’s a chilly wind blowing outside the well-lit hospital I’m working at. I sit at my desk, waiting to heal others while failing miserably at doing the same for myself. There are monsters outside and I don’t want to slay them; I don’t want to have to do anything with anyone at all.
They didn’t teach us how to do that back in school. To slay the monsters when you don’t want to, I mean.
They didn’t teach us how to forget the name of our second grade best friend. They didn’t teach us how to overcome the fear of falling down while on the racing track in the annual sports day. They didn’t teach us how to forget all things bitter-sweet. They didn’t teach us how to go to sleep easily. They didn’t teach us how to unfriend the past. They didn’t teach us how to forgive those who didn’t ask for forgiveness. They didn’t teach us how to not care, how to not hate, how to not love. They didn’t teach us how to not miss people. They didn’t teach us how to dislike blue. They didn’t teach us how to trust and how to not break trust. They didn’t teach us how to sleep without a heavy heart. They didn’t teach us how to stop feeling strange. They didn’t teach us how to do it all again; trust again, believe again, smile again.
They didn’t teach us what to say when a 26-year-old woman’s husband cries at her dead feet after giving birth to their first child. They didn’t teach us how to tell him that giving CPR to his already dead wife would give her more pain. They didn’t teach us how to hold back tears when we declare a patient’s death. They didn’t teach us how to be on-call 24/7. They didn’t teach us how to protect the dignity of the dead whole honouring the wishes of the bereaved family. They didn’t teach us how to deal with loving but disliking your job. They didn’t teach us how to ask the grieving, crying family what their relationship with the dead patient was so we can fill out the death certificate. They didn’t teach us how to eat after witnessing an ant infested dead body of an elderly woman. They didn’t teach us how to politely say no to the many invitations of hanging out with friends and family after an exhausting week of surgical masks, bad chest x-rays, and dropping saturations. They didn’t teach us how to sleep without having nightmares of another dead patient. They didn’t teach us how to say, “I am not sure about this, I’ll look this up in our medical guidelines and get back to you!”. They didn’t teach us that doctors, too, are humans, and can not know a thing or two. They didn’t tell us how to put our emotions to sleep; or rather, how to flick the switch on and off. They didn’t teach us how to politely move away from well-meaning acquaintances looking for medical advice in a party that we went to in hopes of having a break from the stench of disinfectants and the beeping of the blood pressure monitor. They didn’t teach us how to have realistic expectations from ourselves. They didn’t teach us how to pray for our patients – for their good health, for our ability to heal them, to save us all from medical and ethical negligence. They didn’t teach us how to not get attached to every patient we see. They didn’t teach us where and how to draw the line between patient-care and self-care. They didn’t teach us anything about sacrifice, patience, compassion, empathy, and a kind, encouraging word of appreciation.
So even though its another one of those October days, there’s something about the unpredictable weather that somehow got me to pen this down. Thunderstorms, I suppose, often resonate with the ones within us.
A few days ago, my inbox notified me about a message from a young girl who hoped that I’d talk about the headscarf one day. That I’d understand that to stand away from the crowd takes more than some average grams of courage. To do that knowing that all of your accomplishments, the goodness of your character, every little thing will henceforth be only defined by a piece of cloth you wear, is definitely more courageous than anything else I’ve known. Yes, I do understand. I absolutely do.
I don’t know about others, but after the sort of doubts and questions I’ve seen people voicing, I’ll speak out of experience.
Why I started wearing the headscarf was a pretty spiritual decision. I decided it was something I wanted to do. You know how sometimes you’re walking down a lane and you suddenly feel lost but then your gut drags you to turn left or right and when you see your destination approaching, you’re like, “Yes! That’s where I want to go, omgg!” So it was kind of like that. If you believe in magic and in miracles, you’ll believe this, too. This is the world of logic and evidence, so, naturally, I did my research. But I strongly believe that faith is purely experiential. Unless you walk in those shoes yourself, you will usually always think that the other person is a lunatic.
To say that it’s not easy will be the perfect example of what an understatement is. But what convinces me to wear this headscarf every day is what’s more important, isn’t it?
When you see people around you failing to understanding why you are free to make this decision and why it’s nobody else’s business, then you also learn to be patient. You realise that you can’t be judgemental like them, that you can’t judge them for judging you. So you practice patience and remind yourself that they are on their own journey and you must mind your own business and not go around preaching them to cover their heads. You live and let live.
When you see people around you being treated as outcasts or being made to feel uncomfortable because of how they dress – with or without a dupatta, with or without a beard – you learn to practice kindness, compassion, and empathy. To make another human feel comfortable and accepted for who they are, that, is the love that humanity demands of us. That is when you nurture a more tolerant you. That is when you humble yourself and run miles away from a holier-than-thou attitude because this holier-than-thou attitude only forces its way in when we think highly of ourselves, when we consider someone else to be inferior to us. And to look down upon His creations…how can that ever be right?
In struggling to extend this compassion and empathy to everyone around you, you also realise how so many expensive degrees have gone to waste in the name of ‘enlightenment’.
So when you see the society throwing these various daggers at you, you begin to appreciate these mystic attributes of kindness, empathy, compassion, and tolerance even more. Soon enough, you realise that these are more important for humanity than anything else because this world is, by large, getting uglier day by day. You begin to see them as basic survival tools for your spiritual and mental health and the only true way to practice, “Live and let live!”
So because you have seen unkindness and apathy and baseless judgements and intolerance, you vow to not do the same. You give out love and kindness. You hold their hands and you remind them that they’re not alone, that they’re loved, that they are appreciated.
So that is why I continue to do what I do because I, too, am a human who needs a constant reminder to stay a human.
“All mankind is from Adam and Eve, an Arab has no superiority over a non-Arab nor a non-Arab has any superiority over an Arab; also a white has no superiority over black nor a black has any superiority over white except by piety and good action.” Those were the words of the Prophet (P.B.U.H.) when he addressed the large crowd at Mount Arafat in Makkah, on 9 Dhul-Hijjah, 10 A. H. We all know what this particular phrase from the Last Sermon means. No one is superior to anyone else “except by piety and good action.” So anyone wearing a headscarf or sporting a beard is not superior to anyone not wearing it. Anyone not wearing a headscarf or a beard is also not superior to anyone wearing it. How do we decide who is better than who? If the you today is kinder, gentler, more empathetic, more non-judgmental, more empowering than the you yesterday, then, yes, I think you might be better than yourself.
We’ve all been told that we come to this world alone, cross paths with our teachers – for everyone is here to teach us something very valuable, we just need to pay attention – and we die alone. So if we’re all alone in this journey, then might as well only compete with ourselves. Right?
Moreover, we’re told that these acts of worship – whether it’s praying, fasting, giving charity, or wearing the headscarf – are out of love and obedience for God. It truly beats me how these acts can really reflect our love for God if while doing those, we break another human being’s heart through our insensitive actions and words.
To those criticising the headscarf, I wonder what they are trying to prove by putting another human being down.
To those criticising those who don’t wear it, I wonder what love of God you are displaying by making another human being feel unaccepted, unloved.
Kindness, compassion, empathy. You can’t be a human without these, can you?
“Konsay school jaatay ho?” (What school do you go to?)
“Abhi tou myn nahin jaata naa! Corona ki vaja se!” (I am not going these days because of Corona!)
“Oh, Haan!” (Oh, right!)
“Magr abb tou Corona khatam ho raha hai naa! Tou myn abb jaoun ga!” (But Corona is ending now so I’ll go!)
“Haan, yeh tou acchi baat hai naa?” (Yes, that’s good, isn’t it?)
“School myn maza aata hai aapko, Rohan?” (Do you have fun at school, Rohan?)
“Bohat ziyada!” (A lot!)
“Kya karnay maza aata hai? Favourite subject konsa hai aapka?” (What do you enjoy at school? What’s your favourite subject?)
“Mjhe colouring karnay bohat maza aata hai!” (I enjoy colouring!)
“Hmmm? Favourite colour konsa hai aapka?” (Really? What’s your favourite colour?)
“Orange and green!”
“Wow! Yeh tou bohat bright aur happy colours hain! Acha, Rohan! Aap thora straight kharay ho, please!” (Wow! These are such bright and happy colours! Okay, Rohan! Stand a little straight, please!)
“Aap kya kar rahi hain?” (What are you doing?)
“Myn dekh rahi houn k Rohan kitnay tall ho gaeye hain!” (I’m checking how tall Rohan has become!)
“Myn tou bohat barra hogaya houn ga! Myn roz milk peeta houn!” (I’ve become very tall! I drink milk every day!)
“Haan? Yeh tou bohat acchi baat hai! Par shayad aap khatay thora kum hain isliye thoray se weak hain!” (Really? That’s great! But maybe you don’t eat enough which is why you’re a little weak!)
“Acha abb myn sahi se khaoun ga!” (Okay, now I’ll eat properly!)
“Good boy! Thank you! Abb aap apni drawing book mangwa lo ghar se aur koi achi si drawing bana k uss myn colouring karo!” (Good boy! Thank you! Now you can ask someone to bring your drawing book from home and you can draw in it and colour the drawing!)
“Aap dekhyn hi?” (Will you see it?) “Haan! Myn shaam myn aakay dekhoun gi!” (Yes, I’ll come in the evening to see it!)
“Okay! Myn sab se achhi colouring karoun ga!” (Okay, I’ll do the best colouring!)
“Hahahh! Haan! Mjhe pata hai!” (Hahahh! Yes! I know!)
And that is how I took the weight, height, occipitofrontal circumference, and mid-upper arm circumference of the cute little patient we admitted that day.
*Name has been changed to protect the patient’s privacy.
I saw you in my dream today after a very long time. I woke up with a racing heart and tears. Confusion and relief tasting bitter on my dry tongue, I lay there tossing and turning, sleep gone for more days than I want to know.
You were sick. You were very sick. You were dying. Your fragile body in my hands, you were in pain. And I was fighting for you like I always have. I woke up sad and angry because it hurt to see you struggle to breathe. But I know you’re not in pain. I know that because Allah Mian loves you more than seventy mothers, He has been so kind to you, He chose the most auspicious day for The Reunion. So why then? Why?
Are you sad and angry for me? You were always so protective of me. I know, Nani Jaan. I know. But I’ve gotten back my lost place after so long and I’m not letting go of it. So I will not deny this huge favour that He has bestowed upon me. I will not let this go to waste, it’s gotten me back to you.
It won’t get better. It’s the new normal. Our new “Alhamdullillah“. So Alhamdullillah.
So it’s been two whole years since you all -my beloved family, dearest friends, loyal followers – have been watching me shamelessly self-promote Walking Thoughts; the baby venture launched to celebrate my love for reading, writing, and teaching in the glorified hopes of wanting to make a difference my way. Two whole years since I took that leap of faith, ventured into the risky territory of setting up something from scratch and burning the midnight oil to let it become a household name. Yes, nothing makes me happier when colleagues at Dr. Ziauddin Hospital walk up to me and say, “You run Walking Thoughts, right?” And nothing makes me happier when students learn and benefit from whatever little I have to offer them; that’s enough to let me wake up with a smiling, grateful heart.
And now as I celebrate the growth of what’s been a defining part of my career and has made me who I am today, I’m delighted to launch another project that had been a hazy dream ever since my first day in the third year of medical school: International Society of Humanistic Medicine.
At ISHM, we aim to unite healthcare professionals from all over the globe to promote an interdisciplinary approach towards medical ethics and holistic healing, both for ourselves and our patients.
We talk about the following in terms of our own personal and professional experiences and in view of pre-existing data and research: – The human experience in the practice of medicine – Professionalism and work ethic – Patient empowerment – Patient diaries – Medical errors – Patient counselling – Empathy – Medical ethics – Mental well-being of HCPs – Work-life balance – Being better
OUR MISSION To expand and diversify the field of medicine to include a more holistic approach towards patient care while also making working conditions and professional conduct better for healthcare professionals around the globe.
OUR VISSION ISHM provides training, support, and public awareness to all individuals and families affected by ill-health, and all healthcare professionals tending to patients directly. To meet that goal, ISHM is building a movement that aims to broaden public awareness and inclusion in every part of our alliance, with a special focus on patient empowerment, medical ethics, narrative medicine, and mental health amongst HCPs. We aim to increase our visibility and impact by strengthening as a unified organization of shared experiences, as we maximize our engagement with all healthcare communities.
OUR VALUES 🌐 Integrity and teamwork. 🌐 Invest in people. 🌐 Inspire positivity. 🌐 Improve patient care. 🌐 Improve working conditions for healthcare professionals.
Here, I would also like to specially thank Prof. Dr. Ejaz A. Vohra, FRCP (Edin), Director Postgraduate Studies (Clinical), Chairman Department of Medicine (1996-2018) and Professor of Medicine at Ziauddin University. Prof. Vohra has been a valuable mentor for his students and colleagues in promoting Humanistic Medicine. He has truly been an inspiration and a great source of motivation. If I were ever doubtful about the sustainability and impact of this new project, it vanished into thin air the day he summoned me to his office and said, “This is very good, what you’re doing. Now I’m relieved that there’s someone to carry this on with enthusiasm and do justice to it. Focus on your career, but don’t let go of this, either!” I won’t, Sir.
After spending half the day feeling sad about a virtual convocation, I’m now beginning to feel the heaviness of uncertainties and nostalgia descending around me. Most of us have worked as house officers during a frightening pandemic,a lot of us have survived studying for an uncertain exam that had fallen prey to the same fright. And now there’s a whole new life lying ahead of us. We’re excited; scared; tired, even. Reminder to self? Maybe it’s time to take a step back and just enjoy the light drizzling, the melodies of summers gone by, the excitement of a promising future, and a life of purpose, and laughter, and love.
Having received a virtual degree that certifies our status as qualified doctors, let us not forget a very important lesson that all of us have learnt together: we all know that the vicious cycle of ‘I-had-it-rough-so-shall-the-younger-ones’ does not stop at diabolic social norms and customs usually handed down in the ugly disguise of ‘tradition’ from one generation to another, but also plagues our professional circles where one side chooses to override the other. We not only need to talk about uprooting this thorny bush, but we also need to take practical, effective steps to do so. We must be kind to our colleagues, our juniors, our patients; we must not let arrogance get in the way of who we are supposed to be.
As we walk on this thin rope of life, we owe every human being we meet the sincerest form of dignity,respect,compassion, and kindness.
A special thank you to our ultimate support systems – our families and our friends! We couldn’t have done it without you all! When you invest half a decade of your youth into something, it sure does become ‘something’. It’s not the end goal that really matters. It’s the little golden moments that come together to create a new timeline; the small rays of the sun converging to become a beam. The lessons learnt along the way, the answers we got wrong, the friends we lost, the family we made. Yes, it’s all of that.
Class of 2019, we graduate today with an undying hope and a sincere prayer that every single person taking their degree, graduates with a kind, kind, kind heart. Amen.