It’s another September

11:10 AM | 21 September 2019

The heatwave has struck again. As I walk through the corridor of the third floor of the Ziauddin hospital – a reluctant home for these past ten months – towards the cardiac ward, I find myself rather liking this intense change in weather. The hot air sublime on my face – nostalgic, familiar – and the days melting into each other. It reminds me of the hot summer evenings of 2013 spent waiting for the Chemistry class to end so I could head home. The chorus of friends, the pile of unsolved past papers,  biryani packed in plastic boxes and shared with Hira as we sat on the narrow staircase; dumb charades the background to all our college days.

The air that hit my face today is the same. It, too, has travelled through time; aged with experiences, lapped over the helm of lazy ambition, and swimming towards another autumn of dry winds, hazelnut coffee, and exciting new days.

It’s another September. It’s another end. It’s also another beginning.

 

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We have no other choice, really. Hope, it is.

10 August 2019

When we started our paediatric rotation for our final year, I was expecting to learn a lot. But things never go as planned, do they? An unexpected incident gave me the red light and I lost my pace.
The Ziauddin alumni would know what a darling the Paeds department is so that didn’t help either.

I may not have learned as much about little kids and their ailments – but I’ll get there because I want to – but I was certainly tutored in how to battle anxiety and stress and not fret over that which is beyond our control. Fretting over the scary end-of-rotation test and a gargantuan syllabus was not going to help. Neither was worrying over a future that could potentially steal the golden hours of my present. Being happy, staying happy, is a choice; I was beginning to unveil the curtains looming over my subconscious.

So like the generous August downpour greeting our dusty Karachi, I began to feel a certain level of generosity towards the concept of mindfulness and Tawakkal (unshakeable, unconditional faith in God). Let’s just say that I decided to be eternally hopeful.

The rising sun, the eclipsing seasons, each new heartbeat, each new step forward, each new advancement made to better humanity, every little baby being named something sweet – all of this is a reminder that nothing lasts forever. Not joy, not sorrows. So we must go on having hope, we must go on having faith that everything will be fine.
Yeah. Everything will be fine.

We have no other choice, really. Hope, it is.

It’s a strange place to be in as the hands of our clocks slowly tick by. There’s a whole new life lying ahead of us and there are important decisions to be taken. Like any other final-year medical student, I, too, am tired. There’s a lot on my plate and I just keep getting a bigger plate; maybe the exhaustion is waving at you from my words, maybe not. 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.

Paediatrics, thank you for teaching me that, at least! It’s all peaceful now, finally. Thank God!

 

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Photo: Maham Noor Darabu

 

There are six weeks left until five years of this journey comes to an end.

10 June 2019

The man looked really, really, really angry. Clad in a plain white shalwar kurta, he held a slip of paper in his hand, waving it around frantically. We had just reached the orthopaedic OPD – a good sixty minutes late because we knew the consultant was never punctual – and were prepared to wait for another hour till the clinic would begin.

“I will report you in the media! What nonsense is this! I’ve been waiting for an hour for this doctor to show up! Why have you written the time 2 PM here when he comes late? Is our time not valuable?? You charge us an exorbitant fee and make us wait for hours at an end! This is ridiculous! I will make a video and circulate this on social media! ”

We quietly crept back into the clinic. Crept back, yeah. Because we knew that man was right. We knew how valuable his time was. Maybe he had taken a leave from his workplace to especially bring his patient here. Maybe he had travelled a great distance to get to this hospital. But maybe none of that was true and he was just tired of waiting. Because time is valuable. Whether it’s his or ours or the very respectable doctors’.

There are six weeks left until five years of this journey comes to an end. I’m not very sure about how I feel. Ecstatic? Relieved? Accomplished? Scared? Apprehensive? Anxious? Maybe a little bit of all or simply none of these. But my heart is only beating to one realization – 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.

Just six weeks left. I will keep praying that all of us – every single person I’ve shared that lecture hall with – graduates with a kind, kind, kind heart. Amen.

 

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the little secrets of life

7:20 PM | 1 August 2019

Five years ago when I started medical school, I had expected to learn the truth about human life – how we breathe, how we eat, how we sleep. Literally. But what I have stumbled across is far, far greater than that. I’ve learnt how we feel, why we feel. The little secrets of life, you know? Yeah. And how a dua – a heartfelt prayer – works.

We sit on the prayer mat and raise our hands in supplication and cry our hearts out, our foreheads kissing the ground, our souls trembling. We utter our hearts’ deepest, darkest desires. Then we get up from the prayer mat and we expect heaven to have been laid right before us, right away! Not so fast, people! Not so fast!

It’s a process. Slow and steady, usually. Also awe-inspiringly quick, sometimes. A fetus takes nine months to grow into the baby that the mother gives birth to after a tiring labour. I’ve seen duas being answered like that. I see it now, too. I see the ease in the difficulty. “For indeed, with hardship will be ease.” (Surah Ash-Sharh [94])
It’s amazing how I can even see it. Another one of those hugs from God, you know? Pour in a little love, a faith that loves to play hide-n-seek, also throw in an ounce of fear – “what if my prayer isn’t answered?” – and lots and lots and lots of patience: that is your dua. And then the magic begins to show itself; a  few trips here and there, maybe a disaster or two, a couple of heartbreaks and a huge river of tears later..it happens! At the perfect timing, in the perfect way. Perfect here is synonymous to His will, okay?

And so it’s happening! It’s happening and I am in happy awe of how beautifully He is managing the universe! The little ants who get their sustenance; the chirpy birds; the poor cobbler at the end of the lane. Me. You. Us.

We all have such a beautiful relationship with God. He has little secrets with everyone, all of us. That’s so incredibly fascinating, is it not? How He brings ease into my life will be very different from how He sends a hug your way. But the interesting bit is that we all see it. Not always. Just sometimes. And in those “some” times, lies the secret to all of our time on this little planet.

Everything wonderful is on the way. Yeah? Yeah.

 

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The Glasgow Coma Scale

| 9 June 2019 |

During our end of rotation exam, the spot for neurosurgery had a question on epidural hematoma. The question was a case based CT scan image, asking us to state the GCS of the patient, the radiological findings, and the subsequent management plan.

The Glasgow Coma Scale (GCS) is the scoring system used to describe the level of consciousness in a person following a traumatic brain injury. It evaluates the eye, verbal, and motor response of the patient. In simple words: from a total of 15, the lower the score, the worse it is.

As a doctor-to-be, I often find myself wondering how the world would be if there was a consciousness scale for basic human qualities like kindness, empathy, compassion, forgiveness, mercy. Would we have been as concerned if the ‘score’ was low? Would we have made friendships and nurtured relationships on the basis of this score? More importantly, would we have really believed in the credibility of this score to establish how “alive” a person really is, how “conscious” they are, how “healthy” they are? Will the heart and soul ever win over all that the eyes merely see?

This black and white film illustrating an important organ of the human body is more than that if you choose to think about it. If you choose to think about it. Drifting through the mundane motions of life – waking up, eating, going to work, paying the bills, filling up the car’s tank, all of those worldly tasks – the desire to worship through love and kindness drowns in the darkness of fear and confusion and “what will people think”, and we’re left with nothing but an emptiness that tires us. Tires us because our scores are low. And because they are low, sometimes, the sunrise stops becoming the alarm clock for another happy day of happy miracles; and when the foamy waves hit the shore, you only see them too late – going back, not rushing to hug you.

If only medicine had the cure to that. If only.

brain MRI
Source: Google

what i realised during the urology rotation

| 22 May 2019 |

You’re just a patient here; not a businessman, not the most popular guy in class, not the head of the local committee. Just another patient presenting to the OPD with complaints of whatever is keeping you up at night.

There’s an old man here, accompanied by his wife. He’s probably tired but he plays away with time by rolling down the beads of the rosary in perfect harmony with the holy words tasting sweet on his tongue.

A middle-aged man is tense. He sits upright, eyes downcast. Married for six months and no baby shopping in sight. His wife’s reports are normal. He sits alone outside the urologist’s clinic.

An old lady. She hasn’t slept properly since the day before yesterday because of the pain in her left iliac fossa.

One of them is accompanied by a cute little boy who wants “iiik kreeeme”. That’s how they say ice cream with love. I do, too, now.

Seeing one patient after another with the consultant, from one file on to another, I realise that I’m not the same anymore. Maybe it’s not signs and symptoms I’m interested in anymore. Maybe it’s something more…if a more does exist.
Life is sung as love and kindness and smiles, empathy and compassion and humility.
I wonder if all doctors have forgotten that.
Or maybe they, too, are waiting in another waiting area.

 

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Dr Ziauddin Hospital, North Nazimabad, Karachi, Pakistan

The Premenstrual Syndrome

This post first appeared on SehatKahani.com

Science and medicine may have made laudable advancements in making healthcare better (for the affording) but there’s a glaring full stop when it comes to the premenstrual syndrome, infamously known as PMS.

For most women, the thought of their next menses can be frustratingly frightening. Nobody likes dealing with unexplained anxiety, abdominal cramps, headaches, body aches, bloating, diarrhoea, vomiting, even hypotension that can lead to fainting, clumsiness, and irresistible carbohydrate cravings. Not having the energy or the will to go on managing the daily tasks of life – be it studies, a stressful job, a house, or even a simple hobby like playing a sport – leaves you emotionally and physically exhausted, anxious, and if faced with lack of a supportive environment, can even lead to depression.

Since there is no pill to cure the myriad of problems that come with this syndrome, the only other alternative is to manage it with a healthy lifestyle aimed at minimising the stressors.

A little reassurance and an empathetic ear can work wonders in making one feel comfortable. By not acknowledging the gravity of her situation or by callously shrugging it off, not only are we taking away the trust that they show in us by reaching out to us, but we also aggravate the problem. So acknowledge, listen, and reassure her. Rearranging schedules to reduce stress could be a feasible option. An improved diet, regular exercise, and meditation also help – cut down on the saturated fats, take a Panadol for a headache, keep yourself hydrated in case of diarrhoea to prevent an electrolyte imbalance that could further upset the body’s normal functioning, and take plenty of sleep if you can. There’s no good sense in exhausting yourself when your body is shooting daggers at you, threatening to shut down any moment. Be kind to yourself, ladies.

Like most problems plaguing the female lives, PMS is highly under-rated. Every woman’s body is different and no two women experience it the same way. The only way to help another female friend is by showing kindness, by cooperating with them on their bad days and help make even the little things easier. Remember, what goes around, comes around.

 

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