A letter to her (II)

Dearest *Nani Jaan,

You didn’t wish me ‘Eid Mubarak’. You didn’t get up to tell me how my dress looked. You didn’t even chide me for not getting henna on my hands this time even though I love it. Why?
You didn’t lovingly order us to pile our plates with food. So I didn’t. I just sat by you not wondering why Eid didn’t seem like Eid.

It’s getting quieter in here, you know.

There are highs and lows. I have raged and fought with God. I have demanded justice. There was no answer but I know it will come. I just don’t want those empty days to return. Can you possibly come back? Giving up isn’t easy and who would know that better than you? Because this silence that is becoming my new best friend is haunted by guilt.

Regrets are not easy to live with, Nani Jaan. And every time I bend down to move you, every time my own hands touch yours as I tie the damned sphygmomanometer cuff around your bony arm, every time I glance at your sunken cheeks, I find myself beaten up by guilt and regret. And then I run away from myself; my feet falter with the weakness of my heart, my tongue begging Him for help. And then you know what happened? One such moonlit night brought me the answers I had never expected.
Life is so, so strange.
It doesn’t seem fair that through this I’m seeking the mercy that I need, that through this will come my relief, that this is my way out.
It’s so true, Nani Jaan, that human intelligence is bound within the first degree of imprisonment; no matter how many nanoseconds we discover, no matter how many moons we land on, no matter what great genetic engineers we become, we are always helpless in front of His plans. Always.
I wonder if introspection and retrospection are His favourite ‘-tions’? Because they steer us towards His love, and through our own follies and short-comings, we discover His Being, and then with shaking hearts and hopeful souls we go Home to Him.

We go Home to Him.
We go Home to Him.

This doesn’t seem fair. But then who am I to decide that? A small collection of cells that is nothing without His beautiful Will. Absolutely nothing. And I know that when I see how marvellously my own plans fail and how wise are His.

Remember several of those sunny afternoons when we would ask you if you’re hungry? You’d say, “No. God has filled my stomach. I don’t feel hungry. I’m content. Thank God”.
And of course, you don’t. The hypothalamus in your brain has taken care of that. See. I found my answer. Why does that always happen? Why do I find the how to the why as soon as the when happens? Because it’s all a matter of perspective, you’d say, and it all goes back to Him.

This is just so crazy.

You called me your friend, your ‘saheli’. You said that because your friends left, you found me.
“Meri saheliyaan chali gaeeyn tou yeh saheli aagaee”.
Yes, Nani Jaan. One friendship for another. Maybe this is the meezan that God lovingly spoke about, isn’t it?

It really is getting quieter in here. And I miss a lot of a lot of things. Thank you for not giving up. Not yet.


Your Arfu.

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*Nani Jaan: maternal grandmother


there’s just some fog behind

The road was ending anyway, but you eventually said goodbye.

It’s a calm night. The stars are whistling, trying to cheer you up. The wind seems to be dancing around, inviting you to a once-in-a-lifetime. But what are these once-in-a-lifetimes anyway? Foggy regrets that your foolish heart spins into a fairy tale. Or maybe gentle reminders of a cosmos that your fragile mortality could not handle. Does it make a difference, you ask. We don’t know yet. You only know it – feel it – once it floats away from you and when you try to run towards it, it waves at you with a reproachful glance, a disappointed smile.

The night-sky is a delightful companion for the dervish. It often asks you if there is happiness in shutting doors. There isn’t, you say. There’s just peace, the scary kind that does not even tell you if there are other doors, let alone finding the key to the same one. There’s peace in jumping into the deep blue ocean and not knowing whether it will welcome you or which lonely island it will throw you on; that’s what the night-sky believes. But you’ve had enough of islands, you tell yourself. Humans are islands, too, you’re reminded.

You look up again. There’s just some fog behind.

Two shooting stars at each end of God’s canvas; sad, and scared, and defeated, their hearts longing for home. So far away, yet, so close.

Artwork: Safa Younis


So that’s some of the people from my fourth year clinical group; us in our natural habitat, laughing away before a dermatology class, posing for future’s nostalgia, dreaming big, tired but ready to conquer the world. Doesn’t that make you smile fondly?

Now all of us – girls and boys – entered this field with vague ideas of sleepless nights and big, burly books that will bully us endlessly, and hopes of a life straight out of Dr. House. All of us – girls and boys – have been subjected to the same rules and regulations, have read the same textbooks, taken the same exams to get promoted to this level. There is, however, one thing that sets us girls apart – having to deal with stifling, infuriating sexism. You would think that a field like medicine that revolves around healing humanity, with the basic principles of providing quality healthcare regardless of race, religion, gender, would be free of such plagues. Unfortunately, no.

Senior consultants will not think twice before urging our male counterparts to work ‘harder’ because they are the ‘eventual breadwinners’ of the family and us girls will eventually handle the ‘pots and pans’.

You will be shocked, hurt, and angry when instructors will pass similar derogatory remarks, adding that a woman’s place is in the home and a field as challenging as medicine was merely ‘impractical’ for them.

Your correct answers will easily be ignored before the consultant will move on to advice your male colleagues to study properly because “you have to do the real work”.

Do you know what the best part is, however? All of us – my very empowering girls – have never succumbed to the trap laid out by such chauvinists. Why should we? We belong to a nation that has the likes of Dr. Anila Darbar, Pakistan’s first female neurosurgeon; Dr. Rehana Mohammad Ali Shah, Pakistan’s first female orthopaedic surgeon; and Dr Attia Zafar, who bet all odds when she enrolled into the same medical school as her eldest son, the year he was graduating. These are all women of strength who have fearlessly broken all glass ceilings. So why should we bow down to the forces of patriarchy and sacrifice our dreams and ambitions? Certainly not!

Thank you, @clearskindoc and @dr.pamelamehta for bringing together the women in medicine to speak up and support each other through your #shesanequal campaign on Instagram!

Let’s not give in to this, superwomen!

when the earth met the sky

I often wonder – when I’m supposed to be studying for one clinical undergrad exam or the other – how the earth met the sky.

Did they eye each other with suspicion or they hugged like long lost friends? Did the sky ever say to the earth, “Peace be on you”? Perhaps, it didn’t. In fact, I’m pretty sure it forgot. Because our earth seems to be a mere resting place for two-legged beings who call themselves humans and kill with tongues, and toys that stink of ammunition.

Do you think the sky was boastful of the tears that it cleanses the earth with? And how its moody sighs crash waves on the salty sands of our shores, giving some of us a happy respite as we gaily feast on the ice-cream being sold by that old vendor? And how its twinkling stars eye the small crawling insects on the leaves in our gardens and say hello to the fireflies?

I wonder if each of the seven skies – sewn into each other, sometimes thundering, sometimes loving – is as beloved to our strange, strange earth. Because our earth – brown and muddy, blue and windy – sends up these souls every day that leave behind a thousand tears and a lot of loneliness. Who knows?

So I like to think – as I sit down peacefully with the familiarity of what seems strangely new – that the sky and the earth have been the best of friends and that Adam and Eve were the sky’s most precious gift to the earth, and that God – up in His heaven and everywhere in our hearts – loved them both equally. And that love, dear you, is ours to live. And that makes me happy.

Photo credits: Sabrina Merchant (https://www.instagram.com/drmerc/)

A letter for her (I)

Dear *Nani Jaan,

I think I’ve been born twice – the first time I came into this world, I owed it to **Ammi; the second time, to you. Yes, you. It’s been more than a month since your ailment and I haven’t seen the old Arfa around since that day we rushed you to the hospital. I’m not sure if I miss her though.

In a recent blog post, I wrote about finding meaning in suffering, beauty in sorrow, gratitude in hardships, smiles in tears, forgiveness in hate, and most importantly, life in death. I found all of that by your bedside, holding your hand; my palm resting against yours as the fingers of my other hand felt your uneven pulse soothing my fears, wiping away my tears. And so in your silence, I heard it all. Your empty gaze is probably saving me from a lifetime of regrets. In the comforting, trusting clasp of your hand, I found the Rumi that my Shams had so desperately needed.

Nani Jaan, all the lovely moments we’ve secretly shared have come together to create a nebula of our souls. I know that you know that because you have searched for my eyes in a room of several others and upon finding them, you have told me that I know everything. It felt like God was speaking to me then, through you. Nobody understood what you’d meant then. Expect us, of course. We know that that ‘everything’ is beyond the confines of this world, that it celebrates the mysteries of that which is immortal, the ethnicity of our hearts, the truth in the melody of His words.

And so as I’ve sat grieving – for the past and the future – you have led me to live the present; to truly feel the blessings as your palm caresses my head, to marvel over the innocence in your smile, to envy your thirst for His words, to know that what I’m sharing with you is just another once-in-a-lifetime – sent to heal another lost one, perhaps – and to be ever grateful for living this miracle at a time when I thought I least deserved it. And that’s how I found beauty in sorrow.

You’ve been so brave. You miss your father, we know. You miss your father-in-law, even. You miss our ***Nana Jaan and the two sons you’ve had to bury together. You miss them, you cry for them, you bear all this pain that makes us rush you to the doctors but what do you say? “And which of the favours of your Lord will you deny?” And that’s how I found gratitude in hardships.

You asked us not to cry. You implored – without words – and I have listened. I know now that every wound does not necessarily need a band-aid straight away, that it’s okay if things don’t go my way, it’s okay if people leave, it’s okay to let go. I know now that it’s okay to not win the race of this world, that it’s important to keep going, but we’re allowed to slow down. And now as I see you surrendering yourself to your Lord, I have learnt – painfully – that we don’t always need to fix things, and sometimes, just leaning against those who are home is more than enough, that life – with all of the cacophony, not despite it – is very happy, very beautiful. And that’s how I found smiles in tears.

I thought I was one of the transgressors, that the beauty of His miracle would now not touch my life. But I’m glad I was wrong, Nani Jaan. Through you alone, He showed me that these billions of seconds that have worked upon blowing this new soul into me are a sign of His love, of something extraordinary. And that’s how I found forgiveness in hate.

Through you alone, I have been taught where to stop, how to stop. You gave me a second chance at life, one that I had never anticipated. As you hold my hand, I can feel my heart softening as I meet the new me. I’m scared of her, you know? Because she makes me realise how unprepared I was for what I was seeking, how I do not need to answer every question, how I need to play in the cool calmness of the waters of Zamzam before I can recognise the wisdom of Hazrat Khadija’s eyes. And that’s how I found meaning in suffering, life in death.

Thank you, Nani Jaan, for giving me birth. Thank you for passing on the gift of who you are, to who I now am, who I will be. Thank you for waking me up. Thank you for this second chance.

We’ll always be here, together. Isn’t it?


Your Arfu.


Credits: Saleeha Khan Shujra


*Nani Jaan: maternal grandmother

**Ammi: mother

***Nana Jaan: maternal grandfather

I will say, “The wall-clock has broken”.

Huge rivers flowing from large, brown
eyes pool into your heart. It hurts; you cry out. Mountains don’t move,
and you walk ahead towards the storm, away from the tempest. Time will pass, languages will evolve, your letters will rust,
and we will live beyond the realm of unlived dreams.
I will say, “The wall-clock has broken”.

Artwork: Fatima Afzal

a summer dream

It’s decided: one warm summer morning, we will go down to the beach and say hello to the waves. It’s going to be nice and warm. The sun will have just come up and we will stand by the sea-shore, the waves gently encircling our feet, comforting our tired heels. The rising sun will make for the perfect background; the reality of its size humbled against the pretty sea-shells on the soft sea-shore. And we would want to do it all – fly with the birds, swim with the fishes, dance with the wind, sing with our hearts. And then we will sit on the flowery picnic sheet sprawled across the sea-sand and read our books, our summer hats happily perched on our heads. Each turn of the page will come with a sip of our cool orange juice; and occasionally, we’ll look up to see the twinkling water crashing and hugging the shore before we look away – we will look away only to glance at each other with a pride that only two young women who have together waltzed through the ups and downs of this thing called life, know of; two happy friends enjoying the warmth of life, loving their summer dream.

Happy birthday, Saba!

Credits: Azib Manzoor, Exposure Photography

The flower quivered, but it was the bird that fell.

Heartbreaking beauty and a sad, sad nostalgia haunts withering flowers. Withering flowers? Those wise, old flowers that have adorned the gardens of this world for a long, long time, and are now slowly withering away.

Now this flower is rich with love and wisdom, and knows the secrets of life. And it’s this very special knowledge that makes it so hard for the humming bird to say goodbye. But she has to. She will. She sits there, perched on the corner of its petal, watching its very own flower – amongst a bouquet of others – dance lightly with the winds of destiny, bowing down with what is an eternity, smiling to the universes, waving to the wanderers.

“Sshh! It’s going to be okay, you’re going to be okay! The Lord of the sun, and the moon, and the stars loves you more than the soil you’re perched upon. The cool breeze is kinder. Its really going to be okay!”

A few flowers away, another one fell.

“This is the best soil. I’ll take care of it, I promise.”

Her flower.

“Meet me in my dreams till I join you?”

The flower quivered, but it was the bird that fell.

In a parallel universe, the mountains flew, the moon lovingly shared its light with the sun, the neutrons were charged with love and only love, and the night was alive with the poems of those who had lost this world to win the universe.

And then the promise of His mercy made them smile.

My heart is smiling, too. I hope so is yours.

It’s a very shaky bridge.

So, what happens when you are training to be a doctor and a loved one falls sick – so sick that you fearfully begin to count their breaths on the beads threaded through the rosary – and you find it hard to draw the curtain between logical thinking and the overwhelming emotions that are breaking your heart?

I’m finding that out.

Cheyne-Stokes respiration defines more than an abnormal breathing pattern characterised by progressively deeper and faster breathing followed by a gradual decrease resulting in apnea (cessation of breathing). It’s actually the struggle to take in some damned oxygen that their ischaemic heart and brain is screaming for; their tears are wailing that they don’t want to die yet, their kids need them. It’s also you struggling to breathe – painfully – like them because it’s not fair that they suffer alone. But this patient doesn’t complain and you wonder if it really is ‘suffering’ for them.

Muscle atrophy is not just a down-regulation of protein synthesis pathways and an activation of protein degradation; its watching and feeling a strong human waste away to a bag of bones. You also see how osteomalacia is synonymous to fragility.

Vascular dementia becomes less of an ailment that can be managed by adequate doses of Risperidone and more of a heartbreak that challenges your patience, your courage, your fear of losing your person as they sit in front of you, smiling at you with an emptiness in their eyes that makes you look away.

It’s a very shaky bridge, I promise you. Held together by variants of grief and fear, it’s as strong as your ability to find beauty in this struggle. And you can find that if you look beyond the realm of your own existence, at the moonlight glowing over the little miracles dancing around us, begging you to not be a cold scientist treating a bunch of signs and symptoms, but to be a healer for the magical narratives of human lives.

yeh sab tumhara karam hai Aaqa, k baat abb tak bani hoee hai

Huddled conveniently between memes and celebrity pictures, your noisy Facebook newsfeed often carries ‘miracle stories’ that talk about how the zam-zam water cured someone, or some such similar thing. And you smile without as much of a thought and you move on because you can’t be bothered to research the ‘how‘ of the science that may have caused it. I was guilty of the same until a very recent personal experience reminded me of my own words: “It’s like the workings of a car – how you put in the key, start the ignition and the engine starts working, you pull the hand-break and the gear and turn the steering wheel and the car goes in motion. You’re doing these acts because that’s how this car is supposed to work, otherwise, it won’t move forward and you’ll be stuck in the same place”.

It was Saturday night. Kaplan opthalmology and I snuggled together by my ailing maternal grandmother’s bedside. With one eye on the image of the normal retina on the screen of the laptop, I kept glancing at the frail figure sleeping next to me, looking out for the number of breaths that she was adding to those of her children and grandchildren, with her own. Her medicine time was lapping by so we decided to disturb what seemed like her sweet slumber. But she refused to wake up; she had – in very simple words – fainted.

We monitored her vitals: no red flags at all. We contacted her doctor: “maintain her oxygen saturatuon and keep talking to her, reassure her”. Check.

As we did that, I – either out of desperation to see my favourite lady talking or out of an unwavering faith in the power of our unseen God – played Surah Rehman on my retiring phone. What followed was surreal enough to make our eyes hug tears of incredulity, and relief, and gratitude. Within minutes, her previously unresponsive eyes began to flutter. A few more grains of the hour-glass later, her previously stiff jaw loosened and her mouth began to move till she was loud enough for every person in the room to hear.

“She’s saying something!”

“She is. She’s saying ‘Fabiayyi alai rabbikuma tukaththibani’!“

Recent studies have strongly suggested that listening to the Holy Quran causes the release of the neurotransmitter (a chemical released by the nerve cells), dopamine, to send signals to other nerve cells. Dopamine has a significant role in reward-motivated behaviour, also leading to pain reduction and helping individuals recover from stroke or other injuries. It aids in the betterment of cognitive skills, improving endurance and symptoms of dementia. There have also been studies showing that listening to Quran recitation can generate alpha wave, and can be more helpful in relaxing a person as compared to resting and listening to slow and hard rock music.

And so that’s how the car works, that’s how we work!
Because “yeh sab tumhara karam hai Aaqa, ke baat ab tak bani hui hai!”
(O beloved Lord! All is Your grace that my affairs continue to prosper, that my affairs continue to advance!)

And that’s how much she loved her Lord – gentle whispers from His scripture had the very calming effect that her neurons were craving for.

Life – despite its fragility and hues of sadness – can be very beautiful if you choose to listen to the notes of love, (and miracles) and hope dancing within the songs promising you the Everlasting, courting your patience, bejewelling your strength.

I love the sunrise. Don’t you?

Photo Credits: Omama Batool