One Hundred Hours

The morning after Karachi drowned, I did something I do not usually do. At 0700, I walked into Zahid’s room. He lay unresponsive, frothing at the mouth. Twenty-five years old, once trained patiently by my mother and later woven into the daily fabric of my household. Reliable yet often clueless, a boy who grew into a young man - always present, always willing. Now limp in my arms, his breath shallow. He had likely just seized.

What if I had not gone? The question shadows everything that followed.

The floodwaters of a climate-changed Karachi had receded just enough. The rain had stopped. The roads were empty, strangely permissive. Had they still been blocked; this story could have been another one entirely.

Security guards from the neighboring house helped me carry him to the car. My sister-in-law hurriedly drove us to AKU Clifton ER, where competence was ready to act. My former residents, now instructors and SMOs, stepped forward with calm assurance. Nurses and staff I had once worked beside moved quickly, intubating him, controlling seizures with midazolam, pushing naloxone. His airway secured. For that moment, he was held.

The algorithm in my head had switched on.

“Move. Secure. Transfer.”

I did not linger on what-ifs. I did not stop for feelings. The sequence mattered more than emotion.

From AKU, we moved by ambulance to JPMC. In a city still paralyzed from flooding, with no electricity for more than twenty-four hours, it should not have been possible. Yet doors opened. A senior doctor facilitated his admission. ER doctors received him. ICU doctors admitted him. Nurses took their places at his side. An ICU bed and ventilator - scarce even in the best of times - were somehow waiting.

The differentials swirled: meningoencephalitis, seizure, stroke, poisoning, carbon monoxide from the generator that had spluttered all night. Later, numbers gave some shape. Troponins rose. BNP surged. CSF came back nearly empty of white cells. ABG was clear. UDS negative.

Yet in those first hours, naming the illness mattered less than keeping him alive.

Even as I moved him through ERs and ICUs, another dilemma pressed in. Zahid’s crisis overlapped with my daughter’s beginning. Her college life was about to start. One life on a ventilator, another standing at a threshold. Stay or leave. The decision tore through me, yet the answer was made bearable by a providence I could not have scripted. His brother was already on his way back from Punjab. The handover was possible. And it was more than medical. It was a brother receiving a brother, a family stepping in where I could no longer be.

And through all of it, my wife was the anchor. Her steady presence, her ability to communicate and coordinate, her way of stitching fragments together into coherence kept the story intact when I had to step away.

At Abu Dhabi airport, Zahid’s face lingered. Not as the boy who liked every trivial Facebook post of mine, but as someone suspended in a strange limbo.

It reminded me of Márquez’s One Hundred Years of Solitude and its plague of “sleepy sickness.” People who drifted into slumber for days or weeks, time erased. Zahid had lived something like that. He remembers nothing. Only that he fell asleep, then woke four days later.

Nearly one hundred hours gone, vanished.

Meanwhile, his parents had also rushed from Punjab. They stood outside the ICU, refusing to leave for food or rest. They kept vigil in corridors darkened by power cuts, tethered by worry and love.

His mother shook her head at his absent-mindedness, still able to summon wry affection even in that moment. “Always on TikTok,” she said, remembering how he would film, post, dash out into the rain; careless, boyish, as if consequence did not exist.

And then, against the odds, he woke. Extubated. Stable. Talking. His lungs and heart intact. The specter of poisoning, ARDS, and carbon monoxide dissolved. Viral encephalitis became the final name.

He nearly slipped away into his own sleepy sickness, but he returned. Not as a case defined by acronyms and numbers, but as himself, wonderfully and maddeningly alive.

The TikTok King is back!

from Narrative Medicine

Reference: Mian A. (2025). https://tribune.com.pk/story/2521602/whispers-across-time

In acknowledgment: Co-piloted with GenAI, nudged by memory, meaning, and so much gratitude.