an itinerant observer

Ready to traverse a landscape rich with human emotion, ethical quandaries, and the quest for meaning amidst chaos? ‘ Poems from the (ER) Pit’ offers a glimpse into this world, not through clinical case studies, but through the visceral medium of poetry. Each poem illuminates diverse facets of emergency care. Through poetry I navigate the emotional, ethical, and philosophical terrains of emergency medicine. This collection, more than a series of poetic expressions, is a call to reflect, to empathize, and to act. It invites you into the heart of emergency care, challenging you to see beyond the clinical to the deeply human(e) side of healing. ******************************************************** In the dim light of dawn, a child’s battle ends, not with triumph, but with silence. This moment, captured in “C’est La Vie” is a stark reminder of emergency medicine's raw reality. The poem serves as a prelude, inviting us to confront life’s precariousness and the profound impact of...

“Primum non nocere.”  (First, to do no harm) This is how I started a  blog  for the  Express Tribune  a few years ago. I wrote it then because I felt I had to speak out. A sweeper in Karachi had been rushed to a nearby hospital after he succumbed to noxious gases while trying to clear a sewer. The shocking bit was that the fasting doctor on duty refused to treat the critically ill sweeper covered in sewage water, claiming that doing so would have broken his fast. Interestingly, it is Ramazan again, so perhaps an apt time to remind my fellow healthcare professionals to recall their primary responsibility – the patient. Fast forward two years, and I’m once again recalling  primum non nocere , the starting phrase of the Hippocratic Oath – a solemn promise exhorting freshly minted medical and nursing graduates to heal their patients, but prior to that, to do no harm. I am again reminded of the oath, as there’s been a recent upswing in alle...

I heard about the second floor (T2F) in Karachi before hearing about the person behind it. Prior to relocation to Karachi, my birthplace and the city where I came of age, T2F was described to me as the reason why Karachi was still cooler than Lahore. I recalled the 80s and 90s during my school and medical college years, when there weren’t any spaces like the T2F, where one could go and immerse oneself in thinking, for oneself and for those around you.  After resettling in Karachi, I had the opportunity to visit a few sessions at T2F. It was delightful. The talks and discussions were scintillating, photographic or other exhibits impressive, and the café an oasis. But none of that even came close to the person who ran the show, Sabeen Mahmud. Every time I would see her there, I found her exuding vitality and uber enthusiasm for any cause célèbre that she hosted. She was witty and introspective, an intriguing combination - a real charmer, as they say.   Interesti...

My ER shift started in chaos. “Does it have something to do with today being Friday the 13 th ?” I wondered, although not really being all that superstitious, I knew it was just a momentary thought. On bed 13 lay Aleya, a 13-year-old previously normal and healthy girl, youngest of 13 siblings. To add insult to injury she got ‘tubed’ (intubated), unsurprisingly, at 1300 hours. But I get ahead of myself, so let’s start at the beginning.       For the past 13 days Aleya had been running ‘very high’ fever, not confirmed by a thermometer. “Jism bahut garam tha” [body felt really hot] said her 18-year-old brother, repeating the fever-detection-by-hand story that I must have heard over a thousand times already since starting work in the pediatric ER, just a few years ago.  I didn’t say anything to Aleya’s brother then as I was tired of getting on the soap box about inaccuracy of that approach for fever detection. “Get a thermometer next...

What’s the chance of a bad outcome,lik e death, in Karachi? Based on anecdotes circulated on social media and what you read in the news, you might assume that chances for a series of unfortunate events remain high in this city. This prompted a friend to do some calculations to gauge chance of an unexpected death in Karachi, compared to any major metropolitan city in the U.S. Assuming how the percentages were arrived at was fairly accurate, the bottom line, if true, was intriguing: the likelihood of an untimely, unexpected death was similar in the two places. Delving into death rates in Karachi vs. elsewhere was perhaps meant to be an intellectual discourse following the meaningless death of a colleague’s sister in Karachi. Being gunned down outside a famous restaurant after a meal there is hard to rationalize as an expected outcome of a botched cell phone robbery attempt. But this is Karachi. And such occurrences are unfortunately all too frequently heard and shared. Ev...