an itinerant observer

“Baba, today you may pick me up early and take me to the zoo”. And thus Noori had spoken. Noori the kindergartner was obviously having some withdrawal symptoms since she had not been to the zoo in over a month. Noori and Baba frequented the zoo, at times twice a month, albeit for brief visits. Having a yearly membership to the Houston zoo enabled such frequent jaunts to one of the most favorite shared activity spots for the daughter-dad duo. What was more likely though: Mowgli’s spirit had entered Noori that morning, the way she was rattling off about the characters of the jungle book. After school I took Noori straight to the zoo. Hence, the jungle book, without offense to Mr. Kiping, was re-drafted by Ms. Noori. Mr. Sher Khan and Mrs. Sherni Khanum were ignoring each other. They had an argument about who was arranging dinner that night. Colonel Haathi was brushing his tusks after a huge meal of elephant chow. Bagheera was pacing up and dow...

8:00 AM : Monday mornings are generally abhorred comprehensively but they are gloomier if you work as an intern. However, for me, this Monday was an anticipated work free day. Hence, not too sad. I had spent a long time on the breakfast table catching up with friends and then later grabbed my books and went to the library to catch up on my studies. However, this happiness was short lived and in the afternoon I was called to assist in the clinics and a day of no work turned into work again. 2:30 PM : I grabbed coffee and rushed to the clinics, began my job of taking a detailed history of the patient. The patient was a twenty-year-old plain looking girl who didn’t talk much and replied mostly with a yes or no. I started my usual work, asked her questions pertaining to her disease, did a thorough examination and then the hardest part of listing possible differentials and chalking out a plan for treatment. I did my work, stepped out of the room and discussed the case with a s...

Not too long ago I was on call as the resuscitation room supervisor. At the beginning of my shift I had no idea that the day was going to leave such a deep impact - one that would perhaps remain etched on my conscience for the rest of my life... The full narrative was published by Annals of Emergency Medicine and may be viewed at  http://www.sciencedirect.com/science/article/pii/S0196064416301883 [from   Narrative Medicine ] CREDITS : About the Author: Dr. Fareed Ahmed , recently graduated from the Emergency Medicine Residency Programme at AKU. He has also completed a Masters in Clinical Research from AKU.   Acknowledgement: A version of this narrative was first published by the Annals of Emergency Medicine .  Editorial Note:  This is from a 'phase II' continuation of Narrative Medicine at AKU - what started as a Workshop-based initiative on January 20 th , 2016. The editorial work was performed by  the Writ...

I am an emergency physician, and dealing with life threatening emergencies such as sudden cardiac arrest is something I do daily. I am not a storyteller, but today I am going to tell you a story that changed my life and my attitude toward being an emergency physician altogether. It  is the story of my mother.... The full narrative was published by  Annals of Emergency Medicine  and may be viewed at   https://authors.elsevier.com/ a/1UDwsib7DumPQ [from   Narrative Medicine ] CREDITS : About the Author: Dr.  Mirza Noor Ali Baig completed his MBBS in 2006. Since January 2013 he has been an Instructor in the Dept. of Emergency Medicine at the Aga Khan University Hospital. His areas of interest include medical emergencies and timely resuscitation.  Acknowledgement: The full narrative was published by  Annals of Emergency Medicine  and is available to be viewed at   https://authors.elsevier.com/ a/1...

Day 1 of expedition: On which all, except me, start the ascent to Rakaposhi base camp. Photo of Rakaposhi taken from the apple orchard of the Minapin guest house When I woke up the day our expedition was to start, I felt a bit odd. I couldn’t quite pin point the oddity. I ignored the intangible (not quite bordering on distress at that stage), changed into my tracks and went out for a run, as is my norm. I wanted to get my joints freed up enough so the ascent wouldn’t come as too much of a shock. Surprisingly, I couldn’t run much as I lacked energy, so I returned to the guest house where preparation was afoot, somewhat counter-intuitively, for a hearty breakfast for the eager mountaineers. A simple low fat, high starch/protein meal might be the better approach at the beginning of an ascent, but not being a professional trekker who was I to say that aloud. Seeing the parathas , omelets, scrambled eggs and toast did nothing for my appetite. Au contraire, it made...

Narrative medicine (NM), or reflective writing in medicine, recognizes the value of the patient’s story in clinical practice, medical education and research. The idea of combining story-telling with medicine has played a part in medical education for over 40 years, with studies repeatedly showing that a literary flavor of this sort can strengthen and support the compassionate instincts of doctors. Writing about patients and patient encounters, thus, not just creates a unique learning and teaching experience, but also allows for the processing of one’s thoughts, feelings and emotions. This very processing, in turn, allows for empathy and compassion to be bred, acknowledged, nurtured…and then shared in the most fluid of transactions. With this idea in mind came the concept of NM at the Aga Khan University (AKU), with Dr. Asad Mian leading yet another effort under the banner of CriticalCreative Innovative Thinking . The effort soon translated into a workshop on January 20 th , 201...

Illustration / Photo-credit: Saniya Kamal We are told it is an ‘angel’ who takes lives. Maybe that is a good thing. But there’s nothing angelic about it when it happens to 28 year olds. Recently married 28 year olds. Syed Iftikhar Hasan (not his real name) used to bring his ‘wet, wobbly and weird’ father to the Neurology clinic. The said man was old, rigid and irritable. His bulging ventricles on cerebral CAT scan settled down when he got a VP shunt placed and his visits stopped. In all this time no one paid any attention to the son. Of course he was a good son bringing daddy dear religiously for his checkups, but no more than that. Then a year later, Syed Iftikhar Hasan presented as a patient to the same Neurologist with the complaint of new-onset headaches. This was the first time he revealed his own medical history, being an ‘initial patient’. It was late evening and I was immensely enjoying the Neurology clinic. I learnt how to ‘pull myself together’ that day. I stood t...

Illustration/Photo-credit: Saniya Kamal The life so short,  the art so long to learn Opportunity fleeting, experience treacherous Judgement difficult Hippocrates  'Of Medicine’ Learning in medicine is a lifelong occupation. Apart from the books, patients are the main source for one's medical education. But as doctors we rarely give them credit for what we learn from them. In our busy lives and even busier practices, patients are reduced to `cases' and `cases' to a set of signs and symptoms. Cases are only interesting when they present in an unusual manner or are rare. The fact is that like an individual, every `case' is unique and every patient, no matter how common his illness, a rare learning experience.   On the first day of House Job at the Civil Hospital, Karachi, Pakistan I am allotted 'my' beds -  eight in all. They are a mixture of hernias and hemorrhoids, appendicitis and cholecystitis. On two beds are young boys - 10 and 1...