an itinerant observer

“What the hell are you doing doctor, are you insane?” shouted the consultant at his trainee who was presenting a case, while standing in the resuscitation bay of the Emergency Department (ED), surrounded by nurses, patients and their family members. I was shocked and intimidated while observing this man scold a trainee doctor. He was tall, dressed formally in a red tie and a pristinely white starched lab coat. One look at him and anybody would have quickly noticed that he exuded authority. The poor trainee, visibly shaken, was trying to hold on to the medical files and other instruments from slipping out of his hands. He was also trying dearly to hold on to his wits, I could tell. The ED is a dynamic place that sees several consultants at any one time, called there for expert opinion on patients. But the ones that catch my attention the most tend to be the crankiest and meanest of the lot. How they cope with their lives outside of the hospital mystifies me. Being the ED superv...

Photo-credit: Saniya Kamal, AKU MBBS '18 I don’t smoke. I never have. But I feel the itch. The call. When I am tired and overwhelmed, my brain asks for it. Do it. Take one, it says, when a friend offers. But I don’t. I am not afraid of the painful death the cigarette will cause. The fear of death is implacably set in my heart yes, but I do not refrain because of it. No, I am afraid of the road it will take me down. I have known since my school days that I have an addiction-prone personality. I get drunk off of whatever I put my mind to. The way I get drunk from flooring the gas pedal and sending the wheels spinning, the way I get drunk from drinking seven cups of bitter strong coffee every day, the way I get drunk from getting to know the women in my life; I tell myself no. I’m the reason my mechanic yells whenever I bring my car in for maintenance, I’m the reason my fingers shake quite perceptibly at the end of the day, I’m the reason no girl hangs around after my intense 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...

  “If you ever had to adopt a baby then whom would you settle for?” This was the question that I posed to myself recently. Not that I had to nor wanted to adopt a child. I have two of my own (biological ones, so my wife tells me), and they are more than a handful. It all started in Karachi one fine morning while I was working in the ER. A young couple had brought a two day old baby girl to me. The ER triage slip simply stated “baby adopted” as the reason for coming to the ER. I had never come across that as a presenting complaint in the ER, so my curiosity was piqued, irrespective of it being early moments of my ER shift without adequate caffeine in the system. It turned out that the baby had been picked up half an hour before, from a major orphanage in Karachi. The baby had been delivered the day before, per the orphanage staff’s speculation, and she had then been left at the doorstep of the orphanage. Although babies being abandoned there might have been a normal occurre...