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Sitting at Nadir’s Table

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We shared beginnings - different years, same places: Karachi Grammar School and Aga Khan University. A thin but sturdy thread in the doctor fraternity. We also shared the country club in Karachi, and in its gym is where we often crossed paths. Not to spot each other’s lifts but to swap maps of the world. Like the time I was heading to San Francisco for a conference and Nadir, between sets, gave me a street-by-street guide to the city, covering both work and after hours. He could have been moonlighting as a tour guide. That trip of mine went fantastically.  He was never my official career counselor, yet we had enough one-to-one sessions in the club’s garden to make it seem otherwise. He would talk about being at AKU, then moving away, shifting between academic medicine and private practice. When I spoke about my own trajectory in similar terms, he was always gracious in his mentoring. Later I realized he was like that with many others too. His funeral, with its sea of people ca...

Seeking the Simurgh in a Flooded World: A Sufi Reading of Flow

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There’s a cat. There’s no dialogue. There are no humans. That’s how Flow begins; quietly, like a breath held underwater. A world submerged, not just in water, but in silence, memory, and what’s left when the Anthropocene folds in on itself. The cat doesn’t meow for help. It doesn’t explain. It moves: hesitant, curious, sometimes afraid. We follow. And perhaps, like me, you start seeing yourself in the cat. Not in some mystical reincarnation way, but in the way it stares at a collapsing world and keeps moving forward. Alone. Until it isn’t. Flight Time, Liminal Time It’s not the first time a film has gripped me midair. Something about that altitude - between departure and arrival, held in suspension - tunes the soul to a different frequency. Last time, it was Mother, Couch and Lost Lake Confessions during a layover that stirred meditations on mortality and the tragic absurdity of family (as I wrote in “ Under the Weight of Absurdity ” ). This time, it was Flow: silent, surreal...

The Beacon and the Canvas: Beyond the Pseudo-Profound BS of Academic Medicine

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For over two decades, I’ve navigated the labyrinthine halls of some of the world’s most prestigious academic medical centers. Fifteen years in one of the largest healthcare systems in America, spanning renowned medical institutions, followed by over a decade at a leading academic healthcare center in South Asia. These years were filled with purpose, bureaucracy, triumph, and disillusionment in equal measure. But somewhere along this journey, a quiet restlessness began to grow. A persistent question hovered at the edges of my thoughts: Is this still my north star? I found myself staring down the existential dilemma so many seasoned academics face: whether to stay within the familiar walls of institutional academia or step outside into the untethered expanse of something different. In a way, this essay feels like a continuation of thoughts I began exploring several years ago in "Sir? No Thank You!" , a reflection on institutional inertia, misplaced loyalties, and the uneas...

Dancing Past the Ivory Tower

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It wasn’t an ordinary day at work. I’d been called into the proverbial ‘supervisor’s office’ for a discussion about my recent projects. Fair enough, I thought. I’ve led programs in emergency medicine, innovation, wellness, and research. But no. This wasn’t about any of that. Seated across from me were two senior colleagues, firmly rooted in the traditions of academic medicine; faces tight, as if I'd ‘Zalsa’ed’ over a patient chart. Yes, you read that right. Not a research misstep, not an issue with departmental operations - dancing. Specifically, the Zalsa sessions I lead, share about, and - horror of horrors - post on social media. “It’s unbecoming of someone of your stature,” one said, with a look so grave you’d think I had performed a Zalsa routine on the hospital helipad. The other nodded sagely, as if this intervention might save me from further professional disgrace. For a moment, I wondered if I was in a workplace sitcom. Was this an episode of The Office: Acade...

13 Years in the ER: From Chaos to Bearing Witness: A Farewell in Two Acts. Act II

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~ Act II ~   A Letter to the Father Who Returned   Dear Father, You came back to the ER yesterday. Alone. Your eyes searched for the place where your children had been, as though the walls might still hold their shadows. You wandered, lost, and when the tears came, they came quietly at first; grief without sound, until they could no longer be contained. I stood there, silent, because what can you say in the face of such loss? Your grief took me back to 2019, when another father arrived; with his five children, also victims of phosphine poisoning. They had come to Karachi from Quetta on a short vacation, staying in a modest guesthouse. No one knew that a cheap fumigant, silently seeping through the rooms, had already marked them. They were Dead On Arrival (DOA in our lingo). Five small bodies laid side by side, from the youngest, a baby, to the oldest, a teenager. I remember the starched white sheets, how they barely moved as we covered those bodies. I remember dr...

13 Years in the ER: From Chaos to Bearing Witness: A Farewell in Two Acts. Act I

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Prologue I thought I’d prepared myself. My last shift in the ER, after 13 years, landed on Friday the 13th - the most infamous day on the calendar. It felt like a joke the universe was playing, so I leaned into it. I imagined the absurdities, the chaos, the dark humor that define life in a pediatric ER. I even wrote about it preemptively, anticipating the madness. But the universe had more to offer. What I thought would be a final hurrah of irrationality turned into something far heavier. A father, a family, a tragedy that echoed through time. This is my farewell to the ER in two acts. Act I – The chaos I expected. Act II – The weight I couldn’t see coming.   ~ Act I ~ 13 Years, Friday the 13th, and the Madness of the ER Coincidence or predestiny? After nearly 13 years of adrenaline-fueled chaos, sleepless nights, and a steady diet of chai and calamity, my last ER call lands squarely on the unluckiest day of the calendar. I could’ve chosen to laugh, but ...