an itinerant observer

Illustration / Photo-credit: Saniya Kamal Imagine yourself as an ER nurse or physician. Then imagine a parent bringing to you their dead child, with the expectation that you will bring her back to life. What do you do? This happened to me, yet again. The overhead page for pediatric resuscitation was met with the routine ‘rapid response team’ deploying itself from the pediatric ward to the ER ‘resus’ room. There we met a distraught father who had brought in Sasha, his 2-year-old daughter. Once I took stock of the situation, I realized this was a no brainer: I was to follow the pulseless and apneic child (that is, neither heart nor lungs functioning) algorithm from the American Heart Association’s Pediatric Advanced Life Support guidelines.  “Dead child -> go directly to Cardio-pulmonary resuscitation (CPR) -> do not pass Go, do not collect $200!” a professor from my residency years would remind us, specifically for that situation.   I im...

Recently it became newsworthy that PepsiCo's famous CEO Indra Nooyi hated being called‘Honey’ or ‘Sweetie’ . I believe she found such ‘titles’ demeaning in an environment that needed to strive more towards gender parity. Of course, she meant that in the larger context of the contemporary work environment, with higher numbers of women in leadership positions, than ever before. Nothing against that, however, had she not been quoted in that article, a back and forth email thread would not have been generated among a few work colleagues; a heated argument on gender disparity at the workplace would not have resulted; and ultimately, as tends to be the norm, sexism, feminism and other isms would not have been invoked.    Bottom line…a lot would not have occurred. But it did. And here’s a snippet:   “One shouldn’t take these titles too seriously”, said one person. “Whether I am called Honey, Sweetie or Babe is not important to me – what I get to do (at the wo...

Photo-credit: Saniya Kamal, AKU MBBS '18 “Is he in the Emergency Room to sleep?”- These words still resonate in my head. These words still affect me. They still cut deep into me and make me question the very basis of why I chose my profession. Times like these are when you understand the bitter truth of reality; of what medicine is. When I took the Hippocratic Oath 5 years ago, I had no idea. I had no idea of the position I was going to hold; of how many lives I was going to touch; of the power my white lab coat inherently held. I now understand. “Is he in the Emergency Room to sleep?” – These words not only show how important we are in society, but also how important we think we are. Across the country, working in the emergency room automatically offers immunity to medical personnel to do almost whatever they want, however they want, all under the rather overly used banner “we’re trying our very best”. Is this true? Or is this a façade? Do we care more about what we tr...

Having left youth behind, in the throes of my midlife crisis (per my dear wife), I often ponder: What is change? Why is it needed? Where is it needed (most)? How is it brought about in a sustained manner and by whom? Before delving into this more, let me introduce you to my two young friends: Alezeh, a 14-year-old 9 th grader, and Mayank, an 18-year-old college student, with whom I conceived ‘ Biloongra -Books for Change ’, a grass roots effort promoting global child literacy and education. They pondered the above questions along with me at a café, over coffee and kolaches, at Rice village in Houston, on a sweltering summer morning. The discussion, dialogue and debate were timely. I had struggled with the questions primarily because it was unclear to me why we wanted to do something that might affect ‘change’ in public sector kids’ education in Pakistan. The oft cited ‘there’s a crucial need’, fell by the way side, once the going got tough. Such work from afar, while...

Dr. Simi Rahman from LA, connected through Skype I powered up my computer in a fluorescent lit conference room in Los Angeles, on January 19th, 2016, at 7 pm sharp, and found myself transported. Not just across the globe, but back in time. On the screen in front of me were crisp images of people I had known almost 20 years ago, a podium, sounds, accents, rhythms, familiar cadences of English and Urdu, brief flashes of color and the familiar motifs of geometric Islamic art on the wall. After a brief and efficient test, I was plugged into the first-ever Narrative Medicine Workshop at my Alma Mater, the Aga Khan University (AKU) in Karachi, Pakistan. The audience and I were both able to see each other and the room in which I was seated in California seemed to fade into the background. The proceedings were kicked off splendidly by a reading from Dr. Asad Mian: a story he'd written about an Emergency Room encounter , one that resonated poignantly within the room and a...

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...

Photo-credit: Saniya Kamal, AKU MBBS ' 18 I was doing a rotation in anaesthesia. Standing in the pre-operative area, waiting for the next patient for our operation room to arrive, I overheard perhaps one of the most significant conversations of my life. There was a young patient and her Obstetrician / Gynecologist (OB/GYN). There was some talk about removing her uterus, perhaps a cancer or something else threatening her life. I couldn't really hear everything nor was that the intention. Simply stated, I wasn't paying much attention to it. They were going to remove her uterus to save her life. That much I could tell. And then she asked her doctor a simple question. A simple yet bone chilling question. "Meray paas bachadani nahi hoge tau mujh se shaadi kaun karay ga?" (If I don't have a womb, who is going to marry me?) The doctor paused. Smiled reassuringly. "Beta, shadi bachadani se thori hoti hai." (Child, it's not the womb one marr...