an itinerant observer

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...

I will never forget the day when I learned the meaning of stress in the Emergency Department (ED). There was a massive multi-vehicle road traffic accident and many patients were brought in, pulling away most of the ED doctors and nurses on call, leaving the rest of the ED at my disposal. I was focusing on a procedure to save a man with a life-threateningly low blood pressure, when a nurse approached me with an electro-cardiogram of a new patient. Even at a distance, I could see he was suffering from a massive heart attack. And if anything worse couldn’t have happened, there was an overhead page for another trauma patient. I felt my blood pressure rise and I said to myself, “I can’t do this anymore!” What makes ED physicians not only stay calm, but function at the height of their game in face of an emergency? Some people may be a natural at this. But for those who are not, including myself, I have learned that we can rise to the challenge, eventually surprising ourselves. In or...

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...