an itinerant observer

It is difficult these days to understand what war actually is. One hears of drones hovering above deserts and cities, of cyber-attacks that paralyze hospitals and power grids, of missiles launched from thousands of miles away by operators who may never see the faces of the people beneath them. The language has become strangely antiseptic: precision strike, surgical operation, collateral damage. And yet the images remain stubbornly human. Children pulled from rubble. Mothers running through smoke. Men staring at the sky, unsure whether the buzzing overhead is a machine or fate - wounds that someone later will try to repair. In moments like these, an old poem returns to me, one I first encountered as a boy. Edwin Brock’s “Five Ways to Kill a Man.” The poem is brief. Almost unsettlingly so. Its logic is ruthless in its simplicity. Brock begins with the ancient method: you make a man carry wood up a hill and nail him to it. From there he moves through history, through crusade...

~ 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...

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 ...

What’s the chance of a bad outcome,lik e death, in Karachi? Based on anecdotes circulated on social media and what you read in the news, you might assume that chances for a series of unfortunate events remain high in this city. This prompted a friend to do some calculations to gauge chance of an unexpected death in Karachi, compared to any major metropolitan city in the U.S. Assuming how the percentages were arrived at was fairly accurate, the bottom line, if true, was intriguing: the likelihood of an untimely, unexpected death was similar in the two places. Delving into death rates in Karachi vs. elsewhere was perhaps meant to be an intellectual discourse following the meaningless death of a colleague’s sister in Karachi. Being gunned down outside a famous restaurant after a meal there is hard to rationalize as an expected outcome of a botched cell phone robbery attempt. But this is Karachi. And such occurrences are unfortunately all too frequently heard and shared. Ev...

Illustration / Photo-credit: Saniya Kamal 'Any man's death diminishes me  Because I am involved in mankind.  And therefore never send to know  For whom the bell tolls  It tolls for thee'                  - John Donne 1571-1631 Some things are meant never to be forgotten. Some things are meant to remain imprinted in one's memory long after the event has passed. Some things have such a profound effect on one that witnessing them changes one's life forever. Many years ago I was witness to such a happening. I have never forgotten it. It has remained imprinted on my memory. And- it changed my life forever.... Fate, it seems, conjures in all sorts of ways for us to be in a certain place at a certain time. More than twenty years ago, fate intervened in my life and I found myself on the tiny Mediterranean island of Malta. You see, when I graduated from the Dow Medical Col...

“Baba, my friends were saying that little kids died in ‘Conticut’ !” Noori, the 1 st grader, was quite charged when she related that to me. I, as usual, was oblivious to that factoid although I work in mainstream America. I mostly work night shifts so when I picked Noori up from school it was technically bedtime for me. Some blame could be laid on the 3 rd flu-like illness I was suffering through in a 5 week period. Being an ER doc in a busy children’s hospital, the frequent colds were the necessary evil I was exposed to. I had loaded myself up on multiple medications to control my symptoms partly in an attempt to survive that night‘s shift in the ER. The 1 st query that arose in the dazed and drugged mind of mine was: “Noori, what or where is Conticut?” The massacre of the children took a back seat for the moment. “I don’t know! But there were lots of guns and blood – Ella said so”. Ella was Noori’s equally excitable and worldly friend. It was then that my mind gained s...