The Demons Within

         Being a Pakistani is synonymous to being emotional. The most common and perhaps the only way in which we show our patriotism to our homeland is by showing hatred for any country that says or does something apparently negative and that too is conditional depending upon our individual perception, preferences and priorities. Our adrenaline takes a sudden steep peak when Pakistan plays a cricket or even a kabaddi match against India yet we wait desperately for the upcoming Shahrukh Khan or Katrina Kaif movie. We use Islamic laws as our shield against Non-Muslim nations when that seems to be the most convenient thing to do and solves our problem easily or puts us in a superior position while simultaneously we absolutely disregard other Islamic rules in our daily proceedings because it requires patience, sacrifice, selflessness, humanity, kindness, generosity and honesty; all of which are challenging virtues to practice. So many people are being killed daily in our country for years and no one is held accountable for it, no one raises voice against it, yet if someone from another country does that we shout and protest. The value of a murdered human in our country is decided by his social/political/financial background, by the nationality and political/social standing of the murderer and how much hype media creates about it. The two men killed by Raymond Davis were average young Pakistani men. They could have been killed by our own police in a so-called “encounter” or had become unfortunate victim of one of so many suicide bombings that happen all around our country or could have been shot dead by mobile snatchers or run over by drunken truck drivers or have become a target of a stray bullet on a new years’ eve. We would have simply read their news while sipping our morning tea without giving a serious thought to it, their death would have just been mentioned as a number that we come across daily in news like “5 people shot dead in various parts of Karachi”. So I ask a question: Why does it hurt our fake pride so much if a US national kills them and why do we not react in the same way if our own countrymen do that? Davis killed only 2 people; that is a below average number of lives we loose daily due to poverty, sexual harassment, mobile snatching, unavailability of standard health care, irresponsible driving, burgling etc. Do we fight this strongly for the lost lives of these innocent people too who die because of any of these reasons?


The truth is we Pakistanis have our fantasies walking with us at all times which put a curtain over the reality. Freedom, individual identity, national solidarity and unity are words associated with our country only on paper; we once read about them in our Pakistan Studies book but these qualities are extinct from our nation on the whole. We choose to live in a bubble and evade from facing this bitter truth but once in a while situations like Davis case burst our fantasy bubble and force us to see our horrible faces in the mirror of reality; we get to witness our weaknesses, mistakes and failures. We don’t have enough courage to admit that the only thing that is left of a nation whose foundation was laid in 1947 is the geographical boundaries on the world map, that the land of the pure is not all that pure anymore, that we have to stop pointing fingers at other nations and blaming them for our failures, that we have to choose our battles wisely and fight with the right enemy, that the conflict lies within us only and that is where we need to focus our protests.


Having said that, I am not defending what Raymond Davis did. I strongly despise his act and do not have words enough to condemn this brutality. But I was hit a thousand times strongly when mobile snatchers killed two young brothers last month in Karachi , when I came across the case of a Pakistani teenage girl who was atrociously killed by her own father, when my country’s police officials raped young girls and threw away their dead bodies inhumanly, when a teenage girl was shot dead by a stray bullet on new years’ eve just because some irresponsible people felt it was their right to ‘enjoy’ this way.


To conclude, I believe we first need to identify and accept bravely our mistakes and shortcomings and then start looking for solutions to get rid of them and finally and most importantly ACT on those solutions to see the desired results. US decide our future and play our strings as those of puppets because we let them do so. We have amputated our own legs and we use US aids as crutches to stand and a nation that has handicapped itself to this extent does not have a right to complain. Just by showing our anger for any and every attack that US does on us and comfortably ignoring the culprits running freely in our own country would do absolutely NO good. No matter what damage US has done in our country, it is still very small in comparison to the mutilation that has been done by our own hands. Once we have cleared up the self-created mess of dishonesty, corruption, selfishness and lust for money and power, then we’d realize that there isn’t anyone left to fight against anymore because true national solidarity and independence speak for itself and no super-power of the world can dare to look inferiorly at the nations that are sovereign, autonomous and self-reliant not just in words but in each and every action.

Tread with care

              Sitting on a comfortable chair, in an air conditioned room, with almost pin- drop silence, hp EliteBook turned on, sipping my delicious morning coffee and what am I doing? Reading a medical article that boasts about how we have been able to discover a million dollar drug to cure an XYZ disease? NO. Reading a new book that I recently bought from a book store? NO. Facebooking? NO. Googling? NO. I am going through confidential medical files of 3 patients who were either brought dead to ER or expired within an hour of presentation. Although I absolutely savor each sip of my coffee and enjoy the comfortable environment of my workplace, but those three files (read dead bodies) made everything around me distasteful.

Many of you might think I am over-reacting because those are just a few pieces of paper. Right? Literally, yes but figuratively, NO. If those files belonged to (God forbid) any of my dear ones, I wouldn’t have been able to go through them without shedding a tear or without the need to muster up highest level of courage and strength and had I sipped my coffee the way I did now? You know the answer. I could not go through each file without thinking about how young the patient was to suffer such injuries, what his family must have felt when death was declared to them, I check the date of expiry and try to feel what the family would have been feeling now after one or two weeks of their family member’s eternal departure, how they might be re-adjusting to their new life, how a mother would have felt when her teenage daughter succumbed to a gun shot injury within 2 days of admission, how devastated the kids would have been when all they brought their mother for was some fever and she was no more after 2 days.  So, NO, those are not just lifeless papers lying on my desk, they are documents that have stories of their own, stories that have affected an entire family in more ways than you can imagine, stories that have ability to jolt your existence and give you a reality check like no other.  


The profession of healthcare can become a huge business with patients being customers and hospitals being the service providers. The only thing that separates healthcare customers from a customer who walks into a computer shop to buy a laptop is ‘sensitivity’. It is so easy to say out loud this eleven lettered word but trust me it is the most difficult and challenging task to have it stay in doctors’ hearts, minds, words and actions at ALL times. I have seen some colleagues joke around while reviewing mortality files about patient’s injuries and events that led to his demise because for many of us it is just a file. It’s not like the patient or his family is there to see them. And at that very moment, those doctors, no matter how skillful they were and no matter how well-versed they happened to be in their field of specialty, they could not find their way in my good books.


A common perception is that a good doctor is the one who does no harm and saves lives and I cannot deny that but this definition is incomplete without the mention of ‘sensitivity’ and ‘empathy’ and the demonstration of these two qualities not only in front of the alive and conscious patient and his family but also in front of intubated, unconscious dying patient or even his file that remains his only physical representation. How about saying a silent prayer for every ‘expiry’ that I review for my mortality meeting?


Money, the power to heal, the power to be in control of things, the ability to discover something new every now and then and hence bring change around us makes us healthcare professionals so mesmerized that we tend to deviate away from the one thing that we, the physicians, had sworn as Hippocratic Oath, the soul and cornerstone of this profession i.e. – “Humanity”.


For my fellow doctors who happen to read it, just a little reminder of what we had sworn once, the following are relevant excerpts of the Hippocratic Oath:

I swear to fulfill, to the best of my ability and judgment, this covenant:


I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.


I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.


I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.


I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

Prudent Americanization

          As soon as I realized that my future life will be spent in USA, I started to imagine how my lifestyle would change; more importantly how my thought process would change. It didn’t take me much time to realize a horrendous side of this migration, though, like most of the immigrants, I was allured by the charms initially.



Belonging to the profession where humanity comes first (or at least that’s how it is supposed to be), a thought occurred to me today “If I have over $50,000 waiting to be spent on my leisure activities/desires, how will I spend that money?” If I had that money right now while I am still in Pakistan and haven’t put my foot even once on the Obama land, my answer, without having second thoughts would be that two kids suffering from AML (acute myelogenous leukemia) could get the entire expenses of their BMT (bone marrow transplant) from this money, get relieved of this fatal disease forever and have a healthy future; their parents could be saved from the torture of witnessing their young one’s death in front of their eyes; a young one who doesn’t yet understand what living is actually like and is already on his way to the eternal abode.


I tell this to my husband and he puts a challenging question in front of me “Will you think the same way after earning thousands of dollars and living in the best city of the world?” and I could not say a confident ‘yes’ as much as I was tempted to say it.


All humans are made up of the same flash and bones but even if monozygotic twins, who have exactly same DNA, are raised in two different parts of the world, especially one of them being in a 3rd world country, I believe you will see the difference in almost every major aspect of their life. Such is the power of one’s surrounding and adversities/luxuries that an individual is exposed to. But again, no two different random individuals exposed to exactly similar environment grow up or evolve into same persons (with respect to their personalities/ attitude/ opinion about life).



Also, living in a 3rd world country or facing adversities does, in no way, warrant that the individual would be any more humane than a person who was born with a golden spoon. So is there a set of rules that one can follow which affirm his compassion and benevolence especially when he is at the top of his career and financial success is all that he sees? I picture myself standing at the Broadway and with one swipe of my visa card; I can buy anything and everything that I can imagine. So, what is the strongest factor that would stop me from undertaking that shopping spree, not with a frown on my face but with pride in my heart and a warm smile?


I figured out a long lasting formula that does three things for me: helps me save money AND helps keeping my humanity alive AND I get to pay back what my country has given me. The idea is to keep visiting my homeland every now and then, be it physically or virtually over the internet, have a look into the lives of the common man, search for the medical illness that’s on the rise at that time and do whatever I can to relieve people of it or keep in touch with the heads of major hospitals of the country to be aware of the exact needs of my country’s health sector. And then every time I am tempted to spend thousands of dollars over a luxurious car, cruise trip, a world tour, diamond set etc, I’d channel my money towards a kid who desperately needs a BMT, or a bunch of well-equipped ambulances or buying chemotherapeutic medicine for someone who cannot afford it, or donating something for people stricken with natural disasters. Difficult? Very. Doable? Absolutely.


I believe this is the only way that makes saving money worthwhile and keeps one motivated always; if you firmly believe your money can make a difference of life and death in someone else’s life, some random person’s life with whom the only link you have is that of humanity; then you cannot buy a diamond set or a 75 inch flat screen TV with home theatre system, an SUV, or a place in Palm Jumeirah. I have experienced this and so I can vouch for it; helping someone selflessly is addictive, a time comes when this is the only way that makes you happy. I just figured out that more than making you happy, it actually is a great money saver, inculcates patience like no other, makes you earn the kind of respect no money can buy and most importantly when you leave the world, you’d be richer than anyone ever was on the Forbes list.


United States of America opens up a chain of successes for me; it gives me a huge opportunity to do wonders with my skills and my talent, I am in that phase of life where I can take my life wherever I want to. And this is exactly the time when I can lose the focus, get up high in the sky, stack up a pile of dollars and luxuries but fall terribly with regards to respect, honour, love and kindness.Getting 'Americanized' in all the right aspects ONLY is a challenge every immigrant faces and even though I am excited about my new habitat, yet I fear the possibility of collateral damage.

Just out of my cocoon

        Growing up is all about revelations, learning after making mistakes; big and small. Sometimes other people's experiences do save you from making mistakes but that doesn't work at all times. Soon you realize that you're playing singles tennis, not doubles. In the first decade of our life, we think life is a playground and getting your favorite toy and getting to eat chocolates endlessly and getting a day off from school was the definition of happiness for us. In the next decade, we want to be 'cool' and be 'something' when we did not really know what that something was; but something that no one else was and no one else could be. And then comes the adulthood; a killer of all that we had been infused in the form of movies and novels in the past two decades. When the doctor asked me to sign a consent form for a high risk procedure for my father who was in a life-threatening condition, I knew I am an adult now. When I could not figure out what the next step should be while disagreeing or getting disappointed by my significant other, I knew I am an adult now. When I signed off my life, my future, my dreams, myself to someone forever, I knew I am an adult now.

It's funny how we are misled into adulthood, how we never know what we will face when we enter this era of life. All I know right now is that no matter how much you prepare for it, you can never anticipate the next move of life, you'd still be surprised unpleasantly quite often and proven wrong millions of times and you will still end up being in a situation where you'd have no idea what's going on and what to do about it. Even googling doesn't help then and you just have to get your ship out in the stormy sea and figure out on your own what should the direction of the sail be.

Even though I am a woman, but I'd hate to admit that women make life more complicated. The world of a man is so practical, calculated and straight edged but that of a woman is like a maze, made up of complex turns and fluctuations and comes with a warning of 'fragile - handle with care'. Even their dictionaries are different at times; when a woman says no she might mean yes, care in a man's dictionary might mean getting the most expensive gift for her but for a woman care would mean saying 'I love you' (and meaning it) just to make her feel loved, greeting her with a smile and "good morning" when she wakes up, giving her a hug when she needs it the most. Man goes into the problem solving mode while all a woman wants from him is to listen. He thinks money can solve all problems of a woman and it does for some but not for all and not at all times. He understands all the practical/material needs of her but the moment she opens up her box of emotions, he reacts as if she is too demanding, least understanding and mums her up by saying 'you need to change / you need to grow up'.

I have yet to figure out how to go about these differences without jeopardizing the relationship, many questions remain unanswered but one thing that I know now which I was never taught in school is:

"He who has so little knowledge of human nature as to seek happiness by changing anything but his own disposition will waste his life away in fruitless efforts"

Dichotomous and disguised

I was just going through the news of the recent controversy about involvement of our cricket players in spot-fixing. I saw harsh comments of raging cricket fans, someone said they should be killed on the spot, the other said she was insulted at work just because the players brought disgrace to the country. I, for some reason, did not share the same feelings, probably because I hear about bomb blasts and target killings everyday and the dismay of the flood affected people has made this issue look very minuscule. At least no living being died in this incident and some would argue that Pakistan's name and image has been tarnished so well, that, my friends, has already been done thanks to our Mr. President and his likes.


Having said that, I, in no way, intend to defend the players' wrong doings and I support the idea that justice be brought to them. Certain questions popped in my mind, though. Why is the lie that I tell to my boss at my workplace any smaller of a sin than what the players did? Why should I not be punished for using an official vehicle for my personal use,without informing higher authorities, and the players be punished? How is the way my littering around the city, breaking traffic rules, smoking at public place and selling gutka any less of a crime? How many of us have really gone out of the way to defend the name of our country or done slightest bit to make her proud?  What have I done in the past 27 years that I have inhabited this place that would be counted as doing your bit for your homeland? Have I ever contributed to the society for its education, cleanliness, poverty, healthcare issues? How many of us have returned back to our country with foreign education only because she needs us?


The crux of the matter is we as a nation are emotional people who master the 'blame game', and not the 'self' blame game, mind you. We love pointing fingers at others without analyzing our own self. We are hypocrites with double standards, we have a strict set of rules which is applicable only on others. We decide how big a sin is and what must be the magnitude of punishment on the basis of who commits it. It's only a matter of who gets caught while doing his bit of dishonesty; just because no one is there to see my wrong acts does not make me right, innocent or a patriot. A common man would stand up, raise voices and protest violently against the players on match-fxing and doping but he would overlook the litter he just threw out of his home on the street corner, he would ignore the 'kunda' he has put up to steal the electricity, he would disregard the bribe he has paid to get his son an educational certificate and he still considers himself innocent when he mixes  powdered brick in red chillies powder, mixes water in milk, sells rotten, non-halal meat.




In my opinion, we all are Butt, Amir and Asif in one way or the other, each of us have our own set of red flags, it's just that no human has yet been able to hold us accountable for our mischief and this surely does not make us any better than those who have been tried and convicted in the court of law.


"Sin seen from the thought, is a diminution or less: seen from the conscience or will, it is pravity or bad. The intellect names it shade, absence of light, and no essence. The conscience must feel it as essence, essential evil. Sin has an objective existence, but no subjective." - Ralph Waldo Emerson
       

 

The missing 'Humane' link

Many a times, I've wished if I was born 50 years back. Although back then, most of the people never knew what it was like to have a refrigerator, microwave oven or air conditioner yet they knew the exact amount of food to be made so that it doesn't need storage, the entire family ate together at one time so food didn't need re-heating.


Let me share an excerpt from a book that I recently bought called "Outliers"

"Roseto Valfortore lies 100 miles southeast of Rome. A physician named Stewart Wolf was invited to give a talk at the local medical society. Wolf said in an interview "After the talk was over, one of the local doctors said to me "I've been practicing for 17 years and I get patents from all over, and I rarely find anyone from Roseto under age 65 with heart disease". Wolf was taken aback. Heart attacks were an epidemic in US and the leading cause of death in men under age 65. So, Wolf decided to investigate. The results were astonishing. There was no suicide, alcoholism, drug addiction and very little crime in Roseta. They didn't have anyone on welfare. The people in Roseta were merely dying of old age. Wolf first thought that the Rosetans must have some peculiar dietary practices that left them healthier than the Americans. But he quickly realized that wasn't true. Rosetans were cooking their food with lard, they ate sweets all year round which were usually eaten only at Christmas and Easter in US.

When Wolf had dietitians analyze the typical Rosetan's eating habits, they found a whopping 41% calories came from fat!! Wolf later also analyzed the exercise, genetics and location differences among Roseta and Americans only to find no significant difference. As Wolf and his partner Bruhn walked around the town, they figured out the reason. They looked at how the Rosetans visited one another, stopping to chat in Italian on the streets, or cooking for one another in their backyards. They learned about the extended family clans that underlay the town's social structure. They saw how many homes had three generations living under one roof and how much respect grand parents enjoyed. They saw people sitting on their porches talking to each other. They went to mass and saw the unifying and calming effect of the church. They counted 22 separate civic organizations in a town of just under 2000 people, they picked up on the peculiar ethos of the community which discouraged the wealthy from flaunting their success and helped the unsuccessful obscure their failures.

Wolf and Bruhn had to convince the medical establishment to think about heart attacks and health in an entirely new way: they had to get them to realize that they wouldn't be able to understand why someone was healthy if all they did was think about an individual's personal choices or actions in isolation. They had to look beyond the individual. They had to understand the culture he or she was a part of, who their friends and families were. They had to appreciate the idea that the values of the world that we inhabit and the people we surround ourselves with have a profound effect on who we are."

Surprised, right? At least I was when I read this. I never knew about the scientifically proven research on how human interactions effect our bodies and so our lives, but the desire of going back in time is an indirect evidence that to some extent I realized how we as a generation are unfortunate enough to be deprived of the magic of extensive human interaction. Premature new born babies in incubators fighting for their lives heal remarkably quickly just because their mothers held them close to their bodies or held their hands for few hours daily. I've seen kids getting sick very frequently even though they get fully vaccinated and get to eat the best diet available, reasons being parents have unresolved issues which keep the two distant at hearts. We think that a few days' to few months' old child is too small to recognize the invisible differences between the parents, we think the baby is in the goo-goo-gaa-gaa land where all that he thinks about is suck, pee and poo.  The truth is that these differences among parents have significant impact of a kid's immunity and internal body environment to make him fall sick every now and then.

When a newly born baby takes such a huge impression of the lack of good quality human interaction then you can imagine the magnitude with which an adult would be affected.


Take a meticulous look through the lives that we are leading these days. How many of us make extra efforts to spend time with extended family members instead of roaming aimlessly in shopping malls or flipping through the channels of the television? How many of us prefer to wish someone a happy birthday or ask about their well being by texting them instead of calling or meeting in person? Don't you think we know a lot more about what's happening in Shahrukh Khan's life than that of our neighbors'? I've been following an Indian drama for about 6 months now and I understand the fake personality and wait impatiently to know more about the ups and downs of the life of the protagonist of the serial a lot more than the joys and problems of most of my extended family members. I spend more time in aimless facebooking than with my grand mother or even my mother. And if someone complains about our unavailability, we easily put forward the excuses like 'long working hours' and 'kids keep me busy' etc. How many times we go out of the way to help someone without first saving the best for ourselves?


The truth is that we underestimate the power of human expression. We as humans are like a box in which God has placed so many emotions and such strength that can only be seen and felt if and when a person wants to see/feel it. Every human has their equal share, but only some know it's importance and therefore make use of it.


So, the next time you decide to spend your Saturday evening at the new restaurant, take a U turn and instead go visit your khala/phuppo/chacha  whom you visit out of traditional obligation only on Eid days. When you've spend more than 10 minutes on FaceBook, close it and spend the next hour that you have with your parents/grand parents. Don't update statuses on FaceBook/Twitter first but let your mom know about the promotion that you just got because it's 'She' because of whom you are who you are. Smile at kids, laugh on jokes, hug your parents, give them presents for no reason and don't wait for a Mother's or Father's day to show them you care, ask them for their opinions while taking important decisions of life because even though they don't have the Masters degree from MIT like you do, yet they've been taught the lessons of life which only going through life can.   


Let's work towards good mental growth of our next generation, let's inculcate in them the seeds of respect for elders and significance of human relationships by not giving them lectures but by practically being such an example. Kids learn a lot more by absorbing what they see rather than following our serious lectures. Let's teach them not to use any human like a rung of ladder to ascend up in their lives but to learn from them and grow with them to become a part of the family tree. Let's emphasize more on sitting together for the meals rather than wasting tim deciding to cook fish or chicken. Let's spend time with each other not out of obligation but because of the fact that the best interaction that a human can have is that with another human being. Let's make an effort to not allow the mechanization of the so-called modern world take away the very ingredients that set apart a God made versatile human being from a Japanese robot.

"Aglay janam mohay bitya na keejeyo"

One winter morning, my dad's car was having some problems and he could not get it started. This had been happening quite frequently and I used to watch him struggle with it. One day I just could not stop myself and I went down and asked him if I can push the car to get it started. He looked at me and asked if I have lost my mind when I was thinking about pushing the gigantic car on my own. I left him there with a heavy heart, thinking if I was his son, there would have been a different end to this story.


In the society where I have been brought up, daughters are brought up very differently as compared to sons. They are given dolls right from the birth to play with, their minds are fed with the thoughts and dreams of having to leave their parents one day and make a life of their own with husband and kids. Even if the daughter does start making money before getting married, the parents never let her spend even a single penny on them or on home in general. On the contrary, the sons are supposed to be the next in charge of the bills, the maintenance, the grocery, the events etc etc. Parents would rather like the money their daughter is making to rot in the bank or save & spend on her own self rather than letting her participate and share the burden of the family.


What good do we achieve out of this gender discrimination, I am yet to figure that out. I think parents are under an illusion that this way they are being protective and gentle towards the daughters while on the other hand daughters like myself feel helpless and frustrated. I believe being at the youthful age that I am, it is my social and moral responsibility to let my father take a break from his work and let him take things easy now. The seed that he sowed 27 years back, has now grown into a tree, strong enough to give him a shelter from the heat of old age and productive enough to give him fruits to savor. I know if my father reads this he would laugh at me and say 'you don't know how harsh and tough practical life is and just because you feel so much does not mean you can do it too. Emotions cannot satisfy anyone's hunger and are absolutely not enough to make you stand in the ruthless 'practical and material' world." 


I know women are not stronger than men physically but they are far more emotionally stronger and intelligent than men. It's my emotions for my parents which make me think that it's time for my parents to enjoy their lives, to live their lives once for themselves only without having to worry about their kids' desires and needs, be able to go to bed at night peacefully without having to worry about the 'tomorrows', be able to spend some money just for the heck of it since all I've seen them doing from the time I was born is save, save and save for the education, clothes, desires, toys and entertainment of their kids. Never in the past 27 years have I seen my father buy something for himself just because he 'felt' like it, he has been living on the 'need only' basis ever since I know him. My mother has always been cooking the dishes me and my brother likes for the past 29 years. Never have I seen her do something just because 'she' likes it.   


Perhaps, the power of my knowledge and education and the strength of my will power are not enough to push and jump start my dad's car but I believe that they are enough to break the barriers of gender discrimination, they are enough to make me dream about the day when I'd let my parents 'live' their own lives and for once be proud of the seeds that they had sown about 3 decades ago and be content that their life long hard work and nurturing has finally been rewarded with prosperity.