a young pakistani doctor blogs...
Sunday, May 07, 2006
The other day, I took my mother to see a nephrologist. I wanted to consult with one to discuss what I thought was a decreased creatinine clearance as per the MDRD formula applied to the serum creatinine (translation for non-med geeks=I was worried her kidneys were damaged so I took her to a kidney doctor).

We took a taxi to get there because the car was not available. When we got into the taxi, the taxi driver got to talking with us. Before we had turned the first corner, he revealed that his 16 year old daughter had cancer “of the tummy”. My mother told him I was a doctor, so he turned to me and aked, “Doctor saib, tell me something. Are cancer medicine expensive?” I was not really familiar with the cost of “cancer medicine” and asked him if he had gone to Shaukat Khanum Cancer Hospital, which is a top-of-the-line hospital in Lahore that treats 90% of its patients for free. He said he had gone there, and they did agree to treat his daughter for free, but he needed to buy the medicine himself. It would cost about 70,000 rupees, which was probably 8 months salary for this man.

My mother was very sympathetic toward him and said all the right things. I, being a retard in such things, sat in contemplative silence. He complained bitterly of how cursed he was to be poor and not be able to take care of his family. He said he had no brothers, no father and no sons. No one to help him out. He had 3 daughters, all of whom were unmarried and he himself was a diabetic. After he talked about how terrible life for a poor man was in Pakistan, he turned towards religion and stated that God is the one who gives help to the helpless. After reaffirming this idea in several ways, he started praying out loud, muttering the same prayer in Arabic over and over again. And not just for a minute, but for the rest of the journey – meaning for 10 minutes. It became awkward after a while, because his voice would crack every now and then. His naked vulnerability was disconcerting.

In the back of my mind, I started to wonder if he was faking it. But why? For money? Maybe a generous passenger would give him a few hundred more rupees? Pakistanis are the most philanthropic people on earth, I’m sure many of his passengers would give him extra money if they thought the cause was genuine. He was an elderly person, in his 50s, and he had an honest, open face. It seemed unlikely he was faking his problems.

Maybe this was his way of begging. Maybe he was so desperate for money to treat his daughter, that he exposed his anguish to anyone whom he thought might be able to help. Maybe he did receive thousands of rupees everyday from passengers who were moved by his story, and maybe every rupee of this money went straight into the treatment of his daughter’s illness. Maybe he just had no other way. He never asked for money outright, but perhaps he made a decision to open himself up to receiving charity from anyone who wanted to be charitable. I can easily see, in my mind’s eye, a well-intentioned passenger giving him thousands of rupees to help him out.

But then again, wouldn’t this be the perfect scam? I mean, go around driving a taxi, and for the 20-30 minutes that people sit in your car, hold them hostage to their conscience by a display of brilliant acting? Is it not possible?

Anyway… my mother’s kidney’s turned out to be fine. A little damaged from a few years of undetected diabetes and hypertension, but that is mostly under control. She has really bad arthritis in both knees and she’s used a lot of NSAIDs these last few months (one of the reasons I was worried about her kidneys) to no avail. I’m looking into a good rheumatologist and am thinking of intra-articular steroid injections because nothing else has worked for her. Will have more on that in the days to come.
To an extent you are probably right..the man might not have brought up the story if he had someone else as the passenger..wheter that was his intention or not who knows? 70,000 is a lot of money regardless..and I believe cancer meds cost quite a bit in Pakistan compared to other countries.

Good to hear your mother is doing well..have I mentioned to you about using Vitamin E at 400 unit doses as a means of imrpoving diabetic control?
I'm keeping your mother's health in my thoughts and prayers.
That's very interesting...it could well be a scam. But even if he were ritualistically doing this to suitable passengers to save his daughter, I don't think I'd blame him.

I pray your mother's health remains well.
DP....this post of urs really hit home because for the past couple of days I have been whinning about everything and anything...I guess I was forgetting how important it is to thank Allah for what you have!!!!
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Recent med school graduate from Peshawar, Pakistan. Started blogging when in throes of final year exams. Currently studying for USMLE Step 1. Aiming for the 2008 Match. I blog about my studies, my worries, and my thoughts on life. I live in Islamabad.

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