a young pakistani doctor blogs...
Sunday, May 28, 2006
  Third Culture Kid
I never knew there was name for this. I used to call myself a ‘vacationer’, because when growing up, we’d come to Pakistan only for the vacations. ‘Third culture kid’ is a great description and the wikipedia article is dead on. I can totally relate to it.
Thursday, May 25, 2006
  Go Moiz!
Moiz is taking his Step 1 exam as I write this. We wish him the very best!
Tuesday, May 23, 2006
  What women want.
An old friend of mine called me after a long time. We used to be really close a few years ago. I was going through the combined nightmare of living in Peshawar and worried sick about losing the girl who I am now engaged to. This friend, let’s call her E, was engaged for 2 years in her mid-twenties until her fiancé broke it off. She had this amazing job in the textile export business in that she used to travel a lot to exotic places. She’s been to Hong Kong, Singapore, Austrialia, , places in Europe… all around, she probably visited a few dozen cities all around the world during her tenure. I met her through a mutual friend that I knew from the understanding islam forum. She was 28 when I met her. Her father had died long ago, and her mother was old and worried sick about her marriage. She had no brothers that could help with regards to the marriage thing. She had a lot of faith, and an excellent understanding of Islam. Although it must have been really hard for her to ward off her worries with regards to her single status, she managed to keep it together most of the time. I do remember though that she freaked out once soon after her 29th birthday.

In our stupid Pakistani society, an unmarried 29 year old woman is in a really bad situation. I sympathized with her and wished God would sort out her problems. I had demons of my own to exorcise at the time and we relied on each other a lot for mutual support. Her older age came in handy when I needed someone more mature and experienced at life to turn to for advice in the many twists and turns of my own life.

This was about 2 years ago. Fast-forwarding, and skipping over a lot of events, today she’s now happily married to a good man. She insisted that I come to her wedding, but it was smack in the middle of my final year exams, so I couldn’t. Today, out of the blue she called me up and we caught up with each other after a gap of half a year. It’s funny because only the other day I was thinking how every girl I’ve ever befriended has eventually drifted away from my life. I’d be great friends with her, and we’d know each other really well, but eventually circumstances change, we no longer saw each other as often and before you know it, a year or two passes before I realized we haven’t talked. I kind of thought this would be the natural course of events for any Pakistani girl I knew. After marriage, a Pakistani girl practically leaves her previous life, to start up another with a new family. Thereafter, her husband’s family is her own, and she sees a lot less of her real family. It’s sad, and that’s why you’ll see a lot of crying at Pakistani weddings from the bride’s side of the family. She is literally taken away from her real family unless her husband happens to work with them or live close by. I sort of accepted that along with her family, a girl would also leave her friends behind because that has been my experience.

She called me today and it didn’t take me long to pry out some mother-in-law stories from her. The MIL relationship has been close to my mind mostly because I’ve been reading a lot of sometimes sobia’s blog. Sobia is an American who married her Pakistani husband without knowing that she was also marrying an army of in laws, including an incurably exasperating mother-in-law. I asked E, who lives with her in-laws how she is getting along. She does have complaints, chief amongst them that she doesn’t have her own space and is expected to spend all her free time servicing or chatting up her MIL.

E gave me some golden advise today, which I should write down her so I don’t forget. That is: a woman needs to have her own domain. It can be a short, ratty apartment with a tiny kitchen and bathroom, but it must be hers and hers alone. No interference from any other woman can be tolerated for very long. For all the men reading this blog, get a pen and etch this into your skulls.

There have been no fights because E is an extremely diplomatic person and knows how to avoid any ill-will (although she would be hard-pressed trying to deal with Sobia’s MIL). However she has reached the stage where she told her husband, who is the eldest son by the way, that she wants to move out and live somewhere by themselves. Her husband is willing, but says that they can’t just move to another house in the same city, it would be colossally unbecoming for the eldest son to move out of his parents house to go live somewhere else, ostensibly because he wanted to be away from them. So to “solve” his problem, they are going to find a job in another city. They are going to go to Dubai next month and stay with close friends for a while as he goes job hunting there. It is kind of bizarre that they have to actually move to another country in order to get some space for themselves, but believe it or not, I can totally relate. Why do you think I didn’t get married until my Steps were done first? If all goes according to plan, me and my wife will be on a plane to the US soon after the wedding. I have a brother there and we will spend quite a while doing our CS and Step 3 exams, and going for internships. I’ll be more comfortable living with my parents when I’ve got a job contract in my pocket making the transitory nature of my time with them a certain thing.

Is this crazy or what?
  Capital Park
I went out for a long walk to Capital Park today. I didn’t feel like jogging, so I decided to go for an enormously long walk instead. It was great. Capital Park is an enormous park right in the middle of Islamabad. I happen to live a 15 minutes walk away so I decided to go there. This is when I wished I had a camera to take pictures to put on my blog. The park is a really well-maintained, open-aired, beautiful place. If it weren’t so flat so you could see apartment blocks miles and miles away, you could honestly forget you were in the middle of a city.  

I used to come to Capital Park everyday a few years ago in the summer vacations for long walks. It would give me some time to be alone and to think. I also like look at the other people who come there - an eclectic mix of Islamabadis from all walks of life: Those who are obviously elite, wearing gaudy, tight-fitting shorts with overflowing bellies striding along as if they’re in a big hurry. The ones who are obviously middle-class – the father looking pleased with himself for taking his family out, and the wife concerning herself with having a good time and some “enjowhyment”. Then there are those who obviously rarely come to the park. Mostly young men in shalwar kameez and sandals, walking slowly with their arms behind their backs, stealing glances at the woman then exchanging grins with their friends.

The air is clean there. It smells of grass. I came back refreshed and relaxed. Maybe I’ll start going there for my exercise. Certainly Capital Park has a pleasant ambiance and is a million miles away from my books. I also called my fiancé and made up with her, so all around, it was a good day.
Monday, May 22, 2006
  Dark thoughts
I’ve done gone and been lazy again. I haven’t been jogging regularly for about 10 days now, and a slow, insidious depression is creeping in. I must go out today, if not for a run, then a long, brisk walk, alone with my thoughts and far away from these wretched books that keep plaguing my conscience.
  SMS love
Women are sensitive creatures. I’ve been feeling a little down the last couple of days, and when I get like that, I tend to isolate myself. I don’t want to talk much, preferring to be alone. I usually get over my mood after a spell, but for the time that I feel that way, I can come across as cold or unsociable. It’s just one of the many bad habits that I have.

My fiancé and I are not together (otherwise I would say my wife and I). She’s in Peshawar and I’m in Islamabad, and for the last 8 months, we have maintained our relationship over the sms’s and phone calls. It’s not easy, but we make it work. We have our rough spots, and I’m certain its because of the nature of our relationship right now. An sms can’t tell you how you’re feeling. It doesn’t carry the tone or weight of your voice. It doesn’t replace a laugh, a smile, a kiss or a hug. So when I felt down, I didn’t sms her as often as she would have liked, something to which she took exception. She send me a few angry sms’s telling me I was ignoring her and that she resented it. I, being unsociable, didn’t feel very motivated to defend myself and gave up after a few half-hearted sms’s.

She’s been angry since yesterday. She got even more withdrawn today because I was supposed to call her tonight (on the land-line) and talk to her for about an hour. I didn’t do that, because of my crappy mood.

I’m thinking of starting tahajjud prayers soon. I need some food for the soul to pre-empt these dark moody spells of mine.
Monday, May 08, 2006
  Crackerbox Palace
I’ve always loved this song by George Harrison. After the Beatles split up, I think George produced the best solo songs.

I was so young when I was born
My eyes could not yet see
And by the time of my first dawn
Somebody holding me...they said

I welcome you to Crackerbox Palace
We\'ve been expecting you
You bring such joy in Crackerbox Palace
No matter where you roam know our love is true

While growing up or trying to
Not knowing where to start
I looked around for someone who
May help reveal my heart - someone said

While you\'re a part of Crackerbox Palace
Do what the rest all do
Or face the fact that Crackerbox Palace
May have no other choice than to deport you

Sometimes are good . . . sometimes are bad
That\'s all a part of life
And standing in between them all
I met a Mr. Grief - and he said

I welcome you to Crackerbox Palace
Was not expecting you
Let\'s rap and tap at Crackerbox Palace
Know that the Lord is well and inside of you
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.
Thursday, May 04, 2006
  Words to stir
From Aedh wishes for the Cloths of Heaven (with minor alterations)
HAD I the heavens’ embroidered cloths,
Enwrought with golden and silver light,
The blue, the dim and the dark cloth
Of night and light and the half light,
I would spread the cloth under your feet.
But I being poor, have only dreams;
I have spread these dreams beneath your feet;
Tread softly.
For you tread on my dreams.

From a Robert Frost poem
The woods are lovely, dark, and deep,
But I have promises to keep,
And miles to go before I sleep,
And miles to go before I sleep.
  A little whining
These last few days have been messed up with some problem cropping up everyday. Study has suffered for it. Today I’ll be taking my mother to a nephrologist because her serum creatinine suggested a below-normal creatinine clearance. A week ago, I also restricted her salt intake and got her blood pressure to drop down to 140/70, which is not too shabby.

I really hate it when something crops up to throw my whole day off kilter. I’m very fastidious about having nothing more time consuming planned in my day than a jog. Besides a guest who decided to drop in from the blue, who I had to spent a lot of time with, because he came just to see me, my water cooler broke again and it was a pain in the you know what uninstalling the cooler from it’s resting place and hauling it off to the side so I could steal my brother’s cooler and use that instead. I’m not sure why the room cooler broke again, the second time in two weeks. The people who came to fix it said it was because I was filling it with water while it was still on. My mother thinks it’s because I use it too much. My brother’s theory, which he propounds with a suspicious degree of passion, is that I’m a big jackass who breaks things. I hope the first theory is correct. I can easily turn the cooler off while it’s being filled. As for using it too much, I don’t have much choice because other than early mornings, it gets really hot up here in my room. It the cooler goes bust again, it must be due to my excessive use, and since that is not easy to avoid, I might be forced to pack up and haul everything downstairs where it’s much cooler. I’d rather not do that because I really like my room.

On a less whiny note – the last few days, I’ve been breaking up pieces of toast on my window sill in the hope of attracting some birds. They’ve been coming by regularly and it’s a pleasure to watch them feed. There are a lot of trees around our house, and many birds. They fly up to the window and since they can make out my outline from the outside, they constantly peer in suspiciously in between bouts of rapid pecking. It’s nice to watch, but they never stay for long.
Monday, May 01, 2006
  A blanket and hair-dryer
Some people, lazy day-dreaming types like me, can spend a lifetime capturing a childhood that came and went by. Childhood is probably the only time a person ever experiences pure, unadulterated happiness. An adult, even one experiencing the intoxicating high of falling in love, or a spiritual experience involving a nirvanic connection with God cannot compete with the happiness of a childhood that has never known any real sadness or seen this ugly world for what it is.

When I was really young, perhaps 6 years old, I remember being tucked in by my mother. When she left the room, I remember feeling a burst of happiness as I lay there in bed. My parents had bought a hair-dryer that day and I was looking forward to exploring this fascinating creation tomorrow when I woke up. I was also covered up in a new fuzzy blanket which I also thought was incredibly exciting. I remember kicking my legs under the sheets in happiness and thinking to myself “what more do I need?” My life was complete.

I’ve often tried to recapture what it felt like to be alive at that time in my life. I just wanted to feel that way again. I’ve since learnt that this behavior is called regression and is a defense mechanism. Before I knew what it was called, I knew there was something odd about wanting to go back to the days when I was a child. The world cannot be faced the way it is by a child. You need to be an adult, bitten and stung by life before you can stand a chance of getting by with minimal hassle. Childhood, I suppose is a God-given gift, hopefully to be looked back at fondly; a memory best left in the past.
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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