Tales from a doctor who listens to what her patients don’t say

If you have watched the Bollywood film ‘Bhool Bhulaiyaa’, you would be aware of its plot: the female protagonist Avni, played by Vidya Balan, falls mentally ill when she and her husband visit the latter’s ancestral home.

The husband’s family believes she has been possessed by a ghost that lives in the house, but he does not, and so he calls his psychiatrist friend, the male protagonist Dr Aditya, played by Akshay Kumar, to treat her.

However, they face resistance from the family. To cure her, Dr Aditya comes up with a plan that involves both exorcism and medical practice, and eventually he is able to help her get well.

A similar story, but true, has been recorded in the book ‘Among My Own: The Untold Stories of my People’, written by Dr Naseem Salahuddin, an infectious diseases specialist serving at the Indus Hospital, Korangi, Karachi.

The story is about an orphan girl who has caught a deadly infection and is brought to the hospital in an unconscious state by her paternal aunt.

As Dr Naseem is looking at her, her paternal uncle enters the ward and tries to take her away, because he believes she has been cursed by her former fiancé and only incantations can make her well again.

“I tried to reason with him, but he looked me straight in the eye and said, ‘I have no trust in your medicine,’” the doctor recounted while speaking to the audience attending the session about her book at the Karachi Literature Festival on Sunday.

“I asked if money is the problem. He took out crisp thousand-rupee notes from his front pocket and flipped them like a deck of cards. We were in a crowded hall, but everybody was watching our altercation,” she said.

“In my mind I was thinking if there’s a mechanism for the rights of orphans. I came up with an idea, and asked him to give me five days to keep the girl, and, in the meantime, he can use his incantations method while I perform medical treatment. He agreed.”

Dr Naseem said that on the third day the girl gained consciousness, but on the seventh day she was gone. “I thought her uncle would have taken her away, but after a while both of them entered the ward smiling,” she added, in a way that gave goosebumps, at least to the scribe.

“Her uncle was happy the incantations had ended the curse, and for the resident doctors it was the success of medicine. In any case, a life was saved, and that was the most important part.”

The doctor said she found a family in Tharparkar whose child was very sick and could have died. She told the father she could treat her child, but he said he was a peasant and did not have any money. “I told him money won’t be a problem, you just come with us.”

He still did not agree, because he said he could not leave the area without the permission of his master, she said, adding that this is the situation of bonded labour in the remote parts of Sindh.

The session was moderated by Shahnaz Wazir Ali, president of Shaheed Zulfikar Ali Bhutto Institute of Technology, and a former lawmaker. She said to Dr Naseem that though she is a medical doctor, her book talks about society, the disparities between social classes, and the hardships borne by people from different backgrounds and genders.

“Is it because you want to provide a framework to change the medical profession paradigm to make a doctor more humanist?” the moderator asked the doctor. The author replied that the medical profession has become more commercialised now, and so there is a need to view it from a more humanitarian perspective.

She said that there are surgeons who would not operate on a sick child without money, and she termed such physicians ‘a fly on the ward’, which is also the title of a book by Michael K Chapman.

Speaking about the 55 stories compiled in ‘Among My Own’, the moderator described Dr Naseem as a doctor who listens to the things that her patients do not talk about. “The stories of their bodies and spirituality,” as she put it.

Shahnaz asked her what inspired her to do something so extraordinary. The author said she has an adventurous spirit that led her to making a journey to the remote areas of the country, such as Tharparkar, as well as abroad.

“My objective has been that if I can fathom my patients’ minds and hearts, then I can treat them,” she pointed out, adding that she wrote the stories she encountered during her practice, and later, on the insistence of friends and family, put them in a book.

She said that the stories that come out violently than the rest revolve around bonded labour, feudalism, patriarchy, social classes and misogyny, which not only pertains to men’s attitude towards women but also women’s attitude towards other women who speak a different language or are from a lower social background than them.

The doctor said she served at the Aga Khan University Hospital, Karachi, and other similar hospitals in the US, adding that these health facilities cater to the upper crust of society, finances-wise.

She also worked at the Liaquat National Hospital, where people from middle classes, having health insurance provided by their employers, would come. Currently she is stationed at the Indus Hospital, which offers medical treatment to people from lower-income backgrounds.

“I have seen homeless persons, drug addicts with AIDS, people such as housemaids, washermen, tailors and other daily wagers who earn very less, and some of them had to sell their homes and buffaloes to pay for their healthcare,” said Dr Naseem, adding that she has seen utter injustices in society.

She mentioned the cases of cousin marriages, which cause disastrous effects on children, as they are born with deformities and diseases like thalassaemia. She said that once she treated a eunuch who had AIDS, and during that she got to know why they behave like they do, like begging and dancing, because most of them are forced out of their homes by their families, and possess no education or skills to get a job.

“As a child, I was afraid of them, but interacting with their kind and getting to know their stories helped me understand them better. I hope their situation gets better in the coming times.”

At the end of the session, she especially thanked the big-hearted people who donate or finance healthcare facilities that treat people free of charge. She said that the good in society exists because of philanthropists like them, otherwise given the situation of public institutions in Pakistan, it would have been worse.