If you can force your heart and nerve and sinew/To serve your turn long after they are gone/And so hold on when there is nothing in you/Except the Will which says to them "hold on." -- ‘If" by Rudyard Kipling

She was waiting for me when I walked into my office that morning. As I entered, she got up from her chair, leapt towards me, threw her arms around me and gave me a big hug. I hugged her back and she handed me a big cake "This is for you. For all you’ve done."

Samia (not her real name) was a student of mine who had messaged me the night before to tell me she had achieved her dream of obtaining a training position in a US hospital.

She had walked through fire to achieve this goal. When I first met her over two years ago, she was just beginning to come out of a crippling depression. We had met purely by accident. I was sitting in my office skimming through applications for scholarships sponsored by our university’s US alumni organisation. Since I was the Pakistan representative of this organisation, it was my duty every year come December to go through the pile of applications and select candidates who would then appear for a personal interview with a committee of doctors, most of whom had flown in from America for this purpose.

We would select half a dozen of the brightest candidates and award them scholarships worth $5000-$7000 which they could then use to pay for their journey towards a US hospital training position.

This was no small amount. Most of our applicants were from humble financial backgrounds since I teach at a public university. The process from graduating from medical college to starting a job at an American hospital could easily cost between Rs15,00,000-20,00,000, a prohibitive sum for most of them.

A scholarship of several thousand dollars would, therefore, be very welcome.

While going through the pile of applications, I had opened up Samia’s file. Her exam score was considerably below our cut off line and I was about to toss her file aside when I caught a glance at her ‘Personal Statement’.

I skimmed through her statement and was transfixed. I read it through carefully again and then called her on the number listed on her application. There was no answer. I sent her a text message telling her who I was and asking her to come at once to my office.

She showed up a few minutes later slightly out of breath. I’m not sure what I had expected but she looked quite unlike whatever I had thought. Thin, of average height, she was wearing a black hijab and was otherwise casually but neatly dressed. Her eyes were large and piercing and she had a ready smile.

She was from Rahim Yar Khan, from a middle-class family. She had always been good in her studies and when she graduated high school, the family suggested medical college, the usual choice for the parents of bright children. In the case of girls, oddly enough, one reason that parents send them to medical college is that a medical degree apparently commands a premium in the marriage market. A female doctor can get her choice of rishtas even though in most cases the in-laws then force her to sit at home and be a housewife.

In the case of Samia, she did not even have to wait till graduation. While she was still a medical student, her parents accepted a proposal on her behalf and married her off to a man living in America. Being a dutiful daughter, she did not object and dropped out of college to go to America.

Her problems started once she got there. She and her new husband never got along, there were frequent fights some of which later became physical. Alone and away from her family and with no support or help, Samia became more and more despondent until she slipped into depression and eventually tried to kill herself with a drug overdose.

She was found in time and taken to the hospital for emergency treatment then shifted to a psychiatric hospital where she stayed several days. Once she was released, her husband bought her a one-way ticket to Pakistan and promptly divorced her.

She came back to her parents’ home, re-enrolled in medical college and graduated. She then took her exams for the USA but because of lingering depression, did not score as high as she had hoped. She had not given up though and was now studying for the second part of the exam in which she was determined to do better.

All of this was detailed in her personal statement and as she narrated it to me, I looked for any signs of despondency or weakness which might indicate a propensity to relapse into depression. There was none.

I told her I was impressed with her story and wished I could offer her an interview for the scholarship but that her score was too low. She said she understood. I encouraged her to keep working hard and to stay in touch with me and she said she would. She did manage to scrape together some resources to go for interviews in the US but was unable to obtain a hospital position. When she came back to Pakistan, she came to see me again and we discussed her options. She was vacillating between giving up her dream of training in America and settling for training in Pakistan. She was also unsure of what she wanted to do.

She had an interest in psychiatry and mental health (for obvious reasons) but told me she was hesitant. When I asked why, she said, "My mother does not want me to do it. She wants me to be a gynecologist".

I asked her if her mother was a doctor. "No, she’s a housewife," she said. "How educated is she?" I asked. "Under-matric" was the answer.

I couldn’t believe my ears. Here was a bright young doctor deferring to her housewife, barely literate mother as to career options. I told her if this was the same mother who thought it was good idea for her to get married while still in college. For the first time, I saw a tear in her eye.

She came to see me several times over the course of next few weeks while we discussed her options. She seemed to be leaning towards psychiatry and I encouraged her to think about doing her training in Pakistan perhaps at the Aga Khan hospital, possibly the best training hospital in Pakistan.

I lost touch with her for a few months until just recently when I got a message from her saying she was going to apply to America one more time because "I don’t want to give up on my dream just yet".

I wished her the best of luck and told her to let me know if she needed any help. Last week, I got a message that she had found a training position in New York.

She wanted to come see me and tell me in person. When I met her in my office, she looked the same but minus the hijab. I teased her and told her she looked better without it. She laughed and said she had decided to take it off. She seemed genuinely happy.

The position she had obtained in the hospital in New York was in pediatrics (children’s illnesses) but she was just relieved to have gotten something. I asked her, with a smile, what her mother thought and she replied that her mother was fine with it. She is back home now with her family, spending a few well earned weeks of vacation before heading off to the USA to begin her training.

With some courage (and a little bit of help), she has managed to break so many chains that our society puts on women as soon as they are born. The day after she came to see me, I met another young female doctor in tears because her arranged marriage had just fallen apart (more on that another time).

As Pakistan modernises and more and more women become educated and empowered, we will be seeing more of this. The hallowed ‘family’ that we are all so proud of will begin to change, evolve and in some cases break down. We are not ready, as a society, for this sea change in social values and mores. Since we have made no effort so far to deal with this on a social level, all of us will have to pitch in, one person at a time.