September 28, 2007


Posted in Randumb at 11:41 am by Iram

Out of the night that covers me,
Black as the pit from pole to pole,
I thank whatever gods may be
For my unconquerable soul.
In the fell clutch of circumstance
I have not winced nor cried aloud.
Under the bludgeonings of chance
My head is bloody, but unbowed.
Beyond this place of wrath and tears
Looms but the horror of the shade,
And yet the menace of the years
Finds, and shall find me, unafraid.
It matters not how strait the gate,
How charged with punishments the scroll,
I am the master of my fate:
I am the captain of my soul.

–William Ernest Henley

September 20, 2007

A Serenade from the Laughing Spaceman

Posted in Randumb at 5:50 am by Iram

As sung by Spock on the Star Trek episode “Plato’s Stepchildren” that just happened to be playing when I turned the t.v. on during breakfast this morning.

Take care young ladies and value your wine.

Be watchful of young men in their velvet prime.

Deeply they’ll swallow from your finest kegs,

Then swiftly be gone, leaving bitter dregs.

Ah, bitter dregs.

With smiling words and tender touch,

Man offers little and asks for so much.

He loves in the breathless excitement of night,

Then leaves with your treasure in cold morning light.

Ah, in cold morning light.

September 11, 2007

Reflections After a Whole Year in Medical School

Posted in Iramville at 4:58 pm by Iram

I began to pave my path to medical school many years ago, at the young age of 4. I was in Pakistan, visiting my extended family, when the neighbor knocked on our door. She was in a desperate state, carrying her young son in her arms, and was begging for the help of my aunt who was the only physician at the time in our family. I don’t remember many of the details regarding the child’s illness or my aunt’s treatment, but I do remember announcing to everyone right then and there that one day I would be a doctor so that I could help the neighbors too. Since then, I have done quite a bit of growing and maturing, but even on entering medical school last year and donning the shortened version of the white coat my ultimate goal was the same: I was here to help people and make their lives, and even their deaths, better and more bearable.

The first year of school has changed my perspectives on a career in medicine quite profoundly. I have learned a lot about the complicated nature of my goal. I have seen patients deny our care, preferring a “dignified death” to pills and side-effects that promise to keep their brain functioning and their heart beating but cannot cure their ailing souls. I have witnessed physicians teetering across the gray line between minor manipulation and outright fraud in order to provide patients with the care that they need but cannot, by any means, afford. I have experienced the difficulty of juggling multiple responsibilities while constantly staring at the second hand that simply will not tick any slower. Overall, beyond the textbooks, studying and exams that define the first two years of medical school, I have learned a lot about what struggles physicians face on a day to day basis trying to ensure that every single individual under their care receives – and accepts – the appropriate treatment. Issues such as patient autonomy, Medicare, palliative care and noncompliance have moved from being in a mere shadow in some dark corner of my unconscious mind to the forefront of my conscious thought. Throughout all of this, though, my ultimate goal has not changed. I am still here to better the quality of life and death of those around me who honor me by putting their health into my hands. And although I can now recognize, and even lament at, the many roadblocks that make such a noble path so difficult, it has only furthered my appreciation for all of the health care providers that continue to put in their best effort at patient care.

Life as a physician will never be easy, certainly not in the field of Family Medicine that I currently plan to pursue. When you are delivering life into the world with one hand, you are covering a face with stark white sheets with the other. Time spent with family inevitably turns into time shared with a pager and a cell phone, giving instructions to strangers on the other end of the line. I still have several years before I hit this stage in my career, but when I do I hope to be able to incorporate some ideals into my lifestyle that will not only help me serve my patients better, but will also help me maintain my own health and family relationships. I want to be the doctor that is always available to help – whether my patients come in with an illogical concern to which I simply have to patiently listen, or they come to me injured and bleeding hoping for ointment for their wounds. At the same time, I also want to be the doctor that knows when to shut the phone off and pay attention to my own family members, who will someday contribute to the world’s future in a way that I myself will never be able. I also want to be the physician that realizes that my own health needs to be at the top of my priority list; I cannot help my patients if I myself am not in prime condition to think and act. I never want to give up on new ideas and treatments, or close my mind to innovative research projects, but at the same time I never want to recommend any of these to my patients without thoroughly doing my homework first. And perhaps most importantly, I would like to gain the respect and trust of my colleagues and friends and have them know that I will never do anything less than what is within my means to approach any situation that is brought to me. I think my ideals are best summed up by the poet Ralph Waldo Emerson:

“To laugh often and much; To win the respect of intelligent people and the affection of children; To earn the appreciation of honest critics and endure the betrayal of false friends; To appreciate beauty, to find the best in others; To leave the world a bit better, whether by a healthy child, a garden patch or a redeemed social condition; To know even one life has breathed easier because you have lived. This is the meaning of success.”

September 10, 2007

Arranged Marriage – A Modern Perspective on a Seemingly Archaic System

Posted in Commentary at 3:25 pm by Iram

This article, published by the New York Magazine, strongly reverberates with many of my current viewpoints regarding the system of arranged marriage that is so deeply rooted in South Asian culture. At an age where many of my friends, myself included, have begun to wonder who that special someone will be who will come and sweep them off their feet to live happily ever after, I can deeply appreciate the sentiments expressed herein by the writer. So, to all of those lovely ladies with whom I have spent evenings and nights discussing and dreaming about ‘HIM’, enjoy!

Is Arranged Marriage Really Any Worse Than Craigslist?

As with any singles Website geared toward one community, you also get your interlopers. A 44-year-old Jewish doctor managed to make my dad’s first cut: He was a doctor. Mark said he believed Indians and Jews shared similar values, like family and education. I didn’t necessarily have a problem with his search for an Indian wife. (Isn’t it when they dislike us for our skin color that we’re supposed to get upset?) But when I met him for dinner, he seemed a decade older than he was, which made me feel like I was a decade younger.

My father’s screening method is hardly foolproof. Once, he was particularly taken with a suitor who claimed to be a brain surgeon at Johns Hopkins and friends with a famous Bollywood actress, Madhuri Dixit. I was suspicious, but I agreed to speak to the fellow. Within seconds, his shaky command of English and yokel line of questioning—“You are liking dancing? I am too much liking dancing”—told me this man was as much a brain surgeon as I was Madhuri Dixit. I refused to talk to him again, even though my father persisted in thinking I was bullheaded. “Don’t you think we would make sure his story checked out before marrying you off?” he said.

Sometimes, though, you get close, really close. A year ago, I was put in touch with a McKinsey consultant in Bombay whom I’ll call Sameer. I liked the fact that he was Indian-American but had returned to India to work. We had great conversations on the phone—among other things, he had interesting views on how people our age were becoming more sexually liberated in Indian cities—and I began envisioning myself kept in the finest silk saris. My father kept telling me he wanted it all “wrapped up” by February—it was only Christmas! Sameer had sent a picture, and while he wasn’t Shah Rukh Khan, he wasn’t bad.

Back for a break in New York, Sameer kindly came to see me in Brooklyn. We went to a French bistro, where he leaned over the table and said, “You know, your father really shouldn’t send out those photos of you. They don’t do justice to your beauty.” Sameer was generous, good-natured, engaging, seemingly besotted with me, on an expat salary—and also on the Atkins diet to lose 50 pounds. My Bombay dreams went up in smoke.

In this, I guess I am like every other woman in New York, complaining a man is too ambitious or not ambitious enough, too eager or not eager enough. But they are picky, too. These men, in their bid to fit in on Wall Street or on the golf course, would like a wife who is eminently presentable—to their boss, friends, and family. They would like a woman to be sophisticated enough to have a martini, and not a Diet Coke, at an office party, but, God forbid, not “sophisticated” enough to have three. Sometimes I worry that I’m a bit too sophisticated for most Indian men.

That’s not to say I haven’t come to appreciate what Indian men have to offer, which is a type of seriousness, a clarity of intent. I’ve never heard from an Indian man the New York beg-off phrase “I don’t think I’m ready for a relationship right now. I have a lot of things going on in my life.”

Indian men also seem to share my belief that Westerners have made the progression toward marriage unnecessarily agonizing. Neal, a 35-year-old Indian lawyer I know, thinks it’s absurd how a couple in America can date for years and still not know if they want to get married. “I think I would only need a couple of months to get to know a girl before I married her,” he says.

In more traditional arranged marriages—which are still very much alive and well in India—couples may get only one or two meetings before their wedding day. In America, and in big Indian cities, a couple may get a few months before they are expected to walk down the aisle, or around the fire, as they do seven times, in keeping with Hindu custom. By now I certainly think that would be enough time for me.

Other Indian women I know seem to be coming to the same conclusion. My friend Divya works the overnight shift at the BBC in London and stays out clubbing on her nights off. Imagine my surprise when I discovered she was on, courtesy of her mother, who took the liberty of listing Divya’s hobbies as shopping and movies. (I was under the impression her hobbies were more along the lines of trance music and international politics.) Though she’s long favored pubgoing blokes, Divya, like me, doesn’t discount the possibility that the urologist from Trivandrum or the IT guy could just be the one—an idea patently unthinkable to us in our twenties.

It’s become second nature for women like us to straddle the two dating worlds. When I go out on a first date with an Indian man, I find myself saying things I would never utter to an American. Like, “I would expect my husband to fully share domestic chores.” Undeniably, there’s a lack of mystery to Indian-style dating, because both parties are fully aware of what the endgame should be. But with that also comes a certain relief.

With other forms of dating the options seem limitless. The long kiss in the bar with someone I’ve never met before could have been just that, an exchange that has a value and meaning of its own that can’t be quantified. Ditto for the one-night stand. (Try explaining that one to my parents.) The not-knowing-where-something-is-headed can be wildly exciting. It can also be a tad soul-crushing. Just ask any single woman in New York.

Indians of my mother’s generation—in fact, my mother herself—like to say of arranged marriage, “It’s not that there isn’t love. It’s just that it comes after the marriage.” I’m still not sure I buy it. But after a decade of Juan Carloses and short-lived affairs with married men and Craigslist flirtations and emotionally bankrupt boyfriends and, oddly, the most painful of all, the guys who just never call, it no longer seems like the most outlandish possibility.

Some of my single friends in New York say they’re still not convinced marriage is what they really want. I’m not sure I buy that, either. And no modern woman wants to close the door on any of her options—no matter how traditional—too hastily.

My friend Radhika, an unmarried 37-year-old photographer, used to hate going to her cousins’ weddings, where the aunties never asked her about the famines in Africa or the political conflict in Cambodia she’d covered. Instead it was, “Why aren’t you married? What are your intentions?” As much as she dreaded this, they’ve stopped asking, and for Radhika, that’s even worse. “It’s like they’ve written me off,” she says.

On a recent trip to India, I was made to eat dinner at the children’s table—they sent out for Domino’s pizza and Pepsis—because as an unmarried woman, I didn’t quite fit in with the adults. As much as I resented my exile, I realized that maybe I didn’t want to be eating vegetable curry and drinking rum with the grown-ups. Maybe that would have meant they’d given up on me, that they’d stopped viewing me as a not-yet-married girl but as an unmarriageable woman who’d ruined her youth by being too choosy and strong-headed.

This way, the aunties can still swing by the kids’ table as I’m sucking on a Pepsi and chucking a young cousin on the chin, and ask me, “When are you getting married? What are your intentions?” And I can say, “Auntie, do you have a boy in mind?”