January 27, 2008

Me, Myself and I

Posted in Iramville at 2:50 pm by Iram

I like the dark.

I like thunderstorms more.

I have a weakness for dark chocolate and strawberries, sometimes together.

I have an even bigger weakness for potato chips. Keep them away from me (except for the Flamin’ Hot variety). My arteries will thank you.

I find the smell of jasmine essence divine.

When I was little I used to eat whipped cream sandwiches.

I make the best walnut brownies ever – ask my brothers.

I say *y’all* instead of *you all.* I think it’s a Texas thing.

However, I say *aUnt* not *aant*. It’s a British thing.

I lived in London for three years.

I still can’t speak Katchi, but don’t think I can’t understand what you’re saying.

My Urdu is lacking too. I simply can’t seem to remember which words are masculine and which are feminine.

In general, I don’t have proficiency for foreign languages.

I have a tendency to get lost, to drop things, and to walk into things. Please help me.

I have been white water rafting in the St. Laurence River.

When we hit the rapids I didn’t scream. I also didn’t fall out of our raft.

I enjoy taking risks and tripling my heart rate.

I refuse to bungee jump though. Something about bouncing up and down by my ankles doesn’t appeal to me.

I can’t swim.

I can barely ride a bike. The scar on my chin attests to that.

I can’t roller-blade.

I am, basically, not incredibly coordinated.

I did, however, manage to learn how to ski – one pole and two fences later.

I love receiving flowers, even though they die the next day.

I also love diamonds, even though some argue that children died for them.

I hate the *Birthday Song.* I never know what to do when people are singing it.

Babies make me smile. I pinch their cheeks.

When I was a kid I used to inject water into the abdomen of ants and slice open dead cockroaches to see what was inside. This is when everybody knew I would someday be a science nerd.

I have a fascination with the “Disney Vault” and everything that comes out of it.

I can never remember my dreams. That bothers me.

I like to laugh.

I am very easily amused.

I think wit is the greatest sign of intelligence.

I am an idealist. That doesn’t mean I’m naive to reality. I just choose to believe that there is a pureness in humanity and it will prevail.

I believe in the simple philosophy of Robert Fulghum. He’s right, everything I needed to learn I did learn in kindergarten.

I can’t balance a checkbook. Well, I can; I just don’t.

I am a commitment-phobe.

I am not an animal person. But kittens are adorable.

I am not a feminist.

I do, however, fully embrace and enjoy my femininity.

Still, sometimes I think life would be easier if I was male. Then I go to the mall.

If I were a guy, I’d be a total a**.

I am a tech-geek.

I am not a Republican.

I admire humility, confidence, passion and ambition.

Arrogant pseudo-intellectuals irritate me.

I am a pseudo-artist.

My journal can be corny. I apologize. I write best when I’m stressed.

My faith defines me.

I don’t believe in infinite truth. Truth is relative, perceived. Acceptance is enlightenment.

I do believe in fate, karma and the unforeseen.

I am flawed.

I don’t like to admit I am wrong. Ever.

I am nosy.

I question everything.

Often the expanse of the universe overwhelms me with my insignificance.

I am old for my age.

*Snow White* scared me the first time I watched it.

I have watched *My Fair Lady* more than you can count.

I think every young girl should have to read *Little Women* at least twice.

Cheesy Desi music makes me happy.

Actually, anything with cheese makes me happy.

I want a guitar. No, I don’t know how to play it. Yet.

The birthmark on my belly is starting to fade. That makes me sad.

I can’t dance, but that’s never stopped me.

I seem to wear a lot of pink, even more than purple.

In my room there is a tower of shoes that nearly reaches the ceiling. And yet I always seem to end up wearing the same two pairs.

I despise the word *dude.* Though, it’s crept into my vocabulary lately.

I say the word *like* at least 50 times a day.

I run my hands through my hair at least twice that.

I can count at least five little gray hairs on my head. Damn genetics.

I am probably taller than you, especially if I am in heels.

I want the *Cosby Show* life. Why can’t they make shows like that anymore?

I want to grow old like the *Golden Girls*, preferably in the Mediterranean.

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.”

February 20, 2007

Refuge Services – The (semi-)Obligatory Plug

Posted in Iramville at 12:19 am by Iram

This past Friday I paid a visit to Refuge Services, a 501.3(c) organization here in Lubbock that is doing some work that I am more than happy to support. Refuge Services advertises itself as “a public, non-profit organization that provides services for the whole person: body, mind, and spirit. (They) provide hippotherapy, therapeutic riding, and equine-assisted psychotherapy, serving over 75 clients per week.” In other words, they use horses to provide therapy to individuals for whom most other means to achieve wellness have failed.

In my opinion, one of the best services that Refuge offers is equine-assisted psychotherapy for children. By matching each child with a horse that mimics the child’s own personality, the program forces the child to overcome his or her own weaknesses in order to successfully ride the horse. One success story that was related to me was of a 6 year old boy who had become so introverted that he no longer spoke to anybody. Refuge Services matched him up with a docile horse that had a similar personality and no will of its own. If the boy wanted the horse to go anywhere he would have to learn how to be in charge and how to have enough confidence in himself to give orders to another. It was only after equine-therapy allowed the child to regain his confidence that he was able to admit the cause of his silence – he was a rape victim.

I have also experienced first-hand some of the programs the Refuge Services can offer to various institutions. At their open house they held a demonstration of a team-building exercise that they offer to corporate groups and other teams. For the exercise, a group of random individuals was selected from amongst the audience and put in the arena with three horses. There was a jump bar in the middle of the arena, and this group of strangers had to pick one of the three horses and coax that particular horse to jump over the bar. There were some rules involved, of course: nobody was allowed to touch any of the horses in any way, shape or form; bribery was forbidden; nobody was allowed to feed any of the horses; if anybody in the group broke one of the rules the entire group had to climb the arena fence in punishment. It was a simple list, but one that proved to be quite extensive when Ranger (the chosen horse) refused time and time again to jump over the bar.

At the beginning of the exercise, all of the group members tried to discuss their different ideas and plan out exactly what steps they wanted to use to convince Ranger to jump over the pole. They tried to lead by example by jumping over the pole themselves (Ranger’s response was to role around in the dirt after lazily watching their attempts), and when that didn’t work they tried other methods including scare tactics, sweet-talking, and even begging. After about 30 minutes with no success, personalities of the group members began to show through. One of the women tried to take charge of the group, taking the initiative to gather everybody together to regroup and figure out a strategy. When this didn’t work, though, the group members began to split off into two factions, each working fairly independently to convince Ranger to jump over the pole. In addition, the gentleman of the group (a lawyer by profession) began to take an indifferent attitude towards the rules and picked up a stick to ‘push’ Ranger over the pole. When he was reminded that this was still against the rules (to which his very lawyer-like response was that the stick touching Ranger did not count as him touching Ranger), all of the other group members climbed the fence for the punishment but he did not. It was interesting to note, however, that he did not pick up that stick again, leading me to believe that he agreed that using the stick was against the rules, but still considered himself above consequences.

Personal issues became more apparent as well. The mother of a three year old boy kept comparing Ranger to her son, and drew a parallel between Ranger jumping over the pole and her son listening to her instructions. The task of getting Ranger to jump over the pole represented a different difficulty to each of the individuals involved, and as the conversation between the group members continued the on-lookers were able to uncover more and more personal issues behind the behaviors of the different volunteer individuals. If one person was a natural born leader who was able to bring the group together to plan out a scheme, another person was a shy individual who needed the support of the rest of the group to convince her not to give up on Ranger. Throughout the demonstration, Patti (the owner of Refuge Services) talked us through the benefits of this type of exercise, and explained to us how similar exercises could be used to isolate different personal issues that would then be discussed in clinical therapy sessions.

In the end, the volunteers did get Ranger (and his two other horse friends) to jump over that pole, but not before exposing themselves to the rest of us in the audience. After seeing the entire process unfold, I have no doubt that the programs offered by Refuge provide great benefit to their clients, and would greatly encourage anybody looking for a tax-deduction to support this organization (tax day is just around the corner!).

January 27, 2007

10th of Muharram

Posted in Iramville at 5:49 pm by Iram

Monday is the Islamic observance of Ashura. On this day, many Muslims around the world choose observe an optional fast from sunrise to sundown, much like the fasting of the Islamic month of Ramadan. Besides being a day that the Prophet Muhammed (PBUH) annually kept his fast, the day of Ashura is also a day of great historical significance. On this day: Allah (SWT) accepted the repentance of Adam (AS) after his exile from Paradise; Allah (SWT) saved Noah (AS) and his companions in the ark; Allah extinguished the fire in which Abraham (AS) was thrown by Nimrod; And Allah (SWT) spoke directly to Moses (AS) and gave him the Commandments. On this same 10th of Muharram, Job (AS) was restored to health from leprosy; Joseph (AS) was reunited with his father Jacob (AS); Jonah (AS) was taken out from the belly of the fish; and the sea was divided as the nation of Israel was delivered from captivity and Pharoah’s army was destroyed. Ashura is also the day when David (AS) was forgiven, the kingdom of Solomon (AS) was restored, and Jesus (AS) was raised to Jannah (Heaven).

December 26, 2006

Pictures

Posted in Iramville at 5:49 pm by Iram

Pictures are back on! Click on the ‘pictures’ link to see my photo albums.

November 30, 2006

My first snow

Posted in Iramville at 5:01 pm by Iram

Yes, I’ve seen snow before. I’ve seen piles of it in Alaska, along the mountops in the Rocky Mountains, and in the foothills of the Himalayas in Northern Pakistan. I’ve slid down snow covered hills in California and watched little Afghani boys slide down on homemade sleds in Kalam. Never, though, have I actually seen snow falling. The “snow” in Houston doesn’t really count – we get a few flakes here and there but mostly it’s just very small bits of hail for which we have no better name than snow – so obviously I was thoroughly excited to experience my first real snow here in Lubbock. It’s just one more experience that I can put on my list of firsts that I started compiling when I began medical school here.

November 20, 2006

The cultured cell bio book

Posted in Iramville at 11:47 am by Iram

Just about everyone remembers introductory high school biology, where they first memorized all of the components of the cell membrane, learned about the fluid mosaic model, studied the cell cycle and learned about all the little organelles within the cell. I distincly remember Ms. Brewer’s lecture in 9th grade biology about organelles during which she taught us how to discern between each different type of organelle in an image. Mitochondria looked like kidney beans, the rough ER looked like it had chicken pox, and the Golgi apparatus looked like a stack of pancakes. Thus, after using these analogies throughout my undergraduate years, you can imagine my amusement when I saw that our medical school cell biology text says to think of the Golgi apparatus as a stack of pita bread.

November 10, 2006

My first everything

Posted in Iramville at 11:24 pm by Iram

After dinner today I pulled out a little Dove chocolate for dessert. It’s my new addiction, and I love reading the little messages on the insides of the wrappers. Today, one of the messages out of my little chocolates (opened by Bhavik, btw) was “Remember your first everything.” This started me thinking, because the past eleven weeks have been full of a lot of firsts for me. My first day in medical school, my first patient, my first time living away from home, my first time being fully independent, my first time meeting all of these wonderful people with whom I shall have the pleasure of interacting over the next four years, and the list just keeps going. Thus, I decided to post a tally of firsts since the beginning of medical school so that I can remember them all in upcoming years:

1. My first pediatric patient – a beautiful three day old baby girl

2. My first sport – playing frisbee in the lawn outside the library

3. My first football – I finally learned how to throw! Kudos to Ekta, Omar and Sandeep

4. My first fooseball victory – Omar!

5. My first cadaver – thanks to the Willed Body Program

6. My first tank – John the Knife, Dr. Ray, Renee and Angelique

7. My first time spending an entire night at school – with Bhavik and Padma and Shaqueeshra the Space Heater

8. My first spaghetti iftaar in Lubbock – thanks to Adham

9. My first Ramadan and Eid away from home and family

10. My first sports injury – thanks, Padma, for kicking me in the jaw after tripping me and making me fall flat on my face!

11. My first real Halloween party – I was a jar of Hot Salsa and I had a bag of tortilla chips (Ekta) to accompany me

12. My first game of antakshari via AIM – I won, by the way, because my opponent (Bhavik) signed off

October 26, 2006

Vandalizing the Mosque

Posted in Iramville at 3:07 pm by Iram

I have been in Lubbock only nine weeks, yet over this short time I have developed a deep admiration for the Muslim community in this small city. After living in Houston for 19 years I always assumed that every Muslim community was split into factions with widely differing points of view. In Houston we have mosques that are predominantly Arab, mosques that are predominantly Pakistani, mosques that are predominantly for Africans, mosques that are predominantly for converts, and mosques that serve as a catchall for everyone else. At the Rice University MSA, on whose board I served as President, we had two polar factions that were determined to pull everyone in the middle towards either the liberal or the conservative side. It’s sad to think about the Muslim Ummah being divided into these superficial categories, but I’ve seen it happen time and time again. Even within the defined groups we consistently had bickering and fighting over when to start Ramadan, when to celebrate Eid (we always have two of each Eid), and whether going to the Eid Mela is haram or not.

Amidst all of this discontent I left Houston and found myself in the middle of the Muslim community of Lubbock, where I have yet to feel as if I am a new member. Everyone here is warm and welcoming. I go to prayers and have learned to not be surprised that I, a Pakistani, would be standing in the prayer line next to a Syrian and an Egyptian, behind a new convert from Mexico and catty-corner to an American lady. The mosque does it’s best to support all of the community members, as evidenced by the close ties between members of the community and the mosque as well as the connections between the mosque and the Muslim Students’ Association (one of the most important ties as the MSA represents the future of the Muslim Ummah). The Muslims of Lubbock, many of whom are doctors, do their best to give back to their surrounding community as well, as I recently witnessed in the form of a $750 check to the South Plains Food Bank during the MSA’s Fast-A-Thon two weeks ago. Being a part of this small, but close-knit, group has helped me find a place within my religion. Until this point I always felt that something was amiss: we were practicing a religion of peace and solidarity but could not maintain unity within our own community. In Lubbock I have found the type of Muslim community that I always wished we had in Houston.

Looking at this community from my perspective, it saddens me deeply that anybody could be so ignorant as to deface the new Mosque that has just recently been constructed. I was not around to see the first few vandalizations of the mosque, during which, as I understand, much more significant damage was done. But even though this time the only damage was a bit of spray paint that can easily be washed away or painted over, it will leave a deep scar. Despite everything that the Muslim community does for Lubbock, there are groups that are able to ignore all of those facts and act simply out of spite or misconceptions and deface our place of worship. It is disheartening in a way, because it shows that no matter what we as individuals or as a community do, we will never be able to erase all of the ignorance and hatred that prevail in this part of the country.

October 12, 2006

Traumatizing situations

Posted in Iramville, Randumb at 2:22 pm by Iram

We’re only eight weeks into our first year of medical school, but many of the members of our class have already experienced traumatizing situations that will probably remain with them the rest of their lives, and will likely be the stories they tell their grandchildren about their medical school experiences:

1. Being splashed as your cadaver falls too quickly into a tank of old formaldehyde and thrice-used cadaver juice

2. Having to deal with a leaky rectum that wasn’t tied tightly enough when the intestines were pulled out of the abdomen (yes, cadavers still have their feces intact and in their digestive tubes, and these feces will squirt out under pressure)

3. The distinct “crunch” of the bone crusher at work

4. Having the tied up cadaver hand come untied and conveniently fly into your mouth

5. Going home and looking in the mirror to see bone shards tangled into your hair

6.  Cadaver fart – a very unique, but memorable, experience

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