Picture of Zeenat JunaidZeenat Junaid is a medical student in the Class of 2020 at Bahria University in Pakistan


I checked his file again and looked up to see the patient with a tube hanging off his shaved head. Mr. Taj Saboor, 48 years old, had brain cancer —glioblastoma multiforme. It had been removed twice in the last six months, and each time it had returned with pugnacious insistence. If cancers were little shoots and plants, or even weeds or bushes, then glioblastoma multiform would surely be Jack’s colossal beanstalk of lore spurting straight up to the sky. It is fast; it is monstrous. Even when meticulously removed, one never knows where else in the brain the beans have been strewn and where hell may again break loose. It surely is the grand master of all stealthy and lethal cancers.

His son, a strapping young man named Wali, had come to see him. He was also his translator, since Mr. Saboor did not understand the regular urban languages of Urdu or English in Karachi, where he was now admitted. Over the following days — in short, friendly chats — I got to know them better. They were from Skardu, the valley that lies at the confluence of the Karakoram and the Himalayas in northern Pakistan. This was the glacier-covered alpine landscape for which Keats would have uttered, ‘A thing of beauty is a joy forever […] An endless fountain of immortal drink, / Pouring unto us from the heaven’s brink.’ However, the once-kings of exquisite valleys and peaks have lately been making the humble journey south to larger, modern cities like Karachi in search of better job prospects.

Wali had been living here for the last few years as a trained nurse at a local hospital. “How does it feel to be here?” I asked, bemused. Karachi, an insomniac jungle of techno-hyped urbanization with a population bursting at millions, surely takes getting used to. The contrast from a quieter world could be disconcerting, if not paralyzing or even debilitating.

Wali smiled with tired, sleep-deprived eyes. “It is hard. Life goes on.”

He proceeded to hold his father’s hands. They were still firm, as the speedy cancer of the head had not had enough time to settle in the flesh and bones and cause chronic muscle wasting. The father and son smiled and chatted away happily in their own Pashto language, which I did not understand. They even softly hummed a mysterious song that I suppose they had often sung together. Mr. Saboor’s eyes shone; the memorable glint seemed discordant with the baldness of his fate and the sterile white and green hospital setting. That glint belonged to another landscape; to another time. It reminded one of the sparkle of fresh, gushing water from melting glaciers; it was reminiscent of the majestic radiance of dawn as it floods the world with life. The twinkle had tones of laughter and the taste of good food. It was redolent of an after-dinner story; of a clumsy joke and of sharing bread. This shine belonged to a family, called out to friends in Skardu, emanated from the pleasure of a successful harvest… it was an accumulation of a happy life. It was uplifting, and I saw the light reflected in his son’s blood-tinged eyes as they shared the moment.

What were those visions they shared in that mind’s eye? I wondered. Both father and son were walking through unfamiliar territory. Wali had been residentially and culturally displaced from a home of verdant valleys to a cog in the turbines of a highly capitalistic city. His father, Mr. Saboor, was now traversing the basins of death — brusquely departed from the security of health and an expected future. Despite being strangers in these lands, their eyes still glowed as the visions of their past held them together.

This was when a poem by Li-Young Lee I had recently read, “I Ask My Mother to Sing,” acquired a deeper meaning. Lee was a second-generation American who spent his life investigating his identity and heritage through art.

There are patients who are assaulted or isolated; who are depressed or morally divided. There are patients who are terminally ill. There are always migrants or refugees; the expatriates, the homeless or runaway kids, the natives and neighbours and those on interim visas that one receives at a clinic. In one way or another, we are all en voyage in life and may have sailed into new territories where our mental landscapes do not harmonize with the external landscapes we must negotiate. We are strangers here and suffer psychological displacement. There is nostalgia for the glorious past or the safe homes we have left; the path ahead may be uncertain, and we may or may not be the sole arbiters of our fate.

How to keep our wits collected and eyes still glowing? How to relocate our roots and moorings? Like Mr. Saboor and Wali, or as Lee’s poem describes, is it by speaking your language and singing your songs? Is it really that simple? The answer still eludes me — but by watching others seek it, too, my empathy enlarges to something beyond the professionally polite doctor-patient relationship.


Note: All characters in this work are fictitious. Any resemblance to real persons, living or dead, is purely coincidental.