We were having one of our ‘long days’: regular classes till 2:30, then evening Emergency from 6 to 9. We had to stay in university all day, the hostel food was tasteless, we hated missing our afternoon nap and having to set up a temporary abode in the rooms of hostel friends; knowing that despite their reassurances, we were a disruption, a warp in their normal life. Laughter was the only way we could make it bearable. And laugh we did: silly jokes, playful ribbing; all the way to the Emergency.

‘Look, such injuries! Must be an RTA.’ ‘Oy, wo larki dekho kitni deathly pale hai, must be in shock!’ ‘Haan, ruptured ectopic pregnancy ho sakti hai.’ ‘Yar, come here! Yeh dekho, diabetic foot aisa hota hai!’ ‘Eww! Gross!’

Then again, all of us huddle together and break into giggles at a joke. At that moment, it was like one of those flashes of realization that hit characters in the movies; I remember thinking: What are we doing here? This is the Emergency! Patients are DYING around us. What must the people be thinking about us? Heartless doctors? Monsters? To see such death and suffering around them and still laugh! To see us in misery and still smile!

But the fact is, their suffering really doesn’t register. To us, their pain is meaningless. ‘Shock wali larki? Pump in two bottles of Hartmann’s and send her into the OT-she’ll be fit as a fiddle.’ Well, almost. ‘Appendicitis? Ki syapa ay! Mai te akk gaya aan appendicectomiyaan kar kar ke’.

The 10 year old was doubling up with pain, frightened because she had never experienced anything like it before. I went up to her and pressed her RIF hard. She screamed out. I released the pressure suddenly. She shrieked again. ‘Yup, both tenderness and rebound tenderness positive. Ik hor. Appendicitis.’

I’m not an insensitive person. Not at all. I’m touched by eloquent poetry, I sometimes cry when I watch movies, and I feel transported by a good book. The political and security situation in Pakistan fills me with indignation. And the misery, hunger and depravity I see on the streets makes my stomach turn over and my insides churn.

Then why does the plight of a patient not strike a chord with me? Why does their pain not make me nauseous? Why doesn’t the sight of blood make my spine tingle? Why can I laugh and smile and joke around when people are bleeding and moaning and vomiting and dying? Why am I even concerned about these questions? Do they matter? Does it make a difference? Would I have it otherwise? Would You have it otherwise? I mean, the next time a case of appendicitis comes in, I could sit by them, hold their hand, and cry with them. I’m sure the patients would think I was a very compassionate doctor…