Rheumatology is a very interesting sub-specialty in medicine. It deals with disorders of the musculoskeletal system, especially autoimmune diseases, like Rheumatoid arthritis, SLE, systemic sclerosis, gout, and the vasculitides. These are mostly chronic diseases that, unfortunately- and particularly so for our society- predominantly affect women. And so, like medicine as a whole does, Rheumatology mirrors the misery and the suffering in our society. The ignorance and the brutality. The evils. The hollowness within.

We'll call her Ayesha; this friend of mine. We've been living in the same neighbourhood for the past thirteen years. She is a nice, fun person, who like many of us, has been battling weight problems for years. As she was nearing her 30s, all the Aunties around here were pretty anxious to see her happily married off. And then one day, we found out it was really happening: Ayesha was getting married! A respectable, middle-class, educated family. Everyone was truly overjoyed. I remember having fun at her Mayun and Mehndi. And she looked great on her wedding day. Post-shaadi, the reports were very favourable: her susraal was very amiable: Ayesha was very happy.

But a few days ago, Mama came back from Ayesha's mother's house, looking distressed.
Ayesha's mom has had Rheumatoid Arthritis for the past several years. It has been very taxing on their family, especially her daughters, who have been managing the house ever since the disease left Auntie incapable of even the simplest daily tasks. Stiff, painful joints. Fever. Lethargy. Weight loss. And so, day after day spent absolutely bedridden, popping steroids and DMARDS.

The fact that left Mama and everyone else distressed was that Ayesha had suddenly come down with a debilitating episode of joint pain and immobility. A few doctors and a blood test at Shaukat Khanum later, she was diagnosed with Rheumatoid Arthritis, too. Apparently, these diseases have a hereditary component also.

And that is when her in-laws began to show their 'true colours'. The mother-in-law postulated that 'yeh to apni maa ke ghar se beemari le kar aai hai' and the husband declared that 'hamaray to laakhon dabonay wali baat hui na...' The father-in-law would try to reason with his wife and son, but as in most such cases, he probably didn't have much influence over them.

Ayesha's sister's wedding was just around the corner, so she came back to her mother's house, ostensibly to help in preperations. But everyone noticed that she looked pale, wan and haggard. And then, on her sister's wedding, there she was making excuses to everyone as to why neither her husband, nor any of her in-laws were present.

And it made me think: are the bonds of marriage in our society so weak that at the slightest indication of illness or misfortune, women are abandoned, discarded like broken toys, thrown away like expired food? Then marriage is indeed a flimsy institution.

I've always liked that part in movies where they show the wedding vows being taken; the part where they say: ' ...in sickness and in health, to love and to cherish, till death do us apart.' Maybe because we don't take those vows, people don't realize that marriage isn't just about blue skies and calm seas; there will also be thunderstorms and slate grey skies, the sea will roll and boil and rage. But if you don't jump ship, or push your partner out of the boat, it's just possible that you'll make it safely through.

And the sad part is that, when the woman falls sick, she is ostracized. But when the man does, the woman is expected to be accepting, and to care for him and nurture him to health. In Ayesha's case, what about the Huntington's that might be lying dormant in the husband? What about his possibly mutated p53 gene, the other allele waiting for the chance to morph into the monster that is Cancer. What about the Rheumatoid arthritis that may befall him a month, or a year, or 10 years later? I'm not saying any of this should happen to him, Im just saying it could.

I used to think auto-immune diseases were extremely interesting. But now I see that renegade antibodies can destroy not only the joints, but also lives.