February 04 , 2022
Orphaned
Being biologically orphaned carries much pain. Yet to think that I could be metaphorically orphaned, twice, and that the hurt would carry the same quality is hard to accept.
Biologic
I was 17 when my father died of a heart attack while playing tennis. Our family was still reeling from the loss of my teenaged brothers to a car accident five years earlier. And from the glamor of the diplomatic corps, my mother and I were suddenly left with a paltry pension and provident fund in patriarchal Pakistan. The recommendation of the Qur’an in the treatment of orphans (4:8-10) is particularly tender when you live it. And sadly, not much has changed in 1400 years; the treatment by family, friends and society ranged from inhibitive to cruel.
Pakistan
Pakistan of the late seventies and early eighties was safe and fun. Society had not been transformed by the heroin and Kalashnikov culture that the Soviet invasion of Afghanistan brought. Neither had Saudi Arabia’s Wahhabization reached the common man. Our identity was Pakistani, and we remained a devout people.
We were not taught addiction medicine in Dow Medical College and didn’t see its fallout in our clinical years and internships, neither were there any rehab centers in Pakistan. The heroin and crystal meth (also known as ice) epidemic has transformed Pakistan’s youth, and educational institutions. Responding to this crisis, rehab centers dot Pakistan’s major cities. And Wahhabization created a literalism that left its own practitioners awkward and confused.
The most alarming, and, sadly enduring, change has been of our value system, in which the acquisition of money, lawfully or dishonestly, is now a national preoccupation. This, in turn, occurred due to the massive economic mess that a burgeoning population, diminishing resources, lack of democracy and legal recourse, and embedded corruption in the government, judiciary, and media.
This is where I feel I was orphaned by Pakistan. In the face of desperate and visible poverty are the pursuits of the elite. Where a practicing physician from the United States feels decidedly poor. Of name brands I haven’t heard of and (disgusting) luxury I have never seen. I feel so out of place that a two-week vacation becomes onerous. That the azaan, and twittering of birds at dawn, remain my only attraction to going to Pakistan is such sad commentary.
United States
Distressed at the corruption and lack of health care resources for patients in the government funded Civil Hospital, I left Pakistan during my internship. My intention was to complete a residency in the US and return to Pakistan. And perhaps that is why my estrangement with Pakistan happened; too much time went by, and I could not adjust to what was Pakistan’s new reality. America then was awesome too. People were friendly and said hi to strangers jogging in the neighborhood. There was value for education, respect for others, legal recourse, and diversity. Societal values of good manners and tolerance prevailed. I would go grocery shopping in a shalwar kameez and no one stared.
The unbridled greed of the Sacklers, owners of Purdue Pharma, unleashed the opioid epidemic in the 1990s, and the 2008 election of Obama, the first Black president of the United States set in motion the rise of White supremacy, the Proud Boys and QAnon. This unfortunate confluence of factors has changed the character of America. Hatred and violence are published creeds of White supremacists and the Proud Boys. Gone are the days of careless shalwar kameez wearing in the grocery store. Even dressed in jeans and a shirt I get glared at, sometimes unblinkingly, and clearly only for being brown. I again feel orphaned and out of place.
The Black Lives Matter movement in the thick of the Covid-19 pandemic added fuel to the fire of White supremacy. The January 6, 2021, Capitol insurrection made for a sickening similarity between Pakistan and the United States. And seems to have cast a near-mortal blow to the greatest democracy in the world. So much so that US military leaders are now concerned of a military insurrection after the result of the 2024 presidential election.
Republicans are very focused on the two symbols of their freedom: masks and guns. Not wearing one but assuredly carrying the other. Economic stress created by Covid-19, conspiracy theories about Covid-19 and its vaccination, perpetuating the big lie of Biden not winning the election, high gas prices and daunting inflation, make for a powder-keg type of scenario. Road rage is essentially a daily occurrence. I make sure I don’t look at the driver that overtakes me after riding my tail under the delusion that he has a flying car. Who knows he might be armed, and I would become a statistic?
Solution
For both Pakistan and the United States, we need to return to the raison d’etre of both nations. Muhammad Ali Jinnah founded Pakistan due to the economic and educational disempowerment of Muslims in India, and Pakistan was to be a haven for Muslims and all its minorities. The creed of the United States is democracy, equal rights, and liberty.
In both Pakistan and the United States enduring change can only occur if it starts at an individual level, goes to the family and community, and is thereafter legislated nationally. You can’t be corrupt or racist, or condone it when you see it, and expect that things will spontaneously improve.
I know I cannot get my father back. But I frequently, and wistfully, dream of getting my Pakistan and America back. Insha’Allah.
(Mahjabeen Islam MD FAAFP FASAM practices addiction and family medicine in Toledo, Ohio. Her email is mahjabeen.islam@gmail.com)
