In his eyes

"Travelling in the sweltering heat of summer is no joke, I don't know why my parents think I always need some sort of chaperon; I could have easily stayed in the hill station by myself but Amma ko bhi na, go to Khala's house beta, its not safe or socially acceptable for a girl your age staying by her self. I will be back in a few months from the USA. Enjoy your stay in Multan till that time, you have never seen it and you have always wanted to go visit." All the conversations of the last few days were echoing in Rehaams head.
      The last few days had been a blur of activity Ami had needed to go to the USA on urgent business, Abu was not well and had asked her to come as soon as possible. Ofcourse on such short notice it was impossible to take all the family, so she was being shuttled off to khala's house and her brother and sisters were going to go to Nana abu and Dadi ama's houses respectively. Rehaam was lost in her thoughts when the train came to a stop and with it came the deluge of humanity. All the Co Cak Cola and SPrait wala sounds, Kulfi and Garam anday, some charlatan selling snake oils. She really needed to get some tea, her head was hurting too much, she had been up since the crack of dawn and from the looks of it she probably will be up for another day until they reached khala's house at the rate this train was going, they were only at Fateh jang right now. She looked at the seat in front of her, Bua masi was fast asleep; she really did not  want to wake her up, maybe she could go and get two teas by her self after all she was 18 years old and that in her books was old enough. She got up and took the money  out of her back pack and climbed down from the train. It felt good to stretch her legs, she proceeded to the tea stand. There was already a gentleman in front of her ordering tea. She stood to the side to let him finish; and than ordered two teas herself. She took them and was on her way back to the train when the fellow who had been infront of her rushed past her and in the process she managed to spill half her tea, "ouch" she yelped as the hot tea scalded her soft hands "I  am so sorry I was just in such a rush," he said. She gave him an angry look and was about to start off on a tirade when he said, "allow me to buy another one please. I am so sorry, did I hurt your hand also"
"Yes unfortunately you did".she said " let me see", he said as he inspected her hand. "dont worry I am a medical student." "looks like a first degree burn, I have some ointment in the train, i ll bring it to your seat; allow me to bring you some tea now."
  She looked at his receding back, he was tall almost 6 feet and had thick brown hair. He was dressed in an offwhite Shalwar Kameez and wearing the traditional sandals for the region, given the heat it seemed the wise choice, she though staring down at her own sneaker clad feet. He returned in a few minutes with a cup of tea and proceeded to accompany her back to the train. She came to her compartment to find bua ama still asleep. He left her the tea and said he d be back with the ointment in a few minutes. She continued to sip her tea and was immersed in her thoughts when he returned with the medication. "I am really sorry to have injured you, I hope this helps with the burning." he said." She looked up at him and for the first time noticed his eyes, they were the color of  liquid amber, smoldering and warm as he looked down at her. She felt a rush of color to her cheek and looked down at her tea. "Thank you for bringing me the tea and medication"Rehaam said,  "I am Rehaam and this is my bua amma, we are going to Multan to visit my khala," she said in way of introduction. "I am Hisham and I am on my way back to the Medical College, I am a student at Nishtar Medical Center. I feel terrible for my carelessness, I hope you feel better and in case you need anything, I am sitting in berth number 4."  "Ok, thank you Hisham sahib," Rehaam said. After he left she applied the ointment to her hand and than proceeded to sip her tea. He did have the most enegmatic eyes she though as she settled down in her seat and started to observe the bustle of activity on the platform.

Train ride

Have you ever traveled by train in Pakistan? if you have than u must know that by the end of the trip the whole "dabba" is your family. My sudden recall of the train ride is due; cause i watched this movie called challoo dilli, its a well made movie and I would highly recommend it.
  I have traveled by train often between Lahore and Karachi. Infact train is one of my favorite ways to travel, If I have to choose between a train and an airplane I would always choose the train. Train is soooo much fun especcially between Lahore and Karachi because of the way the scenery changes from the plains to the desert. I think we are specially blessed because we have a country so full and rich with culture. On a train you acually get to experience that cultural shift as you get off on the various small town stations for tea and snacks. Travelling with my grand-mothers was the best cause they always knew which place had the best tea, which place had the best samosas and pakoras and mithais and which were special for what area.
If you have ever traveled by train in Pakistan you must also know how often they are delayed, so its quite amazing how all the passengers unite and pull together at times when the trains halt to a stop and there is no idea of when it will start again and the other best part is that if you are a lady travelling alone you would never need to pick up your own baggage, cause some samartan will always be there to help the damsel in distress.
 I remember when I was younger and I d go by train I d make friends with all the passengers and by the end of the journey my mom had to drag me back to my seat from some long lost Khala or Mamoo that I had found. I guess my favorite part was the sharing of food and stories, its funny how culture difference play a role in what one can say or not say in public. In Pakistan any one can be ur baji, or behan ji or khala or mamoo or chachoo and they will ask you about your complete bio data without flinching. So if you are a girl of the marriageable age beware cause you might just be betrothed to some aunty's wonderful nephew who works for some big firm. If  you are married and do not have children beware with a big B cause you will need to explain your choice for not being knee deep in poopie diapers and if you have one child you must have a good reason for not having a dozen as yet.
All this aside i still am in love with the culture where every one's  business is your business and your business is every one elses, it does show some level of care right. When ever we traveled by train with Dadoo she would have a whole basket of food packed for the trip and everything was consumed in order, because one always needed breakfast, lunch a snack and in most cases dinner. There was always fighting in the ranks about which berth to sleep on and for pardah's sake we d have all our chaddars hanging from the top of the berth if there was some poor fellow who was sharing the seat so be it, he would become an honorary uncle right than and would have to tolerate a gaggle of ladies giggling and talking and in our cases young ladies singing and performing some sort of tableau or another.
 I loved to sleep on the train with the steady rhythm of clacikity clack beneath the wheels, what fun that was.....
Trains in some ways remind me of life, in life we travel with a bunch of people who get off on their designated stops. Some stay with us for the long haul of the journey others for a short time, with some we form tight bonds and some we never get to know at all. All the people we travel with leave with us memories; some good and some bad. It is indeed fortunate to meet people and have meaningful relationships and when you meet those people it is always a good idea to keep them around in your life. It is wonderful when you lose some friend along the way and meet them again in some distant future, I guess the beauty of a good friendship is that no matter how much time has passed when you meet you feel you had never left at all, those friendships I think are the real keepers. So my prayer for you on your train journey of life is that may you meet wonderful companions to travel with and may your travels be easy and your burdens light.

Give me wings and I will fly

Well I have successfully finished my rotation at the hospital. This one for me was the  scary bit, I ll talk about that in one second. I just want to talk about a couple of other things before that.
One of the major things I have realized from all my experience working and so on in the last few weeks are
a) how lucky and blessed I am to have the parents I had, who gave up their own dreams and wishes to give me the best education that money could buy. My parents sent me to one of the best English medium private institutes in the country, back in Pakistan and at the time my mom tells me my grand father  had asked her how she ll manage to pay the high tuition fees to which my dad had replied I ll figure it out uncle cause my daughter deserves the best. Having a good education gives us such a big advantage on so many fronts, having parents who were willing to put us through university and hence giving us a boost up in life. I came to this realization while I was working with different students in my rotation groups who unfortunately do not have this support right now. They don't have the luxury of not working. They have to work to make bill payments and to put them selves through school, which is very difficult.
b) I also realized that we have a great opportunity at our disposal. I believe in destiny and I believe that Allah has put me here for a reason, I am currently residing in one of the biggest economies of the world, enjoying the benefits and lifestyle which only about 10% of the US population enjoys. I have a great opportunity here I can use this time and my energies to learn new skills either through volunteerism, or work. If I work I have an even better opportunity now cause with my income, I can do so much charitable work for Pakistan in particular but other places as well, I can take it upon my self to educate just one person who may not have access to education, or support a family for their livelihood in Pakistan. We keep talking about bringing change for Pakistan. I know its very hard for a lot of us to be away from families but we need to realize the opportunity that we have at our disposal here and not using it would indeed be very sad. I think when Allah gives us money, and privileges he gives us an even bigger responsibility to be care takers for those who may not have access to the benefits we have. If we volunteer we will still be learning new skills which we can teach others, use at some stage in our lives, start small grass root organizations to start a change. Use your imagination but please use this opportunity. I think if we were in Pakistan right now, we may not be able to create as much of a change as we envision here because we will be too busy making a living and ensuring a better future and security for our children. So i know it sounds shallow but money has a lot of power and it has a lot of power to buy many different types of things. It is our choice how we use the money and the power associated with it.

Now a little bit about my hospital experience, I had a great time because I got to see so many cool procedures and see many medical devices which I was not aware of. Medical science has progressed so much that we have manages to prolong the average life span of some one living in this society by almost 30 years. But on the other side of the coin it does bring up many ethical questions and predicaments about end of life and what to do when some one is on artificial life support. Working at the hospital was an eye opener on so many fronts. I realized that the old slogan  health is wealth holds so true because if you loose your health nothing in the world can replace that. There were patients there who were on ventilators and some who were receiving tube feedings, things I take for granted every day breathing and eating. Imagine not having the luxury to taste your food. Of-course taking care of patients in the hospital is more work and it does require a lot more skill cause of the level of acute care and the amount of i.vs and things attached to each person can make things like turning some one in bed and taking them to the toilet a big challenge. I have to say Nursing is a very challenging profession both emotionally and physically and the Nurses both male and female do a great job of keeping a calm, pleasant exterior while managing so much paper work, answering call lights and taking care of patients needs. I did not see nurses sitting for one second while on their 8 hour or 12 hour rotations and I only had 8 hours to do I can tell you being on your feet for that long and ensuring you are not Mrs grouchy pants by the end of that, plus making sure you are following all the rules and protocols is no small feat. Nursing is so much about communication and being a team player, being positive to your co workers and enthusiastic about your work. There is certainly a lot more than book knowledge and skill involved. I just have so much more appreciation for people in the health care field and all that they have to put up with and deliver care. 

The care takers of the little things

I finished my first clinical rotation at a Nursing Home/ Rehabilitation Facility this week. Just to clarify when I am talking of Rehab here its not substance abuse rehab, its rehab for people with problems of a more physical nature due to the result of stroke, accidents, surgeries etc. This sort of rehab are done in a sub-acute setting. Where the environment is very much like a hospital but there is a lot of interaction with physical therapy, occupational Therapy, speech therapy, dietary intervention etc.

 A rather generalize explanation of physical therapy is that it exercise of the below the waist limbs, while occupational therapy is the exercise of the upper body limbs. 

 So any way coming right to the point. I learnt some very important lessons and this experience made me see my life in a whole new light. The bull-shit quickly gets pushed aside when you are dealing with life at its most vulnerable and fragile every day. 

I dealt with people who had dementia at varying stages. Dementia is basically the consistent deterioration of memory. It can occur due to many reasons, Alzheimer is one of the most well-known illness which causes it but there are many others but I wont go into more detail cause this is not a biology lesson. I just want to talk a little bit about what I saw and what I got out of it. As a quick side note, its not necessary that every older person will have dementia it occurs in about 10-15 percent of the population. However, I saw that most people in the advanced stages were not able to do anything for them selves. Makes one appreciate our selves, our independence, the ability to do what we want when we want. Here we keep talking about one bad feature or our weight but if you think about it, what if one day we are not able to move, speak, eat on our own, go to the toilet, scratch an itch. WE are left a prisoner in our own bodies and our own heads full of half finished sentences and foggy memories. It made me appreciate my memories my family more and more and my friends. 

  Most of these folks old with or without dementia just used to talk of three main things their faith or religion, their parents, their spouses or their kids. That is it, no one talks about their careers which we spend so much energy and time on, no one talks about the big house they lived in or how many  expensive things they had, no one talks about the big car and the next big adventure. I saw some kids going the extra mile by coming in to visit with their family member every day and it was mostly children, some spouses also. The children were often but not always the daughter and a lot of times the daughter in laws. When you spoke to them about how their parents had been with them when they were young, the more frequent visitors said they gave them a lot of their time, so this I think was the key the time we spend with our family whether it is our spouse, our parents, our kids. We need to be present in the moment spend it with them. More than the physical presence it has to be a mental engagement. Talk, communicate, play games tell them you love them over and over. Bonding with the kids is all about the care-giving the feeding, the bathing the playing its not just having them in your laps while we work on the computer or watch tv. 

 On the Rehab unit, it was more a realization of how much we take our body for granted the smallest of things like standing up can become a challenge if just one thing is not working right. So treat your body well, eat healthy, exercise, sleep and have fun. 

 It was a wonderful experience though, I get this question a lot why Nursing and why a Nursing Assistant who by the way are payed just a little above minimum wage but have to do pretty much all the grunt work on very tight schedules and with limited staff. I can only say it gives me a lot of satisfaction to take care of some one. If I managed to connect with even one person give them some small relief it makes me happy. A lot of times nursing assistants are not being treated with a lot of respect by the patients and by the staff, their work is considered not very fad. But I learnt that the work they do is very important they are ones with the most interaction with the patients and residents, they are the ones keeping the patients clean and fed and they are the first ones to notice if anything is a miss. I had more appreciation for the people around me who are doing the labor oriented tasks. The work a lot of us do not want to deal with and the work a lot of us assume does not require a lot of skill. Yes if you need to take some one and weight them it is not big deal if they are healthy and walk there them selves but if this person is totally paralyzed and really old and fragile the task requires a bit of finesse and skill to ensure the person is not injured by the end of the process. 

 Most of the Nursing Assistants I worked with or spoke to said that Nurses who were Nursing Assistant are better at handling things and who wont be after taking care of 7-8 patients on one shift where you are the ones ensuring they are clean, hydrated and fed working on tight meal and rehab schedules. An older person and even a patient is like a little child in terms of their needs except they are much bigger and heavier and they are not as complacent and compliant and you cannot scold them into doing things.  

 So it was a great experience on the whole cant wait to start my next rotation at the hospital. 

Starting my life in the healthcare profession.

Since I was a kid I always wanted to be a doctor. Every time some one would ask me what you want to do when you grow up. I d go I will be a doctor. Well I went to school and then university and after an especially grueling time realized that although I really like sciences I struggled with them quite a bit and perhaps medicine was not for me. I had always dreamed of being this heroic figure who went out to the field with poorly equipped hospitals in war torn and ravaged countries and worked tirelessly to take care of the people there. But reality and fantasy are two very different things so I kept on pushing back on my dreams and going well I don't need to help people like this, I can do something else like volunteer.... hmmm,well than I had my daughter It simultaneously opened my eyes to the fragility of human life and the resilience a human being has to fight for his life. It made me realize how lucky I was to have the support I had, my wonderful amazing husband, my awesome mother and sisters and my amazing friends. I was awed by how much progress medicine has made and the untiring effort put in by the whole medical team.

Like a lot of people I used to think the doctors are the real heroes, well they are surely but so are all the Nurses and therapists and every one else who is working in the whole healthcare system here. I was especially impressed with the nurses and their tireless work in ensuring my comfort and the comfort of my baby. I had dili dalied with the idea of being a Nurse for a long time, so after my experience I started to put it into practice. I was not sure how I ll react to sickness and all kind of bodily fluids and grumpy tired patients, so I started slow by volunteering at a hospital and contrary to what I expected, I loved it.

I mean I absolutely love working at both the hospitals I am working at right now. University of Washington Medical Center and Evergreen. I am inspired by the dedication of the health care staff and how seriously they take their jobs. I am impressed by how well hospitals and nursing homes are regulated here. There is always human error, of course that cannot be completely eliminated but boy these folks work very hard to make it as minimum as possible.

I feel satisfied and happier than I have ever been in a long time regarding my career progress. So I took the next step and enrolled in a Nursing Assistant program and well the program is pretty intense to say the least. Lots of information and studying involved but it is also quite an eye opener. I was thinking about how sick my grand parents were at the time they passed away and as in Pakistan the old folks always live at home they were at home. I know my uncles and aunts and my mom did the best they could to take care of them but when one does not know how to deal with a specific situation it can get very hard. Things like proper hand washing can eliminate a lot of infections right off the bat but we don't know how to properly wash our hands.

There is a lot of misinformation out there regarding anti-bacterial agents and that causes people to make bad choices, so does misinformation regarding immunization. I ll say a little bit about immunization and than on to my story, the only way and I mean the only way immunization can work is if every one gets it, if half the population is immunized and the other half opts out, it puts every one at risk. The study that came out regarding immunizing kids and children getting autism due to this was fraudulent. The British doctor who did it is behind bars now cause his study prompted quite a few parents to forgo immunization for their children and these kids ended up getting those very diseases the immunizations were suppose to counteract and they died.

So any ways I just recently started going back to school and it kind of feels like when I was at university when life became all about sleeping, eating and studying. I hope I can be good at what I have decided to do, I still have apprehensions sometimes because it is sinking in how much of an influence I can have on someone's life. I can be responsible for someone's death and one false move on my part can make the difference in someone's quality of life. However, a good job by me can also make some one's life a lot more comfortable and easy. I feel very happy when I work in hospitals. When I started this course one of the first things we learnt was about Florence Nightingale. This lady changed the face of health care. She standardized practices for Nurses and actually gave a face to this profession. Things we take for granted like infection control and cleanliness were started by her. She comforted the sick and nurtured them. These are the main things our instructors keep stressing too, empathy, non-judgmental attitude, cleanliness. Get to know your patient, know what they like and how you can make them more comfortable and happy. I don't know, people tell me I am a nurturer by nature so I hope I do a decent job. Lets see its going to be an interesting ride...

food food and more food

Before I launch into my rant, i want to apologize to all my readers for being away from the scene for so long. I was afflicted by a writers block of sorts and by this massive expectation of my self to write something totally profound and original or something hilarious.

I started many posts and always deleted them cause they never fit the bill. Well i have removed that sort of expectation from my self now and I ll just write whatever I am thinking of at the moment without censorship, it may be funny but again it may not be.

So this brings me to today's post. It is about food which i love, I love to eat and I love to cook. Cooking for me is like creating a master piece I feel deliriously happy when I am in the kitchen making some concoction or the other and non of my recipes are ever the same cause I always end up making some change to the original depending on the ingredients at hand. I am very lucky that I was taught how to cook, this skill has served me well it helped me to establish a very successful business and it helped me to survive when living on my own, when I had a seriously tight budget but my knowledge of food and cooking helped me stay healthy. you must be wondering why I am telling you all this, well the reason is that lately I have been watching TED talks and I was shocked to learn that apparently in the USA for the last 4 generations women have literally stopped cooking at home. Its mostly take out, canned food, tv dinners. On top of this most women don't know how to cook. I know its very un fair to pin cooking and house work just on women, men should learn all these life skills too, but more on that debate later.

The health of this country has gone down drastically over the last few years, by the year 2020 more than 70 percent of the population will be obese. Right now new born children are being born obese. What has all this got to do with women cooking you may be wondering, well let me do a quick re cap of history here apparently in the early 1900's women were mostly at home they did the house work bought locally produced ingredients and cooked the food at home over time as more and more women got into the work force tv dinners and canned food was marketed to them to ease the house work load. These foods were generally meat based with tons of other kinds of additives and not fresh ingredients over time this became the norm. The sad part is that as women went into the work force the house work and cooking were still primarily considered their responsibility and hence they were sold on the idea of quick fixes.

I am writing this post for a few reasons one is that cooking is a very under appreciated skill. The other day a friend of mine and I were talking about how perceptions have shifted now. In Pakistan knowing how to cook and keep a good house is considered a very important skill and it is valued. Women who cook well are appreciated and lauded and encouraged. A woman cooking and keeping house here is not really considered to be doing "real work." As more and more women start working the quality of home life will get affected it is key that the men realize this right now and pitch in, if you expect your wife to work than make sure you don't expect her to do all the house work and the cooking. If you don't know how to cook, learn it and most importantly teach your kids, boys and girls to cook. Cooking and food knowledge is key to staying healthy.

The other important thing to remember is what we eat, in Pakistan meat is still considered a luxury so having it once a week is a big deal for some, here meat is much more readily available so our diets change drastically, where we ate meat once or twice a week we end up eating meat on a daily basis. This trend needs to change, eating meat once or at max twice a week is more than enough for our body. It is imperative for health to eat as much vegetable and plant based food as we can.

Dieting? try the kid diet.....

Well its official my child is a toddler. The dreaded stage............ where as one mommy I know puts it you have to save them from killing them selves. Gone are the days when I could cajole my daughter to sleep a few more minutes or hours. Now a days its up at dawn and start running and dont stop till ya drop. I bet she ll make an excellent personal trainer, her clients will be begging for mercy just like her number one client, her mommy.

When she was young I used to take her out for a walk in her carrier to the park where I used to meet other mommy's. At times I would lament about my massive weight gain during pregnancy to which they would reply oh don't worry about it, wait till she starts running all this weight will just melt off. Well we are at that stage now and along with the strenuous training comes the diet restrictions as well. These days my daughters choicest foods are pebbles, sand, buttons, pencil shavings, paper and such deliciousness.

One of my aunts used to say about kids who ate paper that they were little thetaz (person of very high mental caliber). Than come stuff which is on the floor. Food tastes infinitely better when its eaten off the carpet or the floor, the natural sauces of dirt and grime are much better than any Tabasco you might have tasted. Infact I can go as far as to say its better than the tasty treats at Maza grill :)

There is a famous essay by Ibn Insha on children diets. He writes about this man who is complaining of a stomach ache and goes to the doctor. The doctor tell him to start a children style diet. The man goes home but after a week is still complaining of a stomach ache, so he goes back to the doctor. The doctor asks him did you try the children style diet I told you about; the man goes yes but my tummy ache is worse than before; to this the doctor asks what did you eat? the man replies I ate tich buttons, pencil shavings, thread, paper, anything off the floor I could find.....

Even more mortifying than the dietary requirements of my child is her behavior outside the home. I mean I feed her I honest to goodness do, I infact always feed her to the maximum capacity when we are going to some one's place but the moment we enter another persons house she is hungry again. At this point I ll quickly grab a plate and load it with food and bring it to her but she just does not like to eat from my plate, it is always more fun to eat another kids food or food from some one else's plate who is not mommy.

So well these are the latest adventures in mommy town, join me next time for some fun stuff about my little tarzan and her antics regarding jumping on tables...