Me and the Advisor to the President Karzai

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A Hospital with Antique Decoration

Today I went to see Afshar Hospital. It is located faraway from the centre of the city. It looked to be in another part of the world. They have tight security. You have to register your name on the gate, seen by strict guards, given a visitor card, and than enter. It takes a little bet time. For a visitor it is ok, but for an emergency case it is too much. As I entered the hospital, it looked almost a military base, with lots of security people inside. And as I went further inside then it seemed almost like a hotel or a museum. It had interesting design. Furniture’s, design of the window, and doors, and even the small cabinets for the patients were of antique decoration. There were some antique items and lovely rugs hanging on the walls. Latter on I found that founder of hospital was fun of antique designs. I was thinking; for a hospital is it good to such decoration. Maybe not. If I was sick I would love to be in peace, not looking around and wondering about those fancy things.

I need to break my proud

Some days ago one of my geriatric patients died. She had a hard family to deal with. Sometimes dealing with them was frustrating, and sometimes I was upset for what they were suffering. She was more than 70 years old, with hip fracture, chronic renal failure, chronic UTI, depression. She never received an appropriate treatment for her UTI, because her son, who was the closest to her, was thinking it would harm her. She was admitted several times to the hospital for confusion, decreased appetite and change in her bevahior, and investigations at every time showed she was septic. The first time she was in the hospital, I had almost one hour chat with the family to explain them why she needed antibiotics. And then everyday and every visit it became a trend to repeat my lecture about antibiotics, indications, contraindications and side effects. I was acting like a patient doctor, but latter on I was easily annoyed by simple questions. I could not satisfy the family with the way I was treating their mother, in terms of medicine. So they went back to dozens of doctors who were treating her before. She was taken to internists, cardiologist, urologist, and psychiatrist. But could not find the satisfaction for their own and for their mother, and so the family came back to me. To my surprise there was no appropriate medicine relevant to her illness, and letter on I found that the family were interfering with treatment plans. I realized that they were hard to deal with, so I referred her to my senior consultant, who referred her back to me with some advice. She was sick, and I was sicker for her. With some medicine I sent her home. Some days letter son called me that she was not improving, and if I could see her at home. I rejected home visit gave just some advice on phone. At this time I realized that I was a kind of ignoring her. I should have not rejected home visit, but then I was hearing a voice from my inside telling me that you can not help her, and your advice is not heard. The next day son came and almost begged me to visit her mother at home. I was thinking that the patient and family were desperately searching for help and hope, and they are knocking my door, how should I ignore it. So I promised with myself to be again a good, kind, and patient doctor. At home I found her to be quit septic, brought her to hospital and again started antibiotics. Urine culture revealed a very resistant microorganism and needed a very strong antibiotic, she slowly recovered but fear from side effect of the antibiotic and other medicine brought her son back to me to hear my old lectures again. We had a long chat, and I thought that I have given her enough reasons to continue the full course of medicine. Next day I got a phone call from him with repeated concern, and I again repeated my lecture on phone. Latter on in the middle of the day I got calls from his secretary and my brother that the family are concerned about the strong medicine she is receiving. Now I could not stop my anger and said that the son is absolutely mad, he needs treatment for his mental disorder. And so the second phase of ignorance started. I changed all of the medicine according to what he wanted though I knew that it was not appropriate, but I had no other choice. She deteriorated again at home, and I again become a good doctor and did several home visits. At this time I was just giving none medical advices and guiding her to different specialists. She was not improving and I did not know what exactly wrong with her. I could not ask for hospital admission because I was afraid that they will not follow my instructions in the hospital. I was feeling guilty when doing home visit and I could not anything for her. And one day son called me that her mother is not doing well and if I could come to see her. I excused and said that I was busy. He said he would send car and I denied, and finally he said he himself would come to pick me and I said that I could not help her mother at all. This mad him upset, and he complained to my brother that I was not kind to him. He was right, I was not kind to him at that time. And the next day I heard that his mother died. It made me deeply upset. I truly could not help her, but maybe I could help the family. Why I did not continue to be a kind doctor till death of his mother. She was kind to me till his death, but I was not kind to her at the end. I want to go to his son to apologize for my behavior but my proud is against me. I should break this proud.

How do we look to the world?

Everyone has his own way of thinking to the world, but in general there are two approaches and each one in one extreme.
In one of the approaches people look to world in a lovely way. They think everything in the world is good, lovely and beautiful. There is nothing bad, ugly and horrible, except what our mind thinks and makes.
On the other extreme people think everything in the world is bad, ugly and horrible. They think life in general is collection of tricks and to keep it going you must fight or fly. When I look to origin of these thoughts; I generally find that the first idea is raised more in the developed societies, where everything is available for a good living. But the letter idea is more common among people where they are fighting with basic needs of life. People in the first party think that an optimistic look to the life and world has led them to the better life.
As I am socially with the second group of people; I am question myself if that the "optimistic look to life" itself is a key to a better life, or a better life gives birth to this idea. When you have every thing for a good living; you have a good shelter, good food, good income, good security and lots of other good things in your life there is no doubt that you will have good look to your life. But if you wake up with cry of your children weeping from hunger, you passed a rainy night under a broken shelter, you did not get your salary for 3-4 months, every moment you are expecting robbery, or bombardments how can you have a good look to the life?
Sometimes I am thinking about my father, my self and people who have came from the west. My father and people who spent their life in the west were in two extremes and I am wondering in the middle. My father spent most of his life as immigrant; he was fighting with horrible pictures life and finally passed away while he was very sick but could not get a good medical help and had nothing for a good living. The picture he saw from the life was a horrible one; war, hunger, broken shelter, insecurity, disease, and all terrible things that one can think of. On the other hand his friends who passed their time in the west had everything for a good life. They were away from war. Hunger, disease, and insecurity were strangers to them. The picture they had from world was beautiful and lovely. And here I am in the middle. I was a witness war, but now living in a relative peace. I spent my childhood in hunger and under broken shelter, but now am an owner of a better life. I have a test of both groups, and I have a picture from world which has both extremes.
Now if I come back to the message that "good look to the world makes your life good" I don’t agree. I would say that "good life makes you to have a good look to the world"

Association of Afghan Family Medicine (AAFM), a Dream or a Reality?

And here I am back………after many days since the last piece of my memories……do I have anything new now? Yes, I am back with one of my dreams. I am trying to make this dream true, but I am not sure if I would be able to do so. The dream I am busy these days is organizing the "Association of Afghan Family Medicine".

The association entered to my thoughts when I was in the medical school. I entered the medical school with so many problems (mainly of burocracy) and finished it with many more difficulties. In the medical school I was always reading old foreign journals. I did not have access to new journals, but still I was happy if got an old one. Reading from foreign medical journals and from foreign medical associations, I was feeling sad for my own country. We had no journal inside our country, and the country had no medical association. Outside the country, no one recognized our medical school and no one accepted our degree. I was always dreaming I would establish a medical association, a centre of excellence, the association that would struggle to improve the quality of our medical education and fight against the bad criticism we were facing.
When I entered residency program I got to know young motivated colleagues who had the same thought I had. We decided to bring our association out of our thoughts and give it a real physical appearance. But encountered a surprising problem; I found that the distance between our thoughts and our practical work was too much. When we sat and talked, we had wonderful speech and lovely thought, but when we had to practically do something we were lazy. Some of our colleagues thought that the idea was very big and we were too small for it. However I loved the thought and wanted to give it physical appearance. So as a first step I made a website, http://www.afdocs.bravehost.com/ the response to the website was different; some were supportive and some people thought it a funny joke. There was not much help, ……….so I finally thought I will give up, and I did so. Letter on we were about to graduate from the residency program, and we were all thinking that we should have a link with each other, as the result the thought of association again came to the minds. We had many meetings and again had the lovely speech about the association, but in practice we were again very lazy. Maybe we were not so much lazy, but the difficulties we had did not allow us to get busy in something that had no physical profit for us in short term. And so we graduated, and scattered in four parts of the country. A year letter we came back to each other by chance. I again proposed the association, and one of old colleagues said "It is a lovely idea, but I don’t know why we don’t have much interest". And this time I promised that with any price I will work for the association. So I spent days to make a draft to organize it and I finally yesterday I came with some papers. As I finished the draft and the 3 months work plan, I was so happy…..so went to a net café and emailed to friends. Here now I am waiting for the responses……I am sure I will get supportive feedbacks, but I am also waiting for funny jokes. I don’t know what will happen after this…….I hope I will get it done, and I hope this time we wont be lazy.
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I Hate To Start A Day Like This!

Do you know we don’t have stable emotions? They are waxing and waning, sometimes we are happy and sometimes depressed. When we are depressed the world is all dark. Everything is horrible; the black glass on your eyes gives a dark picture of the world around you. But if you remove this nasty glass, then everything is lovely. Sometimes, or maybe most the times I suffer from this waxing and waning in my emotions.
What I wrote below is an example of it:
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I Hate To Start A Day Like This!
Tomorrow is another day to start and I hate to start it as I have to. I have to go to work and office, and do the usual dull and boring tasks. Tomorrow again I have to meet those monitors, whom I hate to answer tiresome questions. Tomorrow again I have to set on that horrible chair and answer those annoying emails. Tomorrow again I have to go and shout on staff for the usual faults they do, and tomorrow again I gave to listen to dozens of complains I receive from patients, their visitors and other people.
I hate to start a day like that!
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Evening:
It was a nice day. I went to work and office, and enjoyed all what I did. I participated in a meeting in Public Health Department, which was wonderful. Monitors were brilliant people. I had no email to answer except for one or two lovely ones. All of staff did their job in a best way. I had no complaints from people.
I love to have a day like that!

I love to be crazy!

My boss thinks I have gone crazy! You know why? Because I am wasting my time (as he says) walking in bloggers world when I am free. As I find something interesting I make him listen for me while I read with pleasure. At the end he laughs and says “Great! Another madness but that was not too bad”, and I continue to walk in my crazy world. I feel comfortable and happy when I am crazy!!! I feel I am flying in the lovely blue sky, touching the beautiful white clouds and singing with cheers of birds, and this makes life fantastic and lovely. But when I am come back to the real life, and see I am back in the ground, way down from the blue sky, no more beautiful white clouds but dark and scary ones, no more cheers of birds except the horrible songs of craws and then I look to myself to be a wise fine person, I hope to be always crazy in the crazy world.

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I love my ugly Flowers

Today I was blog hopping. I came across some lovely ones. Entering those blogs I found myself in a beautiful garden with nice green trees, lovely red flowers and pleasant songs of birds. I went to smell every flower and I was jumping from one rose to another. As I was thinking about the gardener, and thinking myself to be a kind of gardener of my own blog, I found myself very small and to be honest I lost myself. I was jealous for lovely roses I was smelling. I was thinking why mines weren’t as beautiful as those were. And this made me upset. I was thinking I was gardener of my blog and posts, and if they are not well grown it is my faults. But where were the faults? When I was writing by what faults did my posts become so ugly? I went back to my posts, and to my surprise I found them more beautiful than they were. Yes those ugly ones were looking amazingly lovely to me. That was because I was like a mother to them. Though I knew that mines were not as pretty as others, but I still love them.

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Why sometimes we are not honest to our friends?

That is because we are afraid of truth. We don’t have the courage to stay with reality; we love to stay with our imaginations. We don’t have the courage to say no or yes to keep up with the honesty. We modify the honesty with our bias. Most of the time we think the truth may make our friends unhappy. So we lie to them, and to make that lie truth, we make more lies. And these lies give birth to most of conflicts.
Some days ago I found myself in a strange situation. I found one of my friends in a wrong path. I was trying to correct him, but then I was thinking that it may make him unhappy, because he was thinking that the wrong path was absolutely the right way. Bearing this idea in mind, I stopped. But then I was thinking why I did not correct him, and found that I did not have the courage to say him the truth. So I promised with myself to find that courage talking about truth. So I started speaking to him, but at the middle I found that he was in discomfort, and I automatically changed and started speaking about his strong points and he was happy. When I was alone, I was angry with myself that why I lost the battle so soon.
Are we the same with all of our friends? No………We are trying to make those people happy who are very important to us. But those whom we think that we are more important to them, then we are the other extreme. We make them to change to what we think is right, we don’t even care if they will get upset or unhappy. And these friends don’t have the courage to say that we are wrong, because we may become unhappy.
So to do good things and to say truth we need courage.

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Beautiful Samangan with Bahlol, our lab technician

Bidding in office.......

I am setting in my office, down in the yard there is noise; “this one 200 Afghanis for me………and this one 1200 Afghanis……….” I looked to my boss “Sir, what is the noise down there?” He laughs: “well, I have asked logistic department to sell all old and broken equipment. Now the market is very hot….I hope they won’t break each other’s heads, hahahaha” I look down to the yard from the window. Yes, there is some of our office staff with old, broken chairs, cabinet, fan, and refrigerator. It is interesting to me and I ask my boss “Sir, this market is fantastic, shouldn’t we take part in it and see what is going from near” and he replies “ha, good idea, let’s go”. On the way downstairs we see logistic officer and my boss asks “how did you put those prices on those broken items?” He answers “well sir, we did it with help of Dr Nazari. He was our fake costumer; he started the bidding, and now the real costumers are offering better bids.” and we all laugh. We go to the place where bidding is ongoing. In the middle there are the equipment and the costumers are around. When our staff sees us, they all start laughing, and we laugh too. But to the corner is our guard looking angry and unhappy. I ask why he is unhappy and someone answers “He removed all these items from the stock and brought to the yard with the hope that he would receive some of them free, but now on everything there is a price, so he is unhappy” Our boss says “he will receive what he wants free” and all plastic chairs are given free to all guards. Now everyone is happy and laughing. At the end the one of our staff wins the bid and buys all the remaining equipment.

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I promissed to be a good doctor but........

When I was in Samangan, I was supposed to be oncall 24 hours………sometimes I lost my temper, and become very cruel to people……….the same was my colleague; Dr Hazim………. Quarrel with people happened several times, and every time just after the argument, we realized our mistake and become so upset that made us cruel to our own………… finally we found the courage to bring this mistake to each other…………. Since we were the leaders in the hospital and knew that our behavior will affect the behavior of our subordinates, we promised to find more tolerance and to have more control on our emotions…… but what happened next day made me break my promise. A young pregnant lady was brought to hospital with bleeding and prolonged labor, after workup we found that she was candidate for C-Secion…………consent was taken from husband and relatives were asked to arrange blood…….. since it was an emergency case Dr Hazim toke the OT while I got the responsibility to find blood for the patient………. The only person with the same blood was mother……but she refused to donate…..I was explaining that with donating blood she would not be harmed and she would save life her daughter…… but to my surprise both father and mother was pointing to their son in law that it should be him that would lose his wife and he need to find blood. Several times during this argument I lost my patience and become angry but soon I remembered my promise and acted to be calm………..finally I toke father to a private place and said “ is your wife having monthly periods? Is she losing blood in her periods?” he said “yes. Lots of blood……..” and I said “ so we are going to take the blood that she is losing monthly………” saying this he agreed and after a brief talk to her wife she also agreed……..and I asked a nurse to get prepared for blood transfusion…..a minute letter the nurse came back to me that they have changed their decision……..father came to me with a great anger “doctor you promised that you will use blood that my wife is losing monthly………but your nurse wants to take blood from her arm…………… if my daughter is going to die………I don’t want to lose my wife…………” I could not control myself and take from arm of the father and toke him out of hospital and warned him never to come back to the hospital to see her daughter………. Still when I remember the way I behaved, I feel sorry…….and I would be felling sorry as long as I remember.
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I am escaping!!! hahahah!!!

Sometimes when you get a job with a better position, you are happy and work with an interest, but there are times that you have a good position, but you hope you would have been in the lowest post. That is because you see that something is going wrong, but you cannot stop it. You are in the position with authority, but still you need to consider the outcome of your decision, so it won’t be worse than the previous wrong thing. Here is the same with me…… Many things are going wrong here………..and I have to take strong decisions………..but I am not doing so……..why? I think that the outcome would be awful. What should I do? I have two options; either change the way I think about outcome of my decisions or leave the post. I think the second one is easier…………..am I escaping from the problems? Maybe……..
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I am bored........

It is rainy and cloudy today. It looks almost like a night. And maybe it IS night. I am alone in my office. Sometimes I love to be alone, and sometimes it very boring to be away from friends and colleagues. I don’t know what to do…………when I start reading, I cannot, because I don’t want to. I start to write, and then I stop in the middle. I have installed a game on my computer,“Wolfenstein”, very interesting, to waste time, and still I don’t feel ok. So what to do???????????? I don’t know………… Here it is…..My writing mood also finished, hay wait! I have to write……….….

Me and the young hard working man, what is the difference?

Today when I got out going to my private office I saw a young man working hardly to break a big rock. He was a labor working for construction of a house, and sweat was running from his face head and forehead. There was sign of blood on his leg, meaning he was injured during the work. I was thinking with myself, that doing so hard job under the burning sun, how much he would be paid. And then I thought about my own. I spent all my day in a cool room, on comfortable sofa and behind a computer. I had delicious dinner, and hot tea. When I was coming out cleaner had brushed my shoes nicely. I looked myself in the mirror if dressed ok. Doing relatively comfortable job I get good pay. The young man working outside was also a human being, he was working harder than me under the burning sun with empty stomach, and the cash he receives could not be compared with mine. Why is that? Is it justice? Maybe I will say I get paid for the profession I have, I am a doctor!!!??? But can it be a good reason??? I was talking about the same story some months ago with my director; he also did not have a good reason. He laughed at me and said “Well, I don’t know. The guard and the cooks are working harder than me. I am sitting behind a computer relaxed, and I still get good pay. I don’t know if that is right, but I like my salary” But still I don’t have a good logic for this discrepancy. What I know is “I don’t want to be paid the same as that hard working young man was paid.” If you have any logic for this please write in comments.

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Feeling happy with going to ACOMET hospital

I signed contract with ACOMET hospital in Kabul, and here in BDK I am just waiting for 23rd of April. Today I was thinking why I was happy as I am leaving Badakhshan, am I interested in ACOMET too much? Maybe, but I had the same feeling when I was leaving Samangan, I was very happy I was leaving Dehi district hospital. Here I just stopped with my feeling for a moment, and thought maybe after 5-6 months I would be happy leaving ACOMET, but why is that so? I am thinking I am a jumper, no….no…..no. I don’t want to be a jumper. I will try to stay with my next post for at least 1 year, if I am a live and if God wanted. In ACOMET two things are disturbing me, but there are two things that give me hope. Low salary and tight regulations (no private job, no holiday for first 6 months…etc) make me feel uncomfortable, but what I hope to learn, and the chance to share my knowledge with junior doctors makes me optimistic. If failed in my hopes, then maybe I would have the same feeling at that time, that I have now.

How did people understand about my resign?

It is three days passing from my resign from Badakhshan, and it rapidly became public. Everyone comes and asks me why I resigned; even some of my colleagues in Kabul called me and asked me why I was leaving. My answer is very simple; I am joining a professional job. Some of colleagues in turn show that they are unhappy about my leave, and some encourage me to work in a place where I would promote more. But for me it was very interesting that how did these people understand I have resigned, and why they are so interested. It gave me a sense of proud that I have been so important person but I did not know!!!???, but letter on I was thinking maybe people didn’t like me to be here, so they are happy that I am leaving, but the way they are interacting gives the opposite thought.

Lessons from Badakhshan

• A, As manager you need to have a mixture of autocratic and democratic style, but a pure autocratic or pure democratic is of no use
  B, You will not recognize a person with working a day or too, no matter how friendly or harsh he/she is. You need time
  C, As manager don’t ever argue with very low level staff in public. Go through lines of management, or if needed talk with them in private.
  D, Start your day with clear plans; note them on a piece of paper, no matter how ordinary they are, because at the end of day you need to have a tool to evaluate yourself and your day.

The simple head of team........

Yesterday a high ranked team of donor agencies visited our hospital. I had received a notice that the team will be coming in a day or two. I did some preparations in terms of managerial issues, as I wanted to be ready for any question or information they would ask for. So finally they arrived and I was called that they are in the hospital waiting. Some of the team were expatriates and some were Afghan nationals. After initial introduction, we had a tour of hospital. I was leading the team, and explaining about different departments. At the middle of the tour, I saw someone quit simple, entered the room, headed his way to the middle of team and after a brief greeting asked questions and started leading everything. I did not know him, I thought that he may one of the lower ranked people, accompanying the team, and I was not feeling ok answering all of his questions. I was thinking to stop him, but I didn’t do so. As we finished one of the departments, all team members stepped back, opened the way and he was asked “This way sir!” After that I found that he was not the ordinary person, he was head of that high ranked team. I was happy I had not stopped him and after that I was feeling easy answering all his questions and comments.

Our Wishes...

There are things in your life that you cannot express them………….you may say to yourself, but you may not find anyone to hear……………you may have hopes, that you could not achieve…………they may die in your heart, but you cannot bring them to the words……….you may think you would build your future on your thoughts and wishes, but latter on you would find them with broken wings unable to fly…………you may think either you will not live or you won’t do any wish……….but then again it turns to be a none achievable hope. But why our wishes remain just wishes and cannot be a part of our real life. That is because we fly our wishes in the sky, we take them so high that hides from the reality, we fly with our hope high, but finally we have to come to the real life which is down to the ground. You feel you have fallen and failed, and so you are depressed.

Horrible day

Some days, when you wake up, you just don’t feel good. You think you are starting a terrible day. Whoever sees you, can understand your thoughts and feelings by reading your forehead. Maybe you have run to the same condition or you may remember one of your friend saying “hay man, what is the problem, you look depressed?” and you just reply “well, I am not feeling well today”. For most of people it is just today, the next days they are ok………..but what would happen if you are NOT OK for days………..horrible!!!

What is more important to a patient; medicine or good behavior?

Through 4 years of work, I have found medicine to be of three parts: Knowledge, skills and good behavior. If you have knowledge but not the necessary skill to use it, and good behavior to take the care of your patient, you lose at the beginning. If you have knowledge and skill but not the good behavior, you may treat the disease but not the patient………patient never will be thankful………but if you have good behavior, but not enough knowledge and skill, though you won’t be able to treat the disease, but still you can establish a strong rapport with your patient.
People when get sick, cannot have good judgment about doctors’ knowledge and skills, but they get highly sensitive to your behavior…………. your smile, the way you look, talk, touch and react may not attract anyone when you are in a local market or on the street, but when you are in hospital or your private office, every movement of yours is judged by patients and visitors………..that is why doctors are mostly respected in their own property, because everyone wants to seek special attention of the doctor.

How is the life in private clinic?

It is quite simple…
You are just waiting for someone to enter your office. In office the best music ever you will hear is voice of foot coming toward you… And when you have someone in your office, most of your attention will be in the pocket of patient. You are just waiting how much fee is the patient paying. So for some doctors everything ends when patient pays the fee, and then they don’t care what happens to the patient.

Am I the same kind of doctor? I don’t know… I hope I won’t be, but still I like the music of foot coming toward my office. Still I like to get fee from my patients. However my heart doesn’t want to get fee, as most of people here are very poor… but there is something inside me which wants money…Sometimes I resist, and at times I go with its idea. Sometimes I am thinking that doctors are like shopkeepers, they sell what they have, and they have the right to get something back. But then I argue with myself. Doctors are respected much more than shopkeepers, that is because they have unique position in the community. They get two things for their service; money and respect, while shopkeepers only get money. So even if they are not given money, still they receive things that are more precious, and those are prayers and respect.

REFAMPIN for ABDOMINAL PAIN

Some weeks ago I had a trip to Kishm, a beautiful district to the north of Faizabad. On the way, in a valley called Sabzi Bahar, something like 50 KM away from Faizabad, we stopped to take the breakfast in a local restaurant. This was a small, basic and a real rural restaurant, but with delicious food……… Kabab, and Dashi were outstanding……. As we filled our stomach…..and got some energy to see around, we started arguing with each other about infection in the restaurant……after all we were doctors!!!!!!! We had to think about the infection!!!!!!………but the idea came to our mind after we had everything in our belly. Who knows how many parasites and bacteria were dancing in our body……….To our surprise, where we sat and ate our breakfast, on the back of us on the wall there was a big poster about medical ethics!!!!!!Who knows why they posted in the restaurant instead of a health clinic or hospital………..Maybe they knew that we were coming for breakfast…..and they also knew that we were the key health personnel in Badakhshan……….and maybe that was a kind of protest to change our behavior when we faced with patients…………So we had enough agenda to talk in the restaurant with each other; food, infection, medical ethics…………..we did not come to any conclusion in our short post meal meeting!!! We paid the bail and went to one of few shops near the restaurant to buy some fruits to increase our body immunity against all the infection we had eaten!!!(Actually we did that to please our belly by sending something more!!!). This was a small shop, but had everything, maybe it was a super market for the local people. You could find a small sample for everything……fruit, grocery, shoes, clothes and even medicine…….Yes, there was a small bag full of tablets!!!!!!!!!!!!!!! We asked the shopkeeper to show us the contents of the bag……..He had medicine for every kind of disease…….. “if you have headache take this tablet……. and this is for malaria……. this one is for typhoid fever and these red tablet are very effective for diarrhea and abdominal pain……..” yes he was the real Family Medicine Specialist Doctor……. “my co-worker???!!!” That big red tablet, effective for abdominal pain and diarrhea was REFAMPIN!!!!!!!!!!!! Yes he was giving Refampin as a usual drug. We asked that how he found that the tablet were effective……..and he replied he has used on people!!!!!(Retrospective research!!!) We asked him if he knew anything about TB, Anti TB and drug resistance to TB, the reply was brief idea… but nothing about drug resistance……we tried to explain the dangers of giving medicine, side effects and drug resistance and that he may be legally followed……but nothing could convince him……….it was his market……….finally we give up the argument, got up in our vehicle and had enough agenda to talk and to shorten our long boring trip……….

Medicine is driving me crazy!!!!!!!!

Again problem of shortage of medicine…..it is driving me crazy. Every time I am explaining why we are having of this shortage…..but I don’t know if these people don’t understand my language, or I am having problem in conveying my message. At every meeting I am criticized for inadequate medical supply, and I need to explain again and again that we cannot provide 100% free medical service. I have told the story of medical supply from the place it is given, to the point it is prescribed to the patients, the policy and limits, so precisely that every time at the end I think no one will question me again. But when they change their seat at the same meeting the question is again asked. Two, three days ago, in provincial health committee coordination meeting, shortage of drug was again targeted and once more I had to tell the whole story………Unfortunately one of the highest officials of UN in BDK rose the possibility of haif wo mail of medicine in PH………It made me crazy……..and since the meeting was very official, I just answered officially………….while I needed to give him a tough answer……And today in hospital management meeting, again shortage of medicine become the headline of agenda………and it was raised by the person who herself knows the root of problem……..it made me so angry that I could not control myself and answered with a harsh voice and tone…….when I finished talking I looked that everyone was quiet, and understood how much harshly I have answered. When the meeting finished I apologized the lady whom had raised the question, and for talking harshly……….. now it was her turn to talk the same way I did………….

So, finally we finished residency life…

Now everyone is scattered everywhere…
I am in Badakhshan, Matin and Rahim are in Ghour, Hazim is in Samangan, and so on…
So what is all this life? We come together, become like family, than separate. Are we having western type of life? I don’t know. But what we all know is that this is just a life that our fathers were speaking about. I can remember my father telling his stories about his friends… “So! When I and … were in your age, we where the closest friends… we went to army together, and came back to our families 2 years latter together, but then we separated, we never met each other again… and finally yesterday I heard that he has passed away.” I am thinking, am I going to say the story to my son? I don’t know…
I can still remember the last day of medical school, that at depth of happiness, we were all sad. Why? Because friends were getting separated, and we did. I never met some of my friends after that.
But I hope that we will all meet again.

Psychiatric Disorders???

Today I was reading an article about GAD (Generalized Anxiety Disorder). According to criteria for diagnoses, most of patients should be feeling bad about things running around them, they should be thinking that they are in failure……………. And then I started thinking about famous writers and authors. What these people have written about the world and life, shows their frustration regarding what was going with them and around them……… I have read many autobiographies, most of them has negative ideas about life, I have read poems talking how life in this world is difficult and in some cases nonsense. Reading Depression, Bipolar disorder, anxiety…etc and thinking about these famous people, I don’t know if these people were sick……or what they have written is just the reality…….. In many books it is said that pain full feeling gives great inspirations, and the great poems start with it……..what does it mean? I don’t know…….maybe it means when you are in a bout of depression or anxiety you can say or write something great!!!!!!! So if we treat all these depressions, and stop all pain full feelings what will happen to world of literature? I don’t know………. I am not a writer…..nor am poet…….I am not in a position to think about the world of literature, but I am a doctor……..I would be still treating psychiatric disorders.

Who am I? 13.12.87……………….03.03.09

To be honest I don’t know………that is because I have changed through the 30 years of my life…..at the very first as long as I remember I was a child…..with funny dreams………and when I got older and went to school I changed and the same did my thoughts…………and as I entered high school I was a big man……….with great ambition. In University, I was not the same as before………I found myself to be a scholar with interesting objectives………..When I was engaged……..my romantic life started……with lovely ideas…………by marriage and after having the first child I found myself in a new page of life………... and here I am in another face and shape………….
You know how did found all these……….I found that in my diary…….I have recorded my thoughts and ideas in my diaries………many notebooks……..many scratch papers…….As I am going through the history of my life by reading my diaries I see how much have I changed………..but there is one objective which is mushtrak in all pages of my life…………and that is to be a good and real Muslim………..to help the Muslim community to find its lost place in the world and to be a great person…………….Yes Islam is in every cells of my body…….and that is what give me joy and happiness. How much I have reached to these goals? I don’t know……..I am acting like a good Muslim………..But Allah Almighty knows how real actor am I………But regarding the Muslim community………….I have done almost nothing!!!!!!!!!!!!! Sometimes it makes me to think that this is the main objective I am given by Allah Almighty, and so is every Muslim in this world………and I am going back to him…….what I can I say him about it????????????????I don’t have any answer, no good reason……maybe I am lost in my personal life too much………..I am thinking about my own and my family……..but what about the community around me? This is what I have to re-think………and maybe CHANGE ONCE AGAIN.