Bad experience, repeated eleven times

 

COVID-19 pandemic is raging across the land. All types of funny prescriptions can be seen, contrary to scientific guidelines. It appears, all hell of quackery has broken loose. The blunderbuss approach to treat patients without logic is especially obvious in mild to moderate cases of COVID-19 which comprise about 80 % of patients. Even professors of Medicine are advising and treating patients to start vitamins to ‘build Immunity’ (God knows what they mean actually), putting even afebrile patients on antibiotics (even multiple antibiotics. Azithromycin and Cefixime being the hot favorites). Tab Aspirin and even anticoagulants being advised in mild to moderate cases. Dexamethosone is being touted as a panacea and started on the first indication of infection. Antiviral drugs are also being administrated to patients without solid scientific indications. There are still physicians who insist the antimalarial and Ivermectin have a role not only in therapeutics but also in prophylaxis and these drugs are being prescribed to immediate household contacts of patients. All this goes against the consensus among international medical fraternity but who cares.

It appears as if the doctors are either unaware of the latest guidelines or they simply don’t bother as long as the show is going on. To me the second option sounds more plausible especially in case of senior academicians. The rot starts with the way medical professionals are trained and groomed. Medicine is an evidence-based science. All diagnostic and therapeutic decisions must be based on the latest available medical guidelines. This point though emphasized in exams is unfortunately ignored in clinical practice; sometimes even by senior faculty members. This ultimately becomes a source of misinformation for young colleagues who tend to emulate their seniors. During ward rounds a junior pointing out that a particular decision was contrary to scientific recommendations might be admonished that books were just rubbish and useless in practical life. Here experience reins. This approach is not only grossly incorrect but unbecoming of a teacher. These seniors need to understand that experience of any person, irrespective of his/her stature can’t challenge the conclusions based on scientifically designed controlled trials. Interestingly, in exams, every one regurgitates the information given in books but later on discarding everything learned so painstakingly during training. They feel, the bookish knowledge was only for the sake of a degree and now they have a license to practice according to their own wish and instinct.

May be the roots of contradiction go deeper as there appears to be something seriously wrong with the way science subjects are being taught in our schools and colleges. Science always comes second in authenticity when compared to local wisdom or theological teachings; something fickle and unreliable, something to be skeptical, which might mislead the unwary. Simple scientific concepts are scoffed and ridiculed during classes and students’ study without believing them. Theory of evolution being a prime example. To students, it gives an impression that scientific facts need to be memorized only to earn the laurels, no compulsion to believe them as hard facts and laws of nature.

How can we explain the prescriptions from highly qualified doctors containing instructions to take indigenous medicines, euphemistically called Tib-e-Nabwi (about which they have no idea), or writing holy verses for their supposed powers of spiritual cures? Interesting the same faculty members would fail anyone mentioning these treatments in viva voce. This apparent contradiction can only be explained on the basis of ‘loss of faith’ in science. 

Most of the prescriptions in clinical practice contain H2 blockers as if there is an epidemic of peptic ulcer in Pakistan. Anxiolytics being given for years, though in teaching everyone cautions against their use for more than 2-3 weeks. Advising Vitamins is so common, even diabetic neuropathies being treated with injections of Vitamin B12. Even in tertiary care hospitals hypertensive crises being treated by IV injections of Furosemide to drop the pressures in factions of seconds. No one bothers about the sense or the possible consequences in future. 

All these issues remind me of an incident. Once when we were trainees, a consultant claimed that he had eleven years of experience. When this was brought to the notice of our professor, he smilingly quipped that it was not eleven years of experience, it’s just one year of bad experience, repeated eleven times.

 

 

Looking back

In our childhood, we used to read stories in which a prince while going on some expedition was advised by a sage; never to look back otherwise he would be petrified.
Same holds true in real life. Despite all distractions one shouldn’t look back. We all have some nostalgic feelings for the past. We long to visit those places full of pleasant memories for us. To go and relive and experience those moments of bliss once again.

Many a times we are disappointed.
Those places are not the same, at least for us. The people we look far are long gone, those voices faded years ago. It is like visiting a haunted place charming us to come forward and we in its spell become oblivious of a deep chasm of time and space developed; separating us from those memories of yesteryears.
Times we are looking far are lost somewhere, never to be recovered and the people without whom life seemed impossible once; are nowhere to be seen.
The lights, laughter, cries of joys and visions full of hope and ambitions are found to be replaced by closed forbidding doors, dark, cold places with no one to wait for us or welcome us on arrival. Rooms empty with echo of our own footsteps, things once collected with fondness covered in thick dust of time.
Deep inside we all know that no one invited us there and there would be no one to see us off with eyes dim with emotions and appeals to come back again as early as possible.
Deep in anguish, we go out to search for something familiar, someone known to us but faces seem strange, blurred. Shops and bazars though full of lights and hustle bustle of humanity, feel devoid of spirit, figures moving in a thick haze of alienation, unrecognizable. Everything seems to swim in an ocean of unreality.
In despair one retreats to the silence of darkness. In the distance, call of Muezzin opens a floodgate of bitter/ sweat memories and increase the feeling of loneliness.
Time to go out and leave this place to avoid being shattered with grief!
Is it really possible to do so and shed part of us?
Maybe one is already petrified by carrying those relics of the past within one’s soul all the time.

 

 

 

Street photography: A hot debate

(My article has been published in Pakistan photography magazine)

Street photography is a vibrant and joyous occupation for a hundred different reasons. It has faced blazing criticism, occasional legal and ethical backlashes, besides stirring debates on public television and social media. Most street photographers operates on the borderline between intrusion and observation. Even more problematic is the tradition of clandestine photography. The great Walker Evan took a whole series of provocative photographs with a concealed camera on New York subways.

Is street photography, an intrusion on someone’s personal space? Can anyone claim privacy in a public space? Laws vary in different countries. There is a need to be aware of local laws for those interested in documentary photography involving images shot on public places.

Photography, as always, has lot of grey areas, where ethical concerns are involved. Is any image of human misery and poverty, an insult to human dignity? Should we present only a happy face of society? An old man dragging a heavy load, a rag picker boy sifting through trash; do these pictures attempt to exploit human misery for self-promotion? Is showing social hypocrisy in a photograph is a breach of social rights?

Art should not be judgmental, but it is often perceived that way. Sometimes it is the viewers who interpret an image through the haze of their own understanding and that their redemption is to put the ‘blame on the boogie’—the artist. Naked children sitting on the trash, addicts lying on the pavements, or a physically disabled persons begging around the market are reality of our lives as much as hunger and war. It is not something to be pushed under the carpet and pretend that if it does not exist in images, it does not exist at all.

Famous street photographer Eric Kim says, ‘as a photographer, I see myself as a sociologist with a camera as my research tool to observe and record the people and world around me’. It reminds me of Pulitzer Prize winning photojournalist, Stanley Forman and his shot ‘The soiling of old glory’. The picture stirred great emotions when it was posted. A censor on such art would seriously hamper the growth of artistic expression and its potential to create a tolerant and enlightened society.

The picture shown above is of an elderly bearded owner of a boutique, trying to cover his face to avoid the offence of being photographed while standing with mannequins wearing sleeveless low-neck dress. While some may object on this as candid capture, for others it is an excellent social satire on our confused moral and religious criteria, 

Umair Ghani, a Pakistani photographer once commented on one this picture, ‘Commerce and Art play a tug of war with Faith and provoke greater conflicts and challenges for those who consciously focus on such concerns. These trends affect everyday life and our understanding of it. Some societies have learnt to sustain that shock; others are too fragile to come to terms with this recent awareness’.

 Images of women covered in shuttlecock veils shopping in posh markets with explicit advertising contents show challenges presented to prevailing cultural trends in our society. Such images do not stab our cultural façade, but helps us document our bleeding wounds of social confusion and to some extent stitch and heal them. This is serious level of street photography. It is above ridicule or criticism; It is a commentary and interpretation.

Furthermore, street photography is a contested sphere in which all our collective anxieties converge. Terrorism, pedophilia, intrusion and surveillance. Even an attempt to capture the culture of marginalized sections of society is seen by some as a potential threat to the ideology of Pakistan with a possibility of creating fissures in society.

The photography codes of ethics from the US National Press Photographers Association have some solid points and guidelines. Now is the time to address this pressing need to discuss and review those points within our own legal and cultural parameters’

 

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