Through a combination of coincidental privilege, silly circumstances, hard work, persistence, and perseverance, I ended up becoming a doctor. The journey post-graduation is a difficult one, as it introduces you to a world beyond books and examination halls. It’s a world where people are in agony and depend on you for every single ray of hope—a task that is both immense and heavy on the heart.

Being a doctor who takes care of patients in the ICU is overwhelming, scary, and hectic, yet exhilarating. However, with time, you learn how to adjust the ventilator along with administering sedatives, much like a sailor adjusts their sails during storms.

When I started my ICU rotation, I was petrified. I have a tendency to panic at the thought of a patient crashing and needing an urgent call. It seems that I lose my composure long before the patient does, and even after just one round of CPR, I feel the need to be resuscitated myself.

Amongst all the chaos, there’s one thing that has always scared me to the core—not the ghosts that haunt midnight, but rather, the task of announcing a loved one’s death outside the ICU.

Interestingly, contrary to my anticipated sense of impending doom when starting in the intensive care unit, life has been quite the opposite. Apart from being a doctor who ensures prompt patient recovery, I have acquired or rather honed an old skill—investigating cases like Sherlock Holmes, a skill that most of us possess by cultural exposure or genetic inheritance.

From the very first day, the cases I have admitted and followed for recovery have involved poisoning, ranging from suicides to homicides. The population that comes to my hospital consists of individuals who struggle with day-to-day living and attempt to resolve their problems by resorting to rat poison, ingesting their mother’s pills, or consuming hazardous substances that come to mind.

As doctors, we routinely conduct basic urine toxicology tests on young patients who present with histories that begin after fights or seem unclear when it comes to a young patient with altered mental status. After days of finding most test results negative and feeling miserable about seeing a 22-year-old on a ventilator, we often discover, through thorough questioning about the medications they have at home, that their condition was caused by something in their household.

Let me share a few cases I have dealt with: a nurse’s husband who overdosed on rat poison after an argument; a young girl who overdosed on her mother’s medication following a fight with her fiancé; and a borderline personality girl who ingested tablets labeled “do not eat” at home.

Being the curious person I am, with an interest in psychiatry and some past experience, I sit with these patients during my night shifts and ask them about their visions, dreams, ambitions, and what they think about the events that have transpired. Most of the patients I have spoken to have amusing aspirations, such as becoming a beautician, a cook, or simply finding work. Surprisingly, none of them feel guilty about putting their families through the agony of running around in hospitals while praying for their recovery.

I have learned that everyone makes mistakes, but the guilt that usually follows has faded away. The act of realizing what you have done and the impact it has on others, thinking rationally, and weighing the pros and cons no longer exist. All that remains is the act itself, devoid of any sense of responsibility or empathy. These individuals also lack hobbies, personal time, and self-care.

This phenomenon doesn’t just apply to patients who harm themselves when life becomes overwhelming, but to most of us. We live lives where we work, eat, sleep, and repeat. None of us looks beyond our comfort zones to realize and explore our roles on this planet—the talents we possess and how we can contribute to society, even if it’s just through good music, podcasts, volunteering, education, or campaigns that promote creative writing, painting, arts, and hygiene.

This, I believe, is one of the reasons why, when drained and exhausted, we turn to rat killers, pesticides, cocaine overdoses, alcohol, and the like, instead of seeking help to think rationally or engaging in activities that stimulate the brain centers responsible for logical thinking.

This also makes me realize the importance of occupational and art therapy in every ICU case, as it not only aids cognition but also reignites forgotten skills or helps individuals develop new skills that bring peace in this fast-paced life.

Natasha Khalid is a physician in Pakistan.