My mom won’t be home that weekend

Since it was a Sunday, I told my dad that I needed to wake up early for work, so he should wake me up in the morning.

My mom and dad have very different approaches to waking up their children.

My mom’s approach is more aggressive. She shouts at the top of her lungs, turns on the light, and snatches the quilt from us. Sometimes, she curses or cries, blaming us for making her life miserable. On some days, she even pours water on my face. After all this, there’s no way a child can remain asleep.

My father gently taps the door and says, “Betay, betay, aankhein kholein, dekhain subha ho gayi hai” (Child! Get up, look outside; it’s morning.)

His gentle approach often makes him unsuccessful in getting me up initially. However, his persistence ultimately works; after repeating this routine multiple times, I eventually wake up. Despite his efforts, I still take at least three to four hours to get out of bed. I am a deep sleeper, and my family often worries about how to wake me up. Recently, it has been extremely cold in Islamabad, and I often have blocked ears and a runny nose, which makes my sleep even deeper. Because of the blocked ears, I can’t hear anything while I sleep, making it nearly impossible to wake me without physically touching, tapping, or slapping me.

A vivid dream

I had a dream that I was a very young child in a school uniform, perhaps resembling how I looked in first grade. I felt teary-eyed and anxious, paralyzed with fear that morning. My father was shouting at me, tearing up papers and throwing them in my face. His anger was overwhelming, and I felt terrified. I was numb, and tears streamed down my cheeks. I wanted to stop him, but I couldn’t. Then, at that exact moment, I opened my eyes and realized I was in my bed.

I saw my father standing at my bedroom door. He said, “Betay, shukar hai aap uth gayi hain. Aapne jana tha na aaj?” (Thank God! You are awake. You had to go to work today, didn’t you?)

I woke up at 11 a.m., realizing I needed to be on duty for the evening shift, which meant I had to leave by 12 p.m. Thankfully, I still had some time. I brushed my teeth, had breakfast, and cared for a few other things. I was ironing my clothes while my dad sat on the nearby sofa, reading the Sunday paper.

I shared with him my dream, mentioning how, in it, he was incredibly angry with me—so much so that it startled me awake. After a moment of hesitation, he replied, “Betay, jazbaat to mere yehi thay. Subha 8 se jaga raha hun” (My emotions were just as you described in your dream; I’ve been trying to wake you up since 8 a.m.)

I realized that my mind was creating all of that because it was processing my perception that my father was angry. I saw his face in my dream, likely because I had seen him standing in the doorway earlier, but I didn’t understand that at the time.

A challenging case

I had to admit a young man, 20 years old, who was under a psychiatrist’s care. He was an A-level student and came from a well-off family. His maternal uncle, maternal grandmother, and parents were accompanying him.

At first glance, no one would have guessed that he was struggling with a mental illness. I got the impression from the family that he was unaware of his condition, and they did not want to disclose any details about it.

He had a stuffy nose and asthma, which had worsened due to the weather. I examined him, took a brief history of his respiratory symptoms, and explained that we would conduct some tests, provide nebulization treatment, and administer medication. He would be discharged once his symptoms improved and his test results were normal. To be honest, he was not at all satisfied with my explanation. He was irritated and was already arguing with his parents, claiming that they could have done the nebulizations at home and that it was unnecessary to bring him to the hospital.

While the nurse began taking his vitals, I asked his mother to come with me to the counter for signing a few forms. She stepped out of the room, and I took her aside to gather the complete history of the boy.

The mother’s account

She told me that he was 20 years old and a student who had two older sisters at university. He did not want to continue his studies; instead, he wanted to pursue whatever he liked. He frequently expressed dissatisfaction with everything around him and had lost interest in his academic pursuits. At times, he behaved oddly, experiencing sleep problems and having multiple episodes of aggressive outbursts. These outbursts included harming furniture, shouting, and running away from the house.

I inquired about the family history, and she told me that the boy’s grandmother had undiagnosed mental illness and never received treatment because her sons refused to acknowledge it.

The mother, a reasonable housewife, explained that the boy had always been a difficult child, frequently having anger outbursts. As he grew up, he became a rebellious adult, opposing everything his parents asked of him and running away from home multiple times. He also had a prolonged history of substance abuse.

The mother sought help from a psychiatrist, who recommended medication, but the boy was unwilling to take it because he did not accept that he had a problem. He also refused to participate in psychotherapy despite his parents trying everything they could.

Later, she tried a different approach. She arranged for him to undergo blood work and informed him that his liver functions were impaired due to substance abuse, hoping this would encourage him to stop using drugs for a while. She insisted that he needed treatment for his damaged liver.

This strategy successfully brought him to the hospital. We just needed to give him the impression that we were treating his asthma and liver issues, not addressing his drug addiction or mental illness.

A mother’s pain

I probed further to see if there had been a recent painful experience that the boy faced or anything specific that triggered his symptoms, such as the death of a close relative or the loss of a beloved friend.

She replied, “Koi khaas nahi, wohi jo sab ke saath hota hai. Sabko kuch na kuch sehna parta hai; yeh sab ke saath hota hai, wahi aam cheezein” (Nothing special. It’s the same things that happen to everyone. Everyone has to face some difficulties in life; these are ordinary occurrences.)

I told her, “Sab k liye sab aik jesa nahi hota, sab k lye sab kabhi b aik jesa nahi hota. Aisay ho skta ha k jo apki nazar me koi choti si baat ho, wo mere lye aik bohat bara sadma ho” (Not everyone perceives things the same way. What may seem like a trivial matter to you could be a significant shock to me.)

At that moment, I recall a wise person once told me, “Jo humare lye aik maamoli baat hoti hai wo aik naazuk zehan ya hassas insaan k lye qayamat hoti hai” (What is a minor issue for us can be an apocalypse for someone with a highly sensitive mind or nervous system.)

My explanation brought tears to her eyes.

She shared with me that the first 13 to 14 years were very difficult for her and her children. Their home was filled with shouting, anger, slamming doors, broken utensils, and the sounds of crying. I didn’t ask for the entire story of what had happened, but I understood the situation. To be honest, I didn’t have the courage to delve deeper.

I thought to myself that if it was so hard for her, how challenging must it have been for that highly sensitive child?

She asked me if the medication actually works and how it functions. I explained that sometimes, people have an imbalance in their brain’s neurotransmitters. Neurotransmitters are chemical messengers in the brain that require a delicate balance. Factors such as genetics, environmental influences, or traumatic life events can disrupt this balance, potentially leading to mental illness.

Medications primarily function by balancing neurotransmitters in the brain. When these medications are effective, they can help stabilize a person’s mood, allowing them to lead highly productive and fulfilling lives. At this moment, she shouldn’t worry about the outcome; her focus should be on starting his treatment.

I hugged her and reassured her that her son would be OK.

An overwhelming day

In the evening, I was attending to another patient in a room with the nurses when the physician assistant informed me that the hospital administrator wanted to see me and the on-duty nurses immediately in his office. He is a difficult person with anger issues and has humiliated us several times. This latest incident stemmed from a complaint by a patient who was disappointed that the nurse took too long with his IV cannulation and medication administration.

The administrator made it clear that if we couldn’t manage our responsibilities, we should let him know, as he would quickly find replacements for us. I argued with him, but he was behaving irrationally and extremely impolitely. I left his office feeling very angry and frustrated; I was fed up with his behavior. He shows no respect for the doctors or staff and believes he owns both the people and the facility.

I was very angry, and when the other doctor came in for his shift, I expressed my frustrations to him. I was overwhelmed with emotions, but he believed I was overreacting. This made the situation awkward, as I was determined to make him understand the seriousness of my feelings, while he seemed unwilling to offer any reassurance. He felt that I took things too personally and suggested that I should take some time before deciding on any course of action.

I was considering confronting the hospital administrator to address the ongoing issues and figure out why he seemed to hold a grudge against me, given his behavior towards me every other day. But he advised me to wait for a while, and things would get better soon.

A cold ride home

I had tea with my junior doctor before heading home. It was nearly 9 p.m., and the weather was extremely chilly. I was wearing a fully padded jacket, a shawl, and a mask covering my nose. However, it was still very cold on the motorbike. The extremely cold wind made my eyes water, and the rider was driving the bike quite speedily. By the time I arrived home, my nose was completely red from the cold wind.

After having dinner, I went into the next room for my night prayer. This room is at the far corner of the house and is mostly empty. As soon as I entered that secluded space, I found myself crying uncontrollably. Tears flowed freely, and I couldn’t stop. After hours of crying, I began to understand the reason behind my emotions.

The pain of that day had become overwhelming for my nervous system.

From the sheer cold to the unreasonable humiliation, a major reason for my distress stems from the experience of feeling the pain of another sensitive mind. I had been stuck in the same place for decades, a fearful, anxious child who grew up in a difficult household.

Reflections on sensitivity

I empathize with a mind that becomes overwhelmed by processing too much at once. My nervous system often breaks down more frequently than those around me, while others can effortlessly ignore issues that I fixate on for months. I experience excessive overreactions to ordinary situations, along with overthinking and heightened emotional pain. Especially the pain of hearing phrases like, “You are too sensitive,” “You are overreacting,” “It’s not that much!,” and “You feel too much!” over and over again.

While my medical background has helped me cope with physical pain, it does not grant me immunity from emotional suffering—how I wish it could.

A new day brings hope

The next day, when I woke up, my eyelids were swollen and my nose was redder than before from crying endlessly. Thankfully, I can blame it on the season and the persistent flu.

I’m glad it’s my day off, allowing me to enjoy the sunlight and engage in the activities I love.

I feel grateful to be alive, still persevering, and doing my best to help my community.

I truly appreciate being alive.

I look forward to another beautiful day because I know that life itself is a miracle and tough times don’t last forever. It’s just that some days, I forget this. I remind myself of this every day:

“Surely, with hardship comes ease. Surely, with hardship comes more ease” (Al-Quran, 94:5–6.)

A message for those struggling

To everyone who is struggling, please know that you are not alone. There are people out there who will listen to you, understand you, and accept you just as you are despite your pain. They recognize that your past does not define you and see you as beautiful and lovable. They will love you for who you are.

And if you are unable to find that person, strive to be that person for yourself. It’s the best gift you can give yourself. Stay happy, and I wish you peace!

A home for myself

I am building a home for myself
where doors don’t slam
and people don’t yell
and love is scattered across a kitchen table
that was built with kindness and respect.

I am building a home for myself
where the floors can be painted yellow
and the tables can be painted blue
because there is no right way to do anything
except to do it with you.

I am building a home for myself
that will echo the feelings
that live deep inside my chest,
but you will know that
when you step into the rooms
that were built by people
who will love one another
with nothing but respect.

I am building a home for myself
that was made
for lovers like me,
where there is space
for you to be
everything that you have always wanted to be.

(A poem by Cammie Dennis @wordsbycammie on Instagram)

Damane Zehra is a radiation oncology resident in Pakistan.