A Pandemic in Residence: Essays from a Detroit Hospital
By Selina Mahmood
Belt, US
ISBN: 978-1948742931
176pp.

“Sometimes,” A Pandemic in Residence: Essays from a Detroit Hospital opens, “it takes the collapse of a system to see things clearly.”

Clarity amid collapse — this is the theme that runs through Pakistani-American doctor Selina Mahmood’s recently published debut collection of essays, and it couldn’t be timelier.

The world we live in is the world Covid-19 made for us: as the biggest human disaster since the last world war, as a modern plague that has turned all our lives upside down, as a private pain that affects how we feel and touch and breathe.

But amid its wreckage, the problem we face is an old one: how to lend words to a change so vast? Up against a global crisis, it’s fitting that the answer comes from a neurology resident, late of Lahore, and now working at the Henry Ford Hospital in Detroit, Michigan.

A debut collection of essays is a medical resident’s coronavirus diary as well as a book of big ideas about family, migration, creation and loss

Though Mahmood’s book feels global without affecting to be global, it’s hard not to think of what American writer Susan Sontag said on something of the same subject: “Everyone who is born holds dual citizenship in the kingdom of the well and in the kingdom of the sick.”

This holds more than true for the author, a dual national of several kingdoms, where the sickness in question is fresh, brittle and exhausting. Reviews tend to overreach when they say good books are about the human condition. But A Pandemic in Residence points a high-IQ laser at the human mess — thrown in stark relief by the coronavirus — and makes sense of it.

These essays were written during the same days as the contagion’s rise and rise, and it shows. What the West has since written off as a bad dream is made real again — the rush to stock up on toilet paper, the rogue advisories, the Bill Gates conspiracy theories. March 2020, already one of history’s most awful months, is also when Mahmood’s hospital records its first fatality from Covid-19.

“It’s the young deaths that take you by surprise,” the author writes. Though the same danger extends to the hospital’s medical residents more than most, Mahmood’s courage is authentic and unconscious: “I don’t think any of us are actually contemplating that we may die from this; that worry is still reserved for others, but it gives you pause.”

Lines like these tend to bring home just how much of the universe we demand from our doctors: that they be stoic enough to battle illness and organ failure each day, and yet be humane enough to push the needle in, to tell us that those we love won’t make it.

Far from clinical detachment, however, Mahmood’s own story — of family, migration and larger questions of creation and loss — weaves through her essays. As the daughter of former medical residents, she retraces her parents’ footsteps with skill and feeling. “The earliest memories of my father are blue,” she writes, “…as he approached from the hospital in seafoam scrubs.”

It’s also where she finds herself some 20 years later. “Whenever I see my father in the fluorescent undertones of the hospital he calls a second home, brisk in place, eyes bright, I am reminded — I can be better, human, a human. It amazes me as much as it breaks my heart to see how happy it makes him to see me here.”

That said, these essays don’t make for light reading: doctors tend to duke it out with disease, and death is never far from the scene. Trips to the autopsy room devastate the reader as much as the writer: “From an intricate, infinite creature, spent years learning … reaching not even a fraction of reality, to end like this? How to live life, constantly on the brink of this? Where were their souls? All my eyes impressed upon me was death.”

At the same time, the book has plenty of compassion. Places such as delivery rooms are handled with empathy — the author is there in the intensive care unit in Lahore when a pregnancy leads to haemorrhaging, while the family outside keeps screaming if it’s a boy. The answer is complicated.

The author is in a similar room in Detroit some time later, assisting with a 13-year-old girl’s harrowing delivery — “I’d nodded assent to the attending who’d asked [if I was okay], but continued feeling lightheaded and asked to step out; one of the nurses got me a glass of ice chips as I sagged down a wall.”

Between repairing souls in the East and West, there also comes the inescapable question of borders. Unlike the usual diaspora tropes, the author has the good sense not to wish them away. “Borders are necessary,” Mahmood writes, “…borders of the self, family, nation, etc. Now that they exist, they exist — though the question of their porosity remains: do you gash them open, or slit them shut?”

As her obvious affection for Lahore makes plain, it’s a question that weighs heavy. “I flew out of Lahore for New York after I graduated from med school, and this time, there was no forever in the past, no back in sight.”

We’re also reminded that second-generation children “are projected to live in a dream that they never dreamt.” Yet Mahmood’s decision echoes her father’s: “I’ve often wondered what memories my father lives for; his family, his childhood … it was a rare moment at dinner in Lahore with my baby sister that he recounted how he first moved away after graduating from medical school: I looked out the airplane window and just knew; I knew I was leaving forever.”

To call this collection just a corona diary, then, wouldn’t be doing it justice; it’s also a book of big ideas and it names the brains behind them — Austrian neurologist Viktor Frankl on the quest for life’s meaning; Irish poet and dramatist William Butler Yeats on the poetry of memory; and American screenwriter Graham Moore on the line between the great and the good, with the author’s own reflections in between.

That lends what could have been a period piece — the story of a medical resident on the edge of the plague — a touch of the forever. A Pandemic in Residence is written with heart, humanity and the kind of intellectual horsepower that made it possible to end up with a vaccine in record time.

Because, as devastating as the previous year was, it took a triumph of the will — by medical professionals and the state functionaries sympathetic to them — to drag us all back from the abyss. These diaries not only bear witness to the fight, they also speak of the sort of search for truth that made that fight so necessary in the first place.

To close on a note of caution — one already evoked in the title — it’s a pandemic that’s still very much in residence. Covid-19 is a running exercise in intellectual humility; it’s a chance to turn to each other and say, ‘we really don’t know’. Per the book’s very last line, “If it feels like the end, it isn’t the end.”

That’s as much a diagnosis of the pandemic as it is of anything else.

The reviewer is a barrister. He tweets @AsadRahim

Published in Dawn, Books & Authors, December 19th, 2021

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