The Path I Made — A Memoir
By Tasnim Ahsan
Lightstone Publishers
ISBN: 978-969-716-211-6
423pp.

Living on your own terms is not easy in Pakistan, especially for women, and that too those who have been brought up with high societal values instilled in them. But there are daring women who refuse to bow down to pressure and forge a path for themselves, while setting an example for others to follow.

We just have to have a sharp eye to look out for them, as they may not appear at the outset as towering personalities. Tasnim Ahsan is one such person. A well-known endocrinologist and internist, she has the honour of being the first female Executive Director of the Jinnah Postgraduate Medical Centre (JPMC), Karachi, the largest state hospital of the country.

In her recently published book, The Path I Made: A Memoir, Ahsan takes readers on a journey through her personal and professional life, which has not always been smooth sailing.

Starting the book from pages from her father’s diary, she gives a glimpse of her father’s life in his own words. Hailing from Amrath, a village in the Indian state of Bihar, he spent a difficult childhood and migrated to East Pakistan (now Bangladesh) and came to West Pakistan in 1950 to join the armed forces.

We later learn that he was in Dacca during the chaos of 1971 but, luckily, had come to Karachi to oversee some admission issues for the author and her sister and could not go back, as flights between the two wings of the country had been suspended.

Ahsan talks at length about her parents and their siblings and their families, not from a distance but with love and respect, especially when talking about the strength they showed in times of adversity. Her aunts confronted health issues, widowhood and dire social circumstances with bravery and fortitude, which was evidence of their upbringing and strength.

A chapter is devoted to Ahsan’s parents, where we get a glimpse of their personalities along with an insight into their lives, their habits and their lifestyles. She lovingly writes: “I think our parents possessed super-clever parenting skills. They created an enabling and nurturing environment for us with whatever resources they had. They were industrious people themselves and were always engaged in some project.”

Brought up by strong parents, all her siblings (three sisters and a brother) studied medicine and reached the pinnacles of their professional careers.

Ahsan had a carefree and fun childhood, but school years were a challenge, as schooling was often disrupted because of her father’s frequent transfers by virtue of him being in the army. After marriage to her cousin soon after her graduation, she moved to the UK, where both the husband and wife pursued post-graduate education.

She had not planned to resettle in Pakistan and had come back just to visit her family and rest for a while after the birth of her first child, when she had to stay back due to health issues that did not allow her to travel with a young child. After a while, she joined Dow Medical College and Civil Hospital Karachi as an assistant professor.

After almost five years at Civil Hospital, with a brief stint at the Lyari General Hospital in between, she joined JPMC, where her “work life spanned twenty-five long years, which were epitomised by immense professional satisfaction, an uphill travail, a struggle to survive and hold my ground in order to make some meaningful progress.”

She talks in detail about her trials and tribulations during the course of her career at JPMC, the problems she faced and her victimisation at the hands of her seniors because she was not ready to toe anyone’s line and was a woman with grit. Not only was she transferred from one ward to another when she tried to stand up for something, attempts were also made to implicate her in false charges, just to make her bend.

While faced with difficult situations, however, she would recall her father’s gems of advice given to her on her first day at work as assistant professor; he had told her, “Now that you are a government servant, you must remember two things: one, even as a relatively junior grade 18 officer, you will have a powerful official seal; never use it dishonestly or inappropriately; two, all your official communications should be in writing, and always keep a copy of it for yourself.”

While recounting the challenges she faced, Ahsan gives us an insight into the work environment which was, at times, far from easy. Stories of corruption, favouritism, nepotism and political interference are well-known but few realise how they affect the profession, and the person who wants to work honestly.

Her tenure as the first female executive director of JPMC was, in her own words, “a roller-coaster ride.” On her taking over as executive director, “there was general jubilation in the hospital, but the ‘politicos’ were not at all pleased. Those who didn’t know me well, thought that I would not last very long, because I was either ‘too rigid’, ‘too honest’ or ‘too rigorous’, and what was perhaps left unsaid, that I was ‘a woman’. … I did not want to just do my job diligently, but also work from the perspective of a woman.”

While reading the book, we get an insight into the functioning of a major state-run medical institution and the battles Ahsan had to face as its CEO. She had to face opposition, intimidation and threats. She did not refrain from seeking legal help if she thought she was right, such as when she sought the reversal of the order that handed over JPMC to the Sindh government after the devolution of the 18th Amendment.

The challenges of the central laboratory, mismanagement, theft of blood packs from the blood bank, blood donations by drug addicts, and strikes which clearly sought her ouster are some of the bothersome situations she faced as JPMC’s executive director.

The city’s law and order situation, especially bomb blasts, often made matters worse when doctors had to deal with mass casualties; we read how, in the wake of terrorist attacks in the city and a bomb blast at the emergency department of the hospital, doctors kept their focus on providing care to the victims amidst the confusion and chaos that ensued.

With the hospital always facing financial constraints, funds often had to be arranged through philanthropists and by taking help from personal contacts, to provide the hospital’s gratis services. One learns that most of the extension and rebuilding work was also carried out this way.

Ahsan writes: “Everything was getting old and worn out due to the lack of funds, with no funds for repair and maintenance. Throughout my tenure, other than a grant of Rs 40 million by the government (after the A&E was bombed) that was used to repair and extend the A&E Department, not a single penny was released for new development projects.”

Through selfless dedication, Ahsan sought to change the work culture of the institution, but also brought in medical expertise, much-needed funding, and professional insights to improve the working and infrastructure of this institution. Despite facing many hardships, she took up many initiatives, not only as the director but even before that — for example, setting up the Endocrine Clinic, and the Medicine and Endocrine Foundation to raise funds for a new building.

While she gives much space to the problems, Ahsan acknowledges that she was not alone in her journey and generously praises those who helped her and stood beside her under all circumstances. She is all praise for Dr Seemin Jamali (then in charge of Emergency), who later became JPMC’s Executive Director.

The book holds many lessons for the readers, especially women who cower and give up at the slightest signs of intimidation. This is truly an inspirational story, of how hard work and education, along with a supportive family, can help break gender stereotypes and restrictive barriers.

The reviewer is a freelance journalist. X: @naqviriz

Published in Dawn, Books & Authors, April 7th, 2024

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