1985

I came into the picture at a late stage by coincidence. And what a coincidence! It changed everything. I was working in a prestigious government hospital and at the same time heading a private hospital. Life was leisurely and comfortable; I attended the hospital in the mornings, went home in the afternoons, had a nap, and off to the private practice. In the evenings I enjoyed the company of family and friends. It was an uncomplicated and restful existence with minimum worries. I liked it, my family liked it and my friends liked it. That is until one day, when a telephone call changed it all.

"JR how are you?" A male voice, strange to my ears called me. There was a frankness in his tone. I tried to place him. Only close friends called me by my initials, but the voice wasn't one of them.

"Do you know who I am?"

I hated it when someone asked me this question.

"I am trying to remember."

"Eight years ago you treated by wife, Farzana. She had breast cancer."

He stopped, giving me time to guess. I had no clue. In my profession I treated hundreds of patients with breast cancer. After all it was my speciality.

"I am sorry it must be my age." That was the only polite excuse I could come up with. I was 36 years old.

"Never mind." He must have felt embarrassed, because his tone changed. "You see patients in the hundreds and talk to their relatives in the thousands. How could you remember all of them?" He cleared his throat. "My name is Nadim Gerdezy. I am the brother-in-law of Kalim."

Suddenly the penny dropped and I knew who he was.

"Oh, I am so sorry, of course I remember you."

I remembered that eight years earlier, one day, my close friend Kalim rang me frantically and asked me to see his sister who had discovered a lump in her breast. The lump turned out to be malignant needing urgent surgery. Nadim Gerdezi was her husband. When he came to my office to discuss her prognosis, he brought his five years old son with him. The innocence on boy's face hit me. I couldn't say a word in his presence. So, I decided to invite Nadim to my house that evening. He came alone. After loosening him up with couple of whiskeys, I tried to explain the disease and its consequences. He understood the nature of the illness and thanked me for explaining it in the most humane way.

A week later, I operated on her and followed her up for two years until they moved to Lahore. There, she was followed up by a local specialist. Meanwhile, Nadim joined provincial politics and we lost contact. He was always appreciative of the way I handled the situation in a personal manner. It was him on the phone.

"How is Farzana?" I asked.

"She is fine, thanks to you." His initial embarrassment faded away. "I rang to tell you that I have been elected to the National Assembly from my constituency and will soon be moving to Islamabad."

"That's very good; it will give me a chance to examine Farzana."

"Yes, of course." He cleared his throat again. "It looks like the prime minister is going to offer me the portfolio of health."

"Oh, congratulation, that's great news."

"Yes it is, but I will need friends like you to achieve my targets."

"I am honoured."

It was that brief chat, which was going to change my whole life. Nadim became the health minister and I became his eyes and ears on health issues. After a year, I realized that I had become more of a politician than a surgeon. His personal secretary played an important role in that transformation. He convinced me that I could achieve more at a national level if I got involved in administrative job.

"You are a good surgeon and you have reached the top of the ladder at a very young age. Where do you go from here?"

"Carry on treating patients"

"Yes, but remember you are helping patients at an individual level. It's based on a one-on-one link. I see your frustration, when you find some good drugs are not available in the market just because the Drug Registration Board does not register them for silly reasons. You see; no matter how good a surgeon you are; you are at the receiving end just like your patients. The only difference is that the patients look up to you with hope. What about you? Who do you look up to? Those, incompetent and good-for-nothing bureaucrats? So if you become part of the policy-making team you can help millions with one correct decision."

He made his argument pretty convincing.

"So what do you suggest?"

"As a first step, work for the position of Executive Director (ED) of Institute of Medical Sciences (IMS). That would be a good beginning."

IMS was the most prestigious medical institute of the country and I was a mid-level government employee. In bureaucratic language it was a grade 19 post, while the ED position was grade 22. Jumping from 19 to 22 was a foolish idea. Even my friend, the health minister couldn't do anything about it. Only the prime minister, using his discretionary powers, could post me to that position. But then, why would he do it?

One day, when the health minister called me to his office to seek advice on a health matter, I suggested the proposition in a diplomatic manner. He looked at me with a smile and asked one question.

"Isn't that a senior grade post?"

I nodded my head. The discussion ended there. He politely rejected the idea. I never brought it up again, though it became a wishful thought in my mind.

It was in those days that another friend heard of my new curiosity. He rang me.

"JR what's this I am hearing?"

"Believe me Amir, I am not guilty of whatever you heard." He laughed.

"I am coming your way"

"I'll be waiting."

Amir was a good friend of mine. He was personal secretary to the principal secretary of the prime minister. In that capacity, he had a lot of influence in various ministries including the health ministry.

He was also close to the health secretary. Half an hour later, we were sitting in my lounge drinking tea. I explained to him my increasing desire to become involved in administration. He tried to convince me against the idea. But it seemed the private secretary to the health minister had done a good job on me. I was fully convinced to go for it.

"So how can I help you?" In the end, he reluctantly asked. "The health secretary is your friend. Talk to him. See what he says. After all, he is the government."

"Yes; but would the minister support you?"

"I think so."

"You are not sure."

"No."

"Charming." He smiled. "Anyway, let me give it a try."

The discussion changed from my political aspirations to Islamabad's social scene and it carried on for another three hours.

* * *

A week later, he rang asking me to get ready as we were going to see the health secretary at his office. I didn't need much preparation. When he came half an hour later, I was ready. We met the secretary. He received us with all the bureaucratic courtesy. He apparently knew of me because of my links with the health minister. Amir put the suggestion to him. Initially he supported me but when he found out the difference in grades, his enthusiasm faded. Shaking his head, he showed his inability to help. After having a cup of tea, we left his office pretty dispirited.

"JR, to hell with these people. I am going to take you to a place where things work differently."

He took out his mobile and dialled a number.

Sir," He spoke politely. "Can I come to see you? I have a friend with...