The sunlight dances its way into the room through the huge windows as soft music plays in the background, yet the atmosphere inside remains tense. A young woman clad in a burqa sits on a sofa, clearly distressed. I cannot see her face, but her eyes water up as if in pain. Her voice falters as she proclaims, “Zindagi buri lagti hai…khatam karnay ka dil karta hai” (Life itself seems to be horrible, I sometimes want to end it). Across from her sits Dr. Fareed Aslam Minhas.
Dr. Minhas is a psychiatrist- perhaps one amongst a limited number in Pakistan. As he welcomes me into his clinic during the afternoon on a Monday, I get a quick look into what is my first ever visit to a psychiatrist in Pakistan. The office itself seems to defy my expectations of the typical whitewashed doctor’s office filled with the distinct smell of medicines and blood veiled by antiseptics. One side looks into the garden outside with big windows stretching up to the ceiling. A watercolor painting of a cat faces one of the many comfortable seats lying around. An armchair sits in one corner, behind it the wall is covered by huge wooden cabinets that hold papers and books. The doctor himself sits in the center, in a swivel chair that he moves around in as patients come and go. He is impeccably dressed in a black suit, a bright pink tie loosely fastened around the collar.
“I think I was in my third year of medical school when I learnt about a woman who was operated on twice- yet it was later discovered that her ailment was mental and not physical. It was then that I realized how psychological and social factors in illness are neglected in our country.”, says the doctor, as he explains his choice of profession to me. Born in Rawalpindi to a large family with 6 siblings above him, Dr. Minhas breaks into a smile as he tells me he had eight parents to supervise him growing up. He moved on to do his MBBS from Rawalpindi Medical College, where he specialized in Psychiatry. It has been a long road since then, and 30 years into his practice he tells me that psychiatric disorders are not only misunderstood by the community, but also by the medical profession in Pakistan.
“Either there are physical problems or there are medical problems, but people by and large tend to disregard mental illnesses due to the belief systems our population has”, he tells me, taking off his thinly framed glasses. Dr. Minhas has throughout his successful career, tried to raise awareness about mental illnesses. Having remained the head of the Institute of psychiatry at Rawalpindi Medical College and the Head of the Department of Psychiatry at Benazir Bhutto Hospital, he has overlooked various projects that work on removing the taboo from mental illnesses in Pakistan, while improving the facilities available to both psychiatrists and patients. It has not been an easy journey.
“You do get problems from time to time. There are certain people who find it difficult to leave treatments, and that is when sad incidents take place. I’ve been hit by my patients several times; my colleagues have faced the same. The people we are dealing with don’t understand what is right and wrong- they lose that sanity, that control over their behavior and actions”, he says.
As patients walk in, the doctor gets up to greet them, remembering their names with ease and greeting them in different ways. He disarms them with his warm smile, making the occasional joke and letting them rant about their problems. As a couple walk in, the woman complains about her husband to the doctor, who responds by jovially remarking “Wo shohar hi kya jo tang na karay” (What sort of a husband is he who doesn’t bother his wife at all). The patient almost at once falls into ease, smiling at his response. Expecting him to use medical jargon, I am left surprised at the way he translates the diagnosis he has for his patients:
“Imagine that you have to go to Siachen from Rawalpindi- you can either walk or take the plane. The plane will get you there faster. These medicines were supposed to be that plane you took on your route to faster recovery. However, we will take the longer route now- but we will still get there.” he says as he reassures a worried patient whose medications are not having the desired effect.
As we fall into a conversation about the recent cases of child abuse in Pakistan, he remarks sadly that child sex abuse is so common in the Pakistani society that around 1 out of 5 patients that he gets have suffered from child abuse at some point in their lives, which has affected their behavior as adults.
“Unfortunately, we live in a very hypocritical society. We choose not to talk about these things- the things that need to be talked about. All the players who matter are involved themselves in the sad events that take place during child abuse. That is how I view my society as a psychiatrist”.
As our meeting moves towards an end, I ask the doctor about his views on the media and its portrayal of mentally ill patients- who are (usually) sadly portrayed raging lunatics, with poorly crafted stories of supernatural control over these patients. Dr. Minhas seems to be upset about this. “The portrayal of mental health in the media is itself stigmatizing the cause of mental health in this country. They simply don’t seem to care- they are more concerned about what news brings in more money”. He does, however, remark that the media too can help join the fight against mental illnesses by showing them as they are and not creating a warped image of people who are victims of various mental illnesses just to create content that the public enjoys at the expense of others.
At the end of the meeting, Dr. Minhas remarks that it is his ability to affect people’s lives for the better with the knowledge he has, that motivates him every single day. As I leave his clinic, I take with me a changed perspective on the world of psychiatry in Pakistan and a renewed hope in the state of the psychiatric care in Pakistan, through the commitment of individuals like Dr. Fareed Aslam Minhas who leave no stone unturned in their fight against mental illnesses.