Pakistani Bloggers

October 29, 2017

To Be or Not to Be

This post is specifically geared towards doctors on the ‘AKU - Giving Back’ page. I do hope however that others benefit from it. Heck, I hope I do.

Remember those ‘Choose your Own Adventure’ novels we used to enjoy as kids? The ones where each page featured a gripping narrative requiring us to make a choice (often based on the scantiest of information)? Each choice would have an accompanying page number, to which we would have to turn to discover the consequences of our actions. Of course, I hate surprises so I’d just flip to the last page of the book and work my way backwards. Adventures are a lot more fun if you save the world and get the girl right off the bat.

The reason this forgotten pastime has wormed its way out of my subconscious is its comical similarity to this whole Sharmeen Obaid Chinoy/AKU doctor media circus.

Page 1: Sharmeen Obaid Chinoy tweets:

Parhlo Pink latches onto the story. It goes viral.

Choice A: You go girl! Somebody must step up and put an end to this nonsense. Zero-tolerance is the word! #metoo *Turn to Facebook*
Choice B: How dare she turn this into a Pakistan thing? And harassment? It’s just a friend request for God’s sake! What’s next? The doctor appearing on How to Catch a Predator? Witch hunting every oil-slathered, paan-spitting launda in Dolmen Mall? And twitter is certainly not the forum to air this! *Agree it was unethical but turn to Facebook anyway*
Choice C: Fight! Fight! Fight! *Make a meme and turn to Facebook*
Choice D: Interesting story. I don’t think I have enough information to comment. Right, enough Facebook for the day. *Switch off computer and go outside*

Page 2: Doctor in question fired (Can’t find a definite source to confirm this).
Choice A: Liberté! Egalité! Fraternité! Sexualité! *Stay on Facebook and lob grenades at everyone who wants to bring back the corset. Burn some bras too for good measure*
Choice B: That’s harsh. Definitely deserved a rap on the knuckles but termination? IT WAS JUST A FRIEND REQUEST FOR GOD’S SAKE! *Stay on Facebook and throw the grenades right back*
Choice C: *Popcorn anyone?*
Choice D: Glad I didn’t comment earlier. I’d be looking pretty stupid right about now. *Switch off computer and go outside again*

Page 3: Turns out the doctor has a history and was already under investigation. Also, suspended, not fired. (Can’t find a definite source to confirm this either).
Choice A: A-HA! (TAAAAKEE ONN MEEEEEE!!! TAAAAKKEEE MEEEE ONNN!!!) *Stay the course. We’re bringing it home guys*
Choice B: Well, this information should have been made public beforehand *Patch on some hastily compiled defenses to save the sinking ship you’re on*
Choice C: This beats any Oscar-winning documentary any day of the week. *Put second batch of popcorn in microwave*
Choice D: *Nothing. You’re already outside*

Page 4: To be continued…

Very Itchy and Scratchy/Spy vs Spy-esque, eh? I know. But who’s right and who’s wrong? Or is there some middle ground we can stand on? Well, that’s not what this post is about. People have already said enough about this to fill a book and will continue to do so well into next week when the book is thicker than War and Peace or our increasingly short attention spans are distracted by another inane Guinness World Record attempt (whichever comes first).
No, this post is about the importance of making an informed decision. And what to do when you don’t have enough information to do so. I highly recommend the fanfic 'Harry Potter and the Methods of Rationality' by Eliezer Yudkowsky for a great take on the field. Also, Amos Tversky’s and Daniel Kahneman’s 'Judgement under Uncertainty: Heuristics and Biases' is one of my all-time favourites, right up there with ‘The Hitchhiker’s Guide to the Galaxy’ and ‘The Kama Sutra’.
Truth be told, we all know how to make informed decisions. Or at least be reasonably good at it. After all, the guidebook for doing so is just a collection of clichés; “Look before you leap”, “Before passing judgement, Walk a mile in the other person’s shoes”, “History is written by the victors”, “Beware of the half-truth. You may have gotten hold of the wrong half” etc. Why do we then consistently fail to pass balanced judgements?
A number of studies have shown the various fallacies we fall prey to when deciding what’s right and wrong. Accuracy decreases with an increasing required effort to come to a decision. (Einhorn HJ, Hogarth RM, 1990). Then there’s confirmation bias: the tendency to search for, interpret, favour, and recall information in a way that confirms one's pre-existing beliefs or hypotheses, instead of the other way round.
The first questions to always ask oneself: Will MY deciding and therefore holding an opinion on this matter improve my life or the lives of those around me? Or will it do more harm? Conversely, will NOT forming an opinion improve/adversely affect my life? These screening questions really filter out all the grime of life we have a tendency to collect, dramatically opening up time for other more fruitful pursuits, like getting laid.
If your answer to the above questions (be honest with yourself, bury your ego here) tells you to stop, do just that. Treat yourself to a cookie. If it tells you to plough on, get ready. It only gets tougher from here. The next question to ask yourself is, “Exactly HOW will deciding improve lives?” I mean a tangible mechanism, much like the ‘Materials and Methods” section of a scientific paper. Spell it out. No vague “It’s important to be aware of such issues” here. How will being aware improve lives? A cause-effect relationship is needed here.
Once you have that in the bag, question group three is, “What evidence do I have to make a decision? Have I heard both sides to the story? Is the evidence I have reliable?” This is where we must avoid confirmation bias. We have a natural tendency to give preference to only that information that confirms what we already know, instead of evaluating all data and then using it to form conclusions. This is very hard to do and we all do this to a certain extent, but it is an exercise that improves one’s life no end.
Next, form your decision. Go for it. If you’ve come this far, and have been honest with yourself, you deserve it. In fact, I’d go as far as to say not making a decision at this stage would be intellectual laziness and a disservice to oneself. You owe it to yourself to come to a knowledge-based decision where doing so will definitely benefit people. However, keep in mind that the decision you’ve come to is not necessarily representative of the truth. If you’re within that middle part of the bell curve of intelligence and intellect that most people are at, there is a fairly good chance your intellect has failed you and you didn’t compute some variable in your decision, making it incorrect (statistically speaking, you probably are of average intelligence. You, like the rest of us, also probably think that you’re an exception to that rule and are special in your own unique way, just like everybody else). Therefore, keep an open mind to change as new information comes to light.
Now, I’ve said all this but I’ll be the first to admit I very rarely go through this whole exercise myself, sadly. Doing so for every little thing every day is mentally consuming. I therefore carry on with little thought to the consequences of my decisions. Which is probably why the Prophet (SAW) was so harsh about the matter in the following hadith:

“Al-Tirmidhi narrated that the Prophet (peace and blessings of Allah be upon him) said to Mu’adh (may Allah be pleased with him), after teaching him some of the laws of Islam, “Shall I not tell you what is the foundation of all that?” I [Mu’adh] said: “Of course, O Prophet of Allah.” He took hold of his tongue and said, “Control this.” I said, “O Prophet of Allah, will we be held responsible for what we say with it?” He said, “May your mother be bereft of you, O Mu’adh! Will the people be thrown into Hell on their faces or on their noses for anything other than the harvest of their tongues?” Classed as Saheeh by Al-Albani.” The medical principle of ‘Doing no harm’ comes to mind.

As an example, let me run my decision about the SOC affair through the aforementioned process.
ME deciding who was guilty will not affect my life or those around me. However, this whole affair encourages me to read up the ethics of using social media as a doctor, both for my own good and so that I can educate my students when I am a consultant inshaAllah. End of process.
Keep in mind this is only MY evaluation of the event in the context of MY life. I could be wrong, given my intellectual limitations (in which case I’d love it if you could correct me). YOUR evaluation however will be completely different from mine. If say, you are in AKU’s admin, or rub chins with its higher-ups, the algorithm completely changes. You could possibly have access to information the rest of us don’t. You could also be in a position to affect (if required) the outcomes for either one or both of the concerned parties. The point of this article was not to tell you what was right or wrong about the case, but to reflect on the process you used to come a decision. If that has a solid grounding, you will be able to become a more productive member of society, instead of a mere talk-show host on the hunt for ratings. And that’s what Christmas is all about, Charlie Brown.

April 18, 2016

Strike while the Iron's Hot

I wrote this after Dr. Shakil Auj’s murder but forgot to post it:
My wife is a student at Karachi University. What follows is a synopsis of our discussion after teachers there went on strike due to Dr. Shakil Auj's murder (May Allah SWT grant him a place in the highest level of Paradise). We were wondering when strikes are morally okay (as in this case, the students suffered for no sin of their's) and when they are effective (Was the desired end achieved?). I shall discuss the latter only.
A few words about what follows: a) For the sake of simplicity, I shall refer to those on strike as strikers (in this case, the teachers) and those the strike is against as the strikees (in this case, the government/KU administration) and b) My discussion seeks to prove the following 2 statements:
1.       A strike is only effective when the service/product that is being removed by the strikers has value
2.       The strikers can only be defeated when the strikees remove a service/product that the strikers find of greater value than their own removed service/product.
Confused? Let's look at an example.
From 1974-75, British coal miners' union (National Union of Mineworkers) went on strike. The service being pulled in this case was coal, an essential requirement for the British populace, given oil's rising price after the 1973 crisis. Mines were shut down and coal production came to a virtual standstill. The British government instituted a 3 day work week with smaller working hours for the general public to reduce coal consumption to contest the strike. They failed and the government toppled.
From the above example, we see that the strikes are essentially a test of stamina and the ability to outlive the strikee. Both parties, the striker and strikee have reserves. The strikers have reserves of salaries which they get via subscriptions from their members so that they can pay the strikers when they are on strike. The government has reserves of coal. So in the end, the side that wins is the one whose reserves last longer. In 1974, the workers won. In 1984, the government did. The object of value was coal, something the population could not do without, leading to the government losing elections. But let's say the workers' reserves finished. Why couldn't the strike continue? Because no matter what principles one stands for, they all go down the drain when you're looking at starvation or a change in lifestyle, especially for those who depend on you. And those workers weren't exactly of the 1%. In 1984, the same NUM lost because the strikes outlasted the strikers, and the service removed was their salaries, something the strikers needed more than the government needed coal.
Often, our countrymen plunge headlong into strikes without properly calculating the practical consequences of their efforts. Let's look at political protests. When protesting, what product/service of value are they pulling? I can think of 2: the physical problems such as traffic caused by the protest and media coverage making the government look bad in the eyes of the international community. Both of these 2 types of value-pulling have not worked in the past because it doesn't really affect our government. It has very little bearing on the outcome of the next elections and 'the man' has no qualms about blocking roads for VIP movement anyway. Also, media coverage is too intangible an object of value. Will the media have the far-reaching effects strikers intend it to or does it just look good on paper?
Some political parties understood this and created what I term to be secondary services/products of value, i.e. when you have nothing of value, you create it. An example of secondary value is violence. Arming a political party to spread fear and using it as leverage creates value. People listen to them because they fear for their lives.
Now let's look at what value a student at a university has for the administration. What leverage can they garner when fighting for their rights? Unless said student is exceptional, none. Unless they can get the university grants through some brilliant ideas of theirs, the only object of value they have would be their fees. This works if the university is new and they need all the money they can get. But KU's fees are a joke and since it's an old established, economically feasible university, they won't ever be lacking for applicants. The only value that remains is that these students are future recruiters. They will go on to become leaders in their fields, putting their alma maters in a good light. However, this is too abstract and dicey a product of value. Besides, by the time these students go on to do great things, administrations would likely have changed by then, leaving the current administration no incentive to keep their students. Understanding this, many students form parties/unions or join political parties in school. This also explains campus violence.
Next I'll talk about civil disobedience movements. Keeping the above paradigm in mind, I believe civil disobedience will not work in today's world. Gandhi lived in a different world from ours. His India was a rural India, i.e. relatively self sufficient. Aside from modes of transportation and irrigation systems, what did the British do for India that would make the locals dependent on Britain? On the other hand, Britain needed fertile India's resources. Gandhi understood this and knew civil disobedience would hurt Her Majesty's coffers more than India's. The British government did not have a product/service of value that they could pull to hurt the largely independent Indian man without jeopardizing their own operation in India.
Fast forward to today. Urbanization dominates the country. We are miles deep in debt to the world. Globalization means we require Western products/services. Another intangible yet significant product of value is Western culture. Remember, there is only one Jessica Alba but many countries from where you can import cotton. Suddenly, the dynamics have changed. Taking to the streets to protest foreign interference in our country won't help much because frankly, my dear, we need 'em more than they need us.
I think that if we keep these few principles in mind, we as a nation can become wiser to when it's practical to go on strike and when it's just an ill-thought emotional response to injustice. Don't always strike while the iron is hot, or you may end up striking out.
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