Was it a djinn or genetics that was responsible for his strange behaviour?

A common misconception exists in Pakistan that if someone starts behaving oddly, the cause is usually attributed to djinns. Spiritual healers are consulted to resolve the issue while doctors and medicines are usually ignored. This thought is not restricted to the uneducated class; even the privileged strongly believe in the supernatural as it can be witnessed from the wall chalking in Karachi that advertises one aamil after another.

However, a recent incident provided a more realistic and holistic insight. About two years ago, my relative’s six-year-old son started behaving oddly. He was a young and energetic boy who would go to school and behave just like any other normal boy his age would. However, his characteristics suddenly started to change. He began living in constant fear and would complain of being terrified of a black man. He became extremely aggressive and would beat and kick his siblings and parents. He used to be terrified of his grandfather, but during one of his violent episodes, he threw a ball at his grandfather and screamed at him to leave the room. He was even kicked out of school due to his hostile attitude.

His parents were extremely worried and immediately consulted a physician who ordered a series of tests. All of his tests came out normal except for his Liver Function Test (LFTs), which would fluctuate rapidly. A renowned hospital in Karachi cleared him and sent him home but neither the hallucinations nor the aggressive behaviour stopped.

The behaviour continued for two years. The boy’s maternal grandparents were convinced that this was related to djinns and thus pressurised the mother to consult an aalim or maulvi. Out of desperation, the mother conferred with an aalim. He advocated that their house was haunted and gave her surahs to recite and wazifas (recitations) to perform. She followed everything religiously but the symptoms remained the same. Several other aalims confirmed the same thing and gave her holy water, taweez (locket with Quranic verses) and amulets. They even charged exorbitant amounts of money but nothing worked.

The boy’s father isn’t a believer in the supernatural thus his medical treatment continued for a year at a reputed hospital in Karachi. His LFTs would fluctuate abnormally, which according to majority of the relatives, was the djinn’s doing. Baffled at his reports, the doctors eventually asked the parents to opt for a biopsy to check for cancer.

The parents, frightened by the biopsy procedure, took their son to another famous liver and kidney hospital. The same process of tests resumed and eventually the doctors at that centre also gave up on him. The father then resorted to a hakeem who prescribed herbal medicines. The diagnostic process was repeated yet the boy’s condition continued to worsen. The reports concluded that there is definitely something wrong with his liver but all the tests for major liver diseases came negative every time. As a last resort, the parents reluctantly agreed to a biopsy.

However, before the biopsy took place, one of the parents’ friends suggested consulting an expert coming from the US who dealt in rare diseases. After checking the boy’s reports, the expert asked his parents if he could run a few more tests that varied from what had been suggested previously. Last week, the reports came back and it was concluded that the boy has a rare genetic disease called citrullinemia.

Citrullinemia is an inherited disorder that causes ammonia and other toxic substances to accumulate in the blood. This is caused due to a mutation in the ASS gene which upsets the urea cycle and prevents the body from processing nitrogen effectively. Excess nitrogen in the form of ammonia and other by-products of the urea cycle accumulates in the bloodstream, and causes progressive damage to the liver and kidneys. This is an incredibly rare disease as only about one person in 100,000 has it.

After the confirmation, the boy has now been put on a ‘no protein diet’ for the rest of his life. The only cure for this disease is gene therapy, which is currently illegal in almost every country and is not even available in Pakistan.

I remember the time when I would be frightened looking at this boy behaving bizarrely. Even I thought it seemed like a case of supernatural interference because he behaved oddly for a six-year-old. His personality had completely changed. But now I know that the reason for this is due to the fact that citrullinemia attacks the nervous system, causing confusion, restlessness, memory loss, abnormal behaviour (such as aggression, irritability, and hyperactivity), seizures, and in some cases, coma.

The entire family bashed the parents for spending so much money on medical treatments when he was clearly possessed by djinns in their opinion. If the parents had been poor, they would never have been able to afford all those tests and doctors at the best hospitals in Pakistan and would have probably just resorted to solutions provided by aalims. More so, their son’s liver would have been completely damaged. If the boy had continued to take in protein, he would have gone into an irreversible coma which could have eventually led to his death.

I clearly remember that there was a maid’s boy who used to behave oddly and the maid took him to various pirs and fakhirs but eventually, he passed away. Situations like this do occur, and we need to address them.

For my relatives, it took two years, countless tests and multiple visits to doctors and hospitals to discover this diagnosis. What w, the general populace, attributes to djinn possession is probably a medical condition or perhaps an exceptionally rare genetic condition, as it was for this boy. So next time, don’t let people fool you into thinking everything is related to the supernatural.