Taking hospital drama away from the small screen
When I first began reading this book in an attempt to write a review on it, I thought it couldn’t be that hard? Interesting topic, light but not chick lit light, should be a breeze. However, this wasn’t necessarily the case with Rival’s by Saad Shafqat.
Set in the fictitious Avicenna Hospital, a private facility in Karachi, Rivals begins to a slow start. The story, which is about two surgeons who go head-to-head for the chair of surgery position. Both Dr Tanya Shah and Dr Hammad Baig are top surgeons in their own area of specialisations and represent the Pakistani elite, both privileged and entitled in their own ways.
However, Shafqat takes a long time to set the stage before the central story of the book unfolds. This is largely due to the painstaking details of the different sections of the hospital he provides. Not to mention, many instances that focus on the ruminations of the characters.
Soon after the story begins, a suicide bomber blows himself up in the busy Empress Market and thereafter, it unfolds how the incident affects several of the characters in the book. While Dr Hammad complains about the inconvenience of the incident, Dr Tanya grapples with the incoming victims of the attack as they’re brought into the Trauma facility of Avicenna of which she is in-charge.
As the tension grows in the aftermath of the suicide bomb, Shafqat paints a picture of an anxiety and stress-filled trauma wing. Patients are brought in and assessed based on severity of their injuries and then they’re assessed to see whether or not, they need surgery. Tension mounts even further as 10-year-old Nyla Rehman’s spleen ruptures. This is where some details could have been left out. The detailed description of new trauma fellow Dr Zarak Afridi’s thoughts on Avicenna’s trauma department’s efficiency in the middle of the emergency splenectomy only proves to distract and dissipate the sense of urgency of the current scene.
While some supplication of detail is good, there are several such instances where supplication of details make one question their necessity. Another example is the description of Hammad’s friend Raja and his weight gain in the middle of a far more gripping conversation about potential adultery between Dr Hammad and his friends.
So detailed are some of these scenes that the central theme of the book - the rivalry between Dr Tanya and Dr Hammad - isn’t even touched upon till after the first hundred pages of the book when the two main characters are finally put in the same meeting room and the background to their enmity and competitiveness is finally explained. And it is only halfway through the book that the main crux of the rivalry - and the driving point of the story - the coveted chair of surgery position at the hospital is introduced.
Going back to the central theme of the book, the rivalry, when Hammad begins to scheme against Tanya, he says, “The most powerful strategy in any conflict is to take your opponent’s key strength and transform it into a weakness.” This sets the stage for the underhanded scheming which lies ahead in the book.
To further highlight the battle of the sexes, her gender is used to win against her. Hammad says, “She’s gotten ahead by playing the woman card, by using her gender as a marketing tool, and we’ve got to twist it around so that her gender becomes a liability.”
When drawing a comparison between Tanya and Hammad, Shafqat describes them by saying, ‘they are equally qualified for the post.’ Tanya is ‘academically qualified’ and Hammad possessing a ‘dominant clinical presence’. Tanya the ‘straight shooter’ and ‘strategic and visionary’ where Hammad is a ‘schemer’ and ‘calculating and tactical’.
As the climax buildings in the story, the race for the job is described as ‘one hell of a cockfight’.
A notable theme that is, however, executed with impeccable observational detail is the class warfare in Pakistan. In many instances throughout the book, Shafqat creates a narrative where he demonstrates the stark class disparity between the rich and poor in Pakistan. This inequality is acute and it’s felt. It’s hard to miss it: There is the generational wealth with its entitlement and then there is the first generational upper middle class that has had to work hard and claw its way up the class ladder who despite its success and relentless efforts, still have to swallow disappointment and defeat in the face of the former’s entitled, scruple less, far greater affluence and connections. There’s also the working class, who labours to survive, to scrimp and save, and who often goes unnoticed by the privileged of the city.
This is also shown from a few different perspectives. It is shown through Shakoor, the ambulance driver, then again through a brief exchange between Hammad and a beggar woman. It is also highlighted through a car ride with Tanya and her driver. It is also shown through Dr Zarak, who has recently moved from Peshawar to Karachi and finds the city’s elite customs unsettling and intimidating.
Moreover, Shafqat also succeeds in creating three dimensional characters that are believable and make the story more human and relatable. This humanising element enhances the storyline and makes it more readable. The reader is both intrigued and willing to delve further into their stories.
With Dr Hammad’s character, he is able to demonstrate an entitlement from someone who is accustomed to getting his way, and who can be vicious and ruthless when he doesn’t succeed in getting it. Hammad represents the male, womanizing, Karachi elite trope with his success and accolades. He surrounds himself with friends who are just slightly socially and professionally inferior, and who feed his ego through a constant stream of sycophancy. Hammad is someone who isn’t afraid of breaking or skirting around the rules and using his connections to achieve his goals. He is someone who is able to compartmentalize his multitude of affairs with little or no guilt or remorse, and still pats himself on the back for creating a perfect family - or rather another image to be proud of himself for - where is he the married and doting successful ophthalmologist with a perfect trophy wife (who is beautiful but not too ambitious), a big house and two perfect children.
Through Dr Tanya Shah’s character, a subtle but unmistakable battle of the sexes in a patriarchal society is also highlighted in the book. An insight into her driver, Mangal Khan’s, attitude towards her shows his misogynistic mentality in the begrudging manner in which he accepts her role as his boss.
This can again be seen during her altercation with Shakoor when he regards her as a ‘Typical upper-class Karachi lady…They have no respect for people beneath their own social class. They don’t even regard people like him as human.’
And when he thinks to himself, ‘If this woman were his wife, he would give her a proper thrashing. He would teach her a good lesson. He would slap her senseless until all that pride and all that scorn got knocked out of her.’
Shafqat, through Dr Tanya's character, also shows what it is like to be a woman to male colleagues and what it is like to be woman and a professional rival to a man.
Another interesting observing made by Shafqat in the book is the post-colonial legacy of Pakistani culture, where despite the long departure from colonialism, Pakistanis still consider Europeans to be the superior race and still automatically begin to display a servile attitude towards them. This is shown through Avicenna’s Head of HR, Grace Wilson: ‘She discovered early that her European skin was an incredible asset in this setting. She could throw her weight around and get away with it.’ Shafqat refers to this as ‘fawning attention’ and says they ‘treated her like Queen Victoria.’
He further notes, ‘A matronly white woman wouldn’t attract the slightest notice on the streets of Glasgow. Here she is the centre of attention. And she is quite certain, of admiration.’
There have been many hospital dramas portrayed in American tv shows. One of the older ones being ER which first aired in the mid-nineties starring a young George Clooney. Since then many other successful hospital dramas have also launched. Among the most popular being the long-running Grey’s Anatomy, which is now in its 18th season. There’s also many other variants of this recipe such as House, The Good Doctor, Chicago Med, Scrubs and The Resident, to name just a few choice ones.
So it’s easy to imagine why a story set in a hospital would most likely do well. Especially as this one has a unique angle too: it’s set in the tumultuous city of Karachi. While outlining some of the issues of Karachi, as a native of the city, the story seems to barely scratch the surface of the heart of some of these problems. However, it is easy to imagine this story about exotic Karachi riddled with its suicide bombers and muggers to be more fascinating to a foreign audience. In the aftermath of the suicide bombing Shafqat notes, ‘If the bombing has left an aftertaste, it’s not evident.’
And further about the reaction of the bombing by the city’s residents he speculates, ‘Is it resilience or indifference? Or could it be a kind of psychological adaptation or cultural habituation, as if when a frog is placed in tepid water and slowly brought to a boil?’