I write today from the comfort of my home , the cycle of admission -infusion -discharge had become too much to bear – just for this week I guess .
Last week , something was haunting me .
I declined the faculty invitation to the national pulmonology conference this year—a stage I had shared every year since 2018. The decision sat heavy on my mind as I made my rounds, until a voice broke through the quiet of the ward. A patient sat up in bed, his eyes lighting up: “Dr. Mobashir, we’ve been so looking forward to seeing you.”
For a second, his face was a blur in my memory. “I’m glad,” I replied, stepping closer. “How are you feeling?”
“I guess you don’t remember,” he smiled. “I had severe allergic asthma. You started me on biologics back in 2023, and I haven’t needed a single steroid since.”
Memory flooded back. We chatted for a bit, and I reassured him that his electrolyte imbalance from the ICU stay was resolved and his lungs sounded pristine. Walking away, I felt a familiar ache—a echo of the times when I was the star doctor, the high-stakes lifesaver. My mistake over these past few months was equating my worth strictly to the high-wire act of the Respiratory ICU. As a trained intensivist, part of our conditioning is tying our identity to the adrenaline of snatching lives back from the edge. We forget that lives are saved far outside those glass walls, too.
That single biologic injection, given quietly on an outpatient basis, had spared this man three years of hospitalizations. Though my pulse will always quicken to the rhythm of a critical care monitor, perhaps peace lies in aligning myself with the subtle, profound victories of outpatient care.
I’ve tried every cliché of a midlife pivot—the gym, Pilates, obsessing over artisanal coffee, traveling to distant places. But nothing came close to the raw, unmatched satisfaction of intubating a patient and reversing a crisis in seconds. The reality, however, is unyielding: I cannot go back. My body simply will not permit it anymore.
So, I adapted. I took my training in allergy and immunology, walked into my boss’s office, and proposed a Severe Asthma and Allergy Clinic. We are bringing back the classic precision of the skin prick test and pairing it with the vanguard of sublingual immunotherapy and biologics. We launch next week, driven by the goal of intercepting severe, allergic-phenotype asthmatics before they ever need an ICU bed. Eventually, I hope to expand into other specialized clinics. A sabbatical was my first seemingly logical choice earlier this year ,but people like me—do not quiet down well. True relaxation beyond a few days only breeds restlessness.
Yet, underlying my resilience is a quiet thread of survivor’s guilt. Knowing how many people succumb to autoimmune diseases while I stand here alive makes me immensely grateful, but I often wonder if some of that gratitude is just guilt wearing a softer mask.
The human mind is a complex, labyrinthine thing. I likely won’t be writing during my treatments over the next few weeks—there are SOPs to draft, clinic logistics to map, and new beginnings to build. My follow-up with my neurologist is coming up, too. I’m holding out hope that he’ll at least taper my injection dosage; my tummy is running out of unscarred real estate for another 26G needle to house .With four months left in the year, I am quietly wishing for a tide of meaningful, healing change.
Earlier this year, I read Maya Shankar’s The Other Side of Change, a book about how people reconcile with what remains after a catastrophe and build anew with whatever tools are left in their armamentarium. Looking back at my own trajectory—a childhood that forced me to grow up too soon, a mother whose memory is fading like a sunset, and a nervous system in constant rebellion—my life has been anything but quiet. Predictability was never written into my story. But standing here today, taking stock of every scar and every restart, I feel a quiet, undeniable pride in how far I have managed to come.
We spend so much of our lives measuring our purpose by the storms we weather at the peak of our strength, forgetting that the quiet work of rebuilding is an art form of its own. Transitioning from the adrenaline of saving lives in seconds to the slow, deliberate grace of preventing tragedy takes a different kind of courage—one that relies not on the endurance of the body, but on the resilience of the spirit. I may no longer stand at the center of the frantic ICU monitor, but in this new space, I am learning to measure my worth not by the crises I manage, but by the quiet breaths I help safeguard. The landscape has changed, but the healer remains; and in that truth, there is finally room to breathe.
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