Daktar Saab on why a doctor's absence in Pakistan matters

A KMDC graduate, an impostor, and a copywriter at Parlo

The episode opens with Muzamil pointing out that without this particular guest, Thought Behind Things might have started twenty-five episodes later than it did. Dr. Asad Khan — better known online as Daktar Saab — was the push that got the podcast moving in the first place, and Muzamil names that debt out loud before the conversation begins.

Asad walks through the résumé quickly because the interesting part is what sits underneath it. He graduated from Karachi Medical and Dental College in 2016. KMDC is a public college tied to public hospitals, which is why it costs a fraction of a private medical degree. “Thirty thousand rupees a year,” he says. Five years. A hundred and fifty thousand rupees, total, to become a doctor. Muzamil calls the number “just insane,” and it sits there for a moment as the floor under everything else they discuss.

Then comes the part most CVs leave out. “I was struck with impostor syndrome,” Asad says. “I felt I wasn’t capable of anything, that I couldn’t be a doctor.” He walked away from medicine and went into content writing — for Parlo, among others — where he learned audience psychology and what he calls a “spicy way” of packaging things. He was good at it. He also describes leaving with “a little bit of disgust” for the culture he had learned to manipulate. A year at Aga Khan University followed, and that year, he says plainly, “completely changed my life. I realised that medicine is what I want to do.” Everything since has been an attempt to mix medicine and content without letting either one cannibalise the other.

Why Daktar Saab exists at all

The origin story for the channel is not a marketing plan. It is a death.

Asad’s friend’s mother was diagnosed with breast cancer in 2019. What shocked him was that she had been able to feel the lymph nodes in her armpit a full year before she was diagnosed. She did not connect the lump to the disease. “An educated woman from a financially comfortable household either did not know or did not care enough about herself to go and show someone at a hospital,” he says. She did not survive.

That single gap — between what a literate, middle-class Pakistani household knows about its own body and what it should know — is the wedge Daktar Saab was built into. Asad went to his friend Danish Hassan and asked him to help build a platform that would treat health and disease identification as something you could actually enjoy learning about, rather than a dry subject to be afraid of. Two years later, the platform exists, and Asad is sitting across from Muzamil trying to explain why he has not yet boarded a plane to the United States.

The USMLE is an escape, and most people don’t come back

Muzamil names the elephant: nearly every doctor he knows has either taken USMLEs or is in the process of taking them. He asks Asad, who has done the same, what is actually going on.

Asad’s answer is careful. “USMLEs are basically a doctor’s escape from Pakistan,” he says. The framing matters. He is not against doctors taking the exam — he tells students he would push everyone to take it — because the curriculum and the way questions are constructed gave him a fresh perspective on medicine that the Pakistani system did not give him. “Part of the reason I fell in love with medicine again was the USMLEs,” he says. The exam itself was a gift.

The escape is the problem. Students walk into medical school in Pakistan already imagining a foreign practice and a foreign salary. The financial prospect is real. The training prospect is real. The catch is the third one — the return — which most people do not actually do. They leave, and they stay gone. And because they leave without understanding what they are walking away from, the cost is paid by a country that produced the doctor for a hundred and fifty thousand rupees and gets back nothing.

”A doctor’s absence in Pakistan matters”

This is the sharpest claim in the conversation, and Asad makes it twice.

“The US is a well-oiled machine,” he says. “Its parts work. If you don’t go and fit yourself into that machine, someone else will. The machine keeps running. But a doctor’s absence in Pakistan matters.” He names SIUT and Indus Hospital. These institutions exist, he points out, because specific individuals with the option to stay abroad chose to come back. “If, God forbid, on the basis of their intellect and their skill, these people had not returned to Pakistan, we wouldn’t have SIUT or Indus.”

Muzamil pushes back, and the exchange is one of the most interesting passages in the episode. He suggests the brain-drain conversation needs to be honest about scale: Pakistan exports human capital and brings in more than thirty billion dollars in remittances annually, more than all other exports combined. The country, he argues, cannot absorb every doctor it produces. The objection is sound on numbers.

Asad does not concede on principle, but he reframes. “I’m not saying you shouldn’t go for good training or good money. Go. But don’t leave with contempt for the country that made you.” The pathology he is describing is not the act of leaving. It is the act of leaving while shitting on the place. “Go knowing the fact that this country made who you are today,” Muzamil agrees, and Asad calls the missing virtue what it is: “Reverence. Humility.”

Standardisation, NLE, and the doctors who won’t stop crying

The conversation pivots into a long defence of an unpopular position. Asad is in favour of NLE — the National Licensing Examination — and in favour of computerised testing. He knows this puts him at odds with most of his peers.

His reasoning is structural. Medical graduate quality in Pakistan is not uniform. One school produces graduates who pass through a stringent process. Another produces what he calls photocopies. The disparity is not academic; it ends up in front of patients. He notes that Pakistani students who studied medicine in Central Asia or China have always had to take a licensing exam to practise back home. Extending that to local graduates is the same logic. “It’s one step towards standardisation of graduates,” he says. “If done right.”

Muzamil presses on computerised testing. Asad’s answer is unsentimental: “You couldn’t print the paper. The questions are randomised. I personally found it a very good step.” He describes his own recent interaction with PMC — submitting an application online, paying online, receiving a certificate by email within four days and by mail the next. The comparison to the old PMDC process, which Muzamil remembers as requiring physical trips to Lahore and personal favours, is brutal. “We should accept these accountability checkpoints being placed everywhere,” Asad says. “Doctors complain a lot. They complain a lot.”

He says this as a doctor.

Numbers, evolution, and the patience the audience won’t grant

Muzamil shifts the conversation to content — to the space Asad sits inside as Daktar Saab. The diagnosis is bleak. The industry, Asad says, wants to evolve from the inside, but it is not evolving, because creators have run out of patience for audiences that have not yet caught up.

“There’s a lot of hopelessness,” he says. “The numbers don’t come. You make good content and the audience doesn’t watch. You make popular content and the audience doesn’t watch. Hocus-pocus TV is getting more views. What do we do?” He counts himself lucky: because he is not chasing numbers, he can afford to wait. He has the privilege of patience. Most creators do not.

What he is sure of is that creators need to keep raising their own game. “If they keep upping their game, they’ll pull the audience up with them.” He sees the alternative — abandoning the audience to whatever already works — as a defeat dressed up as realism. Daktar Saab, he says, has produced amazing results on small numbers because the impact is real. He thinks the turnaround is four or five years away. “We just have to be patient.”

Performative activism and the kink of staying miserable

The episode’s most uncomfortable passage is a two-handed critique of online culture. Muzamil names the problem first: post-COVID, every creator he knows is being told that their content is tone-deaf to whatever crisis is currently trending, and many of them have started to internalise it. He asks Asad whether he agrees.

He does not. “I don’t agree with the idea of tone-deafness when it comes to the internet,” Asad says. “A room is a room. If people in a room are sad, you don’t go in and crack jokes. The internet is not a room. It’s the world. And the world is full of miseries.” One person, he argues, is allowed to share something about Palestine in one post and a makeup kit in the next, because human beings hold multiple registers at once. Demanding that creators match the timeline’s prevailing mood is, in his framing, entitled. It is also a tell. “When the audience goes to a creator and asks them to be vocal about a particular topic, I start to doubt the intentions. Is this person really feeling that, or is this the theatrics — performative activism?”

Then comes the harder observation, which is about audiences, not creators. Asad says he has spent the last year trying to solve problems for friends and patients, and has noticed something he calls a “kink.” “People don’t want solutions. People are fixated on the misery of the problem.” There is a satisfaction in describing how miserable, oppressed, or broken the situation is, because misery comes with the comfort of being on the right side of history. Muzamil reframes this generously — he reads it as a refusal to take responsibility — but Asad keeps it sharper. The fixation is its own reward. The solution is unwelcome because the solution ends the comfort.

His prescription is plain: troubleshooting mentality. There is a problem. Look at the solution. Stop fixating on the problem.

”There are things you can control. There are things you cannot.”

Asad credits Muzamil with a frame he says he has been carrying since their last conversation, and then he gives it back, cleaned up. “There are things you can control. There are things you cannot. The things you cannot control include consequences. With your moral compass and your goals aligned, ask: what is the best option I have right now?” He calls it an algorithmic game. You move, you hit a wall, you move again. “To try and be sad over things you cannot control is, I think, emotional unintelligence.”

Muzamil layers his mother’s framing on top: pray for what is best for you, not for the specific thing you want. The path that did not work was probably God’s protection. In hindsight, he says, almost every blocked path turns out to have been a mercy. The two of them settle, briefly, on the same word: contentment. Asad calls it the precondition for actually trying. Anxious people, depressed people, jealous people, he points out, do not try at all.

Left, right, and the part of the political map nobody reads

Muzamil pulls the conversation into politics. He notes that Asad is one of the few content creators who is openly political, and asks where he places himself.

“Centre-left,” Asad says. He breaks the answer down: he is strong on personal liberties; slightly right on economics; left on healthcare and education; a little right on social questions. Muzamil offers his own working definition — right as conventionalist, left as progressive, spectrum ends on both sides shading into burn-it-down — and Asad accepts the frame but adds the move that gives the conversation its title.

“The opposite of conservative is progressive. The opposite of liberal is authoritarian. We are all liberals. Stop trying to police people’s thoughts. Stop trying to police people’s actions if they don’t physically harm another person.” Both spectrum ends, he argues, eventually behave the same way. What was progressive yesterday is conservative today, because we are conserving the progress. Push far enough left and you end up back where the right was: telling people what they can and cannot say.

Muzamil’s contribution is historical. He describes how 2010–2015 Pakistani social media was a fight against a religious right that wanted to police what women said and posted. The fight was won, more or less, on freedom of expression. Then, post-2015, an ultra-progressive vocabulary arrived and started doing the same job from the other side. “If you say this, it means you are this. If you say that, it means you are that.” He calls it a religion built out of words that cannot be questioned. Asad agrees and names it: “Blasphemy. In the left, it’s blasphemy in exactly the same way.”

Daktar Saab is bigger than your timeline opinions

Asad makes a small but important admission in this stretch. He says he has been talked into being less politically loud online — not because he was wrong, but because Daktar Saab is bigger than his personal opinions. “I want people to understand how to take care of their health. I want them to see that biology is not some mystical thing. For them to actually believe what I’m saying, they have to trust the person I am. And it’s difficult to hold people’s trust if you’re politically aligned to a camp.” He is naming a specific cost. Pakistani audiences judge a person by their camp before they judge the weight of what the person is saying. A health educator who picks a flag picks a smaller audience.

Afghanistan, and the conversation Pakistanis cannot have with each other

The episode closes on the August 2021 fall of Kabul, which is fresh as they record. Asad describes a Facebook argument with a friend that he eventually ended by saying: we both want a better outcome for Pakistan. We disagree only on the route. The framing punctures the fight. Muzamil names this as the country’s deepest political problem — not disagreement, but the absence of shared language. “Many of our issues, if people would just align their vocabulary, they would arrive at the same thing. One says: look at religion, the outcome already exists there. The other says: look at sociology, the outcome already exists there. They want the same thing for their people.”

On Afghanistan specifically, Muzamil is precise about who was celebrating what. Nobody he respected, he says, was celebrating the rise of the Taliban. What centrist, rational people were celebrating was the end of a foreign occupation — the fact that after forty years of meddling, Afghans would once again decide their own fate. “It is a duty of every liberal,” he says, “to say that no foreign occupier should be running the state of a country they don’t understand.” The right response from Pakistan, he argues, is not outrage and not interference. It is partnership, and it is restraint. Asad agrees, and the conversation winds toward its close on that note — two Pakistanis, one a doctor, one a host, agreeing that the hardest skill in their country right now is the skill of speaking the other side’s language without surrendering your own.