Last Updated on June 8, 2022, by eNotes Editorial. Word Count: 1040
Malala relates that Usman Bhai Jan, the bus driver, rushed the dyna to the hospital once he realized that she had been shot. Two of Malala's classmates, Shazia and Kainat, had also been shot. At the hospital, doctors reassured Ziauddin and Madam Maryam (the headmistress of the girls' school) that the bullet had missed Malala's brain. From the hospital in Mingora, plans were made to airlift Malala to the Lady Reading Hospital in Peshawar. Upon landing, however, Malala was taken to the Combined Military Hospital (CMH) instead. There, Colonel Junaid, the army neurosurgeon, warned against surgery. After Malala began vomiting blood and her brain began to swell, however, Colonel Junaid opted to operate. He explained that, although the bullet had not entered Malala's brain, particles of bone fragments had damaged the cerebral membrane, causing the brain to swell.
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During the five-hour operation, the colonel removed a portion of Malala's skull and placed it in the subcutaneous tissue to the left of her stomach for preservation. He also performed a tracheotomy to clear her airways, removed clots from her brain, and disposed of a bullet from her shoulder blade. Malala reports that the governor gave Ziauddin 100,000 rupees to pay for her treatment. Many important public officials and politicians also gathered at the hospital to show their support. At this time, the Taliban issued a statement claiming responsibility for the shooting. In this chapter, Malala relates that she was also assessed by two British specialists, Dr. Javid Kayani and Dr. Fiona Reynolds, both from hospitals in Birmingham. The specialists warned that Malala's survival was being jeopardized by inadequate aftercare. Following surgery, the doctors had neglected to monitor her CO2 levels and blood pressure on a consistent basis.
Malala relates that the doctors failed to implement Dr. Fiona's very specific instructions for her aftercare. As a result, Malala developed Disseminated Intravascular Coagulation (DIC): her kidneys began failing, her blood stopped clotting, and her blood pressure began plunging. Disturbed, Brigadier Aslam (one of the specialists) alerted Dr. Fiona, and she immediately took steps to airlift Malala to the Armed Forces Institute of Cardiology in Rawalpindi. There, Malala received blood transfusions, and the doctors worked to stabilize her. Meanwhile, the hospital was put on lockdown, and an army major was assigned to protect Malala's family.
Apart from the crisis, the whole world voiced its collective outrage at the shooting. Malala tells us that offers of help came from all corners of the globe. In the end, after extensive discussions between General Kayani and the two British specialists, it was decided that Malala would be moved to the Queen Elizabeth Hospital in Birmingham. Dr. Javid suggested that the Royal Air Force would be able to transport Malala, but General Kayani refused. In the end, the ruling family of the United Arab Emirates offered the use of a private jet equipped with an on-board hospital. For his part, Ziauddin opted to stay behind to sustain the rest of the family. With absolute trust but a heavy heart, he selected Dr. Fiona as Malala's guardian for the duration of her time in England.
In Chapter 21, the theme of courage is juxtaposed with the theme of warring Islamic ideologies. The shooting was an act of desperation on the Taliban's part and an effort to maintain its momentum of influence in Pakistan. However, the act itself galvanized so much international support for Malala that the Taliban's efforts to elicit sympathy from the global community was neutralized. The shooting clearly exposed the Taliban's modus operandi (method of operating) of portraying itself as a persecuted party. Laughably, the Taliban rationalized the attack on a young girl as an act of self-protection: Malala had to be silenced because her outspoken discourse against its policies was an attack on Islam itself. What the Taliban had not envisioned was that this one desperate act would set progressive Muslims and people of all nationalities and religions against its brand of Islam. In this chapter, we see Muslims like Madam Maryam, General Kayani, Ziauddin, and Colonel Junaid working closely with British nurses and doctors to save Malala's life.
In the face of unimaginable tragedy, Malala became a symbol of worldwide courage and resolve against militant Islam. Today, because of the Malala Fund, the United Nations has raised the optimum number of years for children's education from 9 years to 12. Additionally, UNICEF celebrates Malala Day on July 12th every year; not only is it the day Malala celebrates her birthday, but it is also the day her continuing work on behalf of the world's children is acknowledged. So, far from achieving its goals, the Taliban's desperate act has only reinforced the necessity of promoting universal education and free speech on the global stage.
In Chapter 22, Malala reinforces the vulnerability of the average Pakistani civilian. In collaboration with foreign representatives, military and healthcare professionals from the Pakistani army worked to process Malala's transfer to the United Kingdom. Malala's parents were largely left out of the process. Behind the scenes, a power struggle ensued when Dr. Fiona recommended that Malala be moved overseas. While hospitals in either the United States or United Kingdom would have provided superior rehabilitative care for Malala, General Kayani insisted that the former was not an option. The Raymond Davis and bin Laden affairs had so soured Washington–Islamabad relations that the General refused to accept help from the Americans. General Kayani also turned down the possibility of receiving help from the United Kingdom's Royal Air Force.
His political focus during such a crisis highlights the Pakistani government's delicate position: it needed to portray itself as an independent but rational entity, neither at the mercy of Western powers nor reliant upon the good graces of militant Taliban groups. Malala rightly points out that "fear of loss of face" was an important consideration in the General's final decision to receive help from another Muslim nation. Essentially, Pakistan wanted to fight extremism on its own terms; it wanted neither to conform to Western expectations nor to bow to Taliban demands for political and religious supremacy. General Kayani had to balance conflicting priorities, and because the average Pakistani civilian is absent from this process, the level of distrust between the Pakistani army and the people remains high.