Medical Student Before National Exams: Escaping Reality by Traversing Pakistan

Several years ago, when I was in my sixth year of medical school, I traversed Pakistan, from Kashgar in the Xinjiang Uyghur Autonomous Region, along the Karakoram Highway, to the major metropolis of Karachi facing the Indian Ocean.

I submitted an entry based on this trip to this year's "My Travel Books Newcomer Award," and while it made it to the final nine works, it was ultimately rejected. (To be precise, just like the Akutagawa and Naoki Prizes, the result was "no winning work this time.")
However, since I had gone to the trouble of writing it, I decided to take the plunge and publish it on Kindle.
(Those with Kindle Unlimited can read the whole thing for free—and even if you aren't on Unlimited, it's all-you-can-read for 30 days with a first-time registration, so please check it out.)

Why are there no accounts of traversing Pakistan?

I have long had a grievance.

Pakistan is a country with a relatively significant north-south span, and its climate alone varies from snow-covered areas to scorching regions.
Regarding language, roughly speaking, there are Iranian languages in the west, Indo-Aryan languages in the east, and in the north, there are languages with unknown origins like Burushaski; naturally, the ethnic groups are also diverse.
In other words, it is well worth traversing, yet for some reason, no "account of traversing Pakistan" exists. (There are blog posts and the like.)

Xuanzang (Tripitaka), Ibn Battuta, Marco Polo, and Kotaro Sawaki all crossed it from east to west.
Well, this might just be because it is out of the question to go all the way to Pakistan and not visit India or Afghanistan, but regardless, there is no account of a north-south traversal.

Why are there so few travelogues about Pakistan in the first place?

Or rather, even before talking about traversal accounts, travelogues about Pakistan are abnormally scarce.
If you go to a bookstore, you will encounter a staggering number of travelogues about India. But when it comes to Pakistan, there aren't even double digits.Even though it is the 5th most populous country.
Even the "Chikyu no Arukikata" (Globe-Trotter) guidebook hasn't been updated for years, and the copy I bought several years ago, "Chikyu no Arukikata: Pakistan '07-'08," has skyrocketed in price to a level that can only be called a financial scam with a 25% annual interest rate.

Pakistan is a country that encompasses the Indus River basin, the easternmost reach of the Achaemenid Persian Empire.
In other words, to be persistent, Pakistan is the boundary between the region influenced by Persian civilization and the (narrowly defined) Indian civilization sphere that existed beyond it.
Of course, the influence of the Persian Empire isn't everything, but this boundary has created a wide range of differences in current ethnicity, language, religion, and food.
Furthermore, Pakistan is the front line where the Middle East and South Asia meet. You cannot talk about Asia or the Middle East without going there. How much can a person who has never seen the coast say about land and sea?
Everyone, let's go to Pakistan.

Rather than a pure travelogue

I wrote this travelogue by tracing my memories based on the diary I kept at the time.
However, once I started writing, I found myself wanting to talk about various things regarding Urdu (and inevitably Hindi as well) (
Urdu is, personally, the overwhelming number one language that is a "national language" of a country and has a large number of speakers, yet has low recognition in Japan), and I also wanted to write about how the current Indus Plain was formed in the first place (such as the great migration of the Indian subcontinent).Therefore, rather than a pure travelogue, it became something that weaves in elements of Pakistan's language, history, geography, and geology? (I didn't force the information in; I intended to delve into things I became interested in at key points during the trip.)

To put it further, there were many things I wanted to write about, such as the Ismailis and the Aga Khan, but I gave up because it would stop being a travelogue.

The impurity of the travelogue: the national exam

The aforementioned elements are related to Pakistan, but there is also a "purer impurity" in this travelogue.
It is the National Medical Practitioners Qualifying Examination.

Extreme opinions tend to stand out on this topic, but the national medical exam is, after all, a difficult test.
Since the first one was held in 1946, the scope of the questions has naturally expanded year by year.

For example, tuberculosis, which took the life of Jinnah, the father of Pakistan, is now treated with standard multi-drug therapy, and modern medical students desperately memorize these multiple drugs and their side effects.
However, at the time of the first national exam, two years after Jinnah passed away, it had only been three years since the discovery of streptomycin, the first drug for tuberculosis.
It was an era where a drug for an "incurable disease" had finally been created. The world is too different.

There are not many people who can keep running for several months for an exam whose scope expands year by year. Even less so for people who clean their rooms the day before a test.
This trip was one where such a person went to Pakistan while dabbling in Urdu to escape reality.

Therefore, this travelogue contains many scenes not directly related to Pakistan, such as studying for the national exam while traveling on a sleeper bus along the Karakoram Highway.
As a travelogue, it is completely unnecessary impurity, but this was the situation I was in at the time, and I don't think there is such a thing as a trip completely independent of life, so I wrote these things honestly.

Finally

On note, I had written short articles that I was interested in on a whim, but writing something close to 80,000 characters was a first-time experience.
Even though I reread my diary, there are many parts where memories from several years ago are unreliable, so I tried to read several books and papers related to Pakistan to ensure there were no mistakes.
(Because of this, Elsevier, which used to email me medical papers I might be interested in every week, started recommending papers on the breakup of the Gondwana continent and the evolution of leopard geckos.)

I would be very happy if even a few people became interested in traveling to Pakistan after reading this.
As of August 2025, "Chikyu no Arukikata: Pakistan" is 17,800 yen on Amazon, but if it continues to skyrocket at this pace, it will be worth 100 million yen in 40 years, so I recommend taking the plunge and buying it to plan your Pakistan itinerary for your summer vacation.