It is sad, it never ceases to be sad, working in hospitals. Working with the mothers, their fatigued, careworn faces, the infrequent tears, the resigned, long-suffering poise, concealing hearts that are heaving with sadness. The world feels sad some days, a palpable sadness like a cloud spreading out from the feverish body of the sick child.

Other days the world (my world) is a frenzy of bureaucratic activity. The sudden news of an outbreak of cholera somewhere sets off a chain of phonecalls, of meetings, of running around between warehouse and pharmacy to check that we have the necessary kits in place. And I throw myself into this wholeheartedly, despite the awareness that 9 times out of 10 this will turn out to be a false alarm.

In both cases, there is a feeling of ‘total immersion’ to this lifestyle, as if there is no time to waste, as if what we are doing is very real, very vivid, very important. We may step back from time to time, and recall that we are not indispensible, that the world – this community – will find a way through this without our involvement. But the immediacy of the human suffering we witness pulls us back down to earth from this somewhat abstracted position, such that we quickly find ourselves fully immersed in our work once again.

One consequence of such a lifestyle is this intermittent but overwhelming desire to flee. To escape, if only for a day, for an hour. To forget the suffering and the needs that surround us, and instead to re-experience our individuality, to feel that we are something more than the work we do, that we have a life outside of this work that continues untrammeled. And here, as in many cultures, this ‘escape’ has become institutionalized, and is better known as ‘Saturday night’.

Up until now, a quiet drink and a movie have sufficed for me, allowing me to spend the Sunday morning walking or reading. But already I am starting to feel the draw of the Saturday night discos, which promise total oblivion, a complete ‘change of head’ as people here say. Of course, this reduces the Sunday to a hazy interval between Saturday night and Monday morning – but after a few months in such a setting one happily forgets that Sunday ever existed.

Of course such a means of escape may seem a little unhealthy, yet healthy or not it allows us to achieve some sort of equilibrium.  And the loss of the Sunday represents collateral damage in this Faustian trade-off, enabling us to stay (more or less) sane in these challenging situations.

Kiran James Jobanputra has been working as a doctor with MSF in Somalia, Kenya, and Niger since 2007. He is currently project coordinator of the MSF Hospital (Bon Marché) at Bunia, DRC. This blog also appears on the MSF website.