Elections are finally over and in a few weeks we will most likely have new governments at the centre and in the Punjab while Pakistan Muslim League-Nawaz (PML-N) will, most likely, have to sit in opposition in Islamabad and Lahore.

Sadly Nawaz Sharif, the incarcerated ‘supremo’ of PML-N, did not quite get the popular support he expected in the recent general elections. The sadness of not having the popular support he expected is the possible reason he became so sick that he had to be urgently transferred to a hospital in Islamabad.

My readers might have read what I have written in the past about the health of our leaders. But rarely have I thought much about the fact that most of our major politicians fall sick when in jail or when threatened with jail time. And often end up in a hospital for extended periods of their incarceration if they do end up in jail.

The most famous case of an ‘extremely sick’ politician was that of a former chief minister of the Punjab who after losing his position ended up being tried for financial corruption. He spent more than two years in the Punjab Institute of Cardiology (PIC). Twenty years later he is fit enough to contest elections.

So, it does seem a trifle strange that Mian Sahib who only a month or so ago was well enough to travel all over the country addressing public meetings suddenly became too stick to be in a jail after just about a week and had to be transferred to a hospital. Fortunately, he recovered rapidly and was sent back to jail in just a few days.

Perhaps Sharif took time off so that his ‘permanent quarters’ in jail could be refurbished and improved up to his requirements while he was in the hospital.

However, the more likely reason why Sharif ended up in hospital is what is referred to as the ‘VIP Syndrome’. It is a fact that prominent people are treated differently from ordinary people. And doctors responsible for their care often perform as many tests as possible to make sure that they miss nothing of medical importance.

It is a well-established medical observation that if you perform enough medical tests on even the healthiest person you will eventually find something abnormal. And in Sharif’s case if he had drank a litre of water during the hours before his tests, most of his abnormal blood tests would probably have come back normal.

Considering different ‘class’ of jail accommodation available in Pakistan to people of different backgrounds, the question is that is jail a punishment or a ‘sabbatical’ of sorts for most political ‘prisoners’? There was a time when a sojourn in jail was thought to be a prerequisite for a successful political career.

Many politicians came out of jail with books to their credit and strengthened political credentials. However, Sharif has never been accused of a literary bent or has shown any inclination towards chronicling anything during his previous period of incarceration.

But what is different about Mian Sahib this time around? According to medical reports, Mian Sahib suffers from diabetes, high blood pressure and had coronary bypass surgery last year. And yes he is a little more than a year shy of turning seventy.

As far as Sharif’s health is concerned, I am afraid that with his medical history and the level of medical care available at the jail, he will have to go to a proper hospital every now and then.

His presence in jail might do some good to other inmates if a real attempt is made to improve medical facilities where he is at present. That would also decrease the need for moving him in a twenty vehicle convoy to the nearest hospital every other week.

As far as the question I posed above about jail being punishment or not, loss of liberty, in my opinion, is the real punishment for most ‘white collar’ criminals. And I have no desire to delve into the value of punishment as a deterrent for further crime. However, conditions in our jails must be improved and surely even ordinary convicts deserve to be treated in a humane fashion.

Hopefully Mian Sahib does not have to spend the next ten years in jail. As a physician, I can say with some assurance that considering his known medical problems he is unlikely to survive ten years in a jail. As he gets older his medical problems are going to get worse and he will require increasing levels of medical care that are unlikely to be available even in the best jail hospital.

Life and death are in God’s hands but as human beings we can make some determinations about what happens in certain circumstances. One of the areas of some interest to me over the years has been the effect of loneliness especially the loss of a long-time partner or spouse on a person’s health.

Both in my personal as well as professional experience I have seen surviving spouses that lose a partner of many decades often go into what can only be called a ‘death spiral’. A major social and family intervention is then often needed to prevent that person from following a loved one on to the great unknown.

Sharif’s wife, Begum Kulsoom Nawaz, has evidently been unconscious and on life support for quite some time. Medical experience suggests that if a person has been unconscious for that long after a ‘cardiac arrest’, the chance of brain recovery is very slight or perhaps even non-existent. And I am sure Sharif knows that.

I have a vague suspicion that when Sharif decided to return to Pakistan a few weeks ago, for all practical purposes he said his final goodbye to his wife before he left London. Sadly this loss of a long term partner in my opinion will eventually put his life at a greater risk than anything that can happen to him in a jail.

If Sharif had a literary bent, and if he did end up incarcerated for an extended period of time then he could find authorship a useful diversion as well as a form of emotional release. This would be extremely ‘therapeutic’ considering both the political as well as the personal misfortune he is facing at this time.

Most political observers are only interested in the political consequences of Sharif’s incarceration. What will happen to his political party without him out there leading it and being seen as its leader in the political arena is the question that almost everyone is asking and trying to answer. And no, I have no position on Sharif and his guilt or innocence.

As a physician I am worried about Sharif himself. Right now I would not be surprised that in his moments of solitude it is his impending personal loss that occupies most of his thoughts.