One day, it’s a few hours to your birthday. Your brother rings you the night before the day, telling you he’s coming over with his troops (wife and daughter) at midnight to cut cake and have tea. You know you must be getting old when you hear yourself telling him you’re going to sleep.

It’s 9pm on a Saturday. Actually, you’re not getting old, you’re just too tired to explain that you’re dead tired because you work a thankless day job in the public sector, trying to fix initially education, but just about everything lately, it seems.

That’s not entirely true, though. The job in itself is meaningful because of the work. But it’s hard work trying to see the goodness in the day.

I mean, you do try, like when somebody at a government department frequently jokes with you about getting a new soundcard because you have an ‘unusual’ voice (read: not really, just different from the standard higher-pitched ones that are the stereotype by which women are identified as female in our social context), you joke back.

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You tell him you’ve checked with Hafeez Centre in Lahore, and they’ve told you this particular soundcard was custom-made and only produced once back in the late 1980s and will never ever be replaced so deal with it.

Or like when somebody else teasingly announces to the rest of the people in a problem-solving session that you’re mostly male in a woman’s body, you laugh it off.

Maybe there are still people who haven’t gotten the memo that confidence and clarity of perspective aren’t the sole property of the men of this country. Or maybe they just need better jokes.

Then you go home every evening, and sit for a long time in silence on a plastic chair in the darkness of the terrace on the upper storey of your home, and wish you had a cigarette to accompany the confusion with which your day has been filled.

So when your brother rings to say he’s really excited about your birthday, what you really want to tell him is that there’s a lot going on in your mind. But you don’t know where to start so you write this piece instead.

The good thing about a January birthday is that life gives you two chances very, very early each year to make a wish, then immediately renew it.

In 2018, I resolve on the 1st of January to become more patient and more comfortable with uncertainty. My wish is granted immediately. Just over a fortnight later, I am lying limply in an A&E bed of an NHS hospital in a corner of London with an implied diagnosis of some kind of hepatitis.

It is likely the result of a recent trip to Lahore for a wedding, during which my best friend and I decide to have a glass of tea from an obscure dark alley behind Main Market.

Because what’s the chance that I will end up with an illness when I haven’t in all these years of flirting with poor sanitation across Lahore’s food spaces? 100%, it turns out.

I ring my father from hospital to tell him I’ve been admitted, and that nobody is quite sure what’s wrong with me. There is understandably a calm panic in his voice. Is your phone charged? is what he asks.

I don’t know what it must be like to be the last remaining parent of the youngest child, receiving a phone call from her from a borough of a cold, damp country hundreds of miles and an entire visa stamp away.

But I do think my father handles this very well. Yes, my phone is charged, and now I’m putting it away because I can’t think straight. He agrees to hang up. For now.

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I know that despite my unfortunate situation, I am privileged. I am a foreigner in the UK with enough residential rights to merit free treatment in one of the world’s best medical systems.

For the first few hours, as the nurses run my initial bloodwork and call for a wheelchair to take me to the toilet because my legs have turned to jelly, I feel lonely and dazed.

Is this what life is like for people who live by themselves? My birthday is two days away. I don’t want to spend it in hospital. This isn’t how things are meant to be.

As a teenager, I used to volunteer at the Shaukat Khanum Memorial Cancer Hospital in the summers. Until I finally demonstrated enough smarts to be placed in their pathology lab, I was always sent to the children’s ward.

I had to bring the playroom to life through lots of arts and crafts. Apparently, the colour cheered up all the sick children with shaved heads and weak, but persistent smiles.

A part of me was never convinced this was possible. Is it possible to be happy when you were running outside in the sun a few weeks ago, and now you have to be wheeled into an artificially cheerful environment?

One day, we celebrated an eight-year-old girl’s birthday. We all wore hats, and cut a little brownie from the café outside, and she drew pictures until she was tired, but as a nurse wheeled her out of the room, she looked back at us with large, round eyes and a wide smile. I never saw her again.

At Watford General, I wear my favourite neon yellow and grey sweater. My eldest sister bought it for me a year ago, and a friend has brought it over for me from home.

All of this happens after considerable effort at my first hospital shower — the only big thing I seek to accomplish on my birthday in 2018.

A nurse from Kenya sits at the corner of my bed and tells me if I were in Kenya, nobody would have let me wear anything yellow with my yellow face. I laugh and tell her that’s how things would be in Pakistan as well.

She smiles, pats my knee, and says, "Well, lucky for us we’re both in England right now!" But as our eyes meet, we’re both missing whatever version of home we hold dear in our hearts.

I send a sickly yellow selfie of myself to my dad to assure him I am still alive. He texts back, "Everyone misses you. We’re not calling because we know you are too exhausted to speak. You’re going to be fine. Hang in there. Happy birthday. We love you. Daddy."

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My father is the reason I sometimes speak in plural. He has spent his entire life reminding me nothing good happens individually. There is a deep satisfaction in the collective even if it means giving up a bit on the individual, he always says.

Collective are the many teams of gastroenterologists that come to check my case. One comes more regularly, and the familiarity is comforting.

He’s tall, pale-faced, broad-shouldered, with warm eyes and a consistent smile. He jokes with me the most, thrilled that he’s got an Oxford PhD with one of the UK’s rarest illnesses under his immediate care.

I am a source of excitement and experimentation for them all because it is very unusual for a young woman to Uber up to an A&E, unstably shuffle to the nurse at reception, and ask her, "Do my eyes look very strange to you? I think I’m dying. I can’t stand up, and I can’t keep anything down. I need help."

The doctor scans his notes, glances up at me, and asks whether my hands look less yellow to me, oh and also, where am I planning to spend today — my birthday?

I muster a weak laugh, more out of physical exhaustion than lack of humour. He knows very well I’m still yellow, and that I am going nowhere — I can barely move, and the admissions unit has told me it is ‘very good’ that I am still alive, given the enzymes in my adult liver are at the deranged levels that they are. That’s EnglishSpeak for utmost relief, nothing short of a timely miracle.

Then the team bundles on towards the next bed — a teenager with a sudden bout of some form of mental illness that has her yelling to nobody in particular, day in and out — and throughout the night — that "God is great, God has the power."

On two nights, I plug my ears with YouTube tracks of air cabin white noise to manage some rest. One night, I am too terrified to sleep because the anti-emetic they inject into me to stop my constant vomiting gives me the most amazing high — a bewildering, floaty feeling I have never experienced before, and one I immediately associate with a sense of dying.

I am convinced if I close my eyes now, I will never open them again. But I do the next day, and a kindly young nurse with blond hair who is also into The Beatles, and whose brother has recently finished a PhD in physics, is standing by my bed checking my vitals.

She sometimes flops into a chair next to my bed, and tells me I’m the easiest patient in this ward because I’m always quiet.

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For a week, somewhere in northwest London, nurses from England, Wales, Spain, India, Sri Lanka, Kenya and Poland look after me, tenderly, willingly, dedicatedly.

On my birthday, they blow up a surgical glove, and tie it to the bottom side of an upturned sick bowl. Across the purple hand, they write in big black letters on medical tape, "Happy Birthday!".

A close friend brings flowers, and although I cannot keep them in the ward, the nurses allow me to see and smell them as a birthday treat from the normal world outside, before whisking them away.

Other friends bring loads of chocolate treats, none of which I can have so I share with the staff, but they are my best friend’s siblings and he is in Lahore and I am here in London, but now a bit of him is with me, too.

My nieces and nephews in Chicago have a big balloon delivered to me that the nurses tie to the side of my bed. My cousin shows up with my aunt and uncle and brings me a really hip apron — her card to me reads, "I know you can’t right now, but soon you’ll be back in the kitchen and loving it."

A friend rides in from near Stonebridge Park, and has to change at Baker Street onto the Metropolitan to come to Watford, which means she had to go all the way into Central London first.

Another friend flies in all the way from Berlin, and trains from Central London to see me on my birthday. She brings me German treats, and has stopped at the Whole Foods near Piccadilly Circus just to get me specific juices, fruits and healthy treats I can try to gnaw on.

She is a very good friend of my brother’s, and when I see her come through the ward doors, it is like a little bit of home has suddenly come to me.

I try to walk with the IV lines fitted into cannulas on both hands, and the dinner lady teases that I’m already trying to lift weights.

The elderly lady across the bed has a daughter called Rebecca who visits every day — she learns I’ve recently completed a DPhil at Oxford, and comes over to congratulate me and wish me a very good birthday.

That night, as I slowly change into my pyjamas, and the lights are dimmed across the ward, the night nurse comes in to check my vitals, and change my IV.

She admires the collection of cards, presents, balloon and treats piled up next to my bed. "Happy birthday, Soufia," she says gently as she draws the curtains shut to leave me to the privacy of Bed 36 of the Acute Admissions Unit of Watford General.

In a few days, I will be discharged. Before I am wheeled past the corner of the corridor in which my nursing staff stands to wave goodbye, I will look back with round eyes and a wide smile. They will never see me again.

In a few months, I will walk again, then even return to my favourite pastime — running. I will go back to work, I will spend June roaming England’s beaches, and I will spend the summer in Lahore nursing my father back to health after a triple bypass.

I will witness history being made as dynastic politics is finally broken in Pakistan through the power of the vote, and I will finally move back to Lahore, to meetings in which I am reminded that I seem more male than female, but also meetings and work colleagues who tell me at random moments of the day that they are glad to have me around.

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I will return to the only kind of service I know, the service of people, to the only kind of life I know, a life of ups and downs.

I will eventually wake up on my next birthday, and go to a French bakery in Lahore with my family and sit across from my father and etch him into my memory.

I will remember where I was this day last year, and I will feel humbled by all the acts of kindness that marked it.

I will know, as the day winds down, that what is going on in my mind is nostalgia, not for a specific place, person or even time.

It is nostalgia for a sense of happiness — the feeling that finally compels me to get up from the plastic chair on a dark terrace and return downstairs to normal life, the realisation that bewilderment does not just fade, nor should it be left unaddressed, but that bewilderment is best disarmed through the fundamentals of being human: through dignity, service, and the continued resolve to be kind.