S. Akhtar Ehtisham was born in India in 1939 and in 1951, when he was in the ninth grade, moved to the newly-formed Pakistan.

There he completed his studies including university and medical school. Postgraduate work took him to the UK in 1965, then to Nova Scotia, and then to Bath, New York. In this work he contrasts health standards, economic well-being, race relations, and the political atmosphere on three continents during the socially-conscious 1960s and later under bare-knuckle capitalism.

In the 1980s he returned to Pakistan to repay his debt to his country, building a hospital and encouraging international contacts to support professional development in the medical field. He also became involved in the international anti-nuclear war movement.

Anarchic conditions in Karachi drove him back to Bath, New York by 1991. He remains active in Indian–Pakistani physicians’ groups, human rights, and peace organizations.

This sweeping narrative sketches the political and economic realities of the past fifty years while tracing an eventful life from the turmoil following the partition of India and the creation of Pakistan to the present day....

This sweeping narrative sketches the political and economic realities of the past fifty years while tracing an eventful life from the turmoil following the partition of India and the creation of Pakistan to the present day. Discussing politics, government policies, and popular movements, Dr. Ehtisham shows how nations as well as individual lives are shaped by historical events, economic changes, religious fundamentalism, class systems and racial divides. Through his own experience as a doctor and hospital director, he compares the advanced social safety net state of the post-war UK with regimes that are determined to see people "stand on their own two feet" — even when the economic system has already cut them off at the knees.