Punjabi has an ordinary word for a crowd, ਭੀੜ (bhīṛ), and the word has a second meaning that the dictionaries list right under the first. A bhīṛ is a throng, a press of people, a rush at a gate. It is also distress: hardship, adversity, the condition of being in trouble. The language does not keep the two senses in separate rooms. To say that a bhīṛ has fallen on someone is to say that bad times have come, and the image underneath the idiom is of being pressed on every side, with no space to move.
The same language has a warm word for many people in one place, and it is just as ordinary. ਰੌਣਕ (raunak) is the brightness and bustle of a place that is full: a wedding house on the night before, a bazaar at festival time, a street that has come alive. A house with raunak is a house with people in it. A house without it is ਸੁੰਨਾ (sunnā), empty in the way that makes visitors lower their voices. Between bhīṛ and raunak the language holds most of what anyone needs to know about crowds: that they can be the thing that crushes and the thing that consoles, and that the difference is not the number of people but what they are there for.
Amritsar is a city that is seldom empty. The precinct of the Darbar Sahib keeps a day that begins in the small hours and ends late at night, and the city around it has the density of an old trading town that grew up on the roads to Lahore and the hills. A family physician’s waiting room is seldom empty either. This essay draws a line between the two, and it is the kind of line that a memoir is tempted to draw too quickly. Growing up among crowds, the tempting story goes, taught the future doctor to see individuals in a mass, to be patient in a queue, to feel at ease in a full room. I want to test that story rather than tell it. This essay does not recount any particular day, festival or journey from my years in Amritsar; the city’s crowds are described here as public knowledge, and the lesson in the title is an argument made now, not a moment of learning recalled. The question is a simple one with a difficult answer. Is a crowd one thing, or many things sharing a space? And what, if anything, does knowing crowds teach a physician, and where does the lesson stop?
Three Crowds, Three Grammars #
The most famous crowd in Amritsar moves in a circle. Visitors to the Darbar Sahib leave their shoes, cover their heads, wash their feet at the threshold and walk the marble parikrama around the pool, and the walk has a direction that almost everyone follows without being told. Reported figures put the number of visitors on an ordinary day well above a hundred thousand, and the free kitchen, the langar, is reported to serve more than a hundred thousand meals a day. Another essay on this site describes the precinct in the hour before dawn, when it is nearly quiet; at most other hours it is full. What makes the crowd remarkable is not its size but its grammar. It is a crowd of circulation, in which everyone is moving the same way at roughly the same pace toward no exit in particular, and in which the purposes of the people inside it are almost entirely hidden. One person is keeping a vow. Another is grieving. Another comes every evening from habit, and another has come from the other side of the world with a camera. A volunteer with a broom is working against the current of feet. The crowd looks like one thing from a rooftop. From inside, it is thousands of reasons walking together.
The bazaars that radiate from the shrine have a different grammar, the grammar of exchange. Movement there is stop and start: people halt at a stall, step back into the stream, cross it at an angle to reach a shop on the other side, wait while a cycle-cart squeezes past. The purposes are more visible, because they are attached to goods, but they collide constantly. A shopkeeper wants the passer-by to stop; the passer-by wants to get through; the porter with a load on his head wants everyone to stop at once and let him by. The bazaar’s crowd is a negotiation conducted at walking pace, with glances, small sounds, a hand raised a few inches, and it works because most people in it have learned the moves. It works less well for those who have not.
The railway station has a third grammar, the grammar of departure, and it is the only one of the three governed by a clock. A crowd on a platform is a crowd whose members must all be in particular places at particular minutes, and its density rises and falls with the timetable. The train that ran for most of the twentieth century as the Frontier Mail, between Bombay and the north-west, was renamed the Golden Temple Mail in 1996 and runs to Amritsar Junction still; long-distance trains of that kind gather a crowd on the platform before they arrive and then disperse it in the few minutes when everyone is trying to reach a different door. The station crowd is the most anxious of the three, because its purposes all converge on a single deadline, and the most impersonal, because almost no one in it will see anyone else again.
Three crowds, then, in one city, and they share little except density. Each has its own pace, its own rules, its own way of making room. To speak of “the crowd” as though it were one kind of thing is already to have stopped looking.
The Convalescent at the Window #
Two writers in the first half of the nineteenth century looked hard at the crowds of London, and between them they described the two temptations that face anyone who watches many people at once. Both temptations are familiar to clinicians.
Edgar Allan Poe’s story “The Man of the Crowd,” published in 1840, is narrated by a man recovering from an illness. “For some months I had been ill in health,” he says, “but was now convalescent,” and in the heightened appetite of recovery he sits at the bow window of a London coffee-house one autumn evening and watches the street fill. At first he looks at the passers-by “in masses,” as he puts it. Then he begins to sort them. He reads the noblemen and merchants by their decent dress and business-like demeanour, the senior clerks by their sober coats and the right ears that years of pen-holding have made stand off from their heads, the pickpockets and gamblers by small tells he is pleased to have noticed. The pleasure of the passage is the pleasure of classification, and anyone who has trained in a field that teaches pattern recognition will recognise it. Then a face appears that he cannot classify, the face of an old man in which he seems to read a dozen contradictory things at once. He follows the man through the night and the following day, through bazaars, theatres and gin palaces, and learns only that the man seeks out the densest crowds and sickens when they thin. At the end the narrator gives up. The old man, he concludes, “refuses to be alone”; he is “the man of the crowd,” and he cannot be read. Poe frames the story with a German phrase about a book, er lasst sich nicht lesen, it does not permit itself to be read.
The story is a fable about the limits of the classifying eye. The narrator is good at types, and his skill is real. But the moment he meets a single person whom the types do not fit, his method has nothing to offer except pursuit, and pursuit yields nothing. A clinician should feel the sting of that. Medicine trains its practitioners to see patterns in many people so that they can recognise them in one, and most of the time the training serves the patient. The danger is in the window: in watching from a vantage that makes everyone a type, and in mistaking skill at sorting for knowledge of a person.
Notice, too, whom Poe made his watcher. He is not a detective or a physician. He is a convalescent, a man just out of the sickroom, whose senses have been sharpened by illness and whose appetite for the world has returned all at once. The story is told from the patient’s side of the glass. Anyone who has sat in a crowded waiting room knows that patients classify as busily as doctors do: this one will be quick, that one has brought a folder, the man by the door looks worse than I feel, the woman who arrived after me has been called first. The sorting eye is not a professional deformation. It is what a person does in a crowd when the crowd’s order matters to him and he cannot see its rules.
William Wordsworth’s account of London, in the seventh book of The Prelude, begins from the opposite experience. Walking “amid those overflowing streets,” he finds that the crowd defeats classification altogether:
“The face of every one That passes by me is a mystery!”
Then, lost in that mood, he is stopped by a sight he calls “not rare”: a blind beggar propped against a wall,
upon his chest Wearing a written paper, to explain His story, whence he came, and who he was.
The label strikes him, he says, as “an apt type” of “the utmost we can know, / Both of ourselves and of the universe,” and he gazes at the man’s steadfast face and sightless eyes “As if admonished from another world.”
I find it hard to read those lines without thinking of the clinic. A written paper on the chest that explains a person’s story, whence he came and who he was, is the shape of every chart, every triage tag, every referral letter. Wordsworth’s admonition cuts two ways. The label is the utmost we can know; and the utmost we can know is a scrap of paper. In the same book he sees, in a quieter corner of the city, a workman sitting on a low wall with a sickly baby on his knee, brought out for sunshine and fresher air, bending over the child “with love unutterable,” and he observes that the “huge fermenting mass of human-kind” serves as a background against which single figures stand out with more than their ordinary force. That is the opposite of Poe’s lesson, and the more useful one. The crowd does not erase the individual. Properly looked at, it is what makes the individual visible.
Density Is Not Disorder #
A far more influential theory of crowds came not from the poets but from Gustave Le Bon, a Frenchman who had qualified in medicine without ever practising it and turned to social psychology, and whose book The Crowd appeared in 1895. Le Bon held that a person who becomes part of a crowd “descends several rungs in the ladder of civilisation,” loses his individual judgement, and becomes susceptible to images and suggestion. “An individual in a crowd,” he wrote, “is a grain of sand amid other grains of sand, which the wind stirs up at will.” He did allow that a crowd could be heroic as well as criminal, depending on what it was exposed to, but the core of his view was that the crowd is intellectually inferior to the isolated individual, a kind of temporary madness.
The grain of sand has had a long career. It survives in the language of the “stampede,” in the assumption that people in a dense space will panic, and in a habit of managing crowds as threats. Over the last few decades social psychologists working in what is called the social identity approach have taken it apart with some care. In a 2026 review in the Annual Review of Psychology, John Drury of the University of Sussex summarised two decades of such research, on crowd density, emotion in crowds, the health of mass gatherings and behaviour in emergencies. A recurring finding is that people in crowds do not simply lose themselves. When they come to see the people around them as members of a shared group, they coordinate, support one another and, in emergencies, often help strangers at some risk to themselves.
One small study captures the turn. Daniel Novelli, Drury, Stephen Reicher and Clifford Stott surveyed people at two crowded events in Britain, an outdoor music event and a demonstration march, and published the results in 2013. At the music event, the more strongly people identified with the crowd, the less crowded they felt, and feeling less crowded was linked to more positive emotion. At the march, those who identified more strongly were more likely to be found in the densest part. The authors concluded that their results were inconsistent with approaches that treat crowding as inherently unpleasant. The same density means different things depending on whether the people pressed together think of one another as strangers or as us. Punjabi had arrived at the same distinction long before, in the difference between bhīṛ and raunak.
Research at a vast Indian gathering makes the point and then complicates it. Nick Hopkins and Reicher, reviewing work conducted at the Magh Mela, the month-long winter pilgrimage at the confluence of rivers at Allahabad, now Prayagraj, described how a sense of shared identity among pilgrims led them to see others as sources of support, which contributed to their sense of health and well-being. A related study described pilgrims enduring near-freezing nights by interpreting the cold through their identity as pilgrims and by helping one another. But Hopkins and Reicher also noted the other side: the same shared identity may reduce people’s disgust at sharing utensils and drinking vessels, and so ease the spread of infection. Belonging makes the crowd bearable, and sometimes makes it dangerous.
None of this means that crowds are safe. It means that the danger lies somewhere other than where Le Bon put it. The critical factor in crowd disasters is density, not size or mood. Reference accounts of crowd safety put the threshold roughly like this: at up to about five people per square metre a space feels cramped but manageable; at eight to ten people are pressed against one another and can be carried along against their will, and pressure can travel through the mass in waves. In 2007 Dirk Helbing, Anders Johansson and Habib Zein Al-Abideen published an analysis of video recordings of the crowd disaster at Mina during the Hajj on 12 January 2006. They found two sudden transitions, first from smooth flow to stop-and-go movement, then to what they called turbulent flow, in which eruptions of pressure, comparable in their description to earthquakes, displaced people abruptly and caused them to fall. The crowd scientist Keith Still put the conclusion bluntly, as quoted in The Guardian in 2015: “People don’t die because they panic. They panic because they are dying.” The disorder that onlookers see is the consequence of physics in a confined space, not the cause of the disaster.
Five Narrow Entrances #
Amritsar’s most remembered crowd teaches the same lesson in the worst possible way. On 13 April 1919, the day of the Baisakhi festival, a large crowd of protesters and festival visitors had gathered in the Jallianwala Bagh, a garden enclosed on all sides by houses and walls, with a handful of narrow entrances, most of them kept locked. Troops under Brigadier-General Reginald Dyer blocked the main exit and, without warning the crowd to disperse, opened fire, aiming toward the densest sections near the narrow exits where people were trying to escape. The firing went on for about ten minutes. The official figure was 379 dead; other estimates are far higher. (Another essay on this site places the massacre in the history of the city I grew up in.)
What made the Bagh lethal was not the crowd. It was unarmed and, until the firing began, peaceful. What made it lethal was the enclosure, the few narrow ways out, and the force directed at it. The crowd’s density, which had been harmless while it listened to speeches, became the means of its destruction the moment it needed to move and could not. People died at the exits because the exits were where everyone had to go.
A smaller and more recent disaster in the city carries a different warning. On 19 October 2018, at a railway crossing in the city called Joda Phatak, spectators who had gathered on and around the railway tracks to watch the burning of an effigy of Ravana at Dussehra were struck by a passing train; about sixty people were killed. I do not raise it in order to assign blame, which others have argued about. I raise it because it shows a property of crowds that has nothing to do with Le Bon’s madness. A crowd with a purpose has a direction of attention. Everyone on that ground was facing the fire. The danger came from the side the crowd’s purpose had turned it away from.
That property will matter when this essay comes to the clinic. A waiting room also has a direction of attention. Everyone in it is facing the door through which their name will be called.
The Person Who Cannot Move Easily #
When people speak of being comfortable in crowds, they usually mean that their bodies fit the crowd’s pace. A crowd moves at the speed that suits an able adult walking without a load, and its unwritten rules are written for that person. Everyone else experiences a different space.
A small child in a bazaar crowd sees knees, bags and the backs of legs, and moves by holding a hand she cannot let go of. An older person at the edge of the parikrama waits for a gap that the stream does not offer, or keeps to the margin where the pace is slower and the footing is uneven. A person using a stick, or a wheelchair, meets a city built of steps, thresholds, gutters and uneven paving, in which every gathering place has a raised edge somewhere. A woman carrying a sleeping child cannot raise a hand to make room. A porter with a load on his head has the right of way in principle and none in practice. A person who is blind, like Wordsworth’s beggar, stands still while the crowd flows round him, and becomes, in the poem, the one fixed point in the whole moving city.
Each of these people is in the same crowd as the able adult, and none of them is in the same place. The comfort that a lifelong city-dweller feels in a dense street is real, but it is a property of a particular body meeting a particular space, and it can make that body strikingly blind to the experience of others. This is the first reason to distrust the story that a childhood among crowds produces empathy. It can just as easily produce the opposite: an ease so complete that the person who is struggling at the edge does not register at all. Public standards for accessible buildings and transport exist in many countries for exactly this reason. They are written for the people whom the crowd’s natural pace leaves behind, by people who learned not to trust their own comfort as a measure of a space.
There is a second reason to be careful here, which is the habit of romanticising density. Old cities are often praised, by those who love them, for their vitality, their closeness, the way their lanes force strangers into contact. Much of that praise is deserved. But a lane that is vital for one person is impassable for another, and a celebration of the bazaar’s raunak that never asks who cannot get through it is a celebration written from the middle of the stream.
A Queue Distributes More Than Time #
A queue is a crowd that has agreed on a rule, and the rule usually looks like fairness. First come, first served: the person who arrived earliest is attended first, and everyone can see the order. But a queue distributes much more than time, and what else it distributes is seldom equal.
The psychology of waiting has been studied for decades. David Maister’s short essay of 1985, “The Psychology of Waiting Lines,” which another essay on this site reads in the setting of an early-morning waiting room, proposes among other things that uncertain, unexplained and unfair waits feel longer than known, explained and equitable ones, that a wait before service begins feels longer than one after it has started, and that anxiety lengthens every wait. Read with a crowd in mind rather than a single customer, those propositions say something Maister did not set out to say. Each of them describes an inequality. The person who has a book, a companion or a phone waits a shorter wait than the person who has nothing. The person who understands the system, who knows which window, which form, which line, waits a known wait; the person who does not is never sure whether the line she is standing in is the right one. The person who can afford to stand for an hour waits differently from the person whose legs or heart will not allow it, or who must be back at work, or who has a child to collect. A queue that is visibly orderly can be deeply unfair in what it asks of different people, and the orderliness makes the unfairness harder to see.
A queue also has an informal economy that its visible order conceals. Places are held for absent relatives; a family takes turns standing; someone who knows a clerk is waved forward; someone carrying a letter from an official is sent to a different window. None of this is necessarily corrupt, and some of it is simple kindness. But the person who stands alone, with no relative to relieve her and no acquaintance to call on, experiences the same line as a different and longer thing. The single file is democratic in its geometry. It is not democratic in what people bring to it.
Punjabi Sikh practice contains a striking counter-model, which another essay on this site discusses in the context of the family table. In the langar, people do not line up to collect food. They sit in rows on the floor, the pangat, and the food comes to them, carried down the rows by volunteers. The arrangement removes the queue’s central competition. No one gains by pushing, because where you sit does not determine what you get; no one is served less for being slow, or old, or alone. It is not that the pangat has no order. It is that the order has been designed so that the people who move least are not penalised for it. The burden of movement has been shifted from the people being served to the people serving.
What the Waiting Room Shares #
The resemblance that the title draws between a city and a clinic is real, and it can be stated exactly. A waiting room is a crowd of overlapping purposes. One person needs a prescription renewed. Another has a child with a fever. Another has come about a form. Another has been worried for three weeks about something she has not told anyone, and has rehearsed in the car what she will say. Another is an older man who says nothing at all, and whose quietness is itself a symptom no one has noticed. They share a room and a door and almost nothing else.
Medicine long ago decided that the queue’s rule is not good enough for it. The idea is usually traced to Dominique Jean Larrey, surgeon to Napoleon’s armies, who established a rule that the wounded should be treated according to the seriousness of their injuries and the urgency of their need, regardless of rank or nationality. Triage, from the French trier, to sort, replaces the justice of arrival with the justice of need. It is one of the moral achievements of modern medicine, and it is also a problem, because it depends on need being visible. Bleeding is visible. Shouting is visible. A clear, fluent account of chest pain is visible. Stoicism is not. Neither is the patient who does not speak the language of the front desk, or the one who does not want to be a bother, or the one whose danger is real but quiet.
In 1971 the general practitioner Julian Tudor Hart, who practised for thirty years in Wales, named a pattern he had seen across whole populations: the availability of good medical care tends to vary inversely with the need of the population served. He called it the inverse care law. Inside a single waiting room, a small version of the same law operates. The people most able to make their urgency visible are often not the people in greatest need, and a system that responds to visibility will tilt, without anyone intending it, toward the articulate and away from the quiet.
This is where the lesson of Joda Phatak returns. A waiting room’s attention faces the door. The receptionist watches the screen; the clinicians work through the list; the patients watch for their names. Danger, when it comes, may come from the side the crowd’s purpose has turned it away from: the person on the bench whose breathing has changed, the child who has stopped fussing and gone still. Seeing the crowd as purposes, rather than as a line, is not a sentimental exercise. It is a matter of where one looks.
The research on shared identity adds a further, less comfortable observation. A waiting room is very nearly the purest example of a crowd of strangers. Its chairs are set in rows facing one way, as on a platform. Its occupants avoid one another’s eyes, keep their voices down, and guard a small territory of bag and coat. Nothing in the room invites them to think of one another as a group, and Maister’s observation about solitary waiting, that it drags more than waiting shared with others, describes the result. The density of a full waiting room is density without raunak: all of the pressure of a crowd and none of its consolations.
Modern practice has also moved much of the crowd out of the room altogether. An appointment system is a queue stretched across days and weeks, and the people standing in it are invisible to one another and, in an important sense, to the clinic. They are at home, or at work, waiting for a date. The visible crowd on the chairs is only the front of a far longer line whose members cannot see how many are ahead of them, cannot tell whether they have been forgotten, and cannot make their urgency visible to anyone except by telephoning, which is its own small queue. Everything Maister wrote about uncertain and unexplained waits applies to this hidden crowd with special force, and the inverse care law operates in it as well: those best able to work the telephone, the portal and the cancellation list move up, and those least able stay where they are. A city’s crowd is at least present to itself. The calendar’s crowd is not.
Where the Analogy Fails #
The title promises a lesson, and the honest course is to see how much of it survives cross-examination.
Growing up among crowds confers no expertise in crowd safety. The science of density, flow and bottlenecks is a technical field, built on measurement and modelling and hard experience, and the comfortable instincts of a city-dweller are not a substitute for it. The researchers who analysed the Mina video found transitions in crowd flow that called many previous simulation models into question; the people inside that crowd could not have seen them coming. Comfort in a dense place is not safety, and it can be the opposite of safety, because the person who feels at ease is the person least likely to notice that the density has crossed a line.
Nor does it confer clinical judgement. Assessing a single patient is not a skill learned from watching streets. It is learned, slowly and with supervision, from patients; the most a crowded childhood can contribute is a temperament, a tolerance for noise and full rooms, which helps a clinician endure a busy day and has nothing to do with whether he gets the diagnosis right.
Nor, most importantly, does it confer what is sometimes called cultural competence. A person raised in Amritsar knows the bazaar’s grammar, the parikrama‘s direction, the pangat’s rows. That knowledge does not tell him what any particular Punjabi patient believes, fears or wants, let alone a patient from any of the many other communities a physician will meet. To treat a familiarity with crowds of one’s own people as an understanding of persons is to make the narrator’s mistake in Poe’s story: to be so good at types that one forgets they are types. The Magh Mela research makes the same point from another side. Shared identity eases the experience of a crowd, and it also lowers the guard that keeps infection out. The feeling of belonging is not a reliable guide even to one’s own safety, still less to someone else’s needs.
What survives these objections is smaller than the title promises and, I think, more useful. A city of crowds does not teach a person how to manage crowds or how to understand patients. It can teach a habit of perception: that a dense space is not one thing, that its order and its fairness are different questions, and that the people it serves worst are the ones easiest to overlook. Whether a particular person learns that habit from a city is not something a city can guarantee.
Room for Another Person’s Purpose #
Punjab’s year is punctuated by the ਮੇਲਾ (melā), the fair, a word of the same family as the verb ਮਿਲਣਾ (milṇā), to meet. Fairs gather people after the harvest and on festival days, at shrines, riverbanks and crossroads, for music and wrestling, for sweets and bangles and cattle, and above all for one another; the crowd in the Jallianwala Bagh in 1919 included pilgrims who had come to the city for Baisakhi. At a mela the crowd is not an obstacle on the way to some other purpose. It is the purpose. People go for the raunak, and come home tired and pleased to have been pressed among so many others. Le Bon’s grain of sand would not recognise the place. Neither, I suspect, would Poe’s narrator, watching from behind glass.
A clinic’s crowd is never that. No one comes to a waiting room for its raunak. Everyone in it has come with a bhīṛ of their own, in the other sense of the word, a trouble that has pressed on them enough to bring them through the door, and the room gathers those troubles and sets them side by side on a row of chairs. The waiting room is a bhīṛ in both meanings at once: a press of people, each carrying a pressure. That double sense seems to me the most exact description of the place that the Punjabi language offers, and it is a better description than any I could have arrived at by watching streets.
If Amritsar taught anything that bears on medicine, I would put it this way, as a present conviction rather than a memory. A crowd is many purposes sharing one space, and the work of anyone responsible for a crowd, a city planner, a volunteer in the langar, a receptionist, a physician, is to make room for purposes that are not one’s own: to notice the person at the edge who cannot get into the stream, to tell the person on the bench how long the wait is likely to be, and why, to look away from the door now and then, toward the side the room is not facing. None of that requires a childhood in a crowded city. It requires only the refusal to see a mass where there are persons, which is a refusal anyone can learn, and which the crowd, rightly looked at, keeps asking for.
Evidence and Editorial Note #
Documented findings. The essay relies on the author’s public biography: upbringing in Amritsar; practice as a family physician in California; Punjabi as his first language. Punjabi ਭੀੜ (crowd, throng; also distress, adversity, hardship): Wiktionary, “ਭੀੜ”, citing the Punjabi University dictionary; ਰੌਣਕ and ਸੁੰਨਾ are given as general usage. Reported visitor numbers at the Darbar Sahib (over 150,000 a day, The Times of India, 2012) and langar meals (over 100,000 a day, BBC Travel, 2023): as cited in Wikipedia, “Golden Temple”; the essay rounds both conservatively. The Frontier Mail (1928–1996) renamed the Golden Temple Mail in 1996: Wikipedia, “Golden Temple Mail”. Edgar Allan Poe, “The Man of the Crowd” (1840), quoted from The Works of Edgar Allan Poe, vol. 5 (Project Gutenberg eBook 2151). William Wordsworth, The Prelude (1850 text), Book VII, “Residence in London,” quoted from The Poetical Works of William Wordsworth, ed. William Knight, vol. 3 (Project Gutenberg eBook 12383). Gustave Le Bon, The Crowd: A Study of the Popular Mind (1895; English translation 1896), quoted from Project Gutenberg eBook 445; his medical degree (Paris, 1866) without practice: Wikipedia, “Gustave Le Bon”. John Drury, “The Psychology of Crowd Behavior,” Annual Review of Psychology 77, 2026, 339–364 (PubMed 40763250); J. Drury and colleagues, “Facilitating Collective Psychosocial Resilience in the Public in Emergencies,” Frontiers in Public Health 7, 2019, 141 (PubMed 31214561). D. Novelli, J. Drury, S. Reicher and C. Stott, “Crowdedness mediates the effect of social identification on positive emotion in a crowd,” PLoS One 8(11), 2013, e78983 (PubMed 24236079; music event n = 48, demonstration n = 112). N. Hopkins and S. Reicher, “The psychology of health and well-being in mass gatherings,” Journal of Epidemiology and Global Health 6(2), 2016, 49–57 (PubMed 26164280); K. Pandey and colleagues, “Cold comfort at the Magh Mela,” British Journal of Social Psychology 53(4), 2014, 675–690 (PubMed 24261786). Density thresholds (about five per square metre manageable; eight to ten dangerous) and the role of density rather than size: Wikipedia, “Crowd collapses and crushes”, citing Haghani and Lovreglio, Science 2022, among others; Keith Still’s remark as quoted by Leo Benedictus in The Guardian, 3 October 2015, cited in the same article. D. Helbing, A. Johansson and H. Z. Al-Abideen, “The Dynamics of Crowd Disasters: An Empirical Study,” Physical Review E 75, 2007, 046109 (arXiv physics/0701203, abstract). Jallianwala Bagh, 13 April 1919 (enclosed garden, narrow entrances mostly locked, main exit blocked, firing about ten minutes, official toll 379 with higher estimates): Wikipedia, “Jallianwala Bagh massacre”. Joda Phatak, 19 October 2018 (spectators of a Dussehra effigy burning on and around the tracks; at least 59 deaths, later reports 62): Wikipedia, “Amritsar train disaster”. David H. Maister, “The Psychology of Waiting Lines” (1985): the author’s website (davidmaister.com). Dominique Jean Larrey and the triage of wounded by severity regardless of rank or nationality: Wikipedia, “Dominique Jean Larrey”. Julian Tudor Hart’s inverse care law (1971): Wikipedia, “Inverse care law”. The Punjabi ਮੇਲਾ and its kinship with ਮਿਲਣਾ are stated as general usage. Vendor representations. None.
Recollection and tradition. That the author grew up in Amritsar is biography. The essay recounts no particular day, festival, journey, queue or crowd from his life, and no clinic, patient or employer; the crowds of the Darbar Sahib, the bazaars and the railway are described as public knowledge, and the figures in the waiting room are general descriptions, not patients. The customs of the parikrama and the langar’s pangat are described as widely observed practice, without claims about what all Sikhs believe.
Analysis and forecast. The reading of Poe and Wordsworth, the three “grammars” of crowds, the application of crowd research and Maister’s propositions to clinic waiting rooms, and the argument about the limits of what a city can teach are the author’s interpretation and conviction as of November 6, 2026. Nothing here is crowd-safety guidance. Independence. This essay is not sponsored by any institution, company, health system or technology developer. It is personal reflection, not medical advice; readers seeking care should contact their own physician’s office.
About the Author #
Kanwar Partap Singh Gill, MD, traces his family roots to Khadur Sahib in Punjab’s Majha region and grew up in Amritsar. He attended Spring Dale School and completed pre-medical studies at Khalsa College in 1994–1996. He earned his MBBS from Sri Guru Ram Das Institute of Medical Sciences and Research in Amritsar in 2002.
He completed PGY-1 at the University of Arkansas for Medical Sciences in Little Rock in 2007–2008, and PGY-2 and PGY-3 with UCSF Fresno at Community Regional Medical Center from 2008 through 2010. He has practiced medicine in California since 2010.
His career has crossed four distinct information eras: predominantly paper-based medicine, early and fragmented electronic records, the integrated-EHR era, and the emerging age of generative and agentic artificial intelligence.