Tag Archives: hadith

The Expiry Date

This morning I read drkategranger’s blog regarding her expiry date (she is a doctor with terminal cancer who talks about death so candidly, it inspires. I would absolutely recommend!!!). The blog and some of the responses to it got me to thinking about death. I have already written about dying and the fact that I fear it not so much. As a Muslim, I tend to see death as just one of those certainties of life so I treat it quite matter-of-factly. This blog is will be further musings about my experiences of death. I will start with a quote from Hadith (Islamic teachings) which summarises how I generally see life and death:

Al-Hasan Al-Basrî said:
‘The life of this world is made up of three days: yesterday has gone with all that was done; tomorrow, you may never reach; but today is for you so do what you should do today.’ Al-Bayhaqî, Al-Zuhd Al-Kabîr p197

I am generally an optimist or more accurately an optimistic realist so I try not to be morbid and I am generally not one to dwell on death. However, I have had times in my life where the thought of dying has crossed my mind. Last winter was a pretty bad time for me. I was working in the hospital that inspired me to become a paediatrician (which still inspires me) but I was in a job with a particularly toxic individual who succeeded in poisoning the atmosphere. I became depressed after 6 weeks of this. So much so that I hated waking up every morning I was scheduled to work. It got to a point that I would lie in bed, sleepless and think ‘would it be that bad if I didn’t wake up in the morning?’ As soon as the thought came to my mind, I would feel guilty and terrible. Guilty because I knew that my life really wasn’t that bad and that there was so much for me to be grateful for. Terrible because I knew my death, although insignificant in the grand scheme of things, would be horrible for my nearest and dearest. My mama especially. I got through those 4 months because my husband was there and would not let me sink into the depths of depression that kept pulling at me. Thank you George!

I am now back to my normal sunny self despite some current work horrors. As a newly-qualified doctor back in 2009, I dealt with death day in, day out especially on my first job on gastroenterology at a busy inner-city hospital. After the initial shock, I got used to it. Not that I didn’t care or it didn’t bother me but I dealt ok with it. There are 2 patient deaths from those days that have stayed with me. Both died of alcoholic liver disease. Both men in their 40s.

The first patient died slowly from hepatorenal syndrome (HRS). Basically with chronic liver failure, if your kidneys too fail, you will die soon because that means 2 of your 4 vital organs are dead or dying, unless you get brand new organs (i.e. transplants). As things currently stand, you cannot be put on the transplant list for a new liver if you are still abusing alcohol because the new liver will get damaged just the same and it is considered a waste of an organ that is in high demand but short in supply. So with my first patient, who I will call Patient A, when his kidney function tests declined rapidly and nothing we could do medically fixed it, we diagnosed HRS and my registrars and consultants had a meeting with his wife to inform her of the diagnosis and what that meant for the patient. He too was told in due time but because of his liver failure, he was confused and did not fully grasp the fact that his condition was terminal.

He deteriorated slowly over a few weeks but in the meantime, he would ask me daily when he could go home and travel to India to be blessed in the Ganges River. I would mutter something non-committal and beat a hasty retreat out of his side room. Initially, it was clear that his wife knew his death was near. But even she began to belief he would miraculously recover from his liver and kidney failure. Every week, she would say something that made us worry we hadn’t prepared her for the inevitable. Every week we would remind her gently that although she couldn’t see it, he was in actual fact deteriorating judging from his biochemistry lab results and worsening oliguria (he was weeing less and less).

In the week of his death, he suddenly looked well again. If I wasn’t the doctor patiently doing bloods on alternate days and chasing those results and noting the relentless rise in his urea and creatinine, I too would have started to believe in miracles. His wife upon seeing the light return to his eyes and his demeanour brighten plunged headlong into denial and joined him in planning their trip to India to the Holy Ganges River. Less than 24 hours before his eventual expiry date, it was devastating for me to watch her grief as the light in his eyes faded rapidly and he shrunk back into himself. Within 12 hours of his final illness beginning, his strength was gone and his mind with it. His utterings became incomprehensible and he became completely disorientated. The look on her face said it all when we came in to see him on our ward round that morning. We returned the look and she ran out of the room to sob in the corner. He was anuric by then (had stopped weeing completely) with a creatinine of over 400 (in other words, his kidneys had packed up). His liver function tests painted an equally damning picture. We completed his end of life paperwork that morning and when we left work that evening, he was hanging on by the tips of his fingers. We came in the next morning to the news that he had died before the end of the day before. The side room he had occupied for many weeks stood empty, awaiting its deep clean before the next customer.

Patient B was a young alcoholic who had developed liver cirrhosis in the months before I started the job. He had just turned 40 and I don’t think had any idea how serious the consequences of regular alcohol binges could be. Reality hit when another patient who was his ‘neighbour’ on our ward developed HRS and died rather quickly. All of our words of warning had somehow not sunk but with this other patient’s death, his mortality was clear to him. He called me over urgently that afternoon and said ‘Doc, I am ready to change’. I was pleased and felt a sense of accomplishment when I referred him to the rehabilitation programme. His wife found me the next day before they were discharged home to thank me for getting through to him. I was honest to say it wasn’t anything I did.

Unfortunately, he came in a few weeks later unwell with an infection which caused his liver function to deteriorate badly. I was encouraged to hear that he had no touched a drop of alcohol since his last admission. He developed litres of fluid in his tummy and I had to put in a tube into the side of his tummy to drain out all that fluid. He was in a lot of discomfort and fearful for his life and he asked me ‘Doc, am I going to die?’ I hesitated over the words I used but in the end I made no promises. Just that I would do everything I could to help him get through this. At first, it looked like the drain and intravenous antibiotics were effectively doing the job and the next day, the fear was gone from his eyes. I was encouraged by his blood results and left having ordered some more routine bloods for the next morning. Coincidentally, at I was securing his abdominal drain, I carelessly dropped the needle I was using to suture and when I went to retrieve it, gave myself a needle-stick injury. I had to get a co-doctor to inform him and take blood samples off him to check that he didn’t have any blood borne infections I could catch. He apologised every day after the event like it was his fault I had stuck myself with a contaminated needle. He asked me about those results daily – he seemed genuinely to care for my welfare. This went on for over 2 weeks as he slowly improved.

I was doing the ward round alone one morning when I was called urgently to his side. He was in a great deal of pain and was writhing in his bed with his abdomen larger than before we drained him. He was pale and clammy and his eyes looked like a man staring down the barrel of a gun. I could barely make sense of his words and as I changed his prescriptions, called the blood bank for blood products and prepared to get a new drain inserted. I could see the life begin to ebb out of his eyes. In a panic, I called my registrars and told them I needed them on the ward ASAP because patient B had taken a turn for worse and nothing I was doing was making a difference. The registrar told me to leave the drain for the meantime and focus on reassuring the patient. After I asked the nurses to call his wife in, I went to him and I held his cold hand. I looked into those eyes and I knew in that instant that he was not long for this world. I remember saying a mental prayer that he could hang on for his wife to be by his side.

‘Doc!’ he cried. I squeezed his hand and responded ‘Yes B?’

‘I am dying aren’t I?’ he asked. I looked down and swallowed the lump in my throat. ‘I am here for you B and I will do everything I can to help you. Your Mrs is on her way in.’

‘Stay with me,’ he entreated fearfully. I nodded and again I had to look away because the fear in his eyes was too powerful for me to take in. The rest of it was a blur. His wife made it in before he died but not in time for him to know she was there. He was delirious by the time she got to the ward and as he was slipping away before our very eyes, there was little time to have ‘that conversation’ with his wife. The consultant whisked her away and broke the news to her. She could see that treatment was futile by then and knew that he was on maximal available medical treatment. We had no more to offer. She signed the DNAR (do not attempt resuscitation) forms and we set about making him less agitated. When we finally called it a day, he was less distressed, still mumbling incoherently and his eyes had started to take on that distant look I now associate with death. I came in the next morning to a request to come to the morgue to complete his death certificate and Crem forms so that his wife could lay him to rest. I got a call 3 days after his death to say his blood tests for blood borne infections had come back negative so I was in the clear. I cried in the staff toilets. He would have been relieved not to have put me at risk I think.

What did patients A and B teach me about death and dying? Firstly that when it is your time to go, it is your time to go. Life unfortunately doesn’t usually give you a clearly labelled package with an expiry date on it. Secondly, although death is scary for the person dying, it is actually worse for the person who loves them who has to watch them lose their battle to live and battle their fear of the unknown. Who has to go home and face life without them and rebuild their lives around the hole left by the dead loved one. Who for a very long time will think about their dear departed every morning when they wake up and every night before they fall asleep. Lastly, every human is unique. Despite having the same disease and modifying your risk factors, your body will do its own thing. We doctors can try to influence outcome but whether we succeed or not is not within our power to control. That is beyond science and medicine. That is life. That is God. That is reality. May we all depart this world in the easiest swiftest way possible. Amen

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Thou Shalt not be Extremists!

With all of the recent headlines about Islamist terrorists, ISIS and jihad, you may be forgiven for jumping to the conclusion that the majority of Muslims are terrorists, extremists or at the very least extremist-sympathisers. Or at least that we are all being told to be one of those and that we are stupid enough to fall for the lies and deliberate mis-information. Not so in reality. Majority of us are right bang in the middle of the lane. As with all other groups of people.

Most of us are silent because we lack the motivation to get into a shouting match with the more vocal and more strident extremists and the likes. I hasten to point out that most people, Muslims and non-Muslims alike are like that: apathetic, ‘let someone else sort it’, ‘bury your head in the sand’, ‘go with the flow’ Joe Blogs. Most of us are unhappy with the labels being thrown around and although we try to straighten out those around us with salient facts, it is hard to make a dent into the torrents of lies that are being peddled by the extremists and by the media who love a scapegoat and worship viewer/reader numbers which undoubtedly flourish in the presence of terrorists, death and destruction. Most Muslims are tired of having to defend their very being as if the ‘innocent till proven guilty’ rule does not apply to us because of our faith. Despite the fact that our very lives and daily actions provide ample evidence that we are not in fact extremist or terrorist. Most Muslims are disappointed that people with normal intelligence cannot see through the blatant lies, just as majority immediately saw through Hitler’s propaganda for example or even Tony Blair’s weapons of mass destruction in Iraq whopper.

Here are some Islamic quotes to support this very premise in addition to the one in the image above. Please read and share for those who are in the dark about the actual teachings of Islam.

The Quran says:

  • “God does not forbid you to be kind and equitable to those who have neither fought against your faith nor driven you out of your homes. In fact God loves the equitable.” Qur’an 60:8

These are sayings by the Prophet Muhammad (pbuh):

  • “All mankind is from Adam and Eve, an Arab has no superiority over a non-Arab nor a non-Arab has any superiority over an Arab; learn that every Muslim is a brother to every Muslim and that the Muslims constitute one brotherhood. Nothing shall be legitimate to a Muslim which belongs to a fellow Muslim unless it was given freely and willingly. Do not, therefore, do injustice to yourselves..” The Last Sermon.
  • “Anybody who believes in Allah and the Last Day should not harm his neighbour, and anybody who believes in Allah and the Last Day should entertain his guest generously, and anybody who believes in Allah and the Last Day should talk what is good or keep quiet (i.e. abstain from all kinds of evil and dirty talk).” Abu Hurairah, Sahih Al Bukhari, Volume 8:47.
  • The best of all dealings is the one which is moderate.
  • They are the losers, those who make the religion hard and tough. They imperil themselves who enforce tough practices of Islam. They destroy themselves, those who are extremes. Ibn Masood, Sahih Muslim.
  • Make things easy and convenient and don’t make them harsh and difficult. Give cheer and glad tidings and do not create hatred. Riyadh us-Saleheen, Volume 1:637.
  • A strong person is not the person who throws his adversaries to the ground. A strong person is the one who contains himself when he is angry. Islam on Line 
  • “Religion is very easy, and whoever overburdens himself in his religion will not be able to continue in that way. So you should not be extremists, but try to be near to perfection and receive the good tidings that you will be rewarded.” Bukhari 1:38
  • “The best Jihad is (to speak) word of justice to an oppressive ruler.” Abu-Dawood 2040
  • “Avoid Cruelty and injustice..and guard yourselves against miserliness, for this has ruined nations who lived before you.” Riyadh-us-Salaheen 203

Sayings by some thinkers, Muslims and non-Muslims:

And I end on a comment by Steve Earle who said:

Salam!

Separating the Wheat

I was talking to a friend of my husband’s about the politics of Islam and the current trend of labelling every evil person that happens to be Muslim as an ‘Islamist terrorist’. He is Kenyan and grew up in a mixed Muslim and Christian community in Nairobi like I did in Nigeria. Yet he has also been misled by the media who have an agenda. The current agenda being to fuel all the fire in the islamophobic drama and give them more dramatic headlines. People labour under the misapprehension that majority of Muslims are either terrorists or terrorist-supporter and the rest of us are sympathisers with the fanatical extremist groups. Never mind that these extremists are killing us moderate Muslims more than they will ever kill anyone else. Because they want to silence the voices of moderation.

Anyway, this post is to show you words direct from the Prophet of Islam whose teachings we Muslims try to emulate in everyday life. This to me is how I feel about people of other faiths and even no faith. I like many other moderate Muslims want to live together in harmony. We love our neighbours regardless of religion. Oh and breaking news. 99% of us do live together with our non-Muslim neighbours and friends and even family with no evil designs on them.

Through reading via social media, I found this letter written by the Prophet of Islam, Prophet Muhammad (peace be upon him) where he addresses Christians mainly but I would suggest that actually these words apply to all non-Muslims who interact with Muslims.

I accessed the excerpt from http://www.examiner.com/article/letter-to-all-christians-from-prophet-muhammad

 

(The original letter is now in the Topkapi Museum in Istanbul)

“This is a message from Muhammad ibn Abdullah, as a covenant to those who adopt Christianity, near and far, we are with them. Verily I, the servants, the helpers, and my followers defend them, because Christians are my citizens; and by God! I hold out against anything that displeases them.

No compulsion is to be on them. Neither are their judges to be removed from their jobs nor their monks from their monasteries. No one is to destroy a house of their religion, to damage it, or to carry anything from it to the Muslims’ houses. Should anyone take any of these, he would spoil God’s covenant and disobey His Prophet. Verily, they are my allies and have my secure charter against all that they hate.

No one is to force them to travel or to oblige them to fight. The Muslims are to fight for them. If a female Christian is married to a Muslim, it is not to take place without her approval. She is not to be prevented from visiting her church to pray. Their churches are to be respected. They are neither to be prevented from repairing them nor the sacredness of their covenants. No one of the nation (Muslims) is to disobey the covenant till the Last Day (end of the world).”

English translation from ‘Muslim History: 570 – 1950 C.E.’ by Dr. A. Zahoor and Dr. Z. Haq