A Retrospective entry~
It was 8pm, when the SN informed me regarding a terminally-ill patient; a young lady, at her 30s, deteriorating, while her children helplessly looking at her, unable to understand what really happened to their beloved mother. Weakened by her advanced metastatic disease, she was unable to hold her crying daughter. The relatives kept calling for me, the ‘night-shift’ doctor, asking what else could be done to lighten her unbearable pain.
The environment really gave me a heart ache. This lady with androgenic appearance reminded me of my late aunt, who died of advanced stage cervical & ovarian cancer. It was as if she was right in front of me, gasping for air at her last moments before she departed from this world. I tried my best to hold my emotions, acting cool, examining the patient as if ‘this is just another case’ waiting for the death angle to come. (Well, he is always right behind us, isn’t he?)
This is a NAR case, my senior doctor told me. (NAR = non active resuscitation). So, it was a relief – to us, doctor on-call and the night-shift nurses. Well, NAR does not mean we could just let the patient die, we still need to save the patient, but to a certain extend. The patient was not for intubation (putting tube into the trachea through the mouth to assist breathing) or CPR (cardiopulmonary resuscitation), that was for sure. All I need to do was to run fluids and inotropes to the maximum doses if patient desaturates and the BP drops. (Well, it was not that simple, but it’s the simplest way to explain – for now).
It was not a surprise, when her BP started to drop, then went plateau, fluctuated then dropped again despite fluid challenge and inotropic support. The heart rate rised in response to low BP. To my relief, the senior doctor had already consulted the husband regarding the current condition – that her time had not much left. I have to admit, it was not an easy task indeed, to break the bad news. Altough some people might think, it is as simple as telling ‘Your wife/daughter is going to die’. The mother noticed my ‘this-is-not-good’ face. Plus, she was from a well-educated family, of course she understands what the low BP means.
“Doktor, buat lah apa-apa untuk selamatkan anak saya. Kesian anak-anak dia, semuanya masih kecil!”
Some might immediately give this answer, ‘this is the best i can do for your daughter’. But I just could not throw it out. I was not so sure myself, that I had done enough for her. And I was still putting hopes on Allah, that the BP would respond to whatever I had given her. But Allah’s decree is always beyond our might and expectations. He would take back our love ones whenever He wishes to do so.
And at 4.30am, she breathed her last breath.
We left to settle other matters after my senior doctor consoling the family, and to allow them to spend time with the deceased before sending her to the mortuary. After a few moments, the cubicle became crowded – with the relatives.
At 6.30am, when I was about to leave to another ward for my daily duty, the mother in-law stopped me. And out of sudden, she hugged me and cried on my shoulder.
“Doktor, terima kasih sebab sabar melayan kerenah menantu saya. Terima kasih sebab cuba sedaya upaya untuk selamatkan dia.”
I was so shocked initially that I could not speak a word. I hugged her back to show my sympathy.
“Mak Cik, saya minta maaf. Tak banyak yang saya dapat buat untuk anak makcik. Semoga makcik dan keluarga sabar. Insya’Allah, Allah sayangkan dia dan kita semua. Sebab tu Allah ambil dia untuk beri ujian kepada kita.”
I tried to smile, and hid my wistful eye.
After a while, I gently disengaged her embrace. And another lady – the biological mother – came and embraced me with tears.
“Nak, mackcik menyesal tak tunggu dia di hospital semalam. Makcik tak sangka makcik tak sempat jumpa dia.”
“Makcik, insya’Allah ada hikmahnya kenapa makcik tak ada tadi. Mungkin kalau makcik lihat sendiri dia pergi, lebih sukar untuk makcik terima kenyataan ni.”
“Betul tu, bila dah tau lebih awal, tak adalah terlalu terkejut bila tengok dia dah tak ada.” The mother in-law-added.
“Dia satu-satunya anak perempuan makcik. Makcik dah tak ada anak perempuan selain kamu.”
“Makcik kan ada ramai cucu perempuan. Sama-sama kita doa, supaya diorang jadi anak-anak soleh.”
“Kita sama-sama doakan untuk arwah anak makcik, semoga Allah ampunkan dosa-dosa dia dan terima amalan dia. Doakan juga untuk yang tinggal, semoga sabar dengan ujian Allah. Insya’Allah, Allah sayang kita semua.”
The mother held me even tighter, and cried even louder on my shoulder. I just hoped that I have said nothing wrong.
This time I did not try to release myself until she stopped crying.
“Nak, siapa nama kamu? Nanti kalau jumpa makcik di mana-mana, tegur makcik ya!”
Abu Hurayra reported that the Messenger of Allah, may Allah bless him and grant him peace, said, “Remember frequently the thing that cuts off pleasures,” i.e. death.” [at-Tirmidhi]
Abu Hurayra reported the Messenger of Allah, may Allah bless him and grant him peace, said, “Race to good actions as fast as you can. What are you waiting for except delayed poverty, oppressive wealth, debilitating illness, dottering senility, a swift death or the Dajjal? Or are you waiting for an unseen evil, or the Last Hour? The Last Hour will be most bitter and terrible.“ [at-Tirmidhi]
Abu Huraira (Allah be pleased with him) reported Allah’s Messenger (may peace be upon him) as saying: When a man dies, his acts come to an end, but three, recurring charity, or knowledge (by which people) benefit, or a pious son, who prays for him (for the deceased). [Book 013, Chapter 4, Number 4005 : Sahih Muslim]
Allah Almighty says, “Every self will taste death. You will be paid your wages in full on the Day of Rising. Anyone who is distanced from the Fire and admitted to the Garden, has triumphed. The life of this world is only the enjoyment of delusion,” (3:185)
May this physically-and-mentally-challenging-work gives me the most beneficial lesson; A reminder of Death.