Living and Dying- Salim Parker
‘When I was living, I wanted to die. Now that I am dying, I so much want to live.’ She sounded distant and detachedly melancholic. How I wished that I could see her face revealing hidden emotions, see the reflection of her words in her weak hand gestures, her thoughts expressed through her destroyed lungs. It was not possible on this occasion though, as she was bedridden in hospital, with the protocols of COVID-19 preventing unnecessary visits except by those immediately involved in her intensive care. The specialists involved were deciding whether to keep her in hospital where the life sustaining oxygen was available or send her home with an oxygen tank.

‘I want to go home Doc, please try to arrange that for me,’ Then, with the wicked twinkle in her voice that I was so accustomed to, she added: ‘Then I can come and irritate you at your rooms.’

A patient of our practice for decades, she was a well-known figure whenever she made her grand entrance. Never flamboyant or extravagant, but she most certainly had presence. We treated her for her diabetes and numerous other medical ailments. She was in her seventies when she contracted COVID-19.

This was during the first wave when we were learning something new on a daily basis about the pandemic that spread with frightening speed across the globe. ‘I am not worried, I know you people will look after me,’ she encouragingly told us.

We were worried as she was elderly, a diabetic and had other medical conditions which predisposed her to severe complications and even death. She had a good support structure with a very loving family and never needed admission to hospital. We frequently had telephonic consultations with her which reassured both her, her family and us. Her symptoms were slightly prolonged but after about two weeks she again made her appearance at our rooms, her indomitable spirit clearly intact.

The disease did take its toll though. Though she attempted to sound mocking when she referred to rather dying than being in bed like she was for a few weeks, the underlying depressive effects of disease, lockdown, lack of mobility and of course the fear of the unknown was clearly manifesting itself.

It is not unreasonable to predict that being confined between four walls and to be considered a persona non grata, contagious and to be avoided at all costs, can lead to psychological afflictions. She was of the stoic type though and insisted that all would be well and we simply needed to give her some more time to recover completely. ‘You’re still going to be around a long time to hassle me,’ I jokingly remarked. ‘Yes, at least I have a reason to live if that is the case,’ she laughed.

We had one annual conversation and that was about Hajj. She would always come for a consultation a week or two before my departure for her medical consultation and for her to greet me. We would inevitably talk about religion and despite her not being Muslim, she was knowledgeable. What particularly fascinated her was the Day of Arafat when our Creator forgives more of his subjects than on any other day. ‘Devils like you must go every year to get cleansed of all your sins!’ she used to joke.

It was the acceptance of Duaas that intrigued her.

‘So, if you pray for me even though I am not Muslim will it be accepted?’ she asked. I assured her that as long as the intention is sincere, Allah would most likely accept all prayers on Arafat. ‘You must pray for me,’ she requested. I did. Year after year.

‘You must pray for me when you run away from me again,’ she dryly instructed me in the midst of the first wave of the pandemic. I knew she was referring to the upcoming Hajj. ‘I won’t be going at all this year, for the first time in twenty years,’ I replied.

She must have noticed the sadness in my voice and yet she incredulously said: ‘But you always go. You mean I came to greet you for nothing now? You can’t bill me for this!’ she retorted. I explained that only one thousand pilgrims would be permitted to perform Hajj and only those residing in Saudi Arabia could apply.

‘So who is going to pray for me this year?’ she asked. I explained that Allah accepts prayers from anywhere, and this would apply now that circumstances prevent the attendance at the Hajj. ‘But it is not the same as being on your Arafat, right?’ she remarked. I realised that she was absolutely right. Nothing can compare to the physical presence on Arafat.

Hajj is Arafat and the physical presence on its plains on the Day of Wuqoof is an absolute prerequisite. I watched with sadness the Hajj on television that year, withdrawal symptoms overwhelming me. She came to see me for a medical issue a few days after Hajj, a time when I would normally be in Saudi Arabia. ‘Fancy seeing you here!’ she said. ‘Don’t worry Doc, I prayed for you this time around. Don’t forget to pray for me next year when I am sure you will be on Arafat again,’ she added. Her health had improved remarkably and she was back to her normal witty and physical self. Like the vast majority of those infected with COVID-19, she had no long-term effects. But life was unfortunately going to test her more severely.

We as doctors are normally concerned that the elderly with diabetes and hypertension will suffer from heart attacks or strokes. She had none of these afflictions. Instead, her body’s immune system started to fail to recognise her own cells from foreign cells. She developed an auto-immune disorder where the body starts to attack itself. First her face was affected, then other parts of her body.

‘I still am attractive right Doc,’ she used to joke even though she was deeply worried. She also developed a lung condition which led her to be hospitalized as she required continuous oxygen. When I called her on one occasion, she expressed a desire to be allowed to go home. ‘Oh yes Doc, before I forget, don’t forget to pray for me when you go to Arafat this year,’ she reminded me.

A decision was made that she, after a prolonged stay, would be discharged home with an oxygen tank. She was at last in the comfort of her own home surrounded by family members. ‘I have my oxygen, I am going to live. You’ll have to come greet me this year before you go to Arafat as I am not going to come with a machine to your rooms!’ she told me.

It was not without challenges as her oxygen machine was dependent on a reliable source of electricity and the sudden announcement of load shedding led to her family frantically scrambling to obtain a generator.

All these events took its toll on her and she passed away peacefully. Again, it seems that I will not be on Arafat for the second consecutive year. Our hearts and prayers will be there and insha-Allah the prayers we make, no matter where we are will be accepted by our Creator.

Pull out: ‘When I was living, I wanted to die. Now that I am dying, I so much want to live.’

Pic: Duaas on Arafat are for all