Patients are our teachers

Throughout my years as a doctor, I have learned so much from patients. It is not just about their symptoms, their diagnosis, their management but also their experiences, their feelings, their joy and their pain. I have learned most precious and valuable lessons from the way they cope with suffering and also in my own reaction towards their responses.

One of the most valuable lessons learned was from this elderly lady who is a known Chronic Bronchitis patient. She is a chain smoker and over the years, it has affected her lungs and she developed COPD (Chronic obstructive pulmonary disease). She was admitted to our wards and that night whilst I was the house-officer on call, she had an acute attack. We gave her oxygen and nebulisers and we tried everything...we really thought she was going to pass but somehow she survived and the next day, as I was on my way to the wards, I found her outside sitting in her wheelchair lighting up a cigarette. From that moment, I promised myself to never light a cigarette...

Some patients have such an impact on me that I will remember them for the rest of my life. During my obstetrics and gynaecology attachment, I had to counsel many patients with miscarriage. With my own experience of miscarriage and a stillbirth, I try to distance myself emotionally from the cases because it hurts. However, one night when I was on call...a Muslim lady came with her husband with very severe stomach pains. She was 36 weeks pregnant. We did a CTG but we couldn't really get a heartbeat and when we did an ultrasound, it was obvious that the baby had died. That night she went through labour and delivered her baby. The next day, I came to visit her after the ward round. I can remember her face, the sadness in her eyes...she looked at me as I entered her room and she smiled. I thought she was the most beautiful person, the most serene and contented person I have ever met. I sat next to her and although she couldn't understand English, I spoke to her. I told her how brave she was and how her baby will wait for her in Jannah then I bent over and kissed her forehead. I have never done that to any patient before or since; but her strength, her patience in the face of adversity made me feel so close to her. She taught me so much about life...about pain...about hope...about love.

I have seen many reactions from patients, those who wail, those who cry and even some who become angry and blame others. There was another lady who had several miscarriages and she came to the emergency department 14 weeks pregnant and she was bleeding. I had to break the bad news to her, she started getting angry and shouting...she asked me "Why is this happening to me?". My blood was boiling and I really felt like shouting back but I realized it was just her reaction at the time. She was angry and she didn't have anyone to direct her anger to. I just happened to be there...so I kept quiet and tried to make her as comfortable as I could. Later she apologized.

The biggest lesson of all...a case I will never forget is a lady who was brought in collapsed (not breathing and with no pulse). The story goes that she was seeing another man and somewhere during the act...she collapsed. Oh God! this was the worse possible nightmare imaginable. I thought to myself...if for a Muslim, to die in that state...in a state of committing haraam, it would be a nightmare of eternity. People often say "It will not happen to me" but I have seen enough cases to say "It can happen to anyone" because illness, accidents and tragedy can happen to anyone, at any time and it is non prejudice...it doesn't exclude the rich, poor, famous, good or bad.

Learn from the strength of others and from their mistakes. Life is too short to make all these mistakes ourselves.

"Some of us learn from other people's mistakes. The rest of us have to be other people" Zig Zaglar

"There are two kinds of doctors. There's the kind that gets rid of their feelings and the kind that keeps them. If you're going to keep your feelings, you're going to feel sick from time to time that's just how it works. People come in here and they're sick, bleeding and dying and they need our help and helping them is more important than how we feel..." ER Mark Greene

I would like to wish to all my final year students due to sit for their Pro-3 exams the very best and may Allah SWT give you success in this exam and for your future careers. I hope you will be the kind of doctors who will keep your feelings and to learn these valuable lessons from your patients. There are so many beautiful people around us...their beauty is not from their looks but from their experiences, their behaviour, their good heart. We just have to open our eyes and see...

A stillbirth story in 2001

9^th November 2001 was the day that I lost Sulayman. I was due to go for my antenatal check up at Pantai Medical Centre.  I came back to Malaysia to have my baby. It was during the first few days of Ramadhan. but I felt that my baby was not kicking much that night. I kept praying for my baby to be safe.

The obstetrician invited me into her clinic room. I told her my baby didn’t move much. She got me to lie down and examined for the baby’s heart beat. She moved the probe here and there. She muttered something like “I can’t find the baby’s heart beat.” Then, she reached for the ultrasound machine, again moving the probe up and down my tummy. I stared at the monitor, at my baby, there was no movement. There was no heart beat. She told me “I’m sorry but the baby has died”. I started to scream! My mom responded “Astaghfirullah”. My mom said “Are you sure, doctor”. The doctor pushed the ultrasound probe harder onto my tummy in the hope that somehow she had made a mistake but my baby was gone.

Finally I managed to compose myself and said “so what now?”

The doctor told me the best thing is to have a natural birth.

“What!” I thought “I still have to go through labour?”

She said normally it won’t take long for the body to recognise the baby has died and will expel it naturally. So, we went home.

I remembered sitting at the dining table hardly able to eat anything. My mom and dad were with me. They asked me how long before the body recognizes that the baby is gone and will go into labour. I said I don’t know but I said I don’t want to keep this ‘mayat’ inside of me. (mayat = corpse)

I couldn’t believe it...after carrying the baby for 9 months, feeling its every move and dreaming of seeing him for the first time. All hope vanished in a second!

My dad called me and he got me to read surah Baqarah: 151 – 157

“So remember Me and I will remember you, and be thankful to Me, and be not ungrateful to Me. O you who believe, seek help through patience and prayer. Surely, Allah is with those who are patient. Do not say of those who are slain in the way of Allah that they are dead. Instead, they are alive but you do not perceive. Surely We will test you with bit of fear and hunger, and loss of wealth and lives and fruits, and give good tidings to the patient who, when a suffering visits them, say “We certainly belong to Allah, and to Him we will return. Those are the ones upon whom there are blessings from their Lord and mercy as well; and those are the ones who are on the right path.”

I recited it out loud with its meanings and I understood everything...everything about life, about death and cried and cried and cried.

How incredible it was that I had life inside of me...and yet, when the angel of death took my baby’s soul away, I felt nothing! Even though he was inside of me but still, l felt nothing. It was a tragedy and yet, a beautiful reminder of how we are not in control of anything. We have no knowledge at all of the ghaib (unseen).

The next day the contractions started and my parents took me to the hospital. My then, husband took the earliest flight from London to be by my side at the birth. When it was time to push my dead baby out, I refused to do so because I knew it would mean goodbye. It would mean the beginning of my grieving but I had to. I held my little darling in my arms. He was so still, lifeless and yet so beautiful and innocent.

Soon, they had to take him away for burial. His dad took him away shrouded in white cloth to be taken to the masjid for a wash and burial.

After his death, I was afraid that I will not have another baby. I missed my baby even though I never knew him in this reality. I was yearning and longing for another baby and I guess in some way, I wanted to ‘replace’ him. Losing a child is heart breaking, beyond any form of heart break as any parent whom have lost one would know.

Then, six months later I became pregnant. At the same time I started my general practice training and after nine months I was blessed with a baby boy, a mercy from Allah SWT. His arrival was a cure and soothing to the eyes and heart Alhamdullillah. Allah SWT has replaced my pain and grieving with something better, a lovely son in this life and a beautiful baby in Jannah inshaAllah. May Allah forgive my sins and make me amongst those who are successful.

Every time I talk about Sulayman, my eyes still fill with tears. It is not out of ungratefulness as I have accepted the decision of Allah but it is out of love from a mother to a child that will never ever die. I will never forget my baby.

I talk to all of my children about their brother Sulayman and we visit his grave at least once a year, a reminder to us to be grateful for the life that Allah SWT has given to us and to remind ourselves that one day we too will join this tiny soul.