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Bonds of Love

>> Sunday, January 9, 2011





"So live your life that the fear of death can never enter your heart. Trouble no one about their religion; respect others in their view, and demand that they respect yours. Love your life, perfect your life, beautify all things in your life. Seek to make your life long and its purpose in the service of your people. Prepare a noble death song for the day when you go over the great divide. Always give a word or a sign of salute when meeting or passing a friend, even a stranger, when in a lonely place. Show respect to all people and grovel to none. When you arise in the morning give thanks for the food and for the joy of living. If you see no reason for giving thanks, the fault lies only in yourself. Abuse no one and nothing, for abuse turns the wise ones to fools and robs the spirit of its vision. When it comes your time to die, be not like those whose hearts are filled with the fear of death, so that when their time comes they weep and pray for a little more time to live their lives over again in a different way.

Sing your death song and die like a hero going home"

Chief Tecumseh (Crouching Tiger) Shawnee Nation 1768-1813



I was doing the on calls during the Christmas week because I had to come home the following weekend.

Abdulla ( Not his real name) was brought in on Thursday night through the ER. He looked around forty years old and had severe shortness of breath. Through the middle of his struggle for air, he said it was just few days that he was feeling unwell. He had gone to Bangkok for a medical check up and just come back a week back and the doctors there had told him that “everything is fine, and there is no need to go back”. I asked him if he had any medical report with him and he said, “My doctor had gone on vacation and would send it once he is back”

The x ray chest showed he had massive fluid collection in his right chest. I shifted him to the ICU because his oxygenation was dropping. We did an immediate aspiration to remove the fluid and drained a litre and half of bloody fluid. One look at the nasty looking fluid, and I knew this was no ordinary infection, and must be cancerous. But Abdulla was confident. His wife and young son were around. He was relieved of his distress once the fluid was removed and was talking cheerfully to his family and asked his son to go home and bring his favourite food.

The next day we did a CT scan of the chest and found he had a large tumour in the lung. He also had operation marks on his chest, and the films had shown that they had resected some ribs from his chest. Everything put together was clear. I suggested a CT guided biopsy and he refused outright. By the third day he was comfortable and during rounds, he asked me permission to go home. I explained the condition to him and the need to do further tests. His family was outside the ICU. He smiled at me and took an envelope from under his pillow and handed it over to me. There was a detailed medical report stating that he had advanced cancer which was inoperable and resistant to all the chemotherapies they had tried on him. He only had limited time. He had prevented his doctor from disclosing the diagnosis to his family, giving in writing that he was taking all the responsibilities on himself.

Finally, he smiled at me and said’ Doctor, I knew from the beginning you had guessed it. Both of us know now. I know I don’t have much time left. But I want my family to be at peace till the inevitable. Isn’t that reason enough?”

Medicine exists to fight death and disease, and that is, of course, it’s most basic task. Death is the enemy. But the enemy has superior forces. Eventually, it wins. And, in a war that you cannot win, you don’t want a general who fights to the point of total annihilation. I agreed to what all he asked for.

I have seen many terminally ill patients during my career. But not a single one like him. He had tremendous guts. And a concern which is rare these days. I realised how sincerely he loved his wife and son. Love, is not only in taking, it is more in giving.

For the bonds of love are enduring and cannot be severed by death. This is the ultimate comfort in the presence of death and dying – that the bonds of love can grow roots within the heart itself, and once implanted there, are able to remain forever.

He went home the next day, promising to come back to the clinic.

24 comments:

Balachandran V January 9, 2011 at 10:53 AM  

I can imagine the scene! We all talk about facing death bravely, but what would it be when it finally comes? Yet, even if I got scared, i don't think there is anything to be ashamed. That's the way I am. Some are fortunate, like Abdullah.

Margaret Cloud January 9, 2011 at 4:02 PM  

He is indeed a brave soul and keeping it from his family has to be hard on him. I had a brother-in-law that had cancer in his shine bone and he did not tell anyone about it. It was so devastating on us when he died, he was such a wonderful person and the father of eight, most of them grown. To face death and know you will not win comes to us all. I think the worst is when one passes away in the blink of an eye, no one is prepared for that. Have a nice week.

Rachna January 9, 2011 at 8:34 PM  

Amazing man! I love the line -- Love is more about giving than talking. I completely believe in it. Thanks for sharing this touching story and the inspiring initial words.

Insignia January 9, 2011 at 8:48 PM  

It would be difficult to find a brave man like him. His courage would take him through

Alka Gurha January 9, 2011 at 11:31 PM  

I wonder how docs deal with emotions...my father was a doc and I lost him to sarcoma...I can understand the agony here..

RGB January 10, 2011 at 2:22 AM  

A touching story indeed. Just hope his family is just as brave as he is, because they will have to deal with it one day or the other.

BK Chowla, January 10, 2011 at 2:49 AM  

Such are the people who actually care for life and live life king size.
his family would be proud of him.

A January 10, 2011 at 7:53 AM  

Dr Antony,

A very well captured story of this brave and amazing person. Thanks for sharing. Liked it a lot.

Madhu January 10, 2011 at 10:30 AM  

Did he come back yet?
I dont know Dr.Anthony, I mean, he loves his wife, its very evident here but I am concerned for his wife. Obviously she must be deeply in love with him too.
If my husband (God forbid) even has a cold, I would want to know. To each their own but I hope this doesnt shatter his wife when she comes to face the reality by herself.

Heavenly Muse January 10, 2011 at 1:04 PM  

death...
a great teacher....sometimes it changes rather encourages its victim ...sometimes it changes the mental approach of their witness altogether towards life.
in this person case the idea of death got mixed with his innate courage and gave him strength .
my mother's death made me strong....no doubt one's own nature plays an important role while confronting death...but i believe death itself has some charisma it brought tremendous changes.

anilkurup January 10, 2011 at 5:50 PM  

"Out of the night that covers me,
Black as the Pit from pole to pole,
I thank whatever gods may be
For my unconquerable soul.......

Iam the master of my fate:
I am the captain of my soul".

Any way , any means one can be like an Abdhulla?

radha January 11, 2011 at 12:23 AM  

Amazing person. I hope he leaves his family with strength to cope with the void he would have created with his departure.

NRIGirl January 11, 2011 at 10:14 AM  

@Doc! Thank you for introducing us to Abdulla.

I truly admire his strength and also appreciate your take on it. Sometimes it is the doctors who hold the patients back in the hospitals - in fear of later retaliation by the family members. At least that's the case here in the US.

dr.antony January 11, 2011 at 10:22 AM  

@Balachandran
The truth is that we do not know much about 'after death'.If we had an assurance of a life in paradise where milk and honey flows,options would be for sure.
@margaret
That is a real valid issue.If we expect something bad to happen,probably acceptance would be easier.Otherwise,it might become a shocking experience.But anyone with common sense would understand what has been happening and going on.It is impossible to hide truth for long.
@Rachna
Death is simply a mystery.
@Insignia
It is a mind set.Probably that is his nature.He would probably make such kind of decisions all through life.
@Alka
Sorry to know about your father.
Doctors get used to such events,and over time develop some kind of numbness.They can see death as something inevitable and accept it as such.
@RGB
Yes,Dont know how long it can be kept secret. There will come a time,when he deteriorates and no longer in charge of situations,the treating doctor would discuss with the family.
@BKC
True.They make life easier for others.
@A Glad you liked it.Life is full of unexpected.
@Madhu
He didnt come back yet.Our hospital is near his home.He would go to a distant hospital,making it difficult for his family to reach him.That was what he did all along.He would be brought in,for sure.
@Heavenly Muse
We all learn from experiences,and we should.Our responses are all part of our inherent personality.
@Anil
Well said." I am the master of my fate".I wish we could all sing that.There are weak hearted too,who believe in destiny.
@Radha
He has a young son,who appears so insensitive,or I dont know if he was acting.But one day,I am sure they have to deal with the truth.

anilkurup January 11, 2011 at 6:05 PM  

doc, you forgot to mention the most important of largesse that await some in paradise-
twenty high breasted women and four fat well fed boys for buggery and other orgy.

Keats The Sunshine Girl January 11, 2011 at 10:12 PM  

How each of us will face death is in our personality.Cancer is hard to beat and in its terminal stages,very distressing.Love ans support in the dying days are so vital.

....Petty Witter January 12, 2011 at 4:45 AM  

Such a wonderfully thought-provoking post. My nana knew she was dying and yet chose to keep it from us. We, her family, somehow sensed she was dying and yet no-one ever spoke of it. Brave and caring of her to spare her family in such a way? Certainly. But I can't help but feel it must have been lonley for her at times though as Keats, above, points out, how each of us face death is a unique thing, much dependent on personality.

Jay January 12, 2011 at 6:02 AM  

Real brave person..admire his personality..
thanks for sharing..
Tasty appetite

Harman January 12, 2011 at 12:27 PM  

Very well narrated..Doc whenever I read your blog its under absolute silence Coz one or the other thing is very interesting...
Docs are angels..I really salute this noble profession..where they go through life and death everyday,with patience and all emotions..
God Bless!

Happy Kitten January 12, 2011 at 11:58 PM  

No wonder your blog is named heart beats! Each post comes straight from your heart and manages to dash right through and pierce our hearts. THANK YOU.

The courage and love of Abdulla! May the Almighty be with such souls and comfort them through their living moments in this life.

Incidently, my family is also facing this monster and it has decided to take a loved one from our midst very soon. Painful times, which only the Almighty can get us through.

Elizabeth January 13, 2011 at 12:22 AM  

Thanks for sharing this on your blog :)

dr.antony January 13, 2011 at 6:52 AM  

@Anil
Sharp memory.you dont forget a thing!
@Keats
True.For for someone who is mentally prepared to go through the ordeal,it could be a different choice.
@Petty
Yes,it is part of personality and attitude.I have seen many who cry out and complain about each and everything and trying to put the blame on others.That is another way of dealing with it!
@Jay
That is why I suggest to many bloggers to visit you,find something good to eat when they can.
@Harman
Those were really kind words.Every profession has its duties and responsibilities.I think these days the one to one relationship between the doctor and the patient is going downhill.
@Happy Kitten
I am really sorry to hear the sad news.I know how difficult it is to go through it.As silent witnesses watching helpless. I tried to find your mail id to write you something.Could you send it to me?
@Elizabeth
I thought of sharing some personal experiences for a change.

crazycha January 15, 2011 at 12:47 PM  

death is inevitable...but love is always greater than it. i just hope i could face death just like him.

thanks for inspiring.

Renu January 19, 2011 at 9:33 PM  

Its very brave of him to hide it from his wife..but sometimes sharing is also good,as the other person slowly gets prepared for the calamity, whereas a sudden death impacts a lot.and then his wife will always have a regret..only if I knew.as she also would have liked to hundred things for him.

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