Monday, November 24, 2008

Death & Eternal Life After Death

Friends ,

Even hardcore chap like me in a 'hardcore speciality' like cardiology ,supposedly immuned to death ,do sometime feel down ,weighted down by the sense of frailty in man when we have to face death .Too many issues surrounding death this week .

Firstly that young Indian chap who died under my care last week .Just 32 with a young Indonesian wife and 2 year old kid in tow .Her halting sob ,half Indian half Indonesian ,over the cold lifeless body of her young husband ,haunts me .

My mother in law ,her lungs and heart already riddled with cancer cells ,hanging on to dear life ,on expensive state of the art oral medication ,tarceva ,that is supposed to 'buy' time ,for a couple more months before the cancer cells get the better of it ,and invade further .

She is quite oblivious of her fate .Ignorance is bliss .We doctors oftentimes have to 'play god' a lot more than we want to in this part of the world .Asians do not generally want to know the whole bad news !Telling too much can be wrong ,too little ,you will get 'lawyer's' letter on your desk, when the 'undiscussable' do take place 'prematurely' .

In her case I can expect a couple more months of honeymoon and 'personal 'reprieve' then the progressive deterioration in breathing ,loss of cognitive functions and a generally slow slide to unconciousness ,my little 'empire' will be in turmoil.I think I have a heart of stone ,by way of upbringing [ orphaned at age 9 ! ] and training ,but to see loved ones suffer from the impending loss of their loved one ,would be difficult even for Mr Stone .

Then there is this case of a dear colleague of mine this week whom I ,inadvertently found and diagnosed to have advance cancer ,just on a routine annual check up .

If you find my conversation with him macabre or callous ,do not judge so ,because we fellow physicians do not need 'veils' .

"So my friend ,since there are already 4 focus in the lung which look like metastatic cancer ,what are you going to do ,knowing that this sort of cancer is resistant to all kind of therapy ? ".....a rather superficial stupid question on my part ,but actually not very stupid as it seem ,as I was assessing his philosophical leaning .

"There is nothing much for me to do except to accept this ,riddha ,and live my life from day to day "...was the brave and stoic reply .I know the man well .With Riddha [ for want of better word ,Acceptance of your fate ] ,half the battle is won .Won not against the Big C , but against the internal demons of fear and oftentimes kufr .Many a time we practitioners observe a deep initial sense of denial in our patients which later change to anger .Oftentimes anger towards their care givers ,and frequently towards God .The "why me ,why me" syndrome sets in which result in kufr !

In moment like this we should thank our lucky star that we are Muslim : We have Riddha to soften the blow .We have kaffarah [ see Kaffarah ,Saturday ,July 5th blog ] .We have taubat and atonement [ see Some random Thots on Death ,Thursday May 22nd blog ] .We have prayers and we have zikrullah .

As supreme optimist ,and that is what we Muslim should be ,death is not the end . Optimist not in the secular way that come what may we are going to delay that moment of death by mega vitamin doses ,old Inca medicine ,yoga ,best treatment that money can buy etc etc etc or some obscure Chinese or Mexican hospital somewhere.

No ! No ! NO ! , none of these claims and 'super' claims, but by the realization that with the inevitability of forthcoming death we are moving on to the next phase of life , a better one by any scale of measure ,if we have prepared for it .It is not even the beginning .It is the end before the new beginning :The eternal journey .

'Duniya' in arabic is not just 'world' in English as we know it as an exact transliteration of the word .'Duniya' connotes a lower form of existence ,while 'akhirat' means a higher form .We are thus moving from a lower animal like existence with all the incosistencies and inadequacies of the lower 'nafs' to a higher more ephemeral existence of the higher spirit :The eternal journey .

"My friend ,I cannot offer you anything ,but actually when I come to think about it ,you are in a better position than 'numb skulls' like me and million others who today go through life heedlessly ,never giving a serious thought about Him and our Eternal Journey ,thinking we have 20 ,25 more years and one fine day suddenly get caught with our pants down tomorrow or day after ,just like that young Indian patient of mine .In your case you know you have 6 months plus minus 6 ,and work hard at it ,while in our case we tend to forget about Allah because we think we can live forever "

As I walked away from his room ,I felt very relieved that my dear friend has 'accepted' his 'Qadar' [ see Qadar ,Qadr and Lailatulqadr in November blog ] very well with 'riddha' .Insyaallah he will be in good Hand .I cannot but remember the profound thought of that young jihadist who famously said :"To me It is like walking away from a hot furnace ,opening the door ,and walking through into an air conditioned room ".

Let us all work earnestly hard towards that kind of conviction .Death is after all the beginning of Eternal Life .

"Yes ,at the end of our time we should not fear .If we are well prepared ,It should be like walking from a hot furnace into an air conditioned room "!

That young jihadist had understood the full meaning of existence in this 'duniya' with all its shortcomings and inadequacies and look forward to a higher existence in the 'akhirat' .May their souls be placed amongst the blessed .

Dr Nik Howk


Anonymous said...

Dear Dr Nik,

Takziah for you and your wife for the loss of beloved MIL(motherin lsw) and Al-Fathihah for her as well.

Talking about death, I'm an avid believer of AAM (Anti-Ageing Medicine). Through multi-displinary approach of AAM, the life-extentionist like me is expected to live 120 yrs. At 90, I'm supposed to be kicking and rejuvanated.
How far this promise of fountain of youth is true or partially true of a medical hoax.
Your opinion as a cardiologist and physician is appreciated.

Dr Rahmat.

Anonymous said...


How far this promise (fountain of youth) is true or partially true or a medical hoax.

Sorry, for the typo-errors, including MIL (Mother-in Law)
Dr Rahmat

Pearls & Gem said...

I have touched on Longevity in some lenght in my July blog [ see Random Thots on Longevity 101 ,102 and 103 ,and The Muslim perspective also in July blog ]

No straight forward panacea I am afraid .If you have one please share with us .

If we were to go by the the sprinkling of long living small sub groups all across the world , the common the denominators are,all of them lived simple physical and emotional lives ,close knit and their diet mainly vegetarian and complex fibre .

Whether we can live like them is another matter .

Of course if you are thinking of the easy 'pill popping' kind of panacea ,there is none .They have gone thru the whole gamut of GH hormone ,insulin therapy ,etc etc ,high dose vitamins etc etc .Do not work .

At the end of the day one might question ,especially from the Muslim perspective ,whether a long kufr kind of life is worth living [ I am not trying to be the Muslim equivalent of Socrates that say : A life not examined ,is not worth living ! ].

Do revisit the July blog because I really did some research on that .

Shamsul said...

Dear Dr.Nik, I stumbled upon your blog while looking to read on Sheikh Kadir Jilani's works. I'm sitting at the Masjid Kapitan Kling's (Chulia Street, Penang) Balai Seni Lukis Melayu, (annexed)before subuh. I have been sketching (an artist) almost all night long. Reading your article on Death and dying sobered my appetites from the temptation to seek out more glorious sites on the net such as!
If you have the time and inklination please drop in at my site;
Perhaps there is some sharing that can materialize to further enlighten our narrow and veiled percetions of life and death as it is.
It is a rare indee find when you stumble at this wee early hours of the morning upon an uncut diamond in the footsteps of same Masters.
All blesings to the Sheikh for making it so!

Pearls & Gem said...

Thanks Shamsul .You an artist ,reading my blog on death ! You made my day .

I started reading on sufi literature some years ago after completing Hamka's voluminous Tafsir Al Azhar .With that background I think I am on fairly reasonably safe foundation .People say so many things about sufism ,some quite 'bad' and the reflex response is usually is that of people who can walk on water and fly to Mecca in seconds etc etc .

Muchtar Holland ,who has been in malaysia once in the past attach to UKM really did Shaykh Abdul Qadir al Jilani justice by bringing him to the English speaking world in his various books such as 'Sublime Revelation' and 'Utterances '

Currently I am reading Abu Ata Allah's Book Of Illumination which in essence give the reasons why we 'should not plan ' .Difficult read because we are brought up with the premise we all 'must plan '.

When I have time i must also go to see how the other world also tick .

Anonymous said...

salam Dr Nik,just got to read this part today.
indeed redha is an ideal criteria for any illness, be it mild or life threatening.
my son Abdullah, his friends's father just passed away a few weekks ago of lung cancer.he lasted 4 years after diagnosis.Refused surgery, refused chemo, went on certain diet and herbs.His visits to hospital was just for aspiration of pleural effusion and O2.he is an educated person with Phd in education.berore his final hour, he asked his children and mother and wife gather around him to read the yasiin, bade goodbye and pulled of his oxygen mask.according to his son Naufal, wihtin 2 gasps of breath he was gone...Innalillah.
regards from hafiz.

Pearls & Gem said...

Fiz ,

Your son's friend's father must have been afflicted by a slowly growing lung cancer because as lung cancers go ,they are usually aggressive with or without treatment .

Talking about adab ,there is actually proper adab of dying and accepting death .Thank God ,we Muslims have got a good 'template' and example from hadiths and Quran on the proper adab.

As a practitioner and observer of life ,my observation so far is that that 'proper adab' is oftentimes inversely proportional to the size of the paycheque ones bring home .The more wealthy have a tendency to 'behave badly' around issues pertaining to death .That is just my observation over 30 years of practice .