Saturday, January 17, 2009

Pearls & Gem : Redza

Friends ,

Redza .Simple word but has deep philosophical meaning .In English ,acceptance of one's fate ,actually for want of better words .

It is easy to 'redza' a loss in the monetary sense but when it involved a lost of a beloved life ,'redza' can be very difficult even though one can outwardly say "I redza the death of my son in that fatal accident " but in actual sense the interpersonal tension existing between say the parents and the prolonged melancholia and depression that followed speak of hearts not yet fully 'redza' of this unfortunate event .

My long time patient ,had his bypass op some 16 years ago , today came to my outpatient clinic with 'heart' pain requesting for the reassurance of a normal stress electrocardiogram to which I did and as expected was reassuringly normal .I know from his history this time that the pain was not his heart but his 'soul'.He just lost his beloved 11 year old daughter from a spontaneous intra-cerebral bleed of a congenital arterio-venous malformation in the brain which was diagnosed at my hospital a few months earlier following complaint of frequent headache by the child .

My patient[ friend ]and his wife must have been told that an endoluminal technique akin to angioplasty [ except in this case the small feeder vessel in the brain ,instead of being blown and stented ,would be 'stuffed' and closed by overloading it with coils to prevent further enlargement and future bleed ].The parents wanted a 2nd opinion but probably sat on it too long .The bleed occured and the child died .

Interpersonal tension between spouses ensued ."If' this and 'if' that followed .The blame game .Depression .The main issue is when loss of life is involved 'redza' is difficult .Our iman and depth of religious knowledge and wisdom or relative lack or shallowness of them all , showed .Depression sets in .Can be very long ,insiduous and chronic .I told him about my personal story of my own inability to really actually 'redza' even when at the verbal level I said 'I redza' ..

A painful one ,and despite my present apparent 'scholarly' approach to life , it was only just a few years ago that I managed to 'wean' the 'internal sadness' off .That was when I 'revealed' my internal conflict to my eldest brother who had nothing much in term of 'formal schooling' compared to me but I reckoned had many scale higher wisdom than me .Probably through the rough education of 'idongotoyou' university and also having to deal with a lot of young upstarts bosses like me who think we 'know all that need to know' about life .

He just told me I did not yet 'redza 'enough .I understood what he meant and by God ,decades of pain just evaporated .

My 'internal sadness' started when I was a 1st year medical officer then working in the academic department of medicine UKM based in GHKL .Was on call ,manning a very busy Coronary Care Unit at GHKL .A madhouse in 1979 and even now .Much madder then because of under-staffing and lack of hospital CCU beds in KL .A call came from my younger sister's friend by the name of Mustapha from Telecom Hq :" Doc ,Your sis Wan Maziah is in coma in Kuantan GH Casualty Dept from motor vehicle accident in Beserah ".Her husband of 5 days sustained some fracture in the leg .They were driving from KB towards KL to start work after a short brief honeymoon in KT .

I took time off work and attended their wedding just 5 days earlier .Wan Maziah Wan Abdullah ,a bubbly 23 year old economics grad ,bright future ,,University of Malaya Kesuma cultural dancer ,loads of peminat and boy friends,could have chosen any one of them as life partner but as fate had it that she chose one quiet ,nondescript Ahmad bin Zakaria [ young girls those days thought they would be 'andartu' if they are not yet married by 25 !] and 5 days later had a fatal accident !

My God ! I was very busy looking after 4 freshly 'infarcted' patients in CCU that morning .Calls were coming from ER to review another 2 potential 'Acute Infarcts'.The ward round in 1st class ward was pending .Patients' relatives thugging at my shoulder for explanations and reassurances .It was a day when you had to be at 3 places at one time .A typical busy day for a young up and coming MO going for higher things in life .A hundred and one thing a junior medical officer had to deal in the course of a morning's work plus the burden of being the 'On Call MO'- .I needed to find replacement for someone to do my call etc etc .I was numbed .It was only 3 hours latter that I could sit down and 'reorganise' my thought and emotion for my sister presumably lying in coma in a corner somewhere in the casualty ward at Kuantan GH .

By the time I arrived at Kuantan GH in the evening ,my sister was just pronounced dead !Very fresh .Her body still warm .A limited PM done that very night .Cause of death :brain death due to mounting pressure as a result of neglected subdural haematoma .

In lay man's term ,she just had a small bleed under the skull and her death was due to the bleed getting larger and larger over the 8 or so hours of 'callous' and inactive observation in the casualty department .In medical parlance :totally unacceptable .

A simple small burr hole by the 'stupid' demigod surgeon on call would have solved the problem of pressure build up on the brain .As simple as that.The surgeon knew it and on meeting me he knew that I knew it ,but thank God my grieving family members did not know that implication otherwise the 'redza' part of the event would involve more people ,unnecessary anger and more complex .

[A deviation here... Litigations on the care givers in the main are reflections of a 'non redza' state of mind ,from a 'sufic' viewpoint.Ignorance oftentimes is a blessing .I am not saying or stating a position here ,just an observation ,a profound one no doubt .Any remedy then ?Well if you have to have an accident ,try arrange one near Sime Darby Medical Centre with state of the art MRI and CT scan and consultants on 24 hour call .If you plan to have a massive heart attack ,just do it within the lobby of IJN !Try to talk and cajole God about it ,if it can be arranged .Of course if you are in that enviable position you would not have bothered about it in the first place .]

In my mind then there were so many if's .What if I have the presence of mind to make a few intelligent phone calls earlier on to the consultant surgeon in Kuantan ?What if I could have used my family contact who knew the Pahang MB then for a mercy airlift by RMAF to GHKL where medical knowledge and expertise were more 'decent' .If ,if and If .All the 'iblis' If's

I 'redza' that part of the medical officer and surgeon on duty not doing their expected 'bit'[ otherwise they would not be in Kuantan ,I told myself ]but I could not come to term for decades of my inability to act 'proactively' .That was the right setting for future prolonged intermittent melancholia and depression .In actual fact ,on looking back with hindsight , I have been very unfair to myself for having so high an expectation .I was only 27 then .This 'too high expectation of oneself lead to protracted ,really unnecessary and painful ,'internal sadness' and mourning without end .

My other brothers and sister and even parents were fast to 'redza' and after a short period of mourning ,life went on as usual for them ,alhamdullillah .I had fits of depression and lounging for years to come .I was ,in a way too engrossed with the concept of Plan ,Plan ,Plan and plan ,disregarding that Allah has a bigger plan than us mere mortals :forgetting that in the real realms of things ,it should be redza ,redza and redza !The IMMOVABLE will remain IMMOVABLE and what are MOVABLE are MOVABLE only because of HIM .That was my level of 'kufrness .I had to pay with years of depression and lounging s .Lounging for a beloved one that was gone to join the Realm of Reality .

That is 'redza' ,a simple word but deep in meaning and connotation .Shaikh Abdul Qadir al Jilani in a short discourse put Islam as "Following what are prescribed for you by The One and Only ,enjoying what is halal and avoiding what is haram ,and lastly Redza to what is thrown in your way " .One does not have to have an IQ like Einstein to enjoy our faith .

My friend ,'redza' and 'redza' earlier ,than later .Your 11 year old is already in the 'cradle of love' ,while we are still being tested and if we do not 'redza' ,we fail the big test !

2 comments:

Anonymous said...

Dr Nik,

Just now only accessing your blog looking for article on "redha" as you requested, when I came across your blog which referred to a heart patient whose 11 year beloved daughter died. I am the patient. Yes,one must accept death as Allah's destiny when He took my beloved daughter to be under His care. I am comforted that she is assured of Heaven as she is still not "baligh" but I do wonder in "alam barzakh" if she longed for his mama/papa and that her roh may blamed me for procastinating to get her further treated. Semoga Allah cucuri rahmat atas rohnya.

Pearls & Gem said...

I know it is painful .I have been there in a different capacity not as parents but as a brother who 'could have made a difference '.That was what I erroneously thought .

We are tested all the time .The more Allah loves you the more you are tested .Accept and redza .Imsyallah that way you and your wife will not be at each other's throats for that apparent 'misdecision 'or indesicion .You would not know if your daughter had gone for the AVM coiling procedure that she could have thrown a major stroke on the table and both of you would end up with a brain damage child that would burden you forever : Another test .

Or she underwent the procedure very well become a brillaint student with 11 straight A's in the SPM ,went to UK and lo and behold 5 years later wrote back to papa and mama that she would rather follow the route of "Lina Joy' ! Another test on our faith .

Redza and get on with your lives .You have another beautiful daughter to bring up well .Take life a day at a time .You will be OK .The sufi is a child of the present ,says an old guru .There is a lot of wisdom there which mere mortals like you and me have to try to attain .

Insyaallah !