I was a wee bit 'un-eased' last night.
Tossing about in bed unable to sleep. Three hours earlier just back from a glittering Malay wedding reception held in a KL five star hotel, sitting dinner and all; guests resplendent in their best three piece suits; innumerable number of young people going up stage giving their glowing eulogies to the bride and groom; served a fusion 10 course dinner and finally a 'band and dance' to top it all up. A glittering event indeed. A A1Malaysia event par excellence. Najib Tun Razak would have been proud of this.
Could not pinpoint was it the 'fusion dinner' or was it the chay kwaey teow with 'kerang' I had for lunch. Something was not right,perhaps I am getting too old for my age.
3 AM, still could not sleep. My hp rang. A friend [ a much junior medical colleague actually ] in JB rang to tell me that his dear father who was just admitted into the medical ward of GHJB for observation of a recent onset 'central chest pain' [ 'unstable angina' in medical parlance or acute coronary syndrome, will be dealt later in another blog article ] , suddenly collapsed at 1 AM in the general medical ward while under 'observation'and now transferred to a CCU bed, in coma.
Duly intubated and ventilated. Pulse thready and BP on the floor at 60/ ?? Despite being on heroic measures of quadruple inotropes [ intravenous heart muscle stimulants ]. Sounds to me like his father had had a massive heart attack followed by cardiogenic shock following too much muscle loss. Dismal prognosis from the sound of it. The GHJB guys have lost that 'small and short window of opportunity' to change the 'possible outcome'. A primary infarct angioplasty and stenting earlier in the evening before the 'complete closure of the coronories' could have made all the difference. A common fallacy and mistake in being admitted for 'observation' but not really 'observed'.
Maximal modalities of medical treatment all up and situation still dismal. Doing too much now but too late . The 'bus' has already left the terminal. Muscle loss from the infarct has occurred. All the 'iblis Ifs' playing in my mind at 3 AM.
I consoled my 'junior 'friend but told him him that 'as it is now', situation sounded dismal.
" Please do not leave your father. Have someone always reading the Yasin into his ears. He may not be able to hear it now , but his soul may. It sounds like it is a matter of hours before the old heart will pack up ! ".
I was not sure how this kind of advice rub on my friend but at 3 am that was the best I could offer. The window of opportunity was already lost in the evening of 'observation'!
How people respond to your sincere and honest counsel/ advice ??
In my experience,at the worst of time, it differ greatly from people to people depending on their level of piety and ilm, or rather their level of 'secularism' for want of better term. A perfect position and timing for 'the messenger' to get shot !
Could still recall an incidence some 15 years earlier. A Tan Seri in his late 70's, not my regular patient, suddenly admitted with a massive heart attack [ his third one this time ]and shortly in the ward, also had a stroke. All modalities of possible treatment used up and to no avail. The old heart wanted to just go and stop beating.He was dying, full stop.
I summarily called a meeting with close family members and told them the plan : A NO PLAN.
"I have run out of all plans. All that need to be done has been done. Prognosis is dismal. We have reached the end of the road.Your Dad is dying. Let him go gracefully. let us do the 'Yasin' bit.", all to that effect. Family accepted it calmly.
All went OK. The old man died surrounded by close family and all. 'Alhamdullillah' I thought to myself, 'this is the typical ideal Muslim setting related to death'. Prayers and all, no 'ai ya ya ', no howling etc etc.
Four days later, two daughters and son [ one , a law student, another a budding young doctor and a third , a university lecturer ] came barging into my outpatient consultation room and demanded an apology from me for use of 'language' inappropriate. 'Their mother utterly depressed because of that !'
I thought I was doing well, but my Malay may have been 'lousy'. They got my 'apology'.
Just recently I got a full frontal barrage from a dato' and datin for reminding them that 'in death oftentimes there is relief'. Their 90+ mother was very sick and things could go either way. I was anticipating the worse case scenario and preparing them 'emotionally'. That was misconstrued.
That is medical practice for you. It has it ups and down. Even when you think you are doing right, you can be perceived to be 'wrong'. With these sort of people, if you dont apologize readily enough you could get a very hot lawyer's letter on your desk in no time !
I put all these to our current relative lack of REMEMBRANCE and on this aspect let us all listen to Shaykh Al Yacoubi :
quotable quotes on dzikr :
'The Chain of Quintessences'............
The quintessence of the world is man. The quintessence of man is religion. The quintessence of religion is prayer. The quintessence of prayer is invocation. Here lies the meaning of the Quranic verse: The invocation of God is greater [than anything else]. If man had no more than a few instants to live, he would no longer be able to do anything but invoke God. He would thereby fulfill all the demands of prayer, of religion, of the human state.
'The Two Great Moments'.............
There are two moments in life which are everything, and these are the present moment, when we are free to choose what we would be, and the moment of death when we no longer have any choice and the decision belongs to God. Now, if the present moment is good, death will be good; if we are now with God -- in this present which is ceaselessly being renewed but which remains always this one and only moment of actuality -- God will be with us at the moment of death. The remembrance of God is a death in life; it will be a life in death.
Other related articles in the blog :
On Life, Dying and Life After Death, click here