Back to my mother in law who was diagnosed to have advance adenocarcinoma of the lung with metastasis [..'spread'] to the heart and heart sac [..pericardium ].Well ,she was on state of the art medication Tarceva which costs a bomb monthly .Ideal candidate for Tarceva :women ,adenocarcinoma in histopathology,non smoker .
Alhamdullillah ,six months now ,and the chest X ray done yesterday showed complete resolution of the cancer effect on the heart which was double in size earlier on due to accumulation of malignant fluid between the heart and its sac .The 'golf ball' size tumour in the lung has shrunked to just residual scarring .Masahallah !The wonder of modern medicine .
"If the seven seas are ink and all the trees in the world forest, pens ,even that could not touch the immensity of My knowledge " ,so goes one of the ayat in Lord's Divine Speech to mankind .Roughly so ,quoted off the cuff , I have forgotten the Letter and the Ayat index .Mortal men in their quest for knowledge ,like the scientist and researchers who stumbled on things like Tarceva ,are just scratching the periphery and surface of Divine knowledge .
Likewise ,I am an interventional cardiologist ,a glorified plumber .A man with just a hammer .
Najib Razak ,our next PM [ oh my God ! how is it like to be under Najib and madame Rusma for the next 20 years !Please help us ]is a professional politician who probably has not just a hammer but also a chain saw ,a bulldozer and a pickup truck .
...and worst still, he has a wife who can drive pick up!
An accountant is a guy who count [..and in our Malaysian setting induced to occasionally, miscount and creative accounting ] and a KL taxi driver ,drives .The more 'tools' you are endowed with ,the more you can do for society ,and the more damage as well if not done well !
The single most important element that all four of us share in common is our accountability to Him and definitely one of these days we are going to meet Him and have to explain what we do with our 'Time ,Wealth and our Youth '.Najib ,the accountant ,the taxi driver and yours truly ,all of us know this but all of us are in our state of varying degree of 'kufrness' to Him .Allahualam !
Back to my mother in law ,she has been given at the most another six months of reprieve to think ,ponder and do whatever appropriate about that important meeting .She ,I guess ,is in a better position than most of us who generally will be caught with our 'pants down' at the wrong time in the wrong place .
There is grace and mercy even in so called adversity ,if we just care to look beyond the realm of 'ordinariness' !
As I reminded my 28 year old son this morning over breakfast in front of his grandma ,as the Malay saying goes ,"even the young coconuts also oftentimes fall earlier than the supposedly old ones" .
Showing posts with label On Death and Dying [ 1 ]. Show all posts
Showing posts with label On Death and Dying [ 1 ]. Show all posts
Friday, January 16, 2009
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
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
Tuesday, September 9, 2008
Pearls & Gem :A Couple of Milenium Forward ,A Couple Back
Friends ,
Fast forward ourselves a couple of milenium forward :a big group of us ,naked ,dusty from heads to toes ,disorientated ,bewildered ,frightened huddled together like cattle waiting to be slaughtered ,by the abyss ,beyond which lies Hell.The Lord of The Universe say :
"This is the Hell of which ye were [repeatedly] warned ![63] Embrace ye the [ Fire ] this day ,for that ye persistently rejected [ truth ] ![64] "
Surah Yassin [ 36 : 63 ,64 ]
Leaders of nations ,CEO's ,COO's ,head of families ,lawyers ,doctors ,shakers and movers of societies ,gardeners ,plumbers.......
We chose to live by our standards ,Westminster style ,socialism ,democracy ,capitalism ,philosophy , ,secularism and all .We traded at the market place according to our law of the jungle :maximum profit ,minimum loss .We dressed as we please .Some squandered ill gotten wealth like they would live a thousand years .Worse than that crazy ,lonely schezophrenic that paced the street corners picking junks and all .We satisfied our biological need as if there was no tomorrow .We lived like as if we have no souls !
But yet a couple of milenium years back we all have been forwarned :
"If only then we could see when the guilty ones will bend low their heads before their Lord ,[ saying ] :Our Lord ! We have seen and we have heard.Now then send us back [ to the world ] .We will work righteousness .For we do indeed now believe ."
Surah Sajdah [ 32 : 12 ] .
By now closely huddled together by the abyss beyond which lies Hell , we all wished we were never ever been born at all or just that slimy growth among the rocks.
We have been forwarned .We read Surah Yassin and the Quran just like parrots . Many of us did believe ,but that 'time' would be a couple of milenium forward .Will cross the bridge when we reach it .
When our life are just measured by that finite number of breath left ,that couple of milenium forward ,could just be tonight !Mashaallah !
Friends ,shakers and movers of society ,wake up !
Dr Nik Howk
Fast forward ourselves a couple of milenium forward :a big group of us ,naked ,dusty from heads to toes ,disorientated ,bewildered ,frightened huddled together like cattle waiting to be slaughtered ,by the abyss ,beyond which lies Hell.The Lord of The Universe say :
"This is the Hell of which ye were [repeatedly] warned ![63] Embrace ye the [ Fire ] this day ,for that ye persistently rejected [ truth ] ![64] "
Surah Yassin [ 36 : 63 ,64 ]
Leaders of nations ,CEO's ,COO's ,head of families ,lawyers ,doctors ,shakers and movers of societies ,gardeners ,plumbers.......
We chose to live by our standards ,Westminster style ,socialism ,democracy ,capitalism ,philosophy , ,secularism and all .We traded at the market place according to our law of the jungle :maximum profit ,minimum loss .We dressed as we please .Some squandered ill gotten wealth like they would live a thousand years .Worse than that crazy ,lonely schezophrenic that paced the street corners picking junks and all .We satisfied our biological need as if there was no tomorrow .We lived like as if we have no souls !
But yet a couple of milenium years back we all have been forwarned :
"If only then we could see when the guilty ones will bend low their heads before their Lord ,[ saying ] :Our Lord ! We have seen and we have heard.Now then send us back [ to the world ] .We will work righteousness .For we do indeed now believe ."
Surah Sajdah [ 32 : 12 ] .
By now closely huddled together by the abyss beyond which lies Hell , we all wished we were never ever been born at all or just that slimy growth among the rocks.
We have been forwarned .We read Surah Yassin and the Quran just like parrots . Many of us did believe ,but that 'time' would be a couple of milenium forward .Will cross the bridge when we reach it .
When our life are just measured by that finite number of breath left ,that couple of milenium forward ,could just be tonight !Mashaallah !
Friends ,shakers and movers of society ,wake up !
Dr Nik Howk
Saturday, July 5, 2008
Not So Pearls & Gem :Kaffarah
Friends,
Last weekend I was up in Kuala Terengganu for the Edaran Classic 160 kilometre endurance ride,an annual do organised by the KL based AlRaudhah Equestrian Club,but brought specially to Lembah Bidong International Equestrian Centre in Mukim Setia off the pristine coast of Northern Terengganu,as part of the preamble to the World Endurance Championship to be held there later this November.The night before ,to cool down raw nerves ,met and have dinner with Dr Hj Sulaiman Abdullah at a sea food restaurant overlooking Patrick Badawi's Heritage Club on the northern side and the magical Masjid Kristal on the western front of the scenic KT bay [it is easy to fall in love 'with KT' or 'in KT' and if 'SPB' offers me a place by the sea I would readily change my 'passport'! Kota bharu is getting too crowded ].
Dr Sulaiman or Sulaiman Panjang as he is popularly known amongst us Malay Collegians of class 69 , is now a part time general practicioner, also my medical schoolmate at MU,one time PAS exco member,limau madu planter,currently amateur 'longevity' enthusiast and practicioner.Discussed with him the whole gamut of the trade about 'longevity'[low caloric diet ,high protein zero carbo diet ,megadoses vitamins ,growth hormones,testosterone jab,and things as crazy as daily low dose insulin injections], which would be a timely change of subject for my next blog,I thought .A pseudo scientific pseudo religious ,peppered with a sprinkling of haft baked philosophical discourse on 21st century man's ultimate dream of how to defy the ravages of TIME will always captivate the right attention,why not!?
I made a mental note to go into 'longevity' right after my age defying 15 hour night and day ride at Bidong Beach.Then came the short sms from my SJMC pathologist colleague ,the best man in his field of specialisation:confirmed ,your m.i.l has moderately well differentiated adenorcarcinoma ,primary most probably lung.Status:Stage 4.
As if subconciously,my other half,Dr Nik the Physician took over from Nik Isahak the man .Best case scenario 1 year of progressive deterioration for patient with increasing discomfort and breathlessness and hopelessness for patient, and emotional pain for the loved ones seeing such suffering and physical as well as mental deterioration in the beloved who was once an active joyful individual.Worse case scenario,3 to 4 months of fast continuous downhill slump .Subject of 'longevity' disappeared from the screen.What appeared was Grace ,Grace ,Grace.Allah in His Ultimate Wisdom is the God of Grace and Mercy .In illness and suffering there is yet grace and mercy from Allah:the concept of Kaffarah.
When a person accept [for want of better word in English] ie 'riddha'with his illness and bodily suffering that comes with it 'all those small sins are shedded away from oneself like the falling of leaves in autumn' says a well known hadith .Additionally one has to look at illness like these as a mercy from Allah ,one is given time and space to think ,accept and attune oneself to the next phase of life.On the other hand one may not be fortunate enough to have time and space ie right after a wild night out one may be involved in a fatal motor vehicle accident and 'die on the spot'.Secular minded souls always worried 'big' about dying 'interstate' ie 'not leaving a will' .In actual fact this should be the least of our worry ."Dying interstate' with respect to our 'aqidah' ,on which side of the divide we are on ,the full ramification of our shahadah ,etc etc ,these should be our principal worries !
We cannot choose how we exit from this life but if one happened to be afflicted by serious chronic life shortening illnesses do take time to ponder:It is still a mercy from Allah !
The 'short'time given to you ,if used properly may well advance you straight to 'reserve class',whatever 'animal you are ' prior to your illness rather than 'cattle class' for eternity:husnul qhatimah as opposed to suul qhatimah.Allahualam ! !
Dr Nik Howk
Dr Sulaiman or Sulaiman Panjang as he is popularly known amongst us Malay Collegians of class 69 , is now a part time general practicioner, also my medical schoolmate at MU,one time PAS exco member,limau madu planter,currently amateur 'longevity' enthusiast and practicioner.Discussed with him the whole gamut of the trade about 'longevity'[low caloric diet ,high protein zero carbo diet ,megadoses vitamins ,growth hormones,testosterone jab,and things as crazy as daily low dose insulin injections], which would be a timely change of subject for my next blog,I thought .A pseudo scientific pseudo religious ,peppered with a sprinkling of haft baked philosophical discourse on 21st century man's ultimate dream of how to defy the ravages of TIME will always captivate the right attention,why not!?
I made a mental note to go into 'longevity' right after my age defying 15 hour night and day ride at Bidong Beach.Then came the short sms from my SJMC pathologist colleague ,the best man in his field of specialisation:confirmed ,your m.i.l has moderately well differentiated adenorcarcinoma ,primary most probably lung.Status:Stage 4.
As if subconciously,my other half,Dr Nik the Physician took over from Nik Isahak the man .Best case scenario 1 year of progressive deterioration for patient with increasing discomfort and breathlessness and hopelessness for patient, and emotional pain for the loved ones seeing such suffering and physical as well as mental deterioration in the beloved who was once an active joyful individual.Worse case scenario,3 to 4 months of fast continuous downhill slump .Subject of 'longevity' disappeared from the screen.What appeared was Grace ,Grace ,Grace.Allah in His Ultimate Wisdom is the God of Grace and Mercy .In illness and suffering there is yet grace and mercy from Allah:the concept of Kaffarah.
When a person accept [for want of better word in English] ie 'riddha'with his illness and bodily suffering that comes with it 'all those small sins are shedded away from oneself like the falling of leaves in autumn' says a well known hadith .Additionally one has to look at illness like these as a mercy from Allah ,one is given time and space to think ,accept and attune oneself to the next phase of life.On the other hand one may not be fortunate enough to have time and space ie right after a wild night out one may be involved in a fatal motor vehicle accident and 'die on the spot'.Secular minded souls always worried 'big' about dying 'interstate' ie 'not leaving a will' .In actual fact this should be the least of our worry ."Dying interstate' with respect to our 'aqidah' ,on which side of the divide we are on ,the full ramification of our shahadah ,etc etc ,these should be our principal worries !
We cannot choose how we exit from this life but if one happened to be afflicted by serious chronic life shortening illnesses do take time to ponder:It is still a mercy from Allah !
The 'short'time given to you ,if used properly may well advance you straight to 'reserve class',whatever 'animal you are ' prior to your illness rather than 'cattle class' for eternity:husnul qhatimah as opposed to suul qhatimah.Allahualam ! !
Dr Nik Howk
Friday, May 23, 2008
Not So Pearls & Gem :Nik Isahak
" Life[and for that matter death]is a mind game ."
Appears crazy .But in life we have a finite way of choosing ,within a broad leeway of limitation ,how we would like to 'colour' it .Black ,white ,gray even red or purple !
That to most people is acceptable .In death ,even a mind game !This chap is crazy !
At the moment of death or precisely at the brink of death ,when measured in finite time ,may be short , but is it really ?From the Muslim perspective ,all of will meet Mr Izra'il at that moment in time .We are encouraged to 'doa' thruout our life to have a 'peaceful' moment of death :husnul khatimah .Not suul khatimah .What precisely would determine whether we go upward meaning 'husnul' or have a downward spiral as in 'suul'?Allahualam !This has to do with how we lead our lives as preamble to that 'brink' in time at the precise moment before we exit this earthly life go thru the exit door thru to Alam Baka' for another millenium or so !What would determine our state of mind at that point in time to choose the proverbial 'cup of milk' rather than 'wine' when offered by that foxy Mr Iblis at a time when neither wealth or any number of childrens [ or wives ] we have can help us .That is the mind game .
We have to prepare our minds with ILM for that . Back to Ilmu ,Ilmu , Ilmu and Ilmu .But ilm alone is not enough .John esposito has got a lot of ilm about Islam ,so are all the orientalists !With hidayah from Allah ,with ilm we proceed to iman and amal .
That was why Allah started His revelation to Muhammad[ pbhuh] with "IQRA...! .
Appears crazy .But in life we have a finite way of choosing ,within a broad leeway of limitation ,how we would like to 'colour' it .Black ,white ,gray even red or purple !
That to most people is acceptable .In death ,even a mind game !This chap is crazy !
At the moment of death or precisely at the brink of death ,when measured in finite time ,may be short , but is it really ?From the Muslim perspective ,all of will meet Mr Izra'il at that moment in time .We are encouraged to 'doa' thruout our life to have a 'peaceful' moment of death :husnul khatimah .Not suul khatimah .What precisely would determine whether we go upward meaning 'husnul' or have a downward spiral as in 'suul'?Allahualam !This has to do with how we lead our lives as preamble to that 'brink' in time at the precise moment before we exit this earthly life go thru the exit door thru to Alam Baka' for another millenium or so !What would determine our state of mind at that point in time to choose the proverbial 'cup of milk' rather than 'wine' when offered by that foxy Mr Iblis at a time when neither wealth or any number of childrens [ or wives ] we have can help us .That is the mind game .
We have to prepare our minds with ILM for that . Back to Ilmu ,Ilmu , Ilmu and Ilmu .But ilm alone is not enough .John esposito has got a lot of ilm about Islam ,so are all the orientalists !With hidayah from Allah ,with ilm we proceed to iman and amal .
That was why Allah started His revelation to Muhammad[ pbhuh] with "IQRA...! .
Allahualam !
Thursday, May 22, 2008
Some More Random Thots on Death
A colleague just this week was diagnosed with terminal cancer of the pancreas .Medium survival 6 months .With state of the art chemo and radiotherapy,if you are very lucky 1 year .
In the doctors rest room a small group of us were discussing the merit and demerit of 'saying goodbye' to this earthly life the 'fast way'[massive heart attack,mva,plane crash etc etc ]against the 'slow way'[incurable cancers,leukemias,debilitating strokes,chronic heart or lung failures etc etc],since in the same week we have al most gone bonkers discussing Dr M. We could not make any sense of Dr M's recent resignation from his AMNU this same week.....age and the thought of death itself must have hit that old man ! .
On the point of death itself,from my perspective, any superficial discussion generally devoid of divine revealed injunction, would be a sheer waste of time and function.Very naive,rather secular discussion devoid of depth just like the 'war games' they used to enact in the Pentagon before the rape and devastation of Iraq.Without the 'spiritual'content any discussion on death,or rather moment of death,tend to be shallow,for no one can predict at that precise moment of death,the one involve can be in a different 'plane'altogether and that precise short moment could well be a protracted affair for the individual concerned.Only God knows.That precise moment when you face Izra'il ,Mr Death himself,on his turf.You and him would be in the world of your own ,oblivious of the surrounding.
Needless to say as cardiologists in a hospital setting,we 'presided'over most hospital deaths be it during office hours or in the wee hours of the morning.A thankless job,imagine yourself being called at 3 am just to see and maybe 'bring to life'an 80 year old man dying of terminal cancer in Bed 211,who suddenly went blue and noticed by the night nurse to be not moving .Cardiac arrest.The usual euphemism :Code Blue .Either you are there Ist or the anaesthetist on call or the resident MO.I have 'presided' over more than several thousands such calls in my 30 years or so of hospital practice.When you drive home to capture any decent sleep remaining and see your spouse snoring away like crazy you cannot help but feel honoured and priveledged to have been there when even the closest family members of the newly departed were just probably be making their way to the hospital.
It was 3am,you were there and you damn sure Izra'il was also there.You are not paid for the service rendered whatever the time[as all Code Blue are dire emergencies]but what the heck, you are in the priveldge territory and presence of Mr Death himself,Izra'il !. That is an honour and esteem.
I usually say a few prayers for the departed and also for my own salvation .Despite the several thousand times ,during my lonely drive home I cannot help but felt eerie about that kind of encounter :"The next one could well be me feeling". It is time like these that make myself think of my very own mortality 10, 20 times a day , everyday ! And that is a priveledge and a blessed life, if I have got the right hadith correctly that I used to read somewhere!.... was it from Abdul Qadir Jilani's 'Sublime Revelation' ? Maybe from Imam Ghazali's most beautiful long discourse on 'Remembrance of Death and The Afterlife', translated magnificently by T J Winter ? Must be from one of these two or maybe Hamka......
The one million dollar question? How many able to say the 'syahadah' at that moment in time .From my experience,very very very few!I can recall only 2 individuals in my whole quantum of experience.One lady of late 60's,a dear patient of mine 15 years back,mother of my friend,Zul, a self made millionaire thru forwarding business,died as a complication of angioplasty when at that time stent was not invented yet and the resident cardiac surgeons could not help because despite popular believe, they are 'slow animals'.It take a couple of hours to prepare a healthy cardiac patient for surgery.It take only a few minutes for a moribund old heart patient to die.Of course in a court of law ,the judge and lawyers will always appear very clever."I put it to you Dr Nik that you have not exercised due care blah blah blah ".No shade of gray in their superficial world,just simple yes and no! F...k these bastards!If life at that precise moment can be very simple.3 am ,4am ,5 am in the wee hours of the morning ,you struggling with dear life and Izra'il looking over your shoulders ,all the time .All the time!
Well back to this fine lady . She was saying the syahadahs all the way . Very rare breed .Another chap was an old man from Kampong Melayu Subang . Can still remember his name .Javanese chap. Toppan Rusdie . Always very polite.Always come to my outpatient clinic followed by his dutiful son .One day came in with bad intractable angina .Required urgent coronary angiogram but no son and father conferred ,No Angiogram ! No invasive procedure ,we have no fund !Had a massive myocardial infart shortly after that .[Later I discovered this old man had 'many many' acres of land near Subang Airport ].He was destined to meet Izra'il then .Shahadah till the last .
I said only 2 but actually nearly 3 .
I was doing CCU round one bright Sunday morning when I saw an SYT probably in her early 20's,Irish ? Australian ? sitting anxiously outside .One corner of the open bedded CCU then was shrouded and I knew some active resuscitation was going on behind the screen .Someone groaning " Allah ,Allah ,Allah ...".My senior cardiologist colleague was there 'presiding' over the Code Blue .Patient survived .Tun Datu Mustaffa died a week later in Sabah.From then on I make a point not to prejudge a man's destiny with his Maker from his 'apparent' lifestyle and 'colourings'.Only Allah Knows .
In the doctors rest room a small group of us were discussing the merit and demerit of 'saying goodbye' to this earthly life the 'fast way'[massive heart attack,mva,plane crash etc etc ]against the 'slow way'[incurable cancers,leukemias,debilitating strokes,chronic heart or lung failures etc etc],since in the same week we have al most gone bonkers discussing Dr M. We could not make any sense of Dr M's recent resignation from his AMNU this same week.....age and the thought of death itself must have hit that old man ! .
On the point of death itself,from my perspective, any superficial discussion generally devoid of divine revealed injunction, would be a sheer waste of time and function.Very naive,rather secular discussion devoid of depth just like the 'war games' they used to enact in the Pentagon before the rape and devastation of Iraq.Without the 'spiritual'content any discussion on death,or rather moment of death,tend to be shallow,for no one can predict at that precise moment of death,the one involve can be in a different 'plane'altogether and that precise short moment could well be a protracted affair for the individual concerned.Only God knows.That precise moment when you face Izra'il ,Mr Death himself,on his turf.You and him would be in the world of your own ,oblivious of the surrounding.
Needless to say as cardiologists in a hospital setting,we 'presided'over most hospital deaths be it during office hours or in the wee hours of the morning.A thankless job,imagine yourself being called at 3 am just to see and maybe 'bring to life'an 80 year old man dying of terminal cancer in Bed 211,who suddenly went blue and noticed by the night nurse to be not moving .Cardiac arrest.The usual euphemism :Code Blue .Either you are there Ist or the anaesthetist on call or the resident MO.I have 'presided' over more than several thousands such calls in my 30 years or so of hospital practice.When you drive home to capture any decent sleep remaining and see your spouse snoring away like crazy you cannot help but feel honoured and priveledged to have been there when even the closest family members of the newly departed were just probably be making their way to the hospital.
It was 3am,you were there and you damn sure Izra'il was also there.You are not paid for the service rendered whatever the time[as all Code Blue are dire emergencies]but what the heck, you are in the priveldge territory and presence of Mr Death himself,Izra'il !. That is an honour and esteem.
I usually say a few prayers for the departed and also for my own salvation .Despite the several thousand times ,during my lonely drive home I cannot help but felt eerie about that kind of encounter :"The next one could well be me feeling". It is time like these that make myself think of my very own mortality 10, 20 times a day , everyday ! And that is a priveledge and a blessed life, if I have got the right hadith correctly that I used to read somewhere!.... was it from Abdul Qadir Jilani's 'Sublime Revelation' ? Maybe from Imam Ghazali's most beautiful long discourse on 'Remembrance of Death and The Afterlife', translated magnificently by T J Winter ? Must be from one of these two or maybe Hamka......
The one million dollar question? How many able to say the 'syahadah' at that moment in time .From my experience,very very very few!I can recall only 2 individuals in my whole quantum of experience.One lady of late 60's,a dear patient of mine 15 years back,mother of my friend,Zul, a self made millionaire thru forwarding business,died as a complication of angioplasty when at that time stent was not invented yet and the resident cardiac surgeons could not help because despite popular believe, they are 'slow animals'.It take a couple of hours to prepare a healthy cardiac patient for surgery.It take only a few minutes for a moribund old heart patient to die.Of course in a court of law ,the judge and lawyers will always appear very clever."I put it to you Dr Nik that you have not exercised due care blah blah blah ".No shade of gray in their superficial world,just simple yes and no! F...k these bastards!If life at that precise moment can be very simple.3 am ,4am ,5 am in the wee hours of the morning ,you struggling with dear life and Izra'il looking over your shoulders ,all the time .All the time!
Well back to this fine lady . She was saying the syahadahs all the way . Very rare breed .Another chap was an old man from Kampong Melayu Subang . Can still remember his name .Javanese chap. Toppan Rusdie . Always very polite.Always come to my outpatient clinic followed by his dutiful son .One day came in with bad intractable angina .Required urgent coronary angiogram but no son and father conferred ,No Angiogram ! No invasive procedure ,we have no fund !Had a massive myocardial infart shortly after that .[Later I discovered this old man had 'many many' acres of land near Subang Airport ].He was destined to meet Izra'il then .Shahadah till the last .
I said only 2 but actually nearly 3 .
I was doing CCU round one bright Sunday morning when I saw an SYT probably in her early 20's,Irish ? Australian ? sitting anxiously outside .One corner of the open bedded CCU then was shrouded and I knew some active resuscitation was going on behind the screen .Someone groaning " Allah ,Allah ,Allah ...".My senior cardiologist colleague was there 'presiding' over the Code Blue .Patient survived .Tun Datu Mustaffa died a week later in Sabah.From then on I make a point not to prejudge a man's destiny with his Maker from his 'apparent' lifestyle and 'colourings'.Only Allah Knows .
Sunday, May 18, 2008
FW: [jublintan65] Not So Pearl & Gem:Random Thots on Deat
Friends ,
Yesterday , while busy going through my morning clinic list ,I received a call from a clinic staff of Dr Shuiab ,a classmate ,Family Physician practising in Kampong Bharu : He died early morning ,in University Hospital ,presumably from heart failure following a massive heart attack .
My work involve me to think about 'man's fragility and mortality' all the time from from morning till evening even in the seemingly 'fit and healthy individuals passing my door just for a simple annual examination' ,call in a paranoia or whatever ,but after 30 over years in 'the business' , just like any hard nosed top gun entrepreneur ,you have to develop a 'bottom line' approach to your patients ,your clients :ie what is the chance of this individual being seen around end of this year , next 5 years ,will he make it to his 60th birthday etc etc on the basis of limited statistical clinical data I have just from the 'cardiological and endovascular viewpoint I have .Taking away the other variables of a fatal motor vehicle accidents ,latent cancer ,suicides etc etc of course .
A hardnose clinical assessment all the time ,never discussed or divulge unless to the very few ,who really ask .In my experience ,in the ones who really need to know amongst my patients ,very few really want to know and ask .
Still a classmate's demise even at 56 hit me like a speeding car crashing on a brick wall .Time's up .Think of you own mortality .Average lifespan of Malaysian males ,74 ,75 ? .Mashaallah 'we' are heading there already !What if I am diagnosed with a terminal lung cancer tomorrow ?Like another colleague the other day walking in the clinic with just vague weight loss and abdominal discomfort and found on CT scan to have terminal 'pancreatic ca' . Or TS Nazamuddin ,a former occasional patient years back who went to LA for his wife's medical check up but instead brought back in a cold coffin 2 months later ,of 'metastatic lung ca' .And another friend ,Nik Aziz formerly of Petronas ,fighting for his life ,in Selayang Hospital also of lung cancer . And that 35 year dog trainer in Cardiac ward with a heart as big as a' football' with idiopathic dilated congestive cardiomyopathy with only a left ventricular function of 15 % .He asked me gingerly yesterday whether he can get back to his favourite badminton game next month .I was not sure whether he can survive walking to the 'loo' on his own safely even while in the hospital ,preoccupied in my own thought about possible litigation if the unwanted cardiac arrest actually do happen in such compromising circumstances .Knowing that this chap on good statistical basis will improve to go back to his dogs and more than 99 .9 % sure he does not want me to tell him what is in store for him in the next 6 months , 1 year of 5 years .
That is the burden and realm of the cardiologists !
And yet still Dr Shuiab's sudden death hit me like a brick .But is death really sudden ?Is death really sudden ? Sudden to us but as soon as you are born ,your 'date' has already well been cast in iron ! You cannot change that even a second !The scenarios of your death can somewhat be a variable :Death by drowning , plane crash , MVA's , sudden death of a brain haemorrhage , fatal heart attack ,chronic brain or heart failure , kidney failures ,cancers and so on and so forth .Some may appear sudden some insidious , but all to the family members and individual involved seemingly 'untimely ' .
In some it may appear as a 'relief' ie in people with chronic debilitating diseases , in situation of prolong dementia , death is a relief to both patients and care givers especially the long suffering spouses .I know this because my elder brother died last year after 10 years of dementia .After the initial period of grief when we look back that was a relief for everyone around him .
What about those young chaps in Palestine who have decided that there will be more meaning in the deaths than to carry on living meaningless lives under a perceived ' repressive Israeli regime supported by and equally belligerent West ' .All avenues in the last 60 years leading to nowhere except more denials and more repression .Death to them is just like walking 'from a room feeling like a hot furnace thru a door into an air-coditioned heaven ' .
Some random thots on Death ,I must get on with the clinic ,Shan my Clinic assistant frowned at me to indicate some of patients are already making 'animal'noise outside there for the long delay ! More structured thots on death later, if you guys can bear this 'depressive mood ' of mine ! Still Dr Shuiab's death hits me like a brick wall !
Dr Nik Howk
Yesterday , while busy going through my morning clinic list ,I received a call from a clinic staff of Dr Shuiab ,a classmate ,Family Physician practising in Kampong Bharu : He died early morning ,in University Hospital ,presumably from heart failure following a massive heart attack .
My work involve me to think about 'man's fragility and mortality' all the time from from morning till evening even in the seemingly 'fit and healthy individuals passing my door just for a simple annual examination' ,call in a paranoia or whatever ,but after 30 over years in 'the business' , just like any hard nosed top gun entrepreneur ,you have to develop a 'bottom line' approach to your patients ,your clients :ie what is the chance of this individual being seen around end of this year , next 5 years ,will he make it to his 60th birthday etc etc on the basis of limited statistical clinical data I have just from the 'cardiological and endovascular viewpoint I have .Taking away the other variables of a fatal motor vehicle accidents ,latent cancer ,suicides etc etc of course .
A hardnose clinical assessment all the time ,never discussed or divulge unless to the very few ,who really ask .In my experience ,in the ones who really need to know amongst my patients ,very few really want to know and ask .
Still a classmate's demise even at 56 hit me like a speeding car crashing on a brick wall .Time's up .Think of you own mortality .Average lifespan of Malaysian males ,74 ,75 ? .Mashaallah 'we' are heading there already !What if I am diagnosed with a terminal lung cancer tomorrow ?Like another colleague the other day walking in the clinic with just vague weight loss and abdominal discomfort and found on CT scan to have terminal 'pancreatic ca' . Or TS Nazamuddin ,a former occasional patient years back who went to LA for his wife's medical check up but instead brought back in a cold coffin 2 months later ,of 'metastatic lung ca' .And another friend ,Nik Aziz formerly of Petronas ,fighting for his life ,in Selayang Hospital also of lung cancer . And that 35 year dog trainer in Cardiac ward with a heart as big as a' football' with idiopathic dilated congestive cardiomyopathy with only a left ventricular function of 15 % .He asked me gingerly yesterday whether he can get back to his favourite badminton game next month .I was not sure whether he can survive walking to the 'loo' on his own safely even while in the hospital ,preoccupied in my own thought about possible litigation if the unwanted cardiac arrest actually do happen in such compromising circumstances .Knowing that this chap on good statistical basis will improve to go back to his dogs and more than 99 .9 % sure he does not want me to tell him what is in store for him in the next 6 months , 1 year of 5 years .
That is the burden and realm of the cardiologists !
And yet still Dr Shuiab's sudden death hit me like a brick .But is death really sudden ?Is death really sudden ? Sudden to us but as soon as you are born ,your 'date' has already well been cast in iron ! You cannot change that even a second !The scenarios of your death can somewhat be a variable :Death by drowning , plane crash , MVA's , sudden death of a brain haemorrhage , fatal heart attack ,chronic brain or heart failure , kidney failures ,cancers and so on and so forth .Some may appear sudden some insidious , but all to the family members and individual involved seemingly 'untimely ' .
In some it may appear as a 'relief' ie in people with chronic debilitating diseases , in situation of prolong dementia , death is a relief to both patients and care givers especially the long suffering spouses .I know this because my elder brother died last year after 10 years of dementia .After the initial period of grief when we look back that was a relief for everyone around him .
What about those young chaps in Palestine who have decided that there will be more meaning in the deaths than to carry on living meaningless lives under a perceived ' repressive Israeli regime supported by and equally belligerent West ' .All avenues in the last 60 years leading to nowhere except more denials and more repression .Death to them is just like walking 'from a room feeling like a hot furnace thru a door into an air-coditioned heaven ' .
Some random thots on Death ,I must get on with the clinic ,Shan my Clinic assistant frowned at me to indicate some of patients are already making 'animal'noise outside there for the long delay ! More structured thots on death later, if you guys can bear this 'depressive mood ' of mine ! Still Dr Shuiab's death hits me like a brick wall !
Dr Nik Howk
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