By Abeer Chaudhary
The scenes from those 18 months played in mind on repeat like a broken record. The phone call from my sister, the helplessly put-together care packages, the group video chats, the flights back and forth from Chicago, the inkling of hope with each improving scan, the bated breath after a broken hip, the sleepless nights spent in prayer, the heartbreaking family meeting, and then the peace that came with her peace.
The ironies left a bitter taste in my mouth. She used to say she didn’t want to die behind the microscope. Instead, she died underneath it. She buried her mom when she was a medical student. I buried mine a month after taking my own board exam. These uncanny parallels colored my future bleak.
I can’t bring myself to say “I miss her” aloud. Certainly, not to my father. How can I throw that in his face when I know he feels her loss more keenly than her children? For those 18 months, he drove her to her appointments, cooked all her meals, cleaned up after her, flew with her to MD Anderson (twice), and remained the most hopeful out of us despite knowing how this was going to end.
I’ll never forget the look in his eyes after her last oncology appointment. He kept looking at her as though she was going to evaporate right in front of him. We had finished out another Ramadan and Eid in good spirits despite the COVID-19 lockdown, but I could feel the atmosphere shift abruptly. I didn’t push for details that day as it was the week of my boards. I knew they wouldn’t tell me until after I completed them. That’s just how Desi parents are.
Feigning ignorance to perpetuate the façade of bliss was all I could do in the meantime. The day after boards, however, is still the worst day of my life.
Mets in previously unaffected organs. Lab values off the charts. A clinical trial chemo agent that could cause intracranial bleeding. The worst part is that she was willing to continue.
She felt obligated.
For us.
Although we all knew her treatment had been strictly palliative, it still came as a shock to see the actual end of the line. Of course, we could see it physically. It took two of us to lift her up. She had no appetite to intake any nutrients. A yellowish hue finally began to take up residence in her eyes and skin.
My siblings, who were at more advanced stages in their medical training, thankfully took the reigns. “You don’t have to do anything. You can remain comfortable at home.” At the height of a new pandemic of uncertain duration, the thought of her being in a hospital alone with no visitors would have crushed our spirits altogether. Our acceptance and support were the reassurance she needed to step back.
So, we agreed to stop and to let nature take its course, which it did fairly quickly.
The remaining days passed in warm embraces, life lessons, quiet contemplation, Netflix binges, and gradually worsening encephalopathy. Her sharp-as-a-knife mind dulled into a mere butter knife. I’m still unsure whether it was foretelling or foreboding when she mistook 20-something year old me for our 70-something year old president, but I digress.
The night her death became imminent, all four of us bunked around her bed and took turns to get up and administer morphine to calm her death rattle. By the next morning, the rattling stopped.
Her lungs had taken their last breath. Her heart had taken its last beat. Her soul had exited this world forever.
Although the sorrow was deep, the impact of the blow was cushioned in my mind as I already mourned her obtunded state. The physical loss almost seemed insignificant in comparison to the cognitive.
As per Islamic tradition, she was buried the same day after the women of our family performed her ghusl. Her headstone, which would be delivered several weeks later, had carvings of birds because they made her happy. Knowing that made us happy.
The postmortem period involved a recalibration of sorts that was both unfamiliar and instinctual. My father bursting into tears and hugging me when I found out I passed my first set of boards was not the reaction I expected. When the leave of absence ended and it was time for us to return to our respective school/jobs, anxiety was at an all-time high. How would a full-time caregiver react to being alone? Our preventative approach led us to the animal shelter. Enter Alpine, a green-eyed goofy feline who managed to partially fill a void with her warm cuddles and silly antics.
The void never really does get smaller. Its proportion shrinks as other joys fill the space around it, but it remains there as a reminder of what once was. You don’t remain the same, but why would you? Experiencing the brevity of mortality is incredibly humbling. To live in the same attitude would be a disservice to those who have come and gone.
There is not a day that goes by where she doesn’t cross my mind in some form or fashion. The lessons I’ve gleaned from her life and death hover in the back of my mind, and I often ask myself “WWHD: What Would Humera do?” We don’t think of adult children needing their parents in the same way young children do, but I have felt the need for that guidance so keenly in my twenties. The apparent absence during major life events still causes tears to well up in my eyes for a moment, but it is often followed by a smile when I reminisce on how much love I got to know and continue to experience. It is a privilege to carry it forward.
This has allowed me to lift the tonearm and let the broken record stop playing. It is time to listen to something new.
Abeer Chaudhary, D.O., is a resident physician at the UAMS Northwest Campus.