With the Name of Allah, the extremely Merciful at this very moment, and the extremely Merciful at all times
First week on the wards, walking around with no idea where anything is or how to conduct a proper interview, my chief resident sent me down to see my first ever consult in the ER. As I picked up the chart and walked into the room, I came upon a medically stable yet ill appearing malnourished and unkempt homeless man. He looked up at me, confused and lethargic.
“Hi Mr. A., my name is Hateem. I’m the student on the team that’s going to be taking care of you.”
As I completed the history and physical, I looked up the labs and started to formulate my assessment to present to the chief resident. We ended up admitting the patient, starting IV antibiotics, and doing the whole nine yards in terms of workups and imaging. I went home after sign out- which is about 5pm- expecting to follow 3 patients in the morning.
I was not ready for what came next.
When I walked in the next morning, my chief resident said: “Oh Hateem, you won’t believe it, remember Mr. A? He “crashed” last night and was transferred to the ICU, coded and passed away.”
My first patient was gone as quickly as I saw him.
The irony of life is that the only thing for certain is that it will end. Just watching television and reading the news remind us of how many people actually die on a daily basis; but this truth is painfully clearer in the hospital, where everything is expected to be “fixed.” Even so, we rarely reflect on death. What will our last words be? Who will we spend our final days with? How will we be remembered?
Because of our obliviousness, we carelessly live as if we will control where and when we will die. This leads us to making poor choices under the guise of excuses like “we still have time” or “we’re still young.”
I can remember on the Trauma service countless young people being rushed to the ER in unstable condition, multiple lacerations, fractures, and unconscious. Many are quickly intubated, sedated and taken to the operating room where the best can be made of the situation. Maybe they got lucky and didn’t have internal organ injury. Maybe they need an ileostomy and their intestinal waste now needs to pass to an ostomy bag. Or maybe they had severe traumatic brain injury and the next plan of action is to discuss end of life options with the family.
Many times, the victims of these injuries were younger than I was. Maybe they were driving too fast on the freeway or sending a text. Maybe they were blindsided by a drunk driver. Maybe they were an innocent bystander in a drive by shooting. Or maybe they chose to take their own life.
All those who passed left behind a legacy; and so will we.
How will you be remembered?
Death will come to each of us whether we like it or not, expect it or not, or prepare for it or not. As Allah (swt) says:
“Everyone is going to taste death, and We shall make a trial of you with evil and good, and to Us you will be returned.” (21:35)
Was it our fault that Mr. A passed? Was it a fault of the healthcare system? Did we not get there in time? Did we mismanage the patient? Or was it simply his time, and nothing we could have done could have prevented the outcome?
Do we have time?
Do we have time to pick fights with our mothers because we can’t stand they “constantly” call us and ask where we are? Do we have time to drive fast without a seat belt for the thrill of the ride? Do we have time to frown and be depressed that we aren’t where we want to be? Do we have time to put ourselves in risky situations because we’re young and we’re expected to do stupid things? Do we have time to hold grudges and stop speaking to our friends because of a petty argument?
The answer is clear. Pop culture and the media may tell us we’re young, “have fun” (a euphemism for: “be better later“), and that we have time. Medicine reassures me they’re lying.
However, a few questions still remain. When our time eventually comes, and for sure it will come, will we be happy with the way we spent our lives? Will we be pleased with the legacy we left behind, the money we hoarded, the respect that we had, and the company that we spent it with?
My young career and few patients have taught me- rather- reminded me, that our “future life” however we imagine it is not guaranteed. We must make every effort to always say a good word, because it may be our last. How unfortunate if our last word was a curse word! How beautiful instead if our last words were the testimony of faith?
We must make an effort to remember each other in the best way, because it may be our last memory of each other. How unfortunate if the last memory of someone was a petty argument! How beautiful instead if it was an enjoyable conversation?
We must take the effort to be in honorable places. How unfortunate if the final place we were before dying was in the club?
And we must make every effort to be doing something good, because it may be our last deed. How unfortunate if it was a sin against the Extremely Merciful? How beautiful instead, if it was a deed that pushed us closer to the Extremely Merciful?
Death is the unexpected guest none of us want to entertain, yet we must be ready to answer the door, and be proud of the legacy we leave behind.