By Inayah Zaheen

A few months ago, I met a Patient who would have a profound effect on my journey as a medical student. I was on attachment with a palliative care team; she was a middle-aged mother-of-two diagnosed with a rare, aggressive form of brain cancer that within six months had taken her from being fully mobile to bedbound.

I saw her everyday during my month-long rotation on the ward and joined several team discussions with her husband, which naturally involved weighing up whether she would prefer to die at home or in a hospice and whether attempting resuscitation in a cardiac arrest would be futile. Indeed, most of these discussions were rather sensitive, far removed from the more light-hearted nature of day-to-day conversations outside a hospital and healthcare setting.

My true motivations for choosing this field had not always been truly reflected by the answers I gave when questioned about it during medical school interviews in 2010. I suppose, in some ways, I did not really know the answer and, in many ways, am still discovering these motivations, or rather, redefining them as they evolve and are inspired by experiences like these.

Perhaps most importantly, I have seen first-hand how my motivations have become increasingly inspired by my Faith while, perhaps somewhat surprisingly, my faith itself has actually been strengthened and further inspired by the experiences I have had thus far and the diverse range of people I have been privileged to cross paths with.

“I realised I have often found the study and practice of medicine to be one of the most eye-openingly raw disciplines”

As my month on the ward continued, I subconsciously became quite used to checking on the patient during ward rounds, greeting her husband and children when they were visiting. They were always warm and friendly despite the trials they were facing in their lives. On one occasion, I was amazed to learn her children had been raising money in their school in order to fund research into this rare and largely mysterious tumour and cancer. They had written cards for their mother, although she was now unable to hear or respond to what they were saying, to tell her “I love you, mum,” and, “we will always make you proud.” I remember clearly the face of the younger child as he grasped his mother’s hand in the hope she might somehow feel his touch.

Sadly, this patient’s brain tumour was particularly aggressive and she was ultimately unable to communicate with words or even eye movements. It was difficult not to feel a deep sadness about the nature of her condition: she had gone from planning her 40th birthday party just a few months earlier to such a condition where surviving those few months to that birthday would be nothing short of a miracle. On one evening, her husband revealed his sadness to the team: he had begun feeling a deep longing for the “smaller moments” of life. He cried at the idea of his wife missing their children’s graduations, marriages, childbirths. Gripping a nurse’s hand, he wept further for their daughter, who would have to face the trials of adolescence without her mother. At home that night, little could stop me crying too.

On the last day of my rotation, even though I knew she could not respond, I decided to thank the patient and her family for teaching me so much about resilience, love, family ties, hope and faith. I learned from them to value our relationship with our parents, about patience when enduring difficult trials and being kind and good to those around us: all values strongly taught and supported by my faith.

As I approached her room that day however, I was taken aback when I saw a completely different patient in her bed. I initially assumed she must have moved to a different room and it was only when I could not locate her on the patient list, and asked my consultant, that I discovered she had passed away the previous night, aged 39.

I cannot describe the sadness I felt knowing both that she had passed away and that I would probably never meet her family again. That evening, I went home, cried and sincerely prayed for her soul to be at peace, wherever it was, and for her family, in particular her children, to receive the strength and patience they needed to endure this difficult trial.

That day I realised I have often found the study and practice of medicine to be one of the most eye-openingly raw disciplines, particularly when immersed in such sensitive issues. I had naturally turned to my faith when trying to cope with and discuss these sensitive matters but now I realised that I also found inspiration in medicine when reconciling my beliefs with my career choice. The patient’s Death reminded me of a verse in the Holy Qur’an:

“Every soul shall taste death…” [3:185]

I reflected on how it does not refer only to the inevitably of dying ourselves but also that most of us, particularly in the medical profession, will have to face death as a more immediate reality — for our patients, for our families and then for ourselves. Most of us will have death inevitably intertwined with our daily lives, however much we try to forget it.

In the days following my time on that hospital ward, I remember feeling intrigued at how capable we are, as human beings, of forgetting or choosing not to discuss or think about death. Of course, such conversations are not always appropriate or enjoyable but at times it almost seems as though collectively, as a species, we choose to ignore that the only inevitability of life is death. Perhaps this is partly because the thought of losing loved ones and indeed our own lives is scary but perhaps in part it is also due to a false sense of power we all feel we have in our lives. It almost feels as though sometimes, we do not truly believe that death will happen. Even though I knew the patient was in the palliative care ward, awaiting her last days, I was still struck by disbelief upon learning about the end of her life.

During this palliative care attachment there was something enlightening about seeing a patient’s death not viewed as a medical failure but rather a natural end to life. This did not erase the sadness but it did introduce a level of peace — in understanding we could not have done anything more. It struck me how this thought tied so strongly with my Islamic faith. Islam is not clouded by an obsession with death or a looming sense of doom whenever we think life ending. Rather, it is a balance of practical, divinely decreed guidance that enables us to make the most of living in this life, as individuals and within families and communities, while always being aware that all of this will come to an end, and we have no knowledge of when or where:

“Verily, Allah! With Him (Alone) is the knowledge of the Hour, He sends down the rain, and knows that which is in the wombs. No person knows what he will earn tomorrow, and no person knows in what land he will die. Verily, Allah is All-Knower, All-Aware (of things). (31:34)”

As I began to balance my feeling of sadness, I found myself reflecting on this idea a lot. I had learned so much from this patient about life and about living and, in a beautiful and somewhat ironic way, about death. This is something I love about medicine: the variety of people and stories I encounter can always shape or change the way I see the world and influence it for the better. In the case of this patient, I learned much about appreciating my own blessings while my understanding of empathy became something much more deeply-embedded.

What really reinforced my faith though was realizing that as much as we might feel like experts in in our specialized fields — able to explain the patient’s tumour down to its cellular components — it was still ultimately untreatable. We simply do not know enough to be able to treat some diseases. It was in this, perhaps ironically, that I found the most faith: sometimes in our moments of vulnerability, from those gaps in our wisdom, we are able to learn exactly how powerless we are. We can wear the seatbelt in the car but Allah decrees whether it will truly help us.

It took me that month and consequent days of thought and introspection to realise the true answer to those medical school questions. Medicine, for me, highlights our quest to understand and solve the unknown, while also balancing it with the peace in knowing that sometimes, that which we do not know and which makes us powerless, is what gives us the most ultimate power: humility.

Lessons in death and faith from a hospital ward was originally published in Convivencia Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.