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What Is Love?

June 29, 2007

(…baby don’t hurt me, don’t hurt me… no more…)

No try again…

kr’s note: As per the advice of one Imran Hussaini, who suggested that I continue this recent trend of narrating personal events that have affected me into posts, I relate this incident that happened a few weeks ago on the tail end of my medicine rotation, a sort of culmination to a certainly odd year that ended with perhaps a simple and timely lesson that I was finally meant to learn.

kr’s note #2: After reading this post, I do think that somewhere during the process of writing this, I lost my Y-chromosome somewhere along the way and I need to send out an APB to find it… quickly. Alas, fear not friends, I shall have a step-on-someone’s-toes post soon enough….

As a lowly third year student, you’re often made in charge of taking care of relatively uninteresting patients that have straightforward diagnoses that don’t require the interns and residents to invest so much time in working up and managing on a day-to-day basis. Oftentimes, these are the kinds of patients that either admitted under bogus pretenses or are admitted even though nothing medically can be done to help them other than wait and let time do its thing. Or as the Fat Man (from The House of God) teaches, “THE DELIVERY OF GOOD MEDICAL CARE IS TO DO AS MUCH NOTHING AS POSSIBLE.” Man, I need to do a post about House of God eventually… but I digress.

I was given over to manage a gomer (get out of my emergency room) patient who was over 90, nursing home resident, multiple medical problems, etc… who was admitted to the hospital with aspiration pneumonia. The intern that had admitted her on the weekend gladly ‘turfed’ her over to me, since there was nothing much to do for this patient than to administer some IV antibiotics and just watch her, since she had a host of medical problems that couldn’t be solved. She was bedbound, had no orientation whatsoever, no response to sound or even pain (pin-prick), and essentially ‘lived’ by remaining in bed, nasogastric tube (for feeding) in place, half-lying/half-sitting with her body contorted to the left in an unreleaseable contracture, multiple decub and heel ulcers (basically ulcers/erosions of the skin that happen due to pressure from laying down in bed for so long). For all intents and purposes, she was more dead than alive. We were just babysitting her, fixing her up and shipping her out until her next admission which would probably be in a week or so, if her prior two years’ history had anything to do with it.

She was accompanied by her husband, himself with a host of medical problems, who was placed in the bed next to her to make it easier for him to visit. She and her husband, Holocaust survivors from an age and time long since vanished, lived together at the nursing home for the past few years and he wanted to be there at the hospital every time she was there. He himself could barely walk and it had been years since his wife had enough mental cognition to recognize or communicate with him, but he was still there. I remember the first day I walked in and introduced myself. He thought I was a doctor, and I told him I was just a medical student, and he gratefully said that to him, it didn’t matter, anyone who came into see his wife was an angel in his eyes. I explained to him that she had a pneumonia secondary to aspiration since she couldn’t swallow; everytime she would try to eat, food would get stuck in her throat and work its way into her respiratory tract, causing the pneumonia. I had been told that everytime she would come in, they would try to get him to agree to a DNR (Do Not Resuscitate) order so that if something happened, she would go peacefully. But each time–and this time was no different–he refused, and when asked if a g-tube (tube directly to the stomach for feeding) could be surgically placed, he also refused, saying that she had been through enough surgeries in her life, and all he wanted was for her to get better. I tried explaining to him that she kept getting sick cause she would aspirate when she ate, and he replied how she had fed him for so many years in his life and continuing to feed her was the least he could do.

While his reasoning went against medical logic, it was his passion that immediately struck me. For him to continue to hope that his wife would magically get better even after that many years of steady decline struck me to the core. On day 3 of her hospital stay, she began to breathe a little faster and harder in the morning, and I checked her and even called in the resident to look at her–she was OK, just breathing a little harder but nothing too serious. We told him that she was on antibiotics, had good O2 sats, the chest x-ray was looking better, etc–that was recovering slowly but surely.

But not to him. For him, her breathing slightly harder and faster was a medical emergency. Every 15 minutes, he would hobble over to the nurses’ station, a distance of 20 seconds that took him 5 minutes to cover, and he would beg one of us to come in and look at his wife, saying he was worried that she was breathing hard and something would happen to her. And we’d go and check her and reassure him that she was OK, but he continued to talk to anyone who would pass by, begging them to make sure that his wife was OK. He truly believed with every cell in his body that she would recover and jump back onto her feet, becoming the woman that she had once been.

It was that dedication that I was perhaps meant to learn from this old Jewish man from that age long since passed, a time when people like him understood what love was and were shocked to find themselves now living in a world utterly devoid of it, much as a man lost in a burning desert looks to his companions and wonders why they empty their flasks of water into the sands of time. Later he would tell me that they had been married for more than 70 years, survived two wars, and faced joys and tragedies together. And even though he has been unable to communicate with her and she is unable to recognize him (or anyone else), he loved her the same as he did when he first met her.

I asked him how they made it this long. He looked at me, smiling wanly, and gave me an answer that while cheesy, was profound only because of the sincerity with which he said it–it was ikhlas defined:

“I loved her, she loved me, what else did we need?”

And it was at that moment that I realized that this gomer couple from that age long since passed had taught me more about love with one sentence than anyone ever had or maybe even could. And so maybe that’s the secret to love–that it’s not about looks or money or status or what you have or what you don’t have or what society or family or culture or Madison Avenue teaches us… that it’s not complicated, that it never was meant to be, yet we’ve ruined that one thing that makes us alive and in doing that, lost that secret…

Maybe the secret to love is love itself.

That’s not much of a secret, is it?

Bah, what do I know?

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19 Comments
  1. speechless.-Mohd

  2. Anonymous permalink

    that makes me all teary eyed…and I’m not being sarcastic…Mashallah…one of your best posts…

  3. wow, tough crowd with not many props flowin here. here ye go. that ^^ was/is “something, something”. it should go without saying, you’ve got some flow, mA; flow of thought, that is. perhaps, Mode sums it up best. =)   

  4. aaaah. lawe.lawe is very nice one.

  5. deeply moving.

  6. 🙂 SubhanAllah.

  7. i’ll tell you what love is baby.awesome post

  8. Anonymous permalink

    i haven’t given you eprops from an age long ago

  9. subhanallah, that was really beautiful.  It choked me up.  I hope all of us find someone who will love us like that in our life, insha Allah.

  10. Very nicely done. MashAllah

  11. That wasn’t a cheesy line.
    The fact that we of today would that might be cheesy is a sign of how disconnected we’ve become from such sentimental thoughts.
    “Bah, what do I know?” 😛

  12. reminds me of “The Notebook”…good post

  13. Wow, I echo what everyone else above said.
    I especially liked this line: “It was that dedication that I was perhaps meant to learn from this old Jewish man from that age long since passed, a time when people like him understood what love was and were shocked to find themselves now living in a world utterly devoid of it, much as a man lost in a burning desert looks to his companions and wonders why they empty their flasks of water into the sands of time.”

  14. Read this post at ISNA.
    I’m you’ll find a lot of “love” there
    nice post though, mashaAllah

  15. wow, this love story is better than Veer Zaara or even Romeo Juliet.At the same time, I find it old age very scary and what people have to go through with not much support in this country…Good posts man. Keep sharing your experiences. Lot to learn from simple posts…Oh, one comment. Keep the posts less technical or provide more background on those complicated medical terms :p

  16. how does a post like this deplete you of a Y-chromosome? it EARNS you a Y-chromosome.

  17. eprops from afar

  18. eprops from afar

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