A day before our ophthalmology exam, one of my friends shared with our clinical group a snap of Conrad Fischer from the Kaplan lecture series, relating a well-received saying by “our friend, Rumi” to explain how the cornea in our eye is home to a thousand layers of cells:
‘My heart is so small it’s almost invisible. How can You place such big sorrows in it? “Look,” He answered, “your eyes are even smaller, yet they behold the world.’
The ophthalmology rotation is notorious here as one of the driest, and hence, difficult ones. Add to it the unfortunate fact that I was too busy for university even, this rotation was easily one of the most challenging ones, catalysing a kind of growth that I had never anticipated.
The cornea, the lens, the iris, the optic nerve. Cataracts, glaucoma, conjunctivitis, macular degeneration.
As the rotation thankfully ended, I realised that myopia is not merely short-sightedness of the eye. Often enough, we fail to recognise what really is important to the eternal soul and the mortal bodies – myopia of the heart, maybe? To be able to see – in this day and age – that the honour and dignity of human lives lie in kindness, humility, compassion, forgiveness, love, and empathy, is one of the biggest blessings that you can enjoy. To even consider it to be a blessing is a blessing in itself. Just like the proteins in the lens accumulate to turn into the pathology of cataract – clouding your vision and making it ugly and blurry – our prejudices, our egos, and our insecurities scar the beauty of our happiness, leaving behind a tragic trail of lifelong regrets and struggling souls. Weighing the worth of happiness against the bias of religion, caste, creed, and social status is – sadly – How You Kill Love and Happiness.
Maybe one fine morning, we will wake up to a world of mortals where the beauty of the soul will be the joyous Phoenix.
When the same eyes that have once looked at you with adoration haze into a struggle for recognition, it does a little more than break your heart, doesn’t it?
Dementia, described in simple terms as a disruption of the brain’s functioning leading to behavioural changes and loss of memory, is easily – and sadly – one of the hardest ailments to deal with, simply because of the emotional implications for the patients and their families.
The ageing patient might not recognise who you are. They may think it’s the winter of 2012; you tell them it’s 2018 and the heat wave is bad this time. You cut out a few slices of a rosy apple for them and they will keep it in their mouth – chewing and swallowing long forgotten – till you chide yourself for not giving them an easy-to-swallow meal of mashed bananas and warm soup. Your back may ache from helping them move around because sometimes, they may just forget that walking requires you to move a leg. They will be irritable, anxious, confused. But so will you. They will see the shadow of a man where your favourite curtains hang and they will tell you how their dead relatives came to visit them. They may occasionally get scared because they will feel ants and mice scurrying around their bed.
But it’s okay. It really is.
They say old age is synonymous to infancy and it’s very, very true. The same unconditional love and inexhaustible patience that was once lavished upon you needs to come full circle; they need you the way you once needed them. And the kindest way to show them this love is by honouring them and giving them a life of dignity.
Medications will definitely do what they are supposed to do but let us not undermine the power of some psychological management here.
What can you – as a family – do to give them a life of dignified comfort? Here are just a few out of the many things that you can do:
Talk to them gently, patiently, respectfully. If you are talking about them in their presence, say, “Mom is not feeling too good, we need to see her doctor,” instead of “She’s not feeling too good so we need to take her to the doctor.”
Greet them cheerfully whenever you see them. Introduce yourself if they fail to recognise you.
Place a large wall clock in the room. Tell them what day and time it is.
To reduce the risk of trips and falls, don’t clutter the room.
Keep the room well-ventilated, but dimly lit. Too much light in the room can aggravate their anxiety.
Keep your conversations short and simple. Avoid lengthy sentences that may agitate them. Speak slowly, using simple words.
Be patient when they repeat certain phrases or ask the same questions again and again.
Engage them in easy, manageable activities that they can enjoy.
Do not, at any cost, blame them for being ‘lazy’, ‘dramatic’, or ‘uncaring’. It’s not their choice. Remain calm if you tend to get frustrated.
Be attentive to their body language.
Don’t stand too close to them while talking. It may intimidate them.
Include the person in conversations instead of speaking on their behalf or completing sentences for them.
Listen to the person. Give them plenty of time, pay attention to their feelings.
One of the gravest mistakes that you can make, however, is self-neglect. It’s important to acknowledge your own needs, too, and look after your own health. You can not be expected to look after someone else when you yourself are not at your best. Eat well, keep yourself hydrated, have a strong support system that you can turn to when in need. Denying yourself help will not make you more responsible or the more loving one, it’s natural and only necessary.
Dementia is not easy to deal with; it’s painful, it’s cruel, it’s heartbreaking. There will be many tears of frustration, a few of helplessness, some out of fear. There will be more than a few sighs of exhaustion and quite a few breakdowns. You will begin to question everything – why is it happening to you, when will it all be okay, does God even exist? You might even look enviously at your friends enjoying fancy meals when each of your own are caught in a hurry, haunted by thoughts of a questionable prognosis and the sad reality that your elderly loved one is no longer able to share their favourite meals with you. Your own anxiety will become a frequent visitor, and your life will have taken a path different from those around you. But it’s okay, it’s really going to be okay. You will – in your own capacity, at your own speed – grow; you will learn to master the art of patience, you will learn new skills as you care for your loved one, you will strengthen relationships. You will also feel your heartbreak – first all at once, then over and over again at each missed reflex and each reminder of where this could lead to – before you feel it soften into a much kinder, more compassionate, more emphatic one that will have learnt to call out to its Lord as a form of self-reliance. And it’s very advisable to reach out to a professional or to support groups to deal with your own caring mechanism.
So as you and your loved one gracefully transition from fighters into survivors, remember that the crux of human life lies in its dignity, in love, in kindness. Sometimes, medicines and doctors are not enough.
The sun was created to set but the morning is also a beautiful reality.
Emotions are funny companions. They twist and turn the peace of your mind and drive you dangerously through life. Much like an over-excited bus driver racing his queen (you know the one with some eye-catchy Urdu poetry adorned on its back? Yes, that one!) through the broken roads of Karachi, jamming to the latest Bollywood song.
This picture that you see here isn’t something extraordinary. It’s a very mundane moment captured as an expression of disguised vulnerability.
This man – his back to us – may have a family back home that awaits his smile, his protective embrace. To them, the new ice-cream parlor in the city does not matter because not only are they blissfully unaware of its existence, but to them, the cherished moments of joy lie in a few happy hours spent chatting with their old grandparents, drinking some cool falsay ka sharbat, contemplating the meaning of life, and then going to bed with a full stomach, a prayer of gratitude on their lips, and utterly in awe of the Unseen Existence.
Lanes like these map our entire city, don’t they? And each mile of each of these lanes is covered by a thick layer of dust that reminds you that even without the glamour of the city, life can be very beautiful and fascinating. The muddy reflection staring at you from the road tells you that imperfection is real and okay, and the bumpy roads that cause you to jump in your seats are pretty much like the bumps that life has to offer, no? And then at the end of the road, you see a shabbily dressed man happily selling balloons to a group of happy kids. Their smiles are innocently beautiful and you are easily mesmerised by the reality of something so extraordinarily simple. And you learn to laugh amidst the tears. You learn how to count the stars on the dark night. You learn how it’s futile to run away from yourself.
You learn – after the lies and deception of this world and its mortals – the names of the galaxies as you recite His ninety-nine names.
The road was ending anyway, but you eventually said goodbye.
It’s a calm night. The stars are whistling, trying to cheer you up. The wind seems to be dancing around, inviting you to a once-in-a-lifetime. But what are these once-in-a-lifetimes anyway? Foggy regrets that your foolish heart spins into a fairy tale. Or maybe gentle reminders of a cosmos that your fragile mortality could not handle. Does it make a difference, you ask. We don’t know yet. You only know it – feel it – once it floats away from you and when you try to run towards it, it waves at you with a reproachful glance, a disappointed smile.
The night-sky is a delightful companion for the dervish. It often asks you if there is happiness in shutting doors. There isn’t, you say. There’s just peace, the scary kind that does not even tell you if there are other doors, let alone finding the key to the same one. There’s peace in jumping into the deep blue ocean and not knowing whether it will welcome you or which lonely island it will throw you on; that’s what the night-sky believes. But you’ve had enough of islands, you tell yourself. Humans are islands, too, you’re reminded.
You look up again. There’s just some fog behind.
Two shooting stars at each end of God’s canvas; sad, and scared, and defeated, their hearts longing for home. So far away, yet, so close.
So that’s some of the people from my fourth year clinical group; us in our natural habitat, laughing away before a dermatology class, posing for future’s nostalgia, dreaming big, tired but ready to conquer the world. Doesn’t that make you smile fondly?
Now all of us – girls and boys – entered this field with vague ideas of sleepless nights and big, burly books that will bully us endlessly, and hopes of a life straight out of Dr. House. All of us – girls and boys – have been subjected to the same rules and regulations, have read the same textbooks, taken the same exams to get promoted to this level. There is, however, one thing that sets us girls apart – having to deal with stifling, infuriating sexism. You would think that a field like medicine that revolves around healing humanity, with the basic principles of providing quality healthcare regardless of race, religion, gender, would be free of such plagues. Unfortunately, no.
Senior consultants will not think twice before urging our male counterparts to work ‘harder’ because they are the ‘eventual breadwinners’ of the family and us girls will eventually handle the ‘pots and pans’.
You will be shocked, hurt, and angry when instructors will pass similar derogatory remarks, adding that a woman’s place is in the home and a field as challenging as medicine was merely ‘impractical’ for them.
Your correct answers will easily be ignored before the consultant will move on to advice your male colleagues to study properly because “you have to do the real work”.
Do you know what the best part is, however? All of us – my very empowering girls – have never succumbed to the trap laid out by such chauvinists. Why should we? We belong to a nation that has the likes of Dr. Anila Darbar, Pakistan’s first female neurosurgeon; Dr. Rehana Mohammad Ali Shah, Pakistan’s first female orthopaedic surgeon; and Dr Attia Zafar, who bet all odds when she enrolled into the same medical school as her eldest son, the year he was graduating. These are all women of strength who have fearlessly broken all glass ceilings. So why should we bow down to the forces of patriarchy and sacrifice our dreams and ambitions? Certainly not!
Thank you, @clearskindoc and @dr.pamelamehta for bringing together the women in medicine to speak up and support each other through your #shesanequal campaign on Instagram!
I often wonder – when I’m supposed to be studying for one clinical undergrad exam or the other – how the earth met the sky.
Did they eye each other with suspicion or they hugged like long lost friends? Did the sky ever say to the earth, “Peace be on you”? Perhaps, it didn’t. In fact, I’m pretty sure it forgot. Because our earth seems to be a mere resting place for two-legged beings who call themselves humans and kill with tongues, and toys that stink of ammunition.
Do you think the sky was boastful of the tears that it cleanses the earth with? And how its moody sighs crash waves on the salty sands of our shores, giving some of us a happy respite as we gaily feast on the ice-cream being sold by that old vendor? And how its twinkling stars eye the small crawling insects on the leaves in our gardens and say hello to the fireflies?
I wonder if each of the seven skies – sewn into each other, sometimes thundering, sometimes loving – is as beloved to our strange, strange earth. Because our earth – brown and muddy, blue and windy – sends up these souls every day that leave behind a thousand tears and a lot of loneliness. Who knows?
So I like to think – as I sit down peacefully with the familiarity of what seems strangely new – that the sky and the earth have been the best of friends and that Adam and Eve were the sky’s most precious gift to the earth, and that God – up in His heaven and everywhere in our hearts – loved them both equally. And that love, dear you, is ours to live. And that makes me happy.
I think I’ve been born twice – the first time I came into this world, I owed it to **Ammi; the second time, to you. Yes, you. It’s been more than a month since your ailment and I haven’t seen the old Arfa around since that day we rushed you to the hospital. I’m not sure if I miss her though.
In a recent blog post, I wrote about finding meaning in suffering, beauty in sorrow, gratitude in hardships, smiles in tears, forgiveness in hate, and most importantly, life in death. I found all of that by your bedside, holding your hand; my palm resting against yours as the fingers of my other hand felt your uneven pulse soothing my fears, wiping away my tears. And so in your silence, I heard it all. Your empty gaze is probably saving me from a lifetime of regrets. In the comforting, trusting clasp of your hand, I found the Rumi that my Shams had so desperately needed.
Nanijan, all the lovely moments we’ve secretly shared have come together to create a nebula of our souls. I know that you know that because you have searched for my eyes in a room of several others and upon finding them, you have told me that I know everything. It felt like God was speaking to me then, through you. Nobody understood what you’d meant then. Expect us, of course. We know that that ‘everything’ is beyond the confines of this world, that it celebrates the mysteries of that which is immortal, the ethnicity of our hearts, the truth in the melody of His words.
And so as I’ve sat grieving – for the past and the future – you have led me to live the present; to truly feel the blessings as your palm caresses my head, to marvel over the innocence in your smile, to envy your thirst for His words, to know that what I’m sharing with you is just another once-in-a-lifetime – sent to heal another lost one, perhaps – and to be ever grateful for living this miracle at a time when I thought I least deserved it. And that’s how I found beauty in sorrow.
You’ve been so brave. You miss your father, we know. You miss your father-in-law, even. You miss our Nanajan and the two sons you’ve had to bury together. You miss them, you cry for them, you bear all this pain that makes us rush you to the doctors but what do you say? “And which of the favours of your Lord will you deny?” And that’s how I found gratitude in hardships.
You asked us not to cry. You implored – without words – and I have listened. I know now that every wound does not necessarily need a band-aid straight away, that it’s okay if things don’t go my way, it’s okay if people leave, it’s okay to let go. I know now that it’s okay to not win the race of this world, that it’s important to keep going, but we’re allowed to slow down. And now as I see you surrendering yourself to your Lord, I have learnt – painfully – that we don’t always need to fix things, and sometimes, just leaning against those who are home is more than enough, that life – with all of the cacophony, not despite it – is very happy, very beautiful. And that’s how I found smiles in tears.
I thought I was one of the transgressors, that the beauty of His miracle would now not touch my life. But I’m glad I was wrong, Nanijan. Through you alone, He showed me that these billions of seconds that have worked upon blowing this new soul into me are a sign of His love, of something extraordinary. And that’s how I found forgiveness in hate.
Through you alone, I have been taught where to stop, how to stop. You gave me a second chance at life, one that I had never anticipated. As you hold my hand, I can feel my heart softening as I meet the new me. I’m scared of her, you know? Because she makes me realise how unprepared I was for what I was seeking, how I do not need to answer every question, how I need to play in the cool calmness of the waters of Zamzam before I can recognise the wisdom of Hazrat Khadija’s eyes. And that’s how I found meaning in suffering, life in death.
Thank you, Nanijan, for giving me birth. Thank you for passing on the gift of who you are, to who I now am, who I will be. Thank you for waking me up. Thank you for this second chance.
Huge rivers flowing from large, brown
eyes pool into your heart. It hurts; you cry out. Mountains don’t move,
and you walk ahead towards the storm, away from the tempest. Time will pass, languages will evolve, your letters will rust,
and we will live beyond the realm of unlived dreams.
I will say, “The wall-clock has broken”.
It’s decided: one warm summer morning, we will go down to the beach and say hello to the waves. It’s going to be nice and warm. The sun will have just come up and we will stand by the sea-shore, the waves gently encircling our feet, comforting our tired heels. The rising sun will make for the perfect background; the reality of its size humbled against the pretty sea-shells on the soft sea-shore. And we would want to do it all – fly with the birds, swim with the fishes, dance with the wind, sing with our hearts. And then we will sit on the flowery picnic sheet sprawled across the sea-sand and read our books, our summer hats happily perched on our heads. Each turn of the page will come with a sip of our cool orange juice; and occasionally, we’ll look up to see the twinkling water crashing and hugging the shore before we look away – we will look away only to glance at each other with a pride that only two young women who have together waltzed through the ups and downs of this thing called life, know of; two happy friends enjoying the warmth of life, loving their summer dream.
Heartbreaking beauty and a sad, sad nostalgia haunts withering flowers. Withering flowers? Those wise, old flowers that have adorned the gardens of this world for a long, long time, and are now slowly withering away.
Now this flower is rich with love and wisdom, and knows the secrets of life. And it’s this very special knowledge that makes it so hard for the humming bird to say goodbye. But she has to. She will. She sits there, perched on the corner of its petal, watching its very own flower – amongst a bouquet of others – dance lightly with the winds of destiny, bowing down with what is an eternity, smiling to the universes, waving to the wanderers.
“Sshh! It’s going to be okay, you’re going to be okay! The Lord of the sun, and the moon, and the stars loves you more than the soil you’re perched upon. The cool breeze is kinder. Its really going to be okay!”
A few flowers away, another one fell.
“This is the best soil. I’ll take care of it, I promise.”
“Meet me in my dreams till I join you?”
The flower quivered, but it was the bird that fell.
In a parallel universe, the mountains flew, the moon lovingly shared its light with the sun, the neutrons were charged with love and only love, and the night was alive with the poems of those who had lost this world to win the universe.
And then the promise of His mercy made them smile.