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OP-ED: Against regret

  • Published at 12:33 am September 29th, 2021
Hospitals
Protocols demand an ICU in a person’s final days BIGSTOCK

The last few weeks of life cannot steal away a lifetime together

Some days, before waking up, I have a dawn dream between Freud’s mourning and melancholia. In these vignettes, I manage what I could not in the waking time. On the fateful day, I am more alert than I actually was; I do not decide that the family care-taker can handle the evening shift; I do not go home to rest. 

When oxygen levels suddenly drop in the evening, I know exactly what to do. Magically, I have purchased an oxygen concentrator and administered it. Somehow, father is never taken to the dreaded ICU on that night. The next morning, he wakes up and says: “When are we going home?”

Anyone who has been a care-giver for a family member in the final stages (and of late, we are legion) knows it never works out like that in real life. In the awake state, we hesitate, second-guess, and make mistakes; because we are not designed to sustain this high-alert, always-on, medicine-versed, “half doctor” personas we are obliged to be by a pandemic-overloaded health care system.

When a loved one is ill, regardless of whether it is SARS-CoV2, or whether it is all the virus and bacteria and illness that were already here (and many new ones birthed by the “brushfire” antibiotic approach of “modern” medicine), as care-givers and patient advocates, we will make mistakes, or we will not get there soon enough, or we will be paralyzed when asked to make a decision that can prolong life at a terrible cost.

My father was a surgeon in the Bangladesh Army, and I imagined he was enveloped by a force shield made out of the sawab he accumulated from a lifetime of successful surgeries. But the body is the body, genetics will not be defied, and age breakdowns come for everyone. 

Over the last decade, he miraculously recovered from each surgery. Gallbladder operation, quadruple bypass, thoracic duct repair, pacemaker, herniorrhaphy, a rare blood condition -- he came back home from all of it. Family legend gave us comfort that the universe had a design and a doctor would be spared the indignities of hospital. When the pandemic arrived, my cousin said, referring to father’s famous stern demeanor as a military officer: “One dhomok from him and corona will run away.”

Father did not contract Covid, but all ailments are now the collateral damage of the pandemic. A hospital system overloaded by corona patients (and the impossibility of green zones with our population load) will struggle to cure all ailments. That is why the care-giver becomes so crucial, because we are the 24/7 frontline which hospitals do not have the manpower to provide.


Also Read - Maj Gen (retd) MA Mohaiemen passes away


Like every other Bangladeshi born within the British or Pakistan period empire of paper, my father’s official birth certificate was one year off from his real age. About five years ago, I became concerned with correcting it at hospitals. I was convinced that telling them exactly how old he was would encourage them to go a little slower with that antibiotic brushfire. But the system is the system, he remained a year younger his entire hospital journey.

The exact age was important for another reason -- to push back against that ocean of regret. Since August, I have reminded my extended family that my father was four months short of 86 years. But what comfort can I give to my friends who have lost their fathers in their early 70s? Last week, I was sitting on the roof of the DrikPath building, home of Pathshala South Asia Media Academy, with a group of photographer friends. As condolences were shared, we realized that many in our extended visual arts family had lost a father (and some mothers) in the last 16 months. We have been rendered alone overnight, a generational transition sooner than expected.

We inhabit an unwieldy netherworld between faith and science. We routinely say “hayat jotodin” or “Allah took away his peyare banda,” and yet we race toward medical solutions that fight against the body’s natural cycle of decline. Anthropologist Rahnuma Ahmed recently reminded me that “in the old days,” people used to pass away at home, even in their sleep. Why doesn’t that peaceful departure happen any longer? 

It is because at the first sign of troubled breathing, we rush loved ones to hospital. It is now inculcated in us that to do otherwise is neglect. Natural death is considered an aberration. We must all pass in a hospital, where protocols also demand an ICU, intubated experience in the final days.

As a human family, we have not developed any philosophy to face this new pharma-medical universe built out of an unwieldy collision of faith, science, hope, and refusal. We need collective thinking and writing, and the willingness to look outside of big pharma. For my fellow mourners, those who lost a loved one and struggle with thoughts of “if only” (earlier decision, different protocol, etc) -- perhaps we have to accept that the complex unravelling of the body at the end is also part of that hayat.

If you believe your loved ones are in a non-bios space defined by a faith system, believe this: They would want you to celebrate the long life they did live. They would never want us to be trapped in endless melancholy about the brief time of pain and trauma at the end. Those last few weeks cannot steal away a lifetime together. 

We the living, we the dead -- we will live in parallel now, through memory and sharing.      

Naeem Mohaiemen’s father, Major General Dr Mohammad Abdul Mohaiemen, passed away on August 3, 2021.

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