بسم الله الرحمن الرحيم
The first time I saw a patient pass away was in the ward, around 9AM. Newly admitted, fell into a coma and went into hypovolemic shock. The registrar gallantly followed the protocol letter by letter. His hands were as steady as a brick as he secured two IV lines and his calmness distracted me from understanding that an actual emergency was going on.
A couple of minutes later, there were 5 doctors and a nurse surrounding this critically ill patient. Everyone did something. I, the newbie intern, stood and watched, waiting for the patient to recover. This was the ward, early in the morning, during working hours, in a hospital filled with doctors and nurses, recovery was the only option I could think of.
Minutes later, same registrar began chest compressions with his eyes fixed on the pulse oximeter. Minutes later, he used his stethoscope to auscultate the heart, and he brought out a torch and flashed it across the patient’s eyes. Then he took off his gloves, shook his head and the relatives broke down in tears. I was keenly observing his every move, but only then did I understand what had just happened. The option wasn’t just recovery; they were two— recovery and death.
Every time you open a medical textbook, or you walk into the hospital in your ward coat, with people repeating the word “doctor” over and over and over, you feel as though you fell from Krypton into the earth. Your power wasn’t super-strength, super-speed, flying or laser eyes, it was even better and cooler— it was the ability to diagnose and manage, hopefully, effectively.
The same way no superhero starts off his people-saving career thinking about all the innocents he will not be able to save, it is uncommon for a young naive doctor to go into practice thinking of all the people that will die on his watch. The expectation is that as long as you do what you’re supposed to do, and you dot your Is and cross your Ts, then your cape will continue to fly and your list of epic wins will be as big as an encyclopedia.
The shock and the feeling of utter helplessness come when you watch everything that is supposed to be done being done and it not working. “Why isn’t there anything in the textbooks about this?”
I asked my very old Internal Medicine lecturer why he ordered a PSA for a young patient (PSA is a marker used to detect cancer in the prostrate, which almost always occurs in the elderly), and his response was: diseases do not read our books.
The unpredictability of the medical profession is one of the āyāt of Allah. Regardless of your qualifications and your years of practice, things happen that you cannot explain. The most stable patients in the ward who are about to be discharged could deteriorate within hours, for no known reason, and the ones you’ve secretly given up on could recover, for no known reason.
When man thinks he knows, Allah wills for things to happen in the most unprecedented ways, reminding him of his ignorance and his weakness of intellect and body. Man is forced to accept that Allah truly is فعّال لما يريد. The next thing that should then be done is to submit to the Might of the Creator and admit that your knowledge and experience only help a patient when and if Allah wills.
وَإِذَا مَرِضْتُ فَهُوَ يَشْفِينِ
And He ˹alone˺ heals me when I am sick.
(Qur’an, 26:80)
You are NEVER the cause Oh Healthcare Provider, you are just one of the many variables The Causer uses to execute His decree.
And how honoring is it to be chosen to be a variable for a cause this noble?
فَعَّالٌ لِما يُريد
This. This. This. I love everything about it. Thank you so much for writing this. Allahumma barik♥️
An incredible insight. May Allah make it easy for us all and take us when He is most pleased with us. Ameen