By Dr. Khalid Hamid Changal
It was November, and I was in the second year of my cardiology fellowship when I received a phone call from my brother in Saudi Arabia. It was an odd time for him to call me. I picked up and listened to his frantic voice: “Khalid, our mother had a cardiac arrest. She is in ER! Intubated! Going to ICU. I will call you back… I have to go…I will call you back!” I was at my apartment in Ohio, thousands of miles away, as my whole life was turning upside down. After about 15-20 long minutes, I spoke with my brother again: “Khalid, she just passed away!” Just like that, she was gone.
The next few days were the hardest. My immediate thought was to take the next flight to be there with my family. I could hold my mother’s hand one last time and kiss her goodbye. That night I had to figure out whether I could travel or had to stay in the United States. This was when COVID-19 was beginning to spread, and most travel was banned. My J-1 visa would need to be stamped. Traveling to Saudi Arabia was even riskier, as India is my country of origin; my brother works in Saudi Arabia and my parents lived with him there. My passport had expired as well, and it was in the process of renewal. The facts were clear: I could not travel. I had to stay in Ohio. It was very unusual being there in the wake of my mother’s death. In our Kashmiri culture when someone dies, hundreds of relatives come to your house to offer condolences: the whole world stops for you, and all friends and relatives come to help you grieve and remember your loved one. While my friends in Ohio called me, visited me, brought food for me, and even did a Zoom meeting to offer prayers to my mother, it was not the same. The atmosphere around me did not change very much. The neighbors were living their usual lives, getting their mail, walking their dogs, and saying hello to me as if nothing was different. The world did not stop. I was having a hard time believing my mother was no more as I was not able to see her in person.
Four years prior to her death, my mother survived a cardiac arrest. A few days before my journey of medicine in the United States was set to begin, she suffered a cardiac arrest at a hospital in India where I worked as a Registrar in Medicine. I performed CPR on her. Just about when I had resigned to the thought that she might be gone, her pulse returned. Over the next week, she recovered. The first words she spoke to me upon waking after a week on the ventilator was, “You must continue your journey!” Throughout the years I lived away from my mother, she inspired me every day to fight the hard days that life brings to us. She encouraged me to stand tall every day, even when you are broken and feel you cannot stand up. My mother was a survivor and a fighter. She spent years on hemodialysis. After all her AV fistulas failed, she went on peritoneal dialysis, which was also complicated by pleural effusions. In the last year of her life, each time we spoke on phone, she did not count her sufferings. Instead, she counted the blessings in her life and gave me one lesson each day to make me a better human being and infuse in me the resolve to help the sick and dying.
Many physician trainees on J-1 visas in the United States will have to face this situation, of being thousands of miles away when your dear ones are struggling. It is thus important to have a plan for such a situation. While our individual circumstances might differ, having a plan will always be helpful. This plan should involve time, finances, people, and either being ready for travel or accepting the fact you might not be able to travel. In residency and fellowship, it might be helpful to keep your vacation days saved or well planned. Always keep an emergency fund to plan for last-minute travel. Having people around you who can help in such tough times is very helpful too. Friends, neighbors, and faculty are your family. Keep your passports and visa documents updated. Also, be mentally ready for the worst that can happen. Have a plan to bounce back and never be shy to seek help.
Although my mother is no more, I feel her presence each time I do something to help somebody, whether as a physician in the hospital or as a common fellow human being in public. We all have our struggles, and they are all big to us. They make us who we are. I find peace in this saying from Prophet Muhammad (peace be upon him): “When a man/woman dies, his/her good deeds come to an end, except three: Ongoing charity, beneficial knowledge, and a righteous son/daughter who will pray for him/her.”