I find myself questioning whether these infusion mornings are inherently chaotic, or if they only feel that way because my own reserves of patience and energy are running so low. Work does not pause for anyone; in my world, work does not stop even at the threshold of death. Yet, here I am again, wondering if I should continue to walk this path.
You see, there is a patient, Mr.RS, who has been admitted with us for months now. When he first arrived with stage 4 carcinoma, statistics offered him a mere six months; it has now been nearly a year. One could argue that his life is entirely tethered to mechanical support—a tracheostomy for breath, a PEG tube for sustenance, a catheter, and a map of countless cannulas. Yet, he is fully conscious, acutely aware of everything unfolding around him. I watch his wife, who has become half a doctor herself over these months, standing steadfastly by his side. She was a portrait of pure anxiety when we first met, but I have watched a profound stillness settle over her. I can only guess this stems from either true acceptance or the heavy blanket of fatigue—an acknowledgment that this is simply how life is meant to be. Initially, she would say, “I want to take him home walking,” and we would quietly wonder how a man with so many spinal metastases could ever walk again. Now, she simply says, “I just want him to have basic dignity.” It is remarkable how the goalposts of hope change for people over time.
Everyone sees the wife, the son, the sister-in-law; but for a moment, I wonder—who truly *sees* Mr. RS? He cannot speak because of the tracheostomy, but he looks at me with a steady, confused stare every time I visit his room. Sometimes, I crack a silly joke just to catch the glimmer of a smile, and he obliges. His wife, too, manages to smile through the weight of it all. There are times when the nursing staff grows weary of the endless infusions and suctions, and times when we, as doctors, feel the frustration of having no definitive timeline to offer them. Yet, I feel a surge of fortune when I look at him. I can speak. I can walk to my own infusions. I can advocate for myself. In this setting, those feel like monumental privileges.
He is a patient who has accepted the change in goalposts with grace, which contrasts with what often happens in the ICU. When a critical patient arrives on a ventilator, the first target is weaning them off; then, it is moving them out of the unit. Once they are “safe,” the family begins to fret over smaller things—appetite, lingering weakness, the slow pace of recovery. It is a natural concern, but as physicians, we know that this is a marathon, and the path to normalcy is exceptionally long.
If I looked closely at every patient I treat, perhaps everyone would have a unique lesson to impart. I recently read about someone calling themselves a “cancer graduate” rather than a “survivor,” and the phrase stayed with me. There is so much you learn when you fall ill: the terrifying fragility of life, the impermanence of all things, the clarity of what is truly not worth your energy, the vital importance of family, and above all, the necessity of advocating for yourself and setting boundaries. I have acquired these lessons; I simply need to put them into practice. Whatever people may say to your face, everyone ultimately prefers the version of you that wasn’t sick—and that is an incredibly hard pill to swallow.
I choose to read the Quran in English. I have never understood the utility of navigating the foundational text of one’s life in a language one does not comprehend. In English, it offers me a tangible comfort. Faith has sustained prophets through the most harrowing hardships, but to possess a faith that resilient, one must truly understand its principles. Across all paths, the message feels universal.
“But perhaps you hate a thing and it is good for you; and perhaps you love a thing and it is bad for you. And Allah Knows, while you know not.” – (QURAN :2:216)
So, perhaps I hate these needles and the weekly infusions, while perhaps they are shielding me from something far worse. Perhaps this state of being is “as good as it gets,” and it is my own goalposts that need to shift. Perhaps I should sit down with Mr RS one day and communicate more in our shared silence. I say “Alhumdulillah” every time I wake up at night and find my daughter and my husband fast asleep next to me; perhaps I should say it more often. God knows what is best for me, and I can only pray that He guides me through it all—with grace, with decency, and with my own steady, flickering light.
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