Will you walk with me till death?

Will you walk with me till death?

– Ms Vandana Mahajan, New Delhi

Aamir (Name changed) was 28 years old when I met him for the first time. It was a busy day at the OPD.  I was talking to a few people when one of the doctors called out to me, “Can you please counsel Aamir. He refuses to believe that he has been diagnosed with stage 4 lung cancer”. I turned around to see who Aamir was. I saw a lanky, thin man with deep eyes and a curly mop of hair on his head.  I approached him and asked him if he would like to speak to me. He looked at me with eyes full of tears.  “How can I have last stage lung cancer?”. His voice quivered with unshed tears. We stood in the corridor for more than an hour as he began to share everything about himself. I gently prodded and asked, “Is there anything else that I should know about you that can help me support you better?”. Aamir said, “I am not a loser ma’am. I am ready to give it all that I have. I need your support”. I promised Aamir that he will always have my support. This was the beginning of a very special bond.

What makes Palliative care so special? The very basis of palliative care is the recognition that the person under your care is a human being with REAL emotions. Palliative care is caring for the person as a whole and not seeing them as someone with cancer (or any disease). Aamir did very well with oral Chemotherapy. He continued working and would stay in touch with me over the phone. Every 3 months he had to travel to the hospital for a follow up. He would meet me with the exuberance of a young kid. His smile was captivating and it always warmed my heart. The intent of his treatment was Palliative. We would often talk about what it meant. He believed that his God would take care of him. “Miracles do happen”, he would often tell me. I always believed that he should hold on to hope.

He addressed me as Ma’am. When the Ma’am changed to Ma, I don’t know. He would always say, “I have two mothers. One is my biological mother and the other is you”. Such was his love. A year later he told me that his parents were insisting that he get married. I didn’t say anything. He shared that he was in love with Saima and that they were childhood sweethearts.  He waited for me to respond.  “Aamir, you know your prognosis. Your time on earth is limited. Is it fair then for you to get married?”, I gently asked him. He said “I know Ma. But my parents are not ready to listen. Saima too has agreed to marry me.” After this conversation there was no correspondence with him. He didn’t text and call. Two months later he had his follow up. He met me and said “I am married, Ma. Hope you are not upset”. He brought a box of sweets for me. I was happy that he was happy. It was his decision and I respected it.

A few weeks later I received a call from him. He was nervous as he had a seizure and had fallen on the road.

As expected, the cancer which had been stable for 2 years now, had metastasized further into his brain. He came back to the treating hospital where he was now prescribed Chemotherapy and whole brain radiation. Within a matter of a few weeks, his health deteriorated rapidly. The cancer was not responding to any treatment. He had debilitating symptoms. He asked me how many days or weeks he would live. There was no right answer but I told him that death was close.  I told him that I would walk with him till the end. He however, wasn’t ready to believe me. Denial set in and again he stopped all correspondence with me. His wife Saima reached out to me and we stayed in touch. She knew Aamir was going to die soon.

By this time Aamir had severe breathlessness and needed oxygen support. He called me and said, “I know you are worried about me Ma. Please do not cry. I can’t see you like this”. This was my last coherent conversation with him.

His family took him back to their native place.

He was now actively dying. Saima would give me updates daily. One day she called and said that Aamir was in severe pain and was bleeding through is mouth and GI tract.

The village they lived in was 200 kms away from the main city. He needed morphine. How could I arrange for the same when I was sitting miles away?

I wasn’t ready to give up.

Sitting in North India I networked with amazing human beings from across the country who agreed to help readily. I was able to connect him to a Palliative care team in the nearest city.

Although morphine was now available, there was a new challenge now waiting for us. Aamir’s mother didn’t give him the medicine. She believed that Aamir would die in his sleep, due to morphine. Saima, despite being aware that morphine could ease Aamir’s distress watched on helplessly.

This myth that morphine will cause death while asleep has unfortunately deprived comfort and pain relief for many dying cancer patients.

Aamir had now stopped eating and was on oxygen support. One day Saima called and said that he wanted to see me one last time. I choked up on my tears. We connected via a video call. He was unable to speak. He wanted to hear my voice. I only remember that I told him that it’s ok for him to let go and transition into another realm. He had tears in his eyes. That was the last time I saw Aamir alive.

Before he died, he texted me this “Ma, you often told me that Saima’s future has to be secured. I have 50 thousand Rupees in my account. Without telling anyone I have given it to her”. I am overwhelmed by a surge of emotions till date, when I think of this.

Two days later Saima texted to share that Aamir had died. I called her and listened to her weep and grieve. A few hours later Aamir’s sister called. Her heart rendering sobs still bother me. She said “He really believed in you Ma. He would always say that he has two mothers. How lucky was he? Now he is gone. What will we do? I wanted to meet you but couldn’t”. I was silent for the next 20 minutes while she expressed her pain.

A day later was his funeral! Saima called me. She was weeping. She said, “Ma, do you want to see him one last time”. Yes, I saw him one last time before he was buried. As per their culture, Saima ensured that I wasn’t left behind. Aamir knew I had to say my final goodbye to him. I am so grateful to have received love so pure.

This was Aamir! He was a wonderful son, a great brother, a loving husband and above all a beautiful human being.

Early integration of palliative care in a cancer diagnosis is very important. Aamir’s story is a testimony to this!