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COVID – To shame or not to shame
A thread
https://drtaqi.wordpress.com/2020/10/28/covid-to-shame-or-not-to-shame/
A thread
https://drtaqi.wordpress.com/2020/10/28/covid-to-shame-or-not-to-shame/
Bismillah, alhamdulillah: I came across an article which was highlighting the 'poor' behavior of patients in dealing with their dying relatives in an ICU setting in Blackburn.
It made me reflect over the situation and try to understand the difficulties being faced by COVID patients and their relatives as they face death.
On the one hand I understood the frustrations that the medical staff were facing in Blackburn. I work on the front line in a COVID center. Along with my colleagues I face patients who are afraid, worried, resigned, imagining the worst and those on their way to hospital.
We spend every day explaining the rules, the science but we only have a few moments to deal with their human side. Our consulting skills have been compressed into a brief smile but even that is hidden behind our masks.
I remember a case where a young man could not see his dying mother because he had not been allowed back to due to travel restrictions. After a few months he was able to come back but was placed under quarantine post travel.
His mother was a cancer patient in a palliative care ward. His heart must have been shredded to pieces by the emotions going through his heart.
He wanted to follow the rules and complete his fourteen days of isolation after arriving in the country but could not face the prospect of letting his mother die alone. The emotional pressure on him was too great. He eventually found his way to his mother.
A great relief for him, but at what cost to others? Luckily for him his exit swab was also negative and he never put anyone at risk. But had the opposite been the case how would the world have judged him?
Sometimes, especially in these COVID moments, health professionals have to see the other side. We need to empathize with the social situation. To die alone is horrible. Many cultures and religions encourage being close to dying relatives, especially parents.
In Islam relatives are encouraged to help the dying person restate their creed. For the dying person and their relatives these moments are deeply emotional and will forever be imprinted into their memories.
Perhaps relatives in these situations will try and bend or even break the rules. Doing so will put other at risk but to precisely quantify that risk is elusive and impossible for any human to pin down.
The emotional drive of relatives is like the power of thirst to man who is parched and desperately seeking water in a desert. The power of reason and logic hold little say in front of him.
To try and prevent or control such events by laying down rules that cannot be policed is not a wise move. It is only an invitation to break the rules.
I heard of an amazing story which illustrates the human dilemma that many people face. One patient lay in his bed weakened by his muscular dystrophy. His wife was nursing him at home when she heard that her mother had got COVID and needed help.
The hospitals had rejected her as she was managing with oxygen at home. The setting India. The lady was left to fend for herself at home with an oxygen cylinder and home medications.
The mother wanted to be with her daughter who lived in a different house with her sick husband. The daughter asked her husband's permission from her husband fully knowing that this put him at risk.
He replied drawing on his ethical values framed by his faith, Islam, and said, "If it were my parents would I turn them away from my house?" He then gave her permission to bring her mother to the house for nursing care.
When I heard this, I thought what an amazing deed done by a man who is bed ridden and yet faces the prospect of death with such calmness and nobility of human spirit.
Sometimes we are forced to take risks for the sake of greater rewards. At other times, we must yield to the natural love that God has placed in every human heart.
Yes, sometimes we may suffer or cause suffering to others, not out of malintent but out of a consequence we may find difficult to perceive.
What this teaches me is that we need to be balanced in our view of patients in such a difficult situation. We need hospitals to cater for both the patient and his or her family. Cure and care are not solely driven by science.
Every doctor and nurse knows the power of love and its tremendous beneficial effects. Its opposite, depression, has a profound negative impact on health. This has been well studied and clearly documented in the scientific literature.
Hospitals need to cater for both the body and soul, both of the patient and their near and dear. They should rise to a higher standard. Blaming or shaming relatives whose grief has made them emotional is not the way forward.
Perhaps the answer lies in dedicating hospitals to COVID and setting up bubbles for the dying and their relatives. The exact solution may not be clear, but what is clear is that we need better more human solutions.
This leads to one of the consequences of death, bereavement. The whole question of what happens once death has touched a family and the acts of condolences and the harm it may cause is another huge area.
Will we shame those who went to visit their parent if one died and the consequence was the spread of COVID? It is a difficult issue and the spread of COVID in such situations where people pay their condolences, I think are common and will become increasingly so.
There is a hadith or saying of Prophet Muhammad ﷺ which offers an insight into the issue. It narrates an argument between Prophet Moses (AS) and Adam (AS) as follows:
The Prophet said, "Adam and Moses argued with each other. Moses said to Adam. 'O Adam! You are our father who disappointed us and turned us out of Paradise.' Then Adam said to him, 'O Moses!
Allah favored you with His talk (talked to you directly) and He wrote (the Torah) for you with His Own Hand.
Do you blame me for action which Allah had written in my fate forty years before my creation?' So Adam confuted Moses, Adam confuted Moses," the Prophet added, repeating the statement three times. (Bukhari)
Prophet Moses was effectively blaming Adam (AS) for causing the removal of mankind from Paradise – a negative outcome of not maintaining sufficient distance from the forbidden tree.
But as the great teacher and mercy to mankind, Prophet Muhammad ﷺ pointed out, it was Adam (AS) who won the argument. The scholars of Islam point out that Adam (AS) was not using destiny as an excuse for his sin of approaching the forbidden tree.
Especially as the Quran itself clarifies that Adam (AS) acknowledged his sin and repented to God:
They (Adam and Eve) said, "Our Lord, we have wronged ourselves, and if You do not forgive us and have mercy upon us, we will surely be among the losers." (Quran 7:23)
They (Adam and Eve) said, "Our Lord, we have wronged ourselves, and if You do not forgive us and have mercy upon us, we will surely be among the losers." (Quran 7:23)
So why did Prophet Muhammad ﷺ say that Adam (AS) won the argument and what can we learn for the situation that we find ourselves in today with COVID?
The commentary on this hadith points out that while Adam (AS) was responsible for his sin he was not responsible for the unforeseeable impact of that act.
That was something hidden in the mystery of 'qadar' (Arabic for destiny) and something that only an Omniscient and All-Knowing God could know.
The lesson I draw from this event is that the consequences of an action of a person when far removed from them are not the fault of that person. Especially where the precise consequences are elusive and impossible to pin down.
Today the COVID epidemic has placed people in a parallel situation. They can see their immediate actions and consequences, but the far-reaching consequences of their actions are difficult to define and are elusive. The chain of transmission is a statistical phenomenon.
Translating statistics and probabilities to individual realities and stories is simply impossible. An impossibility that is hard coded into the very rules that govern biology and the world.
The transmission of a virus from a given person to another given person is neither guaranteed nor precisely predictable. They remain hidden in a statistical understanding of the world and perhaps destiny itself.
Working at the front line of medicine, especially in a COVID center, we face the abuse and anger of some patients.
Sometimes the doctors and nurses get angry, but it is at these moments that we need to draw on our humanity rather than our medical authority to deal with these problems.
It is only the nobler side of our humanity that can allow us to empathize and overlook the choices that differ with ours of those who have come to our door for help.
Like our human predecessors, mankind today is sailing on a single ark. Our journey is through a fierce storm on a vast ocean. The dark waves of this epidemic are crashing over us.
As the waves crash down on us, cursing the ocean or being angry at each other will not help us reach our destination. We are all on the same ship. We sink together and we survive together. Like the passengers on the ship caught in the ocean's grip we need to encourage each other.
We have no choice but to turn back to the virus's Creator to strengthen our humanity for our humanity gains greater and deeper meaning and is ennobled when we link ourselves to something greater and more noble than us.
The wisdom of the Quran calls out to us:
The wisdom of the Quran calls out to us:
It is He who enables you to travel on land and sea until, when you are in ships and they sail with them by a good wind and they rejoice therein, there comes a storm wind and the waves come upon them from everywhere and they assume that they are surrounded, supplicating Allah,…
…sincere to Him in religion, "If You should save us from this, we will surely be among the thankful." (Quran 10.22)
This thread can be read here: https://drtaqi.wordpress.com/2020/10/28/covid-to-shame-or-not-to-shame/
