5 Mar, 2000

My mother-in-law’s last days: One woman’s misery was another’s profit

Imtiaz Muqbil

Originally Published: 05 Mar 2000

My mother-in-law died last week after an 18-month battle with cancer. That was about 12 months more than the doctors had given her after she was diagnosed. She was 73, the third elderly person in my family to move on in the last six years.

Shuttling her in and out of various hospitals and clinics has been a sobering, humbling and soul-searching experience. Perhaps most galling was the way she was treated — only a few doctors actually CARED; the rest just basically wrote her off.

We tried everything, from regular chemotherapy and radiation treatments to herbal remedies to alternative therapies to faith-healers, all backed up by heavy doses of prayer. They all worked in bits and pieces, but in the end, death comes no matter what.

Doctors, along with lawyers and journalists, are part of that hapless group which makes money out of other people’s misery. But doctors make daily decisions that involve life and death situations. In the US, they also face the constant threat of malpractice suits. Not so here, which gives the medical industry much rein.

Caring for the sick is usually a very spiritual experience, especially those who are elderly and destined to die. It becomes even more so when the dying person is a parent or child. The helplessness and desperation is acute. Even those not normally inclined towards religion and things spiritual can find themselves wondering whether they are wrong.

Prayer becomes very much a part of life, especially if the sickness lingers. Like a roller-coaster, the twists and turns offer hope on bright days and despair on others. Watching loved ones suffer is worse than suffering oneself. Why them, one wonders? What did they do so drastically wrong to deserve such punishment?

Our problem actually began with the early misdiagnosis. The X-ray showed a spot on my mother-in-law’s lung that the doctor brushed off as being ‘’too small to be anything serious.” She was asked to come back in a few months. When she did, it had grown too big and begun to create complications.

A second doctor we had checked with at the time told her the same thing. Queried about it later, he said he had had some misgivings but was too ‘kreng jai’ towards the first doctor to contradict him.

We took her to the US where relatives had arranged an appointment with a leading oncologist. A battery of expensive tests later, he told her to go home and us to ‘’make her as comfortable as possible.’’ Another US doctor, a younger one who specialised in ‘holistic’ treatment, said he could not help much but his wonderful bedside manners lifted both her morale and spirits.

Another Thai doctor with a good reputation whom we saw after returning to Thailand found his good reputation becoming a liability. The queue outside his office would be several people long. He would often be there till late night. By the time he saw my mother-in-law, both he and she were tired out; both just wanted to go home as soon as possible.

For many months, we put her on an organic diet of carrot juice and barleygreen. That did perhaps the best good, but she, a vivacious, well-travelled woman who enjoyed the dining experience, tired of the ‘boring’ organic intake and started taking regular food alongside. To what extent that diluted the benefits of the organic food we will never know.

One of the most unusual experiences was at a famous hospital where she had to go regularly to get some surgical dressing changed. It was a routine procedure. One day, we overheard the doctor talking on his mobile phone. We don’t know who he was talking to but the subject involved ways to increase the hospital’s profitability.

When he finally attended to my mother-in-law, he abruptly suggested that she be admitted immediately. Needless to say, we declined.

Many hospitals have gone public to finance new buildings and expensive equipment. It’s a bit of a double-edged sword; certainly it helps improve services and standards but it also requires that the equipment be used, medication dispensed, tests carried out and rooms occupied. Shareholders are king and the bottom-line is the name of the game. Our worst experiences were at the biggest hospitals.

Some doctors were real gems, but they were in the minority. They clearly told us what the situation was and what options we had. They gave proper replies to questions. One doctor actually consulted us before taking any action; towards the end, he suggested we move her to the ICU. He meant well, but we declined, knowing that that’s when the tubes and pipes would take over and a dignified death would be the first casualty.

I, too, often found myself feeling guilty. Her trips to the clinics and hospitals took up time. Having a large family allowed us to divide her trips up amongst ourselves. But there are many baby-boomers out there facing a transition of their parents and grand-parents who have ‘’no time’’ to care of their elderly. They are ‘’too busy’’ working to support the living and have too little time to worry about the dying.

Both she and we were in search of hope. Always, those who helped and offered the most hope were those of a more spiritual bent. They genuinely cared and showed it. Often, that alone made her felt better. Like all cancer patients, she suffered in the last few weeks but eventually died peacefully in her sleep, which surprised even the doctors.

Most of all, I feel sorry for the poor who put up with the most wretched medical conditions and become the primary victims of the general decline in the VALUE of human life. Death, misery and pain greet us every morning in the newspapers and every hour on TV. It numbs the mind and consumes the soul.

The high costs of medical care and the pain of death are two factors slowly taking people back to the tested, proven and true philosophy that prevention is better than cure.

World-wide, disease and ill-health are the outcome of poor lifestyle, bad eating habits and deteriorating environmental conditions. Sadly, promoting such lifestyles and eating habits is backed by billions of dollars in marketing money. Improving environmental conditions, too, involves huge costs.

First, someone profits by creating problems. Then, others profit from fixing them. Eventually, however, it is humanity at large which pays the price. These days, a whole new school of thought is profiting from prevention, too. That money may be ultimately the best spent.