19th December 2015. I had just come for my shift at the hospital. I can very clearly recall the sense of relief I was feeling, knowing that Maama was now stable according to the briefing with the doctor I had the day before. Unlike other days, I wasn’t too restless or anxious. The doctor had said that we could consider Maama to be stable now and that she wasn’t critical as such anymore even thought she wasn’t responding to any sort of stimuli. The plan had been to continue on Palliation until … Maama decides to leave. I was alright with it. As long as Maama was not in pain.

I remember walking into Maama’s cubicle at around 11.30 am and commencing my usual routine. For the past 28 days of her admission I had always had a specific drill that I undertook before I say a word or even touch Maama, and this time was no different. I looked at the Ventilator for any changes to it’s settings,  then I looked at her urine bag for her urine output and finally, I checked the monitor for her vitals … and I froze. ‘This is not good. This is not good!’, I thought aloud. Maama’s pulse, blood pressure and Oxygen saturation had all dropped significantly. ‘Maama?’, I called out to her and patted her shoulder by force of habit, hoping that this would help. And nothing. I sped out of her cubicle and called a nurse and enquired. ‘No. She’s been like that the whole day today. We’re not sure what’s happening either’, he said. ‘Are you going to give her something to pick up the blood pressure and change her ventilator settings?’, I asked. The nurse replied that he’d ask the doctor and left.

I felt weak in my legs and could barely hold my self up. I knew I needed to be with her for as long as I could. I remember lifting up her blanket to get access to her hand and saw that her left hand was not just swollen but had now turned black. The lump in my throat came back, but I knew what I had to do and so started speaking to Maama and reciting the Shahada and Surat al Fatihah. I remember anxiously  and repeatedly glancing at her monitor to see if any of her vitals picked up but all I saw was ‘VT Run’ and the amber light flashing indicating that she was not okay.

Forty minutes or so later I remember the nurse coming into the cubicle and gently asking me to leave since the visiting hours were over. I asked her for one more minute with Maama because I needed to tell her something important. I walked over to Maama and whispered in her ear with my hand on her forehead.

‘Maama annahchey kokko kairiah? Love you ingey?’

‘Maama. You’ll come back to me, no? I love you’

What an absolutely childish thing to do. Almost forty days in the ICU and I was still not ready to let her go.

As per ICU rules, visitors are only allowed inside except during 2 hours allocated as visiting hours. I sat outside the ICU waiting impatiently. Part of me knew that I’d done everything I could do and that it was now up to a higher power, but the other part of me wanted to barge into the ICU .. and just stay with her and hold her hand.

‘ICU Bed number 1, Thithi Kamana’s relative please come to the ICU’

I jolted at the sound of the PA system and ran into the ICU. The nurse looked at me and asked, ‘Are you Thithi Kamana’s relative? I’m sorry but is there an adult around?’. This was the second time I was asked this question. ‘I am an adult. I am her granddaughter and I’m here now. I’m also a Doctor so I can comprehend whatever you tell me’. I was a little upset as this back-and-forth thing between the nurse and I was just hindrance in getting the information I needed. After my response I was asked to come into the ICU, where Maama’s consultant was waiting for me. ‘She’s not doing well. Her BP, pulse and Oxygen Saturation are all low. We’ve changed her Ventilator setting and we’ve started her on an Inotrope drip. We’ll change it to something else if it doesn’t work. We’re trying whatever we can’. He looked troubled and confused, similar to his expression the day he told us she is to be put on Palliative care only. ‘You’ll let me know if she .. if anything changes right?’, I asked him. He nodded.

I remember walking out of the ICU and to the balcony and taking a moment to breathe. ‘Can I do this by myself? Do I want someone here with me?’, I thought to myself questioning my ability to handle what was now inevitable. Subsequently I called Mamma and asked her to come. I couldn’t and didn’t want to be alone when something happens. Now, it was not a matter of if something were to happen anymore. It was a matter of when. I knew Maama didn’t even have a day left to live.

I was right. 21 hours later, she left us.