Working in the ICU is one of the toughest experiences for a new budding doctor. It’s rare to find a patient who can talk. Most lie unconscious, connected to ventilators and machines that hum and beep around the clock. They exist in a space between life and death, and every day we witness some of them take their final breath.
That’s why I was surprised (and honestly, a little delighted) when a young man in his early thirties was wheeled into the ICU. Finally, I thought, someone I can talk to.
He looked like a gentleman: calm, cooperative, and always wearing a warm smile whenever someone glanced at him. Somehow, his presence softened the cold, metallic atmosphere of the ICU.
I hadn’t yet seen his file. Both of his legs were swollen (bilateral pedal edema), but what had brought him here? Before I could find out, orders came for urinary catheterization and ascitic tapping to remove fluid from his abdomen. We completed the procedures swiftly.
Real physician voices, twice a week
Free, and one click to unsubscribe.
Taking a detailed history immediately afterward felt inhumane, so I decided to begin with small talk. Pulling a chair beside him, I asked, “How are you now?”
“I’m great, doctor. How are you?”
“Wow, I’m fine. Thank you for asking!”
He smiled again, his voice gentle and genuine.
“What work do you do?”
“Ask me what work I didn’t do, sir.”
“No, I won’t,” I laughed.
He told me about his life, from being a manual laborer to working as a driver, constantly juggling jobs just to keep things afloat. “Why do you work so much?” I asked.
He replied with a kahawat (proverb) I didn’t quite understand. Then he added softly, “To take care of my family.”
“Tell me about them.”
His eyes lit up with pride. “I’ve got my mom and dad, who are still healthy, my beautiful and caring wife, and my two little children.”
“Two children? MashaAllah! What do they do?”
“My elder one has just started going to school.”
The happiness in his voice was contagious. For a brief moment, I felt as though I had been given a glimpse into his little world.
“My younger son is just one and a half.”
His voice trembled. A tear slipped down his cheek.
“I wish I could play with him.”
“Don’t worry,” I said gently. “You came here so that you can get better, right? You’ve come to the right place.”
He nodded, wiping away his tears. “Who’s taking care of your children now?”
“My parents.”
“So who’s here with you?”
“My wife and my brother,” he replied, then paused. “Doctor, if possible, could you tell my wife that I’m fine? She’ll be worried.”
“Don’t worry,” I smiled. “Visiting time is about to start. You can tell her yourself.”
Then, unexpectedly, he asked, “Also, can I get a newspaper?”
“A newspaper? Why?”
“They said no phones. At least with a newspaper, I won’t get bored.”
I smiled. “You can call me whenever you’re bored. If I’m free, we’ll talk. How about that?” He nodded.
Later that day, I checked his CT scan, a habit I had developed in the ICU to correlate clinical findings. The scan showed multiple lesions throughout his abdomen. Shocked, I even tapped the monitor, wondering if it was a glitch. Just then, the postgraduate resident walked in and noticed my expression. I showed him the scan.
“Yes,” he confirmed. “We’re suspecting abdominal tuberculosis. That’s why we did the ascitic tapping.”
I opened his file to understand what was really going on. It was heartbreaking. Between our conversations, he had mentioned feeling weak and noticing the swelling. Then he said something that stayed with me: “You know, sir, I worked very hard for my family when I was your age. But it cost me my health.” He didn’t sleep well or eat well, his immune system was affected, and he fell prey to the most infectious killer known to man: tuberculosis.
Before my shift ended, he looked at me and said, “Sir, talking to you feels good.”
That night, I told my co-intern to spend some time with him. Maybe bring him a newspaper. Just be there. Over the next few days, whenever I found a few free minutes, I would visit him. We’d talk, joke, and even exchange a few shayari (poetry). Between witnessing deaths in the ICU, spending time with him somehow helped me put myself back together.
And every single time, before I left, he would smile and say, “Sir, talking to you feels good.”
Then came my final ICU shift. That day, I found him visibly distressed. His swelling had worsened. I sat beside him again.
“Doctor, please, let me go from here.”
“You know why you’re here, right? We’re trying to make you better. Don’t you want to play with your son again?”
He nodded weakly. “So we’ll do our best to help you get there, OK?”
“OK, sir.”
Before leaving, I said, “This is my last ICU shift. I’ve told my friends about you. They’ll come and talk to you just like I did.”
He looked genuinely surprised. Then his face fell with sadness, the same feeling I had when I first saw his CT scan.
A few days later, while I was back in the medicine ward, I met my co-intern who had just finished her ICU posting. I asked about him. She went quiet.
“Things got really bad. The swelling worsened. It later became clear that he had disseminated tuberculosis with severe complications.”
“What happened then?”
“He went on DAMA, discharge against medical advice,” she hesitated. “As we speak, you know, he’s gone.”
I stood there silently. Why did tuberculosis take its cruelest form in this man? I had tried to give him hope. I still wonder if I said the right things.
He smiled through the swelling. He missed his son with a breaking voice. He asked only for a newspaper, and a little company.
And perhaps, in that quiet corner of the ICU, Almighty God was building something far greater than any of us could see. Perhaps every sigh he hid, every tear he wiped away before it fell, every moment of patience was raising his rank. Perhaps he was never really alone.
The Prophet Muhammad ﷺ said that Allah says, “O son of Adam, I was sick and you did not visit Me.” The servant will say, “O Lord, how could I visit You when You are the Lord of the worlds?” Allah will say, “Did you not know that My servant was sick and you did not visit him? Had you visited him, you would have found Me with him.” (Sahih Muslim 2569)
May Almighty God forgive him, envelop him in His mercy, expand his grave, reunite him with his family in the gardens of Paradise.
Arshad Ashraf is a physician in India.
