ISSUE 51

I scrolled down her medical history. Sayeeda Sheikh. Age 65. Symptoms included indigestion, pain in the upper belly, bloated feeling after eating, nausea, vomiting. Upper endoscopy prescribed. Biopsy report positive for cancer. Endoscopic ultrasound showed cancer spread from stomach lining to stomach wall. Chemotherapy recommended to shrink cancer cells before surgery. Hospital gastroenterologist surgeon Dr Shakeel Qasim recommended to advice on surgery – subtotal gastrectomy indicated. First of eight chemo sessions undergone. Below her history, my initials, as her oncologist.

When she entered, the first thing I noticed was how lightly she walked. Earlier, she had tended to stoop as she moved, dragging her feet as if carrying a weight on her lower back. Her face looked different. It seemed touched with light that shone from her eyes and moved like rays through the creases on her thin face, lifting her lips in a smile I had never seen before. At the end of the physical examination, she said in a low voice, ‘Dr Afzal, can we do another endoscopy? I … I have a reason for this which … which I cannot explain just yet. Please prescribe this. Please cooperate….’

I was baffled. I could not accede to this. Her endoscopy showed her cancer had already grown deep into the stomach wall. The tumour was in every danger of spreading to nearby organs like the liver and pancreas. In fact, I had already looked for signs of fluid in the belly in case of spread in the stomach, and for yellowing of the skin and eyeballs that would indicate the liver’s involvement. An endoscopy was slated for after the full chemo cycle so Shakeel could assess the extent to which the tumour had shrunk after chemo.

She had loosened the grey and black spotted scarf around her head. Grey strands of hair peeped out to frame her calm face. When she repeated her request, she did not implore nor plead. She looked at me with the patience of one who had waited for years for things to unfold, so knew how to wait. There was a curious knowledge in her grey eyes that sealed things for me. I wrote out a prescription for a second endoscopy.

When she came next with her test results, I felt a vague uneasiness. Like the uneasiness before the screening of my colon to see if yet another polyp had come up, another clump that needed to be removed before it turned malignant. This time her scarf was a floral orange that stood out in cheerful contrast to her grey abaya. I took a long time to study the results of her endoscopy, and she waited with the same earlier patience, her eyes focused faraway. The moment I looked up she turned to me, nodding. Her cancer was in complete remission.

She looked at my shocked expression in silence, then volunteered, ‘I pray regularly at the shrine of Seyh Yusuf el-Hekim. He was a medical doctor, a saint. His tomb is a pilgrimage site where believers can be healed if he chooses to appear in their dreams. But it was Hizir who came…’

I knew of Hizir as a legendary figure associated with spring and renewal. He was supposed to have drunk the waters of life and achieved immortality, giving life and good fortune to the deserving. People often used the phrase ‘Hizir gibi yetismek’ when something that was needed came unexpectedly as if god sent it. But a mythical figure achieving miracles like remission seemed impossible in this day and age.

Sayeeda Sheikh looked at me for a long moment, then focused on gathering her test reports. In that moment I felt her piety and faith. I knew nothing of her life but sensed hardship like a hard tumour that could be felt by the fingers – full, painful and swollen. What was it that could reverse the genetic mutation of cells? From a rapid growth that goes haywire when cells that refuse to die turn into a lump of cancer. What miraculous means could cause them to get restored as normal healthy cells? In all her movements I felt an equilibrium.

I waited for my stomach cramp to pass but it persisted. It had been a long time since Shakeel had done an endoscopic mucosal resection to remove polyps – that had grown larger each time. He had insisted on continuous monitoring but I feared more tests, feared their results. The indicators now were disheartening: a persistent change in my bowel movements from diarrhoea to constipation and back. I was losing weight and felt constantly fatigued. The previous morning there was blood in the stool. Disequilibrium. I wanted Sayeeda Sheikh to stay, to speak.

‘The shrine was empty,’ she volunteered. ‘I went into deep prayer, when I felt a hand on my shoulder. I thought it was my daughter who had been sitting outside. But the silence … in the silence, I knew it was Hizir. There was so much light, I could see nothing but light, not even his feet, for I did not dare to look up. The light swept through my body and I trembled with relief. My tears were cool like … the light. Then … nothing … just silence.’

I could feel the effect of her words long after she left, like a lingering fragrance, like the light of dusk that refused to fade. Seyh Yusuf el-Hekim, a medical doctor who appeared in dreams, a healer long dead at whose shrine thousands still flocked for cures. Hizir, a legendary prophet who appeared physically or in visions, always unpredictably, always to those he considered pure and pious. In the cold light of my sanitised chamber, this seemed impossible.

I sought out Shakeel at the hospital cafeteria at lunch and told him of Sayeeda Sheikh’s remission. He seemed less baffled than me, pondering over the news as he ate. There is something in these cures, he said, nodding his closely curled head. I used to see these sudden cures more with common gastro issues: irritable bowel syndrome, ulcerative colitis, gastro reflux. Long years of discomfort, then a sudden and complete cure. I never could fathom what alternative systems these guys were using. You know, this business of herbal medicine, cupping therapy, bloodletting… But complete remission of an advancing tumour. That’s something, man. We need more scientific studies on these sort of things. Or more faith, maybe, he added softly.

‘I am taking a couple of days off,’ I said. ‘To drive about in the country. Need fresh air.’

‘You ok?’ he said, looking up sharply. I nodded. His brow furrowed at my bright smile.

It was a long drive to the shrine of Seyh Yusuf el-Hekim. By the time I reached, it was past nine at night. A small square tomb with a dome, it shone in its marbled whiteness in the star-studded night, distinct from the tombs and shrines of other saints and sheikhs in the compound. The open space in front of the tomb was crowded with people sitting in groups on mattresses and chairs, with children playing about. Some women were unpacking food and passing it around. It could have been a picnic ground at night except that there was a hushed expectancy in the air. The atmosphere of the sacred grew on me very slowly: the dim light of the stars seemed one with the dimly lit tomb; people removed their shoes and lit incense, leaving the sticks to glow on the marbled slabs at the tomb’s doorway; the aroma of incense wafted mistily into the open space; pilgrims touched the door frame with their eyes, some kissed the frame again and again. I noticed thin pieces of green and orange cloth tied to the sacred laurel and olive trees in the compound and to the window grates of the shrine. These had to be the wishes of the pilgrims, the vows they promised to make if their wishes were fulfilled, their ties to the saint they had come to worship.

There were signs of sickness too. Some lay huddled on mattresses covered with blankets. A man with what I thought was rheumatoid arthritis so advanced he needed help to walk. There was a lot of coughing, some of it deep and chesty. A man had rolled up his trousers to massage a marble cylinder over his knee joints, a piece probably picked up from the precincts and used as an aid to relieve arthritis. The incense was itself seen as blessing, for people waved its smoke towards themselves before stepping into the shrine.

A boy came up to me with a plate of cucumber tomato salad and some home-baked bread. He came from a large family group that sat nearest to me. The group remained reticent, as if on guard against idle chatter with a stranger.

Before stepping over the threshold of the shrine, I took off my shoes and burnt some incense. I breathed deeply. It was a small shrine with two windows, one at the end opposite the doorway. The shrine was a carved wooden casket covered with pieces of richly embroidered cloth on which were placed numerous copies of the Qur’an. Worshippers stood in prayer before the shrine. From my corner I could see that the prayers carried a range of emotions: worshippers stood silent, implored, wept, bowed low in supplication, raised their hands high for the saint’s grace. When they began their circumambulation of the shrine, they moved anti-clockwise, palms up, hands raised. Picking up one of the numerous Qur’ans lying on top of the tomb, they would kiss it three times and bring it to their foreheads with each kiss. The wall opposite the entrance was also kissed, as if it was a protective enclosure in itself. In dim corners, people sat murmuring verses from the Qur’an. From my corner, I noticed a pleasant-looking shrine staffer move around asking people if they wished to rent bedding for the night. She handed me mine: a patched grey blanket and a lumpy mattress on which I quickly sat down – my observation post. There was the flash of a camera next to us. The woman’s expression changed as she scowled at the young photographer who hastily crouched low to pack up his equipment. Most pilgrims needed no reminders that this was sacred space: people had placed small and large canisters of water before the shrine to receive the saint’s blessings on it for anointing the sick. From balls of silk yarn placed on the tomb, they tore off strips which they could tie to the pillars, window grates, trees. It seemed they wished to tie their needs, their despair, to the mercy of the saint. People helped themselves to oil placed in bowls on shelves to massage their hands, joints, foreheads. As the aromatic smoke of incense from the shrine filled the air, they waved the smoke towards their faces and bodies.

As the night wore on, the patients came more clearly into sight. The old man with rheumatoid arthritis was carried on the shoulders of a man who slowly circumambulated the shrine. People limped, coughed, whimpered and staggered about with diseases unknown. This strange amalgam of sacredness and sickness, was pierced by the scream of an infant. The young parents tried to soothe the child by turns, then placed it on a bundle of soft cloth near the shrine. The skin on its face, neck and arms was red, inflamed and blotchy. The child continued its frantic screams. Its mother bent before the shrine in distracted prayer. An elderly woman’s calm and ringing voice suddenly resonated from the arches and vault of the tomb as she read from the Qur’an. The child fell asleep. When the parents left with the child, I noticed the mother dip a strip of cloth into an oil bowl, squeeze it, then press it into tight folds with her hands.

By midnight I was no longer the observer. It was as if the observed and the observer had melted into one. I must have dozed a little. It was from this dazed doze that I rose and began circumambulating the shrine. At close quarters, I became alert to its strangeness, to its aura and aroma, to the saint and his pilgrims. I became acutely aware that I did not belong, that this was not a world I knew. It took a long time before I fell into rhythm with the walkers, in tune with their worship. Theirs was a need for healing, a need for reassurance, but above all a need for peace. It was this peace that fell on me unexpectedly after many rounds of walking, without any attempt on my part to be in tune with the place.

Outside, I found space beside a family of four. There was now more intermingling between the groups as people shared food and drink, identities and sicknesses. I looked up at the star-strewn sky and wondered if starlit skies played a role in unifying people. Unlikely. Maybe it was the sickness. Or the saint. Or the saint and the sickness. Seyh Yusuf el-Hekim. A medical doctor who granted wishes to the pious and the good. To the deserving. There would be many who would not be on his list for cures. Yet, there was this sense of oneness, of a suffering shared.

I saw my neighbour pour out steaming hot tea from a thermos into a cup. I was surprised when she offered it to me along with some sunflower seeds. I smiled as I took the cup gratefully. She didn’t open up a conversation, and I felt grateful for the silence in the middle of this animated night. It was the children and the elderly who began to fall asleep first under blankets on this early summer night. Women from different groups sought each other out, sat together and talked in hushed tones. I stretched out on my mattress and stared up at the cloudless starry sky. I could smell the sea on the gentle breeze. My eyes closed and I slept.

It was a short but intense dream: I am lying on a stone bench. Two men come to me in white lab coats, one led by the other. The man behind the leader carries a surgical light that is so bright that their faces appear dark. A deep clear voice says: ‘You are afraid but it will be alright. It has started to spread. We will remove this bad section. There will be pain for ten days.’ I look for the face behind the voice but the surgical light blinds me. I feel such terror that my body shakes. A hand reaches out to cover my heart. I drift into a haze, feel nothing, know nothing.

I woke to a sense of great peace. The sky was faintly lit by the first rays of the sun. I turned my head to see it rise from behind the huge mountain to the east of the pilgrimage site. It was only when I turned my body to rise that I felt the pain. I winced at its suddenness, then waited to locate it in the region of the left lower abdomen. The ascending colon. The pain felt like the raw ache of post-surgery, suppressed by pain-killers. My disbelief conflicted so sharply with the earlier sense of peace that I could not rise but lay stiffly to one side. All around I heard people rising, rousing their children, picking up their belongings, clearing up the litter. Many smiled at me as I continued lying on my side. It was only when the crowd thinned, did I get up to pick up my belongings.

The shrine was almost empty when I handed over my bedding to the staffer who smiled her pleasant smile. Sunlight had entered from a window in a long slanting shaft. I began circumambulating the shrine till some peace returned, still jostling uneasily with shock and disbelief. For a long moment I kept my hand on one of the tomb’s shrouds, picked up the Qur’an to bring it to my forehead. I bent low before an incense holder to allow its smoke to drift over me.

Back at the hospital, the first thing I did was to see Shakeel. Sitting in his cluttered hospital room, he remarked on how good I looked after my little trip.

‘Where did you go?’ he asked.

‘To a coastal village. Needed some sea breeze,’ I replied. He nodded.

‘Shakeel,’ I added, ‘I need you to do some tests on the colon so we get a clearer picture. It’s been awhile.’

‘Sure,’ he said scrolling down his screen for his appointment schedule. ‘How about tomorrow? Ten am.’

I hesitated then murmured, ‘Can we do it after ten days? I have a little discomfort at the moment.’

Shakeel looked at me, nodded, but said nothing. When I rose abruptly from my chair, I winced with the pain. Seyh Yusuf el-Hekim. It was for the first time that the pain came with a deep sense of reassurance.