Ramadan Reflections, 2020

As the last day of Ramadan comes to a close, I think back to several weeks ago - as the month had drawn nearer and COVID-19 cases continued to climb, and social distancing guidelines appropriately grew stricter, the thought of a Ramadan without the mosque open for prayers or others’ homes open for iftars struck a chord of sadness within all of our hearts. No one saw this Ramadan coming, nor what it ended up being. Paradoxically, this ended up being the best and most spiritually fulfilling month that many of us have had in a long while. Without our usual comfortable routines, we were forced to find ways to implement that same search for spirituality on an individual level, while coming together as a community virtually. For me, that meant nightly FaceTimes with my family and regular Zoom sessions with old friends, daily online lectures from my mosque back home and in the place I now call home and from institutes of learning, attempting to incorporate reading the Quran more into my daily life and attempting to pray taraweeh on my own, and mostly, finding moments during erratic and extensive work hours for small acts of worship.

Even before the pandemic ensued, I was especially apprehensive about this Ramadan as it was to be my first one working as a resident physician. I distinctly remember being a third year medical student, and making extensive pro-con lists to help me choose my future specialty (see photo below). One of the reasons I was initially scared of choosing a surgical field was that I was under the impression that the hectic environment would somehow cause me to lose touch with my faith. At the time, I was scared of choosing something that wouldn’t be compatible with the Islamic teachings - would I be able to pray my prayers in on time, would I be able to keep my fasts without harm to myself or my patients, would I face difficulties being a hijabi in the OR, etc - the list was endless. As it turns out, none of my fears were necessarily specific to neurosurgery; many of my racing thoughts could be experienced in any residency or rigourous field with extensive training hours. [A brief flashback to the year after, as a fourth year medical student doing a subinternship in Neurosurgery at an outside institution during Ramadan - standing in 10 hours cases, taking call shifts that lasted up to 40 hours, all while fasting every single day… the prayer room in the main lobby of the hospital was my most frequented spot. I had wanted to prove to myself that I could have both, and though that month was definitely difficult, it was also incredibly motivating. (Also - I learned how to deal with hijab, AND this institution had specific hijab scrub covers for the OR!)] Prior to that experience, I was scared of letting myself even dream of this impossible seeming career for me, and had to mentally battle every excuse and doubt (from within, and also from the outside). I have grown leaps and bounds in my spirituality since then, and my relationship with Islam changes and is redefined regularly, but in short - if you are passionate about your pursuits and are sincere in your efforts to hold onto your faith, you will find that your life shifts to allow you to focus on your priorities.

“Namaaz?” aka “prayers?”. [Can you see the “7 years?!” above?… I might share the whole list one day].

Saying the previous platitude is easy enough, but actually living it is by no means simple. The very first night of Ramadan this year, I was on call and had barely taken a bite of my date to break my fast when I was emergently paged to the Emergency Department for a head trauma (unhelmeted motorcycle crash, leading to an epidural hematoma) that needed surgical intervention. As we were in surgery there was another emergent page for a patient (spontaneous subdural hematoma, herniating) that needed to be added on for surgery immediately after. I was not able to get a moment to rest until the middle of the night, where I had a combo iftar/suhoor before continuing the shift, as almost immediately there was another patient (subarachnoid hemorrhage from a ruptured aneurysm), that needed to be set up for surgery as well. I was definitely unprepared for the evening, but did learn to implement the surgeon’s motto from that point onwards - “eat when you can, sit when you can, sleep when you can”. I love what I do but I’m not going to try to glamorize the field at all - working as a medical resident is tiring, and while fasting even moreso. 

Set up for an EVD (yes , that is a skull hand drill)

There were days when I was so tired I couldn’t bring myself to do much in the way of ibadah other than pray, and there were times that I couldn’t pray on time due to being in a case. being busy managing patients and would have to make it up later. There were even days when I fleetingly thought if I shouldn’t fast the next day because I wasn’t sure if I was mentally or physically strong enough. During the month, I had a few instances of needing to place an emergent bedside external ventricular drain (aka EVD, aka cut skin, drill hole in skull, pass catheter into brain) on patients undergoing COVID testing - the full PPE garb plus small sweltering ED rooms plus being (maybe more than) mildly dehydrated in a fasting state was a new challenge. Fortunately, there was never a moment where I truly felt I was beyond my capabilities or where I thought that my fasting state would be harmful to my patients. In this field, it’s inevitable that that moment will arise, and I will let y’all know I deal with it when it does. This Ramadan, I was on night shift for two weeks, day shift for one week, and off for one week - honestly, neither days nor nights are better for fasting when you’re busy, it all blends to be the same. The week off was definitely a blessing, and it was when I was able to complete many more of the traditional Ramadan acts of spirituality. I’m only (nearly) one year done out of seven of residency (!!!), but this Ramdan went about as well as could be expected, and I look forward to the years to come.

Annual dawah iftar I host for my non-Muslim friends - much, much smaller this year, but I learned how to cook all my mom’s specials (even made biryani for the first time)!

Though I can now quell the doubts/fears of my third-year-medical-student self, there was an aspect to this month that I did not anticipate experiencing - the intermittent feeling of paralyzing loneliness. Ramadan is usually a month of communal worship and family and friends and celebrating with community, and this was the first Ramadan in my life where I was not able to be with family for even a day or for Eid. Between being a first year resident (our schedules are not designed for flexibility, who would’ve thought), and wanting to keep my family safe from my likely exposure (or I would’ve gone home with my week off), and all the local mosques being closed (thankful for online programming tbh) and usual iftar parties on hold (though I may have had one or two with fellow hospital employees), there was a sense of sadness that I had to actively address with new solutions. Shout out to my family, who put up with my FaceTimes every. single. night. and to everyone else who kept me going this month. I definitely strengthened my relationship with others and God, in spite of all of the obstacles this year threw at us. As this Ramadan comes to a close, I hope everyone has been able to benefit from the month during these “unprecedented times” and taken something with them to incorporate into their daily lives! I know my month of fasting and worship was not perfect, but it was a start to figuring out how to find the balance we all strive for in life, and I’m happy with what I was able to achieve, alhamdulillah. It’s always sad to see the month we hold so dear to us leave so soon, but inshallah, until next year. Eid Mubarak to all!

(never will I ever get sick of my hexagon wall panels)

{If any of y’all have any questions about Ramadan, or Islam, or life as a neurosurgery resident, or how I work to integrate science and faith, or really anything at all, please ask away!}