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SUMMER
2012
27
Those who have been through it know
only too well the agonizing frustration
and petrifying responsibility of taking
care of a terminally ill loved one. Ques-
tions are many. Am I doing the right
thing? Is this a normal reaction to a medi-
cation? Why is he doing this? Should I
rush her to the ER? What am I supposed
to do now?
The confusion is very scary. You have one
chance to do it and do it right. If you
don’t, it could be disastrous.
And then, of course, there’s the huge emo-
tional factor of helplessly watching your loved
one suffer psychologically and physically.
Dr.
Hibah Osman ‘86
had purposefully
stayed away from this domain during her
doctoral studies in the US and chose what
she described as ‘happy medicine’ – “mothers,
birth, babies,” she said. “Family medicine.”
When she returned from the US,
she joined the Department of Family
Medicine at AUBMC and successfully
practiced her “happy medicine”.
And then came in an elderly patient. She
was diagnosed with cancer. Despite her
family’s wide knowledge of medical care,
they were at a loss. Osman stepped in
and began managing her patient’s care.
As her family’s anxieties begin to ease, so
did her patient. A short while later, the
woman passed away.The family mourned,
of course, but there was a distinct feeling
of peace in knowing that they had given
their mother their best care and allowed
her to die with dignity.
It was a turning point for Osman. “I
realized what a major difference pallia-
tive care can make to patients and their
families, and that there is a big need for
palliative care in Lebanon,” she said.
Most of the time, patients and their
families are left on their own to figure out
how to manage and deal with an illness.
Osman noticed her patients’ stress and
confusion and began to look into pallia-
tive and hospice care. She attended inter-
national workshops and studied hospice
care organizations abroad. Finally, she
felt ready to found an NGO. Colleagues
expressed great interest and before long
she had established a five-member Board
of Trustees.
Balsam, the Lebanese Center for Pal-
liative Care, was born in 2011 with the
aim of giving everyone – regardless of
religion and nationality – end-of-life care.
Families are never billed for the service.
“We completely depend on donations,”
explained Osman. “We can’t burden dis-
traught families with bills.”
So far it’s a skeleton staff of seven but the
word is spreading quickly – even quicker
than Osman expected. One morning, she
received an email from a man residing in
Sweden. His mother-in-law, he wrote,
lives in a Palestinian camp and is dying
from cancer. Her elderly husband is un-
able to care for her. All her children are
abroad. Could Balsam help out?
Osman and her team showed up to the
camp and located the woman. Much to
the distraught husband’s relief, they took
over managing her care. Despite dona-
tions, Balsam’s funds remain meager and
the woman needed a nurse to bath her
regularly. In fact, it was her fear to die
while unwashed.
As luck would have it, Osman (mother of
three children) was on a play date when she
received a call that a nurse was willing to do
the job at reduced rates. Still, those rates
were beyond Balsam’s capacity.Then and
there, the host mother took out her check-
book and offered to pay for all the baths the
dying woman needed. A few weeks later,
the woman died. She had been bathed that
same morning - as was her wish.
“A lot of what we do is social,” said Osman.
“The medical part is making sure that the
patient is comfortable and not in pain or
getting bed sores. But a major part of our
job is sitting down and telling the families
Dying with Dignity
In the summer of 2009 my father was diagnosed with lung cancer. In a few seconds, the safe
world that I had known tumbled around me. It was the beginning of a role reversal that would
last for 10 months. Suddenly the rock in my life was crumbling. A doctor himself, he took
charge at the beginning – as he always did. But all too soon, the chemotherapy and radiations
therapy took their toll. His strength was leaving him. “I’m sorry to do this to you,” he told me
sadly as he handed the reins of his medical care over to me and my distraught mother.
Stumped, we didn’t know how. Somehow we had to put our emotions aside and become
caregivers. But we had never dealt with cancer and didn’t know where to begin. Seeking
advice from his oncologist turned out to be useless. Years of dealing with the terminally ill
had long desensitized him.The internet became my best friend. Horrible things happen to cancer patients. Frightening things.
At most, we could only watch helplessly. We did the best that we could but I knew it wasn’t enough. I had read about the term
“hospice” in the internet: a group of doctors and nurses who voluntarily come to your home and look after a terminally ill patient.
They also give the desperately needed compassionate support and advice for caregivers. At that time, hospice didn’t yet exist in
Lebanon. If there was a geriatrics care unit we hadn’t heard of it either.
Many times we broke down and cried (out of my father’s sight). We needed hospice care desperately.
On June 8 2010, my father succumbed to his illness and I lost the most caring and loving man that I had ever known. Until this
day, our lonely and frightening caregiving days continue to haunt me. My father – and all terminally ill people and their caregiv-
ers - deserve better.
These two articles are dedicated to Dr. Fouad Salim Haddad – my father.
Reem Haddad