My friend, Abir

“Merhaba” is Arabic for Hello. It’s the only Arabic word I know. When I met a young Libyan woman in Daycase a few months ago, I was delighted to recall it and say it to her. She too was delighted that someone spoke to her in Arabic, even if it was just one word. It seemed to create a special bond between us.

Her name was Abir, slim, a bit taller than me, pretty with large brown eyes, and a warm, engaging smile. She was 32 but looked about 20 at most; I was shocked when I found out that she was the mother of four young children. She looked nervous. Hardly surprising when I understood that she was only in the UK for treatment for leukaemia, so she not only had to deal with the fears of treatment, but also not understanding much of the language, plus the foreignness of an unknown country, people and culture, not to mention being separated from her children and probably other family and friends. We never spoke about any of this, but I could imagine.

I saw Abir quite a few times in Daycase, always wearing a little white knitted beanie hat to cover her baldness. We always greeted each other warmly and asked how the other was doing. I met her mum once or twice too, who spoke almost no English, but also appreciated me saying merhaba to her. I could see how anxious and lost she looked in this strange environment. At one point, Abir and I talked excitedly about helping each other to learn each other’s language – off in some unspoken future. I really enjoyed seeing her and looked out for her whenever I was in Daycase. I felt a special concern for and connection with her – maybe warming to that sense of unbelonging and her youthful sweetness.

Time moved on and my Velcade treatment finished, so I no longer attended Daycase. A few weeks later I began attending the Transplant clinic prior to my donor transplant. Since leaving hospital after the transplant, I have been attending the Transplant clinic every week, as does everyone who goes through a transplant. We are all closely monitored for infections, blood tested specifically to check on the level of immune suppression and watched carefully for any signs of GvHD.

The waiting area is set out with two lines of seats facing each other and I found myself some weeks ago sat across from Abir, with a man, who she introduced as her husband Muhammed. I was delighted to see her again after the gap. She was about to have a transplant. I wished her well and we agreed we’d see each other back in clinic again once she was out of hospital.

I understood that I wouldn’t see her for a few weeks… The conditioning prior to transplant for leukaemia is different to that for myeloma, so a longer time is spent in hospital.

A few weeks went past and I still hadn’t seen her back at clinic. I wondered about her, questioning if perhaps she’d returned to Libya…? But that wouldn’t be possible, as she would have to be monitored and take immune-suppression medication post-transplant, as I did. They wouldn’t have come all this way for half the treatment, besides it being dangerous, but where was she? Why was she not yet turning up at clinic? Perhaps she had had to stay in hospital longer, perhaps her type of leukaemia was a bit different?

I sat with these questions for a week or two and finally about four weeks ago, I went to ask Lynne, the Transplant Co-ordinator, about her. She told me that Abir was seriously ill and in Critical Care. She said I couldn’t visit as Abir was so ill, but I decided to go and find out for myself. Maybe I could at least leave a message for her…

I went to the Critical Care ward, way over on the other side of the hospital. As the receptionist led me through to the Visitors’ room, there was Muhammed, speaking with another Arabic man who I’d not seen before. Muhammed got up and welcomed me warmly, which put me at ease and halted any anxiety I had about coming to see her. The other man is an Egyptian psychiatrist at the hospital. Although they didn’t say as much, he must have been helping and interpreting for the family with the doctors. Muhammed explained that Abir had a very serious lung infection and was sedated so they could keep her ventilated. He was hopeful for her recovery. I asked if I could write a message for her, which I left with him and promised to return the following week.

The next week, I went straight to the Visitors’ room and met Muhammed with Abir’s mum and dad, who I’d not met before. A few moments later, they were called away to speak to the consultant, so I waited until they returned. The night before something had happened, where she had almost died, but had pulled through. She was still sedated and on ventilation though and still Muhammed was hopeful and positive. Abir’s mother looked like any mother would in such a situation – totally worn out and anxious. I gave her a hug.

Muhammed explained that Abir had previously had a fully-matched (10/10) donor transplant from a German donor. Sadly this had failed quite quickly – in just a few months, which of course I could relate to. This time, they had used only a 5/10 match from her mother! I’d had no idea. I think this must mean that it was a desperate final attempt, to use stem cells that are only half-matched, so perhaps the doctors already suspected that there could be serious problems.

They had been allowed to use a small room next to the Visitors room, where they could sleep or at least rest, yet be close at hand. Muhammed asked if I wanted to see her, so I said yes. He took me through to a private room, where Abir lay, her limbs propped up on pads and pillows, tubes and monitors attached to her and her whole body being jiggled up and down by the ventilating machine.

The third week, when I arrived at the Visitors’ room, it was empty. There was no sign of Muhammed or Abir’s parents. I asked a nurse, who advised me that they were now coming a bit later in the day. She recognised me from previous visits and invited me into Abir’s room, where another nurse was busy. Abir’s eyes were very slightly open, it almost looked like she was waking up, but the nurse explained that she was still sedated and this wasn’t unusual, that they applied eye drops to ensure her eyes didn’t dry out, as she wasn’t blinking. He also said that it was ok to touch her and speak to her and encouraged me to do so. He said it might be possible for her to hear me despite being sedated. He left me alone with Abir in the room.

I stood next to the bed and held her hand. Her face, fingers and arms seemed puffed up; perhaps they had her on fluids, or maybe I’d just not noticed such details previously. Next to her head on the pillow was a Digital Qur’an – an iPod-type device, which I imagine is like an audio book of the Qur’an that her family were probably playing for her as motivation. I didn’t know what to say, and can’t remember exactly what I did say in the end. I babbled away self-consciously about expecting to see her in clinic, that we still needed to teach each other English and Arabic, that I’d seen her parents and that she had a friend here, as well as her family wanting to see her recover. I avoided saying anything about God or praying, as I am not religious. I felt completely inadequate. Before I left, I wrote a short message for Muhammed, just to let him know that I had visited and that I would come back the next week.

She was on my mind all week and I was keen to visit her again last week after clinic. I walked into the Visitors’ room, which was empty again. So I went over to the nurses’ station, which is opposite her room, but I couldn’t see inside as the window curtain was closed. A nurse asked if she could help me, so I asked about Abir. She was clearly busy with something and asked me to wait in the Visitors’ room. That’s when I began to feel a sense of unease…

After what seemed like forever, the nurse returned and sat next to me. I knew what was coming… “I’m sorry but Abir passed away on Tuesday morning.” I cried. I barely heard the reassuring words of the nurse explaining that Abir really had been very seriously ill.

The family had already returned to Libya. Like in the Jewish tradition, Muslims seek to bury their dead as soon as possible after death, preferably within 24 hours. There were no contact details for me to write to the family. The nurse did suggest I could leave a card/letter which they could send on to the address in Nottingham where the family had been staying, but I really didn’t think that it would actually get to the family in Libya.

My last hope was to contact the Egyptian doctor I’d met on my first visit. The nurse gave me his name and extension number. I called and left a message and have since heard from his secretary that he is away on leave until 10 August, but she would pass on my message and hopefully, maybe, just maybe he will have contact details for Muhammed. Writing to the family is the last thing I can do. Of course it won’t change the fact that Abir is dead, that her mother and father have lost their beautiful daughter, that four young children have lost their mother and I feel so sad to have so briefly met this lovely young woman, only for her to die before I could get to know her better.

The hard thing is the irony that the only reason I met Abir is due to the illnesses we shared. There was always a chance that one of us could die… We were already facing life and death when we met. A hospital is not a normal social environment, yet we make friends…

This week in clinic, I found myself chatting to one of the patient volunteers. A patient volunteer is someone who has a haematological illness but is sufficiently well to volunteer – offering a friendly ear, advice, support, etc. to other patients. I mentioned to him that a friend had died following her transplant and when I told him it was Abir, he told me that he’d supported the family while they’d been here. He had been with them at Nottingham station as they departed on the Tuesday morning she died. He told me that she was an accomplished artist, well-known in the Northern Africa area, that she also played classical piano and had been receiving hundreds of messages from people who knew her and her work. What a talented woman and what a sad loss on so many counts.

Finally though, he mentioned that Muhammed is planning to return to Nottingham in September to sort out the flat where they had been staying, which of course, they’d not had time to do before they left. So, I will be able to pass on a card to him and the family.