November 21, 2018

A Jewish doctor, a Muslim patient, a love story

“Doctor Emrani,” yelled the nurse, excited to see me in the Emergency Room. “This woman is about to die and she is refusing care.”

I met Zahra for the first time as part of a code. Code Blue is dire, announcing impending death. 

She spoke only Farsi, and I happened to be nearby admitting another patient. I tiptoed to her, so as not to frighten an injured bird. I asked everyone to leave the room, took off my white coat to let her know I was safe, pulled up a chair and sat next to her. I reached for her hand with mine.

“Mother,” I whispered. “You are having a heart attack and a stroke at the same time. It’s your body. I’m not going to force you to do anything that you don’t want to.”

With her short, silky, silver hair and blue-gray eyes, she pleaded “nothing invasive.” Through her pending stroke, she was having trouble pronouncing words. She spoke with her eyes more than with her mouth. I nodded.

A clot had formed in the artery that supplies oxygen to the front of her heart, causing a heart attack, paralyzing the pump. As a result, a second clot had formed inside her heart and was now going to her brain, causing a stroke. 

I spoke her language. Sinking in an ocean of “foreign” speakers, I was her Farsi buoy. She relaxed. I joked. She let me give her a thrombolytic — an intravenous infusion of a clot-busting drug. It was a gamble. She could have bled inside her brain. But it was all she would allow me to do. I always respect patients’ wishes.

Three days later, she walked out of the hospital intact. No neurological deficits. Her initial stutter turned into fluent speech.

That was 16 years ago, just before Yom Kippur, in the Days of Awe. 

That year, I heard the shofar with a heightened appreciation for life, each broken note resonating with the sounds of the bells and whistles in the Intensive Care Unit. Just as alarms awaken us from sleepwalking, so, too, the shofar reminded me of life’s fragility.

In temple, I pleaded with God to make me lucky with the care of patients like Zahra. I felt her hand in mine. It took me back to my childhood in the streets of Tehran, when, on Fridays, I would wake up to the sound of the azan over the local PA system. I imagined Zahra as a young woman kneeling, praying to Allah, being moved by the azan at a time when I, as a child, had goose bumps on hearing the sounds of the shofar. Once, I heard President Barack Obama quoted as saying that “the sweetest sound I know is the Muslim call to prayer,” and I knew what he had meant.

The beauty of medicine is that it strips us of our superficial labels. The X-ray of a man, a woman, white or Black, gay, straight or divorced, Muslim or Jew — they all look the same. Beneath our skins, under our cloaks, our hearts are identical, and they all break in the same way, vulnerable to the same insults. In these times, when the daily bombardment of news divides us, builds walls between us, medicine reminds me to remain humble, to care for each patient equally.

In the movie “Sully,” airline captain C.B. “Sully” Sullenberger, who executes an emergency water landing on the Hudson River, makes a profound statement: “I’ve delivered a million passengers over 40 years, but in the end I’m going to be judged by 208 seconds.” Back when my family escaped Iran, I found myself thinking about this same notion many times over. Cyrus the Great was good to the Jews. Persia was vastly good to the Jews. I did not want to judge Iran and Persian Muslims for the last few years by the actions of the mullahs.

To this day, Zahra calls me her “son.” She prays for me, asking Prophet Muhammad to bless me. She is a poor woman of little means who holds a special place in my heart. When her daughter died a few weeks ago, she called me before she told her family. After we talked for a while, she confided in me that I was the only person who had ever truly loved her. Others had pretended to love her, but I had always acted lovingly toward her. Then, sobbing, she said to me, “We’re all brothers and sisters — Jews, Christians and Muslims — but sometimes we don’t know it until we lose a child and realize how much time we wasted hating in a short life that should be spent loving.”

The great poet Rumi wrote, “Out beyond ideas of wrongdoing / and rightdoing there is a field. / I’ll meet you there. / When the soul lies down in that grass / the world is too full to talk about.” 

This week, Zahra dropped off a Quran for me, not in an attempt to convert me, but out of respect, and because it is the most valuable item she has in her household. The holy book is over 100 years old, making it an antique. I will donate it to a mosque in her daughter’s memory.

DR. AFSHINE EMRANI is a cardiologist in Tarzana. Read his blog,