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This is a personal story about my mother’s journey with breast cancer. It began in September 2018 and ended on October 15, 2020.

During my mother’s journey, I learnt some invaluable lessons from her — how to laugh during tough times, and how to cope with pain and disappointment. I also discovered that in our society, people often lack empathy and emotional intelligence. In a field as important as medicine, where decisions directly impact human lives, emotional needs are often overlooked.

When I make calls, I frequently hear the tinny voice on my mobile phone explaining how to examine your breast for lumps so cancer can be detected and treated at an early stage. Breast cancer is a devastating disease that demands both knowledge and understanding.

My mother Musarrat Jabbar, my best friend Asma Nabeel, and my aunt Guddi all fought breast cancer. Their journeys were long, filled with both pain and disappointment, yet these three strong women faced this illness with unwavering strength, smiles, patience and, above all, courage.

My mother was taking a shower when she discovered a lump in her left breast. At that time, her best friend and sister-in-law, Guddi, was undergoing treatment for stage three cancer at a well-known cancer hospital in Lahore. Guddi had once told my mother that she had noticed a lump under her arm long ago but had ignored it. By the time she consulted doctors, the cancer had already started spreading rapidly. Keeping this in mind, my mother immediately informed my father, all of us children, and consulted with doctors.

I have beautiful memories of my mother and aunt — two remarkable women whose deep connection and support were truly inspiring. My mother used to send Guddi dishes like saag and karhi as Guddi wasn’t fond of cooking. They would often attend family weddings together, always loved to dress up in clothes as colourful as their personalities. I’ll never forget their endless Punjabi jokes.

I still remember when I was going through my divorce in 2010, Guddi looked into my eyes and asked, “Sadia, tell me what’s bothering you? What’s in your heart?” Her concern was palpable, and she wanted to listen and understand what was going on without judging me. Unlike other aunts, she never made negative comments or criticised the younger generation.

Guddi’s husband and children were unhappy with the hospital’s treatment. I had been living in Karachi since 2012 and when I found out about my mother’s breast cancer, our family decided to move her to Karachi for better treatment. She relocated from Lahore to one of the major hospitals in Karachi for treatment.

When I think of breast cancer, how could I not mention Asma Nabeel, a renowned writer who gave us the blockbuster drama Khani, and my best friend. She was an ambitious woman with two beautiful children. She bravely fought breast cancer and lived a happy, healthy life, but unfortunately, her cancer returned, and she passed away in 2021.

My mother, my aunt and Asma were three very different women but they all had something in common — their gratitude and a constant smile on their faces. Despite their illnesses, they never complained or became frustrated. I often see people who, when faced with illness, start complaining, become frustrated, and create difficulties for their loved ones and family members who are there to support them during tough times.

Breast cancer is quite prevalent in Pakistan, with the country having one of the highest rates of breast cancer in Asia. It is believed that one in eight Pakistani women develop breast cancer at some point in their lives.

Emotionally detached doctors

Discussing death is never easy, especially when it strikes close to home. But in those dark moments, support and wisdom can make a world of difference. Under the care of a cancer specialist at the hospital, my mother was reassured that her condition was manageable. The prospect of surgery without breast removal was a relief. However, it was a shock when we were informed about the necessity of chemotherapy and radiation. Having witnessed my aunt’s painful journey through chemotherapy, both physically and emotionally, we were worried.

Chemotherapy is a crucial part of cancer treatment but also a cruel one. It strips patients of their hair and vitality, making them feel weak and drained. Sometimes, it necessitates emergency hospital visits for drips and additional care. It’s a difficult phase for every patient as well as their families.

We had the unfortunate experience of encountering a heartless doctor who dealt with chemotherapy patients. My mother, whose heart was already weakened by a previous silent heart attack, was met with cold indifference. Instead of explaining the risks associated with chemotherapy in a soft and calming manner, the doctor bluntly stated, “Death can occur during chemo”.

The impact of his words was immediate and severe — I can still recall my mother’s pale face, her silence, and my own numbness followed by the surge of anger that coursed through my veins. The news that she would have to undergo chemotherapy felt as if someone had laid a roadmap of the painful and risky days ahead. As we processed this news, the doctor handed me a document to sign. Nestled in a file was an ordinary looking paper that stated that the hospital wouldn’t be held responsible if my mother died.

It lay untouched on the table for 46 hours.

When I think of the doctor’s bland expression and callous delivery of the news, I still can not fathom the cruelty — and irony — of the situation. Despite our best efforts and the hospital’s support, we encountered a healthcare professional, a doctor, who appeared to be remarkably heartless about a patient’s life. That doctors see dozens if not hundreds of patients every day is a given — but perhaps they too need a reminder that for each person they see, these moments are matters of life and death.

Doctors need to exercise compassion, as each patient’s experience is deeply personal, and significant to them. It may be the fifth diagnosis they’ve given that day, but to the patient it’s the first they’ve ever received in their life.

That lack of compassion was evident when the cancer specialist spoke to us about chemotherapy. His lack of empathy cause just as much pain to my mother as the prognosis itself. How could someone meant to heal cause so much pain, my mind screamed. I felt like screaming aloud too, but didn’t utter a word. Ami and I quietly left the doctor’s room to go home and consult with our family.

The journey requires both medical expertise and a strong spirit. Looking back, I realise it’s a challenging path, and I’ve come to understand that some doctors, though highly skilled, may appear emotionally distant or detached during these hard moments.

Chemotherapy and a patient’s emotional turmoil

When I called Asma after getting home from the hospital, she cautioned that my mother’s age would not allow her to bear the stress of chemotherapy and said I should reconsider the treatment. I didn’t and my mother’s chemotherapy commenced with a series of four shots, spaced 15 days apart.

Looking back, considering my mother’s age (64) coupled with her diabetes and heart issues, I wonder if we should have opted for a different approach. Perhaps refusing chemotherapy and considering a mastectomy might have been a better choice.

As a patient or even a family member, it’s natural to second-guess your decisions later, but it’s very important to make informed choices with the guidance of your doctors. In hindsight, I feel the doctor should have advised us that, given my mother’s weak heart, a mastectomy with the complete removal of the breast could have eliminated the need for chemotherapy. These are the kinds of discussions we rely on medical professionals for, so we can fully understand all the options and make decisions accordingly. But as they say, hindsight is 20/20.

After 24 hours, at the dinner table my mother calmly declared, “I will go for chemo. Treatment is a must, and Allah will give me health.” There was courage and positivity in her voice. I took a deep breath, gazing at her calm face. She didn’t make any fuss about it nor did she cry. Instead, she strengthened herself from within.

My mother faced her chemotherapy sessions with a strength that was truly inspiring. She would apply makeup and smile as if she were preparing any other day. She even had new dresses made for herself and showed such power in doing so. Finding a good tailor in Karachi was a challenge at first, but she approached it with the same determination she approached everything else in life. Try as it might, the disease was never able to dim her spirit.

I remember vividly her first chemotherapy session and how she went to the mall to shop after, showing no signs of slowing down. However, her health soon took a turn for the worse, and we had to rush her to the hospital. Her chemotherapy left her body weak, as it is wont to do, and hospital visits became frequent in the days following her sessions as her condition worsened.

But even during those tough moments, she found stillness. The image of her sitting calmly through her chemotherapy sessions remains crystal clear in my mind, reading the newspaper as if nothing could shake her. I have videos from that time that show just how resilient she was, refusing to let the disease define her.

When she started losing her hair, she became upset, grieving, and crying most of the time. For me, we were already fighting a war between life and death, so who cares about a shaved head? But readers, that’s not how some patients see themselves. I remember she was speaking to her brother on the phone one say and started crying. “Bhai, I’m losing my hair, but don’t tell Sadia that I’m crying, she gets upset.” She hid her pain at times, which many women do during this process, not realising that sharing your feelings and your pain can make the process easier.

As more hair fell due to the chemotherapy, she began wearing a hijab. She didn’t just wear it — she styled it beautifully, making it her own. She would search for new scarves and even asked me to help her find some. I wasn’t sure where to get them back then as I was unaware of online shops at that time or where to get them physically, but she embraced that change with such grace. She even used to ask our domestic help to style her scarf as I didn’t know how to do it. All of this happened without any sadness but with the same lightness, she carried throughout her journey. She faced it all with an open heart and courage that still leaves me in awe.

Asma was equally brave through her chemotherapy sessions. When her cancer came back and her hair was falling out due to chemotherapy, she took me to the salon to have her head shaved. Her smile was radiant throughout the process.

I ordered a salad and coffee from Xander’s, a local posh café in Karachi, and she immediately said, “Order one for me too.” She wanted to enjoy the salon trip as if it were just a regular day out with friends. Asma’s second name was strength; she was determined and hopeful to beat this battle with her courage.

A little kindness goes a long way

In my opinion, some healthcare professionals and doctors forget to be kind. My mother went for a routine checkup during a chemotherapy shot where she met a doctor. When she asked, “Am I losing my hair?” she was seeking encouragement, but he bluntly replied, “It’s your chemo doctor’s issue; ask them.” His lack of compassion left me feeling awful, wondering what kind of doctor responded to benign questions like this. My mother just offered a sad and hesitant smile in response.

In professions that deal with vulnerable individuals, a little kindness can make a world of difference. A gentle word or a reassuring gesture can provide immense comfort and hope to people who need it most. Compassion is a simple yet powerful tool that can transform difficult moments into ones of support and understanding.

I think back to a similar incident when my mother went for a checkup to a cardiologist. The doctor, quite old, put his hand on my mother’s stomach and said with a smile, “It’s all goat fat.” My mother also managed to smile, but the comment left me feeling angry and frustrated.

Our society needs to cultivate more empathy. Rather than offering unsolicited advice or criticism, we should focus on supporting individuals, especially those who have been through difficult experiences, such as chemotherapy. It’s essential to accept and appreciate diverse body types without making hurtful comments or trying to dictate how others should look or feel.

I later realised how seriously my mother took the doctor’s comment when I saw her consuming lemon in an attempt to lose weight, which wasn’t good for her throat. Body image concerns are often prevalent among cancer patients, as they experience rapid and significant changes in their appearance.

A journey of peace

I vividly recall a day during my mother’s treatment, when she was standing near the sink and I was searching for something in a nearby cabinet. She came to me and said, “Allah, do not grant me a life of dependency; May Allah call me in peace.” I was entirely frozen at that moment, realising that a mother was prioritising death for the ease of her children.

“Ya Allah grant me a peaceful death, I am concerned about my children. They will face difficulties because of my illness,” she said.

It took a year from my mother’s first surgery, through chemotherapy and radiation, to her departure towards Allah. She passed away due to a heart attack, as her heart was already weak. Her death anniversary falls on October 15 — in Breast Cancer Awareness Month.

Breast cancer is already a deadly disease and what makes it more deadly the stage at which it is diagnosed. We all have to eventually return to our Creator, but it’s my belief that in a comfortable and comforting environment, surrounded by loved ones and in the care of healthcare professionals, it is possible for the journey of illness to end peacefully and smoothly.