The idea for Ramadan
I was at a dinner party with some interesting people who had done aid work in developing countries. A few of them remarked upon how
difficult the month of Ramadan is, with everyone being tired and hungry, and
worst of all, people getting ill from fasting. Imagine working in the Middle
East when Ramadan is during the height of summer – people working outdoors
would rapidly become dehydrated and some would pass out.
So, my friend and I thought we would do Ramadan this year to
experience what Ramadan is like for the millions of Muslim who partake in it
all around the world. She pulled out though as she was writing her thesis, but
I thought I would give it a go.
Day 1 – June 18
Breakfast: Sticky
rice, 7-11 coffee
Iftar: Hospital
omelette, peas & corn; cheesecake
Dinner: A
large chunk of sourdough
Dark
chocolate gelato from Gelato Massi
Leftovers
with rice
In the intervening weeks, I had forgotten about Ramadan
entirely. I got up on this day as on any other day, had a quick bite of some
leftover sticky rice and got on the bus to go to St V’s. Along the way I read
my messages and my friend asked if this was the beginning of fasting.
Had to postpone my Hugonettes crepes plans and quickly grabbed a coffee before
I got on the bus. The sun was rising and Central station was painted a hazy
purple that morning as I sculled my coffee and got ready for a day of fasting.
It wasn’t too hard given I was distracted with grandma
related activities for most of the day. The hardest time was when she was eating
and I couldn’t eat with her. The hunger was the greatest from 11am (when I
usually have elevensies) to 1pm. After that the hunger faded and I just felt an
intense thirst.
I broke the day’s fast with some tap water from the ward
kitchen. Water never tasted so sweet before – so refreshing! I wolfed down some
of my grandma’s unwanted hospital food, even the bland omelette and overboiled
peas & corn tasted amazing.
Once home, I felt like I was binging as I walked around the
kitchen and saw so many things I wanted to eat. I ate some bread and gelato
before dinner, and realized I’d consumed in 2 hours at least double what I
would normally have for dinner. I told myself that I would get used to the
fasting, and that tomorrow it would be easier.
Day 2 – June 19
Breakfast: Leftovers
with rice
Iftar: PB
& banana on toast, half a papaya
Dinner: Palsaik
Korean BBQ – Kimchi jigae, pajeon
Late night Chat Thai dessert –
dough sticks with pandan, salty coconut soup with random balls
This was the first day of my week of work and I felt pretty
good in the morning. It was a sodden day and I stood in the rain waiting for
the bus, feeling like it would maybe be a good day.
I was busy enough not to feel too distracted. Again I was
hungry from 11 to 1, but afterwards just felt thirsty. Around 3pm I felt pretty
hypoglycaemic and lethargic, people asking me questions was difficult and my
mental performance was definitely not optimal. It wasn’t too bad though as it
wasn’t a busy day at work.
Breaking the fast felt surreal. Every food related sensation
was heightened – the bread was extra crunchy, the papaya silky soft. Afterwards
I felt manic and like I was bouncing off the walls. I think the sugar rush must
have signaled to my brain “do this again! I like this!” I had a great evening
out with my uni friends and barely felt tired even though it was way past my
bedtime. It felt like a strange reversal of the usual diurnal variation, as if I’d
spent the day hibernating and woke up for the night time.
Day 3 – June 20
Breakfast: Spaghetti,
Shelley’s cheesecake on toast
Iftar: PB
& banana on toast, half a papaya
Dinner: PappaRich
Chatswood – roti canai, veg biryani with veg “mutton”
Lid
& Jar for chai
Without realizing it, I carb loaded myself for the day by
consuming so much carbs for breakfast. I always loved cheesecake, and having it
on toast was an extra treat. Though I’d only slept for a few hours as I
had a big night out, I felt great in the morning.
I really struggled in the afternoon though. In the late
afternoon I saw an unwell patient and as I was thinking through the clinical
problems, it felt like my brain had just left the building. Then I started
talking to the patient’s wife, and engrossed in the conversation, didn’t realize
it was sundown. At 5:30pm I sat down to break the fast with the same food as
the day before, but I didn’t feel so elated because of a terrible headache. Vincent
said I shouldn’t take aspirin because it could be a subarach, but I took some
anyway and the headache eventually faded.
I had dinner with Chats at Papparich and I was a bit delirious
when I arrived. There was a sign outside Papparich celebrating Ramadan and
somehow I thought they had a separate Ramadan menu. Never mind, the curries that
came with my roti canai were tasty and I enjoyed the veg biryani. We talked
about everything and anything, but I distinctly recall discussing how people
present themselves to the outside world –
do we set ourselves unrealistic expectations because we are comparing one side
(the worst) of ourselves to a different side (the best) of others?
Day 4 – June 21
Breakfast: Spaghetti,
Shelley’s cheesecake on toast
Iftar: Avocado
on toast, an apple
Dinner: E’s
birthday cake
Dinner at home
with dad
I had a pretty groggy start to the morning, having being on
call and woken up several times. At an hour I would usually be sitting down to
coffee, I was in ED seeing a really sick patient, and the day gradually unraveled
from there.
I felt less powerful than I usually am. Physically I didn’t
feel as strong and I just didn’t feel like doing anything. It’s not like I
thought about food much, and people eating certainly didn’t bother me. But
perhaps usually in our workdays, our time to eat and drink is also our
downtime, so I didn’t have as much downtime as I usually would have.
I went to visit grandma after work, and felt really tired by
then. As usual I had laid out the music I planned to play that night, but I
only managed a couple of mazurkas and the last three Chopin nocturnes before I
felt buggered and went to bed early.
Day 5 – June 22
Breakfast: Oats
Iftar: Avocado
on toast, an apple
Dinner: Lunchbox
by dad, miso soup
I left early to get to work, but obviously not early enough.
I sat in traffic wondering why I live in Sydney, and also wondering what the
future holds. I thought about where I would be in ten years time, but I just
could not picture myself there.
It was Monday so the registrar and consultant changed over.
The mood notably changed, but I was not my usual self. Maybe with all the ups
and downs of the weeks following my grandma’s broken hip, I was even more
melancholic than usual. My mouth felt dry and parched by mid morning, and I
wondered how I would get through the day. John barely eats but that somehow
exaggerated my lack of eating. Around lunchtime I sat with the others in the
tearoom but when someone came in to ask for something, I volunteered to go back
to the unit. Maybe I missed eating as much as I missed having a proper break? I
resolved to sit in the office for a while, but I never got there.
There aren’t really any windows in the ICU, so it’s hard to
know when the light is fading. At ten to five I went to fetch my bag of snacks
so I could get ready to break the fast, and I felt really lightheaded by then.
I thought about how hard it must be for patients to fast for surgery (and then
have it cancelled and have to do it all over again!)
Day 6 – June 23
Breakfast: Noodles
Iftar: Sandwiches
and sushi from grand rounds
Dinner: Cabbage
poriyal and a boiled egg with rice
The on call was again quite taxing, and after one of the
early morning calls I decided to get up to eat. I looked in the bathroom mirror
and felt like my face was all red and dry. Was this somehow related to fasting?
I resolved to take some lip balm to work (which I was later accused of eating
during fasting).
I decided to have noodles for breakfast, and as I was
cooking them the phone rang again and as I was talking to him I was
faced with a most odd decision – do I go to work and intubate the patient (and
fast till sundown) or do I eat my noodles? I ate them as quickly as I could,
and suffered from chilli reflux for the rest of the morning.
Post on call days are always hard as you struggle with sleep
deprivation and the need to keep everything spinning. At least my team was good
this week in distracting me from fasting, though they teased me endlessly about
it. At grand rounds I saved some sandwiches for breaking the fast, and they
tasted extra good at sundown. I felt mildly euphoric afterwards and even felt
like cooking when I got home.
Day 7 – June 24
Breakfast: Noodles
Iftar: Avocado
on toast, kiwi fruit and mandarin
Dinner: Lunchbox
by dad
I had noodles again for breakfast but added less chilli this
time and had more time to eat it, so no more reflux. In the afternoon I had to
put a central line in and I felt extra lightheaded whilst scrubbed up. I
struggled to keep my hand steady and couldn’t feed the wire onto the line. My
physical performance was clearly subpar. I wondered how doctors who are fasting
in Muslim countries do complex things like place central lines or perform
surgery – are they exempt because they actually have to concentrate for patient
safety?
Afterwards I couldn’t get the plastic drape off the patient,
and I became extra annoyed by the drape. Upon reflection, my degree of
annoyance was way over what it usually would have been. I had a major rant and
then went around asking everyone what they thought about the drapes – the
degree to which I took it was just plain silly. I got into a heated discussion
about it with my boss whom I love, and afterwards felt so stupid about the
whole thing. Did it really spiral out of control because of my hypoglycaemic
crankiness? I felt ashamed of my own lack of self control and stupidity. As
others have pointed out before, my frontal lobe doesn’t work on the best of
days, but it was extra bad with fasting.
Day 8 – June 25
Breakfast: Lunchbox
by dad
Iftar: Avocado
on toast, banana and mandarin
Dinner: Four Frogs: Spinach, feta,
mushroom and avocado galette; nutella strawberry crepes and lemon curd crepes
Another bad night on call. After a few calls I decided to
get up and go to the hospital just before 5am. It was a dream run, hardly any
cars on the road at the time. As the patient got wheeled off to theatre, I sat
down to eat my breakfast, but didn’t drink enough water so was extra extra
thirsty for the rest of the day.
Hungry, thirsty, tired – not a good combination.
A sick patient arrived in the afternoon and I felt like I
was floating off somewhere. As the “senior” person I was asked to place the
central line quickly, but I really struggled, and had to have a second stick. I
knew I was under-performing as it’s been a very long time since I had to do a
second stick in such a straight forward case. I felt like I was sick, maybe even worse than if I was
sick. I woke up a little bit in the cold of the cath lab, and then the rest of
the day just blurred by. We went out for team dinner and the food took ages to
come, but I felt more or less re-energised by then as I had eaten and drunk at
iftar. I was so tired by the time I left the hospital that I was scanning my
apartment keys and wondering why the hospital carpark gate wouldn’t open. By
the time I got home it was after 11pm and I collapsed into bed.
Mmmmmm... crepes
Day 9 – June 26
Breaking of the fast: Cabbage
curry and eggplant pickle with roti
When I opened my eyes, I knew from the light that it was day
time and I missed the time to eat. I thought I could maybe spend the whole day
sleeping, but alas, my brain was already awake. After talking on the phone for
an hour, the thirst felt unbearable. This is what people on fluid restrictions
have to experience every day? There was a glass of water next to my bed and it
was calling to me.
I sat up and looked at the glass. It looked back at me, full
of precious clear hydrating fluid. I took a sip and it tasted sweet like
nectar. I gulped the rest down and felt my cells de-wrinkle a little bit. I got
out of bed and drank another glass.
Then I made breakfast and enjoyed every
bite. Then I had a cup of coffee and thought, this might be a good end to my Ramadan.
Final thoughts
Ramadan was challenging. Without having the cultural and
religious context, fasting from sunrise to sunset was pretty hard and I got
sick of explaining to everyone why I was doing it. Most people thought I was
crazy, but a fair few were interested in my quest and some shared stories of
being in Muslim countries during Ramadan. As a non-Muslim, it has given me some
empathy to those who are fasting – it is physically and mentally tough for them
to get through the day, especially when all their friends and colleagues are
carrying on all the usual activities. It must also be awful to be a hungry
patient, surrounded by others eating but unable to take anything by mouth.
Finally, virtual thanks to all the people that saw me though
the days of fasting. I apologise for the crankiness.