PTSD, Tests and Tears
Ramadan is hard enough
as it is. Why did this earthquake have
to happen now? What was God thinking?
You see it is harder for me than the
average Pakistani mourning our national
tragedy. I have to relive mine: the
loss of two brothers ages 14 and 15
in a car accident when I was 12, and
then the death of my father, while playing
tennis, five years later. I feel like
quite the tragedy pro.
I regressed and relived after 9/11 as
well, for a week later, the tears would
not stop, so work had to. This time
the evenings hang heavy as GEO carries
endless coverage of the devastation
and I sit clutching the remote, glued
and gaping. “Enough, Ammi!”
says my daughter Faiza, as she tries
to wrest the remote from me. The silent
stream of tears leaves me too drained
to fight her.
It’s been decades since our lives
were shattered, and I think, all told,
my mother and I have done rather well.
After all I conquered the grueling workload
of Medicine and became a doctor. And
yet when I grieve in face of such tragedies,
a friend suggests that I might have
PTSD, post-traumatic stress disorder
and that therapy might help.
I agree, I may well have it, for, generally
it is natural disasters that snatch
away three people from one family. PTSD
is a condition that typically occurs
after witnessing or experiencing a traumatic
event, such as an earthquake, and it
is typified by flashbacks, nightmares,
sleep disorders, a sense of estrangement
and an increased propensity toward depression,
alcoholism and drug addiction. Treatment
is largely based on therapy and in some
cases medication can help.
With the magnitude of the earthquake,
there will be essentially an epidemic
of PTSD. And how can there not be? To
have the earth move wildly under your
feet and then have concrete come crashing
down and have you buried for an interminable
period, screaming for help and hearing
the cries of others and then perhaps
silence, is enough to give PTSD and
more. The four-year old with blood shot
eyes sits on the hospital bed, her saucer-wide
eyes just stare, her face blank. She
has stopped talking, she either stares
or sobs. A man searches the rubble with
his bare hands even days afterwards,
only so he could find the bodies of
his wife and children, and get closure.
The stages of grieving explained by
Elizabeth Kubler-Ross apply so predictably.
The first stage of denial or disbelief
is one that is rampant in the survivors.
The older children and adults speak
about the tragedy as though it had happened
to someone else. With flat expressions
they matter-of-factly reel out family
casualties like one would a grocery
list. “My mother died, my brothers
did also; my father was buried under
the rubble but they got him out.”
My nightly resurrection of tears turns
morbid when, TV out of bounds, I devour
articles about the quake. The terror
visited upon fellow human beings is
mind- boggling: posing as relatives,
people are claiming young children,
with the intention of turning them into
sex workers. The government is trying
hard to prevent this by installing armed
guards at hospitals and freezing all
adoption proceedings.
How does one make peace with 54,000
dead, over 65,000 injured and three
million homeless? And the Himalayan
winter now threatens to spike those
figures. How can a country that had
the sketchiest of infrastructures, ever
be able to withstand this monumental
challenge? There was scarcity of potable
water, high illiteracy, poverty and
unemployment to start out with; now
it seems Pakistan’s economy and
development have been set back a century.
The earthquake had to follow the tsunami
and Hurricane Rita; donors are now fatiguing.
Kofi Annan was widely reported as saying
that the devastation of the earthquake
was greater than that of the tsunami,
but it seemed to fall on deaf ears internationally.
What should be like the Berlin airlift,
or at the minimum a helicopter based
rescue effort, is chaotic and ineffective.
The donor fatigue and delay only translate
into death.
The sole sliver in this gloom is the
manner in which this national catastrophe
has galvanized Pakistanis. Individual
and collective efforts are so dramatic
that you want to cry all the more. From
man-on-the-street to rock star, the
collective consciousness of the nation
has changed. God works in mysterious
ways they say; not only did this happen
in Ramadan when zakat is traditionally
at its peak, the national malaise that
had engulfed Pakistan has gotten a powerful
jolt.
Questions about end-times, tests and
punishments swell in each mind. Sheikh
Abdul Qadir Jilani in his discourses
compiled as Futoohul Ghayb or Revelations
of the Unseen, does wonders in helping
to distinguish between a test and a
punishment. It is a test, he says if
in the face of calamity, the person
has patience, fortitude and a sense
of inner calm. According to him, the
one that reacts with bitterness, anger
and vociferous complaints is probably
being punished. All of us have, of course,
our own moral inventory, a quick scan
of which can be rather revealing. Man
is tested to elevate his spiritual station,
and harsh events such as these erase
sins very effectively.
Monday morning quarterbacking a la Islam
now blames the rising materialism and
hedonism in Pakistan as having invited
God’s wrath. Unable to figure
this I asked Imam Dr. Muneer Fareed,
Professor of Islamic Studies at Wayne
State University, whether Pakistan was
being tested or punished. “All
of life is a test, including the calamities
that befall us,” he said. “Pakistan
is certainly being tested individually
and collectively. A nation established
in the name of religion has a far greater
responsibility than a nation established
to preserve ethnicity or nationality.
All of the teachings of Islam that speak
to humanitarian values apply with greater
poignancy to a nation like Pakistan.
In addition to the materialism argument,
which may well be true, Pakistan needs
to reexamine its moral compass, its
raison detre, for now more than ever,
it is being asked to compromise its
principles in the national interest
or worse still in the interest of global
mavericks bent on molding the world
in their own image.”
“What about end-times” I
asked for certainly by Biblical and
Qur’anic tradition the world seems
to be ending. He explained that the
relevance of global end-times is negated
by the fact that what we will notice
as individuals is not global end-times
but our own deaths. At a time of extreme
national suffering, we are best advised
to shelve the philosophy and concentrate
on practical rehabilitation of the victims.
People will deal with PTSD at their
respective pace. It takes a minimum
of three months for the bereaved to
accept, at a subconscious level, that
their loved one is gone. There is also
a vicarious PTSD, like my crying evenings.
Extrapolated there is a national PTSD,
a pall of despair, periodic disorientation
and detachment, flashbacks and insomnia.
No amount of therapy can rewind and
redo those deadly minutes. The flashbacks
and the memories are here to stay. I
have donated and facilitated, but seems
my only tribute, really, are my tears.
Not just to the dead; but to those that
die every day they live.
(Mahjabeen Islam is a freelance columnist
and physician practicing in Toledo Ohio.
Her email is mahjabeenislam@hotmail.com)
