This past week, I had a 26-year-old patient who was placed on a ventilator after being involved in a motor vehicle accident. His father had been in and out of his life but mostly out. In an act of maturity and grace, his father – legally, the decision maker in this situation as the sole surviving parent – let the patient’s sister make the care decisions as she knew her brother’s wishes the best. As we discussed prognosis and quality of life, she said “I know that my brother would never want this. As hard as it is for me, I have to speak for him and respect his wishes even if I want everything done to save him.” I told her that her brother was very lucky and that very few people have that relationship with their siblings.
When I was growing up, my mom always said that my brother and I were linked. She said, “Alwiya, when you got sick, Abdi got sick” and vice-versa. When I was seven and Abdi was five, we moved from a refugee camp in Kenya to the United States. Abdi was sick for a couple of weeks, and I followed suit. My mom, toting four kids (half of them sick) across the world to a country she had never been to with a language she did not speak, had her hands full. Given our seeming coordination in making the resettlement process even more difficult, it’s no wonder my mom to this day says that Abdi and I share a special bond. We were in cahoots from the start.
Abdi and I were unique in our own way within our family and different from the community that we came to in the US. Abdi and I had memories of Kenya, but we grew up in the US. My older siblings grew up in Somalia and Kenya, whereas my younger siblings only knew the US. Abdi and I were part of a secret society. The kids that knew both worlds.
But to the outside world, it probably seemed like Abdi and I had nothing in common. During our high school years, we could not have been more different. I was the invisible girl. In school, I always sat in front of the class, wishing a teacher never called my name. At home, I retreated to my room, book in hand not to be heard from until mealtime. Abdi, on the other hand, was the popular guy. Everyone knew him. He was the cool, tall, well-known high school kid who was in the local newspaper more times than I could count. The visibility I did have existed only as the sister of one of the best basketball players in our town.
As we went through our college years, we spread out geographically. Our bond never changed. The anxiety of finding ourselves and defining our identity was never easy, but we always knew we had each other. Through break-ups, failures, and moves, I knew I always had my brother.
As fall of 2019 began, I was finishing medical school and beginning to apply to residency when I was diagnosed with stage-4 cancer. I remember November 4, 2019, like it was yesterday. I called Abdi around 4 PM that day and told him that what they found in imaging was concerning for metastatic cancer. That night, I was lying in the hospital bed with our mother sleeping on the hospital couch and afraid of the unknowns to come. At exactly midnight the door opened, and I saw a tall person. Abdi had gone to the airport as soon as we got off the phone. That night, I did not spend the night alone scared of what to come next.
Fast forward to 11 months after my diagnosis, I was on the phone at 2 AM as Abdi told me his own cancer diagnosis. Hearing his diagnosis was worse than hearing my own. I felt so helpless, lost, and confused. The person I ran to was now in the same position as I was. For months, as he went through his own treatment, I tried to find ways to keep myself grounded and stay optimistic for him.
As we continue to navigate the world of young adults with cancer and careers, he continues to walk this path with me. Currently, he is in Rochester, and I am in Seattle. Although miles away, he continues to be the person I share my failures, happiness, and joy with. As much as I wish this was not true, he remains the one who understands the anxiety and my fate of living scan-to-scan.
My connection with Abdi has been a constant source of strength and happiness. While I wish more than anything that Abdi and I had just one less thing in common, our bond has been one of the greatest gifts life has given me.
As I walked out of my patient’s room, I smiled, cried, and told myself “I know Abdi would have done the same for me.”