I have a decision to make. I can try to go back to sleep for half an hour, or I can just start the rest of my day. Typically, I have early morning cases that I need to round on at the hospital, so I forego the luxury of this power nap. This is the first of several opportunities to rest that I will not take advantage of. I walk past my sleeping daughter and into my bathroom to perform the morning ablutions. Then, I sit on my prayer rug and recite the morning call to prayer. My daughter stirs briefly but returns to her deep slumber. The prayers are necessarily quick, as efficiency is the word of the day, my modus operandi. I throw on some scrubs and head to the hospital.
At the hospital, I make sure to see all of the new consults first in the mornings. We get their treatment plans in place, and then proceed to my postoperative follow-up patients. I have another waypoint in my morning. At 8 AM, I drop everything and run back home, a five-minute drive from the hospital. As I throw open the front door, my daughter comes bounding to the foyer and asks me if we are late or on time. I assure her that I am on time. We shove some breakfast into her mouth as she tells me about her ladybug collection. I then toss her into the back seat of my pickup, and we drive to school. School starts at 8:30 AM and we rarely make it there on time.
After school drop-off, I head back to the hospital and finish rounding on my patients. Then, I head over to the clinic and see my morning appointments. Typically, that is around seven to 10 patients with a veritable smorgasbord of problems and complaints. My staff and nurse practitioners feed off of my energy, so I try to keep it positive and upbeat. It is this time of my day when I will expend the bulk of the fuel I gave myself early in the morning. I do not eat or drink anything after the sun rises above the edge of the horizon and the morning prayers have been offered. That makes the morning clinic just a little tougher. I fight my way through it and arrive at lunch. My staff breaks. I get a moment to breath.
Ramadan Kareem. It is that time of year when over a billion people around the world spend their days praying, working, and sleeping.
I typically celebrate the arrival of the month of Ramadan with a Last Lunch with my staff. There will be no lunch for the 30 days of this auspicious month. There will be no snacks. And in the heat of the Texas summers, there will be no water. I take my lunch break to say the noontime prayers. If there are any other hospital patients that need to be seen, this is their time. My staff schedules very few patients for me in the afternoon, and never anyone after 3 PM. This is my breaking point, my witching hour. My staff tells me that after 3 PM, I am not allowed to see patients. The hunger is wearing on me, but the thirst for water starts to make me intolerable. They call me “hangry” and prefer to leave me alone in my cave. I do paperwork quietly, and eventually head home before 5 PM.
Home is a place I barely see during these holy days. On my arrival home, there is not even a moment to rest. There is a serious flurry of activity. My daughter is excited to get a chance to play with Daddy. My wife is preparing for the iftaar, the evening culmination of the day’s fast. She packs a protein shake and several dried dates into a small satchel that also holds my prayer rug. My mother gives me my freshly-ironed pehren, the robe I will wear to the mosque that evening. I help my daughter get dressed and prepare her satchel. She does not fast, but she still has to maintain a good supply of dates, a thermos of water, and the Cheetos she will share with no one as the sun goes down. Once we are all set, we pile into the SUV and head to the mosque for the evening services.
These services include recitation of the Quran and a brief sermon by our priests. I try to listen attentively, but the thirst for water becomes all-consuming. This is the most difficult part of the fasts of Ramadan. The body starts to anticipate the satiation of this thirst with just a sip of water. The sun starts to dip closer to the horizon. The light turns the world a rich hue of orange. Maghrib. This is the time when the sun touches the horizon again. We observe the evening prayer of Maghrib. As soon as the last words of the Maghrib prayer are recited, a din of activity erupts in the prayer hall. Volunteers start passing out sweet milk, hot tea, and cold water. I break my fast with a bite of the dates in my satchel. I drink my protein shake. I make sure that all of the little kids sitting in the prayer hall around us have a snack to eat and water for their thirst. Whereas before Maghrib the mood in the mosque was somber and quiet, after Maghrib the mood is festive and ebullient.
During the month of Ramadan, in other parts of the world, the nights get turned over and become day-like. At night, we FEAST, and then we pray some more, and then we FEAST some more, and then we pray some more. Eventually, my family and I head home. We get there before midnight. My daughter falls asleep in the car, as does her grandmother. This is the quietest part of my routine. I reflect on the day. This is Ramadan. This is Islam. This is a cleansing of the mind, body, and Soul. There is hunger, thirst, fatigue, and all of the trials and tribulations of life, but every day culminates in prayer, praise to the Almighty, and thanks for the bounties bestowed on us. I am thankful for every moment of my day, time with family, service to my patients, and service to my community. There is no time for anything else. And nothing else is important in the grand scheme of things. I get home, carry my daughter to her bed, kiss my mother and my wife goodnight, and then finally close my eyes. At 5 AM, it all starts over again.