Salaam, Love

by Ayesha Mattu

  After eight years of suffering, my wife of eighteen years decided to stop treatment in order to spend her last days here on this earth with dignity. Joan died in December 2012. She was only forty-one years old.

  Now that Joan is gone, many friends have asked me: If I’d known the struggles to come, the pain, the horror, and the heartache of watching her live and die, would I have still stepped forward into our relationship? The answer is a resounding YES. I would do it all again—the postsurgical therapies, cleaning up her vomit after chemotherapy treatments, bathing her when she could no longer bathe herself, carrying her tenderly up and down the stairs of our home when her energy was depleted, helping to dress her—because to do so would mean that she was alive and still with us.

  Joan told me once that while she hated what the cancer had done to her body, she would not be who she was without having endured it. Cancer taught her how to face death without fear; it taught her what she was capable of handling. Without the cancer she may have grown old, but perhaps would not have been as strong. Facing death showed her that she did not have time to waste. She even defined her approaching demise as simply, “Needing some time to rest.”

  “I will love you forever,” I promised my wife repeatedly during our eighteen years together. Only she and I know what that truly means. Joan loved me with her constant encouragement to live up to my full potential. Life without her is frightening, but also holds limitless possibilities because of what I learned from her. Continuing to love her after she is gone means doing something new or different every day, continually discovering so that I never stop growing.

  In my devastation, as I mourn the passing of my wife, our marriage, and the most beautiful experiences of my life, I still wake up every day living this promise to her: I will never stop growing. God bless you, habibti.

  Fertile Ground

  By Khizer Husain

  We are in a bright corner office. Outside is the Baltimore skyline. Trees like torches. The air is crisp. We are seated across from Dr. Zacur, who is sketching a portrait on graph paper. Suddenly, he looks up.

  “Your ovaries have no eggs.”

  I snap out of my daydream. Zuleqa is slumped in her chair.

  “I never say that someone has no chance of conceiving, but . . .” His voice trails off. The portrait of Zuleqa’s condition in his hands is titled “Idiopathic.”

  He continues, “We could take a donor egg.” He looks at Zuleqa. “Do you have a sister?”

  Zuleqa nods. I am no Islamic scholar, but I’m pretty sure that my gametes and those of my sister-in-law should not mix. Idiopathic sounds more idiotic and pathetic by the minute.

  I am numb and speechless. This was not part of the plan. I stare at Zacur’s bowtie. The room suddenly feels like a sauna. Did Zacur just call my wife defective? Can we crack open a window in here? I can’t breathe!

  I want to blame Zacur, but it’s tough to hate a man like him. He’s a Norman Rockwellian doctor who probably used to make house calls early in his practice. But now I wish that he’d step out of the room. We need privacy. I know Zuleqa needs a hug. I’ve learned in our six years of marriage that hugs are the currency of love, the strongest refuge during storms. Hugs can articulate what words can’t—I am here for you, jaanu. We’ll get through this, inshAllah.

  Reproductive endocrinologists are optimists. There’s always some possibility for fertility. Our fertility probability is 10 percent. Does that mean we have to try ten times harder to conceive? Is it all moot if there are no eggs? How does he know there are no eggs? Ultrasounds look like WWII–era technology for finding German U-boats. What about my side of the equation: are there legions of healthy swimmers, or a sorry mess incapable of doing the job?

  Zacur stands, signaling that our appointment is at an end. He relates a story of a young patient who had the same diagnosis, primary ovarian insufficiency (POI). He thought she had no chance of conceiving, but she came back twenty years later with a baby in her arms. “That’s why I vowed to tell my patients there is hope—but don’t bet the farm on it.” In other words, we might be able to get that senior citizen discount at diapers.com.

  I have a lot of questions I cannot articulate. Zuleqa is uncharacteristically quiet. Anyway, our time is over. Another anxious couple waits. I force a smile their way as we make our way out. Good luck—I hope Zacur sketches a happier graph paper portrait for you.

  Zuleqa and I courted for about ten hours over ten days in the spring of 1999 in Hyderabad. She was starting med school. I was on spring break from grad school in London.

  “Farawla. Doesn’t it sound like a perfect name for a girl?” I offered over strawberry ice cream on our first date at Softy World.

  “Of course!” Zuleqa held back a laugh.

  I told her about the epiphany I had while studying in Cairo a couple of years earlier—that the Arabic word for strawberry would be the perfect nickname for my first-born daughter. It just sounded right: F-R-W-LA. Delicate, warm, earthy. Based on my brothers’ track records, I was destined to have a daughter. The “Y” guys were just too bashful.

  We married the following year. We never talked directly about whether we would have children. As with most Muslim couples we knew, having kids was a question of when, not if. We each had three siblings, and parents who came from colossal families. Yet our maternal and paternal clocks didn’t dictate our lives. We did not “ooh” and “aah” at the mere sight of babies or have an urge to hold them at dinner parties. Still, the POI diagnosis caught us flat-footed because we’d never not thought of having children. Chapters in our lives that we’d set aside for kids now needed to be replaced. But with what?

  The U.S. immigration process forced us to live apart the first year of our marriage: I in Illinois, Zuleqa in Hyderabad. We e-mailed and called but when my brothers announced their intention to go on hajj, I climbed aboard. Zuleqa’s parents were expats living in Makkah, so coordinating a hajj rendezvous was straightforward. The “hajj-y-moon” was spectacular—spiritually and otherwise. A month later, I got a call from Zuleqa.

  In a meek voice: “Jaan, I missed my period.” There was a pause. “Hello? Did you hear me?”

  I cleared my throat. “Um, say that again.”

  “You heard me.” She sounded giddy.

  “Not really. Reception’s bad. Static-y.”

  “Mera paun bhari hai.”

  “Your foot is weighty?” I tried to decipher the Urdu idiom.

  “Khizer . . . I’m pregnant!”

  My heart started racing. Good God. Terrific news—I think. We had less than two grand in the bank and neither of us had a job. Gulp.

  “Mubarak! This is fantastic. Alhamdulillah.” I paused. Breathed. I heard a muffled giggle.

  Knowing Zuleqa’s mischievous streak, I suggested, “Why don’t you break the good news to Ammi? She’ll want to hear it directly from you. Here . . .”

  “No! Wait!”

  “What’s the matter?”

  “Nothing.”

  “Okay. Ammi, Zuleqa has a very important announcement.”

  “Ah . . . jheesh. Khizer—April Fool’s?”

  I sighed, relieved. “You conceived a fine ruse, madam.”

  In the months following the diagnosis, we remember those innocent exchanges. April Fool’s smacks more of April irony and farawla of some forbidden fruit. So, we aren’t going to have kids. Not a big deal, right? There are tons of infertile people. A few months prior to our diagnosis a cousin had revealed his. After years of trying IVF, he and his wife were putting it on hold. The emotional highs and lows were taking a toll.

  Not having kids is probably a good thing, I rationalize—the planet is overcrowded and the Qur’an says God will test you with wealth and children.

  Wealth and children are an adornment of this world’s life: but good deeds, the fruit whereof endures forever, are of far greater merit in thy Sustainer’s sight, and a far better source of hope. (Sura al-Kahf [The Cave], 18:46)

  Zuleqa and I recite the first fe
w words like they’re a tasbih—no money, no kids, no problem. One less thing to be tested with. We’re God-seeking people: if God does not want us to have kids, then we should be fine with not having kids.

  But to have peace with this was not so easy.

  “Would you have married me if you’d known about the diagnosis?” Zuleqa asked casually as I was chopping onions.

  “Bilkul,” I said reflexively. I’d actually never thought about it.

  “Why would you?” she pressed.

  “Because I loooovvvvve you,” I crooned. Zuleqa had the “I’m serious” look. I went to hug her but she dodged. Not this time.

  “Look, I’m not crushed that we will probably not have kids,” I explained. “But I would be devastated if I did not have you.”

  I stared into her eyes. She opened up for a hug. I squeezed hard. Rivers ran down our faces. I blamed it on the onions.

  Over the next few months, we talk less about the diagnosis. Other things in life come to the fore. Drama at work. The funeral of a close family friend. The Cherry Blossom Festival. We get into the routine of Zuleqa’s new assortment of pills and patches. It’s tough enough for a twentysomething to keep on regimen. I have no idea how seniors do it. The next time I pick up her meds at the pharmacy, I get a weekly pill dispenser. It’s purple. When I give it to her, Zuleqa smiles with her eyes.

  “Let’s explore adoption,” I suggest one evening. It’s been a year since our visit with Zacur. Adoption is a tough topic, partly because it implies “giving up” on having biological kids and partly because I know that “Muslims don’t adopt.” Zuleqa had related the practice of “adoption” in the old country, where people give their own children to those in the family who can’t have kids. Years later a teenage girl realizes that the people she had believed to be her parents are actually her biological aunt and uncle. Recipe for resentment, if you ask me.

  We attend the Freddie Mac Foundation Adoption Expo in Washington, DC. It’s a happy carnival of smiling faces of children and eager couples. Everyone is incredibly nice; I feel like I did when I attended Apostolic service as a junior high schooler in Iowa with my good friend Curt and his family. Here is the thing—this time around, I want to be converted. I know that adoption can be a great solution, which allows love to flourish. Plus, we know that adoption among American Muslims is needed. Some kid in a bad situation will help us to complete our family. But front and center in my mind is a nagging question: which one of us—Zuleqa or me—will not be able to hug our postpubescent adopted child? Mahrameyat—the concept that you can be physically close to those of the opposite gender only if they are related through blood and marriage—makes adoption unpalatable. I know it’s small in the grand scheme of things, but it’s a pretty big deal to us.

  Were we being too “fiqh-y”? Islam prescribes emphatic support for orphans.

  They will ask thee as to what they should spend on others. Say: “Whatever of your wealth you spend shall (first) be for your parents, and for the near of kin, and the orphans, and the needy, and the wayfarer; and whatever good you do, verily, God has full knowledge thereof. (Sura al-Baqara [The Cow], 2:215)

  Yet Islam advises against “Western” adoption and supports foster parenting instead—love the child, but they should know their biological lineage and keep their birth family name. There should be no confusion about their heritage so that they maintain their own identity. Perhaps we can revisit this option in the future. Foster parenting seems like temporary parenting and, like temporary marriage, doesn’t seem to sit right. We don’t know any foster parents in our community; we don’t have the courage to be pioneers.

  “Khizer, I found this Muslim fertility doctor who practices in the metro area. We should see her. Get a Muslim perspective.” Zuleqa spent random evenings on the Internet searching for insight into her rare condition. I was supportive of a second opinion.

  I can’t get time off work, so Zuleqa flies solo. Not a good idea. Dr. Abbasi turns out to be everything we don’t want in a doctor. Listening is not her forte. She plows over Zuleqa’s sentences with an “I’ve heard these stories a million times.” Her solution is adamantly pro–egg donation.

  Zuleqa asks, “What does Islamic bioethics—”

  Abbasi barks, “Look, Zuleqa. I have so many Muslim patients. Do you want to have children or not?”

  This was the nadir of the infertility episode. POI is tough—a life sentence of hormone replacement therapy just to be as normal as possible. Falling off the regimen can increase the risk of certain cancers. Zuleqa thought that a Muslim specialist would be an asset, someone who understood our needs and could guide us in this uncharted journey. Abbasi turned out to be a bully. We felt betrayed by one of our own, and that stung.

  Abbasi might have found it unremarkable for some donor egg to hook up with my sperm and for that embryo to be transplanted into my wife’s womb, but we had tons of questions. For this to work within Shia fiqh, would I need to first marry the donor? I don’t want to be the first bigamist in my family, even if it’s for a few hours. If the baby is male, would breastfeeding him be sufficient to make him mahram to Zuleqa? And how would we explain this to our child? “Well munnu, half your genes come from this nice lady your mom and I met at the egg bank. So, yes, you have two moms, but not in the same way as Jenny at school . . .”

  Our families are supportive. Faith is strong among the parents, and no one freaks out about POI. They do introduce us to a plethora of duas and special namaaz for having children. I find the ayah involving Prophet Zakaria to be a tongue twister, but it is powerful:

  AND [thus did We deliver] Zakaria when he cried out unto his Sustainer: “O my Sustainer! Leave me not childless! But [even if Thou grant me no bodily heir, I know that] Thou wilt remain when all else has ceased to be!” (Sura al-Ambiyaa [The Prophets], 21:89)

  Zuleqa is more diligent in these prayers than I am. I am a bit confused theologically: are we supposed to pray hard to miraculously have kids, accept the test of being childless, or both? I want to close the fecundity chapter and move on—thankful and childless. No to egg donors, no to adoption or foster parenting. If kids happen, great. If not, no problem.

  Much more difficult is keeping at bay masjid aunties who have a compulsion to know about everyone’s marital and reproductive lives.

  “Beta, how many years you have been married. When will you give us the good news?”

  Zuleqa has an incredible gift for understanding and empathizing with these aunties. Having grown up in India definitely helps. She waves off these probes with a “Just keep us in your duas, aunty,” or a “You’ll be the first to know.” I lack this finesse. In fact, I’m sure that I would have caused many embarrassing masjid incidents had it not been for the high perimeter fence surrounding the sisters’ section and the constant din of wailing kids drowning out the Fertility Inquisition.

  I wonder if the prophets who had trouble having kids faced the same type of aunty full-court fertility press in their time? Can you picture Prophet Ibrahim consoling Sarah after some aunty goes on about having fourteen kids before she was thirty? Maybe Prophet Zakaria trying for decades to convince a gang of uncles that he is totally fine not having children. “I really don’t need to continue my family line . . . aren’t we all children of Ibrahim?” he’d remind them.

  What does annoy Zuleqa are the odder fertility rituals that well-wishers from the old country prescribe. “Boil these twigs and bark and drink the potion every Friday—before fajr.” “Tie this string around your midsection and leave it there for forty days.” “Buy this maryam herbal plant in the holy city of Makkah and soak it in water and leave it by your bedside every night until you conceive, become pregnant, and go into labor.” We amass a community apothecary that she wants to throw out. I don’t have the heart to tell these friends and relatives that we won’t be needing their ancient wisdom.

  Three years into the diagnosis, Zuleqa looks up from her computer screen. “Jaanu, check this out!” The National Institutes of Heal
th was conducting a study on individuals with POI. Zuleqa needed a real second opinion and the NIH was forty-five minutes away in Bethesda. Zuleqa would need to send her medical records to see if she could join the study to develop treatments to restore fertility and to determine the ideal form of hormone replacement. In May 2009, Zuleqa received the thick package from the NIH, with her appointment calendar and details for her four days onsite.

  In July, I helped Zuleqa get situated in her semiprivate room at the NIH hospital: “You’ll have a great time at POI Camp! See you on Family Night on Wednesday.” She was anxious. I kissed her forehead and said, “Khuda hafiz.”

  Each night, I received updates. “In our Zacur and Abbasi visits the conversation was so clinical, so focused on my hormone levels,” Zuleqa said. “It was nice to have a health professional allow me to speak about POI in the larger picture of what makes me happy in life.”

  I thought about those instances that bring out the best in Zuleqa—spontaneous picnics, hosting a sham-e-ghazal, organizing scavenger hunts at family reunions. We have built a life creating community that transcends faith, family, or ethnic lines. Zuleqa is fun, a ball of energy. POI does not define her, nor does infertility.

  The next day, I went for the group session with Dr. Lawrence, the lead investigator of the study. He was engaging, funny, realistic, and had time for questions. When Zuleqa and I stepped out of the hospital to head home, the summer air felt good. Zuleqa was beaming.