Two years ago, Hassan Rasouli checked into Sunnybrook hospital to have a brain tumour removed, fell into a coma, and provoked a Supreme Court battle over who decides to pull the plug. Then, one day, he awoke
Early in the summer of 2010, Hassan Rasouli, a 59-year-old engineer, had a problem with his right ear. He noticed sounds were coming in muffled and indistinct, as if through a ball of cotton. By August, his hearing loss was getting worse. The ear was slightly numb, too, and at times Rasouli caught himself feeling dizzy. He didn’t think much of it. He had moved from Ishfahan, Iran, to Toronto just four months earlier with his wife, Parichehr Salasel, a family doctor, their 27-year-old daughter, Mojgan, and their 22-year-old son, Mehran. They’d come to Canada with the capacity for risk particular to the new immigrant, the kind that leads someone to abandon a life of familiar comforts for an uncertain world where the possibilities might open up a little wider. They were excited about creating a new life.
With his bulbous nose, expressive eyebrows, thick moustache and bemused half-smile, Hassan Rasouli looks like a rumpled, Persian Groucho Marx. He was the adventurous one in the family, the parent who would drag the kids on road trips across the country every year, barbecuing kebabs at the roadside and camping in the forests of northern Iran. He was the kind of father who, at family parties, would cajole his embarrassed adolescent daughter into accompanying him on the piano while he sang his favourite pop song.
When the Rasoulis qualified for immigration in 2005, Hassan took the family across Canada to find a place to settle down, visiting Montreal, Vancouver and Quebec City before deciding on Toronto, a place where they already had a few friends and relatives and where the work and education opportunities seemed best. They moved into a house near Yonge and Steeles and joined the local mosque. They went on walking tours of Toronto’s parks, exploring their adopted home like tourists. Mojgan signed up at Waterloo to start her second master’s degree, this one in urban planning. Mehran enrolled at the University of Ontario Institute of Technology in Oshawa to study engineering. Salasel was beginning the long process of preparing for Canadian medical exams while Rasouli set up his own engineering consulting company.
At his regular checkup that August, Rasouli told his doctor about the ear problem. He was sent for a CT scan and an MRI, which confirmed Rasouli had a brain tumour. As brain tumours go, it was a good one—it could be removed with a relatively safe, reliable surgery. Rasouli’s doctor recommended Mahmood Fazl, a neurosurgeon at Sunnybrook Health Sciences Centre who happened to have graduated from the same university as Salasel, the best medical school in Iran.
On October 7, the day of the operation, Rasouli was in good spirits. “Don’t worry,” he told Salasel. “I’ll be home in two days.” At noon he said goodbye to Salasel and went into the operating room. Nine hours later, Fazl came down to the waiting room and assured Salasel that the surgery had been a success. They’d managed to remove 99 per cent of the tumour. There had been a small incident when they were intubating Rasouli, Fazl explained, but everything should be fine.
When Salasel visited her husband that evening, however, he was weak and groggy. His breathing was ragged and he had difficulty swallowing. He squeezed Salasel’s hand before shooing her away. That night he went into cardiac arrest. The staff revived him, intubated him and moved him to the critical care unit, where a rotating team of doctors oversaw his care. Over the next few days, Rasouli got worse. He was feeble and agitated. His legs twitched. Salasel remembers one of the doctors trying to reassure her. “She said to me, ‘It’s okay, that’s normal. After brain surgery everyone is like this. Don’t worry, it will get better.’ But it didn’t get better. Every day was worse than the day before.” During a visit on October 15, Rasouli looked weaker than ever. His family gave him a pad of paper. “I am tired,” he scrawled in Persian, the characters falling off the page. They were his last words.
The next day he fell into a coma. He had caught bacterial meningitis after surgery. The bacteria had spread throughout his brain, inflaming his ventricles and setting off a series of strokes. The hospital put Rasouli on a mechanical ventilator. It was an unfortunate situation, the doctors said, but now the family would have to face their new reality: Hassan Rasouli would never regain consciousness.
In the weeks following Rasouli’s surgery, multiple MRIs revealed widespread brain damage. In mid-November, Brian Cuthbertson, the chief of critical care at Sunnybrook, took responsibility for Rasouli’s treatment. He told the family that an escalation of medical care was inappropriate. It was time to let go.
The Rasoulis were stunned. Hassan had been a healthy, vigorous man. He had walked into non-emergency surgery under his own volition and caught a bug from the hospital, and now that same hospital was saying they wanted to let him die? As a practising Shia Muslim, Salasel believed that life was a sacred gift. As a doctor, she thought it was too early to reach such a drastic prognosis. When the doctors suggested cutting off life support, she refused to give her consent. She told them she knew her husband was there, somewhere deep inside. The hospital just needed to give him a chance.