I won’t let you forget about Lucila Iqbal
Reflecting on her life has given me clarity about which questions matter.
In a long-term care home in Scarborough on Christmas Day 2020, Lucila Iqbal died in isolation and silence. While I wept for our loss at her funeral yesterday, I grappled with how my once independent and feisty godmother’s life could come to such a quiet end. Lucila’s story must be told not only because it intersects with those of many of the lives lost over the past year — but because it reveals as much about the woman as about the society she lived in.
An unlikely addition to the family
Back in 1988, my parents were looking for a tenant for their Junction home when a skinny South Asian man hurriedly arrived on their porch. He insisted that he had someone for them who would be “not cause any trouble”. A few days later, a middle-aged Filipina woman arrived alone, with bags in tow.
Working through the language barriers, Lucila soon befriended my mother and became an indispensable part of the family. Lucy took a great interest in caring for my sister and I from the time we were toddlers. She was a devout Catholic and would affectionately refer to my sister and I as her godchildren. We would for walks to the corner store or for donuts at the neighborhood bakery (where Lucy might indulge in one or two as well). Cheerful and chatty, Lucy was known for talking circles around whoever was listening, even though her train of thought was hard to follow. Perhaps her easy-going nature was why I was so shocked the first time I witnessed Lucy become intensely upset. In those moments, she would slam doors, break things, and swear loudly in Tagalog. However, it was not long after these unpredictable outbursts that Lucy’s memorable laughter would once again fill our home. I came to understand that Lucy was “different” in some ways, but similar in so many more.
Lucy eventually moved out, but my sister and I would arrange visits with our unofficial godmother at the Dufferin Mall, close by her new home in Parkdale. Over the years, I wondered more about how this kind, vibrant, and sometimes peculiar Filipina came to be a part of our family. What I learned was pieced together from Lucy, her family, and my parents.
The brightest of the bunch
Lucila was born in the Philippine Commonwealth in 1937, one of eight siblings. When she was just a few years old, Japan invaded and conquered the Philippines. By the time the Philippines came to exist as we know it today, she was already 9 years old and had lived through American, Japanese, and independent governments. Despite these tumultuous circumstances, Lucy blossomed into an intelligent young woman and studied chemistry in university. She was recognized by her family members to be the brightest of the bunch. She was the first of her family to immigrate to Canada in 1968, and sponsored others thereafter.
Shortly after arriving in Canada, Lucy fell in love with and married a man I only know by last name, Iqbal. Lucy became pregnant, but the delivery ended tragically in stillbirth. While Lucy struggled to process this traumatic loss, Iqbal started a family and life with another woman. Lucy’s mental health eventually deteriorated further, and in a few years she could no longer work or live independently. Eventually, she arrived on my family’s porch.
It just comes back
Collecting bits and pieces of this backstory brought me closer to Lucy as years went on. I could not help but be drawn to the quiet resilience of this woman. Despite a barrage of hardships and tragedy, she still found a way to have the loudest laugh in the room, or to smile with her eyes in a way that said, “I love you as if you were my own son”.
Lucy’s most remarkable trait was always her desire to share what little she had. Whether it was the biweekly cheque she picked up from her Public Guardian and Trustee, toys she found at the Salvation Army, or some of the fries from her lunch tray, giving brought Lucy peace. She would smile, gently whisper “It just comes back”, and finish stuffing a $20 bill in my pocket despite my continued protests.
Someone will call with an update
As Lucy and I grew together, the city around us changed too. Gentrification swept through Parkdale in 2015, and Lucy’s group home was closed and put up for sale. She had to relocate on short notice. Perhaps it was the sudden, destabilizing nature of the change, or the unfamiliarity of management at her new building with Lucy’s temperamental nature — but the police were called, and Lucy was suddenly an involuntary patient on a mental health ward.
I naively rushed over to visit her, anticipating that she would soon be discharged. Instead, Lucy’s time in hospital extended from weeks to months — she was not welcome back to her new home. I watched her characteristic zeal wear thin. Her discharge was delayed by the search for a long-term care placement. A medical student at the time, I wanted to talk to her healthcare team about her diagnosis and why she needed to go to long-term care, but these questions were respectfully sidestepped. I was not privy to her health information, they were looking into all options, and someone would call me with an update. No update came.
Eventually, she was placed at a private long-term care home in Scarborough. The most difficult change for Lucy was no longer being permitted to traverse the city deftly on transit as she had just months prior. When I went to visit, she seemed sedated and subdued. Shortly after moving to the home, Lucy had her first fall. Lucy tried to keep her legs moving on her own, but despite her best efforts, she would never walk again. We continued to enjoy sharing food and reminiscing over old memories, but eventually Lucy started having less and less to say, until she no longer spoke at all.
How were the last nine months of Lucy’s life? After the first inevitable first COVID-19 outbreak at her long-term care home, less than 15% of the residents there had escaped infection. About 30% of the resident population died in those few weeks, with more deaths following. The few familiar faces remaining on staff were hidden behind masks, face shields, and gowns. Did Lucy understand why? As the pandemic progressed, each of my video calls to Lucy ended with a “I love you” or “I miss you” more desperate than the last. She would stare back at me silently, as if she could sense the guilt buried deep behind those words. For a woman who shared everything she had with me, was that all I had to give?
Lucy’s story leaves no doubt that that she was her courageous and resilient self, right up until the end. While it says much about her character, what does it reveal about the institutions that shaped her life?
In my training as a psychiatry resident, a basic principle I’ve learned is that every mental health crisis has its triggers. In Lucy’s case, the crisis that led to her hospitalization was prompted by a precarious housing situation. While changes to the cityscape are inevitable, I wonder how many lives like Lucy’s have been destabilized by unchecked gentrification. In an age of renewed public investment in mental health, is housing security a priority area for funding? Do our regulations adequately protect tenants from upheaval, or should the “free market” continue to determine the fate of our vulnerably housed?
After years of training in the medical system, it is now painfully clear to me that I could have advocated for Lucy more effectively during her hospital stay. But how many people navigate our healthcare system without this privilege, and how does that impact their outcomes? The bottleneck of patients from hospital to long-term care incurs terrible costs to our health care system and patients alike. How many families and friends deserve to be left feeling helpless as their loved ones decondition for months, stuck on a hospital ward meant for brief admissions?
For those who do make it to long-term care, inadequate management and lack of government oversight have set up these institutions to fail them. There must be others who watch their loved one follow a similar trajectory through long-term care and wonder which setbacks in their health could have been avoidable. The failings of our long-term care system have become the subject of national reports and daily front page news. Will this exposé force us to restructure this failed institution in a way that optimizes well-being, dignity, and quality of life for our elderly? Or will we return to the status quo?
For my beloved Lucila, there was no justice in her quiet and lonely death on Christmas day. Honouring her memory requires that we demand answers to the difficult questions that arise when we consider the challenges she faced throughout her life. If we consider them to be somebody else’s problem and continue to neglect becoming involved, in her eternal words, they will surely just come back.
