The Last Living Gentleman

(Author : Gayathiri P.)

It had been more than a year since I had seen him, yet the bond between us remained us profound as ever. He stood at the doorway of his simple terrace house, his kindly grizzled face illuminated by a smile of heartwarming joy. He is the last living gentleman of an all but extinct moral idyll.


It is no surprise that Alfred Kunalan quickly became my favourite patient at Hospis Malaysia two years ago during the course of my Community-Based Practice programme. With a magnanimous charm and effervescence undiminished by a decade-long affliction with colon cancer, Alfred was a character who appeared ill-placed in the sterile hospice environment resonating with ominous terminality. He dispelled the stifling funerary ambience with his compassionate nature and keening wit, a refreshingly unique spirit in a domain almost unanimously associated with futility and hopelessness. Alfred radiated positive uplifting energy, a compelling antithesis to other patients similarly affected with malignancies, but embattled with bitterness. In fact, while seated at the table and glaring with mock anger at a volunteer who dared to take away a plate of candies before he had his fill, he seemed more alive than even the healthy people in the room.
Yet Alfred was the odd one. Volunteers and hospice staff perceived the gloomy patients as the normal ones. Who could fault them for their depressed spirits? Practitioners of conventional medicine had deemed their unfortunate predicaments beyond the tangible aid of medical intervention. Palliative care was merely a means to prepare them for the inevitable end, and not many of them were willing to go peacefully.


The Kübler-Ross model highlights five discrete stages narrating how people cope with grief and tragedy. Alfred must be one of the few individuals who readily accepted the trials and tribulations of life from the outset. The diagnosis which might have crippled the spirits of younger, more able-bodied men fortified his own, and provided the impetus for him to serve as a source of spiritual enlightenment for others.
Alfred perceives his disease as a blessing: “Before I had cancer, I thought the world was condemned. Beyond redemption. But after that, I realised just how many beautiful people there are still around. And it’s beautiful people like you and others that make the world go round.”
He narrated the stories of Sodom and Gomorrah: “Abraham begged God to spare the twin cities if he could find one, just one virtuous person in each of the cities. God promised that for the sake of the righteous dwelling within each city, He would wreak no destruction. I believe that that promise from God still holds true today.”


When I discovered that I failed Year Two in 2008, I was shattered. Alfred was among numerous people who encouraged me to not quit medicine, for he was convinced beyond the shadow of a doubt that I was destined to be a gifted medical practitioner. “It’s not because you are brilliant, because you know that and everyone else knows that. But you have a beautiful heart, and God knows that you’ve made me so happy. You’ll have the chance to make many people happy when you become a doctor. Aspiration is not equal to ability, but you have both. That’s why you’re going to succeed.”

“Sir, maybe I just don’t have what it takes,” I cried.

“When we pose a question to a computer, we never question the answer it gives us. Why do we always question this computer?” I could hear him tapping his finger against the side of his skull. “This computer created that computer. Why do we always question it?”


Alfred is quite the ladies’ man at church, never short of a few dozen female companions at the end of the evening service. He takes a good half hour to walk the short distance from his seat to the exit. Without fail, an attractive young lady loops her arm through his and escorts him home. “God must love me dearly,” he tells me with a rakish wink. “He gave me a stroke, which reduced mobility in my one leg. Now I’m always in the company of pretty girls.”
Were it not for his uncompromising devotion to religion, Alfred could be easily mistaken for a decrepit old lecher. But it is common knowledge that he shared naught but platonic relationships with women and girls. “I love you,” he tells me as he clutches my hand with paternal affection. “I love many young ladies. But I always tell people, never confuse love with lust. My four sons know this, too. They know I will throw them out if I ever find out they’ve been abusing a woman’s love.”
With a twinkle in his eye, he recalls how he courted his wife for four years, never once laying a finger on her. “People thought there was something wrong with me,” he said. “But our wedding night was beautiful and pure because we saved ourselves for each other. And that’s the most precious gift two people in love can give one another.”


Alfred's wife of thirty-three years, Bibianna, was diagnosed with cancer one year after Alfred himself was diagnosed with stage IV colon cancer. Doctors concluded that she had an exceedingly poor prognosis: two months at the most to live. But she persevered for five whole years. Alfred is not acquainted with ‘mind-body medicine’ in the same manner as those in the medical field, but still acknowledges the vital role psychosocial factors played in Bibianna’s life during her twilight years.
“We are a close-knit family and community. Bibianna came alive when she received visitors. The physical pain she suffered during those visits was excruciating, but she refused to take her morphine until after they had left. She said that although the morphine dulled the pain, it had a similar effect of her emotions, putting her in a stupor. She just didn’t want to be robbed of any aspect of special human interaction.”
When Bibianna succumbed to her disease in 2004, Alfred was initially distraught but found solace in religion. “She went before me, to prepare heaven for me,” he always tells me. “I hate it when people talk about how much I loved my wife while she was alive,” he tells me. “I never loved my wife. I love her.”

The concept of love and marriage has been accorded evolving interpretations over the years. Alfred speaks despairingly how people have acquired a disenchanted perspective of intimacy and romance. In his youth, he says, when an individual elected to remarry, especially in situations where the dissolution of the marriage did not stem from the natural death of one partner, society viewed the newly married partner with a certain degree of disparagement. Now it is not unheard of for newlyweds to request annulment of their union within days of the ceremony. At the most, it makes for some interesting, albeit short-lived headlines.
“I have loved many women throughout my life. Bibianna is the only one I have ever, and will ever, love beyond platonic attraction.”

Another reason why Alfred’s memories of married life resonate so profoundly with me is the fact that like my beloved Christopher and I, Alfred and Bibianna were (or rather, are) an interracial couple. And like us, their love was subject to relentless opposition from family and friends. Their respective families stigmatised romantic relationships between individuals of different races. Bibianna literally had to choose between marrying her soul-mate, and abiding by her family’s wishes. Her parents disowned her on her wedding day, and she would never hear from them again for the rest of her life.


A history of forty pack years preceded the day Alfred officially received his diagnosis of colon cancer. He mystified everyone by quitting cold turkey on that day itself. On the same day, he gave up alcohol.
“Mind over matter,” he says simply. “We can do anything we want to, provided we have the motivation.”
Alfred is fond of mentioning how doctors are perplexed by his medical history. Although his cancer is in remission, his diabetes and hypertension persists. His kidneys are in poor shape.
“They always say it’s a miracle that I’m standing upright.”


Alfred is a testament to what the best doctors have known for years: that physical and psychological health is inextricably linked. He claims that he discovered the true secret to enjoying good health only after realising his body was falling apart. The secret is one frequently scoffed at as a ‘medical myth’, and undermined by orthodox medical specialists. “Love,” Alfred declares, “is God.” A pious Catholic, Alfred is succoured by staunch devotion to the faith, and his love of cultivating meaningful relationships with those around him. How he has inspired the hundreds of people privileged enough to cross his path defies verbal description.


My experience working with Hospis Malaysia and Alzheimer’s Disease Foundation Malaysia over these last two years have convinced me that I am impassioned to contribute to the health of the elderly. My present interest in gerontology may be a fleeting one, but that which remain indelibly imprinted upon my psyche are the often underestimated contributions of the elderly population to the generations succeeding them. Their lifetimes are educative and emotive tapestries of richness beyond compare. Some are blessed to be born into circumstances of abundant bliss and satisfaction, and such fortuitousness follows them from the cradle to the grave. Others are touched and moulded to conform to a chosen destiny. The patients I encountered in Hospis Malaysia often recall their lives with deep regret and pain. Overwhelmed by the misery of apparently having their lives not merely shortened and riddled with physical and mental suffering, but robbed of significance, is akin to the most dreadful violation. Those who no longer knowingly have a life, or even memories, to call their own, such as those tragically afflicted by Alzheimer’s disease and dementia. Yet all these elderly people share one commonality – to be invaluable tutors of life, directly or indirectly. The elderly are marginalised, ostracised and segregated from society at large, on the basis of their disability or lack of productivity.

Mr. Alfred Kunallan.

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