'Everything led to anger': Brain tumor caused Singaporean man to be abusive to wife

·Senior Editor
·6 min read
A CT scan of Sadayan Ahmed Maideen Jabbar's brain tumor, and the medical team that cared for Maideen (clockwise from left): Associate Professor Yeo Tseng Tsai, Dr Rambert Wee, Dr Nivedh Dinesh and Maideen. (PHOTO: Nicholas Yong/Yahoo News Singapore)
A CT scan of Sadayan Ahmed Maideen Jabbar's brain tumor, and the medical team that cared for Maideen (clockwise from left): Associate Professor Yeo Tseng Tsai, Dr Rambert Wee, Dr Nivedh Dinesh and Maideen. (PHOTO: Nicholas Yong/Yahoo News Singapore)

Sitting in the amygdala, the almond-sized part of the brain where rage and anger reside, the tumor measured just 2-3cm in length.

But it ultimately led to the breakdown of Sadayan Ahmed Maideen Jabbar's marriage, as it caused the 48-year-old to engage in violent and abusive behavior towards his wife and children. Things escalated to the point where police were even called to the marital home, and the couple divorced in June 2020 after 16 years of marriage.

"Everything led to anger," recalled the father of four of his behavior that emerged over two years. "You would think that it’s just you – the kids are growing, work is different, COVID has started."

It was only a year after the divorce was finalized when Maideen experienced multiple “white-outs” – or epileptic seizures – that he was admitted to the National University Hospital (NUH), where he had once worked as a frontliner during the SARS epidemic and that he recalled as a "loving place".

After multiple tests, Maideen was diagnosed with glioblastoma (GBM), a rare malignant brain tumor that affects just three in 100,000 people in Singapore. It was the same cancer that took the lives of US Senator John McCain and Beau Biden, son of US president Joe Biden.

In the Philippines, there is little data available on the survivorship of glioblastoma cases. However, according to a National Library of Medicine study of 48 surgically managed GBM cases over a period of five years, the median overall survival was 7.6 months.

In Maideen's case, the tumor was located in the temporal lobe, triggering the behavioral changes that led to his divorce. It took two operations, which involved temporarily removing a piece of his skull, to excise the tumor.

Maideen continues to undergo monthly chemotherapy and experiences short-term memory loss. He can no longer hike or cycle regularly as he once did, nor is he allowed to drive. But he does not display violent behavior anymore.

And there is a happy ending too: in April this year, in front of a "very small, 10-people crowd" at the Registry of Muslim Marriages, Maideen and his wife tied the knot again.

The condition is incurable, but Maideen, who has gone back to his job at a Germany-based medical company, remains stoic. While there is guilt over his past behavior, he stressed,"I don’t think about the past now, I just think what’s ahead. I plan my days one day at a time."

Inability to restrain oneself

Associate Professor Yeo Tseng Tsai of the National University Hospital, points out the tumour in the left side of Sadayan Ahmed Maideen Jabbar's brain (PHOTO: National University Health System)
Associate Professor Yeo Tseng Tsai of the National University Hospital, points out the tumour in the left side of Sadayan Ahmed Maideen Jabbar's brain (PHOTO: National University Health System)

Speaking to reporters at a media briefing on Tuesday (17 May), head of NUH's neurosurgery division Associate Professor Yeo Tseng Tsai stressed that brain cancers are very uncommon in the city-state and difficult to detect. Prof Yeo, who operated on Maideen, noted that breast, lung and colon cancers are far more common.

And while GBM usually grows rapidly, Maideen's symptoms went back over a period of two years, leading doctors to initially conclude that he had a benign tumor.

Prof Yeo noted that GBM also typically affects elderly patients, and its location determines how they are affected. Many experience headaches and nausea, while others may find loss of motor control. "In his case, it wasn't a very large tumour, but it was a very specific location," he said.

Prof Yeo explained that the amygdala is a primitive part of the brain that helps regulate emotion and triggers the fight-or-flight response. In normal circumstances, there are inhibitory fibers that allow a person to restrain themselves when they encounter upsetting situations.

"(A person) can recognize that 'I'm angry but I'm not going to manifest the anger right now'. But when that connection is severed like in this case...you just behave (like) any animal, so to speak, without any inhibition."

And while he has seen rage attacks in epilepsy patients, Maideen's is an unusual case. By removing the tumor, said A/P Yeo, the "normal networks" that enable self-restraint have been restored in Maideen.

'Why did I do this?'

The day after his first brain surgery, Sadayan Ahmed Maideen Jabbar celebrates his birthday with the nurses in his care team at the National University Hospital (PHOTO: Sadayan Ahmed Maideen Jabbar)
The day after his first brain surgery, Sadayan Ahmed Maideen Jabbar celebrates his birthday with the nurses in his care team at the National University Hospital (PHOTO: Sadayan Ahmed Maideen Jabbar)

A/P Yeo, who had gotten to know Maideen when he preciously worked at NUH, recalled thinking that the latter was a "broken man" when he saw him again in 2021. "He was not the person I knew from many years ago. When I heard of the problems he had with his wife and the physical abuse, I found it very hard to reconcile."

Ahead of the first operation, only Maideen's brother accompanied him to the hospital. While he tried to keep it from his ex-wife and children, they eventually found out. "When she came to know about it, she helped as a friend, not as a spouse," said Maideen, adding that she drove him to and from radiation therapy after the second surgery.

"After the surgery, everything changed. I was not the angry man like before," said Maideen. "All of a sudden, I was thinking: why did I divorce, why did I do this, why did I do that?"

While Maideen declined to elaborate on his family or the details of his abusive behavior, he said of his wife, "She has always been a very nice person. It was me who changed."

Asked about Maideen's prognosis, Prof Yeo, "For a GBM, you can never get it all out. With the best surgery in the world, this is still an incurable brain cancer. It will come back one day. No one can predict (when)."

While the median life expectancy for GBM patients is 18-24 months, Prof Yeo is hopeful that Maideen can be an outlier. “ So far, he has done exceptionally well."

On his part, Maideen is grateful. "I’m very happy that I got a second chance, thanks to God and the team here." He added to laughter from the room, "How many people post-divorce tend to get the same spouse?"

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