Dying before death
“The waning days of our lives are given over to treatments that addle our brains and sap our bodies for a sliver’s chance of benefit” – Atul Gawande. How true. It is sad that most are not able to accept that leaving things as they are, sometimes, is the best for the patient. That the answer is sometimes a plain and simple No – there is no cure. This IS the beginning of the end. Doctors rarely say it. Patients hardly accept it. Those who do should be treasured and appreciated. Instead, most go from treatment to treatment, hospital to hospital, doctor to doctor, hoping for that ‘sliver’s chance’.
I just began reading Atul Gawande’s book “Being Mortal”. It got me thinking of death and end-of-life issues. I had seen my grandfather die in front of me. I have seen many deaths subsequently. However, when my father AND father-in-law passed away within three months of each other, absolutely unexpectedly and without any warning signs, it sent my husband and I reeling. Until then, death was a mere abstraction. In the typical confidence of the twenties, I felt assured that nothing will befall me – not then, anyway.
My father-in-law was diabetic and asthmatic but, a doctor himself, had them both well under control. My father had no pre-existing conditions, was extremely disciplined with food and exercise and fitter than most 20 year olds. So, when they died, in our absence, miles away, mere hours after we had spoken to them, we did not know quite how to digest it.
After I had sent my devastated husband on his flight back to Madras, I sat down and took a deep breath. I thought about the grandfathers my in-utero daughter would never see – about how my father never got to know that it was indeed a girl on the way. About how she would never know the paternal grandfather who hand stitched her first paavaadais (Indian skirts) for her which he was to bring along with him the next day. How my son would not have his doting grandfathers ever again to comfort him as we, the parents, lost patience with his precociousness. I wondered why me? I asked what I had done to deserve this. Then I wondered why God had been so unkind as to not have them ail, even for a while, so that I could prepare myself. Selfish. Selfish.
Then, I made phone calls to those who should be informed. One made all the difference. He said unequivocally “You are both fortunate, Vidya. They died without suffering and stayed independent to the very end.” Silly as it might seem, that point had not struck me at all. He proceeded to explain his own father’s long term suffering from a stroke and his aged mother’s dealing with it on her own, since the children lived elsewhere. Then he said how he wished his dad would die – for his own good – to end the suffering – to give them closure. Everyone felt so helpless.
His words were echoed by some others I spoke to – until it started registering in my own head. Then, and only then, did I reflect on how happy I was that these upstanding gentlemen had not had to suffer and watch themselves become shadows of their former selves. How it was probably for the good. How it would have hurt us indescribably to see them become shrunken and progressively incapable.
Since then, I have seen friends and relatives of all ages afflicted by various conditions, debilitating and otherwise. I have seen them go the extra mile for any kind of treatment, however invasive, however uncomfortable and I wonder, is it worth it? Is living longer worth it if it means going through all that pain, a literal living hell? For me, the answer is clear. Right now anyway. Who knows how that will change later? Like death, one has to experience it first hand to be able to understand. No amount of reading and empathizing can do that. Maybe I can do it for myself, but can I accept that decision if made by those closest to me? I can only wonder.
Then, I think of my cousin, a palliative care specialist, and wish there were more like her around. Folks who will make the end of life tolerable and minimally invasive – hopefully well away from hospitals….. So that, they, nay, we, can all die peacefully.
