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Monday, December 23, 2013

Death - The Best Medicine

Laughter is the best medicine..... or is it? The more one dwells into the abstract, the more one realises that it perhaps isn't.
"How was your MICU posting?" I asked a colleague. I expected he would say things like x number of CPRs or y number of Central lines or something of that sort. But he replied," Kuch nahi..... ABG karo and then around 3-4 am patients start dying. It happens everyday.... 4 -5 to jaate hi hain." Chuckle, and we moved on.
Such is my profession, that we laugh at almost any and every thing. My mother says, especially since my internship has commenced, that I have become very pessimist..... that I do not say 'good' things any more. 'Good things', how do you define good things?
About a year and a half ago, a bunch of us junior college buddies met up. Being the sole medico in a hitherto group of 6 +/- 1 engineers, I tried to keep pace with the conversation and give my inputs as they spoke of Accenture, Infosys, Patni going out of business, fat packages and so on and sultry. Then, probably after a few PJs which made it clear that I was loosing tract, they courteously asked, "So, Jayesh, what do you do? Tell us about the best thing you have seen in medicine."
"It was on Diwali night of my second year", I began enthusiastically. "A diabetic wheeled in. He had gangrene of his foot. Three of his fingers had rotten and we performed an amputation......... We cut his leg just below the knee...." I simplifiied so that they could follow what I was saying, as we chewed on a sumptuous lunch. "I assisted in that procedure. It was beautiful!" 
"God! Jayesh, what's wrong with you! How can you say that rotten feet are beautiful?" They echoed as one choked and the other gagged on their morsels.
Okay, I get it, i don't speak 'good things' any more.
But, while my profession has been making me heartless.... emotionless so to say.... squeezing me dry and devoid of the very aesthetic that differentiates sajeev from nirjeev, it has indeed opened a portal to the mystic and the subconscious. I perhaps understand life a little better now. And nothing helps understanding life more than understanding death.

Death is universal. I probably learnt to spell death in Sr. KG when they taught that the opposite of life is death. Then, when I was around 7 my grandfather expired. As the rituals about the funeral proceeded, I wondered why the ladies in the house were weeping so inconsolably? More elders dressed in white poured in and tried consoling them. All this time, I only wondered, trying to configure what was going on. This is all that I remember of that day.
Then, about a couple of years later, my father rescued a sparrow and it became my pet. I used clean its cage, feed it grains..... and then one morning, it just lay motionless. My dad said, it had died. I cried.... for my friend..... not because it understood what death meant. 
A few years later my grandmother expired. I cried because, I realised I wouldn't get to see her any more. Death, per se, still remained a strange entity. I never gave it much thought.... never pondered over its complexities...... partly because I got too engrossed in my own life and also (luckily) due to the fact that no one else in my family has passed away since. 
In between, my English curriculum in school had two poems, 'Death be not proud' and 'Death the Great leveler', but still I failed to grasp the abstract.
Now a days, people just keep dying all around me. And, I realise that some people are valuable when they are alive and some others after they are gone. There are some for whom you wish they are better dead, some whom you wish, live forever.
A distant relative of mine sent me a MRI for opinion. The report was suggestive of Interstitial lung disease. ILD- one of my hot favourite topics these days in view of my exams. Different diseases causing ILD of upper lobe predominantly and some others of lower lobe predominantly..... their treatments, for majority of which none exist.... and few experimental novel drug..... which I mug up but which in reality will probably never get out of the labs and in clinical practice. But its exams..... pet ka sawal hai.
So, I tried, in my hallmark mask face and expressionless emotionless monotonous voice, explaining that the disease had a very bad prognosis, that there was only one way...... going down and none other that they should NOT believe any ayurvedic or such practitioner who will claim a cure..... ayurvedics claim a cure for everything..... that she has little time left and they should brace themselves for a tough time maintaining her. That it is not cancer and not infectious.
Today, as I was discussing the same with my mother that how bad an end awaited her, it came to my realisation that knowing every disease and more importantly seeing the end, has just made me a bit paranoid when it comes to the health of my beloveds. 
There is an entity called "The Final Year syndrome" - it occurs universally to everyone irrespective of age, gender or race or culture- in which Final year medical students read of diseases and start finding symptoms of the same in themselves. Can you imagine, diagnosing yourself with a near fatal disease every single day....... that's why the final MBBS exam is called the toughest exam. And, to the quote the idiom. 'What doesn't kill you, makes you stronger.'
So, as we were discussing, the phone rang with the sad news. "Be happy" I told my mother. "She has actually been spared of a lot of pain and suffering. Imagine, if had lived longer, she would have been confined to a bed, wouldn't have been able to breathe without a ventilator .... her caretakers would have had their personal lives destroyed....... Be happy, that she died peacefully."
She had gone to the village, for a change of air and to pay her respects to the family diety. "If she had been in a hospital, we wouldn't have let her die and she wouldn't have given up a life that wouldn't have been worth living."
Life in a hospital is all about witnessing battles for survival.... brave battles, day in and day out. You feel overwhelmed sometimes by the extent to which humans cling on to life.... till very last bit of it. But then, death is so good.... No pain, no suffering. No worries, no anxieties. Do we live lives? No, we only live worries... some real worries and some only a creation of our minds. We live our ambitions, others' ambitions, we live protocols and etiquette. No where, do we live life.
Death on the other hand is so liberating..... In death at least, perhaps, is a chance living life. Death, should be celebrated, not mourned..... for it is the best medicine!

Am I ready to die? .......... No....... I am mortified by the thought of death. But at least, I think about it....there are so many a ways to die, that one must be just plain lucky to be alive, let alone be  healthy and alive. We all live on borrowed time..... and so, I value life even more......may be understand life a little bit more, EVERYDAY.

                    May the departed soul rest in peace.