Dr Atul Gawande writes about this so hauntingly in his book “Being Mortal”. It starts with an anecdote from Tolstoy’s Death of Ivan Ilyich. Tolstoy writes “What tormented Ilyich most was the deception, the lie, which for some reason they all accepted, that he was not dying but was simply ill, and he only need keep quiet and undergo treatment and something very good would result”. But he was in tormented by overwhelming fears of approaching death. “He longed to be petted and comforted…he knew that what he longed for was impossible, but he still longed for it”. Gawande is reflective and at times quietly critical about the way modern medicine responds to those who are terminally ill. He describes the journey from being independent to needing assistance to full time care that the elderly and their families have to cope with. Many of us would have faced similar situations in personal or professional lives. Quite often “our reverence for independence takes no account of the reality of what happens in life: sooner or later, independence will become impossible” (p. 22).
What lends strength to the book are the many personal stories of people struggling with their mortality. With remarkable insight he writes, “for human beings, life is meaningful because it is a story. A story has a sense of whole, and its arc is determined by the significant moments, the one where something happens…and in stories, ending matters” (p.238). Some are very moving accounts, some are inspiring - none more so than Dr. Gawande's own experiences as he deals with his physician father's decline and eventual death. It is a poignant and moving account. Having tended to three elders who spent the last days of their lives at home his accounts deeply resonated within me. Dr Gawande is more eloquent in describing these moments, “I never expected that among the most meaningful experiences I would have as a doctor-and, really, as a human being-would come from helping others deal with what medicine cannot do as well as what it can” (p.260).
Dr Gawande makes a journey to Benares to immerse his father’s ashes (as per his last wish) and he writes, “Although I didn’t feel my dad was anywhere in that cup and a half of gray, powdery ash, I felt that we’d connected him to something far bigger than ourselves…Floating on that swollen river, I could not help sensing the hands of many generations connected across time. In bringing us there, my father had helped us see that he was part of a story going back to thousands of years-and so were we” (p.262).
As I was re-reading the book, my eyes welled with tears many times.
Suddenly there was a flash of a delicate blue in the tree near the balcony. A kingfisher!
A poem by Ann Lewis came to mind…
Prayer is like watching for
The kingfisher. All you can do is
Be there where he is like to appear, and
Often nothing much happens;
There is space, silence and
No visible signs, only the
Knowledge that he’s been there
And may come again.
Seeing or not seeing cease to matter,
You have been prepared.
But when you’ve almost stopped
Expecting it, a flash of brightness