The Audacity of Death

The Audacity Of Death

The year was 2014. It was a quiet summer morning – much too early for my ten-year-old mind to be functioning properly. I was standing outside my house, in an adjoining field, holding my father’s hand. There was a small pit in front of me, freshly dug. And into it, we laid Pluto, our pet German Shepherd, to rest. He was fifteen. And I had never known a life without him.

At that moment, I could not comprehend what had happened. They had said that he would get better. That… “thing” that we had just buried couldn’t possibly be him. But then came acceptance and, with it, tears. Over and over again, throughout that day, and for weeks afterwards, the same thoughts replayed in my mind: “I miss him. I want to hug him one last time. Why did he have to die? Why couldn’t the vet save him?”

It is all too common for man to react to devastating news by trying to make sense of it. Praying to his God, he screams, “Why?” Death, in its eternal wisdom, retorts “Why not?”

Credits: Lament for the dead, Eyeteapot

The pages of the calendar flew and it was 2019. I had turned fifteen, and was standing next to my grandfather, my dada, as he lay in his ICU bed, intubated. Air was being pushed into his lungs at an unbearably high pressure via the ventilator, and a feeding tube was providing him liquid slop- nutrition.

Standing there, I couldn’t help but think how different this meeting was from the one we had just a few months ago. He had been healthy, driving his scooter all by himself to the market to buy us kachoris and groceries. It was in sharp contrast to the person I saw in front of me- living off a machine, unable to sit up or speak due to the numerous tubes and IVs inserted into his body.
He was in that ICU bed for more than a week before he died due to multiple organ failure. I do not doubt that those doctors did all they could to save him. But I still couldn’t bring myself to accept the inevitable nature of what had occurred.

To be human is to be limited. These are the constraints set by our biology- our genes, our flesh and bones. Our role in medicine is to aid people struggling with those limits. But, at some point, the limits cannot be pushed any further. Entropy increases. Things fall apart.

Fast forward to 2022. It was the middle of the exam season. I was studying inverse trigonometric functions and contemplating just giving up when my mother walked over to me with tears in her eyes. In a trembling voice, she told me that her father- my nana – had died.

It was a massive heart attack- no one could have done anything. He was rushed to the hospital, to no avail. I was dumbfounded and heartbroken. Another constant in my life was just… gone.
Still, the apparent irony of that situation didn’t escape me. A soldier in the Indian army and then a policeman, he had survived numerous attempts on his life. All that, and yet what brought down that giant of a man was his own body – late-stage Parkinson’s and heart disease.

In the medical field, we come to terms, albeit reluctantly, with the idea that some of our patients will die. Even I, a student , acknowledge that. We are taught the various definitions of what dying is and what it looks like. We have worked on cadavers in Anatomy and been a part of autopsies in Forensics. We have seen people teetering on the brink of death during our clinical rotations and witnessed families crying over recently deceased loved ones. The very nature of our profession makes it so that we cannot escape the constant spectre of death.

And yet, the reality of death, especially of a loved one, still transcends the concepts that we are taught in the sterile environment of our classroom. No amount of theoretical knowledge about the dead prepares you for the impact that they have on the living.

Science loses its calm demeanour when faced with the illogicality of human emotion. Detailed statistics, the bread and butter of researchers, lose their relevance within hospital rooms.
Paul Kalanithi, the author of ‘When Breath Becomes Air’, during his final few days, penned in a very concise manner: “My relationship with statistics changed as soon as I became one.” The pain of coming to terms with your own mortality finds no treatment within the realm of complex probabilities.

Death doesn’t care about statistics or probabilities, or new gene therapies. It doesn’t care about who you are or what you mean to others. It doesn’t care whether or not the doctor understands why you are its target. It’s not polite, and nor does it wait for the “ideal” moment. Nobody “has it coming.” But it snatches you up all the same. And therein lies the audacity of death.