Waiting to Exhale

As a child I hated hospitals. So when an old family friend met with an accident I baulked at going to visit him, but he was fond of me and I of him, so I eventually went, with my brother in tow and carrying a large basket of flowers. He’d just been moved out of the ICU to a room and we didn’t have his room number, so we searched, from room to room, down corridors smelling of ether and cheap disinfectant, and then I caught a glimpse of an old, white haired man lying on a bed in a room and walked into it.

Suddenly there was a flurry of activity all around.

“Hey, Uncle Nap”, I called out, loud and cheery through the din. But neither he, nor did anyone else turn to look.

And then I heard it… the gurgle. You read about it in books and watch it mimicked in movies, but hearing it in person is something else. He gurgled again, slower this time but distinct and loud, a sound that hasn’t quite left my ears and then there was nothing, except the voice of the doctor yelling that he had lost the man. I dropped the bouquet of flowers and my brother caught me before I hit the floor.

When I came to, my brother told me it wasn’t Uncle Nap. We eventually found him in another room, his leg in a cast, eating his pudding.

Saw a film on TV the other day titled, ‘How to die in Oregon’. Thought it was a dark comedy looking at the title… It wasn’t. But it made me wonder if taking one’s own life, when in the throes of agonizing physical and emotional despair can be termed as dying with dignity? And I wondered what was  so undignified about lying in a bed, hooked up to machines that helps you breathe easier than you normally can, and on medication that helps ease your pain?

Dying isn’t easy despite all that I’ve been raised to believe. It’s never easy to let go… attachment our biggest bane and we forget the part about death being glorious, wonderful and a pathway to greater glory… provided you’ve been good. If not, you’re condemned to being slow roasted.

The film brought into focus a law in the US state of Oregon that allows people suffering from terminal disease which gives them six months or less to live, to take their own lives, supervised or assisted by a physician. The provisions of the law are rather stringent to prevent misuse, and dictate that the patient has to make the request to terminate his/her life, in person, to a physician, with two witnesses required to co-sign the request in the presence of the patient. The patient can of course, at any time, rescind the request. The attending and consulting physician’s diagnosis and prognosis are vital in considering the request, and the patient should be capable of making a conscious and voluntary decision to end his/her life by taking the prescribed lethal dose of medication. So basically while the physician actually does not pull the plug, he/she helps you while you do it yourself, informed, guided and counseled. It apparently gives you control over your own life or what’s left of it and got me thinking about what I would do if I knew that my life, if consumed by a terminal disease, wasn’t worth prolonging. If I knew that every subsequent moment of my existence would be wracked in excruciating pain, with no hope except that of death.

Watching the film made me wonder what would drive a person to seek death prematurely and I wondered if I would have it in me to end my own life or the life of someone I love, on so-called humanitarian grounds. Fortunately I’ve never been faced with that dilemma. And though I find it fascinating, I realize that I would find it extremely difficult to take that road.

I cannot however stand in judgement of someone else’s decision, whatever it may be.

The film also brought into focus the question whether dying with dignity should be equated with suicide or not, and whether there’s a difference, moral and ethical between active and passive euthanasia. My Christian upbringing dictates that suicide is a sin, and encompasses within that term the taking of one’s own life by whatever means, regardless of the circumstances. And then I’m a lawyer and the law in India views suicide as a crime, that is, if you’re unlucky enough to survive. Ironic isn’t it, given that you want to die because the world around you doesn’t seem worth living in and you fail, even at that and then the law terms you a criminal. That’s criminal!

My years of meditation have brought me to a place where pain, suffering and loss are the flip side to joy, happiness and gain, the one useless without the other. I lost my best friend when I was five, and then I lost another two over the years, three in all, one from illness, another in an accident and the third to suicide… all before I stepped into adulthood. I’ve also learned through meditation not to fear death, to look at it just as it is… as simple as inhaling a breath of air only to let it out again, inhaling and exhaling, just that and nothing more… watching everything arise, only to pass away. It has to happen, one day or another. You’ve got to be prepared… just make sure you have clean underwear.

But then again it’s all intellectual and while I’ve meditated on death, decay and disintegration of the self and have tried to be equanimous through illness and pain, I have yet to come face to face with my mortality in a tangible sense. I am not walking the path that some of those who chose to take these decisions walk. And while I may say that too much of one or too little of the other ought not to be a measure to determine the continuation of life, this isn’t only about me and my thoughts and views.

Watching people who suffer from ailments, diseases or conditions that consume them painfully is tough. I watched my grandma die of cancer. It was painful, with God, prayer and her family her only refuge. Equally painful would be watching someone consumed by demons that plague their minds with despair that’s so overwhelming, it chokes them, prevents them from being wholesome and shuts the windows of hope, clogging every crack in the door with darkness. It is difficult to draw the line, difficult for me at least to differentiate between physical and mental disease that’s so consuming, it gives you no hope, and makes it difficult to differentiate between euthanasia, passive or active and suicide. If you permit the one, you should permit the other… that would be logical.

‘How to die in Oregon’ followed Cody Curtis as she dealt with her impending death from liver cancer, a journey towards death that was painful and imminent, and her decision to terminate her life, with the support of her family and friends. While the film was sensitive, choosing not to show Cody’s final moments, it made you listen in as she sang songs with her family, laughed and hugged them, before she finally drank the concoction of Seconal that her volunteer doctor prepared, and her life ebbed away. She seemed at peace.

It is a Buddhist belief that when the body dies, karma continues, determining the nature of one’s subsequent birth. Karma is the link in the chain, the continuum of life and living, until there’s nothing to work out… until you are fully liberated. The moment of death is therefore all important, and the state of mind at that time of special significance. Dying in acceptance of death, with peace and calm is said to ease the way. So I wonder if making a conscious decision with awareness to terminate one’s life is preferable to dying in terrible agony with nothing but pain and despair, at times unconscious, hooked up to machines that live for you when you are no longer able.

The film also brought to mind the Aruna Shanbaug euthanasia debate and how I felt following the proceedings of that case, the religious and so-called ethical versus the legal and the logical. A part of me, wanted the Supreme Court to have granted Pinki Virani’s petition as next friend of the almost vegetative Aruna, lying like an injured, traumatized animal that we would have put down on humanitarian grounds. But she lies condemned, for as long as her body holds out, twisted and bent on her hospital bed, uncomprehending and incomprehensible, cared for no doubt and admirably so by her former colleagues and the generations that have followed, keeping her fed and alive to die another day, every day.

I wonder what would be more humane.

So the debate goes on, whether one has the right to take one’s own life. I’m sure it won’t be long before the law in India changes as well, given that the Supreme Court has legalized passive euthanasia… so our law makers have their task cut out. But first please revoke Section 309 of the Indian Penal Code.

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