I started reading Atul Gawande’s Being Mortal nearly a year ago and somehow never got around to finishing it. It’s admittedly a difficult read in the sense that it can be overwhelming at times. I finally finished it last night partly because my wife wanted to start it on the Kindle and also because my grandfather, or as everyone called him, Dada passed away on Sunday. He was the last of my immediate grandparents to pass away.
By all measures, he lead a good and charmed life. He was 95 and suffered from no major illness apart from heart disease that afflicts all Indian males. He lived couple of blocks from my parents and my dad regularly checked on him; so much so that my dad would refuse to come visit us for more than a few weeks because he didn’t want to leave Dada alone in case “something happened”. The “something” never happened. Dada was never limited in his movements and walked all around the town as far as I can remember. He passed away peacefully during his afternoon nap. It’s the kind of death that everyone wishes for but very few get. He outlived my grandmother who couldn’t recognize her own son by the time she passed away, by three and half years. Dada had a fractious relationship with his children and grandchildren. As they say, if you can’t say anything good about a person after he’s dead, you are better off not saying anything. So I’ll not say anything. All I’ll say is that I hope I don’t end up like him in spite of him leading a charmed life.
Going back to Gawande’s book, the premise focuses on the quality of life rather than the length of life and more specifically, the manner in which you choose to pass away. Medical science has advanced to such a degree that humans can be kept alive for a much longer time than you would imagine. But no one has stopped to ask the question of whether we should. Or as in Amitabh’s immortal (no pun intended) words, yeh jeena bhi koi jeena hai. Gawande cites several examples from his professional and personal life that focuses on the individual’s choice on care and ultimately, way to die. The Republicans’ favorite chant ‘death panels’ actually referred to the end of life counseling that doctors offered their patients. It’s the ultimate decision you can take for your life.
You do not choose to be born in this world and as of today, most laws even prevent you from actively choosing to die but at least you can choose the way you die when and only when you’re diagnosed to. The DNR is the most commonly known legal process in our pop culture and medical professionals are taught to honor it just as they’re taught to honor the first do no harm principle. Others like hospice care are fraught with emotions that you may not be fighting back hard enough. But after a while, it’s useless fighting nature.
Being Mortal will not only make you aware of your mortality but actually prepare you for it. I say that in the most humble and optimistic way. You aren’t immortal. You’re going to die. You’re born in perhaps one or two ways but you can die in umpteen different and uncharacteristic ways. The worst I believe, waiting to die which can be a long and painful process not only for the person but also for their loved ones. Modern medicine can perhaps keep you alive for as long as it is possible today but it’s entirely within your rights and choice to decide when enough is enough.
Even before I finished reading the book or even before hearing about Dada’s death, we had confirmed our appointment for signing our living wills and codifying end-of-life processes with an estate planning attorney. I have had the conversation with my brother about his role in the process. It reminded him to do the same as well. It’s the conversation we should feel comfortable having with our loved ones. It shouldn’t take a death to start having that conversation.