BackField notes from an ICU
When your parent has a close brush with death, all of what they stood for and lived by begins to fall into place
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Contrary to what I always imagined, the ambience outside the intensive care unit, or ICU, where my dad sleeps now isn’t antiseptic. Around me are a few chairs, and a few weary faces. Pretty much everybody is glued to mobile handsets. The only time they come to life is when one of the security personnel shouts out a number. The guardian of one of the human beings admitted in the ICU then jumps up and scrambles to do whatever it is that the resident medical officer (RMO) or nurse in charge wants them to.
The only times I have seen my dad are when the number he is now identified by is shouted out. I haven’t been allowed in any place close to him since he was wheeled into the emergency room earlier today. Since then, he has become just another body that lies sedated in a sterile environment, in sharp contrast to the air outside. I don’t know what will become of him when he gets out of there. The doctors in charge claim they don’t know either. “Under observation for 48 hours," is all they mutter.
* * *
I think it was yesterday. Or at least it seems like that. The two sons of a junior warrant officer (JWO) in the Indian Air Force (IAF) and his wife would walk the lanes and bylanes of Sion, a suburb in Mumbai, every evening.
At some point, the young officer would strike a deal with his sons. Either they could stop by a street vendor who hawked comics where they could debate and deliberate further on which title of Amar Chitra Katha they ought to settle on, or whether they’d much rather everybody share a plate of vada sambar or masala dosa at Hanuman Restaurant right across where the vendor sat. The only times there was no debate was when the latest copy of Tinkle hit the stands.
At all other times, the officer was clear it had to be either the comics or the food. Certainly not both. The boys resented it because they thought they were being disciplined into making choices. The young officer made it sound that way while the mother looked on indulgently. More often than not, the comics won over the food.
Purchases done, all of them would troop home and the young man would lie on his bed, open the comic, the boys on either side, and he’d animatedly read out tales from the Mahabharata, the Ramayana, Valmiki, the Jataka Tales, and every once a while stories of heroes from contemporary Indian history that Amar Chitra Katha thought appropriate to publish.
The older boy grew to become me—a journalist; the younger one, my brother, a researcher in the neurosciences. Thirty-five-odd years down the line, in hindsight, the both of us know the young officer wasn’t trying to teach his sons to choose. It was because a JWO in the IAF then barely took home enough money to make both ends meet.
We grew up in an India where “India was Indira and Indira was India". My folks hadn’t heard of economic liberalization and its potential benefits until the early 1990s. Not that it made sense to them. But by the time they did and figured out what it meant, their boys were ready to join the workforce. Until then, the only kind of parenting most middle-class folks like them knew was to give their boys the best, like buying comics pretty much every other day. If that meant mortgaging little pieces of gold at the local pawn shop from our mother’s meagre dowry, then that is what they did.
But something happened, a mutation if you will, between generations. The kindness and genteel parenting dad weaned us on got replaced by “helicopter parenting" of the kind my generation and I practise.
My older daughter Nayanatara doesn’t have the time for long walks with me. Just out of Class IV, her mornings are crammed with a ruthless curriculum that leaves no room for simple joys like Uncle Pai in Tinkle. When done with her formal class hours, she attends classes for taekwondo, kathak, phonics (which will apparently do her diction good), quilling, art and pottery. My wife and I think it par for the course if she has to grow up into a well-rounded individual.
My folks aren’t so sure. They think their kids—my brother and I—turned out to be reasonably decent blokes given the Rs400-odd the IAF paid my dad every month by way of salary. I suspect they may just have a point.
Each time dad tried to tell me that gently, I’d go into a funk and tell him the times have changed. But as he convulses yet again, the RMO tells me they’re at a loss, and that the ventilator sounds the most plausible option—someplace in my head tells me I ought to consider his advice on parenting a bit more seriously. It’s okay to let children be and soak life in without imposing the ideals of what adulthood ought to be like on them. They’ll just turn out fine. So long as you have the bandwidth to attend to their simple needs—be a playmate when they need you and read a few comics together every once in a while.
* * *
The kind of literature on medicine I have read includes the compassion of Atul Gawande, the eruditon of Sherwin Nuland and the perspective of Roy Porter. Their expositions on the practice offered me stunning insights into the relentless world of young resident doctors, the nature of how we biologically live and why our cells die. That is why I always thought of medical practitioners as romantic ideals.
But in the real world, across the glass wall where dad lies right now, Gawande and Nuland and Porter are just that—romantic ideals. The resident doctors are—pardon my expression—kids on whom the graveyard shift is an imposed one. They are trying their damndest best to do what the textbooks have taught them. But experience is still to mentor them.
Over time they will morph into seniors, like the ones doing the rounds now, and who during their normal waking hours are arrogant pricks. Pardon my expression, but there is no other way to describe them. Allow me tell you why. Fed up of the “He’s under observation" line, I thought up a quick one to throw at the senior doctor on the rounds.
“Excuse me sir, but which lobe of his is affected?"
“You understand medicine?" he asked me condescendingly.
“I’m a practising biochemist," I lied through my teeth.
“Ah! You’re one of us," he melted and proceeded to take me through the initial prognosis.
Much of it sounded like Greek and Latin. But because curiosity had compelled me to read Gray’s Anatomy and some textbooks on biochemistry closely in the past, and carry an app called HealthKart on my phone that I look up every once a while to understand the nature of various drugs, I managed to nod intelligently, ask some questions, and finally get a fix on what is happening to dad.
Perhaps I am being unduly harsh on the fraternity. When looked at from one perspective, how can an overworked medic sit down and possibly explain the nuances of medicine to traumatized caregivers clueless about the machinations of medicine?
I can think of exceptions to the rule like the good Dr Natarajan, an obstetrician, who devoted patience and time to my wife and me when we’d gone through a scare a long time ago when she was carrying our second child. He assuaged our concerns and treated us like humans—not like preserved tissue samples in formaldehyde jars that reside in medical schools. That said, I maintain that the likes of him are exceptions.
But why should it be? If kids weaned on comic books purchased on the back of wafer thin pay packets and mortgaged gold can grow up into informed individuals, what makes medical professionals think they can be condescending? I buy the argument that they soak in an enormous amount of pressure. But what if these medics were put into the pressure-cooker environment that is the newsroom; or a trading room at a broking outfit; or asked to frame policies that rein in the fiscal deficit? None of these professionals can get away without explaining the nuances to the masses. Because if they don’t, they’ll get lynched.
Why did I have to lie and claim I am a biochemist to understand what’s going on? Why did their doors open warmly only when my brother, who is actually a doctor, walk in? What if I hadn’t lied? What if my brother wasn’t a doctor? Much like the weary souls splattered across chairs outside the waiting room, I’d be groping in the dark and be on tenterhooks.
The problem with the practical medicine that exists in hospitals outside the books of Gawande, Nuland and Porter is that they don’t understand the nuances of what it means to be human. It lives instead in a cloistered world seeped in arrogance.
The other problem with contemporary medicine—and by that I mean allopathy—is that it exists in silos. There are neurologists, cardiologists, urologists, pathologists, pharmacologists and so on and so forth. Each of them has a microscopic understanding of the microcosm they work on in the human body.
A good general practitioner (GP) with a holistic view is practically impossible to come by. Contemporary allopathy has, for all practical purposes, killed the GP. Philosophically, Ayurveda espouses the idea of holistic medicine. But it is hopelessly outdated. In times of crisis, it is not a science that can be relied on. The way it is now, it is but a body of ancient texts that practitioners turn to. As for homeopathy, anybody who thinks it a science ought to be an idiot. How am I to take any system that believes in the placebo effect seriously?
Where does this leave us when faced with a crisis but to turn to a splintered system like allopathy? For all of its frailties, at the end of the day, it has done more to extend our life spans than any other system.
Now, if only it could temper the arrogance its practitioners come with!
* * *
Dad thought it only appropriate he marry my mum when he first set his eyes on her. He was 22. She was 20. Her old man, my grandfather, was scandalized in what was then a very traditional Malayali society. He tried to talk the young man out of it. But dad firmly declined. She was his first girlfriend. He was her first boyfriend. They’ve been married 45 years now. Neither will eat a meal without the other. Nor will they end the day without having reported to each other all of what they did during the day.
I always thought this an old-world relationship that is pretty much impossible to sustain in the world we live in now. I’ve had conversations in the past with friends who practise psychology. Their hypothesis is easy to comprehend.
We live terribly busy lives. Not all of our needs can be satisfied by one individual. So, in theory, it is not just probable, but okay to seek multiple partners so that all of our needs are satisfied. To that extent, I am told many practising psychologists believe adultery is kosher—and that over time, the mainstream will come to accept it.
During one of my long walks with dad, I asked him what he thought of the hypothesis. He laughed gently, as is his wont. “Your mother meets all of my needs," he told me then. “I haven’t looked at another woman, ever."
“You won’t understand how we love," mum once told me.
That is why, even as his sedated mind now groans out for her, she watches stoically from the other side of the glass door. There is nothing she can do but hold his hand in the brief moments they allow her to.
A wall of silence separates mum from both of her sons. Her front is brave. But deep down, I guess she needs to talk to somebody. But that somebody lies in a mist. What will happen of their 45-year-old love story if he isn’t around? What will happen of her if he isn’t around to pamper and drive her around? I don’t know.
I wish that I knew how to love like he loved—the good, old-fashioned way—devoid of all pretences.
He tried his damndest best to teach us that through Amar Chitra Katha so we understood how to love our spouses in much the same way that Satyavan did Savitri, so that when Yama, the god of death, comes calling, death can be cheated.
As I wind these dispatches up, I wait and watch quietly, hoping Satyavan will indeed wake up from the deep sleep he is in now, beat the odds that Yama has placed on him, and walk back home to the Savitri he loves so much.
“We’ll keep him under observation for 48 hours," I’m told again and am jolted back to reality.
Charles Assisi is co-founder and director of Founding Fuel (www.foundingfuel.com), a digitally-led media and learning platform for entrepreneurs. He tweets on @c_assisi
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