Death and Life: A Doctor’s Profound Journey with Death
The Inescapable Presence of Death in Medicine
Death, a word often spoken in whispers, casts a long shadow over the halls of hospitals worldwide. As healthcare workers, we find ourselves on the front lines in the battle against this inevitable end, wielding our medical knowledge and tools in a relentless pursuit of life. Yet, even as we celebrate each victory, the presence of death lingers, a reminder of the delicate balance between life and mortality, its final end.
For many medical professionals, the reality of death is brought into sharp focus through the experiences of our patients.
Nagesh’s Journey: From Vibrancy to Farewell
One such patient, whom I’ll refer to as Nagesh, embodied this journey for me. Over many years, I witnessed Nagesh’s transformation from a vibrant individual to a being delicately holding onto life, his vitality eroded by a relentless wave of medical conditions. At 75, despite battling diabetes, hypertension, and other lifestyle-related ailments, he radiated an infectious zest for life. He would often insist on my presence at his home, greeting me with humour and a genuine interest in my well-being over his own. His conversations were always personal and warm; He would playfully chide me for missing social gatherings he hosted, like a family wedding or a pooja, and would casually admit forgetting to take his new medications. Over time, my affection for him grew, and his visits felt like those of a family member.
The discovery of his chronic liver disease due to a fatty liver marked the beginning of a steep decline over two years. Yet, his demeanour remained unchanged; the liveliness and curiosity that defined him persisted. Eventually, the severity of his condition led to his admission into the ICU, and within days, we lost him. His passing not only highlighted the impermanence of life but also the profound emotional resonance that the death of a patient can evoke.
In a gesture of respect and to honour the connection that had formed between us, I attended his Vaikunta Samaradhane, the 13th-day death ceremony. There, surrounded by his warm and welcoming family, I faced Nagesh’s photograph on a decorated table. As I scattered flowers over his image, I found myself overwhelmed with emotion, my tears invisible but heartfelt, and my throat tight with grief. In that moment of farewell, I could almost sense the warm embrace that Nagesh had always extended, a final, loving gesture transcending his absence.
Death in the Biological and Cultural Context
Death is not just a personal loss; it represents the final act of the biological process of life. It’s a symphony of cells and organs, each playing its part until the music gradually fades into silence. As healthcare professionals, we play a crucial role in this final act, ensuring that our patients’ last moments are marked by dignity and comfort.
Culturally, death is a mosaic of rituals and beliefs. In many cultural traditions, the rituals and ceremonies that surround death play a profound role in the human experience. These rituals, particularly within the Indian tradition, are not merely formalities but serve as a bridge between the earthly and the spiritual, between the past and the future. In the wake of loss, these rites offer consolation to the bereaved, providing a structured means of expressing grief and bidding farewell. Such ceremonies also provide a moment of connection with one’s ancestors. By performing the same rituals that have been passed down through generations, the living can feel a sense of continuity and belonging. This connection to the past imparts a sense of identity and place within the cosmic order.
Philosophical Perspectives on Death
For doctors and medical professionals, recognizing the importance of these rituals is essential. It enables us to offer support that extends beyond the physical aspects of care. By acknowledging and respecting these practices, we affirm the values, beliefs, and emotional needs of our patients and their families. In doing so, we help weave the thread that connects the individual experience of grief with the broader human experience, honouring the life that was lived and the legacy that endures.
The Bhagavad Gita delves profoundly into the nature of life and death. It presents several verses that contemplate the essence of death:
- “Death is as sure for that which is born, as birth is for that which is dead. Therefore grieve not for what is inevitable.”
- “The soul is neither born, and nor does it die; nor does it exist by coming into being, or cease to be by death.”
- “Just as a man discards worn out clothes and puts on new clothes, the soul discards worn out bodies and wears new ones.”
Path to a Good Death
Philosophically, death challenges us with the question of what constitutes a “good death.” Is it defined by a relentless fight against the inevitable, or is it found in a peaceful acceptance of life’s natural conclusion? In our role, we navigate these philosophical waters, aiding our patients not only in battling illness but also in finding a path towards a dignified end.
For young doctors, the encounter with death is a transformative experience. The facade of clinical detachment often crumbles when faced with the realities of a patient’s final moments. Balancing professional detachment with compassionate engagement is a delicate act, one that shapes the essence of our profession: to heal both the physical and emotional wounds of our patients.
The Mirage of an Endless Life
Imagine a world where death is but a mirage, where life extends indefinitely. In such a world, the concepts of urgency, achievement, and emotional depth might lose their meaning. The finality of death gives life its urgency and beauty, encouraging us to cherish every moment and connection.
Embracing Mortality: The Essence of Life
In embracing our mortality, we find the true essence of life. Death, while often feared and mourned, is a natural part of our existence, lending a preciousness to every moment we have. As doctors, our role extends beyond the physical; we are tasked with guiding our patients through the journey of life and, ultimately, helping them to face the end with grace and dignity.
The Human Spirit in the Face of Mortality
In grappling with death, we, as doctors, discover the depths of our humanity. It is through this process that we become more than just medical practitioners; we become caretakers of the human spirit. Our dance with the inevitable is an integral part of our profession, and it is in this dance that we find our greatest strengths: grace, honesty, and a deep understanding of the value of life.
Reflecting on Life and Death in Medicine
As we continue to navigate the complexities of life and death, let us do so with the knowledge that in the shadow of mortality, life shines its brightest. Our journey with our patients, through their struggles and final farewells, enriches our own lives and serves as a constant reminder of the profound impact we can have as healers.
I invite you to reflect on your own mortality. How will you approach death’s inevitability in your personal life and professional practice? How can you better support patients and families facing end-of-life decisions?
