Yesterday evening I saw a documentary on Frontline called Being Mortal, which is based on a book written by Dr. Atul Gawande exploring the medical profession’s unease in dealing with dying patients. As I watched the documentary, I noticed that the people that they videotaped in their homes seemed well off financially. Their homes, at least, looked nice. The wife of one of the patients said that they have a wonderful home, family, and friends, and this illness came out of left field. The wife of another patient, who lived in a beautiful home on a farm, said her husband’s life grew bigger in his final days as many family members and friends surrounded him.
The negative person inside me thought that these people had really good lives and if only other people had been as lucky. I have this cry me a river response when I hear news stories of people who, by all accounts, were wonderful human beings, pillars in their community, beautiful home, family and friends, and then something bad happens- an accident, a diagnosis, and everyone is crying and voicing their shock at this injustice. I see things differently because I have had a different experience. My experiences are not popular stories. Certainly the aforementioned stories are much more palpable.
Somewhere midway through the documentary I realized that these people handled their illnesses with grace, and my second realization was that they probably handled their lives with grace, which is why they had good lives to begin with. My mind shifted from comparison to compassion. And then I realized, to a degree I hadn’t before because I didn’t allow myself to go there, how terrible it is to have a terminal illness, especially at a young age. If one thoroughly thinks through all the repercussions, it’s terrible. It’s not a story for the people affected. It’s just terrible.
And then I realized, almost at the very end of the documentary, that there is an element of birth and newness to their deaths. At least that’s how I felt at the end of the documentary. When Dr. Gawande is sitting by the Ganges river, where he scattered his father’s ashes, and life is going on all around him, as a viewer having participated in his story, I didn’t feel alienated as one does when something horrible happens and nobody knows, or cares, because life moves on. Instead, I felt what Dr. Gawande described, that the manner in which they disposed of his ashes was a ritual that has been going on for thousands of years. By partaking in that process, the elder Dr. Gawande is part of that ritual, and so he lives, because the ritual lives, the Ganges lives, the old city where they took the boat lives. The people that come to the shore of the Ganges every day, the elder Dr. Gawande is there, because he is now part of the river. I don’t know how it happened, but I felt like this death gave birth to life, and I didn’t cry at the end. In fact, I didn’t cry at all, which is unusual for me, because, as I now realize, Dr. Gawande handled the topic with grace.
As for the other patients who died, I felt like they were given new life, because they were no longer in that emotional cloud of death. It was an awful experience, and now it’s over, even though it was still awful. I saw the farmer’s wife in black and I was grateful that she had family and friends around her. Very bad things can happen after a death, and it seemed to me she was fortunate not to be in that position.
The people left behind were freed from the deaths, so to speak, and after long ordeals, could look at life. The segment where the farmer tells his grandchild that he has seen life and death on the farm and that he wasn’t afraid of it was such a beautiful moment. His grandson didn’t cry, but understood. That is the response we should all strive for in broaching difficult subject mater.
I wonder how Dr. Nayak, the woman specializing in brain cancers, finds the will to live each day. As she pointed out, she chose a profession where nearly all of her patients die. How does she not cry every day? I couldn’t do it. She is young and beautiful, with long black hair flowing down her back. She dons a bright pink dress in one segment. How does she stay chipper?
And then there is Dr. Selvaggi, who helps other doctors have conversations with their patients about end of life care. Watching her work, I realized that she is a servant, in the same way that a social worker or a nun is a servant. Even though she doesn’t get paid like a servant, she is a servant of a very difficult and noble profession. The way she handled tough conversations with patients, I felt better for having heard her. She couldn’t fight the “system,” i.e. cancers, but she made it more bearable for people. She couldn’t change what was happening physically, but emotionally and spiritually, she packed a power punch. I was also humbled by her humility when she said patients don’t always understand the same way doctors think they understand, and so it is important for doctors to listen to their patients to hear what they heard and what they want. That’s why she is a servant. In an era where doctors act like gods, how refreshing to have a doctor acknowledge that they can’t control their patients, and maybe it’s time to listen to them?
And then I confronted my discomfort of people who are dying. In my mind, I am afraid to touch someone with cancer, irrationally thinking maybe it’s contagious. I’m treating cancer victims like lepers. When I saw Drs. Nayak and Selvaggi work, I was reminded that I shouldn’t be afraid. The ideal is that we should be loving toward them.
Finally, I realized that Dr. Gawande’s writing life, which served as a visual narrative in the documentary, must be supported by someone. There were no kids, no housecleaning, and no cooking. Yet he has to eat and have a clean house. Through his work he is able to provide, and these provisions support his work. May we all be as fortunate.
