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Death- A Truth Unacknowledged

The most certain thing in life is that we will meet with death one day. But how often do we discuss this truth?

Mr. Arjun (name changed)  was 62 years old when he was diagnosed with last-stage cancer of the mouth. The treating oncologist told the family that the cancer was aggressive and that the prognosis was very poor.  “He has three to four months to live,” the doctor said to them. Distraught, the family reached out to another oncologist who told them that they should not give up since many treatment options were available. If one line of treatment failed, there was the 2nd line, then the third, and so on.  The family saw hope and grabbed it.

The treatment began. Arjun lived beyond what the first few oncologists had predicted. But every chemotherapy cycle sapped him of life and he became weaker - both physically and emotionally. There came a time when he couldn't stand by himself. By the end of 10 months, he was bedridden. He couldn't eat, he couldn't walk up to the bathroom and he was in agonizing pain. But as promised by the oncologist Arjun was not dead! 

His family was happy that he was 'alive'. One day I asked him how he felt. He said, "They say I am alive and should be grateful for it. But am I really alive? Is this what living means? Do I deserve this indignity? I am dying painfully each day. I wish I were dead once and for all rather than see myself die every day. I feel so trapped. If I tell the oncologist that I can't go through all this, I am told that I have to be brave and FIGHT! I am told that there are more treatment options available. My family doesn't understand me. I have become a nobody." 

He shut his eyes and a tear rolled down his cheek. “If I hadn't chosen to undergo chemotherapy, I would have lived for a shorter time but I would have lived BETTER! Now, I have lost not only my dignity but all my life savings too.”

His heart kept beating and his breaths could be felt  - he wasn't dead but was he alive??

Even when Arjun’s condition was deteriorating rapidly, the chemotherapy continued and so did the side effects! Arjun died a painful death 6 months later. 

The chemotherapy given to him had deteriorated his quality of life.  The benefits were only in fractions but side effects amplified with every chemotherapy. If the chemo had been stopped then do you think Arjun would have been more 'alive'?  Instead of adding painful years to his dying life, would it have been better to add life to his years?

Arjun's story is very common and thousands like him die even though they are medically alive! 

Was there anything that could have been done to allow Arjun to live better even though the prognosis was poor? Arjun was dying but no one from the treating team spoke to him and his family about his impending death. Why do you think this happened? 

In my opinion, it was because of the lack of death literacy in India. We still continue to be a death-denying society. Talking about death is a taboo.  We forget that everyone who has been born will die someday.  If at the time of diagnosis, someone from the treating team had spoken to Arjun and his family about his death, do you think they would have chosen things differently? 

When I met the family, Arjun’s health was very poor. I counseled his wife and told her that Arjun was nearing death. I also spoke to Arjun. He was bed-bound, very frail and his voice very feeble. He told me how much he loved his wife. I asked him if he would like to say “I love you’ to her. He mustered all his strength and said the magic words. I looked at his wife and she blushed. 

I gently asked her if she wanted to say the same words back to him. She giggled like a young girl and said, “In my 40 years of married life I have never told my husband that I love him”. I told her that this was the right time to tell him how she felt or she could never do so. Tears welled in her eyes and she went up to his bed and with all her might told Arjun that she loved him.  They both looked happy. I asked Amrita, his wife, what it was about Arjun that she loved the most. She said, “Arjun is the best father to his children and a perfect husband to me. I am grateful that I have shared my life with him. I will remember him as a gentleman who loved listening to Md Rafi’s songs.”

By avoiding discussing his death at the time of diagnosis, was the family denied and deprived of such magical memories?  I leave you all to answer this question.

Edited by Parth Sharma.

Image by Janvi Bokoliya.

Vandana Mahajan

Vandana Mahajan is a cancer conqueror and a palliative care counselor.