Thirteen weeks

Date of admission: 2nd Sept 2022 (Friday)

Date of Surgery:     5th September 2022 (Monday)

Date of demise:      2nd December 2022 (Friday)

Length of hospital stay: 13 weeks (91 days)

82 years old gentleman with no significant medical history was admitted for an elective Anterior Decompression of Cervical Canal Stenosis. He wanted to regain his confidence in walking and return to playing golf. He was not on any regular medications. He was not overweight, diabetic or hypertensive. He had no history of heart or lung disease. He lived independently with his wife in their flat on the second floor of a building that had no lift. He went out at least once or twice every day without much difficulty. He was an ardent and proficient bridge player. He drove his car to a friend’s birthday party one week before he was admitted to hospital.

He underwent an uneventful surgery but afterwards he lost power in all his limbs. They took him back to re-operate and make more space for the spinal cord that had swollen up, according to the MRI. That didn’t make any difference. His lungs were unable to work properly as the muscles of his diaphragm became weak. The domes of the diaphragm separate the chest from the abdomen. They play an important part in effective breathing and coughing.  Yes, surprisingly, the nerves to the diaphragm, originate from the neck (C3,4,5). They stopped conducting electricity. His lungs became unsupported.

His doctors said he’ll get better. It was just a matter of time. We needed to be patient. He needed help with his breathing so his windpipe was hooked on to a machine with numbers and waves and graphs and bleeps. He could not speak. No air came through his vocal cords.

Over the next few weeks he regained the sharpness of his mind and found that he was unable to breathe or speak, move or eat, turn from side to side in bed or have any control over his environment. He couldn’t really tell if it was day or night. The machines in the ICU made mad beeping sounds throughout the day and night and no one cared.

Patience wasn’t one of his best qualities but he was patient. Over the next few weeks he regained some strength in his forearms, enough to wave us hello and bye. Enough to blow us kisses and indicate that he was enjoying the music we were playing for him. Enough to bring his hand up to my ears and mouth the words “Nice ear-rings.” He learnt to communicate through his lip and arm movements. He said thanks to everyone who came to see him. He also said, “I love you” more than ever before. He smiled a lot despite his predicament.

His younger son is a writer and a storyteller. He told him a story of two well-known writers of modest means who visited a super-rich investment banker about something. In conversation the banker said he had great wealth, what did these two measly writers have? One of the writers said, we have something you will never have. “Really. What might that be?” He asked with a smirk.

“We have enough.”

After a moment, this patient father on Bed number 19 formed these words with his smiling lips, “I have enough.”

His lungs got infected five times in three months and the morale of his family went up and down like a yo-yo with him. No one knew what would happen next. In between, there were good times – going for a spin on a wheel chair, bowing to the statue of Buddha down the corridor, having bits of tomato-ketchup-flavoured-pringles with tiny sips of Coke, watching sparrows on frangipani trees. But this was not his chosen way of life. He had had enough. His heart had had enough. It stopped. The time to say good-bye left his doctors and nurses in tears too.

Ninety-one days of pure love and deep suffering. The former remains while the latter is done.

May there be peace for all beings everywhere.

“What will survive of us is love.” – Philip Larkin.

Unspeakable.

Age: 82 years.

Sex: Male

Residence: Bed number 19. Intensive Care Unit.

Duration of stay: 70 days and on-going.

Last heard speaking 68 days ago.

Up and down with repeated pneumonias, rising and falling need for support with breathing and blood pressure, weeks of starting and stopping a plethora of antibiotics, kidneys pushed to their limits, sepsis coming and going, metabolic state constantly fighting off infections. This goes on and on and we, his family go up and down with him. In between spells of invasions by nasty bugs, he mouths words, some of which we can decipher and some we can’t. It’s excruciating on both sides when he gives up after a few times of trying to be understood.

“I want to speak.”

Last evening, he insisted silently, sitting up in his hospital bed. His lips firmly formed the shapes of those words. After a quick consultation with the doctor in-charge, we arranged a brief attempt to enable him to speak. We did the appropriate suctions, explained everything to him and blocked his tracheostomy manually with a thumb covered in a sterile glove, to enable the small amount of air in his lungs to leave through his vocal cords, which have not been used for nearly ten weeks.

This man who used to have a big voice, spoke four languages and sang sweet songs had been rendered wordless. In a somewhat broken, hoarse, unrecognisable semi-voice he whispered, “I am trying.”

There were tears. Lots of them. Of love and all the unspeakable stuff.

His eyes were two bright lamps in a poor man’s hut. Oh! To be understood!

For no reason at all.

Andretta is a small village in the foothills of the Himalayas. It has been calling to us for the past five years. We’ve been working towards becoming able to take it up on its invitation and finally, we are here.

I return to my country, a stranger. I am not that young lady who left and this land is different from what it was when she left twenty-three years ago. It is noisier, busier and dirtier. People and houses everywhere. The national highways used to run through wide expanses of green and yellow fields but now they are lined with messy shops, workshops and warehouses. Overweight people used to be a rarity but now obesity is commonplace, even in kids and village folk. The forests are thinner and the weather full of surprises. The number of extreme rain events has risen three-fold since the beginning of the last century, possibly due to a warmer Arabian Sea.

It was in the last century that I ventured abroad. The dreams that lived in my eyes then, are a mere story now. Those dreams had to be dashed, so I could wake up. My heart had to be shattered before it could learn to be full. I had to be completely humiliated, before I could be truly humble.

Maybe it was necessary.

Fifty-four days ago, my father walked into a hospital for an operation that he believed would improve his quality of life. He has been unable to leave his hospital bed since. Every time I turn from one side to another in my sleep, I am aware that my father can’t do that. He needs help with nearly every activity of life. He’s aware of his predicament and we all are helpless. This helplessness is an old friend from a few years back. Looking back, it might have been better if he’d not had the operation but we don’t know for sure and it’s too late now. It could be worse. I could be better. It could be different.

I wonder why things happen as and when they do? Is this a question worth asking or is it completely pointless? Some questions are unanswerable no matter how frantically the logical mind looks for answers. There are none.

This is how it is. For no reason at all.

Long shadows

A few months after Day 0, at a SOBS (Survivors of Bereavement by Suicide) meeting at the All Saints near Euston, I met a father who said, “Eight years” when I asked him how long it had been since his son died. I looked at his face as if he was the most spectacular and wondrous impossibility of the world. Is it possible to live as long as that after the death of a child? He was proof. It was. I had never seen anyone who had been bereaved that long, standing and smiling and speaking sense.

Last Monday I joined the 3 dads on the last leg of their long walk to Westminster alongside many people who want the government to add suicide awareness and helpful resources to the school curriculum. We walked and talked in the rain. I said ‘Nearly eight years’ in response to how long has it been since my son passed. I got the same look from a young mum recently bereaved. She stopped and looked into my eyes through the thick rain drops. Past and future, face to face. “Gosh! Does it get any easier?” she asked. It does, I replied, holding her hands.

All these years I have tried to keep Saagar alive in every way I could – writing, public speaking, teaching Youth Mental Health First Aid courses, advocating for young people, working with various people, charities, NHS, Churchill Trust and other organisations, making films and so on.

I have read other people’s accounts of loss, hoping to lessen my pain and deepen my understanding. The latest book I read was ‘The Year of Magical Thinking’ by Joan Didion. She says:

I know why we try to keep the dead alive: we try to keep them alive in order to keep them with us.

I also know that if we are to live ourselves there comes a point at which we must relinquish the dead, let them go, keep them dead.

Let them become the photograph on the table.

Let them become the name on the Trust accounts.

Let go of them in the water.

Knowing this does not make it easier to let go of him in the water.”

Eight years! No time at all.

Time is the school in which we learn.

Time is the fire in which we burn.”

  • Delmore Schwartz.

Entrances and exits.

The two little lads were inseparable. Saagar and Rohan. They cycled together all evening after school and kicked a ball about for hours. They had dinner at each other’s houses. They created snowmen and played with snowballs together. They even shared a bath every now and then. Luckily, they lived right next to each other and their parents were friends.

At Ulster Hospital in East Belfast, the staff accommodation is a set of six flats. Rohan‘s family lived in the one just below us. His mum, Shruti, was the best grower of indoor plants. A gentle, sweet lady. She was also a doctor but at that time, was not working. Over time our families became close friends and continued to visit each other even after we moved to London and they moved to the north of England. If you ask me to name my oldest friends in the UK, Shruti’s name would be on top.

Eventually Shruti started working in Psychiatry and seemed to enjoy it, even though the exams were a struggle as they are for many of us, when they must fit somewhere in between work, kids, husbands, homes, pets, friends, sleep and homesickness.

When Saagar was diagnosed with Bipolar disorder, I needed to speak with her. I needed her. I asked her by text what time would suit. She said she’s call me after work and she did.

“Hi Shruti. Thanks so much for calling.”

‘No problem. I am driving so we may get cut off. I’ll call you back if that happens.’

As soon as I started speaking it got cut off and she called back and the same thing happened again. And again. And then she didn’t call back.

When Saagar died, she came to see us the very next day with her husband, utterly shocked.

A month later I needed to connect with her again. She said she’d call me back after work. She called while driving. She had to pick someone up from somewhere or drop someone off somewhere. She was on the move. On – Off – On – Off : our phones connected and then rudely disconnected mid-sentence and stayed disconnected for seven years.

Two days back a message arrived from Shruti on Whatsapp saying, “Please join us and bless the couple.” Rohan gets married soon. A nice little electronic invitation to the reception was posted underneath the message. The invitation wasn’t for anyone in particular. It had no names on it. I can’t be entirely sure it was for us.

I am happy for the family and for Rohan. Wishing them all possible happiness, I RSVP’d with apologies for being unable to attend. There’s nothing here and let’s not pretend there is. I felt sad for a little while at this loss of a valued friendship, but not for long. This is an opportunity to let go. Yet again. If there is one thing I want to be skilled at, it is to keep letting go, remembering what the Bard of Avon said – ‘All the world’s a stage, and all the men and women merely players: they have their exits and their entrances …’ I get it.

I would like to live

like a river flows

carried by the surprise

of its own unfolding.”                                    

John O’Donahue