The Ultimate Dignity

“Life’s a bitch…”

The Buddha didn’t put it quite so crudely, but his first noble truth is that life does not satisfy. Our journey on earth is scarred with dukkha, with physical pain and psychological trauma, with the despair of loss and the existential angst of being human -  “What On Earth am I doing here?” 

And yet, we cling to life, as if death is the biggest fail of all.

…and then you die”

Between the two halves of this assertion is a deep blue ocean into which I often dive, but I’ve never come up with a pearl. It’s a great party line, too - especially if you throw it away. Often, it gets lost in the clatter of small talk, but sometimes, it lodges in someone’s brain, and you can almost see their wheels beginning to turn.

Last week, I started chewing on this particular piece of cud again, when my elder sister circulated a news feature* about Jeanette, an ailing Canadian artist who had decided upon a medically assisted death. 

“I’m ready. It’s time, It’s become too much. I just can’t deal with all this anymore. I need to go home.”

Sometimes, the dukkha of life becomes too much, and you just want to go into the dark, hoping it will be more peaceful. Most people “think they have to live till their illness takes them away. They have a right to that…but sometimes I think they aren’t aware a person can have control and dignity when they die, control over how they die.”

Inevitably, we remembered my mother. Decades of diabetes had impaired her kidneys, and when Ma was 83, her doctor said she would need to enter into a regimen of dialysis three times a week. She was getting ready for a month in her mountain cottage, and the doctor said the process could begin when she returned. But when she was back in Delhi, Ma announced she was not going to be plugged to a machine for the rest of her life.

“You won’t be plugged to a machine, Ma”, I countered, “it’s just 3 sessions a week.”

“Every day of the week, I’ll either be on dialysis, or thinking about my next dialysis. That’s not how I want to live”. 

I didn’t argue.

Jeanette gave a CBC crew generous access to the last days of her life, wanting the world to know that a medically assisted death is an option. She had “tried to live a good life. Now, she was seeking a good death.”

Those words could have been taken from Ma, who said, “I’ve done everything I wanted to in my life.” And she had. A warrior to the last, she had battled cancer, a broken collar bone, and two hip fractures, to establish an old age home and over twenty creches in the slums of Delhi. Now she was saying, let me go in peace.

We conferred with her doctor about the end of life. 

“As her renal condition deteriorates, she will come to a stage where she will begin to hallucinate. You will know the end is near. We will need to put her on oxygen, to prevent pulmonary distress, and morphine to ease the pain.”

I was hiking in Binsar when my sister called over a dodgy mobile network. 

“Ma asked her maid to get her swimming things ready because she was going swimming with you tomorrow”

Ma hadn’t swum in 40 years, and I was up in the mountains. 

I needed to get back.

Like Jeanette, Ma was perched in a lounge chair in her living room. She was easing in and out of consciousness when I returned. The next evening, our family gathered round, my nephew baked a chocolate cake for her, and we topped it with ice cream, both of which had been taboo for several years. She wished her grandchildren good-night, and slipped into sleep. 

The CBC feature echoes Ma’s dinner,

“A procession of friends and family comes by the table to laugh and cry with her. After a few bites of fish and chips from her favourite restaurant, Jeanette is taken to bed just after 8 p.m.”

For the next five days, Ma’s presence ruled the room, even though she was lost to the oxygen and the morphine. Through those five days, visitors filled our home with love and respect, for she had nurtured so many souls in her effort to lead a good life.  

But above all, I think it was Grace that ruled the room, the grace of acceptance, and the grace of a dignified departure, in the heart of a home filled with flowers and loved ones.

Not all of our loved ones agreed with Ma’s manner of departure. My beloved Chacha and his daughter, both medical professionals, felt that we should have persuaded her to submit to dialysis. That was an expression of their dharma, their unceasing dedication to a life of saving lives. 

But for us, there was a deeper dharma, a respect for the most intimate of personal calculus: when the dukkha of life exceeds all the meaning you have imbued it with, all the love, all the compassion, all the caring, slipping your moorings from the pier of the living is your final act of dignity.

*https://www.cbc.ca/newsinteractives/features/a-good-death-maid