LIVING DYING

( By Dr Manu L Kothari and Dr Lopa A Mehta )

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Reverence for Death is Reverence for Life

He realized now that to be afraid of this death he was staring at with animal terror meant to be afraid of life. Fear of dying justified a limitless attachment to what is alive in man. And all those who had not made the gestures necessary to live their lives, all those who feared and exalted impotence - they were afraid of death because of the sanction it gave to a life in which they had not been involved. They had not lived enough, never having lived at all.


Albert Camus

They had not lived enough, never having lived at all. And those who can’t live well, can’t die well, for dying is the last act that the living perform. Life and death are not absolute experiences belonging to separate categories, but are just two sides of the same reality, the seemingly polar opposites that are but parts of a single, larger whole. A good death, a happy one at that, then, is a crowning glory to a good, happy life.

In the Art of Loving, From distinguishes between the ‘love of emotion’ and the ‘love of decision’, the former by its very nature evanescent, the latter, abiding. An abiding love of life can spring only from a decision, a resolve to love life. And such a resolve, scriptures and seers, philosophers and writers emphasize, has as its underlying fountainhead, the acceptance of death.

Talking of terminal cases, Kubler-Ross has described ‘the stage of acceptance’, a time when the patient comes to terms with the prospect of death, and makes peace with it. Should not all of us, even in health, weave this thread of the acceptance of death into the very fabric of our life? The fairest deaths, Montaigne declared, are those that are the most voluntary, to which Fontaine added; ‘Death never takes the wise man by surprise; He is always ready to go.’

Death in life

The eminent biologist and Nobel-laureate Jacob has concluded his tome The Logic of Living Systems by a generalization that precisely and intrinsically programmed death is inherent to every form of life. That life here and now is equivalent to death here and now, is the most scientific and the most profound truth about life and death. Such scientifically-based reverence for death and reverence for life leads us to deliberate upon euthanasia (good death) and euvivasia (good life).

Euthanasia: a semantic error

The lexicographic error is to define euthanasia as ‘mercy killing,’ a classical example of the bad use of a good word. An editorial in The Medical Journal of Australia pointed out that by conventional standards and by the law as it is, euthanasia means murder: ‘Behind this is the blunt fact that euthanasia, for all the mildness of its root meaning, in current usage means the active and deliberate ending of a life - that is killing.’ A British Medical Journal editorial written in a similar vein concluded that what now connotes euthanasia had better be replaced by the concept of assisted suicide. The conundrum is traceable to the fact that, as a cover for our conceptual inadequacies , euthanasia has been forced to mean the monstrous hybrid called mercy-killing.

Huxley, in The Perennial Philosophy, has asserted that many a thought is unthinkable without appropriate vocabulary and a frame of reference. Let us use Huxley’s statement to clear the seemingly insoluble confusion and to return to euthanasia its pristine benignity and glory. Towards this, we may also be helped by Apley who pointed out that we indispensably need new words to keep abreast of new ideas.

Eu- as a prefix clearly implies ‘good’ or ‘well’; thus we have eupepsia, euphoria, eugenics and so on. Euthanasia then means good death, and not, as the British Medical Journal erroneously assumed, an ‘easy death’. What the so-called euthanasia or mercy-killing purports to provide is a swift end to the process of dying, a quick death that could logically be called tachythanasia (tachy meaning ‘quick’ or ‘rapid’). When Sigmund Freud suffering at 83 from an obstinate oral carcinoma for 17 years was injected with four centigrams of morphine by his physician- friend Max Schur, he was not euthanatized, but tachythanatized.Tachythanasia could be defined as a medically-eased-death.

The distinction between euthanasia and tachythanasia is in order: euthanasia is self-earned, self-willed dignified departure unsullied by any medical intervention or condescension. Tachythanasia is a medically offered facility that helps to expedite the task a patient is already engaged in - protracted dying. It should be clear that tachythanasia is not assisted suicide. Jumping into the Thames or off the Eiffel Tower also is not tachythanasia. It is suicide. Dysthanasia, a bad death, on the other hand, is, in the opinion of many, a common sin of modern medicine. Medical technology has made dying lonely, gruesome, dehumanised, mechanical, obscene and immensely troublesome. The fact that modern medicine has chosen to distort euthanasia to suit itself, and has not bothered to label as dysthanasia much that it does, speaks of the current intellectual crisis in medical thinking.

It is a paradox of modern times that medical men are busy prolonging the lives of diseased, senescent individuals, while destroying, quite lawfully, nascent fully-formed fetuses. It is equally paradoxical that the Japanese, who pioneered the free abortion movement soon after the Second World War, should have recently prosecuted and punished a helpless father who felt compelled to put an end to the life of his desperately handicapped son. Sir Theodore Fox, lately the editor of The Lancet, has declared that ‘Life is not the most important thing in life.’ If heart attack, stroke or cancer takes away a human being in a split second by engendering what may be called a ‘guillotine- death’, then each of these very diseases, as a necessary polar- opposite, makes itself a protracted affair, where in the soul of the patient is a suffering prisoner of the ailing soma.

Euvivasia : A good life a means to a good death

The balancing opposite of, and the highway to, euthanasia is euvivasia - a good life, a yea-saying to life that ends with a yea- saying to death. Describing euvivasia is too tall an order, but an attempt may be made by weaving the theme around Schweitzer’s concept - reverence for life. The meaning of existence is to preserve unspoiled, undisturbed and undistorted the image of eternity with which each person is born. A genuine sense of reverence for the elements within and around us, can help each one of us steer our life towards imparting to our existence a meaning, towards living a good life culminating in a good death.

Reverence for time

The only representative of the eternal time that the mortal being has control over and access to is this moment, a realization that springs not from a business executive’s utilitarian regard for time, but a homage to This Timeless Moment. The disease of modern times is hastiness and superficiality, a pathology rooted in man’s inability and reluctance to revere each moment as an inseperable part of eternity.

The overcrowded curricula and the shallow media foster the obsession of time only as a means to lucre, laurels or levity. In the absence of such gains, the best that people can do is to kill time. Time only for gain compels the adoption of haste and superficiality, and these in turn, spawn a perpetual chase for the new. ‘What’s new?’ is an interesting and broadening eternal question, but one which, if pursued exclusively, as is the raging fashion, results more often than not in an endless parade of trivia, the silt of tomorrow, and the fossil of the day after.

Should not this acquisitive, overachieving, information- obsessed, technological society call a halt to its progress, and declare the worth of the idea of beholding Heaven in a wild flower, and infinity in the palm of one’s hand? In Janus, Koestler points out the striking disparity between the growth-curves of science and technology on the one hand, and of ethical conduct on the other, as evidenced by the sixth century B.C. emergence of Taoism, Confucianism and Buddhism, and the twentieth century burdens of Stalinism, Hilterism and Maoism. In Candle in the Wind, Solzhenitsyn, through Alex and his urbanized uncle, debates the gains of electricity versus no electricity: ‘Did Plato have a battery? Did Mozart have 220 volts? In candlelight, Uncle, your heart opens up.’ In the face of death, there is no escape from allowing the inner light to illuminate our hearts, our lives, our every this moment.

Reverence for self

‘Oh my dear, you are one in a million.’ This affectionate assurance from a grandmother can with impunity be multiplied 4000 times to declare that each one of us is one in 4 billion. Outside a Yoga Center in Bombay is written: ‘Each living being is a new thought of God.’ The atheist could take this God as the bioforce of a Generator, Operator, Destroyer, or as a Gene Ordered Design. Be it as it may, each one of us has the blessing, the privilege of being a unique person, the like of which is not to be found now, nor in the past, nor in the future. Let each one of us be proud of this uniqueness.

The world is waking up the innate wisdom of the scriptures. It is a pity that the utilitarian, demeaning educational systems the world over, floundering in the quagmire of comparative evaluations of human beings, unregenerately succeed in smothering the awesome truth of each person’s right to exist. This truth lost, most of us die a thousand death every day till bodily death puts an end to this dying. Suicide is a crude expression of such self-denial. In Japan, for example, the approach of spring traditionally brings a countrywide suicidal rush; a major factor in this phenomenon is that school examination results are made known by April and the victims of Japan’s competitive educational system often kill themselves rather than carry the stigma of failure throughout their lives. Every year, hundreds of children in Japan commit suicide after learning that they have disgraced themselves in exams. What price progress! This example, widely found in the West and likely to infect the developing East, is a strong incentive towards reviving some eternal values whereby human beings are taught, from the very start of life, to value their own self as larger, grander and more important than marks, grades, position, possessions, or shared opinions.

Solzhenitsyn once wrote, ‘It is enough if you don’t freeze in the cold and if thirst and hunger don’t claw at your insides, if your back isn’t broken, if your feet can walk, if both arms can bend, if your eyes see, and if both your ears hear, then whom should you envy? And why?’ Each one of us, as a rightful individual in the universe, owns the moon and the stars, each one of us is cosmically rich. Rachel Carson, the author of Silent Spring drives home the importance of a sense of wonder as one of the requisites for full living. The much acclaimed seven wonders of the world will go down in history as the greatest understatements of all times: what is it that is not wonderful? The Zen Masters advise seeing life’s every moment, every little act with the ‘everyday mind’ whereby life - routine, humdrum life - becomes not only a way to enlightenment but enlightenment itself. In Zen, one who has achieved satori (enlightenment), lives entirely in the present, gives fullest attention to everyday affairs, and experiences unceasingly the wonders and mysteries of life in every little act:

How wonderous this, how mysterious!
I carry fuel, I draw water.
I can wonder, I can see.
I can hear the music of the spheres.

Countering this conception is the indifference, the neglect, the injustice that the modern human being perpetrates on his or her own self in the name of being successful and sociable. The two wheels on which the chariot of sound health runs are proper sleep and proper sleep, towards achieving which the body sends out, day in and day out, a thousand signals and silent pleas in consonance with one’s individuality. To suit the conviviality of a party, to meet a deadline, to please a business contact, nourishment gets perverted, sleep abjured and distorted. The climax is reached when a person must take a pill to sleep and a pill to keep awake. Lin Yutang has defined happiness as largely a matter of good digestion, while Sophocles defined it as the only medicine that gives ease. The science of Yoga teaches, as a primary requirement, the ability to sleep soundly and refreshingly.

Medicine, which boasts of knowing how many nanograms (a nanogram is a 1000 millionth of a gram) of a vitamin are needed by the human body, might be better employed to research into how much of right thinking and right living - even prayer, meditation, compassion - are needed to make for a better person, a better life.

Reverence for the living

The grand unity of life manifests itself through the intriguing genetic, structural and functional similarities exhibited by all living forms, from plankton and protozoa to the primates, and plants. Life implores and deserves reverence.

‘Oreshchenkov offered him the cake as an equal, and he took it as an equal.’ The ‘he’ there was intelligent, sad-eyed, tranquil, thoughtful, even transcendental - and ‘he’ was a dog. Joy Adamson could grow eloquent the same way for a lioness, Schaller for a gorilla or an Indian mahout for an elephant. Dhoomketu, a noted Gujarathi writer, has described the true-life story of Ali and his buffalo; the latter caught inextricably in a train-track, sees to it that his master Ali who was trying to save the animal is thrown to safety before the train runs the animal over. Nobility, lofty and poignant, is far from an exclusive human feature. The Secret Life of Plants has awakened us to the glory of the botanical kingdom, and the rapidly advancing deserts and the recurrent famines have driven home to us the link that human life has with trees - probably the sole example of life with all goods and no bads. Jainism ordains that hurting a leaf or a petal is tantamount to violating the divine order. There is an old Chinese saying: ‘If you cut a blade of grass, you shake the universe.’

Everything that throbs with life is an integral and inter- connected part of the universe. Plant and animal life may be sacrificed to meet human necessities, but not luxuries. The butchering of magnificent whales for cosmetics and the clubbing to death of seal-pups for fur coats represent man’s tyranny over other fellow life forms as it worst; a bestiality that demeans human life.

If plants and animals must be respected, what of man? Avaricious and fiercely competitive modern living has robbed mankind of the faculty of seeing another human being as a fellow child of the universe. Human beings, in countries rich and poor, are often weighed on the scale of utility, as a means to an end, with results that have been a chronic despair for philosophers. Schweitzer has summed up the problem and its solution in his characteristic way: ‘Wherever there is lost the consciousness that every man is an object of concern for us just because he is a man, civilization and morals are shaken, and the advance to fully developed inhumanity is only a question of time.’

This elaboration on the ‘doctorine of divinity dwelling in all living creatures’ is no attempt at preaching but a pointer towards achieving euvivasia, or good life. Some moral values are essential for human life; one such important value is reverence for life, reverence for all that is living.

Reverence for the dying

The dying are persons - not always in need of one more investigation or operation, but a kind word, an affectionate squeeze, a warm pep talk; in short, love. The recent Hospice movement owes its origin, in part, to the realization that doctors treating terminal cases are frequently too obsessed with the disease process and have too little concern for the patient as a person. ‘Today’, according to an article ‘A Good Death’ in Newsweek, ‘when mistakenly prolonged attempts at cures are at last abandoned, many doctors desert the dying, who are left unsupported at the most demanding point of their illness.’ The kith and kin of the dying, with their overweening regard for medical men and nursing homes, follow the doctors and give up the dying when they most need the human touch , or a plain humane ‘hello’.

What relevance do the dying have to a good life? It is multifold. Each dying person is a model of what is inevitably going to befall another person. What is more important, it is one’s witnessing or assisting good, dignified dying that prepares oneself for the event; perhaps a utilitarian, selfish viewpoint, but a valid one.

Beyond one’s selfishness, there is the altruistic challenge, of making somebody’s moment of dying, the moment of soul- satisfying living. The dying can’t do much, but they can feel a lot. The dying cannot hurt, only love, and be loved. The dying being close to us, offer us the last, parting chance to grow up, to understand them, to love them.

The Hospice Movement could be defined as institutionalized reverence for the dying. It has been rightly described as a therapeutic community within a society, helping the living to live until they die. The Hospice movement must, in spirit, move into every home whereby the survivors learn to help dignify the passage of the dying by giving and thus receiving. George Eliot’s assurance that ‘the growing good of the world is partly dependent on unhistoric acts’ allows the near-ones of the dying to love and console the latter, without much effort, expense, or medical intervention. The dying are worthy of reverence, for they are the best teachers that we have.

Euthanasia: A good death


Euthanasia is climactic to euvivasia. It is difficult to spell out its method. Humble inquiries into the lives of people around would reveal for oneself the true death-story of many who died a good death, without any medical tutoring. They could predict their end and welcome it, as they would a friend. Some could even time it. Robert Platt, the English physician and writer, relates the case of a vivacious young Scandinavian with progressive pulmonary fibrosis, admitted to an English hospital during the Second World War. One day he asked a nurse what hour would a patient’s death cause the least bother to others. Next day, he was found dead, at the time he was apprised of. A celebrated example, of yet a younger person, is of John Gunther Jr., who, in the words of his father, died without any fear or pain. We personally witnessed, recently, a robust, lively man of 88 suddenly discovering that he had throat cancer. He said, ‘My time is up.’ For 3 months thereafter, until his death following a heart attack, he was a picture of grace, gratitude and what is more, love and affection.

Amongst the deaths of the notables, two are worthy of mention here - Haldane, and Einstein. JBS Haldane had cancer of the rectum, and typical of him, he died after leaving behind an elegaic tribute to his own cancer. ‘Cancer’ he wrote, ‘can be rather fun/Provided one confronts the tumour / With a sufficient sense of humour.’ Of his death from it, he admitted that ‘I know cancer often kills / But so do cars and sleeping pills.’ Einstein’s final hours have been described by his daughter Margot: ‘I did not recognize him at first - so changed was he by the pain and the lack of blood in his face. But his manner was the same. He was glad that I was looking a little better , joked with me and faced his own state with complete superiority; he talked with perfect calm, even with slight humour about the doctors, and was waiting for his end as if for an expected "natural phenomenon." As fearless as he was in life, so quietly and modestly he faced his death. He left this world without sentimentality and without regret.’

There are some gifted individuals who know the time of their death, a kind of personal thanatognosis. An example close to the authors is cited here. Mrs. K, who died at the age of 80, predicted her death 16 months earlier at a time when she was enjoying full health. On the appointed day - Narsinhachaudash, a holy day amongst Hindus - all her family members came and took her blessings. Her doctor-son checked her in the evening and assured everyone that she was perfectly normal. A little later, she requested that she be left alone. She prayed, and died soon after. A veterinary surgeon of Bombay has described the willed death of a dog under poignant circumstances. A dog was run over by a car that left him severely injured, paraplegic and in shock. Admitted to the hospital, the doctors said that he would not survive for more than a few hours. The dog’s master was in England, and his return to Bombay took three days. The dog lingered on. The master rushed from the airport to the hospital. He took the dog’s head in his lap, and while he was stroking his head, the dog passed away.

Reverence for life is Schweitzer’s legacy to mankind which deserves a balancing opposite, a reverence for death. This dual concept in its manifold sense, is a way towards still farther reaches of human nature, and human soul. It is good, for man, to revere death so that he can revere life.

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