A Step Into Understanding the Inevitable Universal Future!
“Maut se kiski yaari hai, aj humari to kal tumhari baari hai”.
Help me! Help me! moved the struggling lips of my patient (I will call him Mr. Johnathon in my story).
While rounding on the patients in the ICU, my senior got a call from the Emergency room for an ICU evaluation for a patient with Stage 4 Prostate cancer and cholangiocarcinoma who recently became short of breath and was intubated in the ER.
When we went down to the ER, we found an elderly man lying on the stretcher, intubated, unable to speak. After gathering his history from the nursing home records, I went back to the patient to examine him. He was in distress and was struggling to make some gestures and moved his lips. As I could read them, they said Help me! help me!
I held his hand and asked him, what can I do for you? He moved his lips again. This time it looked like he was saying ‘phone’. I asked him if we wanted me to call someone. He nodded his head. I asked him if he would like me to call his family. He nodded again but this time from side to side. I wasn’t sure what he was trying to say but I reassured him that I will try my best to inform his people.
I called the nursing home and his primary care doctor and found out that he had no family and was alone. I felt a little helpless in being unable to help the old guy.
We did the needful for Mr. Jonathon and got him transferred to the ICU in the shortest possible time to provide him with critical life support. Several times I went to his room. His eyes spoke volumes to me but in a language that I could not understand. It was French to my eyes but I knew they were crying out loud for help. I would hold his hand and pat him on his shoulder but felt helpless that I couldn’t do anything more for him.
My shift got over and I went back home. Returned the next morning. Happy to learn that Mr. Johnathon improved and was planned for extubation. He sounded much relieved after extubation. His voice was vibrant this time. I asked him about his family. He said he was the last descendant and his wife passed away 10 years back. I asked him what was it that he was asking for last night. He said that he wanted to speak with his primary care doctor. It turned out that he had requested a DNR/DNI and didn’t want to be intubated. He said, ‘Don’t ever do that to me again’. My senior and I reassured him that we will honor his wish. He looked fine thereafter, humming to himself, ate some food, and rested thereafter while we rounded on other patients.
Soon after, the same evening, the patient started desaturating, He was DNI and he also refused a mask for ventilation. We felt helpless for him and explained to him that if he denies respiratory support, this could be the end. He closed his eyes, prayed to Jesus, and softly uttered, ‘Let me go…’
There was a moment of silence. We looked at each other, speechless. The respiratory tech put the pt on High flow oxygen and we gave him morphine for comfort.
We thought that this was it. He is probably not going to wake up again but to our surprise, he did, and again with full spirit. For some reason, I was getting very anxious because so far I had seen the demented patients go but he was the first one who was fully in his senses with a great sense of humor, waiting for the time to come. I don’t know if I was comforting him or myself but I went to him again, smiled at him, and asked him how was he feeling. He nodded and winked and showed me 6 fingers to rate his pain followed by a thumbs up. We smiled. He asked for some ice and water. I gave him. Then there was a long pause.
To break the silence, I casually asked him what were his hobbies. He said he loved painting and cooking. He smiled back. Then he said, “I have never discussed this earlier. My wife passed away 10 yrs back. I have been sick in the past and during one of those times, I had this experience. I saw a very beautiful white light and there she was standing in very beautiful white and blue. A white that was such a beautiful white that I could not make it with my colors. A blue that was so beautiful that my colors could not paint. I tried hard to paint the picture but could not. I saw my wife again in the same white and blue. She was holding my hand, Then she went to the other side of the door and I came back. But I know there is a wonderful life waiting for me. My wife is waiting for me. We are going to unite again in a very beautiful world. I am no longer afraid of dying. I am so ready to go. I am so ready to meet her again.” Then he closed his eyes. There was a very calm smile on his face.
He started humming again. Then he spoke about this apple pie that he made with his wife. He said they no longer make them in restaurants anymore. He said, ‘If you want it, you gotta make it on your own.’ As if he really cared about that apple pie. I asked him if he wanted to eat something. He said, ‘No, I don’t feel like eating anything…You are an angel.’ Then he told me that he hadn’t slept in many days and was feeling really good after getting a good deep sleep. Don’t know why but my eyes were brimming with water and as I was struggling not to blink to contain it in my eyes, he said, ‘I am no longer afraid of dying. A very beautiful life is waiting for me. Then he closed his eyes.’ I didn’t know who was comforting whom.
I asked him to let me know if he needed anything and came out of the room, still hoping for him to survive.
Every time, I see a patient dying, I feel this strong urge to save him forever. If only, we could save everybody forever. But the truth is that everything that has a beginning, has an end. Everyone who has a birthday will also have a death day. I will also go one day. My loved ones will too. Everybody will!
The roads that we walk today, had been walked by a completely different set of people, who are not there anymore. Yesterday, our ancestors were running the world and tomorrow our descendants will. . . There is an end to every existence. Then what is the purpose of life? Are we born to create castles, and bridges, invent electricity, and robots, and find cures for diseases? Or, are we born for something more meaningful? Are we born for an experience? An experience of love and fulfillment. What matters more!
I read a book recently, ‘Only Love is Real’ by Dr. Brian Weiss. It makes more sense to me now when I saw my patient lying on the deathbed with a gratifying smile. He had lived a very loved life and was ready to leave this world with a bag full of experience, learnings, wisdom, and love that prepared him for marching toward a new mysterious existence with his loved ones. He had no fear because his love overpowered his death. Could money, fame, or power get him the gratification he needed for an easy transition from one life to the other? Maybe not. But his love did. He indeed has a life beyond our mundane existence. A life of gratification, serenity, calmness, and love!
The answer probably lies in finding ourselves. Finding our utmost desires for which we came to this world. Every soul has its own goals. Gratification could come from any action as long as it is the deepest desire your soul wants to fulfill or your senses want to enjoy. It could come from being a doctor and treating patients, it could come from painting the most beautiful scenes in the world or building megastructures on earth, It could come from traveling the world and enjoying nature, eating the most delicious food in the world, wearing the beautiful dresses and enjoying the soft touch to the skin, it could come from meditating and exploring our minds or it could come from enjoying our sleep and then waking up fresh. It could be found in taking care of the parents who raised us or raising our own kids into successful parents or it could be found in finding our soulmate and having a cup of coffee with him/her every day over a meaningful discussion. What really matters is ‘Peace with your own soul’ and that’s the key to salvation that completes the journey of life.
I will end this discussion here as I begin my journey to explore what I came to this world for. Wish thee well!
-Jaya Sonkar MD MPH
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