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Tuesday, April 15, 2014

A Mighty Heart Beats No More


I raced off on an urgent trip to India two weeks ago, my father was in critical condition after suffering a cardiac arrest, right at the hospital door. He had been resuscitated in time and was recovering well, able to recognize and speak with my mother and other relatives.

My sister rushed with her family to Appa's bedside, as did I. We emerged from the planes, apprehensive of what we might hear from the phone about his current condition. All was well, we felt assured, as he responded to treatment in the critical care, and next, intensive care units where he was placed.

I regularly went to see him for the few minutes visitors were permitted twice a day in the ICU.  He was weak, but in good cheer, glad to see us and tending to speak vigorously whenever he got the chance of respite from the silence of the long hours in bed. The nurses hovered around to make sure he wasn't strained beyond what his fragile state would permit.

On the seventh day of his hospital stay, we were to accompany him on a ride to a diagnostic facility, where they would perform a scan of his heart to determine how much viable heart muscle was left, prior to a possible ICD implant for irregular heartbeat. My brother-in-law and I accompanied him, along with a staff nurse, on a harrowing ambulance ride that broke all speed records (Ulloor to Pangode in 7 1/2 minutes flat in rush hour- unheard of!)

It was the last substantial chunk of time that I would spend with him. The nurse and I clutched at his leg for dear life, to keep him from shifting on the stretcher where he rested, as he grimaced and clutched whatever nearby object he could as well. The siren blared deafeningly where my brother-in-law sat next to the driver, while we were shielded inside the ambulance patient transport cabin.

Two days later, just as a date had been set for the ICD implant, he experienced heart failure episodes. When I went to see him at the 4 pm visitors' hour, he spoke little except to ask me to open a tetrapak of apple juice, insert the straw and give it to him. He slurped it up quietly, and waved me to leave in a few minutes.

Later that evening he collapsed with a second cardiac arrest, even as he was talking with the doctor. This time, he was not so lucky. Despite every effort by the hospital team to resuscitate and stabilize him, several hours later Appa ended up with strong heart beat, temporary pacemaker, mechanical ventilation (with no patient breaths) and minimal neural activity.

Every day next, we would take turns during visiting, striving our best to wake him up from the deep sleep of coma. But he did not respond. We called, tapped his arms, pleaded, pinched. My aunts and uncles (doctors with varied specialties) arrived and tried their best as well to elicit a response. But four days later, we sat defeated. There was nothing beyond the strong heart beat. No patient breaths (as his brain stem that controls that had been damaged during the cardiac arrest and loss of oxygen that occurred till they could restore the heart rhythm). No neurological responses beyond some minimal artifacts that were promoted by the mix of dopamine and other drugs they were giving him. Waxing then waning kidney function.

It was time for tough decisions. Would Appa want to continue to live like this for whatever duration, tethered to a machine to breathe for him? We thought not. We made the request to the doctor to discontinue ventilation. But he said he could not remove it, as it would be against hospital policy and tantamount to euthanasia.  We were at a loss as to what to do.

My sister and I asked for a meeting with the doctor, after a hurried conference with our aunts and cousins (doctors all). I asked about the pacemaker, which the doctor assured me was in 'standby mode', only there to support the heart which he said was beating strongly on its own, set to 65 beats per minute.  He didn't think it was doing anything to sustain the current comatose condition. My sister asked about the drug cocktail being given, especially the dopamine. The doctor conceded that since there was no hope of recovery, there was not any point to continuing them. He still seemed a bit unconvinced by our request to have those discontinued, as well as turning off the pacemaker.

Who knows what went on in the doctor's mind? A couple of hours later, he quietly acceded to our requests, ordering the stoppage of drugs and allowing the turning off of the pacemaker. Over the next two hours or so, Appa's heart slowed down, drifting below the 65 bpm that had been programmed for the pacemaker to kick in. He went into bradycardia resulting in a final cardiac arrest. The time was 7:25 pm.

We were outside the ICU when the doctor confirmed his passing. It was a bittersweet moment. We each had our roles to play in easing his passage, difficult though it was for us to say goodbye.

And so the mighty, generous heart that had beat so long, striving to overcome all the weaknesses that beset it, especially over the last few years, beat no more.

Appa, fare well on your next grand adventure. Resting in peace is not for you.
 

Tuesday, January 28, 2014

Deep Freeze

Or Polar Vortex, to mimic the media's latest buzzword. It does have a cooler ring to it than merely saying 'It's cold!'

I don't recall seeing these kinds of sub-zero temperatures since the last twenty years. The first time that I did, I was a new mother with a jaundiced new-born, necessitating daily trips by bundled up nurses to test his bilirubin levels. The cold weather left me unshaken, cozy as I was in our overheated small apartment with heaters blasting out a balmy 75 degrees fahrenheit.

Now, it's all I can do to exhort a newly-minted non-teenager to dress appropriately for the sub-zero temperatures as he returns for the 'spring semester' in college.

How do the birds survive this bitter cold, I wonder. The birdfeeder on the deck stands sadly empty, a large hole rusted the bottom out entirely, and I haven't had the time  to go and get a new one. I should do so pronto, maybe even tomorrow, urged on by the tips on this website. Water and high-protein feeds, that's the key to providing the few birds that remain in the area with some sustenance.

Sorry, Deer. You are out of luck the next time you approach the bird-feeder for a snack. I will have replaced the rusted one with a brand new one that will not yield this year to your depradations ( I hope.)
But wait a few days longer and this Polar Hell will be gone, with balmier temperatures in the 20's returning by the end of the week.


Tuesday, December 24, 2013

Life Book

'Tis the season for snow, carols, bell-ringers, gifts....and proselytizers?

M received her first attempt at proselytizing in guise of a 'holiday gift' from a classmate. I had noted before that Z seemed to come from a solidly Christian household, with walls covered with crosses and Christian kitsch art galore on the one occasion that I had allowed M to attend a birthday party there. I thought nothing much of it at the time.

M came back from school the other day, brandishing a bag full of gifts and goodies from her friends, most of which were thoughtfully tailored to her interests, except for this odd little white book.

Z had packaged it delicately in white paper with a gold design, attached a thoughtful gushy note in blue paper about how M's innocent query about some bracelet she sported had triggered this 'impulse to share'. More blah-blah about 'It would be the best holiday gift if M would just read the book over the break, and to be sure to contact her via email with any questions.'

The 'hit back' urge was strong. "What if you gave her the mini-Bhagavadgita as a return present?"  M laughed and said "That might be a good idea." But then I nixed it after thinking, Z would most likely toss it in the trash, so strongly convinced might she be of the absolute rightness of her path.

I skimmed through the book, written in the format of Cliff notes of the Bible, just in more contemporary language, with faux notes in the margins by three or four 'representative' Bible-studying demographics- teen girl, young man with Xtian girlfriend, 'repentant sinner and former jailbird' and 'sceptical' young man. Z had added her own sticky notes in spots. I ached to supply answers to them and pondered the idea of returning the book to her in a gift bag, with my own real notes and answers to her sticky-note questions. I nixed that idea as well.

So now the book sits quietly in a corner of my bookshelf, jostling for space with the latest 'Mahabharata' contemporary retelling and Jhumpa Lahiri. It feels too mean to consign it to the trashcan, so there it will sit, until the next round of clear-the-bookshelf by giving away unread/unwanted books to the Friends of the Library booksale.

And meanwhile, I try to come up with suitable ways to teach M a life lesson that I suspect that she has already learned- how to be gracious to pushy people without giving in to them or their agenda.

Tuesday, November 26, 2013

Melody Floating in on the Breeze

The iconic rendition of 'Kaatrinile varum geetham', by Carnatic doyenne M.S. Subbulakshmi, of course.

My mother always loves to recount how I loved the song so much as a toddler, that it was among the earliest that I could lisp out in my baby voice, astounding my aunt who had to concede that yes, Suji was indeed singing that song, even as she had barely started to talk!

I had read accounts that said it was based on an older version of a Hindi song, rendered by the inimitable Juthika Roy, and later adapted to become the even more famous 'Kaatrinile', but internet searches to locate the original proved fruitless, until today.

The original version of 'Toot gayi man beena' was sung, not by Juthika Roy, but by a lesser-known but equally melodious Sheela Sarkar, as part of a private selection of songs. Here it is:

'Kaatrinile' is almost a complete lift of the original tune, with some minor changes in the orchestration, as can be seen below.



Does this make the copy less iconic? In my case, it is still the M.S. version which holds a spine-tingling charm, probably the result of it being associated with my earliest memories. But I remain grateful that the original version by Sheela Sarkar has finally seen the light of day and can be acknowledged as a lovely precursor.

Monday, November 18, 2013

Veils

What makes a veil so fascinating?

Is it the anticipation engendered in the viewer of the uncovering of mysteries? Is it the untutored charm of a baby waiting for the face to appear behind the hands in the game of peekaboo? What gives the hidden a power that trumps that of the seen?

This morning, as I walked towards the last moon of autumn,  it wobbled large across the dark blue western sky, dropping behind a thin mantilla of tree lace, further dipping behind the burqa of the balsamic pine.

Now you see it, and now you don't.

Then, up again, brilliant, only to hide again behind a thin layer of cloud.