SMS (“Stanford Medical School”) Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.
I’ll pick up where I left off - after the rain.
My grandfather, a pioneering cancer surgeon in the city of Kolkata in India, a dynamic and daring individual, had been ill since a fall in February. I flew home to be with him, and our family took close and attentive care of him both at home and through multiple trips to the hospital.
The morning my grandfather ultimately passed, I had been by his side from an hour before, called in because his pulse was dropping to half of its normal range. His eyes were still closed in sleep, his forehead cool, and a feeble pulse fluttered at his wrist. We called an ambulance, realizing that he was sinking, but feeling ambivalent about transporting his body to the hospital and having him hooked up to intravenous lines and various leads and wires - something he had told us he did not want. In the meantime our family crowded onto the bed, surrounding him with loving thoughts, and I turned on one of his favorite CDs, a collection of devotional Hindu songs dedicated to his guruji, Sadhu Baba. By the time the emergency doctor came up to our seventh floor apartment, about thirty minutes later, his pulse was gone and his heart had stopped. I checked the time: 7:10 a.m.
I share my experiences as a reminder of the poignancy that these rituals may hold. Though these may be private moments...doctors can and should be attentive to them
Mourning is a culturally-mediated experience, and in the world of our family grief was a physical, tangible thing. When the uncertainty of my grandfather’s situation (Was he really gone? What else could make a pulse disappear?) turned to disbelief, and the disbelief to heavy acceptance, our first reaction was to hold the hands that lay tenderly on either side of him, to run a palm along his cool, sunken cheek, to hug his flesh.
I was with him as his body was painstakingly dressed in his favorite cream suit and a lilac tie, with fresh socks on his feet and gold-rimmed glasses in place. He remained resting in his bed, as family members and friends poured in to offer their respects, to pay darshan: to see and be seen by him. The air conditioning was turned on to keep the body cool in the draining April heat.
I was there two days later, when his body, this time in his black suit with a red tie, traveled through the town in a long, silver hearse and was brought back home. We pulled into the apartment complex, where loved ones lined up. They opened the doors at the back of the glass case where his body lay, and placed flowers over his chest, or touched his feet in a gesture of respect toward one’s elders. Some mourners wailed and threw themselves onto his body, or pulled at his clothes, letting their tears dampen his clothes. One bewildered, heartbroken friend and former patient kissed my grandfather’s feet.
And I was there – along with at least 50 other people – at the cremation grounds, where his body was showered with petals, blanketing in fragrant wreaths. Then, the flowers brushed away, we prepared him for cremation, covering his skin with ghee. His three children held a flame and circled around him in prayer, then his body was hoisted into the electric cremation pyre. I was there when we waited thirty, forty, long minutes for the flesh to disintegrate and liberate his soul.
The images of that period of mourning are not easily shaken from my mind. The physicality of grief and the startling presence of my grandfather’s body stay with me. I feel he left us twice - once when the breath ceased to rise and fall from his chest, and twice when his tall form dressed in a crisp suit and tie was placed in the cremation pyre and turned to ash, handed back to us in a fist-sized vessel.
In Hindu rituals we feed sips of water to individuals who are about to pass, so their souls will not be thirsty. When someone passes we leave the light on in her room, at least until the period of time allotted for her soul to make safe passage above. We never leave the body of the loved one alone, unattended; rather, we always keep it company. We garland photos of our loved ones with fresh jasmine, and buy sweets to feed the presence of that person who lingers in the photo, in the room.
As medical students, we don’t learn about such rituals, or about what happens to a body when someone in the hospital passes. We don’t learn how many hours families may keep the body in the hospital morgue, and then how long they have to make funeral arrangements. We don’t learn about the role of the body in the various religious and cultural traditions of our patients - why a lost limb, or a fetus, may matter as more than just remains. These are lessons I learned while in India, in helping my family to care for my grandfather, and to tend to his body.
I share my experiences as a reminder of the poignancy that these rituals may hold. Though these may be private moments, ones that doctors do not necessarily share with their patients, we can and should be attentive to them. Facilitate them. Understand them. And we must all recognize the importance that the body, even the dead body, holds in the process of healing or grief.
Amrapali Maitra is a fifth-year MD/PhD student working towards a PhD in Anthropology. She is interested in the illness experience, the cultural and social basis of health, and practices of care. Amrapali grew up in New Zealand and Texas, and she studied history and literature as an undergraduate at Harvard. She is a 2013 Paul and Daisy Soros Fellow.
Photo by Arian Zwegers