Who’s Life Is It Anyway?

My father-in-law has the softest, gentlest demeanor. With neatly-parted lush silver hair and a calm reassuring voice, he is a doctor you would trust in a heartbeat and love forever. He continues his disciplined routine, regimented eating and exercise from his three decades of service in the Indian Air Force, living everyday what he preaches.

Two years ago, he was also the fittest septuagenarian I knew. So, when on their morning walk, he lagged behind his wife citing chest discomfort, she instantly knew something was seriously wrong. Although his discomfort was fleeting, being a family of all doctors, we didn’t let it slip. While Papa carried out the rest of the day normally after receiving reassuring initial reports, we scheduled further tests advised by the cardiologist. He was uneasy with the fuss. He said he felt fine soon after returning from the walk and maybe a bit of rest is all he needed. I was with him when he stepped on the treadmill reluctantly for the stress test the next day. I remember how his face contorted with discomfort after just minutes of walking briskly on it. Without a glance at the beeping monitors strapped to his chest with long intertwined wires, we knew what it meant. The test was positive for inducible ischaemia. He had suffered angina the day before, likely due to a blocked blood vessel who’s inadequacy of blood supply to his heart showed up while he exercised and his heart’s need for blood rose. Further tests and discussions happened. Two days later, Papa was wheeled in to the Cardiology catheterisation lab for an angiography and if needed, angioplasty. The skillful cardiologist deftly put in a stent to open up the single blocked artery he found. The whole procedure took under an hour and Papa was in the intensive care unit.

I visited him there with his daughter. It was heartbreaking. He seemed old and frail, as if he had aged a decade overnight. He was irritated with the sounds of monitor alarms going off all around. His arm hurt from where the access to the heart had been obtained. His back ached the most, he said. We massaged it, all the while reassuring him pleasantly on how well the procedure went and how soon he will be up, leading his normal life, as if nothing happened. We exchanged an understanding glance, knowing fully well that this was untrue. While the procedure had happened smoothly indeed, return to his previous life was not to be.

We all would just have to deal with it later. His immediate recovery was the top priority right now and whatever was needed to support it was done. His daughter fed him the watery khichdi served in the hospital, but he wouldn’t take any, beyond a few spoons. Our purposeful and pleasant bonhomie was having no effect it seemed. It is hard for anyone to be ill, but it is harder for doctors to be the patient in their familiar environment of a hospital. The role reversal just doesn’t settle in.

He only finally settled in, once he returned home the next day. Our family formed a circle of eager caregivers around him. We fussed over his nutrition and rest. We made sure his medications were adhered to like clockwork, kept a hawk’s eye on his status and arranged follow ups with the clinical team. Visitors kept him good humoured company. His grandchildren sat around him playing and laughing, happy to have access to their most beloved adult for an extended duration of time. He seemed to light up in their presence.

Out of his earshot, we had discussions around how his life would change going forward. The clinic routine had to go. No way can he take the strain of looking after so many patients for over five hours a day. And isn’t 74 a ripe old age when one, in fact, should look forward to ‘retirement’? We needed more help around the house. Papa did way too much – looking after his plants, feeding the birds/ants/street dogs, helping out in the kitchen, fixing anything that’s broken, overseeing any repair needed…essentially he kept the house running. This isn’t the age when he should bother with so much. We agreed resting in bed, socializing in the defence officer’s club nearby, reading newspapers, watching TV, evening strolls, gardening etc were far more age-appropriate activities he ought to be indulging in. What was he thinking going on like an active 50 year old all this while? We felt guilty. And protective. We were grateful for this wake-up call that had finally opened our eyes to what should have happened years ago. The truth was Papa needed to slow down. And now the iron was hot.

He had been away from work for a week already. His beloved patients had hopefully begun getting accustomed to his absence and started looking up options. He seemed to be following all our guidelines for rest so far. Cajoling him further at this time wouldn’t be too hard, we thought. He seemed weak. And we assumed his physical weakness also translated into a weak will that will bend as per our wishes. We were his loving, well-meaning, family afterall, only looking out for his best interests. We wanted him to lead a long, happy, fulfilled life and this episode was just the right stimulus to effect an overdue retirement. Papa smiled his angelic, mystical smile when I casually enumerated the activities he could now enjoy. I thought I was making real progress and had his consent when he put his hand on my head, while blessing me.

I was going to be schooled. The silent protest he efficiently put up reminded me of Mahatma Gandhi’s civil disobedience. One fine day, he went through his morning routine as usual and seemed brighter than he had been since the surgery. Self-satisfied as the family’s spokesperson, I congratulated myself for the impact of my eloquence and the power of our family’s love for him. My impression that he had begun to enjoy his new routine didn’t last long. Papa got dressed, filled and picked up the flasks we carry to the clinic and walked out to the car to go to the clinic.

“What!!? But we thought you had agreed last week?” “Haanji beta” (yes, my child), he said to my protests. I was momentarily confused. He is saying yes, but he is doing just the opposite. He is doing exactly what he wants. And why is he getting away without even arguing with me, with us? If he doesn’t argue, how do we convince him? Why is he being so stubborn about living his life his own way? The irony of the last question was lost on me. I looked at my mother-in-law and my husband to strategize on our options now. But the look of resignation on their faces illuminated to me that we had lost.

Without a word of disagreement, Papa had defiantly got back into the clinic taking up his duties. Over the next few days, he clawed his way back into his full routine. He gradually took up everything that he did in his pre -angina days. Our resignation dissolved into concern once again for his health and well-being that we believed was being jeopardised. We feared how would we all cope if his heart gave in again.

However, he looked great, I have to admit. Lying on bed, he had seemed morose. But now his eyes twinkled again, his voice had the perfect authority of thehigh-ranked Air Force officer he was, intertwined with the loving compassion he had for all of life and nature. The spring in hisstep was back. He was once again the towering figure of inspiration in his petite 5-foot frame.

Once, on the way back from the clinic, Papa spoke to me candidly about how he felt. I have always had the highest regard for him and his experience of life. I listened. He shared how happy and meaningful his life is when he is serving his patients. It lends more than a structure to his weekdays. It is his motivation to get out of bed every morning, to dress up, be well-informed, serve and connect meaningfully with fellow human beings. I sensed the same passion in his voice that I have when I talk about my patients, my practice. I deeply resonated with it. He shared that while he felt better after the initial days of rest and recovery, it was return to playing his role of a doctor that enabled him to heal fully, integrating him back into the fabric of life. I watched him with renewed regard.

I reflected later, how do we know how much restrictions to place after an illness? And for how long? When does caregiving become stifling? Who gets to decide the boundaries? Is it the treating doctor who is the expert on the malady or is it the loving family who knows the patient‘closely’ and can be entrusted with ‘his interests’? Or is it the ‘patient’ himself? How are we to know whether an elderly man’s refusal to give up his work is just out of a habit that he is unwilling to change, one that his aging, ailing body can no longer support. Or is it the wellspring that nourishes his soul, enabling him to live a full, meaningful life that he has worked so hard to build.

Through my deeply personal experience with my father-in-law, I was transformed as a person, as a daughter, as a doctor. I saw the truth that we all know but rarely acknowledge. And it is that we are all going to die. In our fear of death and disease and disability, we sometimes take away more from our and our loved ones’ lives, than the disease or disability does by itself. This must change. Our job as caregivers is not to overcome death. But to ensure and best enable a life well-lived, a life of choice and personal agency. As we became more aware of our motives and actions, we transformed from being fearful into a happy, supportive and brave family. Caregiving was now a compassionate relationship of equals.

Today, as papa continues to live an active life guided by his intuition and will, we cherish every day spent together a little more. At 76, he is again the fittest septuagenarian I know!

About The Author

Dr Parul Chopra Buttan 

Dr. Parul Chopra Buttan is an obstetrician & gynaecologist with a private practice in Gurugram. A passionate advocate of women’s health, she is also a mother, writer, story teller and student of Vedanta. She found her life’s calling in caring for women, especially expectant mothers and delivering babies.

She believes in the healing power of stories. Enriched by her vast clinical experience and her own spiritual journey, she writes to share stories she has had the privilege to be a part of. Stories that will inspire an exploration within yourself towards healing.

Her academic qualifications include MBBS and Masters (MS) from Delhi University, DNB from the National Board of India, MRCOG from London and certifications in Advanced Laparoscopy and infertility. With over 15 years of experience she has also received many awards and certifications for her contribution in the field of gynecology.

Her writings can be found on her Facebook page, https://www.facebook.com/drbuttanswomenshealthclinic/

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