Between The Two Mysteries

Appa was the fittest person I knew. Certainly in his age cohort, though he could out-walk me on occasion when I would take him on the trail. He worked out everyday, looking up exercises on YouTube. Strength was a priority. So was endurance.

Every morning he would get up, brush his teeth, have his coffee, and then start with his exercises. Sixty minutes, sometimes two hours. He would track his heart rate on Fitbit and share it on the family group. Then he would have his protein milkshake, a concoction he made himself by grinding various nuts and legumes.

He expected to outlast Amma, who was having issues with her back and hand. Amma never exercised. While she could be browbeaten into helping Appa make his food and adhere to his particular diet, she never gave in to his demands to maintain a more active lifestyle.

Even when Appa was diagnosed with lymphoma and was undergoing chemotherapy, he did not relax his schedule. Not at first. Over the course of the year, as the disease progressed and survived one treatment after another, he gradually slowed down. His back was giving him trouble. The doctors said it was alright and he should deal with it. It was painful enough that he couldn't carry his granddaughter.

It turned out that the last chemo had no impact on the cancer. It only grew, and now there was a malignant fistula in the stomach, along with gastroparesis. He had to be admitted to the hospital immediately, and an attempt would be made to remove part of the stomach if needed, and place a stent to connect the intestines to esophagus.

When I rushed back home, Appa was no longer the man I recognized even from a few weeks earlier. He had lost weight, to the tune of 1 kg a day. Tubes were sticking out of his body. One connected to intestines. For feeding. Another to the nose, to collect bile. Another in the hand, below the wrists, for medicines - paracetamol, ultracet. I was told that in the hospital he had a tube in the neck for the painkillers.

Appa always enjoyed his food. He would make large meals, and insisted on eating something different each day. Now he had to be fed by a nurse who would stuff formula in the tube six times a day. His hands were too weak to prop him up, not to mention his legs. The nurse had to clean him and help him between rooms.

While physically he was incapacitated, his mind was still the same. Appa had an enormous sense of agency. He was responsible for his life, and he would make decisions and act on them. Fast, rarely with a second opinion. After the procedure to place the stent, he was alert, asking the doctor questions about next steps, diet, and progress. The doctor told him that he would be taken care of and not to worry about it. This is not an answer that would have made him happy. It would have made me angry as well - I am his son after all. Back home, he instructed the nurse how to keep records of the aspiration of bile, and Amma about starting on solid food. He wanted to get going with Rituximab, and for that he wanted to get stronger. Right now that meant waiting, and he was not someone to wait.

Waiting.

In Hindu cosmology, one's actions create specific consequences that one must experience. These are the Karma Phala, the fruits of karma. In Skanda and Garuda Puranas, there are various hells where punishments directly mirror one's earthly obsessions. Take Asipatravana, a hell meant for those who destroy the environment. Those thus punished are forced to tread through dense forests where the leaves are as sharp as knives. These descriptions are meant to be metaphorical, intended to drive home the point. You cannot accuse us Hindus of not having a sense of poetic justice. What is it if not ironic that Appa, the lover of good food and robust health, charging through the world, now has to be bed ridden and on liquid diet?

Appa has had a full life. A life that he created for himself. That's more than could be said for anyone. He always fought for what he wanted, and he usually got it. Usually. Right now, the best I can hope for is that he takes it in his stride. He will. He's a fighter after all, and in exercising choice here he's still exercising his agency.