A toast to a good life, because we are a long time dead!

A toast to a good life, because we are a long time dead!

Oftentimes, while discharging elderly debilitated patients to a subacute rehab, I wondered what kind of experience do patients get there. I went to the rehabilitation center today where many elderly patients were living in a nice blend of a hotel and healthcare facilities. It harbored multiple family activity rooms, physiotherapy room instead of a gym, a humongous bathroom with giant bathtub instead of a pool or a jacuzzi, a big cafeteria with diabetic, renal, cardiac, puree and clear liquid diets instead of delicacies and a dedicated smoking area. A soothing music  and fruit flavored water everywhere made the patients and visitors feel welcomed.

A very nice Geriatrician gave me a tour of the facility and introduced me to the world of Geriatrics. After a brief introduction and discussion of the real problems of old age , complexities of diseases, multi-organ failures and goals of care, I started rounding on the patients. I met Mrs. Walker, an 80 yr old pt who had a hip fracture from a fall and was recovering at the rehab center after her surgery. She looked content with the care and was waiting to get better to be able to return home. I saw several other similar patients, spoke with them and their families. Most of them were content with the care and didn't want any aggressive care. They were all a little scared too regarding whether they would be able to go home or would they worsen and return to the hospital.

When it was time to finish the rounds and go home, I walked through the passage towards the elevator when a very old frail lady on the wheelchair caught my attention as she was extending her hand towards me. I reflexly extended my hand towards her to comfort her, when she held my hand nicely and warmly and tightly and she wouldn't want to let it go. It felt very cute. It felt very cute just like it feels when a baby holds the hand. She was trying to say something, but was unable to express. She was demented and had multiple strokes in the past which had hindered her communication skills remarkably.

I don't know who she was, how she was in her young life, was she nice to people, was she mean to people. To me, at that moment, she was as pure and innocent as she could be. 

We all start our lives so pure and most of us end or will end our lives so pure. So what happens in the middle. Some people understand the meaning of life earlier, some later and some never. Some people live their lives to the fullest, live happily, some make mistakes and repent, some don't learn from their mistakes and some try to create mistakes in other's lives.

Based on the experience with terminally ill patients and very old patients who retained their mental status till the end, everyone had one thing in common. Everyone who was content , whether rich or poor, light or dark, short or tall, fat or small, they all had true love in their lives. True love could be with anyone, parent, sibling, spouse or friend or any person who gives you a deep understanding. It's a feeling of loving someone more than yourself. The love with material makes the process of dying harder. The true immaterial love makes it easier.

In our productive life, we should focus on finding and giving love and kindness. Bringing a smile on a face of someone in pain, wiping a tear from a crying face, feeding the hungry, and healing the sick gives a deep satisfaction. These good deeds become our immense treasure as we grow old.The materialistic pleasure stays here while the soul flies away on parting from the material body. Acts of kindness and love make the soul lighter and lighter. And the lighter it is, the easier it flies.

In our productive years of life, we must gather richness of kindness and love and keep our heart lighter and brighter. Ego, jealousy, power play and treachery would make the soul heavier and heavier.  We should aim not for ruling the mini kingdoms but for dissolving such mini kingdoms that create knots in the smoothness of nature. We should aim at making someone's life better and not miserable.

People who understand this earlier are able to live a better and fuller lives. Those who focus on materialistic pleasure, sadism, and power play end up miserable  in their own minds. I have seen elderly who have been miserable repenting on the bad things they did and wasted their lives. I have also seen elderly who made a very good use of their lives, learned their lessons and completed their journey feeling fulfilled that made them happy and content which in turn made their transition from the material phase to the immaterial phase very easy.

The nice old demented lady was still holding my hand. I tried to understand what she was saying. She was hungry and wanted to be taken to the cafeteria for food. She kept holding my hand as if I was her mom and she was my little girl. I assured her that we will take care of her. A nurse just walked up saying that she was going to take the patient to the cafeteria. I continued to hold her hands for a few steps towards the cafeteria while looking into her eyes and patting her back just like I do for my daughter when I drop her at the school. I then pulled out my hands from hers slowly and let her go the rest of the way with her nurse  The warm touch of her hands didn't just touch my hands, it touched something within and it gave me a very deep good gratifying sensation in my heart.

Let's try to stay as pure as we can while we have all our senses and mind and feel the depth of the gratification that results from that purity.

Let's raise a toast to a good life, because we are a long time dead! Let's raise a toast to a good soul, because it is forever living!

-Jaya Sonkar, M.D., M.P.H.

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