-- By Arulnambi K.

[ This concludes the essay series on my mother's last days and the time I spent with her then. By way of forewarning, this part is intense and personal. Most of it was originally written two weeks after my mother's passing. ]

​One week after I had returned to the U.S., Amma fell silent. She stopped speaking completely, and only ate a few spoonfuls of food everyday. Amma's palliative care team, her nurses and my own research all indicated the same thing - she was days away from the end. Nobody had the heart to tell my father, who was at least outwardly positive and still pinning his hopes on the latest alternative treatment he had just started for her.

And then, on February 9, 2015, at 10:45 PM IST, Amma was gone, released from her suffering. Her prayers had finally been answered.

In the evening of February 11, Thambi (Tamil for younger brother) and I reached home in Chennai after a very long journey. Amma lay in her ice box. She was ever so lifeless, ever so still. Tears did not come. Maybe, I had mentally prepared myself too well for that moment.

A bit later that same evening, as Amma's body was being transported by ambulance to the crematorium, Appa (Tamil for father), Thambi and I followed by car. The ambulance's back door was kept open for that drive, as they were sprinkling flower petals through it along the road. I could see Amma's head and her white hair bobbing up and down as the vehicle moved on. That image reinforced her lifelessness. She was really gone. An oppressive weight was settling inside me. Still no tears, just that feeling of great weight.

The front room of the crematorium, where the bodies would be kept briefly to allow families to do any religious rites or ceremonies that they wished, was dark and damp, with a dirty and wet floor and what
looked like sooty walls in the badly flickering half light that was trying to burn there. Amma's body was shifted to lie on some pieces of wood that were tied together to make a rough (and very suitable to burn) stretcher of sorts. I lit a piece of camphor, and we prayed silently. After waiting for a few minutes as they finished preparing the inside of the crematorium, we carried Amma's body into the inner room.

We placed the stretcher with Amma's body on some rails that led to a closed iron door. I could feel the heat from inside that door. I was asked to light another piece of camphor, this time right on Amma's clothing near her ankles. Then they asked us to move back, opened the door, and pushed the stretcher with her body along the rails right into the chamber behind the doors. I caught a brief glimpse of the stretcher and her body surrounded by flames, then they closed the door and asked us to leave without looking back. There was a deadpan finality to that moment.

Later, as we drove back home, we were silent in the car. Then it struck me. I had left Amma behind, all alone. I had left her alone, in the fire, in the darkness. A rush of emotion and tears pushed through. I cried silently, looking out the car window. Nobody seemed to notice. They were all lost in their own thoughts or just focusing on getting home.

I hardly slept that night. Many memories and emotions flooded me. Most of all, Amma's absence in that house was itself a smothering presence. I exchanged messages with my wife. I wished she and my son were there. I cried a lot more, and always silently. A few times, Thambi, who was sharing the room with me, seemed to sniffle just like me, like he had a cold, only he didn't, or was it allergies? I wondered if he was actually awake and thinking the same thing about me.

​In the end, I had fulfilled one of Amma's last wishes. She had wanted me to come from wherever I was to perform her last rites. She had told me just a few weeks earlier, and it was my duty as her elder son. But there was one other wish I could never fulfill, which was for me to be with her during her last hour. So, if I had a first wish, I wish I could go back in time just once, and hold her hand as she passed from this world.

[ Part 1 - Into the Maelstrom ] [ Part 2 - Blessings in Disguise ] [ Part 3 - Crucible of Pain ]

  -- By Arulnambi K.

Cancer is perhaps the most cruel of human ailments, and can be insidious in the way it creeps into a life. Often, pain that presents as a symptom could mean that it is already too late. Medicine has few answers to even the most common types of cancer, especially when the disease has advanced beyond its initial stages. For those of us who have seen a loved one felled by cancer, and have seen the physical and mental suffering, those images and emotions stay on forever.

Every episode of Amma's five year struggle with colon cancer began with pain. She was probably always fighting against a foregone conclusion, and she knew it only too well, being a student and teacher of zoology. Nevertheless, she tried to stay positive and leaned on her faith, but it was not always easy as the disease progressed. She suffered immensely during her last months, every week bringing new or more intense symptoms, as the disease increased in ferocity and choked her from the inside out.

I am still struck by Amma's courage in making that very difficult decision to not prolong the agony by opting for one more round of treatment. Her surgeon would later tell us that she had made a wise decision. It takes courage to fight the disease like she did until 2013, subjecting herself twice within three years to surgery and the harshness of chemotherapy. It takes even greater courage to say, "I've had enough. I will face what comes, which is likely going to include great pain. I will say my goodbyes and face the end."

How brave was Amma in making that decision? One has to marvel at the courage needed to make the decision she made, and go through all the torture that she went through. She suffered, she questioned the suffering, she pleaded with her late mother for the end to come quickly. She wanted our love, our attention, our compassion and our understanding. But she faced it all to the very end. Such a frail, simple and loving soul. And such suffering.

Some images and incidents linger in my mind, such as Amma lying on a stretcher in the PET/CT scan center, so tiny and weak, and hardly aware of the procedure she was going to undergo. She had been so anxious about it prior to her seizures. I had utilized her post-seizure euphoric state to get her to agree to those tests. Right after her scans were done, the technicians had rushed to roll her out of the scan machine. They seemed to project some sort of emergency, and my heart jumped into my throat for a second in blind panic, thinking something had happened to her. Later on, when I went to pick up Amma's scan results, my heart was pounding heavily. I knew what to expect, but nevertheless, I was more nervous than I had ever been. The results were as bleak as the doctors had expected, but seemed like good news to me as I had been fearing even worse.

The predominant symptom during those last months for Amma was an intense pain in her back, and she could hardly walk or even sit. She would take short, assisted walks around the house with a nurse holding her on one side and Thambi or me holding her on the other. I tried to distract her from her condition whenever I could. Once, while on one such walk through the kitchen, I pointed out the shabby job my father had done cleaning a dish he had used to boil milk, and it brought a small smile to her lips. The contrast between my parents, when it came to such matters of tidiness, was the source of a number of such inside jokes in my family over the years.

Amma hated staying in the hospital. So, I tried to distract her during her hospital stay earlier that month by having her watch "Animals Are Beautiful People," a favorite documentary of ours, on her iPad. She smiled and said, "You are distracting me very well." She was very sick but still sharp as a tack. She had read my intentions as astutely as ever. Later, one night in the hospital, she was in much discomfort and I tried to keep her comfortable. She said, "உன்னோட இந்த அரவணைப்பிலேயே நான் போய்விட வேண்டும்." ("I wish to go (from this world) in your care.")

My time with Amma had to end as I had to return to work after a prolonged leave of absence. Later that month, on January 25, 2015, to be exact, just before I left for my flight back to the U.S., I gave her a hug and a kiss and held her for a while. She had not expected it as we are not given to a lot of hugging in our family culture. She kissed me a few times and was in tears. It was very bittersweet, but I will never forget those last minutes with her. It was the hardest thing I have ever done - saying goodbye that day.

[ This series of essays is a meditation on the last days of my mother's life and the blessed time I was able to spend taking care of her. It seeks to shine a light on the last days of a great soul - on lessons learned, health, family, relationships, love and hardship. ]

[ Part 1 - Into the Maelstrom ] [ Part 2 - Blessings in Disguise ]