-- By Arulnambi K.

Amma enjoyed her motherhood and parenting her sons immensely. If you find joy in what you do, you will do it exceptionally well. This was certainly true of her parenting. The proof that she enjoyed it lay in her remembering so many details about our childhood, right from the time my brother and I were born. Well into her retirement, she would find joy in recollecting our school days and all the things she did with us. In general, she also loved children and enjoyed spending time with them. She would narrate little details of her nieces and nephew when they were children, surprising even their parents. My greeting (see below) on her birthday a few years ago pays tribute to her love and the joy she found in the memories of her motherhood.

How are we going to truly remember and honor the memory, ideals and values of Dr. Kanthimathi and her husband? The following blog post on her late husband's birthday seeks to answer:

​http://www.kvkaliappan.org/blog/the-point-of-it-all

Dr. Kanthimathi's recipe collection has been updated with the addition of some easy-to-make rice dishes. She always strove to increase the nutrition content of the food she cooked, and favoring rice recipes that included vegetables, greens and lentils was a good way to do it.

Click here to see the recipes

The beauty of the Tamil language lies in its brevity. Dense ideas can be expressed with just a handful of words by a skilled writer. The above poem by Dr. Kanthimathi is one such creation. In just eleven words, it postulates the ultimate futility of human existence by tracing its progress through life's beginning, development and end. Here is an attempt at a translation that tries to do justice to the word play and the brevity:

O Human! Will you...
Begin as a captive in the womb,
Grow as a captive of convention,
And end as a captive of circumstance?

  -- 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 ]

  ​-- By Dr. Indira Raghavan

[ Dr. Indira Raghavan was a former colleague and very close friend of Dr. Kanthimathi. They worked together for many years, did their Ph.D. research together, and had a very close friendship that spanned four decades. A memorial meeting was organized in Chennai on February 18, 2015 by Dr. K. V. Kaliappan, Dr. Kanthimathi's husband. Dr. Kaliappan was also the Ph.D. co-guide to the two friends. The following is the English transcript of Dr. Indira's tribute to her friend in that memorial meeting. The audio of the speech, which was delivered in English and Tamil, is included in the YouTube video below. ]
​

Dear friends, I have come here with a very heavy heart. I never thought…. When Dr. Kaliappan told me that there would be a condolence meeting this evening, I was mentally very disturbed. I am just standing in front of you with a very heavy heart. I never thought that I would be attending such a sad occasion…. without my friend. We have gathered here… to share our memories and perception about my friend Kanthi. Three to five minutes is not enough for me to tell about our 40-year friendship. She was 28 years old, and I was 33 years old, when we both met and joined in North Madras (College). From that day till date, we remained as good friends. I can tell you everyone in my family…. Sorry, excuse me…. Everyone in my family used to love Kanthi. She was an extended family member. I shall just share with you one or two instances about her. The time is too short. I have to give opportunity for everyone to talk about her.

This will be news to my professor, Dr. Kaliappan (Kanthi's husband). She was an ardent admirer of her husband. I will quote one small incident. Aravinth (Kanthi's younger son) would have been 9 years old at that time. He was studying in Don Bosco. So, the professor and Kanthi used to go and pick up both their son  in the evening from the school. Kanthi told me about this incident that happened one such time when they had gone to pick up their sons. The bell had rung, and all the children ran out. There was a big stone lying in the pathway where the students exited. All the children ran around that stone. Dr. Kaliappan was watching from his car as Aravinth also ran up. He stopped, looked at the stone, picked it up and placed it on the side of the pathway and then ran to the car. Dr. Kaliappan, after seeing this, said to Kanthi, "This is love for fellow human beings. See how he did not just run around but removed the stone from the path. That's great." Upon hearing her narrate this, I told Kanthi, "It's natural, he's your son!" But Kanthi disagreed. She said, "No, Indira, all the good qualities of my sons came from my husband." She said it so proudly.

Kanthi would share so much about Arulnambi and Aravinth, how she was parenting them, and so many stories about them.

There was another incident she shared with me as she was greatly moved by it. It was in 1980, I think, when she had loss of pigmentation in her fingertips.  She was very upset and shared her feelings with me. I said to her, "Kanthi, we are scientists. This is not a disease. This is just loss of pigmentation. Just forget about it. Ignore it. Don't even look at your fingers. Don't bother with it at all. We will do our work."

Kanthi said, "Sir (she would refer to her husband as sir when she was mentioning him to me) is also saying the same thing. He said, 'Why are you so upset about this (trivial) thing? When I see you upset like this, I wish this problem had come to me instead.'  Who would get a husband like this, Indira? I must be really blessed." I said to Kanthi, "What (real) worries do you have? Be happy. See how much courage and confidence he is imparting to you."

​I will narrate one more incident and then close as I don't want to take much time. There's so much I could talk about.

I was doing my Ph.D. and Dr. Kaliappan was my guide. I was close to finishing it - in about 10 months. We were going to submit the synopsis and so forth. At that time, I lost my husband in a tragic accident. I was 46 years old. I was totally shattered. I could not write my thesis, could not concentrate. Why should I study anymore? Why should I get a Ph.D.? My husband had helped me so much. I started telling people I was not going to finish it. At that time, Kanthi helped me a lot and Dr. Kaliappan helped too. I could not drive my car. My hands had started shaking. Both of them came to my house for 10-15 days and talked to me. They would say, "You can drive, right? We'll go in our car first and you should drive your car by yourself and follow us. You can drive. You are a very courageous girl. Don't get so upset," and encouraged me.

I would sit in the department in our college and cry a lot. Kanthi said, "You have to finish your Ph.D. I just want to say one thing: கனவுகள் எல்லாம் நனவாகும், நிறைய காயங்களுக்குப் பிறகு (Dreams will become reality, after many injuries). Remember that." When I see her poems now… I lost my husband in 1990. What she said at that time is still in my mind. I recall it often. When I face a difficulty and it gets resolved, I think of what Kanthi said then: "கனவுகள் எல்லாம் நனவாகும், நிறைய காயங்களுக்குப் பிறகு." I said to my mother after I heard Kanthi say it, "Amma, Kanthi let fly a poem today. After hearing it, I feel so encouraged."

I can talk about a lot of incidents like this. One cannot get a friend… like this. I cannot express how close we were. We would talk daily. She would talk only after she had wrapped up all her daily family duties and I would wait until then. When I called, I would ask her, "Kanthi, are you busy. Can I call after a half hour?"

In college, whatever was the work that was going to be allocated, whether it be the principal or the head of the department or the other staff, they would say, "Put Indira, Kanthi together (as a team)," and we would do it together. I am 5' 8", and she was short, but we were not conscious about that height difference at all. Everyone would remark that we did not even need to look up and down at each other when we were speaking. She would not look up and I would not look down but we would be talking to each other and going our way busily. We were that much in sync with each other and that close to each other.

I am not able to bear her loss, but only God can give the professor and her children (she would refer to her children as her மக்கள் - makkal) the courage they need to bear this. I am sure her soul will stand in support of me, her family and her close friends.

[Click on each image above to enlarge it]

  -- By Arulnambi K.

Sometimes, what seemed like a curse or a cruelty can turn out to be a blessing in disguise, with the passage of time and the perspective it offers on the worst of our pasts.

I suppose I could say that I knew even then that my time with Amma during her last weeks would be precious and enormously meaningful to our mother-son relationship. As it turned out, it helped elevate that relationship to greater heights, as only a crisis can really do, and offered me opportunities to express my love, regard, respect and concern for Amma in deeply meaningful ways.

Bond of Blood

By early December of 2014, my parents were both caught in a deep inertia about doing something, anything, to investigate Amma's near constant pain and suffering and seeking possible remedies or at least palliative measures. The first thing I did after reaching Chennai on December 23 was to seek out a doctor who would be willing to come home, examine Amma and recommend next steps. I also wanted to get some basic tests done right away. The doctor visit and the tests were both done within two days, and the results indicated two things: she was critically anemic - hemoglobin was 3.4 (normal range for women is 12-15 grams/deciliter), and her CEA level was clearly abnormal, possibly indicating a recurrence of the cancer.

Amma agreed, after much discussion, to get hospitalized the next day. My father would say several times over the next month that Amma would have never agreed to the tests and the hospitalization if I had not come down and convinced her.

The first thing the doctors wanted to do was to put Amma on blood transfusions. Several units of blood were required and the blood was readily available. Amma shared the same blood group with both her sons, and I wanted to donate her a unit. I spent a largely sleepless first night at the hospital with Amma. She was in much pain and discomfort for long periods. The next day, after Appa took over at the hospital, I walked to the blood bank which was about a 10 minute walk from the hospital and donated blood for the very first time in my life. The experience was comfortable enough, but I would admit that it was a bit disconcerting to see so much blood come out in such a short time. It was also immensely satisfying that I could help my mother in that very critical condition, even if my donation was more symbolic than satisfying a real need (although Amma's hemoglobin climbed back up more rapidly than expected and they said that blood from a close family member could have that effect). I could also see that it made my parents very happy. Over the next weeks, they would mention it with pride and satisfaction to many people.

Eye of the Storm

On January 2, 2015, a few days after returning home from the hospital, Amma suffered three separate seizures within a period of about 5 hours. The aftermath of those seizures left her conscious but detached from reality and at times mildly hallucinatory for almost a week. That she was mentally present, but not fully, seems to be the best way to describe it. Among all the blessings in disguise during Amma's last weeks in this world, this was perhaps the most immediately apparent. 

Immediately after her first seizure, Appa and I rushed her from home to the nearest hospital - a mere shack of a place with a single doctor and a single nurse, and just a handful of beds. They did a good job of stabilizing her and performing some basic tests. She suffered two more seizures just after reaching the hospital, but they got it under control quite quickly. Thinking back to those harrowing few hours, a funny thought always pops into my head. Amma was extremely tidy, neat and orderly, and frowned upon any kind of mess. It was a good thing she did not realize where she was then, and could never recollect what happened that day. If she had, Appa would have been in trouble for bringing her to a hospital like that, and she would have walked out of there, all the pain be damned! It was that kind of hospital, with questionable bedding, dim lights, a sloppy lab assistant who could not get a blood sample even after repeated attempts, and what looked like a splattering of dried blood on the wall near the bed where Amma was lying.

The seizures left Amma in a mentally altered state for about a week. This was a golden week for her and for all of us. She was mostly happy, not feeling or oblivious to any of the pain and discomfort she had been experiencing previously. She would grin broadly at me, and say things that were perhaps unintentionally funny but would bring a smile to my face nevertheless. It was almost magical, like the calmness in the eye of a storm. The nurses who had joined us at home to give her what was essentially in-home hospice care would chat about all kinds of things with her, sharing their life stories, talk about food and recipes, and so on. My brother, my wife and son had joined us in Chennai over the past week, and we would all sit around her and join in those conversations.

But, every now and then, a random hallucination would occur, reminding us of the grim reality that was hiding just underneath it all. She would imagine blood flowing on the walls, or hear sounds nobody else heard, and seemed to lose her ability to read Tamil. But these were fleeting, and her overall mood was upbeat and happy. She got through that week without taking any pain medication at all.

A Birthday Together

​For the first time in 16 years, on January 13, 2015, I got an opportunity to celebrate Amma's birthday with her. Thambi (Tamil for younger brother) had been able to do it a couple years earlier after a long time, but this was the first birthday in over two decades that we were there together with Amma. We made the most of it, given the circumstances. Thambi, who takes after Amma in his culinary interests, baked a special cake that took into account her dietary needs and restrictions. Amma's favorite among her nurses at that time was Brighty Paul. She had been fast tracked by Amma to a near daughter-level relationship within a period of a week. Brighty and her husband got her a birthday gift - a portrait of Lord Murugan, Amma's favorite deity. Amma was doubly impressed that Brighty and her husband, Mestin Thomas, Christians from the heartland of Indian Christianity in Kerala, had chosen to give her such a thoughtful gift. Amma cut the cake in bed, surrounded by her family, including Dorai Mama, who happened to visit that day. Later, Thambi and I visited the local Murugan temple to pray for Amma. It was a good day. Amma had been slipping more heavily into her symptoms after the brief reprieve offered by the aftermath of her seizures earlier in the month, and Appa had wanted to do something special on her birthday. We were able to achieve that for at least a few hours on that 68th birthday of Amma.

[ 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 ]

  -- By Aravinth K.

​January 13th is my beloved mother's birthday. I remember some lessons which we learned in the way she brought us up and which I hope and pray that I can implement myself.

Nutrition 
My mother truly believed that the human body is the temple that houses the more precious soul and spirit. From the earliest days, I remember her researching, asking, learning and implementing good nutrition in our diets as my brother and I were growing up. There was an abundance of the essential minerals, vitamins, carbohydrates, good fat and protein in our diets. I remember eggs in the morning on most days, three glasses of milk a day, yogurt at least once, if not twice a day, nuts, fruits, multiple vegetables, etc. There was at least one freshly cooked meal a day for us from someone who worked full time and many perceived discomforts on her part to ensure all of this, including cooking fish or chicken for us during the weekends despite being a vegetarian herself. Her flair for cooking and her ardent interest in experimenting in the kitchen made even the not so pleasant tasting but good for you type foods find their way into our bellies.

Exercise
She would enroll us in tennis classes, karate lessons, etc. as she felt exercise for the physical body needed to be accompanied by the mental discipline that comes from repetitive techniques and respect for others that is taught in pursuing martial arts. Disinterest or discouragement that we faced because of not being naturally athletic did not faze her. She let us go to these classes till we got enough of what we needed from them before she was fine with us pursuing other things.
​
Educating us outside the classroom and helping us develop a reading habit
This was without question one of her most valued skills and required all of the extraordinary patience she was capable of with me. Reading 1000s of books to us, explaining the pictures EVERY night from our toddler years to when we could read for ourselves, developed our fascination for stories, pictures and books that was the foundation of our reading habit. Countless trips to both private and public libraries, bookstores, book fairs and an almost unlimited budget when it comes to purchasing books for us both to educate us and to reward us was instrumental in making us hungry for information and entertainment through the written word. To this day, a book continues to hold more fascination for me than most forms of entertainment or sources of information, due to this invaluable habit that she helped us cultivate.