The air was crisp and chilly. A shroud of white fog hung over the city’s spires and the water. A temple guru sang mantras broadcast over staticky speakers . The sound drifted across the river to the early bathers with their bars of soap, the rows of washermen beating clothes on stone tablets, and a kingfisher sitting on a mooring. We passed riverbank platforms with huge stacks of wood awaiting the dozens of bodies to be cremated that day. When we’d traveled far enough out into the river and the rising sun became visible through the mist, the pandit began to chant and sing.
As the oldest male in the family, I was called upon to assist with the rituals required for my father to achieve moksha—liberation from the endless earthly cycle of death and rebirth to ascend to nirvana. The pandit twisted a ring of twine onto the fourth finger of my right hand. He had me hold the palm-size brass urn that contained my father’s ashes and sprinkle into it herbal medicines, flowers, and morsels of food: a betel nut, rice, currants, rock crystal sugar, turmeric. He then had the other members of the family do the same. We burned incense and wafted the smoke over the ashes. The pandit reached over the bow with a small cup and had me drink three tiny spoons of Ganga water. Then he told me to throw the urn’s dusty contents over my right shoulder into the river, followed by the urn itself and its cap. “Don’t look,” he admonished me in English, and I didn’t.
It’s hard to raise a good Hindu in small-town Ohio, no matter how much my parents tried. I was not much of a believer in the idea of gods controlling people’s fates and did not suppose that anything we were doing was going to offer my father a special place in any afterworld. The Ganges might have been sacred to one of the world’s largest religions, but to me, the doctor, it was more notable as one of the world’s most polluted rivers, thanks in part to all the incompletely cremated bodies that had been thrown into it. Knowing that I’d have to take those little sips of river water, I had looked up the bacterial counts on a Web site beforehand and premedicated myself with the appropriate antibiotics. (Even so, I developed a Giardia infection, having forgotten to consider the possibility of parasites.)
Yet I was still intensely moved and grateful to have gotten to do my part. For one, my father had wanted it, and my mother and sister did, too. Moreover, although I didn’t feel my dad was anywhere in that cup and a half of gray, powdery ash, I felt that we’d connected him to something far bigger than ourselves, in this place where people had been performing these rituals for so long.
When I was a child, the lessons my father taught me had been about perseverance: never to accept limitations that stood in my way. As an adult watching him in his final years, I also saw how to come to terms with limits that couldn’t simply be wished away. When to shift from pushing against limits to making the best of them is not often readily apparent. But it is clear that there are times when the cost of pushing exceeds its value. Helping my father through the struggle to define that moment was simultaneously among the most painful and most privileged experiences of my life.
Part of the way my father handled the limits he faced was by looking at them without illusion. Though his circumstances sometimes got him down, he never pretended they were better than they were. He always understood that life is short and one’s place in the world is small. But he also saw himself as a link in a chain of history. Floating on that swollen river, I could not help sensing the hands of the many generations connected across time. In bringing us there, my father had helped us see that he was part of a story going back thousands of years—and so were we.
We were lucky to get to hear him tell us his wishes and say his good-byes. In having a chance to do so, he let us know he was at peace. That let us be at peace, too.
After spreading my father’s ashes, we floated silently for a while, letting the current take us. As the sun burned away the mist, it began warming our bones. Then we gave a signal to the boatman, and he picked up his oars. We headed back toward the shore.
Notes on Sources
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INTRODUCTION
Tolstoy’s classic novella: Leo Tolstoy, The Death of Ivan Ilyich, 1886 (Signet Classic, 1994).
I began writing: A. Gawande, Complications (Metropolitan Books, 2002).
As recently as 1945: National Office of Vital Statistics, Vital Statistics of the United States, 1945 (Government Printing Office, 1947), p. 104, http://www.cdc.gov/nchs/data/vsus/vsus_1945_1.pdf.
In the 1980s: J. Flory et al., “Place of Death: U.S. Trends since 1980,” Health Affairs 23 (2004): 194–200, http://content.healthaffairs.org/content/23/3/194.full.html.
Across not just the United States: A. Kellehear, A Social History of Dying (Cambridge University Press, 2007).
The late surgeon Sherwin Nuland: S. Nuland, How We Die: Reflections on Life’s Final Chapter (Knopf, 1993).
1: THE INDEPENDENT SELF