His name was the first to go. The nurse at the registration counter took that. With the efficiency of long practice she relieved him of the familiar arrangement of its letters, not even stopping to glance at it as she replaced it with a single initial. That was all he was now. Kumar, J. The heading to a chart of numbers that rose and fell with painstaking regularity. Nobody ever called him anything but Mr. Kumar or Patient Kumar now. Nobody needed to. He knew some of the other patients resented this, insisted on being called by their full first names. He himself was grateful for this partial anonymity, as though by quarantining him from his name the doctors had protected that beloved word from being infected with his disease.
His appetite was the next thing he lost. He woke up one morning to the familiar smell of over-boiled eggs and felt gingerly within himself and found that the desire to eat was no longer there. The staff at the hospital didn’t like this much. For a while they mounted a valiant search for his lost hunger, sending nutritionist after nutritionist to make careful enquiries into where it was last seen, what it looked like, etc. until he felt almost guilty for not having taken better care of it. Eventually, they resigned themselves to its absence though, and a bottle was fitted to his arm, to drip liquid sustenance directly into his veins.
The next to go was shame. The skin he had always assumed to be a part of his body turned out to be little more than an alien covering, a presence wrapped around him. Hardly a week had gone by before it erupted into angry sores, the very rawness of its protest robbing him of all comfort. Struggling to deal with its insurrection, he learnt to distance himself from it, so that seeing it naked and exposed he felt no shame, only the embarrassment of one who sees a stranger being humbled. He felt a great deal of sympathy for his body now, watching it waste away under his gaze, but he saw himself only as a witness to its deterioration, not as a participant in it.
The last thing he lost was interest. For months he kept careful tabs on his own condition, forcing himself to listen carefully when the doctors spoke about him – sometimes to him, sometimes using him as an exhibit. Medical terms he had never heard before became a second language to him, he followed every twist and bend in his case with the intentness of a teenager riding a roller-coaster, sure that in the end it would all make sense.
Finally, though, the futility of it all came home to him. The pointlessness of hoping for a real answer. The doctors could not tell him what he really wanted to know because the doctors did not know themselves – all this technical gobbledy-gook they spouted, all these diagnoses and prognoses and critical conditions were just the words they used to disguise the simple fact that in the end it was all up to chance. He learnt to pay less attention to them, and finally, no attention at all. Like someone who listens, head bowed, to a priest reciting the morning prayer, going through the ritual of it because it has to be done, but thinking, meanwhile, of other things, he learnt to nod along to the liturgy of the daily rounds, all the while planning the thousand little subterfuges by which he would trick himself into getting through the day.
That’s why when the operation was first mentioned, he didn’t even notice. It was a while before he realized that the doctor was waiting for him to say something (his participation in these discussions was usually not required) and had to collect himself and ask for the point to be repeated before he could answer. The prognosis was not good, he was told (he had heard this before) they had decided that it might be best to operate. They wanted to know how he felt about that. Operate? He asked, what did that mean exactly? A long description followed – the gist of which (as he understood it) was that they would slit his chest open and try to cut away as much of the growth inside as they could. It was a long shot – the odds were not good – but it was his only chance.
He thought about what Sita would have said to this. Let it be, she would have said, at least have the courage to die with dignity, instead of exposing yourself to the humiliation of being cut open like some rotten fruit. But there was no dignity in death. He knew that now. He supposed she did too. He didn’t seriously expect that the operation would work, but it was a change, something to pass the time, and as for the humiliation and the pain, well, what would you call what he lived through every day? He looked up at the doctors, who were watching him anxiously. Yes, he nodded slowly, I’ll have the operation.
After that the tempo of his life changed. For months now he had floated in a haze of sedatives and tests that proved inconclusive, now the date of his operation became an anchoring point, one that all his other activities aligned themselves to, like iron fillings drawn by a magnet. As the day drew nearer, the preparations for the operation blurred the emptiness of his existence with activity. He was shaved, prepped, a battery of tests were done on him, a small flock of papers made it to his bed for him to sign. There were decisions to be made (it had been so long since he had made any), the seriousness of the procedure forcing the hospital to officially acknowledge, for the first time, his mortality (they called it the ‘event of his death’ as though it were to be some sort of formal occasion) – though the social worker who came with the forms still spoke of it disparagingly, as though death were some poor relative who had come to pay a visit after the official visiting hours were done. For the first time in months he felt a sense of motion, of progress, and though he was careful not to allow himself to hope, he couldn’t help but feel a mounting enthusiasm for his surgery - an excitement that was tinged with anxiety, true, but excitement nevertheless.
Then, before he was quite prepared for it, the day was upon him. Two white-coated attendants stood by his bedside, a stretcher on wheels ready between them. As they lifted him onto the stretcher, he imagined how light he must feel to them, the cage of his bones almost empty. He thought of how they had told them in school, all those years ago, that birds had hollow bones. He wondered if his own bones had grown hollow now, so that his skeleton was little more than a network of badly connected pipes. It certainly felt that way.
As they wheeled him out of the room, he felt as though a great weight had been lifted off him. He tried to imagine what it could be, then realized that it was simply the bed sheet that was no longer covering him. The thought of how weak he had grown shocked him. The air on his exposed skin felt cold, almost accusing. For the first time in a long while he thought about the robe he was wearing, the way it hung entirely open in the back, displaying his buttocks to anyone who happened to look. The thought of his nakedness, so taken for granted back in the ward, returned to mortify him. He tried adjusting the gown around himself, but he was too weak. He tried signing to the attendants who were taking him, but they didn’t pay him any attention. He noticed that they were constantly looking away, almost as though they were intent on not seeing him. Realization flooded in. He wanted to smile, wanted to laugh out loud at the foolishness of his vanity. Nobody wanted to look at a dying man. Nobody wanted to see this diseased, wasted flesh of his. Everywhere they took him, people would no sooner catch a glimpse of him than they would look away. His condition was a better guarantee of his modesty than a dozen bed sheets, a dozen tightly arranged gowns, could ever be.
As they glided through the busy corridors of the hospital, he found himself staring at the row of lights on the ceiling, the neon tubes that sped past him like rungs of some electric ladder that he was rapidly climbing. How strange that we never notice ceilings, he thought, though they are always above us, always hanging over us, their whitewash cracked and peeling. We look ahead, or to the side, or down, when we walk - we notice walls and floors and doorways – but ceilings always seem to escape us. Perhaps, he thought, it’s because ceilings are so unremarkable; one ceiling is almost exactly like another. If he survived the operation and had to make his way back to his ward on his own strength, with only the ceilings to guide him, could he make it back? The idiocy of the question made him smile.
The men with the stretcher didn’t notice him smiling (what would they have thought if they did?). From his horizontal perspective they seemed very far away, almost like a different species, larger than life. This is what the angels must look like, he thought to himself, this is how distant they must seem.
Ten minutes later he was in the operating theatre, the great light overhead shining down on him like a constellation, the surface of the table cold and hard under his back. There were more of them now, these white clad super-beings; they had even hidden their faces behind masks of gauze. Judges should wear masks like that, he thought to himself, so that when they pronounced sentence, no one would know who was speaking, and the infection of revenge wouldn’t take hold. With the light shining bright in his eyes the figures above him lost their identity, became little more than outlines, a multitude of reflections bending over him, a single, anonymous being multiplied many times by some imagined mirror.
One of the super-beings was talking to him now. It was a woman, her hair tied up in a small explosion of plastic. Her voice was soft and comforting, like a warm towel. She asked him how he was feeling. He wondered how he was supposed to answer that. She didn’t seem to want a reply though, she went on, briskly, efficiently. In a minute she was going to put a mask over him, she said. No need to panic. All he had to do was take deep breaths and count to ten. It was just medicine, an an-es-the-tic (she pronounced the word slowly, stretching out the syllables), it would ensure that he felt nothing. Did he understand?
He nodded. But inside him an urgent panic began to take hold. Not feel anything? But how would he know that he was still alive then? What if they put him under and he died? Would he feel that? What if he didn’t feel himself dying? What if he never even found out? Surely a man was entitled to know these things. The conviction grew within him that awareness was a very important gift – not a thing to be given up lightly. After all, what else did he have left, except his consciousness?
The lady with the soft voice was back. She was holding something large and rubbery towards him. It was the mask. It was too late. He felt the mask slip easily over his nose, sniffed the beguiling sweetness of it, felt it constricting him, binding him. This is how a dog must feel on a leash, he thought. His mind rebelled against the mask’s confinement, searched, in vain, for the bodily strength to pull it off. The lady was asking him to breathe and count to ten. He wondered what she would do if he refused, if he simply held his breath. What would they do? Would they let him go, accept this last minute decision of his not to have the operation, even in the face of their assembled presence? Or would they simply hold him down and keep the mask pressed to his nose and watch him writhe and struggle until he could hold out no longer and inhaled deeply and floated away into the neverland of sleep they had planned for him?
No. Resistance was useless. And silly, besides. After all, thousands of people went through surgeries like his every day; if they didn’t see any reason to object why should he? He steeled his nerve and took a deep breath. 1, 2, 3. The smell of it so cloying, so rich in the sweetness of its deceit. 4, 5, 6. The lady with the soft voice was smiling down at him, trying to look encouraging from behind her mask. 7, 8, 9, 10. Right.
He was still awake. The realization of this arrived in his brain at the same time as it filled the operating theatre, so that the shock in one was perfectly reflected in the silence of the other. Surely it isn’t supposed to work this way, he thought. Shouldn’t I be unconscious by now? What’s going on here? He could feel the uneasiness in the room around him. “The patient’s still conscious”, someone remarked, his voice weary with displeasure. The lady’s face disappeared; he could hear her fiddling around with the instruments behind his head. Then her face came back. Was he feeling sleepy at all, she wanted to know. He smiled and shook his head.
This was a lie. The truth is that he felt exceedingly sleepy – waves of lingering tiredness ebbed and flowed within him. It would have been easy, in fact, to give in to them, except that it felt like surrender, and the thought of being entirely at the unknown’s mercy frightened him. So he fought the drowsiness, riding above it the way a surfer rides a wave, moving from side to side to keep from getting trapped in it. If he didn’t tell the lady all this it was partly because he didn’t have the strength left to put all this in words, and partly because he knew what her answer would be – she would not understand, she would urge him to let go, to give in. And that he was not prepared to do.
Meanwhile, a hurried conference was taking place between the doctors. He turned his head to watch. Phrases like ‘unexpected resistance’ and ‘enhanced dosage’ floated back to him. Then the soft-voiced lady was at his side again, making some adjustments to the equipment, then offering him the gas mask. Not to worry, she told him, as she slipped it on. This happens sometimes. Just breathe nice and deep, and we’ll have you out in no time.
This time the smell of the gas nauseated him. The drowsiness was stronger now. It felt like a blanket, smothering him. He fought for consciousness desperately, closing his mind over it like a boy closing his fist over a small coin, unwilling to let go. He could sense the fingers of the gas plying at him, feel the soft seduction of their promise. And he knew he had to resist.
…9, 10. The silence in the room was longer this time, more shocked. The eyes of the doctors stared at him from over their masks in frank disbelief. The soft-voiced lady had turned pale. In her voice, when she spoke now, there was an anxiety barely held back, as though she too were struggling to keep control of herself. Was he still not feeling sleepy, she wanted to know. He shook his head, though the effort, taking away from the single-mindedness of his defense against sleep, cost him a lot. She stared at him in open bewilderment.
Another huddle of doctors, the voices louder this time, more frantic. “Impossible” “Medical marvel” “Never heard of such a thing” “How can this be?” The words filtered slowly into his head. And a new feeling seeped in with them – pride. He was holding out against them, he had them foxed. He had not thought this was even possible. Had anyone ever managed this before? Perhaps he was the first. The thought put new strength in him. “Can’t take the risk of administering any further; I’ve already given him more than I should have”. This from the soft-voiced lady. So he was safe. For now.
A few more minutes of whispering, and then one of the doctors came over. “Do you still have sensation in your body?” the doctor asked. He shrugged his shoulders. He didn’t know. The doctor pressed a hand to his side. “Can you feel my hand against your side?” He could, but the touch was very faint, as though it were coming through a dozen sheets (Wasn’t there a fairy tale like that?). He wasn’t going to admit to it, of course, that would only make them give him more of the vile anesthetic. He shook his head. “No feeling, absolutely none?” He shook his head again. No. None.
Another whispered discussion, though this time the relief in the room was palpable. The doctors had found an answer, an explanation; they were happy. One of the doctors still held back. “But he’s still awake”, he said, pointing to his face, his eyes. He was overruled, the eagerness of the doctors to get on with the operation almost unseemly, like the haste of priests preparing for an important sacrifice. “Patient response satisfactory” he heard the soft-voice lady say. Another doctor said something about “some sort of freak hysteria”. At any rate, the white coated figures were soon back in their places. Someone placed a cloth lightly over his head to keep him from seeing. Then the surgery began.
The pain was immediate and excruciating. There was a quick stab of it first, piercing his side, followed by a regular metronome of agony, as though he were been sawn in half. It was a good thing for him that his face was covered, otherwise someone would surely have seen him blanch. As it is, it was all he could do to keep from crying out, biting down on his own lips to keep the scream from escaping. This was what he wanted, he reminded himself, the pain was important, it was proof that he was alive. Consciousness itself was pain. It would be easy for him to stop this, easy for him to shout or raise his hand and have them put an end to his suffering. But how would that be different from that other option, that other surrender, the one Sita would have wanted, the one that would allow him to escape life itself. No. He would not, must not give up on this now. The pain made the tears trickle from his eyes. He gritted his teeth and held on.
And so it went. As the doctors pulled and struggled to get the cancer out of him, to rid his frail, wasted body of the evil that had taken hold, he fought his own battle, struggled with his own anguish. As the storm of the operation pitched and tossed the battered ship of his body, he wrestled with this other enemy, locked away in a secret hold, the agony an arrogant intruder that he pinned down again and again, trying to make it surrender. His was the real fight, he wanted to tell them. That thing they were cutting out of him was only a symptom. The real disease was here, in the mind – the fear of pain, the temptation to give in, to give up. Those were the things he needed to be cured of.
After a while the pain grew quieter, gave way. Was it the anesthetic taking hold? Or was it that the main part of the surgery was now over and the rites of closing up seemed like pin-pricks to one who had borne so much worse? Or perhaps, (could it be?) his mind was really winning? In the battle between will and instinct, the mind was finally having its way?
It was a long, long time before the hands working away at him finally came to a halt (the procedure was supposed to be two hours long, he remembered them telling him; it felt much longer). There was no agony now, just a terrible raw ache in his side. The towel placed over his face was lifted. The soft-voiced lady peered down at him, starting a little in shock to see his eyes staring back at her, the blood on his lip. Did she understand what he has just been through, what he had achieved? He wanted to tell her. Wanted to say, I can feel! I felt it all! I survived! But his mouth felt too dry, too hollow, and his lips, when he managed to touch his tongue to them, tasted of salt. She nodded down at him anyway, her eyes kinder, more understanding, now that the big light over the operating table had been switched off. “It’s alright”, she said, “the operation was a success. You’re going to be alright.” He nodded. He wanted to tell her that he knew that, that it was he who had made that happen, but she had already turned away. He lay back on the table waiting for them to come and fetch him. With the great light off, he realized he could finally see the ceiling of the operating room. It was a beautiful, pristine ceiling, a ceiling of pure scrubbed white. He smiled. Then, as the clatter of the stretcher was heard in the distance, he shut his tired eyes, and finally, after so long, allowed himself to sleep.