Between the Lines
Sir is on life support, and I have told his family. Now we must consider where we go from here.
It’s a conversation I have to get right first time, and without intimating my personal connection with him. We have a contentious history, Sir and I, and with nothing resolved, I’m in two minds myself about what should happen next.
It was Sir who taught me the importance of getting things right first time. Life is easier when we do, he said. Death too, though I don’t suppose that was in his head back then.
And yet, for all I know, those glioblastomal cells in his brain might already have begun to stir.
Like all cancers, this one begins unnoticed.
It is the same with obsessions.
I observe him in the bed, his body replete like a sponge, the face bloated, arms and hands swollen with fluid and failing circulation. On the respirator his breathing is slow and heavy.
He is hooked up to attachments that keep him alive, and a morphine drip for his pain. Without the morphine he might imagine he was buried in sand up to his neck, his face smeared with syrup, and a million fire ants had chewed their way through his eyes, lips and nostrils to get at his brain.
But Sir feels nothing.
That is exactly how I remember him.
His family are bearing up, perhaps more troubled by what I’ve left unsaid than by what I told them. They’re difficult to read, but I sense that their attitude to this man—this husband and father—is strangely detached. How will this affect our conversation, I wonder.
“I regret to tell you that even if he survived another surgery he would not have much of a life.” I use the conditional because it has an undertow of unlikelihood that what’s being discussed will be allowed to happen.
“How much, Doctor?”
It’s the son who asks, an image of his father at that age—blunt features, nostrils dilating at any hint of challenge. That’s how I remember Sir, a face ready to go a few rounds.
The daughter sits erect, knees together, hands folded on her lap like she’s in church. She wears no make up, and I imagine her face would be pretty if she smiled and didn’t have to peer through that fringe. But this is not a time for smiling.
The mother sits stony-faced and stares across the bed at her son, content for him do the talking. She seems accustomed to being spoken for.
Sir liked to be in control, I recall.
“His mobility would be restricted.”
The son angles his head. “A wheelchair?”
“A fully loaded one. With all that entails.”
He nods. The mother looks away. The daughter stares at her feet.
“Communication would be minimal.” I slowly shake my head. “His bodily functions….”
Seeing no reaction, I apply a last turn of the screw. “Though even in this state he could survive for a time.”
“How long?” The son again.
“At the outside, a month.”
“And at the inside?”
I look at him. “Any time.”
The daughter raises her head.
He looks at her, then at his mother.
It doesn’t have to be like this, are the words I’m not allowed to say, but I believe the daughter has cottoned on.
She looks at me, big-eyed under her fringe, alpaca-like. Her voice is soft. “Our father was—I’m sorry, our father is—a religious man, Dr. Mishra. I suppose you know what that means,
given your own…given what I imagine to be…. You are Hindu, are you not?”
I shrug. “Not so much anymore.”
She nods. “Anyway, the choice is not ours to make. Nature must take its own course, however long that is.” She glances at her brother, then at her mother, like she’s spoken out of turn.
The mother stares. It’s the son who speaks. “Are you offering us a choice, Dr. Mishra?”
I shake my head. “I am only describing to you the situation. It isn’t for me to offer a choice. It’s for you to tell me what you want.”
Removal of life support is all I’m permitted to do. Beyond the law—though perhaps not beyond the spirit of it—I can give nature a nudge, for dignity’s sake.
“Can we have some time alone, please, Doctor?” The daughter again. She seems to be the main advocate against fine-tuning God’s plan.
“You must take all you need. Call me on my extension when you are ready.” I get up and go out, drawing the curtain behind me.
In my office I take out the medical file on Arthur Rankin. The Rankin file—how apt for the record of an ordinary man. Aged seventy-five. Occupation: teacher (retired).
His subject was physics—I recall his fondness for immutable laws during our one and only standoff at Grantham.
I was fifteen when my parents packed me off to boarding school in Canada. Our Punjabi State remained unstable into the late ‘Eighties, and they were anxious for us to join our extended family in Toronto. My uncle had recommended Grantham Academy in Welland, and offered to put me up in the holidays until my parents could leave India themselves. It would all work out, they said.
But they reckoned without me.
A self-absorbed adolescent, I took my exile personally and resolved to resist all attempts to educate me. Grantham’s reputation was in better shape than its facilities, so I had plenty to moan about in my first letter home.
At assembly early in the first term, the headmaster announced the launch of a capital campaign to raise millions that would take the school into the twenty-first century. I remarked to my roommate sitting next to me that the school had a decade left to become part of the twentieth century, never mind the twenty-first. He snorted aloud, drawing glares from the teachers seated up on the stage, and planting the idea in my head that maybe I could survive this place as cynic-in-residence. I would challenge the pointlessness of everything while fending off those among my peers who liked to poke fun at my accent and pigmentation.
My verbal adroitness gave me a leg up. Seven years spent at the English school in Amritsar familiarized me with more than just the spoken word. I became adept with the unspoken word as well, its layers of inference, inflection and nuance—language we don’t see but hear well enough.
When I wasn’t taking down my peers, I drooped around the place, sullen and unapproachable. I thought only to bide my time until something different happened.
I was there, but not there. Literally, on the day of the school photo. My roommate dared me to appear twice in the panoramic photo by timing a dash behind the bleachers, in synch with the slow swing of the camera at the front. But I took off too early, and arrived too late at the other end; so I never appeared in the picture. There and not there.
Until Sir got involved.
As my academic advisor—a meaningless role to most teachers at the school—he occasionally did evening duty in my boarding house. I remained at my desk the nights he was on, and turned only to nod when he put his head around the door to see if I was working.
One evening my housemaster informed me that Mr. Rankin wanted me to report to his classroom before chapel the next morning. Something to do with my French.
I was annoyed at having to eat breakfast earlier than usual. No one else I knew had been summoned to appear on parade before chapel. What did a physics teacher have to do with French anyway?
He glanced up when I appeared in his doorway. “Ah, Mishra. Come in. Sit here if you would.” He pointed at a desk in front of him.
He said “Ah, Mishra” like he was surprised at my arrival. I hated the way teachers addressed us by surname. My grandfather had spoken of the practice when he served as a sepoy under British command in Burma. Ah, Mishra.
I walked to the back of the classroom and found a desk.
He was turning the pages of my exercise book and didn’t look up. “Please come to the front,
“If it’s all the same to you, Sir, I’m comfortable here.” I fixed my eyes on him.
He looked at me. Then he stood, walked around to the front of his desk and leaned against it, never taking his eyes off me. “I’m not here to make you comfortable, Mishra.” He held up my exercise book so I could see all the red ink. “Now come to the front.”
“Whatever you say, Sir.” I got up and moved to a desk under his nose. I wanted to provoke him now, make him cross a line so I could report him. “It’s your show.”
He nodded at my exercise book. “Monsieur Gagné said this latest effort illustrates what he calls a desultory and disinterested attitude. Other teachers have echoed his sentiment. What do you say to that?”
“My attitude is uninterested, not disinterested. Disinterested means—.”
“I don’t care what it means, Mishra.” The nostrils flared. “You know what Monsieur means and that’s all that matters. Now what do you have to say?”
“Well, I suppose I should feel disappointed in teachers who complain behind my back, but I don’t.”
“And why is that?” He looked uncertain now.
“Because they’re only living down to my expectations.”
He took a deep breath, then pulled a chair over next to me and sat down. He laid out my exercise book and put a finger on the page. “Tell me what’s wrong with this word.”
I shrugged. “Is it missing an accent?”
“Okay, grave. Whatever.”
“So why didn’t you add them?”
“Because we know what the words mean without them. Accents are a waste of time.”
He nodded. “So you’re able to rewrite the rules of French before you’ve even learned them. Is that right?”
“You’re always right, Sir. Like everyone here.”
He nodded again, then pointed at another sentence. “What’s this word?”
“Mur. It’s French for ripe.”
“No, Mishra. Mur is French for wall. With a circumflex it’s French for ripe. But you don’t bother with accents, do you? Have you a French dictionary?”
He placed a finger on another sentence. “Is this word spelt correctly?”
“Monsieur has circled it in red, so you tell me.”
“Did you think you spelt it correctly when you wrote it?” I could hear the tension in his voice.
“It’s close enough. You know the word from the context.”
“And if a misspelled word turns out to be another word that means something completely different, what happens to the context?”
“The reader will be intelligent enough to figure it out.” I was enjoying myself now.
“And will this omniscient reader figure out that when you wrote poison you meant fish, and when you wrote horse you meant hair, and worm when you meant glass, because in French one is only a misspelling of the other. Does that matter, do you think?”
I looked at him and shrugged once more.
“You don’t care?”
“Not much.” I smirked. “So, tell me, Sir, does that make me disinterested or uninterested?”
The nostrils dilated again, but he said nothing. He closed my exercise book, flipped it onto my desk and stood to go back to his own.
He looked pleased, like he’d won the round, having likely got a quick tutorial from Monsieur before our meeting.
Looking back now, I wanted to make him regard his life as unhappy and pointless as mine.
So I went for him. “If you’re so clever, Sir, why didn’t you do something worthwhile? Why did you settle for a high school physics teacher when you could have been a rocket scientist? You could have probed Uranus or something.”
His face tensed. But his voice was steady when he spoke. “Because teaching high school physics is important to me, Mishra. Do you know of anything that might be important to you? And do you realize you’ve spent the last ten minutes finding creative ways to defend being lazy? You worked harder to excuse your wrong answers than you’d have done finding the correct ones. Why not get it right first time? That would be clever, don’t you think?”
Then I saw his eyes narrow and realized he wasn’t finished.
“The trouble with you people, Mishra, is you come here expecting it all to be done for you.”
My breath caught and I felt a hole in my solar plexus. I thought to smash my fist into his face, but I was unable to move, or speak.
He looked across his desk at me, claiming his spoils. And I understood exactly what they were. Had he said people like you, Mishra, it would have been different. But you people meant my Indian-ness. My family. And I had compromised them all.
You people. My anger receded before a hot flush of shame.
I had made it all too easy for him. I hated him of course, but I hated myself more for
legitimizing his slur. That’s what I felt, and I had no comeback.
“You’ll show me your French homework every morning before you hand it in.” He stood up. “Now it’s time for chapel.”
I remember neither the entrance nor recessional hymns, nor the homily between. I conducted my own service in chapel that morning, a combined antyesti and namkaran. I laid to rest Arjun Mishra, the feckless adolescent who tilted at windmills, and incarnated Kumar—my middle name—to replace him.
Kumar would get it right first time and make his family proud.
Sir and I avoided each other after that. Even in my final year when I was assigned to his class we talked only physics. He was a competent teacher, and my top mark contributed to my winning the academic gold medal. My French was up to speed by then too, and served me well during six years of medical school at Université Laval in Montréal.
But I always wondered if he regretted saying those words. When I received my acceptance to study neurology at Johns Hopkins I wrote to him. I wanted neither to acquit nor rebuke him, only to acknowledge his impact. My real wish was to start a conversation.
But he never responded, and so my fixation grew—another kind of malignant cell.
Five years on, I was appointed neurologist at the regional hospital in Burlington, and shortly after that, received an invitation to address Grantham Academy on Founder’s Day.
I had always avoided alumni reunions, having no wish to reacquaint myself with peers I hardly spoke to while I was there; now I felt unsure about accepting the invitation. It would be disingenuous, I thought.
But in the end my need to lay a ghost to rest proved too strong.
The headmaster introduced me to the assembled staff and students with the predictable hyperbole. I knew he would showcase my success as proof of the school’s mission statement. To counter his theme of exemplary round pegs slotting into Grantham’s round holes, I spoke self-deprecatingly of being a delinquent square peg who never really fit in. It went down well enough.
Sir attended the reception afterwards, but I had no opportunity to take him aside until near the end, when I spotted him on his own. I approached him, not at all sure what I would say.
Fifteen years had aged him. His hair had thinned, like his face, the blunt features a little slackened, the complexion paler.
His eyes narrowed as I walked up to him, and he gave a kind of smile. “Ah, Mishra,” he said, shaking my extended hand. “Doctor Mishra, it is now, isn’t it? How well you’ve done.” He squeezed his eyes shut. “Such a credit to our school.”
The smile was almost smug, like that morning in his classroom when he rounded on my failures. He was now claiming the spoils of my success. I had wanted to bring up my letter, and ask him if he ever received it, but his manner now made me think the question unnecessary. Of course he had read my letter. I had regretted sending it then, and I regretted speaking to him now, which was funny because I hadn’t said anything yet.
What I did say then surprised me—it was out before I could stop myself. “Vous souvenez-vous que vous m'avez dit, M. Rankin? Cet matin dans votre classe quand vous m'avez réprimandé pour mon français?” I smiled.
“I’m sorry. What was that?” His eyes lost focus, like he was looking at something behind me.
“I said do you remember what you said to me the morning we discussed my French homework?” I managed to keep my voice steady.
He shook his head. “You must remind me.” The nostrils dilated for a second, long enough to tell me he knew. Then he closed his eyes and smiled again.
Whatever card I played he would trump. If I reminded him of his slur he would deny it, or tell me he only made it to turn me around. If I pushed him further he would attempt to make me feel small for nursing a grudge all those years.
I could see the headmaster standing to one side, watching us. He too was smiling, no doubt pleased to observe the noted neurologist reconnect with a teacher who had inspired him.
I shook my head. “It doesn’t matter, Mr. Rankin. Good to see you again, Sir.” Then I crossed over to the headmaster, thanked him and excused myself—I had an early surgery in the morning, I said.
I slipped away feeling as I did fifteen years earlier: relieved to put Grantham behind me. Relieved, and still resentful.
Fifteen years later Sir and I are together again.
The family have called to say they’re ready to talk.
They are again gathered around his bed when I arrive. I draw the curtain behind me, then glance at the monitors and check that his attachments are in order.
The daughter speaks. “Dr. Mishra, if you remove those things that are keeping him alive how long will he survive?”
I look at her. “That would be for God to determine.”
She nods and looks at the others. Her mother stares at the man connected to the machinery like she’s trying to recall where she’s seen him before. Her brother glances at her and nods. She turns to me. “Then we would like to sign.”
I nod—we’re all bobble-heads now, everyone nodding—and I ask them to accompany me to my office.
The document states that the undersigned permits the hospital to make the patient’s withdrawal as painless and natural as possible. The sub-text is less explicit. Son and daughter read through it once more, then pass it across to their mother to sign. She hands it to me when she’s done.
No one speaks.
Will his death be a relief for them as for him, I wonder. Again I feel the disconnect in the room and try to imagine what kind of husband and father he was. A man who could never apologize—no, more than that—a man who felt he never did or said anything to apologize for. Is this why they have agreed to a procedure that contravenes their faith? Do they just want him gone?
Should I tell them my story, I wonder. The impact he had. How he got everything right first time. But how can I know if this is what his family wants to hear? Now they’ve decided, it might only complicate things again. So I say nothing.
Like most families, they wish not to be present during the procedure. I leave them for a few minutes to say their goodbyes.
After they depart I page my nurse so we can begin.
With the removal of the respirator his breathing becomes laboured. It catches, stops for a moment and then resumes for a time before catching again—a longer interval between each breath. Eventually I hear the beginnings of the distant rattle, but I know even this is a stage that can continue indefinitely. I nod to the nurse, and she connects a separate drip to the saline tube attached to his forearm. I insert a fresh hypodermic into a phial of morphine. Drawing back the plunger I watch the barrel fill with the clear liquid.
With the nurse at my side, I refrain from actually saying the words in my head— a sort of gratitude for the shot in the arm he once gave me. I apply the syringe to his drip and depress the plunger. His body trembles intermittently, tiny shudders grasping at life. It will take another two, possibly three, doses for the morphine to stop his heart altogether.
And our account will be settled.