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Sunday, February 14, 2016, Falgun 2, 1422 BS, Jamadiul Awwal 3, 1437 Hijri

Delaying the inevitable death
Tapan Chakrabarty
Published :Sunday, 14 February, 2016,  Time : 12:00 AM  View Count : 412
'What am I going to do with these two young boys?' mother wailed in a broken voice, banging her right hand on the ground, which was shaded and fanned by the shivering leaves of a shelled-coconut tree in the yard. Seated next to her were brother Swapan, 13, and I Tapan, 11, both shell-shocked and clueless as to what lay in store. There on the ground, shrouded in a white hand-made quilt, lay the stiff body of Mr Aswini Kumar Chakrabarty, a Sanskrit teacher, who only five hours earlier had been getting ready for classes, wearing a dhoti and a punjabi, as he had done in many other mornings, since the foundation of the famed Matlab J.B. High School in 1917. A couple of hours earlier, headmaster, Mr Waliullah Patwari, wearing a lungi and a punjabi, had called me out from a classroom, where I, wearing a short pant and a half-sleeve shirt, was gripping a fountain pen with three tired fingers, while writing a grade-six final exam. Arriving in our house together, headmaster paid final tribute to his 'golden pundit', and the pundit beseeched his headmaster and bosom friend of many years to take care of his two soon-to-be-orphan sons. With eyes welling up, headmaster then left for the school, leaving others in the room in tears. Within an hour or so, father's soul departed his body. Mother screamed. Birds fluttered away. The mango and guava and coconut trees in the yard shivered. A pall of sadness engulfed the sky of Matlab village in East Pakistan (now Bangladesh).
Mother was delirious. She was saying how much father had loved the family and how difficult it would be for her to raise her two children by herself. She seemed to be also suggesting that father somehow was at fault for contracting and succumbing to cholera, and that he should have delayed his death until we finished our education. Blaming the deceased for his or her death by the surviving loved ones was not an uncommon practice in the village. It was kind of a defence mechanism for coping with the terrible loss. Some would go as far as declaring the deceased as an enemy of the family, or as a dacoit who had just robbed it of peace and stability.
Death, no doubt, is cold, cruel, and devastating for the families when it strikes. For living beings, it is a certainty waiting to be certain one day, for some sooner, for some later, but always certain in an uncertain time. Humans and doctors might delay death to some extent, in some cases. Delaying the inevitable, if possible, however, is desirable, at least for the sake of the vulnerable children, left behind in the cruel world by the departed. If death is cruel, then leaving young children fatherless (or motherless) is its most heinous act.
Despite all the cultural and spiritual myths and mysteries surrounding it, death, to doctors, is nothing but the heart ceasing pumping oxygen-rich blood --- be it because of an infection, heart attack, stroke, or uncontrolled growth of cells (cancer), among other maladies --- to vital organs and other parts of the body. Without oxygen, life is dead. (Doctors also declare one dead when the brain has stopped functioning altogether, even if the heart may still be kept pumping, aided by a ventilator.)
Since birth, humans are at constant war with diseases. The human body is a spectacular machine, with built-in defence (immune) systems. Those defences alone, however, are not always adequate. The body has to rely on external interventions from doctors in its war against deadly diseases, in the same way the Mujib Nagar Government had to rely on India's military intervention to reinforce the Mukti Bahini in the 1971 Bangladesh Liberation War against the genocidal Pakistani army.
As a chemical engineer, I marvel at my fist-sized heart, a pump that has been pumping blood non-stop for 66 years, the past 15 years of which working even harder to supply more oxygen to the muscles, while I was running close to 27,000 km (including training prior to each of the 29 marathons I ran) in seven continents. It is outperforming a human-made pump in an industrial plant, which lasts merely 10 to 30 years, even after scheduled maintenance and being fitted with replacement parts. I am also amazed at how my narrow arteries carry oxygen-rich blood for as many years continuously, outperforming the pipes in an industrial plant, which get plugged up and require scheduled pigging or cleaning.
Just as sticky debris build up on the interior walls of industrial pipes, clogging them up, plaques --- comprising cholesterol (waxy material), calcium, fat --- build up on the interior walls of human arteries, clogging them up, restricting oxygen-rich blood flow to the brain and the heart and other parts of the body. A piece of a ruptured plaque may create a blood clot, which may, in turn, trigger a heart attack or a stroke. Stroke and heart attack are caused by stoppage of oxygen-carrying blood flow to the brain or the heart, respectively. Fortunately, causes of, diagnostic tests and prescriptions for stroke and heart attack are also strikingly very similar, making management of both diseases somewhat easier.
Unfortunately, heart attack and stroke are number one and number two killers, in that order. They are also 'silent killers', striking surreptitiously and suddenly. 'Tapan, your brother (Swapan) was well at night. Got up in the morn and went to the bathroom to get ready for office. Then a thud and we rushed ?' My sister-in-law from Avadi near Chennai, India, described how the tragedy of a fatal stroke befallen her family on one February morning in 2012, a day after the Swarasati (the Goddess of learning) Puja, in which brother was active as the secretary of the puja committee.
Prevention is to arterial blockage in a human body as scheduled maintenance is to blockage in pipes in an industrial plant. Both are needed. We, however, are not as diligent when it comes to keeping our arteries clean. We do not seem to have time for prevention, when we have a plenty of time for watching a cricket game, or a football match, or browsing Internet, or corresponding in social media, none of which does much for our well-being, except to make us feel good, fleetingly, when our team wins (or feel depressed when it loses) or when we get too many 'like' on our postings. We may, subconsciously, rely on money or medical insurance, should something go awry. We may also be depending too much on doctors' capabilities and medical science's advances. This we do, despite being reminded by some doctors that they cannot cure all diseases and complications, and that for a stroke or a heart attack, there is but a short window of time, beyond which not much can be done.
Prevention has to be a person's responsibility. Doctors do not always stress prevention. Medical training and practice both seem to be more focussed on cure or temporary fixing than on prevention. None of my family physicians in Canada ever advocated the value of prevention to me. There could be a conflict-of-interest between a patient's interest in his health and a doctor's interest in his or her bank account, or a private hospital or a pharmaceutical company's push for profit.
The push for profit by private hospitals and pharmaceutical companies is evident from stories in TV, Internet, or in print media. It is also raised by some candidates in recent US Presidential debates on the topic of increasing health care costs. We had a first-hand experience of this push in such a hospital. When in Houston on an assignment in the late eighties and early nineties, our son, aged 8 then, was hospitalized for an asthma attack in a private hospital. We were taken aback by the attention he was receiving. After his regular medicine (nebulizer), he was feeling fine, and was ready to go home. But doctors and nurses won't let us. Tests after tests continued. We finally left, with doctors and nurses following us in the hallway, warning what a serious mistake we were making. The bills continued coming for days. Fortunately, insurance covered most of it.
Despite all the advances in medicine and knowledge over the past few decades, not much prevention is being practiced by many of us. Plaques continue to build up on our arteries, clandestinely without raising any alarm or causing any pain. Then the unthinkable strikes! The news of a young engineer succumbing to a stroke or a heart attack in Calgary or elsewhere pains me. It pains me even more when I think of the uncertain future that lay in store for the young children left behind. Distressing memories of what befell us two brothers, since father's death, surface from the deep recesses of my mind.
My brother Swapan, one year after our father's death, decided to forsake his top-grade East Pakistan (now Bangladesh) Board scholarship for the uncertain lure of India, supposedly a 'haven for the Hindus', following the partition of India in 1947. But it did not quite turn out that way for him. Father's most beloved son was physically and mentally abused by our step-brother's family, whose cruelty extended to denying him entry to their house, the night before his grade 11 board final physics exam. With poor marks in physics, his dream of becoming an engineer was dashed. 'If your father were alive, he would never let Swapan go to India,' mother used to bemoan. 'If I were in Bangladesh I would be an engineer,' Swapan intimated to me more than once, many years later.
Discouraged by Swapan's misfortune in India, Mother and I stayed in East Pakistan, where as a merit scholarship student, I studied in a great school under the tutelage of the greatest headmaster in the history of the country, and at BUET, the best university in the country, graduating from there as a chemical engineer at the top of my class (1971 batch). Father's absence, however, affected my health and study. I used to feel twitches, squeezes, and spasms in my throat, spine, lower abdomen, groin, and brain --- all psychosomatic symptoms, presumably caused by lack of nutrition, stress, societal injustices, and living penniless (paisa-less) for nine months as a refuge in India in 1971. During those turbulent times, two inspirational mantras kept me afloat.
A calm voice of reason and reassurance used to ring in my head, once in a while. It could very well have been that of the soul, which had left the body of the only bread (rice)-earner of the family, then living peacefully in a tiny tin-roofed house with two windows, until that dreadful day in 1961. The house did not have much furnishings, but it was filled with familial love and sounds of Sanskrit (the root of Bengali language) mantras, uttered by father in his morning and evening prayers; of mother's reciting the epic Ramayana, in which Rama and younger brother Lakshmana of Ajuodhya, India, crossed the ocean to Sri Lanka to fight Ravana, who had kidnapped Rama's beautiful wife Sita; and of studying by two Matlab High School students, Swapan and Tapan: the former double-promoted and the latter a top-of-the-class.
Sadly and suddenly, the family peace had been shattered into pieces, one morning in 1961, leaving us two brothers in the lurch, and separating Swapan from the family, a year later.
A strange sequence of political events: the 1970 Pakistan election, military crackdown, declaration of independence, and mass migration, forced mother and me to take refuge in India, along with ten millions of people fleeing for their lives. The 1971 Bangladesh Liberation War, a war for the separation of the east wing of Pakistan from the west, ironically, united, after nine years, us with Swapan, then subsisting on a bare-minimum allowance as an apprentice, getting training for making garments for the Indian military, which helped liberate the country of Bangladesh, nine months later. Mother and I returned to Bangladesh, where I finished my coveted BUET engineering degree. And joined the prestigious BUET as a lecturer!
Brother Swapan might have fulfilled his dream of becoming an engineer too, had father's death been delayed by just one more year or had the cholera research centre come to Matlab one year earlier. Father, with his calm voice of reason, might have succeeded in reversing his favourite son's decision of forsaking the certainty of receiving an almost-guaranteed engineering education in Bangladesh, his country of birth, for the uncertainty in another country. Father would have a winning argument in that case. After all, he himself had decided to stay his entire life in East Pakistan: for the love of teaching, for the love of Matlab School, and for the friendship of its legendary headmaster. And, most importantly, for the love of the land, his motherland! Where he wished to be and was
cremated after his death!
Tapan Chakrabarty --- a BUET chemical
engineer with a PhD from University of Waterloo, a seven-continent marathon finisher, an inventor and an innovator --- writes from Calgary, Canada. The article is dedicated to his elder brother, Swapan Chakrabarty, who died of a massive stroke in 2012

Editor : Iqbal Sobhan Chowdhury
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