It was Dr. Kalam who suggested that I write a book about Dr. Kakarla Subbarao. I was a huge fan of Dr. Subbarao and idolized him as my role model. However, when I approached him, Dr. Subbarao laughed at the suggestion and said that a doctor’s life is indeed made up of his daily encounters with the death of his patients – many survive, but others depart. But upon Dr. Kalam’s insistence, he later agreed to share his insights about how we live, age and eventually die.
I would sit in Dr. Subbarao’s cabin at NIMS in the evenings and take notes. My colleague, S.G. Prasad, would be by my side. There were occasions when Dr. Subbarao was choked with emotion. I was shaken to see the pain he hid behind his smile. Dr. Subbarao unveiled to me certain things that people outside the medical fraternity would never know. He said, “Death comes through one of the five simple universal processes: the stoppage of blood circulation, the inadequate transport of oxygen to the tissues, the flickering out of brain function, the failure of organs and the destruction of vital centres. If we understand that these are paving stones that tread on by everyone, big or small, rich or poor, to his or her exit, a familiarity with them will certainly make the walk less stressed and more purposeful. If the process of death becomes just a bit more familiar, life will be less frightening.”
Dr. Subbarao wrote, “I have lived with the awareness of death’s imminence for more than half a century, and saw several thousand doors people take for their exits. I am living my eight decade. There is no way to foretell whether this is to be my last decade or whether there will be more. I maintain good health, but beyond the absence of a disease, good health is a guarantee of nothing. The only certainty that I have about my life, and by implication, my death, is another of those wishes we all have in common; I want to exit without suffering. There are those who wish to die quickly, perhaps with instantaneous suddenness, perhaps in sleep; there are those who wish to go after a brief, anguish-free illness, just long enough for everyone who loves them to be by their side. I think I belong to the earlier category. I believe in dying before death comes. The world in me must die before I in it die so that I can look back quietly and dissolve into divinity.”
I dedicated this book to my father, Krishna Chandra Tiwari. He died at the age of 49 after ten days in the ICU. A disciplined life and total abstinence from non-vegetarian food, alcohol and smoking could not prevent his coronary arteries from narrowing and chunks of his heart muscle from blood starvation. Finally, the end came when a blood clot completed the obstruction and choked off the already compromised flow. The acutely starved heart muscles generating electric impulses went into the chaotic squirming of ventricular fibrillation before settling for a final halt. My father, however, still lives in each of my 60 trillion cells that follow the code encrypted on the 23 chromosomes I inherited from him.
I consider this book the best I could have ever written. Dr. Kakarla Subbarao is 94 now and lives an active life. He continues to be my role model and I am very sure that he will exit the way he wishes to. Do read this one book for me!
