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Tuesday, June 11, 2013

Memories Don't Leave Like People Do...

Cheenu at four

In London open-topped bus

IT'S more than six months now since I said my last goodbye to my only sibling, my brother Cheenu. It was a heart-wrenching experience because I had seen him a mere three months before when he seemed hale and hearty. The tumour started on the base of his tongue and he had difficulty swallowing even when he was in India in July-August 2012.  Amma remarked on the swelling on the right side of his neck and it was only then he told her that it had begun in July itself and that the doctor had said it might be tuberculosis. However, that test had come out negative. They had aspirated some cells from the area for testing but he said the test did not conclusively say it was cancer. That required a biopsy which he would do on his return.

He was obviously in pain but he didn't let slip a single word of complaint. He visited ENT specialists in Mumbai and in Chennai. In Mumbai, the doctor repeated all the tests that he had already undergone in the US in Mumbai, but all the result said that it was suspected Hodgkin’s lymphoma. The doctor said that since he was resident in the US, he should start treatment there.

On his 28th birthday in Mumbai - Amma, me, Cheenu, my husband Kumar
He returned with his family, wife Latha and sons Arjun and Ashwin, to the US on August 17th and was in great pain even on the flight. As soon as he reached, he had a biopsy. The result was due in a week, but he had to leave his elder son Arjun at MIT in Boston in the meantime, because his course was starting in September. He was in such terrible agony that he couldn’t even drive.  They couldn’t take a flight because of the luggage. He just dumped Arjun in college and started back immediately. The pain was too much to bear and he checked into a hospital in Boston to see if they could alleviate it in some way. They advised him to get admitted in the Inova Hospital in Fairfax, Virginia immediately to start treatment.  In the meantime the biopsy results had come. On September 12, we got the dreaded news that the tumour was malignant. On the phone, his voice was already garbled. They began chemotherapy under one of the best doctors in the US, Dr.Dipti Patel Donnelly. The tumour had meanwhile grown rapidly and spread to the base of his neck on the right side. After the first two rounds of chemo, the news was positive. The tumour had reduced in size. After his immunity levels rose they sent him back home. He was being fed through a stomach tube and his wife Latha had to learn how to clean it and fix the food bag.

He had hardly been home for two days when he had an episode of severe breathlessness. Latha called 911 and he was taken by ambulance to the nearest hospital where he was rushed to the ICU. He was on oxygen and when he stabilized they shifted him to the Inova hospital again by helicopter. Here he was fitted with a tracheal tube to aid him in breathing.  Unfortunately the next round of chemo did not work and the doctor said that they were going to try radiation.

Cheenu was extremely reluctant to have radiation since he had to keep his head flat and still and he could not do that without a lot of pain, due to the trach tube, but somehow they persuaded him. He was very uncomfortable during the procedure. The radiation left him with a grotesquely swollen face but it did not stem the spread of the cancer, which jumped to his liver. That’s when Dr.Patel said she could nothing more and sent him home! Why did she put him through the torture of radiation therapy when she knew it would be of no use?
At home, he developed high fever and was so weak he could not even go to the bathroom on his own. As a last ditch effort, my cousin Neela contacted an oncologist in Mumbai Dr.Purvish Parekh and he got in touch with Dr.Shanti Marur who was the cancer specialist at Johns Hopkins Baltimore. It was the Thanksgiving weekend and they could admit him only after a week on November 20.

This is the email Dr.Marur sent to Dr.Parekh on November 22, 2012:

Met with Mr. Srinivasan on Tuesday. He came in stretcher bound in septic shock. We admitted him at Hopkins and he was on 2 pressors and slowly turned around. As of yesterday he was still on one pressor, but more alert. The family understands the prognosis is very poor and chemo is not an option at this point. He has rapidly progressing disease in the liver and left neck, base of tongue. This has not responded to TPF a toxic combination. Second line therapy after this would be less responsive and would require at least a doublet. Family aware more chemo will not prolong survival and would in fact increase his risk of succumbing to the underlying septic shock. Very sad situation... But wife and family are all on board and I think the visit to Hopkins is giving them closure. I was hoping I could help in some way, but situation is not salvageable.

 Thanks again for the referral,
 Best
 Shanthi

I had wanted to leave the moment I got the visa on October 25th but Cheenu and Latha discouraged me saying that if I came in January when he was home, it would be a bigger help. Her parents were already there. I wish I had not listened to them and just gone. I lost one month of precious time which I could have spent with him. Maybe if he had seen me it would have lifted his spirits. I had also started going to Siddhivinayak temple on foot everyday from October 9th to pray for him and said I would come for 45 days. That got over only on the 22nd of November. Latha felt that I should not break the vow and come to the US before it was completed. 

I had many ill omens and good omens during these 45 days. Once, the pujari gave me an empty coconut shell. Twice I got to see the evening aarti unexpectedly. Once I found Baba’s photograph lying on the table near the entrance. But after 15 days of walking daily, I suddenly developed a painful nerve compression in the right leg which curtailed my original walking distance from Antop Hill to Prabhadevi to the distance from Portuguese Church to the temple. At the Satyanarayana Puja held in our home, the flower that the pujari told me to offer to the lamp, fell directly on the flame and extinguished it. I had thrown it gently, but it was as if some force pulled it forward and dropped it on the flame even though the entire lamp was covered by a glass.

We consoled ourselves that a miracle would happen and he would be cured and that Baba would not forsake us in this hour of need. He had cured so many people of cancer and even brought people back from the dead. Would He not give my brother a lease of at least five more years of life?

Finally I got the call that he was in a critical condition and that I should come! I left on November 24rd early morning. The previous day I had made 108 modaks and offered it to Ganapati since it was the last day of my mannat. Every day I had offered 9 home made modaks to him as part of the mannat. So I made 44 x 9 x 108 modaks, more than I had ever made in my whole life! Why, oh why didn't Ganapati listen to my fervent prayers? 

I reached on the 24th at 5 p.m. The whole journey went in a daze. I was in tears most of the time. It was my first trip abroad, my first trip to the U.S., my first visit to see Cheenu. Why did it have to be in this most terrible of circumstances? Why hadn't I gone in more joyous times?

When I met Latha outside his room, she said, “Don’t be shocked. His appearance has changed a lot.” 

Still I wasn't prepared for the sight of my handsome brother ravaged by the cancer. I controlled my reaction and my tears because I didn't want to traumatize him further. I tried to make inane conversation about a book I had read on the flight. Idiot me! I held his hand tight. I applied the vibhuti and the homa ash on his forehead. I stroked his head and arm but he said he didn't want me to touch him. His old allergy to any physical display of affection surfaced even then! “Your presence is strength enough,” he wrote.

He could not speak because of his swollen lips, neck and throat. He could not breathe without the aid of a tracheal tube and he was being fed through another tube in his stomach. His once luxuriant crop of hair had fallen out. I saw him without that bushy moustache after maybe 30 years. The sparkle in his beautiful almond eyes had dimmed. His eyes were swollen and dull. He was so weak that he could not even hold a pen in his hand. He communicated by writing and it was an illegible scribble. He had been writing in a diary for the past 2 weeks because he could not talk. The swelling and the tracheal tube made it impossible. The guy who was used to talking nineteen-to-the-dozen had been silenced. 

“I want to see my sister” he had written on one page. I am heartbroken even now that I didn't go to see him a month before. Now it seemed I had come to watch him die – most cruel, most cruel, the cruellest of all situations – seeing a dear one dying and not being able to do anything about it.

All I have now are memories of him which are more precious than jewels. I will dearly miss his nonstop talking, his jokes and jovial laughter, his love and concern for everyone, his patience and his reluctance to hurt anyone with word or deed. Conversations with him were never ever boring. He had a fund of knowledge and a keen curiosity about all things. Mom remembers him watching the TV show Jeopardy when she had gone to the US to look after baby Arjun, and his getting every answer right!

He got me my first pair of jeans from the US – a Gloria Vanderbilt which fitted perfectly! He got me a music jewellery box which I still have. Even on his last visit (did he know it would be his last?), he got me my favourite peanut M & Ms and Clairol shampoo as well as Banana Nut Crunch cereal. I had taken him to task about not visiting Amma after she had a stroke in September 2010 (the same year Appa was in hospital for a month in May and he had come then). I now wish I hadn’t been so harsh.

When he was here last in August 2012, he used to say, “Jayanthi don’t go home yet. Stay and talk to me.” How I wish I had…How I wish I had remained to hug him! Regrets, regrets and more regrets...how foolish we humans are. 

He was so good with machines and gadgets. Our Physics teacher in school used to say, 'Your brother is a master in Physics.' I don’t think Amma ever gave any appliance outside for repair. He was very handy around the house a quality I guess he got from our Dad.

He had a wonderful creative imagination. I remember a school composition in Std.10 in which he had written about the how a beer factory shut down because 'the yeast went on strike'!

He was a wonderful father who wanted to give the best to his two sons, whether it was answering their endless questions, taking them to tennis, swimming and piano lessons and concerts, attending each and every event they participated in at school, taking videos of their performances. He was so proud of both of them and his conversation would be peppered with talk of their achievements.

He adored Latha (it was always Lathu this and Lathu that when he spoke to her) and was always concerned about her reaching office safely. He would call her as soon as he expected her to reach, so that even her colleagues teased her about it! He refused to let anyone else stay with him in the hospital.  He admired her genius in Maths and always said that she was the one who was responsible for their sons being such high achievers.

He called me on New Year’s 2012 to say that Arjun his eldest had got admission in the best university in the world – MIT at Boston.  He couldn’t contain his joy and pride. He would have been so happy to know that Ashwin his younger son has got into Thomas Jefferson High. He had given the entrance test when Cheenu was in hospital.

Cheenu darling, we hope you have found eternal happiness and that your soul has found peace and rest. It is obvious that God loved you so much more than we did because he took you back sooner than we expected. I am so proud and happy that I had you as my brother. I will miss you dearly and will never forget you…

PS We were almost twins – he was born on July 26th 1958 and I was born exactly one year, one month and one day later on August 27th 1959.

If Tears Could Build A Stairway

If tears could build a stairway,
and memories a lane.
I would walk right up to Heaven
and bring you back again.

No farewell words were spoken,
No time to say "Goodbye".
You were gone before I knew it,
and only God knows why.

My heart still aches with sadness,
and secret tears still flow.
What it meant to love you -
No one can ever know.

But now I know you want me
to mourn for you no more;
To remember all the happy times
life still has much in store.

Since you'll never be forgotten,
I pledge to you today~
A hallowed place within my heart
is where you'll always stay.
 Author: Unknown