Impermanence, Death, Closures and Continuity through Body Donation

In brief, my mother died at home two days ago, on Sunday evening from aspiration pneumonia. In accordance to her wishes, I donated all the parts of her body that I could. Her eyes went to the eye bank; her brain went to the brain bank for research; the rest of her body went to a medical teaching hospital for students studying anatomy. Again, as per her wishes, her body was at no point put up for viewing, and no other rites were held.

These various body donations put a dignified, respectful and heart-warming end to a life that had been racked with challenges and deterioration for many years now. My mother looked peaceful, and it was the sort of end she always wanted, and I was glad I could respect her wishes.

Sharing below some of what happened.

The day started much as normal. My mother had been stable but deteriorating. The March beginning blood tests were normal. She had problems swallowing and would sometimes make gurgling sounds; they sometimes subsided in a short while, but sometimes needed medicines, including antibiotics. My mother was spending most of the day sleeping and not showing any interest in people around her most of the time.

It was around mid-morning on Sunday that she started the gurgling again. It seemed worse than the minor kind that subsided on its own, so we made her lie on her side, and called the doctor. Her expression showed no discomfort in spite of the gurgling sound, but her breathing was shallow and rapid. After a while, her body seemed warmer than normal.

Hubby and I surfed for gurgling while waiting for the doctor. We downloaded pages and PDF files with scattered, even contradictory information. Some people said gurgling came and went, some gave the gurglers just a few hours or days to live after it started, some gave them a few months, some said there was no correlation. Some explained that gurgling sounded bad to the family and worried them, but was not actually a hurtful experience for the patient. One document cautioned medical practitioners not to use the alternate term for gurgling (death rattle) in the presence of family members.

The doctor came, checked her, made me hear the gurgling through the stethoscope placed on her chest, prescribed antibiotics to be given via IV. He initiated the process of a nurse coming over with the IV stuff, while hubby went to buy the medicines. After a while, my mother’s gurgling reduced, and she seemed very tired. I tried to talk to her, but felt she wanted to rest. We cleaned her, and let her rest. Things seemed better with her. Meanwhile, we were following up for the nurse with the IV, and as soon as we realized the nurse would be arriving shortly, hubby went to my mother’s room to tell her that.

She was not breathing.

Hubby tried to check the breath by holding his finger, and then his mobile under her nose, and started chest compressions. I was there by then, trying to locate the pulse. Nothing. Her eyes were half-open and showed no response. The nurse arrived right then; she, too, checked my mother and said she seemed to have passed away. I promptly called the doctor; he was off for the evening (Sunday, see), so I rang up the alternate doctor, and she said she would be there as soon as possible.

As we waited for the doctor, I placed a wet cloth on my mother’s eyes; she had been particular about eye donation and other body donations. I checked my emergency bag and file and collected all I’d need to take to the hospital. We cleaned up my mother to the extent we could.

The doctor arrived, confirmed the death, gave the certificate. The brain bank was contacted to inform them we wanted to bring the body right away (there is a window within which body donations must be done). We tried to arrange an ambulance; the first party we contacted called back after a while saying their drivers were not locatable (Sunday, see). We managed to order another ambulance. The ambulance man came up with a stretcher; my mother was moved to the stretcher and then carried down six floors with the help of some persons. We followed the ambulance by car and reached NIMHANS, where the brain bank was, and where the doctors expected us and had made preparations to receive us.

I requested that the eye donation be done first, and while we waited for the eye bank doctor to arrive, the eyes were moistened with saline. Then the eye bank van arrived and the doctor got to work. Various consent forms were signed.

The second donation was the brain donation. I had signed the consent forms. The brain removal required a team, so the brain bank staff did the necessary steps to keep the body correctly overnight, and the brain removal was scheduled for the next morning. Hubby and I returned to an empty home, and closed the laptop’s browser windows full of information on gurgling.

The next morning, the doctors from the brain bank called and informed me that the brain had been removed, and that they had prepared the body for its third and final stage: the donation of the rest of the body to the anatomy department of a medical teaching hospital, where I had already enrolled my mother. I handed over my mother’s medical records and her brain scans to the brain bank doctors, in case they needed them while studying the brain. I also offered to provide any other information I had if they needed, assured them I was available, and told them that they could quote me to any potential donor who may want to know what the family feels about such donations, and may want to meet people who had actually done this type of donation.

Unfortunately, the tribe of brain donors is not large…But that is a topic by itself…

My mother died on Sunday evening; by Monday afternoon, we had completed all the formalities of the body donation, and what I had now instead of my mother was a bunch of certificates: death certificate, eye donation certificates, brain donation certificate, body donation certificate. I had seen my mother being slid into a freezer in the college mortuary.

I’ve given the functional account above, and I’ve also had some people talking to me after they heard what I’d done, and it seems that most people assume that the donation part was gruesome/ difficult/ unpleasant/ requiring tremendous courage, so I’d just like to briefly say: NO. The process was not gruesome, not difficult, and not unpleasant. It did not require great willpower or courage either.

Frankly, the donation process was the most beautiful way I could have ended the physical process of my mother’s final journey.

All through the donation process, every doctor I met was not just considerate and helpful to me, but very gentle with my mother’s body. In this final phase of her mortal journey, she was treated as someone valuable and for that I am both grateful and happy.

At one point, I saw a doctor adjust the sheet around her face with such tenderness and concern that I felt he had honored her in a way I can’t begin to describe.

When the eye bank doctor was working, I asked whether I could watch the process; it was the sort of thing my mother would have expected me to watch. I, too, wanted to be there when this process, so important to her, was happening. When at the final stage the doctor was placing cotton and closing her eyelids over it, I remembered suddenly how my mother’s eyes were always considered beautiful. Last year, when sharing memories of my mother in a blog post (My mother, a collage of my memories) I had even mentioned this.

As I watched the doctor use a saline-dipped swab to gently wipe her face, I wondered what beauty really was. So yes, eyes may look beautiful when they are large and expressive, as my mother’s eyes had been, but to me on Sunday at that late hour, it seemed that my mother’s eyes had probably never been as beautiful as they were when they were being offered for use to others to see from.

I knew at that moment that the donations I was signing consent forms for were donations I would never regret, that the whole experience was so sacred and so heart-warming that all other forms of closure paled in front of it.

When my father had died fourteen years ago, I had performed his last rites in the religious way. Being an only child, and though female, I did the steps that only sons are supposed to perform, including the tap on his skull that allegedly releases the soul (I think that’s what it is supposed to be for). Though we did an abbreviated version of the traditional process, it still stretched across days involving long lists of things to be bought from specific markets, coordinating priest timings, and what not. There had been immersion of ashes, havan, prayer meeting, stuff like that. The experience, supposed to bring closure and peace, seemed surreal at times, disgustingly commercialized at times. It left me unhappy, disoriented, and depressed, partly because of the crass materialism of many of the priests, vendors, etc., who tried to wrangle out all they could, and cheat when they could, but also partly because the whole process was so full of sadness and reminders of that.

As a contrast, what I experienced with this process for my mother was happiness and relief that my mother, who had always wanted to be useful, and whose health had thrown up extreme challenges leaving her unable to even communicate–that mother of mine ended her journey in a way matching her beliefs and her life, surrounded by respect and consideration, a fitting end to a great life.

Post referred to in this blog entry: My mother, a collage of my memories

Important note added: After my mother’s death and this blog post, I received several queries about donation, and I have therefore posted a blog entry to address the common queries: FAQ on Organ/ Body/ Brain/ Eye Donation.

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