After neurosurgical transversal for OCD, the improvements, if they come, will arrive with time. For patients with movement disorders the new world comes all at once, and the first sign is their hands. As the transversal proceeds, the doctors instruct them to hold out one hand and watch the tremors change. The arms start out waving crazily like hoses left unattended but then, within seconds, shudder to stillness. For the first time in years, the fingers can bend to hold a pill or a pen or just to touch lightly. Whatever possessed the muscles is gone, and while it’s only electrical impulses, it really does look like a miracle. As a matter of course, the patients weep.
One woman whose name I no longer remember did something extraordinary as she cried. In the recovery room, she sat up immediately without saying a word and extended her new hand to her husband.* Improbably, it stayed obediently outstretched, quivering only a little. The room went still. The doctors and nurses stopped their work and watched as her husband quietly extended his palm toward hers. The air between them grew warm and vanished, and then everyone was weeping in the fluorescent light.
Notes
* Nevertheless, it’s being researched with enthusiasm as a possible alternative to the neurosurgical protocol that preceded it, ablation, in which targeted parts of the brain circuitry are burned by lasers until permanently “neutralized.” Deep brain stimulation, for all its echoes of dystopian sci-fi, has the benefit of being adjustable and, for the most part, reversible.
* It’s worth noting, though, that OCD has something like a 91 percent lifetime comorbidity with other Axis-1 diseases, most commonly depression, generalized anxiety disorder, panic disorder, addiction, and anorexia/bulimia. In a study published in 2008, three-quarters of OCD patients from a clinical sample met the criteria for lifetime mood disorders, nearly 40 percent were unable to work because of psychopathologies, and 14 percent were on disability specifically for OCD. In light of these numbers, a diagnosis of OCD is plenty grim.
* In the seventeenth and early eighteenth centuries, nerves were thought of primarily as connective tissues in musculature. It wasn’t until later in the eighteenth century that the nervous system was understood to have any relationship with emotion. With this switch came the association of the word nerveswith anxiety, nervousness, hysteria, and other “morbid affections,” an evolution to which we owe dubious thanks for the nervous Nellie, Jane Austen’s exquisitely irritating Mrs. Bennett (who won’t stop mewling, “My poor nerves!”), fashionable neuroses, and Woody Allen.
* The particular metaphors that arose around neurosis, or “nervous diseases,” are suspiciously similar to the metaphors that, in Illness as Metaphor, Susan Sontag argued were associated with tuberculosis in the nineteenth century: nobility of soul, creativity, Romantic melancholy, et cetera. Sontag was unimpressed with this equation: “My point is that illness is not a metaphor,” she wrote, “and that the most truthful way of regarding illness—and the healthiest way of being ill—is one most purified of, most resistant to, metaphoric thinking. Yet it is hardly possible to take up one’s residence in the kingdom of the ill unprejudiced by the lurid metaphors with which it has been landscaped.” Later in the book, she lambasted the modern impulse to psychologize disease, declaring psychology a “sublimated spiritualism” with such sneering conviction that Denis Donoghue, reviewing the book for the New York Times, was emboldened to declare her mind “powerful rather than subtle,” a critique it might have been entertaining to witness Sontag read in the paper.
* Incidentally, since the dawn of psychotropic medications, the incidence of OCD in the general population has jumped from 0.005 percent to 3 percent.
* Two roommates, one family member, and a handful of acquaintances have reported to me, independently of one another, that they “caught” OCD after watching the television show Monk, by which they usually meant that they’d started buying hand sanitizer and color-coding their folders. These are instances of the way we subtly assume mental states can be “catching,” but also examples of the way OCD has become equated with desirable perfectionism, much as it was equated with sophistication in the nineteenth century. In certain circles, it is now a form of poorly disguised self-congratulation to profess, in confessional tones, that you are “totally OCD” about your work, your house, your record collection, eating organic. Like gluten intolerance, it’s an ailment that has taken on chic associations, especially to people who don’t really have it.
* The exact same gesture sets the events of Romeo and Juliet in motion: “palm to palm is holy palmer’s kiss.” A young man and woman press their hands together at a dance, and whatever happens just then transforms them. I think of the play as orchestrated around two thin places: the holy’s palmer’s kiss (two hands) and Juliet taking the potion (only her hand).
AMITAVA KUMAR
Pyre
FROM Granta
My mother died in Patna on January 7, 2014. We cremated her two days later on the banks of the Ganga at Konhara Ghat near Patna, more than 150 miles downriver from the burning ghats of Benares, where Hindus have cremated their dead since at least the middle of the first millennium BCE. I took notes. During the long fourteen-hour flight to India I dealt with my sorrow by writing in my notebook a brief obituary for a Hindi newspaper that Ma read each morning. I was paying tribute. But once I had arrived in Patna, my reasons for note-taking became more complicated. Grief makes you a stranger to yourself, and I was struck by this person that I saw pierced with loss. I was taking notes so that I could remember who I was in those days following my mother’s death.
A Hindu cremation is usually held on the day of the death. In Ma’s case, there was an inevitable delay. She had wanted me to be the one who lit her funeral pyre, but I live in New York; I had boarded a direct flight to Delhi and then taken another plane to Patna. It was evening on the next day by the time I reached there. My family had tried to spare me from distress and hadn’t told me that Ma had already died; but, unknown to them, before I left home I’d received a message on Facebook from a distant relative offering condolences. A large crowd stood in the dark outside our house and no one moved or spoke when I arrived. In the parlorlike space on the ground floor of our house, my father sat on a sofa with other males whom I didn’t immediately recognize. I touched my father’s feet and he said something about my luck in getting a quick connecting flight from Delhi. I stepped further inside. My two sisters were sitting on a mattress next to a metal box, their faces looking swollen; I embraced them, and when I did that the other women in the room, seated on chairs pushed against the wall, began to wail.
A white sheet and strings of marigolds covered the rectangular box, but at its foot the renting company had painted in large letters in Hindi: EST. 1967 PHONE 2219692. At first I thought the aluminum box was connected to an electrical outlet, but later I found out that the box had space along its sides that had been packed with ice. A square glass window on its cover allowed a view of Ma’s face. Her head was resting on a thin yellow pillow with a red flower print. Bits of cotton had been stuffed into her nostrils.
An older cousin took me to another room and told me that the cremation would be held the next morning. I was asked if I wanted to get my head shaved at the ghat just before the ceremony or if I’d prefer to visit a barber’s in the morning and be spared the sting of the winter cold. I chose the latter. There could be no cooking fire in the house till the body had been cremated, and a simple vegetarian meal was brought from a relative’s house. When most of the visitors had left for the night, my elder sister, whom I call Didi, said that the casket needed to be filled with fresh ice. A widowed aunt remarked that we should remove any jewelry from Ma because otherwise the doms at the burning ghat, the men from the supposedly untouchable caste who built the pyre and were the custodians of the whole ceremony, would simply snatch it away. They didn’t care, she said, and would just tear the flesh to rip off the gold. It was their right.
Ma’s nose stud came off easily enough, but the earrings were a problem. Her white hair was wrapped aro
und the stud; using a pair of scissors, I cut the hair, but the earrings seemed stuck to the skin. My younger sister struggled with one of them and I with the other. I didn’t succeed, and someone else had to complete the task. At one point I found myself saying it was better to use surgical scissors right then so that we didn’t have to watch Ma’s ears torn by other hands. Didi said of the doms, using an English term borrowed from her medical books, “For them, it is just a cadaver.” I was unsettled but understood that the doms were also reflecting an understanding that was drawn from deep within Hinduism: once the spirit has departed from the body, what remains is mere matter, no different from the log of wood on which it is placed. There was maybe a lesson in this for us, that we discard our squeamishness about death, but I felt a great tenderness as I looked down at my mother in that metal box. I caressed her cheeks. They felt cold to the touch, and slightly moist, as if even in death she had kept up her habit of applying lotion. A thin line of red fluid, like betel juice, glistened between her lips.
Having touched Ma’s body, I also felt I should wash my hands. I went up to her room. Over the past couple of hours there had been the comfort of shared tears, but now I was alone for the first time. In the room where I had last seen my mother alive and quite well, only a few months earlier, her walking stick was leaning against the wall. Her saris, whose smell would have been familiar to me, hung in the cupboard. Next to the bed were the two pairs of her white sneakers equipped with Velcro straps for her arthritic hands. Standing in front of the bathroom sink, it occurred to me that the bar of Pears soap in the blue plastic dish was the one that Ma had put there just before she died. My first notes in Patna were about these items, which appeared to me like memorials that I knew would soon disappear.
My sisters and I slept that night on mattresses spread on the floor around the aluminum box. On waking up after perhaps four hours of sleep, I saw that my younger sister was awake, sitting quietly with her back to the wall, looking vacant and sad. Under the light of a bulb near a side door, visible through the glass, stood a man with a scarf wrapped around his head. It took me a minute to recognize him. He was from our ancestral village in Champaran and had been a servant in our house in Patna when I was a boy. He had traveled through the night with fresh bamboo that would be used to make the bier on which, according to custom, Ma’s body would be carried out of the house and put on the funeral pyre.
When the sun came out after an hour, the rosebushes in the garden were only half visible through the fog, and the fog was still there on the water when we arrived at the river around noon.
That morning, while my sisters were washing Ma’s body in preparation for the funeral, my father and I went to get our heads shaved. Papa asked the barber the name of his village; it turned out that the barber’s village and ours were in the same district. My father knew a politician from the barber’s village. The radio was playing Hindi songs. Zulfein teri itni ghani, dekh ke inko, yeh sochta hoon . . . Maula mere Maula mere. The barber was a small, dark man with a limp. He was extremely polite to my father, listening quietly while he talked about inflation and the changes in the economy. At one point my father said that when he started life in Patna, he could buy a chicken for ten rupees and that now it would be difficult to get an egg for that amount.
I listened to what my father was saying with a rising sense of annoyance. I thought he was being pedantic when I wanted him to be sad—but why exactly? So that I could write down fragments of sentences in a little notebook? I began to see that Papa too was finding comfort by writing his own story of loss. There can be so much pathos in accounting. All the dumb confusion and wild fear of our lives rearranged in tidy rows in a ledger. One set of figures to indicate birth, and another set for death: the concerted attempt to repress the accidents and the pain of the period in between. Entire lives and accompanying histories of loss reduced to neat numbers. My father, with his phenomenal memory, was doing what he knew how to do best. He was saying to everyone in the room that everything had changed but the past was still connected to the present, if only through a narrative about changes in the price of eggs and chicken.
Ma’s body had been taken out of the aluminum box by the time Papa and I returned home. Her fingernails and toenails were painted red. She was now draped in a pink Banarasi organza sari and a burgundy shawl with tiny silver bells and a shiny gold pattern of leaves. There were bright new bangles on her arm. Minutes before we left for the burning ghat, my father was brought into the room where Ma’s adorned body lay on a stretcher on the floor. He was asked to put orange sindoor in the parting of Ma’s hair, repeating the act he had performed on the day he married her. Papa was sobbing by now, but he was asked to repeat the gesture thrice. Then all the women in the family, many of them weeping loudly, took turns rubbing the auspicious powder in Ma’s hair.
When we were in the car, driving to the Ganga for the cremation, Didi said that my mother was lucky. At her death, Ma had been dressed up in new clothes. Papa had put sindoor on her head, signifying that they were getting married again. Ma was going out as a bride. Had my father died first, none of this would have happened. If Ma were still living, sindoor would have been wiped away from her head. She would be expected to wear white. The women from the family who were now wailing would still be wailing, but if Ma were the widow, these women would have had the task of breaking all the bangles on her wrist before Papa’s corpse was taken out of the house.
As I listened to my sister, I understood that even in the midst of profound grief it was necessary to find comfort. One needed solace. It was possible to hold despair at bay by imagining broken bangles and the destiny that my mother had escaped. I would have found the sight of my mother’s bare arms unbearable.
I left India nearly three decades ago, and would see my mother for only a few days each year during my visits to Patna. Over the past ten or fifteen years, her health had been declining. She suffered from arthritis and the medicines she took for it had side effects, and sometimes my phone rang with news that she’d fallen asleep in the bathroom or had a seizure on the morning after she had fasted during a festival. I knew that one day the news would be worse and I would be asked to come to Patna. I was fifty years old and had never before attended a funeral. I didn’t know what was more surprising, that some of the rituals were new to me or that they were exactly as I had imagined. That my mother’s corpse had been dressed as a bride was new and disconcerting, and I’d have preferred a plainer look; on the other hand, the body placed on the bamboo bier, its canopy covered with an orange sheet of cotton, was a familiar daily sight on the streets of my childhood. In my notebook that night I noted that my contribution to the funeral had been limited to lighting my mother’s funeral pyre. In more ways than one, the rituals of death had reminded me that I was an outsider. There were five hundred people at the shraadh dinner. I only knew a few of them. I wouldn’t have known how to make arrangements for the food or the priests. Likewise for the shamiana, the community hall where the dinner was held, the notice in the newspapers about the shraadh, even the chairs on which the visitors sat.
There is a remarkable short story by A. K. Ramanujan called “Annayya’s Anthropology” in which the Kannada protagonist, a graduate student at the University of Chicago, makes a terrible discovery while looking at a book in the library. The book is by an American anthropologist whose fieldwork had been done in India; the pictures in the book from Annayya’s hometown appear familiar to him. One of the photographs illustrates a Hindu cremation, and Annayya recognizes in the crowd a cousin who owns a photography studio. This is a picture that appears to have been taken in Annayya’s own home in Mysore. The cousin, whose name is Sundararaya, is mentioned in the book’s foreword. When Annayya looks more carefully at the corpse in the photograph, he sees that it is his father on the pyre. Ramanujan was making a point about the discipline of anthropology, about the ironies of our self-discoveries in the mirror of Western knowledge, but the story tugs at the immigrant’s dread that distance
will prevent his fulfillment of filial duty.
I had been luckier than Annayya. I had been able to speak to Didi in Patna when Ma was taken to a hospital on the night she died. On WhatsApp, on my phone, a text came from my sister later in the evening, assuring me that Ma was doing better. Then came the call about my flight timings. While the use of social media also meant that I got the news of my mother’s death from a near stranger on Facebook, it was also true that technology and modern travel had made it quite easy for me to arrive in Patna in less than twenty hours to cremate my mother. During the prayer ceremonies a priest told me that the reason Hindu customs dictated a mourning period of thirteen days was that it used to take time for all the relatives to be informed and for them to travel to the home of the deceased. But this, he said, putting his hand on his ear, is the age of the mobile phone.
At the ghat, the smoke from the funeral fires mixed with the lingering fog of the winter afternoon. An advance party organized by a cousin’s husband had pitched a small shamiana on the bank and arranged a few red plastic chairs next to it. Above the din, a tuneless bhajan played on a loudspeaker. In the crowd, I was led first in one direction and then another. My movements were restrained because of what I was wearing; according to custom, my body was wrapped in two pieces of unstitched cotton. My freshly shaven head was bare. I saw that Ma’s body had already been put on the pyre. There was such a press of strangers, many of them beggars and curious children, that I had to ask people loudly to move back. Ma lay on heavy logs and a bed of straw, but the priest directed me to pile thinner firewood over the rest of the body. Other family members joined me, adding sticks in the shape of a tent over the corpse.
Ma’s face had been left bare. Now the priest told me to put five pieces of sandalwood near my mother’s mouth. Some of the sindoor that had been put in Ma’s hair had scattered and lodged in her eyebrows and on her eyelids. The dom who would give me the fire had an X-shaped plaster stuck on his right cheek. He had a dark face and his eyes were bloodshot. His head was wrapped in a brown-and-blue muffler to protect him from the cold; he wore jeans and a thin black jacket and he had about him an air of insouciance that would have bothered my mother, but I liked him. His presence was somehow reassuring, or real, because he was outside the circle of our grief and yet the main doer. He was solemn, but he certainly wasn’t sober; his very casualness brought a quotidian touch to the scene, and he accentuated this by haggling about his payment. A maternal uncle’s son stood behind me, repeating for my benefit the priest’s instructions—this cousin of mine, a few years older than I, had cremated his son recently. The boy had passed away after his liver stopped working, the result of an allergic reaction to medicines that have reportedly been banned outside India. The priest told me to sprinkle gangajal again—the endless act of purification with what is in reality polluted water—before the dom lit a bundle of tall straw for me. Three circles around the pyre. Then followed the ritual that is called mukhaagni. I understood suddenly why the priest had given me the five pieces of sandalwood, the size of small Snickers bars, to put near my mother’s mouth. In that moment, while performing mukhaagni inadequately, inefficiently, even badly, in my grief and bewilderment, the thought passed through my mind: Is this why my mother had wanted me present at her death? Mukhaagni—in Sanskrit, mukha is “mouth” and agni is “fire”—means in practice that the male who is closest to the deceased, often the son, sometimes the father, and in some cases, I imagine, the husband, puts fire into the mouth of the person on the pyre.
The Best American Essays 2016 Page 19