Undiscovered country. Ghosts in our machines

I have spent too much time attending to the dead. It leaves a certain something behind to wash and lower bodies into a grave, or to wait by the ghat as the flames rise and consume what used to be a human body. All our ways of dealing with the dead are horrible, even the ancient Zoroastrian ritual of leaving the body in the towers of silence to be picked clean by carrion birds — a form of sky burial that is found also in Tibet and among certain Native American communities. It is not the physical ritual that is hard. Fire is gorgeous, and the work of the earth — whether swift through vultures or slow through bacteria — are wonderful in their own way. It is the fact that the body housed a human spirit, that someone like us is being thus consumed, that is distressing. Ashes to ashes, dust to dust.

But maybe it is not the end that is the most distressing, but the places in between, that leave a greater shadow upon us... the hospitals, where the struggle between life and death is reduced to its simplest logic. One theory of consciousness, that thing that makes us “us”, is that sentience is the outcome of an operating system. To drive a complex machine such as a body requires coding; we need to know what is happening, to understand the world. Humans, with their outsize brains, seem to do that and more, allowing our imaginations to create stories, to anticipate not only what might happen, but also making up complex imaginings of what and why might be happening, and how we fit into the whole scheme of things. It is this glorious flowering that, some speculate, is the “I” in a person, the personality, the being we know, sometimes love, sometimes hate.

In a hospital, though, on a hard bed, hooked up to machines, laid low by either disease or accident, the hyperactivity of the operating system on overdrive is muted, or gone. We are left with the bare body, the physical machine, holding on to life, sometimes slipping away. It is on this physical shell that medical practitioners apply their skills and power — what greater power is there than to intervene between life and death? Some are generous and squander their energies, others less so, possibly overburdened by work, by the vastness of their responsibilities.

At one of Delhi’s overcrowded public hospitals a few days ago, I sat in a ward as an elderly relative was being resuscitated. One medical officer was conscientious, the other brusque and rude. I was tempted to tell him the story of the white lab coat that he wore as his badge of authority. My sister, managing a large hospital, had found that these coats were one of the vectors of disease, as doctors carried the infection from one patient to another. Trying to figure out their utility, and how they could be replaced, she did a bit of background research. It seems that lab coats were adopted by the emerging medical fraternity in Europe in the 19th century. At that time, when such practices were new, and led as much to death as anything else, medical practitioners adopted the coat from lab technicians to suggest that they were “professionals” and not mere hacks. It did not always work. In India, for example, as Ziauddin Sardar documents in his book Balti Britain (patchy, at best, but full of useful nuggets), it was only the crushing of the 1857 uprising that allowed European trained medical practitioners to replace local hakims and medical practitioners. They had not been trusted before, had not been able to assert authority.

And, yet, that tale of the lab coat is part of us, what makes us human, what is possible, and what changes occur because of the stories we tell, the meanings we attach to those stories. These are not possible if the shell is lost, and consciousness spills out like the yolk from a broken egg, so I concentrated on that, on the rasping breath, on easing the straining muscles, on making sure that the oxygen flow remained unimpeded, and that the right medicines were available. We are fragile beings, even more so when rendered extremely vulnerable in the depths of an under-resourced, overburdened public medical system of India. It is uncomfortable to be reminded of that, but it is the truth of our lives, as ghosts in our machines.

Omair Ahmadis the South Asia Editor for The Third Pole, reporting on water issues in the Himalayas

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