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Monday, April 4, 2011

11.38 Cancer 3 - How to Die in Japan

Slim Novel 11 -  http://adventuresofkimi.blogspot.com - See Homepage

38. Exitus
On community rounds one week later, Kimi witnesses Exitus. Sanya says E has just requested it and comments as they enter E's home, “It happens this way later or sooner where breathing and circulation remain intact. All her abilities to enjoy life are lost and she waits patiently for Exitus yet it keeps just beyond her grasp. And one day she no longer accepts continuing consciousness but is too weak to leave it by ordering her body to stop. Euthanasia (voluntary ending of a life) is the answer. Everyone knows it is illegal, unaccepted by all religions; but, like abortion, it fills a deep human need.  
   You would be surprised how often it is done. I have it from a top British doctor that King George V was dispatched with morphine, based on his pre-coma request and with the agreement of his family. And even practitioners of the middle class do it. How? The two main ways are hard for police to detect. The one for the patient who can manage by herself is several grams phenobarbital: a death dose at start of weekend and a caretaker arranges that no one discovers it until it succeeds in a death. Alternatively there is morphine sulfate – its code name MS! In a weak, ill patient, a 2 milligram intravenous dose will stop breathing in minutes.”


All this is said while sitting in outer room. The helper indicates all is ready. Kimi follows to bedside. E's face is as before and her body outline on the mat barely nudges the single sheet cover. One thing is different from before – her eyes. Upper lids are widely drawn up and the eye whites are yellow from jaundice. Her eyes flick back and forth among the three persons at the bedside, the pupils showing recognition then settle on Sanya. As the helper prepares the morphine sulfate syringe, Sanya speaks. “I am here to do your request. I have no word of wisdom. I can say truly your life has been important for donating to Science.” She bows head and Kimi and the helper do likewise.  
   “Thank you, Etsuko.”
   Lifting head, Kimi notes that E moves eyes to each person in mute but clear “Thank you and good-bye” then drops her upper lids and appears asleep. Only slow, shallow rise and fall of the skin-outlined collarbones indicate remaining life.
   The helper hands Sanya the syringe. Sanya pushes the needle into a blue vein on the back of E's right hand and injects the dose. Then the three sit silent beside E, and Kimi's mind drifts and at times she lightly sleeps.

Later Kimi is aware that E no longer breathes and E's her upper eyelids stay closed and her mouth hangs partly open showing whites of teeth.
   Sanya says “It is done.”
   In the next minutes, Kimi and Sanya and the helper prepare E's bedridden cancer-ravaged body for death viewing. They pull back the sheet, take off E's nightgown and, using warm water with soap, clean the skin with soaked cotton balls and sprinkle light fragrance incense over it then they cover its nakedness with a light green dress selected by E for the death viewing, and Sanya expertly places skin cosmetic and lip color, closing E's lips to give a more normal expression; and the helper using a comb arranges E's hair into ponytail with red band. She leans over E's torso and takes both arms and puts the hands palms pressing, fingers intertwined in prayer position at center part of lower chest and wraps Buddhist prayer beads around the hands. And places sprigs of small fragrant violets around E's head. The sleep mat is replaced by a new, clean, colorful one on which they lay E’s body for viewing in the dress and with light green feet socks. The room is cleaned and aired and more flowers are arranged around E. A head and shoulder life-size photo of E is placed on a table a little way behind her head, which rests elevated on small white pillow.
   Like most Japanese, E is main sect Buddhist which dictates this arrangement, as Kimi knows. She also knows that within the next several days, as soon as it is a propitious day in the Buddhist calendar, E will be cremated after a ceremony and the ashes and bone fragments placed in a white porcelain jar and that stowed in a natural color wood box 28 centimeter (cm) high and 25 cm square on sides, and then kept at home on a table in front of the head-and-shoulder photo, the flowers, and candles and incense, which are kept burning for 49 days numbered from day of Exitus. Afterwards, the box may either be kept home on family altar or at a Buddhist temple in a family niche for small monthly fee, or buried.
   Sanya’s speculations on death, consciousness, ultimate meaning and reality.
Pausing outside Santa says: Individual death is the blanking out of the individual’s consciousness forever. The consciousness has its one existence, having been started by action of a sperm and ovum and shaped by the several years of growth and environment interaction. It is what chance, location, and, perhaps, free will choice makes it. It contributes to the greater reality, changing it in a small way. Then it blanks out at death. What meaning? Here I follow Wittgenstein in not being able to speak of what I do not know. I do what I think will improve the future. Enough! Let us move on to next.

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