Chains, Keep Us Together

Updated: Nov 17, 2019

By Karthik Ramaswami | @karthikskorner

I remember how he was in those final moments. The endless IVs inserted into his arms disappeared. The monitors occasionally screeching to notify nurses to change his drips were gone, too. The dialysis machine had been ushered out earlier that day, and the MARS machine was taken away the minute Appa did not qualify for a liver transplant. The only thing left was a heart monitor, his ventilator, and a single drip of morphine to ease the pain.

It was not easy being told that they had tried everything they could to save my dad. It was especially not easy being told my father was about to pass when I was only eighteen-years-old. It was strange. I was old enough to be an adult, yet somehow I transformed to an innocent, crying toddler the second the doctors informed me about his untimely departure. I specifically remember that day two weeks prior. Appa had just been transferred to Emory Main Campus, and the head doctor of the ICU ward gave it to us frank.

“I’ve never seen anyone recover from this. His respiratory has failed. His brain is experiencing constant seizures. His liver has failed from the alcoholism, which has now caused his kidneys to fail. And with the massive blood loss yesterday, I would call it a miracle if he survived. Your dad is fucked.

She didn’t say that last part, but she might as well have. If not that, then she should have said my dad screwed himself for being an alcoholic. Or, I guess she could have said we had failed him time and time again by not trying as hard as we should have to save him when he was still conscious. These thoughts yelled a loud ringing in my head as I drove back to my house that day.

I had not eaten or drank anything all day, but I could care less. Rohini and Amma were still at the hospital, and I promised them I would bring them some fresh clothes, yet I was so numb that I walked through my front door and headed straight down to my basement for a quick smoke to feed my newfound addiction to American Spirits. Amma would have killed me if she had known that I had started to smoke since Appa had been in the hospital, but to me it was a way of connecting to him.

I scrunched my fingers, shoved them into my dark denim jeans, and whipped out my pack of cigs. My fingers were already shaking as I tried lighting my cigarette, so it took me four frustrating attempts to finally light up. But when it was finally lit, I took a deep breath in and let loose a sigh of deep, brooding, painful breath. I felt it. Straight in my chest. The pain hurt like hell. I knew something was wrong, but I heard my Appa’s voice calming me down. He always did that. Calm me down.

I took another deep breath from the cigarette, and the rest is a blur. I remember hitting the ground and gasping for air. There was sheer panic that flowed through my veins. This was it, I thought. It felt like death was marching straight to my doorstep and was asking me if I wanted to go, too. I started to cry out.

Appa, please! Appa, please I—”

Then, I remember coughing and crawling to the bathroom. I don’t know exactly how I got off of that basement bathroom floor, but the pain didn’t go away for the rest of that night.

The next thing I remember was lugging a bag of my mom and sister’s clothes and heading back out to the hospital.

Two weeks later on the dot, I stood in Appa’s ICU room with Amma, Rohini, and a few of our closest family and friends. We told the doctors and nurses earlier that day we were ready to let Appa go. Appa would not have wanted this anyways. Amma and I still to this day recall how he eerily predicted his own death.

“If I ever am in a hospital bed, and I have tubes all over me, put me out of my misery. I would be fucked. I don’t want to live like that.”

I just thought he was drunk that night and was talking bullshit because of it, but I guess he had a point after all. He did look miserable.

His face had dried—mouth ajar. His teeth had been displaced by the ventilator tube that once entered through his mouth, but after a tracheostomy, the tube was connected through his neck. He had become bloated from all the fluids that were building up inside him since he was not conscious to eat, but to be honest, I do not know if he would have even been capable to eat if he was conscious. His eyes were closed, and sometimes I would see a single tear forming at the crease where his eyelid met his face. In those moments, my sister or I would grab a tissue and gently wipe his tears away.

I found that part ironic. The fact that we wiped his tears away. I know he must have been in an insurmountable pain that was beyond my comprehension, but I can distinctly recall many times where he would question why my sister or I would be “sulking”—as he put it.

There was this one memory in particular that has ingrained my insecurities on my own masculinity. It was the summer before my sophomore year of high school. Appa and I were on a rooftop in India, and I was yelling at him because he was drunk and creating a scene in front of our family. Me yelling at him because he was drunk was not a rare occurrence, but this moment never leaves me. I was crying. I was pouring. I was sulking monsoons. Appa put both hands on my shoulder and exclaimed, “Hey, don’t cry! Guys don’t cry.”

I do not want to admit the conversation that night described my relationship with my Appa perfectly, but I would be lying to myself if I did not. That was a lot of our interactions towards the end of his life—me sulking and yelling at him while he was drunk. He would always reassure me that he loved me during those “talks,” and I know that pains me the most. Knowing I wasted so much time yelling at him for being a drunk kills me. I should have been rehabilitating him instead. Or I should have put out my hand and told him that everything was going to be okay. Or maybe I should have just told him that I loved him.

Fast forward three years later, and here I was standing next to my Appa’s deathbed. Not crying. I couldn’t. I just couldn’t. Every time I would start, I would hear Appa telling me to stop. I felt I owed it to him. Even in this moment when he was passing.

I hate that I couldn’t cry, though. I mean not even one proper fucking cry. I just stood there. I felt like I had to be strong for Amma and Rohini because I’m sure that is what Appa would have wanted, so I obliged.

The doctors and nurses came in one by one and paid their respects while taking another instrument imperative for his survival out and away. Even though Appa was dying, and soon he was going to feel the comfort of nothing, my family only had one request: for him to feel no pain as he passes. Soon the only thing left was Appa’s drip of morphine, a machine to monitor his vitals, and a room full of his closest friends and family.

The doctors promised that he was going to pass within 30 minutes given how weak he was. Those first moments were utterly depressing. I was going to see someone die before me. This was not just anyone, though. This was my appa. Every boy’s first role model. He was going to die a month before my high school graduation. My first major milestone. He was never going to see me finish college, or get married, or have my own kids, or anything. He was going to miss everything.

As the minutes passed, Amma and other aunties in the room began chanting religious prayers. My sister nudged me to join in to comfort Amma. I usually would have fought her in moments like these because I had no idea if I truly believed in all this—especially not when my own damn dad was about to leave me forever—but it felt like the right thing to do was to make Amma feel comfortable so I began to chant, too.

Minutes turned into hours, and somehow Amma was still chanting, but I was left perplexed. I stopped going through all the memories that once were. I started to get anxious and delirious. In a moment I now look back on with much amusement, I turned over to Rohini who was pensively staring at Appa, and I whispered, “Damn, even when Appa is dying he’s stubborn!” That got a slight chuckle out of her, but she evidently felt disturbed by the dark nature of that joke. Tough crowd, I guessed.

Appa was a fighter and took awhile to pass. So much time that Rohini and I actually went back to her townhouse to nap. Amma eventually called us around 4:00 a.m. to let us know to head back because the nurses said he should pass soon, and he did. Rohini and I made it a minute too late. Appa passed at 4:26 a.m. on April 19th, 2018.

While that night on the rooftop in India where Appa got mad at me for crying never fails to leave my memories, neither does what he said right after he questioned me for crying.

“Hey, don’t cry! Guys don’t cry. I love you, Karthik! C’mon. Don’t cry. I love you!”

I love you, too, Appa.