Summary:
Jolted
awake by a ringing telephone, the narrator (assumed to be Mukherjee) listens to
his mother give a tearful report of his 83-year-old father’s waning health. Telling
her that he will book the next flight from New York to New Delhi, Mukherjee’s
mother wavers, regretting that her call now spurs him to purchase expensive
airfare. In a tone of knowing sarcasm, Mukherjee writes, “The frugality of her
generation had congealed into frank superstition: if I caught a flight now, I
might dare the disaster into being.” Arriving in “sweltering,
smog-choked Delhi,” Mukherjee joins his mother in a hospital’s I.C.U. A physician
himself, Mukherjee notes the facility’s piteously tumbledown conditions, its crumbling
floors and exposed utilities, jibing that, if one were to trip on the concrete
rubble, “a neurologist would be waiting conveniently for you around the corner.”
No doubt accustomed to the comfortable amenities of American hospitals, Mukherjee
magnifies the miserable disarray of the Delhi facility—a defective heartrate
monitor, a fractured suction catheter, a hospital bed with cracked wheels, a delivery
van used as an improvised ambulance. This world, far from New York, is mired in
seemingly eternal disrepair: “Delhi had landed upside down. The city was
broken. This hospital was broken. My father was broken.”
These
would seem to be the smug observations of a dismayed tourist were it not for Mukherjee’s
thoughts on the intricate and noiseless machinery of homeostasis, the cohesive
force that sustains internal constancy. “There’s a glassy transparency to
things around us that work,” he writes, “made visible only when the glass is
cracked and fissured. […] To
dwell inside a well-functioning machine is to be largely unaware of its
functioning.” As Mukherjee witnesses the spiraling decline of his father’s
health within a deteriorating, dismally ill-equipped healthcare system, he focuses
on the regularities of equilibrium by juxtaposing the homeostasis of
healthcare institutions and human bodies. Mukherjee relates a memorable story
from his early career when he staffed nightshifts at an urban clinic, where his
colleague, an older nurse, stacked oxygen masks, oiled oxygen valves, and arranged
beds. He belittled the nurse’s exacting preparations as an “obsessive absurdity”
but, when his first patient arrived with an asthma spasm, he realized how
critical the clinic’s flawless order was to his life-saving efforts: “The knob
of the oxygen turned effortlessly—who would have noticed that it had just been
oiled?—and, when I reached for an I.V. line, a butterfly needle, just the right
size and calibre, appeared exactly when I needed it so that I could keep my
eyes trained on the thin purplish vein in the crook of the elbow.” Had these
things not been prepared, had they not been finely tuned for use, had an
instrument been misplaced, would Mukherjee’s patient have lived? He experienced
an example of institutional homeostasis, conducive to optimum medical care, which
facilitated essential processes to occur successfully without mishap.
Now
in the New Delhi hospital, Mukherjee notes that its medical staff has “to
settle for a miserable equilibrium. Amid scraps and gaps and shortages, they
had managed to stabilize [my father].” He arrives at another stark realization,
“I had versed myself in the reasons that my father had ended up in the
hospital. It took me longer to ask the opposite question: What had kept my
father, for so long, from acute decline?” Recollecting his father’s life at
home in between hospitalizations, Mukherjee references a different kind of
homeostasis that helped to prolong his life. For example, when his father was unable to go to the
local market to haggle for fish and cauliflower, the vendors came to his home for usual business— “The little rituals saved him. They […]
restored his dignity, his need for constancy.” Mukherjee accentuates the protean
workings of homeostasis, its variegated forms that sustain the patterns of normalcy
that give regularity and meaning to human life—indeed, equilibrium is not only
an infinitude of minute chemical and biological factors, but familiar ease in a
world that one knows and loves. Equilibrium, however rigorously maintained,
succumbs to decay. Mukherjee aptly quotes Philip Larkin’s poem, “The Old
Fools”: “At death you break up: the bits that were you / Start speeding away
from each other for ever / With no one to see.” Mukherjee notes that the experience
of his father’s decline was not so much observing him disintegrate into a
similar kind of molecular dust, as imaged in Larkin’s verse, as it was his solidity
upheld by homeostatic forces, a steady chugging of biological gears that made intricate
compromises to sustain his deteriorating body.
After
his father emerges from the coma, Mukherjee enlists curious pedestrians to help
lift him into a makeshift ambulance. His father’s jostled body resembles a
“botched Indian knockoff of an ecstatic Bernini.” The thematic kernel of
Mukherjee’s narrative, homeostasis, draws scrutiny not only to the experiences
of individual bodies but the systems and institutions that heal them, to the
material environments in which fragile bodies are cared for, repaired, and
rehabilitated. “The hospitals
that work, the ambulances that lift patients smoothly off the ground: we neglect
the small revolutions that maintain these functions,” reflects Mukherjee, “but
when things fall apart we are suddenly alert to the chasms left behind.”
View full annotation