Aruna: Whose story is it?

Supreme Court has given its verdict: Aruna Shanbag lives. The wise judges have however made a distinction between active and passive forms of euthanasia and have suggested that the parliament make a law in this regard. Aruna's story, the court case as also the verdict are bound to generate a vigorous debate about related issues like euthanasia, right to life - and to end own life, what is life and so on. The debate may even sway towards the necessity to conserve scarce resources like medical healthcare for the sake of the needy and the productive among our citizens.
All such debates are welcome since such brainstorming is indeed necessary for updating our understanding of the changing context, and therefore of the changing perception of the human condition. I am going to do my bit to add to the babel. I want to introduce an aspect or two which I find missing in all the arguments and counter arguments being made all around.
It was Pinky Virani who approached the court. Ms Virani has written a book named Aruna's Story where she has traced Aruna's life as a nurse in KEM Hospital to the rape that destroyed her future to the vegetative state she has been surviving as, for the past 38 long years. There is no reason to doubt Ms Virani's professed empathy nor her purpose in applying for putting an end to Aruna's life. Ms Virani honestly feels that Aruna suffers and has had enough of suffering till now and that death will release her from the constant suffering. Let us also agree that the chances of Aruna regaining a normal life as person responsible for and taking care of her own physical existence, are remote, almost non-existent: a part of her brain has been damaged irreparably and she has shown no recovery during the past 38 years she has been bed-ridden.
But as the enquiry committee observed, Aruna is not all vegetable. She responds to music, to dishes she likes. She also perks up on being greeted by her caretakers. She opens her mouth, she chews, she approves when she is cleaned and freshened up. It may safely be inferred that Aruna's sensory perception is not completely disabled, she perceives though she cannot react more vigorously. Her motor nerves cannot command her muscles to act in more than a rudimentary fashion.
We withdraw our hand reflexively upon touching a hot object; the command to move the hand is short-circuited from the spinal cord and there is no conscious decision making involved. It is claimed that Aruna's responses constitute something akin to the reflex action and do not involve any brain activity. Is it true? Is there a way to ascertain the claim? Have there been attempts to elicit more involved responses from Aruna? If there have been such attempts, what were their outcomes? Have the outcomes been analysed by experts? Have the experts agreed unanimously? Medical science is far from an exact science and we know precious little about the brain functioning. But, the point is, have we tried to learn more about the functioning of the human brain through Aruna? It is possible that no conclusive inferences are possible; but are there any tentative leads? Any new lead could be the road to a deeper understanding or to a more reliable hypothesis.
The world knows of another individual who cannot control his own movements and is confined to a wheelchair for the past many years: Dr Stephen Hawking. But Dr Hawking is so active intellectually that it would be preposterous to suggest that there is something common between him and Aruna, except for the fact of their confinement. However, imagine! If Dr hawking were to be diagnosed as an invalid incapable of any motor activity and were to be abandoned to the care of a charitable home; what colossal loss it would have been for the mankind. Again, I do not intend to suggest that there lurks an intellectual giant in Aruna's mind. Again the point is, have we tried to assess the extent of intellectual activity Aruna is capable of? Where exactly do we draw the line to decide what is intellectually active and what is not? Can Aruna add to our understanding of the subject? Can she help to make the line a little sharper? If the answer is NO, let it be an unequivocal "no" pronounced authentically and publicly.
Aruna Shanbag is the rarest of rare cases where an individual is lying in bed for 38 years. What has happened to her memory? Does she think? A sailor living all the time on a ship becomes bow-legged, a man spending a long time in total darkness cannot open his eyes to sunlight for quite some time. A prisoner in solitary confinement has hallucinations; here is a woman who has shut herself off from the world for so many years, what has happened to her?
May be my queries are naive. I shall be happy to be proved utterly naive. I shall welcome a solid, evidence-based proof of my naïveté.
Now to another aspect that plagues me.
Who is the next longest surviving patient who is totally bedridden like Aruna? And how long has he / she been surviving?
I think, the achievement of the nurses and other concerned staff of KEM Hospital is exceptional. The Supreme Court lauded them for the fact that Aruna has no bedsores, that the bed is spotlessly clean even though she is totally bedridden for as long as 38 years. And they are doing it entirely of their own volition. They are so fiercely protective of her that they abuse Ms Virani for the euthanasia plea. "How many days has Pinky Virani spent in care of Aruna?" they say. One must not forget that hardly any of Aruna's colleagues are there at the hospital now. Yet the spirit of selfless commitment survives. And they are so calm about it. I have visited the hospital a number of times but not once has anybody cited Aruna's case in support of their sense of duty. No nurse there ever refers to Aruna: they do not want to parade her before the public, they are too civilised for that.
What is their motive? Does it come from the training they receive? From their 'culture' (Indian / Maharashtrian / KEM)? Who spends for Aruna's upkeep? Is it the hospital? It is a Municipal hospital; so how does Mumbai Municipal Corporation account for the expenditure? Or does it come from the nurses themselves? Again, what drives them? What a contrast does the strong sense of duty towards a life offer to the euthanasia debate!
Consider the possibilities here. The quality of service Aruna receives is exemplary. And it is reasonable to trust that the other patients at the hospital also benefit from the same quality of service. So, what difference does it make to the overall standing of the hospital? Or of the particular department? Has there been a study to compare the effect of this kind of service on the well being of in-patients? On their recovery? I know it is difficult to make such comparisons, especially since humans are involved. But I also know that there are techniques which can help. What I do feel is an embarrassment that we are not giving the KEM nurses their due. We are completely deceived by their attitude into belittling their feat. It is their modesty that they do not demand gratitude or recognition. But it is our callousness that we do not give it to them.
One last observation: is it easy to keep a comatose / bedridden patient alive and well for so long? Without any bedsores? What diet does Aruna have? Is it a standard diet or is it something that is a result of experiments? Has she not picked up any infection like common cold? Then what does the staff do? I think, 'the experience of treating Aruna' is a book on good diet and good healthcare!
I salute the KEM nurses. They make me proud. Theirs is a story of human good nature and it must be highlighted in all its glory in the current gloom of scams and frauds in high places.