January 8, 2018 Issue

Siddhartha Mukherjee, in his absorbing “Bodies at Rest and in Motion,” in this week’s issue, recounts his experience of his father’s dying. He writes,

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? I had to reimagine the fall—the blow, the bleed, the delirium, the coma—and try to understand why such disasters hadn’t occurred earlier, as his brain had inched, woozily, inexorably, unrecognizably, toward dementia.

Why is he still alive? – it seems like an odd question to ask about someone receiving medical care. Why is he dying? And what can be done to prevent it? seem more to the point. But Mukherjee already knows why his father is dying (“the blow, the bleed, the delirium, the coma”). He knows his father’s condition is terminal. His question – why is he still alive? – gets at a different matter, a quality we tend to take for granted when we’re healthy – the body’s resilience, it’s resistance to death. Mukherjee points out that the physiological term for this resilience is homeostasis (“the capacity to maintain a functional equilibrium”), which he says has often been called “one of the defining principles of life.”

I confess I’ve never thought of the human body as resilient. The adjective that leaps to my mind is “fragile.” “We are the delicate part, transient and vulnerable as cilia,” Lewis Thomas said, in The Lives of a Cell. After the collapse of his homeostatic resistance, Mukherjee’s father is incredibly fragile. His “feats of resilience surrendered to the fact of fragility,” Mukherjee says. In what, for me, is the piece’s most memorable passage, Mukherjee describes his father’s death:

And soon all his physiological systems entered into cascading failure, coming undone in such rapid succession that you could imagine them pinging as they broke, like so many rubber bands. Ping: renal failure. Ping: severe arrhythmia. Ping: pneumonia and respiratory failure. Urinary-tract infection, sepsis, heart failure. Ping, ping, ping.