Till the first half of twentieth century, the main thrust of gerontology was premised in the field of medicine. Even the scholars from social sciences relied on the principles and beliefs framed by medicine to begin working on old age. In the last quarter of twentieth century, scholars working on old age began to feel that something was missing in a purely scientific and quantitative gerontology: a fundamental question about old age – what does it mean to grow old? – was yet to be addressed (Cole and Ray 1). The cultural turn in the second half of the century gave birth to the trends of looking at old age culturally and thus led to the emergence of cultural gerontology. Cultural gerontology paved the way for an area of research focusing on different meanings of aging – humanistic gerontology. The cultural turn was basically the outcome of interactions between post-structuralism and newly emergent theoretical strands – feminism, postmodernism, postcolonialism, body studies and queer studies (Twigg and Martin 353). Humanistic gerontology covers interventions of humanities such as history, literature, philosophy, ethics and arts in studies on old age.

Studies on aging and old age by literary scholars began in the west in the 1970s with the emergence of a theoretical approach that combined literary criticism with issues emerging in gerontology (Wyatt-Brown 300). In its early days, literary gerontology laid emphasis on the problems of attitudes of literary authors towards aging and old age. The growth of more critical readings of aging within literary texts led to the trend of relating aging in literary texts to other humanities like history, religion, ethics, philosophy and the arts. Another strategy that developed in literary gerontology was to study literature from the perspective of psychoanalysis, which is to use the ideas of Erikson, Jung, Winnicott and Lacan in order to analyze old characters. Some literary scholars have also attempted “psychoanalytically informed studies of the creative process” of aging recorded in literary works.  One important approach in literary gerontology has been to combine literary criticism with gerontological theories about life reviews, autobiographies and midlife transitions (300-310).

A recent approach in literary gerontology focuses on the application of literary narratives dealing with aging in medical care and medical practice. Narrative medicine, a recent development in medical humanities, not only aims to improve the quality of the care provided to the elders, but also positively affects the care-givers’ personal satisfaction with the care they provide to the elders. In parallel to the same development, scholars have started using literary experiences to reevaluate the ways aging people have been treated in the field of medicine and by their care-givers.

In Stories of Aging, Mike Hepworth says that aging is “simultaneously a collective human condition and an individualized subjective experience” (Hepworth 1). Integrating literary works into aging studies has helped link the objective aspects of old age with the subjective experiences of aging. In the past years, critical inquiries into literary narratives (generally novels), done by Kathleen Woodward, Barbara Frey Waxman, Constance Rooke, Anne M. Wyatt Brown, Margaret Gullette etc., have particularly played an important role in exposing various social constructions and cultural stereotypes associated with old age. These scholars have shown how modes of living, rituals and customs have been complicit in the marginalization of elders in different cultures.

The present paper aims to investigate The Last Burden, a novel by Upamanyu Chatterjee, as a site of contestations and collaborations between what aging means in India and the recent theoretical developments in the understanding of old age and aging bodies. The paper will rely on multiple narratives of old age inherent in the novel in order to inquire into different trajectories and possibilities that exist on account of the relation between aging body and disease.

Upamanyu Chatterjee’s The Last Burden is about an old couple, Urmila and Shyamanand. Urmila and Shyamanand live in Mumbai and have a joint family. They have two sons, Barfi and Jamun. Burfi is married to Joyce and they have two children – Doom and Pista. Jamun works in a “muggy, forgettable” (Chatterjee 278) town in Maharashtra. He is unmarried and is in relationship with a married woman, Kasturi. The novel has several flashbacks which centre round a major heart attack that Urmila suffers.

After heart attack, Urmila is immediately admitted to a nursing home where she is kept in Intensive Care Unit. Dr. Haldia, who looks after Urmila, diagnoses her with a range of diseases. The doctor “has no time to be genial with those who have waited for long” (Chatterjee 62). He says to Shyamanand:

‘Hahn your Mrs’s case…infarcation…angina…coronary thrombosis…intense hypertension…clot…embolism…dyspnoea…cardiovascular murmur…phlebitis arteriosclerosis…arteritis…high blood pressure, dogtired heart, pacemaker…surrogate, standby, booster…’ (Chatterjee 62)

Dr. Haldia states that Urmila needs to undergo a major operation, since her heart requires a pacemaker.

Bodily decline is an integral aspect of old age. With the aging of body organs, they suffer from malfunctioning. Many times, the malfunctioning organs also fall prey to dangerous infections and add up to the misery of the elders. The way Dr. Haldia expresses the case of Urmila before Shyamanand implies that biomedicine has changed the way people know and “live” old age these days… [C]linical medicine has come to rely more and more on numbers, pictures, and results generated by a plethora of diagnostic tests and procedures that enable ever-more finely tuned interpretations of disease states and bodily conditions. More broadly, we come to think about the truths of the body – and of life itself – through those numbers, scores, and scans.(…) Also, with these advancements, “many conditions – cancers, heart failure, kidney disease, and liver disease, for example – can be managed as chronic illnesses for long periods of time, even decades, and well into very later life. (Kaufman 225-6)

After the doctor recommends a major operation to Urmila, Jamun asks him, “[i]s my mother strong enough for the operation? You remember, you cleared her for the piles operation and she caved in because of the strain. How much’ll this one cost?” (Chatterjee 62). The doctor says there is no choice else placing a pacemaker in Urmila’s heart. While returning home, Shyamanand responds to the doctor’s opinion in the following words: “Twenty-five thousand for the pacemaker. Does she need it? Can she bear it? We should consult a second specialist” (Chatterjee 63). Shyamanand then expresses the reason behind his concern over the hefty amount needed for the pacemaker: “I don’t have twenty-five thousand in ready money. I’ll be forced to break a bank deposit, borrow – and pay interest for my own savings” (Chatterjee 63). In the case of Indian elders, the treatments that prolong life have created a broad socio-cultural context that basically includes older adults and their families, and hinges upon two basic questions:

1. who will pay the cost of the treatment?
2. who will take care of the patient?

When Jamun talks to Burfi regarding the cost of the pacemaker, Burfi shows his displeasure over why their father is bothered about his money. At the same time, he seems equally unhappy with Shyamanand spending his own money on Urmila:

‘Ironic,… Baba’s first love will now be gobbled up by the hocus-pocus to extricate his first hate, his wife…

‘Cheers. Here’s to things mending,’ proffers Burfi. After a while, he runs on, ‘Baba’s already paid out a good many thousands in the piles fuckup. He’ll disgorge more yet – his is an old chastisement. (Chatterjee 63-64)

This statement of Burfi not only carries an extreme level of ageism¹, but also unfolds the growing contrast between the younger people’s attitude towards their elders and the sense of intergenerational reciprocity inherent in Indian culture. This contrast also crops up in a conversation between Shyamanand and Burfi that happens as soon as Jamun comes to see his mother. Burfi says to Shyamanand: “It [the expenses of Urmila’s healthcare] shouldn’t be an issue at all! She’s your wife. You hatched her maladies. You should pay for them” (Chatterjee 44). Shyamanand responds, “But you are her sons! Are you not her sons?” (Chatterjee 44). Burfi replies, “That’s not the point either! Thirty years hence, if Joyce is dying, will I angle for money from Pista or Doom for her pulling through? You are gibbering” (Chatterjee 44). In India, while the developments in the field of medicine have increased the life-expectancy of elders, the costs of the treatments of older people and the growing requirements of their care have increased the tensions between generations.

While the older adults in US have devised such kinds of living styles which manifest individualism both in economic and emotional terms, most of the older people in India are still caught in the expectation of what Sarah Lamb calls “long-term deferred reciprocity” (Lamb 51-52). This long-term deferred reciprocity is nothing but the familial sense of care, which has been an integral aspect of Indian households and is now slowly vanishing from Indian families. Lamb configures two kinds of phases in long-term deferred reciprocity. In the first phase, the seniors (parents) rear the junior (child). In the second phase, the junior (child) takes care of the seniors (parents). Various kinds of transactions that take place in two phases centre round body, food, material goods (clothing, money etc.), services (cleaning up urine and excreta, daily care etc.) and Samskaars (first feeding of rice, marriage etc. in first phase; and funeral rites in second phase) (49). In both phases, the media of transaction (body, food, material goods etc.) are same, and the givers and receivers are simply reversed (52).

Sarah Lamb associates the decline of the familial sense of care in India with the modernization of Indian society. The ushering of the west into Indian families in terms of values and living-style and increasing urbanization are two important factors behind the making of modern Indian society. According to Lamb, these two phenomena, along with increase in life-expectancies, have been pivotal in the growth of conflicts between generations in India (Lamb 88-89). Lamb quotes Ashis Nandy to show how colonial modernities, which are basically products of the Enlightenment ideology, are also responsible for the decline of the status of Indian elders.

British colonial rule…also played a decisive role in “delegitimizing” old age in India by importing Europe’s “modern” ideology, which casts the adult male as the perfect, socially productive, physically fit human being and the elderly (as well as effeminate) as relatively socially inconsequential. (Nandy 16-17, quoted in Lamb 90)

The Last Burden also includes the story of a sixty-four-old maid who suffers from Tuberculosis and works in the house of Shyamanand and Urmila. She does not have any relative and lives in her employers’ house. Her husband had ditched her long before she was recruited by Urmila. Her two sons had died in an earthquake. When Burfi and Jamun were children, the lady had served as their Aya (their maid). She is diagnosed with Tuberculosis when Jamun is eighteen. Shyamanand objects to the presence of Aya keeping in mind the contagiousness of the disease: “She could transmit Tuberculosis to us, to Jamun. She cooks our food. She coughs incessantly, a parched, corrosive hawking, as though sand and bonedust gnawed at her windpipe” (Chatterjee 87). “She is deserted at the government clinic” (Chatterjee 88). The doctor, a young man, is initially “most unwilling” (Chatterjee 88) to admit her to the clinic. When Shyamanand pretends that he has an acquaintance in health ministry, she gets a bed in a befouled ward for the days which Shyamanand needs to find a TB hospital for her. On the next day, Aya returns home and states: “I’m not going back to that compost pit. This is my home. If you toss me out of here, I’ll die at your gate” (Chatterjee 88). “The costs of her therapy oblige them [Shyamanand and his family] to recognize that she is not the limb of the family” (Chatterjee 89). The maid, who has a part of the house of Urmila and Shyamanand for twenty years, dies of Tuberculosis and Diabetes in a rundown charitable hospital.

What Shyamanand and Urmila do with the Aya in her last days of life, is not only ageistic, but also hints at the vulnerability of poverty-ridden and homeless elders in India where the government is yet to guarantee proper economic security to not even half of the population of elders. In an interview published in The Hindu (dated September 30, 2018), Nikhil Dey, the coordinator of Pension Parishad, informs that, in India, “[o]ut of a 110 million people above 60, about half don’t get any pension” (2). On September 29, 2018, 1,200 senior citizens gathered in the country capital for a rally in order to a universal social security scheme. Mathew Cherian, CEO of HelpAge India provides another set of data that speaks of the sorry condition of senior citizens in India: “While the Centre gives Rs. 200 [per month], the State governments vary. While eight crore people are entitled to the pension, currently only 2.2 crore of them receive it” (Ghosh 2).

If an elder suffers from a contagious disease, the disease often adds up to the social exclusion of elders. While Tuberculosis is not considered a fatal disease these days and is curable, elders suffering from HIV are still forced to survive at the margins of societies. In India, the stigma associated with Leprosy is still a serious impediment to the social emancipation of those elders suffering from it. While aging-as-disease has been an important reason behind the marginalization of elders for ages, contagious diseases many times become a reason for the reduction of aging bodies to “untouchable” ones.

In the novel, Shyamanand suffers a paralysis attack caused due to cerebral thrombosis (a blood clot in the venous sinuses of the brain). This paralysis attack leaves his left hand and a part of his left limb dead. The doctor who checks Shyamanand says: “Nothing at all to fret about, dear… Your Papa has not lost consciousness – just a tiny cerebral thrombosis… His speech’ll pick up not to worry… Only his left side is packed up…” (Chatterjee 204, emphasis added). The paralysis attack changes the life of Shyamanand. He feels incomplete and thus dejected: “‘I want to die!’ He’s pounded his impotent left arm, and with the snarling, warped features of a hysteric, screeched out his powerlessness. ‘Please, please let me… die’” (Chatterjee 212):

With only one active hand, Shyamanand finds shaving irksome, hence he cultivates a lush beard that straggles down his chest and of which he becomes tolerably vain. The stroke alters his body in inconsequential ways too. The nails of his left foot and hand, for instance, begin to grow much more slowly than those of the right; they are pared half as often. (Chatterjee 216)

The description of Shyamanand’s struggle with the left side of his body point towards how disabilities in old age aggravate the difficulties elders generally face while handling daily chores. Also, the impairment in old age because of paralysis or heart attack or kidney failure can have an adverse impact on the psyche and morale of the elders:

In due time, the fact of impairment ooze through into his [Shyamanand’s] subconscious, for at ten one winter morning, he discloses that in his frightful dream of the previous night,… he’d been transfixed even though he hadn’t been bound, and within the dream itself he’d recognized… that he could not stir because he was wholly paralysed. (Chatterjee 216)

The Last Burden gives an elaborate idea of what aging means in India. It succinctly describes the relation between aging body and disease in India. One of the salient features of the text is the use of narrative for gerontological purposes. The novel brings together multiple narratives of old age in order to show how there can be several meanings of aging within a single culture. It uses narrative in order to understand old age as inclusive to life-course, not as an experience detached and different from other stages of life. Narrative fills life with meaning. This meaning, instead of shrinking, changes and expands as one ages. The advancements in bio-medicine have given longevity to the later life. At the same time, the medicalisation of the aging body has brought a big transformation in the way older people are identified by doctors and care-givers. Discussing the effect of biomedicine on human identity, N. Rose opines:

Biomedicine, throughout the twentieth century and our own, has thus not simply changed our relation to health and illness but has modified the things we might hope for and the objectives we aspire to…. And, I suggest, we are increasing coming to relate ourselves as “somatic” individuals… as beings whose individuality is, in part at least, grounded within our fleshy, corporeal existence, and who experience, articulate, judge, and act upon ourselves in part in the language of biomedicine. (25-26)

Aging bodies are most prone to this change, since, in old age, medical identity overpowers all other human identities. Contagious diseases can worsen the marginalization of the elders suffering from them. In an article, titled “Archaeology of Untouchability,” Gopal Guru writes how the discussions on impurities of the body often begins on ecological context, perforates into socio-cultural context, and end up distinguishing the “perfect” or “sacred” body from the afflicted one (49-56).

Notes

1. Ageism is the discrimination meted out to elders at various levels – socio-cultural, economic and linguistic.

Works Cited

Chatterjee Upamanyu. The Last Burden. Gurgaon: Penguin Books, 1997.

Cole, Thomas R., and Ruth E. Ray. “Introduction: The Humanistic Study of Aging past and Present, or Why Gerontology Still Needs Interpretive Inquiry.” A Guide to Humanistic Studies in Aging: What Does It Mean to Grow Old? Eds. Thomas R. Cole, Ruth E. Ray and Robert Kastenbaum. Baltimore: John Hopkins University Press, 2010. 1-29.

Dey, Nikhil. Interview. “Pension is a recognition that everyone contributes to the economy.” By Priscilla Jebaraj. Hindu. 30 September 2018, Allahabad ed.: 2.

Guru, Gopal. “Archaeology of Untouchability.” Economic and Political Weekly 44.37 (September 12-18, 2009): 49-56. JSTOR. Web. 27 September 2018.

Ghosh, Shinjini. “Higher Pension required for us to lead respectable lives.” Hindu 30 September 2018, Allahabad ed.: 2.

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Hepworth, Mike. Stories of ageing. Buckingham: Open University Press, 2000.

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Nandy, Ashis. The Intimate Enemy: Loss and Recovery of Self under Colonialism. Delhi: OUP, 1988.

Twigg, Julia, and Wendy Martin. “The Challenge of Cultural Gerontology.” The Gerontologist 55.3 (2015): 353-359. Web. 17 February 2018. <https://academic.oup.com/gerontologist/article-abstract/55/3/353/589149>.

Rose, N. “The Politics of Life Itself.” Theory, Culture and Society 18(6): 1-30.

Wyatt-Brown, Anne M. “The Coming of Age of Literary Gerontology.” Journal of Aging Studies 4.3 (1990): 299-315.