Where Would You Go If You Were Dying?

Albus Dumbledore once said, “To the organised mind, Death is but the next great adventure.” For the rest of us mere mortals, death is a looming shadow; a friend we are yet to make, but would rather not. This poignant photo story by photographer Hari Adivarekar trails death in the form of terminally ill cancer patients, and the caregivers at the Karunashraya hospice in Bangalore. We interviewed him to know more of his 3-year-long journey trailing death and all his friends.

HG: What made you pick up a camera to begin with?

HA: “It started with me capturing moments with my family. There was always a camera around because my Dad has been in advertising for 40-45 years now. I was around 11 or 12 when I started developing a very cursory interest in it, but it was never more than capturing just friends and family. It got series when I joined Rave magazine. Until I finished college, photography was always in the background. I was using my Dad’s old Minolta camera that he had from 1969, when he was in Art school. Being a film camera, it disciplines you in the hardest way possible which is on the wallet. You really pay for your mistakes - it was a great way for me to start off where thoughtfulness in a way is forced into you when you’re taking these pictures.”

HG: How did you end up choosing cancer patients in a hospice as a subject? Tell us the story behind Where would you go if you were dying?

HA: “I went from music to doing many years of photo journalistic work and reportage for different magazines. Eventually I wanted to do something more long form in nature. At the same time, my dad was doing some design work for Karunashreya, which was the hospice I focussed on for the story. He told me about it and it sparked off this interest because I have seen a decent amount of death growing up, and it’s always been something that made me go beyond feeling awkward about it - it made me think about what it meant. The moment I realised there was a place where people were coming to literally die, I was very interested in the people who came there, but also the people who were working there and seeing this on a daily basis. What was going through their minds? How were they dealing with this? What was their motivation to do this? The first time I went there I was quite taken aback because it’s a beautiful place but people are really suffering. They are given a lot of care, but it’s very hard hitting when you see their families, and you see young people. It’s nothing like what you expect. You see the full range of human emotion - some people are completely resigned, and other people are really trying to fight against it. That’s when I realised that this was the subject for me to practice long form.”

HG: Had there been a person who you had taken a picture of who had passed on during your time there?

HA: “Yea. There’s a photo of a family gathered around a bedside. That man was barely 34-35 years old. He had lung cancer. This was in his home - where the hospice would provide home care. There were two autos that would take nurses all over the city to people’s homes, and on that day we were in the home of this man - he was a tempo driver. It was very jarring, but it was also really incredible to see how the hospice team dealt with the situation. Especially the auto driver, Somashekara - how he dealt with the situation. You could cut the tension with a knife in that room, and he just softened everyone and everything and made it all about caring for the man. He’s been doing this for almost 20 years. They hired him just to drive the auto, and over the years he has become so many things, for so many people. We were on the road an hour after that, and Somashekara got a call. He stopped the auto on the side and said, ‘See Sir, this is our life. The man whose house we just went to? He’s dead.’ It sends a shiver down my spine every time. I was just walking around in this world of theirs, trying to make sense of it in the little way I could.”

One person by his bedside that day was not a family member. Somashekara Chari encouraged the family to take Kumar to Karunashraya, the pioneer Bangalore hospice that offers free palliative care for advance-stage cancer patients who are beyond medical cure. Somashekara might notionally be just the designated auto driver for Karunashraya, but he has been visiting the dying for almost two decades as an emissary from the hospice. He has also become an official Karunashraya homecare manager in the last few years. That day, Somashekara cajoled Kumar into drinking a few sips of coconut water while cradling his head.

HG: In the whole time that you were there, was there one story in particular that stuck to you more than anyone else?

HA: “For me, it was Somashekara the auto driver. He told me in an interview how obvious he was to all of this, and he came into this job thinking its a regular gig, and he’ll just make some money. It was purely chance - someone knew someone who knew him, and he came to apply for the job. The hospice was barely built at the time, and he’s been there right from the beginning. They started first as a home care as they had no facilities for the Hospice. After 20 years of doing this, he is always upbeat and cheerful and making people feel better - always.

An hour after he left and still on the road, Somashekara learnt of Kumar’s death. Most of Karunashraya’s patients live in destitute poverty and close to the border of death.

Death is an interesting thing. If you work backwards, apart from showing you what caused it, and the things in our world that are causing certain parts of society to have a certain type of cancer, while other parts have certain other kinds of cancer. If we don’t shed some light on this, people are just going to be doomed to make the same mistakes over generations. It’s the choices you’re making - ghutka over cigarettes. If you’re choosing the first you are more likely to get throat cancer over lung cancer. The man with a hole in his mouth is in his late twenties with a child, and he didnt realise the effect - he started the habit when he was 13, and it just made him feel good. Their lives don’t really help - if you’re prone to addictions, stress doesn’t help at all. It sheds a lot of light on the people making these products and knowing how to market it to ensure sales. And that’s all just one aspect. Gutka is just one amongst the many poisons out there.”

HG: How would you want people to perceive this work?

HA: I would like them to see the everyday heroism that exists. Here are people who are selfless on a daily basis. I want people to know that this sort of place exists, and people are doing work like this that is going completely unnoticed. They do this without any expectation of fame - which is the beauty in their work. There are also the deeper questions of death and the kind of people in these places, the space, and what it is to live your last moments and look death in the face. The idea of death either gnaws at you or relaxes you, both of which are good things. If it gnaws at you, it provokes you to seek out information and understand it as best you can. If it relaxes you, then what more do you want?

HG: Our last question to you is to understand your stylistic choice for these pictures, seeing as how they have a very noir essence to them. What made you decide to do it in this fashion?

HA: Mainly, the subject is a little unpredictable in terms of light. The moment you aren’t able to control the light in the way that you want, and I’m not even talking about artificial lighting, but even in terms of something dramatic - colours become very difficult to control. But with black and white, it becomes purely about form, light and shadow and this allows you to play with the form a little bit more and express the mood as well. Death isn’t normally colourful, in some cultures it is in the way they send off their dead, but to the people they’ve left behind - there isn’t much colour there. That’s why I chose to do it the way I did.

To look at the full photo story, as well as Hari’s other work, check out his website here.

Pushpalatha, a home care nurse, treats a 27-year-old who was in the last stages of mouth cancer caused by chewing gutka. The nurses check vitals, change dressings and ensure correct medication is provided between visits.

Somashekara has physically lifted people who could not move, cracked jokes for gloomy patients and their families, scolded those who were giving up on life, given practical advice, and cleaned up after people who vomited or soiled themselves. He has personally helped over 2,000 people in their most desperate hours. Almost every time, he leaves patients with a laugh and good cheer.

Accessing morphine for pain relief is one of the biggest challenges for institutes offering palliative care in India. Here, a home care nurse labels a bottle of oral morphine solution to prevent accidental use.