The Weight of Flowers

I sit down with Nirmal on a small bench in her garden. It is December here, yet the smell of jasmine flowers permeates the morning air; Bangalore is one of few places with a forgiving enough climate that allows them to grow year-round. Nirmal sits comfortably in a lavender and grey nightie, the airy fabric blooming and wilting in the breeze. “Oh!” She rises gingerly and shuffles her way through the back door into the kitchen—her Parkinson’s demands slow and deliberate movements. She reemerges a minute later with a glass in one hand and a pill box in the other. Tossing a handful of pills into her mouth, she takes a large gulp of water and swallows them all in one go. I wonder aloud what she is taking. Her brow furrows in consternation as she struggles to recall the names of her various medications. A long pause. “Syndopa!” she exclaims triumphantly. She cannot conjure the names of the other ones but tells me they are for depression, anxiety, insomnia, and incontinence. I ask if she wouldn’t mind sharing her journey with Parkinson’s and she graciously agrees.

In early 2018, Nirmal felt as though she was slowing down. As do many women in their 50s, she dismissed any legitimate concerns, chalking them up to “normal aging.” To combat this feeling, she joined a gym. She was dedicated to her 30 minutes of physical activity a day and paid close attention to her diet; however, every time she stepped on a scale, her weight read the same. None of these lifestyle changes seemed to help—in fact, she continued to deteriorate. Nirmal described moments where her limbs felt leaden, inhibiting movement and imprisoning her in her own body for minutes at a time. Then it was hours—but this still didn’t alarm her.

One afternoon, while driving to the mall with a friend, Nirmal found that her accelerator had suddenly stopped working—she was unable to depress the pedal even a centimeter. The oppressive Indian traffic had chosen an ideal time to rear its head, allowing the pair a few minutes to scramble for a solution. Finally, her friend asked if she could come over to the driver’s side and try it for herself. They switched places just as the traffic began to dissipate, and when her friend stepped on the accelerator, the car lurched forward without trouble. 

As they sat in the auto shop awaiting the mechanic’s diagnosis, her friend noticed Nirmal’s hand quivering, so slightly it was almost imperceptible. “Since when has that been happening?” she asked. She worked in the hospital as a scribe, and although she didn’t have complete medical training, Nirmal always appreciated her input and heeded her concerns. As Nirmal walked over to pay the bill, her friend observed: small, cautious steps, four of them in a circle to turn, arms stiff at her sides. There was an eerie inertia hidden in her movements. That was the day they made her first neurology appointment, and the last day she ever drove a car.

“Parkinson’s,” the first doctor said definitively. Because Nirmal’s daughter insisted on a second opinion, they saw another neurologist. “Not Parkinson’s,” this one said, equally decisively. Nirmal was young, and her symptoms did not follow the typical disease chronology, confounding all six of the doctors they consulted. Finally, they decided to drive a couple hours to a Parkinson’s research institute, where she spent a week in close proximity to the lab, undergoing hours of cognitive, psychological, and physical examinations. At the end of a tiring seven days, they had an answer: drug-induced Parkinson’s. The culprit? An over-the-counter painkiller called Saridon.

Nirmal first began taking Saridon in 1987, not coincidentally, the year she got married. India is a country bursting with vibrant colors, incomparable flavors, and sensational tunes, but it has never been heralded as one that values humanism, a painful truth held in the home lives of women across the country. Because there was little discourse (or recourse) for any sort of abuse—physical assaults, gang rapes, acid attacks, even trafficking of sisters and wives—there was no way for the concept of emotional abuse to be heard. Thus, all Nirmal could do was keep quiet and exist cautiously under the tyranny of her husband. The stress triggered headaches nearly every day, which she instinctively treated with a dose of Saridon.

A couple months into their marriage, Nirmal became pregnant with her first baby. She saw this as a blessing, as a way for them to come together over the joy of bringing new life to the world. But as soon as they found out she was having a girl, her husband absconded, leaving Nirmal to fend for herself while carrying his child. It was only when her father bribed him with a new house that he agreed to stay with Nirmal. Although her husband’s involvement in the pregnancy was minimal and his emotional abuse maximal, divorce was never a passing thought for her—such was the time; such was the culture. Such is the culture. Her headaches turned into migraines, which she treated with a double dose of Saridon, twice a day. No one told her this may be too much, but even if they did, she probably would have continued taking it. All she wanted was to be well enough to help her daughter have a good life—one that was blissfully ignorant of everything going on at home.

As the years passed, Nirmal began to feel like her daughter was lonely, so she was overjoyed when she became pregnant for the second time. She shared the news with her husband, who to her surprise, offered to take her to the clinic for a prenatal health check. Nirmal knew that he hoped for a son, but she maintained confidence that they would be able to work through any outcome—after all, he came back last time. She rubbed her belly excitedly as he filled out paperwork, asking for her help or her signature every once in a while. Soon they were called back to an exam room and she was given a gown to change into. The doctor entered the room with an ultrasound monitor.

The blood drained from her face as the doctor explained the procedure and possible side effects—never once stopping to ask if this was what she wanted. When he left to fetch his instruments, Nirmal fell to her knees. She sobbed, begging her husband to let her keep the baby. She promised she would never ask him for any help or any money; however, despite her pleas, the abortion proceeded as planned. From that day onwards, the frequency and severity of her headaches increased tenfold, and again, she multiplied the number of painkillers she was taking to treat them.

After the abortion, Nirmal was deemed sterile. Thus, when she became pregnant once more, she felt it was nothing short of a miracle. She hid the pregnancy from her husband until abortion was no longer an option, at which point he said: “If it’s another girl, don’t bother even coming home.” With the strength of her and the unborn child inside her, Nirmal uttered the word “divorce” for the first time. A traumatic court battle raged for three years, and took a huge toll on her relationship with her kids. This maternal strife was worse than anything she had experienced before. The migraines were also worse than she had ever experienced before, and the Saridon was barely able to keep them at bay. 

The damage had been done by the time she finally went to see the neurologists in 2018. Her condition could not be reversed, and even if she stopped taking the Saridon, she would continue to worsen. Nirmal’s life was forever altered, but if she were to do it all over again, she would. Her kids were successful—her daughter, a fearless leader at Facebook, and her son, a budding engineer in Chicago. She had done what she always intended to do: give them a better life and spare them the trauma she faced. 

Now she bides her time in this little villa on the outskirts of Bangalore, where the wind is sweetened by the smell of her favorite flower. Her condition comes with a lot of dangers—falls and seizures being the worst—however, she is adamant on remaining independent. The Parkinson’s might limit her daily activities, but it does not limit her freedom. Many of her family and friends feel it is in Nirmal’s best interest to pursue assisted living, but she refuses, vehemently. After twenty years of living under the shadow of a despot, she is finally free to live on her own terms. And when the time comes, she will go, knowing that her freedom will live on in the jasmine-scented wind. Her freedom will live on in this story she shares. Her freedom will live on in her children.

Parallel Chart:

Nirmal is my maternal aunt. She was never meant to be the subject of my assignment, but it seemed fitting because I had not really known her before—not in this way, at least. To me, she was my Mum’s older sister, the one we saw every couple years, the woman who made the best daal in the world. Single mother was never label I had for her in my mind; maybe that’s a testament to how strongly she was able to maintain a carefully curated reality, just to protect us young ones. 

We sat in the garden that morning, talking casually about the new lehenga I bought and what we fancied for dinner as we waited for the rest of my family to arrive. She fumbled with a pill box in her lap, and I wondered if I should offer my assistance or if that would seem degrading. Luckily, she discarded my moral conundrum by popping the lid off on her own. My Mum had mentioned her sister had developed Parkinson’s, but I hadn’t seen Nirmal since learning this. I asked with mild curiosity what medication she was taking, uncertain if she would want to discuss it with me. A lot of things are stored in the recesses of an Indian woman’s mind; such is the training of our culture. She took a second and eventually recalled her Parkinson’s medication, but was unsure about the names of the rest of her pills.  “Wait, one minute” she said. She stood up and walked with renewed energy to a thick folder on her dining table. She placed the medical records in my hands and beamed. I was the only (student) doctor in the family. And I knew that more than me helping her understand her records, she just wanted the chance to be proud of me. 

I had my phone in one hand, Googling the English names of these medications. I was more surprised than she was, when I was able to explain each one to her, how they worked and what side effects might be (which she was certainly facing). So much of her illness had been written off as psychological instability, as something that was self-inflicted. She told me about how her brother, my uncle, always commented on how dull and depressed her face seemed. He would berate her for overthinking and then tell the doctor that she was being overly emotional. The doctors would heed his words over hers, inappropriately changing her treatment plan. It baffled me that something with so much credible clinical evidence, such as flat facies, was still being handled in this manner. Some things, she admitted, would never change—not in this country, not in her lifetime. She herself had been persuaded to believe some of the accusations her family and doctors made.

I tried earnestly to dispel any misconceptions about the disease. It reminded me of own history with mental illness and how the damaging Indian mindset of the past generation has seeped into the U.S. with the wave of immigration. I thought about my cousin, originally from India, but now a family medicine practitioner in the States, and his opinions on my use of SSRIs. “You have to change your mindset. Try doing meditation.” These phrases echoed in my mind. I know with certainty he would not speak this bluntly to his American patients. Is it just that we hold the ones closest to us to the highest standards?

My Mum had told me that Nirmal’s Parkinson’s was deemed “medication-induced,” but she had not elaborated. Now free from the fear of her being guarded, I asked her if she would take me through her experience. 

During many parts our conversation, I felt a strong urge to cry—and I’m not a crier. But as she recounted the events of her harrowing marriage, there was not a waver to her voice. I told myself I couldn’t let my tears fall, in respect for the steeled resolve with which she told her own story. But the burden of grief and guilt that so many Indian woman have to carry silently just about broke me.

I couldn’t remember my uncle, her ex-husband, and by the time she finished narrating the nightmares of her marriage, I was glad that I didn’t—some things are beyond unforgivable. As the saga unfolded, I really couldn’t believe my ears. I asked her to clarify or repeat things more than once, and every time, I had in fact heard right. It was that bad. I thought back to my own family, thinking about how I had begged my mother to divorce my father numerous times. Each time she told me: “Your father is not a bad person. Your pedhamma has faced much, much worse.” I thought about how differently “bad” is contextualized in the East versus the West. Is it necessarily fair to hold my Indian mother to my American standards? Is it wrong for me to silently label her experiences as traumatic when she herself doesn’t feel that way? 

One of the recurring themes of our conversation was her children. They were her source of strength, but she loved them so much that they were also her greatest vulnerability. At the time of the divorce and custody proceedings, Nirmal felt as though her children hated her. She grew the most emotional when remembering how her daughter didn’t speak to her during the three years of the court battle, and as soon as she became old enough, she moved to the U.S., hardly saying goodbye. Even though I am not a mother, I somehow viscerally felt her pain. It momentarily made me reluctant to have children, but I realized, that was not her point.

I felt grateful to be privy to some of the most traumatic moments of Nirmal’s life, and for her, hearing the whole story strung together for the first time seemed to offer a sense of relief. When I met my Mum a few days later, she told me Nirmal described me as her therapist. I laughed and denied the accolades—all I offered was a few reassuring statements. Mostly, I just let her talk. It pained me so much to realize that she had never been afforded even that. If just one person had been by her side through those twenty years, I wondered if she would even be in this position. Would the Parkinson’s have been avoided altogether? I became so acutely aware of the dangers of leaving a psychological need ignored, and the direct consequences on physical health. This is an extreme example, but an important one nonetheless.

I helped my pedhamma organize her pills for the upcoming week, and we finished just as the rest of the family announced their arrival with a loud honk from the driveway: It was time for us to go run errands. I asked if Nirmal cared to accompany us, but she was reluctant to leave the house—any outing would wipe her out for the next few days. Besides, it was time for her afternoon nap.