|Year : 2022 | Volume
| Issue : 3 | Page : 312-314
Aye zindagi – The show must go on!
Jaya Agarwal1, Pallavi Kumar2, Christi Titus Varghese1, Unnikrishnan Gopalakrishnan1, S Sudhindran1, Urmila Anandh3
1 Department of HPB Surgery and Solid Organ Transplant, Amrita Hospital, Faridabad, Haryana, India
2 MOHAN Foundation, Multi Organ Harvesting Aid Network, Faridabad, Haryana, India
3 Department of Nephrology, Amrita Hospital, Faridabad, Haryana, India
|Date of Submission||01-Dec-2022|
|Date of Decision||09-Dec-2022|
|Date of Acceptance||09-Dec-2022|
|Date of Web Publication||28-Dec-2022|
Dr. Urmila Anandh
Department of Nephrology, Amrita Hospital, Faridabad, Haryana
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Agarwal J, Kumar P, Varghese CT, Gopalakrishnan U, Sudhindran S, Anandh U. Aye zindagi – The show must go on!. J Med Evid 2022;3:312-4
In an atmosphere where we all continuously despair about the disappointing state of affairs of organ donation in India, there comes a movie shining as a beacon of light in our theatres. The Bollywood movie 'Aye Zindagi', released in October 2022, carries a powerful and affirmative message that is the need of the hour. How multiple lives can be saved with a single 'yes' for donation comes out strongly in the movie. The motion picture appealingly conveys there always is a ray of hope amidst clouds of sadness and despair. This message of hope is very relevant in the current environment where the majority of Indians shy away from organ donation.
The film can be split into three parts. In the first part, Vinayak, the protagonist (played by Satyajeet Dubey), is confronted with the diagnosis of liver failure. With the unrealistic belief that he can carry on with his job while getting treated for the ailment, he makes every possible attempt to conceal it from everyone around him. However, as his disease and his symptoms progress, he is unable to cope with the challenges of work and is faced with the fear of losing his only source of income as well as his impending mortality. In the second part, the director Anirban Bose has skillfully tried to instill a sense of humane touch by showing how Vinay's brother (Kartik), friends and colleagues rally around him and leave no stone unturned in getting him through the journey of a liver transplant. The longest and the most torrid part of his journey was about to start. The third part depicts the survivor's guilt where Vinayak gets caught up in his inner duel between 'desire to live freely and happily' and 'to not having to carry the burden of gratitude'. The three phases are seamlessly adapted throughout the movie except in the last phase, where the audience would have liked a shorter and more taut narrative.
The opening scene introduces Revathi Rajan (played by veteran South actress and three-time National Film Award winner Revathy Menon), a grief counsellor preparing herself to counsel a grieving couple to donate organs of their recently deceased loved one. The scene depicts how her job requires her to persuade grieving families to organ donation, where she gets rebuked initially but is finally able to inspire the family to consent. Although her gloomy profession casts a shadow on her family life, she retains her faith and perseveres to encourage organ donation and transplants, an area of work both new to the country and to her.
This is a story based on the true life events of Ms. Lalitha Raghuram, who is a grief counsellor. As the Country Director of the MOHAN Foundation, she has paved the way in streamlining the process of organ donation in accredited hospitals in our country. She, along with MOHAN Foundation, has played the role of a catalyst between the public and private sectors to build a culture of organ donation in our country. Actress Revathy has efficiently portrayed her role in the movie and has projected the emotions of despair, love and hope in a laudable manner.
The debutant director Dr. Anirban Bose has projected the life of the patient in a very realistic way. Dr. Bose is a senior nephrologist at the University of Rochester Medical Centre and Advisor and President for MOHAN USA. Lalitha's story touched him in a profound manner, and he took the dive to direct a movie for the first time in his life. The message that although transplant surgery is a 'major' surgery, it actually plays a very small role in the life of the patient was conveyed in a very convincing manner. A transplant recipient can move on, pursue his career ambitions, build on his desires and dreams and lead a normal life was something that the movie could clearly display.
The strength of the movie lies in the powerhouse star cast. Vinayak, the 'impatient patient', carries on his young shoulders in an outstanding manner. His journey is that of a middle-class ordinary 30-year-old man who has never consumed alcohol yet starts having symptoms of liver disease. The skilful description of the symptoms of liver disease is a must-watch, especially for medical students, as it depicts all the symptoms from head to toe as liver disease progresses. One has yet to see a commercial, non-medical film portraying the symptoms of liver failure in such a real and graphic manner to the minutest details.
Revathi, as the counsellor, depicts the dilemma that the family has to go through when a near relative is declared brain dead. Most feel as she rightly says that the vitals are stable, and it looks like the patient is only sleeping. Understanding the concept of brain death and accepting their loved one has died is very difficult for the majority of families, and this movie is an outstanding effort in the right direction. This wholesome saga is a must-watch; however, do keep a tissue handy as some scenes are gut-wrenching.
The movie also portrays how the disease affects the patient's personal and work life, how he feels he has been given a death sentence and goes into depression. With the help of a closely knit circle of family and friends, he is able to get hope and yearns for a healthy liver so that he can lead a fruitful life. 'Umeed ki kashti ko kinara mil jaata hai (navigating the boat of life, amidst the mist of despair the shore of hope begins to emerge)' when he gets the news that a deceased donation has happened. Post-surgery when he finds that the donor is Revathy's son, he is taken aback. He is shown to suffer from the survivor's guilt that he has been able to live only because someone else whom he knew had died. This is probably the reason why in the current medical practice, the donor's identity is not disclosed with the patient or their family.
Another important point that is highlighted in an impressive way in this movie is the sacrifice and contribution of the near and dear ones of the patient. Vinayak's elder brother, who is in the prime of his career as a doctor, had to postpone the opportunities that came his way to aid his brother in going through the transplant and supports him throughout the process. The easy camaraderie between the brothers and the sharing of some light moments brought the much-needed respite and humour in between the tense scenes and made the viewer laugh even through the pathos.
The closeness of Vinayak's friend circle, as depicted in the movie, is the need for the hour. Their support both in aiding with the work and helping to raise funds was commendable. The initial lack of support and the subsequent understanding of the management of the firm where he worked towards his illness and in helping him through the transplant should set an example for the social support that a patient must get in a country like ours. The financial implications of a transplant are huge to the patient as well as the family. Ways to support them in the form of government policies, insurance schemes and crowd-funding opportunities should be accessible to all, and the movie was able to bring this out quite well.
Another point that was briefly hinted in the movie was how organ allocation happens in our country. The movie is set in early 2000 when the system of organ allocation in our country was in its infancy; it has gradually evolved over time. The listing of the patient, severity of disease and a uniform and fair allocation system that is common to the entire nation are something that still requires considerable work to streamline the process. This would help create faith in the system and encourage more people to pledge for organ donation.
Although one feels that the romantic angle between the patient and the nurse is deliberately put in the story to give a dramatic touch to the story, in reality, it depicts the true stranger than fiction real events that happened in the patient's life. The recipient and the nurse do fall in love in real life and go in to get married and move to the USA. It does offer great hope to the viewer and highlights the beauty of organ donation by putting forward the fact that although the donor due to unfortunate events could not be returned back to the family due to the donor's effort, another individual can go on to live a completely fulfilling life.
Even the scene at the airport where Dr. Kapoor, Vinayak's transplant surgeon, says that every person comes into this world with an 'expiration date' and that if he was the father of the girl, he would have given consent for her marriage to Vinayak was very reaffirming and gives a positive message on how transplant recipients can live a healthy and complete life post-transplant.
There were some flip sides of the film that required more focus and could be better explained. The reason for liver disease, although briefly mentioned was not emphasised in the film. A lot of patients, especially young patients who are teetotallers also get a liver disease which demands in-depth evaluation and awareness about the same.
Although living donation entails putting a healthy person at risk of major surgery which may have complications as well, it has become a pressing priority in the current scenario in our country. Patients, who are very sick, cannot wait long for organ donation, and due to the appalling number of deceased donations in our country, living organ donation is legally allowed from near relatives. The scene where the doctor was counselling against living donation in the movie might put forth a wrong message to the public, even if it was relevant in the early 2000s. Medical science has advanced greatly now, and living donor transplants are routinely and safely performed.
The transition from Vinayak receiving a transplant to his life 7 years later was too quick, and we feel some emphasis should have been given on post-transplant lifestyle modification as many patients after a few years of surgery either stop taking their medications or fall back to habitual drinking.
Finally, the guilt that Vinayak carries, while understandable since he knew Revathy Rajan, was to our mind stretched a bit too far and could have been slightly underplayed.
Although a lot needs to be done in the path towards making deceased donations acceptable to the public at large, small baby steps may be a good place to start with. This has been portrayed in an exemplary manner in this invigorating piece of art.
The emphasis that Revathy puts on the fact that 'One brain death donor can save seven lives' comes out in an outstanding way, especially when she is seen explaining this fact to her own daughter after her own son is declared brain dead. She aptly suggests deceased donation as the 'magic of instant seven-fold return on investment, where death is not an end but a new beginning of seven lives'. In a corollary to this, there was a heart wrenching depiction in a series called 'Resident' of how a doctor makes his 5-year-old daughter hear the heart sounds of the patient in whom her mother's heart was transplanted after she met with an accident and was declared brain dead. It gave a sense of eternal presence to the family members of the close one who died in an unfortunate and unexpected manner.
The statistics and messages given at the end were powerful messages on the need for donation. Pictures of Luv Dhody (Vinayak) with his wife and two children were reaffirming images of the power of transplants, and the picture of Ms. Lalitha Raghuram with her granddaughter shows how life goes on and happiness can be found even after tragedy and loss.
Even in the movie, Revathy very appropriately states that Vinayak does not remind her of her son's death; it actually reminds her of his life. The show must go on!
Under the guidance of Dr. Puneet Dhar, this movie was screened at Amrita Hospital, Faridabad in an effort to sensitise the staff and doctors about the benefits of deceased organ donation. We would like to thank the producer Shiladitya Bora who gave us the movie link at a subsidised price to stream to enable this review. We would also like to thank the management of the hospital for allowing us to broadcast the movie at our hospital. We would like to thank Swami Harshamrita and Ramu for aiding with the audio-visual transmission of the movie and the subsequent zoom session without a glitch. We would like to thank the director Dr. Anirban Bose, Dr. Sunil Shroff, Dr. Sudhindran and our post-transplant patient Ketan for joining through zoom for a group discussion which clarified a lot of the unsaid points. We would also like to thank Dr. Samiran Nundy (who helped draft the Transplantation of the Human Organs Act 1994, making organ donation possible) for gracing the occasion.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.