The Four D’s of Life: Disease, Disability, Dependency and Death

When I think about what leaves people dependent on others, or even destitute, it almost always comes back to one of four things: disease, disability, dependency and death. And all four are inevitable. Watching a family member go through a long illness made me think about them more deeply. They are not just words. They shape our lives in ways both obvious and quiet, and understanding them can help us live with more wisdom, compassion and resilience.

Disease: the wake-up call

Disease is something no one invites, but almost everyone meets. In India, diseases like dengue and typhoid are common, and chronic conditions like diabetes increasingly so. When someone falls ill, it affects not only them but their whole family and their friends. Life takes a sharp turn. School or work is put on hold, routines fall apart, and everything revolves around recovery.

Beyond the physical and emotional strain, disease is a reminder that life is unpredictable. It makes us stop and value the health we took for granted, and look again at our habits and choices. It taught me something more personal too. I used to be a perfectionist. Then I fell ill, and realised: if I myself am not perfect, how can I expect perfection in what I do, what I get or what I see?

Disability: redefining what’s possible

Disability can come to anyone, at any time. Some people are born with it; for others it follows an accident or an illness later in life. Consider someone who has only one eye. To most of us, that looks like a limitation. But if the entire world had only one eye, would we still call it a disability? Probably not. What we call disability is relative, shaped by what the majority has taught us to see as normal.

And there are countless people who, different from the majority, have achieved remarkable things as professionals, athletes and artists. Arunima Sinha lost a leg in a train accident and went on to become the first woman amputee to climb Mount Everest. She didn’t let her disability set her limits. In a country like India, where accessibility is still a real challenge, living with a disability often demands enormous creativity and resilience. Disability asks us to rethink what normal means, and what is possible.

Dependency: the strength in relying on others

However much we value independence, everyone faces moments of dependency, through illness, injury, age or circumstance. Asking for help can feel uncomfortable, yet it is one of the most human things we do.

There is a story, often told about the anthropologist Margaret Mead, that the earliest sign of civilisation was a healed femur. In the wild, a broken thigh bone was fatal: you couldn’t move, hunt or defend yourself. A healed one meant that someone had stayed, cared for the injured person and protected them until they recovered.

In India, family is central, and several generations often live together. Dependency is seen as a natural part of life, especially in old age, when children or siblings become caregivers. That is not only obligation. It is the bond of love and respect that holds families together. Preparing for these moments practically is what I wrote about in Life File 101. Our ability to support each other is what makes us stronger, not weaker.

Death: the ultimate teacher

Death is the one certainty we all share, yet it is the hardest to talk about. Most of us have lost a grandparent or another loved one. The grief can be overwhelming, but it also brings people together. In many Indian traditions, death is not an end but a transition, part of the cycle of life, and the rituals that follow are as much about honouring a life as mourning it.

Death reminds us that life is short and finite. Knowing our time is limited can push us to live with intention: to pursue what matters, to spend time with the people we love, or simply to notice the beauty in an ordinary day.

Living with the four D’s

Disease, disability, dependency and death are inevitable, and deeply connected. Rather than fearing them, we can accept them as part of the journey, and let them make us more compassionate, more resilient and wiser.

Life is not only about reaching the destination; it is about the journey, with all its challenges and rewards. The journey to the destination is determined by destiny, yet how we walk the path is what defines our legacy.