Monthly Archives: December 2019

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The Begging Bowl

We all have needs; we are all mendicants at some level. Sometimes subtle: a smile that begs response, a look that hopes for more; sometimes obvious: a verbal request, or even a sign that solicits aid. But sometimes it is more blatant. Glaring. Almost rude.

I was once accused of that –of shameless, brazen panhandling. And right in my office. Near my desk.

It started out quite innocently, as I recall. I was given a clay sculpture by a Mexican patient. I don’t encourage gifts -to tell the truth I feel embarrassed by them- but she seemed so grateful for her care, her delivery, and her healthy baby, that I felt compelled to accept. The moment she struggled in with the box unannounced, her eyes shining, and her face a risus sardonicus, paralyzed with joy, I realized I was trapped. No matter the contents, I was meant to appreciate it. My mind returned to Christmases past with presents of socks or itchy home-knit woolen sweaters from my aunts, and how I had to pretend not to be disappointed. So it was not an unfamiliar skill –just long-dormant.

She seemed so pleased with her choice: a poor woman in a shawl sitting on the ground holding a begging bowl. The whole figure was done in a dirty grey clay and fired so it was rough to the touch. The most striking thing about it though was her expression: despite the lack of fine detail, the face commanded attention. The eyes in particular demanded succour -redress for what Life had thrown at them; compensation for the indignity of having to beg.

Whether my patient was concerned for the aesthetic welfare of my office, or the medical system in Canada, she didn’t say. She just watched, beaming and toothful as I opened the box, hugged me, then headed for the door. She hesitated for a moment before leaving, turned her head and pinned me to the spot with her eyes. “I know you understand, doctor,” she said slowly, the smile tucked away somewhere inside.

Well, to tell the truth I didn’t at first. In fact, I didn’t know where to put the begging woman either. Eventually, I brought a little oak table from home and put the two of them in the corner by the window on the other side of my desk. The fact that my patients sit beside the bowl she proffers didn’t strike me as particularly important. In fact, I forgot about it. When you see something every day that neither moves nor changes, it becomes invisible. At least to me.

One day I was talking to an older Asian woman when I noticed her glancing at the bowl whenever I wrote something in her chart. She seemed more troubled each time she looked. At first I thought it was because of the reason for her consultation –an ovarian cyst that looked malignant on ultrasound- but she didn’t sound worried. She didn’t even look anxious. Just perplexed.

“Am I supposed to make an offering?” she said suddenly, in the middle of a question I was asking.

“Pardon me?” It was such a non sequitur, that it threw me off my line of thought.

She reached into her purse and after a moment of scrabbling the depths, her hand emerged with a two dollar coin. “Not much,” she said almost to herself as she placed it carefully in the bowl, “but the poor woman looks so sad with that empty pot.” She stared at me for a while and then smiled. “Maybe it’ll bring me good luck…”

Well, that started the deluge. The coin glinted in the bowl like a flashlight, beckoning. A single offering demanded more: Fill the bowl, it said. The begging woman said -I didn’t; I just watched with fascination each time someone saw it and felt compelled to add something. Just in case. It couldn’t hurt, was written on each face.

Occasionally, I had to empty the bowl when its contents began to spill onto the floor each time someone accidentally touched the table leg with her foot. But an unfilled bowl seemed to spur even more contributions -I used them to fill real begging bowls, though, so I didn’t feel particularly weighed down with guilt.

It was a bowl that fascinated children. Whether it was the money, or the novelty of seeing something like that in a doctor’s office, they used every distracted maternal moment to try to sneak past a knee and grab for a coin. Most mothers are quick, but some are indulgent -trusting the judgement of their experimenting child and assuming that, unlike fire or naked electrical sockets, no harm is likely to come from their curiosity.

I, who watch nervously from the wrong side of the desk, do not trust, however. I am suspicious of every lunge, every mischievous grab. I recognize my younger self and the need, the compulsion, to out-wait the unusually tolerant eye and outwit the momentarily inattentive face.

But sometimes I, too, am preoccupied. Busy with the constraints of medical practice, focussed on mother not child. And so it began –softly at first, of course. A young child I apparently delivered three or four years ago while on call for my colleagues, made it past a set of knees and too-slow hands to reach the bowl. The mother caught the statue before it hit the floor, but not before the coins explored the room and the child screamed in a terrified expectation of retributive justice.

No lasting harm was done, although the little boy wouldn’t stop crying as his mother, down on her knees behind the desk, attempted to refill the bowl. I tried to reassure her, but I could see she was embarrassed and flustered. When the two of them finally surfaced from behind the desk, laden with silver, her mood had changed. She seemed more annoyed than apologetic.

“Why would you put that thing where someone could knock it over?” she said, pointing at the begging lady with anger bordering on litigiousness. “What’s it for, anyway? Bribes?” she added, either in a try for black humour, or more likely, threat.

I smiled in an attempt to diffuse the situation. “It was a gift from a lady I delivered,” I said, trying to remain calm now that the child, recognizing that his mother was mad at me not him, began to cry again.

“Well,” she said, huffiness creeping into her now-trembling voice, “It’s a good thing I didn’t get hurt.”

“Yes it is,” I agreed. Someone had to remain in adult mode. “Maybe I can put it somewhere else…”

Her face immediately softened. She realized she had made her point; I was listening. She lowered her eyes and took a deep breath. “I’m sorry,”she whispered. “I know it was Devon’s fault…” She burrowed into me with sad, repentant eyes. “I always get upset when he cries.” She blushed and immediately reached into her purse and put two coins into the now-overflowing bowl.

Then she looked at me for a moment before speaking. “One coin is for the one I saw him put in his pocket… ” -she glared at Devon briefly- “…the other is a bribe so you don’t tell anybody,” she said chuckling softly. “And,” -she reached across the desk and touched my hand- “I want to thank you for delivering my little boy. You had no way of knowing…”

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Truth hath a quiet breast

All these years I have been naïve, I suppose; I did not question that democracy entailed giving those governed a say in their fate. Perhaps I was not thorough enough in my analysis of the matter, and assumed that this would be obtained when and if a sufficient majority agreed to a particular proposal. But as I grew older and more contemplative, I recognized that merely acceding to the majority’s decision might leave the remaining minority at a disadvantage – disenfranchise them in a way.

I began to appreciate the wisdom of a tripartite system of governance for at least attempting inclusivity. This consisted of the elected members of government to create and uphold laws, the courts to interpret those laws and ensure they were upheld, and a free and unfettered press to inform the governed whether that was indeed happening -holding truth to power, as we now call it.

The naïveté, though, was in believing that simply informing the public of the state of affairs would be sufficient -that the mere declaration of independently confirmed facts would allow people to decide whether or not things were proceeding as they had believed. But it seems I was wrong -starry-eyed, or at least dangerously innocent of the power of confirmation biases in this era of socially mediated information-bubbles.

I am older now, though; I have been left behind, and perhaps the mist of years is beginning to envelope me like a gauze winding sheet. But, every so often, I find a tear in the fabric so I can see the room in which I lie more clearly. And I can smile, and hope that there is a route from the labyrinth that does not pass the Minotaur -or that there is, somewhere, a modern Theseus…

An essay in the Conversation by Kamyar Razavi, a television news producer and PhD candidate at Simon Fraser University offered me a kernel of hope. https://theconversation.com/how-journalists-can-rebut-trumps-fake-news-claims-110307

He begins by outlining the problem: ‘The news media wield tremendous responsibility over democratic discourse. Yet all too often the media are blamed for fuelling mistrust… News reports typically identify a conflict (a war), diagnose its causes (ISIS) and draw on sources (military analysts) to shed light on what’s going on. But there’s a fourth frame, identified by journalism scholar Robert Entman, that is easy to overlook in news reports — discussing remedies to problems.’ This is so-called ‘solutions journalism’.

‘Solutions journalism tries to change the journalistic equation by giving more prominence to solutions… [but, it] is not about advocating for solutions. It’s about turning a light on the remedies by making them a more prominent part of the narrative… For instance, where a typical climate change story may report on the latest doom-and-gloom statistics about forest fires, a solutions-oriented piece might explore the simple steps you can take to fireproof your backyard and your home. The solutions story still gets you thinking about climate change and forest fires, but in a way that is far more familiar and accessible.’

While disasters capture attention in the news, they seldom help us to think about how they might be avoided -especially if the next day, or even the next column, there are reports of yet another catastrophe. In other words, there seems to be ‘excessive emphasis in news reports on chaos, conflict and all that is wrong in the world —as opposed to what is actually working… It’s this constraining dynamic that can drive people into echo chambers and filter bubbles. It also makes people cynical.’

‘According to McIntyre and Gyldensted [journalism scholars], one of the ways journalists can open up a discussion about solutions is by adding a future orientation to their story — by asking, and trying to answer, the question: “What now? For example, reporters can ask their sources how problems could be solved, how people could collaborate, or what kind of progress their sources envision.” Another technique for drawing out solutions is for reporters to ask questions that get at people’s reasons for thinking a certain way — or that tap into what “the other side” thinks’.

I like this approach, because as Razavi points out, ‘solutions journalism gives people more reasons to think there are ways out of difficult problems — because there usually are.’ Hopelessness does little to encourage solutions -sometimes we need a few flowers.

I will always remember the day that my father died. I was at work at the hospital when my brother phoned, and told me of his not unexpected death at home. I had just delivered a baby, and was sitting in the nursing station writing my notes. Up to then, it had been a wonderful occasion with the husband and their four year old daughter in attendance at the birth. But after the phone call, I found I couldn’t concentrate, and the words I wrote seemed to belong to someone else -seemed, in fact, to describe something that had happened in another life. Another place…

Close to tears, the timing of the two ends of life did not escape me, but the coincidence seemed purposeless. Unfair. The nurses noticed my obvious distress, and smiled encouragingly at me as they hurried about on their never-ending duties. Some of them stopped to ask me why I seemed so sad, but I had trouble answering without giving in to uncontrolled sobs and looked away with a shrug at the questions. I had already told them his death was imminent, so I think they understood.

But as I sat there, staring at the chart with inchoate thoughts swirling about slowly in my head, I felt a tap on my leg.

“Doctor?” a little voice beside me said.

I looked down at the sad face of the little girl who had just become a sister. She was holding a single flower from one of the bouquets in her mother’s room -a white rose, I think. She reached up and handed it to me as a tiny smile crept onto her face. Her eyes twinkled as they locked with mine, and long black curls of hair danced on her shoulders with the movement of her arm. She was dressed in a long white princess dress with silver sparkles that shimmered under the fluorescent lights, and in that moment she reminded me of a latter-day Shirley Temple come to visit.

“Mommy thought you could use this,” she said, the smile growing with each word as the nurses stood around to watch.

And yes, I needed that -it touched me more than I could guess. There is always hope when there is someone to share it with. There is always purpose, even when it seems to arrive like the shadow from a departing cloud.

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There is nothing either good or bad but thinking makes it so.

If I’m brutally honest with myself, I suspect I side with Goldilocks in her preference for the just-right-baby-bear stance: not too hard, not too soft. I have always been more comfortable in the middle of the Bell Curve with lots of wiggle room on either side; I’m not really cut out to be an extremist. And I was always taught to be sensible and use things wisely: buy good quality and look after whatever I bought so it would last. But times change, I guess, and as the price of goods declined with improved production, and fashion began to favour frequent change, the temptation to buy and replace increased.

Still, making-do was what my parents did, although perhaps it was easier in the days when planned obsolescence was just an economic dream. Unfortunately, now I replace things more often than I reuse them -and more often than I really need to, as well. As the months slip past and the years pile up one upon another on the shelf, I fear I have also become a creature of things. A collector of more than just Time.

And yet I have always harboured a suspicion that new is not necessarily better, nor is more always preferable to less. I would probably make a rather poor salesman, with the menace of the sharp needle of conscience only millimetres away -although I have to confess to feeling the thrill of buying a new and different watch each time the 5 year battery runs out. I justify it by assuming I’m assuring that someone will have a job -and anyway, I’m keeping the economy afloat… Aren’t I?

Dichotomies like these make it difficult to choose sides, though, don’t they? Sometimes it helps to step back far enough to see both sides of the street, and an essay by the author Nick Thorpe in Aeon put things in a rather intriguing perspective for me: https://aeon.co/essays/we-should-love-material-things-more-than-we-do-now-not-less

‘We’ve got used to the transitory nature of our possessions, the way things are routinely swept aside and replaced,’ he writes. ‘It’s one of the challenges facing the UK Department of Energy and Climate Change, whose chief scientific adviser, Professor David MacKay, in January bemoaned ‘the way in which economic activity and growth currently is coupled to buying lots of stuff and then throwing it away’… According to data aggregated by the Global Footprint Network, it takes the biosphere a year to produce what humanity habitually consumes in roughly eight months.’

One could try to avoid consumer goods altogether of course, and yet things do wear out. Things do break. And some things become sufficiently outmoded that they no longer function in the rapidly evolving technosphere. So I suppose we have to persevere ‘with what the British psychologist Michael Eysenck calls the ‘hedonic treadmill’, holding out the unlikely hope that the spike of satisfaction from our next purchase will somehow prove less transitory than the last.’ But as Thorpe observes, ‘If Western consumer culture sometimes resembles a bulimic binge in which we taste and then spew back things that never quite nourish us, the ascetic, anorexic alternative of rejecting materialism altogether will leave us equally starved.’

The answer, as Goldilocks knew all along, lies in compromise. It’s not that we value things too much, but rather that we don’t value them enough. ‘The challenge is to cherish our possessions enough to care about where they came from, who made them, what will happen to them in the future.’

We seem to be innate categorizers, more addicted to the hierarchies of price than cognizant of intrinsic value. And yet, with only a slight shift in perspective, wouldn’t it be valuable to ‘retain the pulse of their making’ as the British ceramicist Edmund de Waal put it? Much as a gift wears a different aura, and adds a different value to the object than is merely contained in its function, consideration of its history and its craft may well do the same.

In the modern world we are too far from the source to marvel at the genius of its production. I am reminded of one of the novels of Mark Twain –A Connecticut Yankee in King Arthur’s Court– in which an American engineer from Connecticut sustains a head injury and awakens in the medieval English court of the mythical King Arthur. It hadn’t developed the processes and gadgets we take for granted nowadays, so it fell to the engineer to develop them from scratch.

I tried to imagine making a working bicycle and the need to fashion it from whatever raw materials were at hand. And had I succeeded -which would have been well beyond my skill- I certainly would have viewed it in a different light than nowadays. The same had I built a clock, or fashioned reading glasses, or even devised a flashlight… My midden would not have required weekly removal.

Still, it’s not just keeping everything you’ve ever bought -that would be hoarding- but in valuing the item enough to repair it and continue using it: Repair, Reuse, then Recycle. Thorpe writes about a growing trend (at least in his part of the UK) of repair shops, and about an absolutely delightfully named social enterprise ‘‘Remade in Edinburgh’ [which] is one of a growing network of community repair shops dedicated to teaching ordinary people to mend and reuse household goods.’

Of course, the ability to avail oneself of this sort of thing is dependent on the initial quality of the item, as well as the opportunity to avoid the planned obsolescence of a technology wrapped in its own hubris. It also requires role models that we can all admire and emulate -people -and things- of proven worth.

Much as we tend to look up to sports heroes, say, or famous scientists, perhaps we need look no further than ourselves, and our biology’s long evolutionary history of successful strategies to reuse what we already have. Sometimes there is no need to develop new genes, or even new organs, to increase our success: existing equipment can be repurposed. Exaptation is the word that the palaeontologist and evolutionary biologist Stephen Jay Gould and his colleague Elisabeth Vrba proposed in 1982 to describe a new function for which an organ, say, was not originally intended. An example might be that of feathers on dinosaurs -in that instance, they may have been helpful for warmth, but were obviously not originally intended for flight as in their later descendants, birds. Or another example, drawn from my own specialty (Obstetrics), but drawn to my attention in an essay in Livescience by Wynne Parry: ‘All vertebrates have sutures between the bones of their skulls to allow for growth, but in young mammals these sutures have acquired an additional use easing birth by allowing the skull to compress as it passes through the birth canal.’

Inventions are seldom wasted in nature; why should we think our own artifacts need be an exception? There are so many obvious precedents that should encourage it -maybe would encourage it- if they were more widely known.

Okay, I’ll admit it’s quite a stretch, and perhaps unduly naïve to think that it would have much of an effect on the average person. But sometimes I think it’s important for us to believe that we have permission to rethink our obsession with novelty, and to realize that we are here today largely because of repurposing. Reusing. And then, ultimately, being ourselves recycled so we can all begin anew…

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The Whirligig of Time

Every once in a while, I come across something that seems at odds with the history I’ve learned. Admittedly I’m the product of an older, more gendered Zeitgeist, and in the intervening years, have struggled to accept what I might once have termed historical revisionism. Each epoch seems to want to believe its own version of the past and interprets artifacts -whether newly discovered, or housed in dark drawers in museums- accordingly. Traditionally, of course, history has been written by the victors -the powerful- and so it has always been a matter of conjecture how accurately ethnographical descriptions of the time, captured the lived reality of the era.

It is often tempting, either through lack of sufficient historically corroborative evidence, or currently prevailing attitudes, to denigrate the achievements of women in the past. Evidence of the contrary, must needs run a gauntlet of well-entrenched, and therefore not entirely impartial judges. The current of paradigms run deep and largely unnoticed until challenged, and the resulting turbulence, no matter how insightful and epiphanous, can nonetheless be unsettling.

How can history change if it has already occurred? Is it merely interpretational -like the apocryphal two people crossing the same bridge seeing different bridges? Or more nuanced, more coloured by our present day conceits than we would like to think -the hammer judging everything to be a nail?

Sometimes a sturdier explanation arises from evidence being viewed with modern and, hopefully, more objective techniques -techniques like, say, DNA, or perhaps, sophisticated chemical analyses which largely remove any subjective biases.

One such study I discovered while strolling through the various online magazines to which I am habituated, seemed unusually compelling. It was an article written by Sarah Zhang in the Atlantic that outlined how the analysis of dental plaque in the remains of a medieval woman revealed the existence of hitherto unexpected female scribes in what had been seen as an almost exclusively male profession. https://www.theatlantic.com/science/archive/2019/01/the-woman-with-lapis-lazuli-in-her-teeth/579760

A brilliant blue was found in the dental tartar of a 1000 year old woman buried at a women’s monastery in Dalheim, Germany. ‘It was ultramarine … a pigment that a millennium ago could only have come from lapis lazuli originating in a single region of Afghanistan. This blue was once worth its weight in gold. It was used, most notably, to give the Virgin Mary’s robes their striking color in centuries of artwork. And the teeth that were embedded with this blue likely belonged to a scribe or painter of medieval manuscripts… [T]hese embedded blue particles in her teeth illuminate a forgotten history of medieval manuscripts: Not just monks made them. In the medieval ages, nuns also produced the famously laborious and beautiful books. And some of these women must have been very good, if they were using pigment as precious and rare as ultramarine.’

Anita Radini from the University of York, and her co-author Christina Warinner, a microbiome researcher at the Max Planck Institute were actually looking for other things, but became captivated by the blue particles on the teeth.

Alison Beach, an historian at Ohio State University who studies female scribes from 12th century Germany has cataloged the overlooked contributions of women to medieval book production and she noted that ‘while most manuscripts with signatures are signed by men, the vast majority of manuscripts are unsigned. But a small number of surviving manuscripts are signed by women, and scholars have found correspondence between monks and nuns about book production.’

The question about the lapis lazuli was obviously how it got into the woman’s dental plaque in the first place, though. Was it through some sort of medicine, or even from devotional kissing the of the manuscript? Both of these things were ruled out by knowledge of contemporary practices, and the fact that the particles were particularly fine suggested that ‘the stones were purposefully made into pigment.’

Finally, it was concluded that ‘two scenarios are most likely: The woman was a painter who could have ingested ultramarine paint while licking her brush to a point, or she breathed in the powder while preparing pigment for herself or someone else.’

Either way, though, the findings are certainly evidence of the largely unreported roll of women in medieval life -and the respect accorded them in their areas of expertise. Admittedly, in this case the scriptors and illustrators were nuns, and presumably more educated than the vast majority of feudal peasants of the time outside of their walls -and yet, so were most of the men in the grips of that same system.

Given the intellectual equality of the genders, I wonder how much more there is about historical women we do not yet appreciate. Since women were not usually allowed to sign the religious scripts on which they had worked, how many other things were they contributing that has been lost to time? I cannot believe that men when confronted with problems, whether in trade or everyday practical issues, would not consult with their wives for solutions -especially if survival was at stake.

Of course, special cases like Hildegard von Bingen spring all too easily to mind. She was a German Benedictine abbess living between 1098 and 1179, and so roughly contemporaneous with the lapis woman (whose bones were dated to between 997 and 1162). As Wikipedia describes her, she was a ‘writer, composer, philosopher, Christian mystic, visionary, and polymath. She is considered to be the founder of scientific natural history in Germany.’ I have to admit that I only became acquainted with her because of her music, not her numerous other talents, but the very fact that she was able to be fêted in her own time despite her apparent lack of instruction in ‘the Seven Liberal Arts, which formed the basis of all education for the learned classes in the Middle Ages’ encourages me to think that others, albethey less well known, were also able to succeed along with her.

Still, I suppose we may have to await future discoveries to appreciate just how much women in less publicized arenas contributed to the well-being of their families, or the success of their husbands engaged in other endeavours.

But hurray for teeth, eh…?