musingsonwomenshealth.com

Reflections on 40 years as a doctor in Women's Health

Most people are other people


Do I really have a true self? There was a time when it seemed obvious that I, quite apart from being an individual and not a replica of my neighbour, possessed a unique identity; or at least it was something that I would eventually have, because, as the philosopher Sartre wrote, existence precedes essence; I would define who I was by my actions, and choices; and these would eventually determine my identity: my essence. I wasn’t born to make certain decisions, I just did. My essence wasn’t somehow stitched into the egg and sperm that created me; there is no True Me that either my genes, or circumstances will necessarily force me to become.

Still, should I try to be like someone else, someone who I admired, or who has contributed to society? Perhaps, but wouldn’t that amount to a form of identity foreclosure (a term often defined as the premature commitment to an identity: the acceptance by individuals of a role, values, and goals that others may have suggested to them.) Might that not lock me into a viewpoint that I find difficult to change even if later circumstances suggest I should?

Identity is an interesting word, and one that lends itself to self-definition; it comes from the Latin identitas, with the root idem, which means ‘same’. So if I lose a stable identity have I lost who I am; would I no longer be me? An interesting question, don’t you think?

The problem, though, is that things around us are always changing; we cannot always predict what may happen next. If our still comfortable identity makes it difficult to react appropriately to new external influences, we  might find it hard to accept a new one that can guide us more appropriately through the change and uncertainty.

Still, I wonder if what some have called our original nature is really the only important one -the one with which we were born: the unfettered, uncluttered, and naïve one… So, if we try too hard to establish a later definite identity for ourselves, we break faith with our original and true nature; the fluid, adaptable nature; the nature with the capacity to take on many forms without being defined or imprisoned.

There is an ancient Chinese story about the influential philosopher Zhuangzi. ‘Zhuangzi awakens from a dream, in which he was a butterfly fluttering freely. He doesn’t know if he is Zhuangzi, who dreamt he was a butterfly, or a butterfly now dreaming of being Zhuangzi.’ This story puts Zhuangzi in contact with ‘the transformation of things’ – a reality in which identities are always fluid and never fixed.

Having left a long career in medicine a few years ago, and having had for all those years, a rather fixed identity, it was difficult for me to shed it in retirement; the tale of Zhuangzi seemed strangely apposite. What should become of the identity that had defined me? An identity that many of my colleagues still try to maintain in their retirement; an identity they continued to wear to prove they were still who they once were. Otherwise who, then, would be in control?

I wonder if the story of Zhuangzi’s dream helped me cope with no longer being a doctor, no longer being able to wear the clothes I was only lent for a time. A butterfly’s essence is fluttering, isn’t it? Maybe the lesson to be learned from it is to recognize the capacity for inner fluttering; an inner indefiniteness that lies hiding deep inside me; a butterfly simply waiting for me to open a window and let it wander freely like it used to…

That was an epiphany for me, but like most revelations, I had trouble putting it in words; trouble explaining it to any who were even interested enough to listen.

I had a friend who was  a kindred spirit in medical school and we had stayed in tenuous phone and, later, Email contact over the years; still able to share unusual ideas that others would have rolled their eyes at for people of our advanced years. As Oscar Wilde once wrote ‘With Age comes Wisdom, but sometimes Age comes alone.’ Andrea and I used to joke about that when we were still in practice in our respective specialties in cities on different sides of the continent; joke about our lives beside the different oceans to which we were now privy. But we were both octogenarians now, both retired, and both playing in what seemed like the end game.

We hadn’t been in contact for several months because of her ill-health, but I thought I’d chance catching her at a lucid moment in her slowly dissipating cognitive skills; a phone call contact, not a cerebrally taxing Email or text. She was now living in a long-term care facility on the East coast, but still prided herself on what remained of her independence.

The phone rang for a long time, and I rechecked the 4 ½ hour time difference to make sure I wasn’t waking her up; finally, a groggy voice answered with a raspy ‘hello’ followed by a cough. Then, I suppose she glanced at the name on the screen of her phone and her rasp suddenly softened.

“G,” she said in an overly loud voice. “You still in Vancouver…? I keep hoping that you’re finally here in St. John’s…”

I wasn’t sure if she was joking; Andrea sometimes gets confused nowadays; she says it’s the medication she’s on, so I never press the point. “No, I’m still on the west coast Andy.” When she didn’t say anything to that, I replied the usual way: “But I’m still planning to visit you over there some day…”

She stayed quiet for a moment; then, “Well you better hurry up, eh? I’ve only got a leaf or two left on my branches, and they’re already changing clothes…”

Although she often uses that metaphor, it still makes me chuckle; I thought perhaps it was a good time to try my butterfly metaphor on her. “Remember the philosophy we used to talk about in the old days? The  ancient wisdoms…?”

Silence for a moment, then “We talked about a lot of things, G…”

“Zhuangzi’s dream… Remember that one…?” Except for her stertorous breathing, she stayed silent. “Remember,” I reminded her, “He couldn’t decide whether he was dreaming of a butterfly, or it was dreaming of him…”

Her silence was a bit unnerving, but now that I had started, I figured I’d better continue with my epiphany. “Anyway, it made me wonder if the butterfly’s aimless fluttering between flowers or whatever, was telling me something about my life now… about my lack of direction. About my apparent lack of purpose since I retired…” I didn’t really know how to put it into words for her -or myself, for that matter.

Her voice, wavering and soft, crept into my ear from the phone. “You’ve always fluttered, G; you were always undecided about ideas or the essays you used to write no matter what else was going on… You never seemed to land for long… just like me; I suspect I’ve finally settled, though…”

I  waited for her to continue with the thought, but it was a minute or so before she spoke in a stronger voice as something occurred to her. “Just remember the Butterfly Effect of chaos theory though, eh? Even a tiny change can cause unpredictable events in the future.”

Wow, Andy still has her moments.

“Still…” There was hesitation in her voice as things began to slip again. “When a butterfly stops dancing between things, I’d worry about it, wouldn’t you?” She was again silent for a time. “I think it would mean the butterfly is now dreaming of you…”

I hope Andy doesn’t stop dreaming for a while yet…

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gozzter

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