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Doth the lady protest too much?

I am neither a psychiatrist, nor a psychologist, and apart from a career in medicine, hold no official accreditation in counselling. Heaven only knows, my own Black Dog is never far away, and anxiety gathers little dust as it waits expectantly in a brightly lit corner of my closet. And yet I am still a sounding board in my retirement, it seems.

A colleague from my student days somehow recognized me in a prairie coffee shop, three days drive from my coastal home. I’ve never been good at faces, but sometimes a voice will riffle through the fading file cards in my head and find a memory lightly pencilled in.

I was sitting in a dark and unobtrusive corner of a Starbuck’s near the university in Saskatoon when a voice caught my attention. It was talking quietly on a phone, so I probably wouldn’t have noticed, except that it was at the next table and its owner spilled coffee on me during a nervous laugh.

“I’ll call you back,” she whispered into her phone and quickly grabbed the few napkins in which she had dressed her cookie. “I’m so sorry,” she said, greeting me more with her hands than her voice, as she attempted to wipe the coffee off my tee shirt.

“Don’t worry about it,” I said, taking the napkins from her hands and finishing the wipe myself. “Stuff happens…”

She sat back suddenly and fastened her eyes on my face like ocular nappies. “Don’t I…”

But her name came to me first. “Susan?”

She nodded enthusiastically, still not sure of herself. Then, as I was about to remind her of my name, “G…?” she said, and touched my arm excitedly.

I nodded, surprised, but impressed that she’d remembered my nickname from medical school. I have to admit that mine was the easier task, though -Susan, the valedictorian of my graduating class, had made a name for herself in oncology, and most doctors, no matter their specialties, would probably have read at least a few of her papers. I certainly had.

We joined our tables and sat reminiscing. There was a lot of ground to cover -I had recently retired after 40 years in practice, but she still seemed to be in the thick of things.

“I’m just having a quick coffee before I have to chair a conference at the U,” she said, checking her watch. “But I still have a few minutes,” she added, and smiled reassuringly. “What have you been doing since we last met?”

I knew she’d ask, but I hesitated before replying. My career had been a satisfying one, for sure, but certainly not as illustrious as hers. “I specialized in Ob/Gyne,” I said with a little shrug. “In Vancouver, actually, “ I added, knowing she would wonder what I was doing in a Saskatoon coffee shop. So when one of her eyebrows posed the silent question, I was quick to respond. “I’m retired now, and since I was born near here, I thought I’d do a little catching up.”

“Vancouver?” She said the word with a wistful look in her eyes. “I gave a presentation out there last year, G… I’ve always loved the west coast.” She sighed and rested her eyes on me again. “I’ve often wished I’d settled out there rather than in Toronto, you know…”

“There are probably more opportunities in Toronto.” I said. “I mean, it’s the center of the universe, and everything…” I meant it as a joke, really -the quintessentially Canadian retort whenever the city is mentioned- but it had a chilling effect on her and she shrugged apologetically.

“If I were still in practice, I’d likely be picking your brains at this stage, Susan,” I said, suddenly ashamed of my thoughtless remark.

She smiled, but still apologetically, and she sat for a while, quietly nibbling on her cookie. Suddenly I could feel her eyes resting on me again. “Was there ever a time in your career when you felt like an imposter?”

I thought about it for a moment, then nodded. “Sometimes when I was trying to justify a diagnosis, or a procedure, to the young resident doctors… Especially when they’d tell me that my colleagues did things differently.”

She took a deep breath and a little smile surfaced briefly on her lips. “I feel it more and more as I get older.” She concentrated on her cookie for a few bites. “It’s like I’m supposed to be the expert, but things move so rapidly in my field it’s difficult, if not impossible, to keep up -and I’m always afraid that one day, someone is going to put up their hand at a lecture and point out that I’m not current anymore.”

I stared at my rapidly cooling coffee and nodded. That -plus age, of course- played a large role in my decision to retire.

“My psychologist partner calls it my ‘imposter syndrome’ and laughs at me,” she said, shaking her head. “He doesn’t take it very seriously -I suppose that’s why I unloaded it on you… Sometimes I just need to talk about it with someone.”

“The welcome stranger…?” I rolled my eyes to show I was kidding.

She smiled half-heartedly, but I could tell she wasn’t finished yet.

“After all these years, I wonder if the mask still fits,” she said, more to the cookie than to me. “That’s what reputation is, you know: a mask.” She finished off the cookie and sat back in her chair. “You work for years to achieve it, all the while wondering if it is starting to fray -if it still conceals the face underneath.” She chuckled, then scraped her chair back from the table. “I often think I should get out while it’s still intact. While it’s still worth something… Like a hockey player retiring after his team wins the Stanley Cup.”

She checked her watch and stood up, but as she stooped to pick up a rather heavy looking briefcase, her eyes interrogated me once again. “I have to leave for Toronto right after the conference this afternoon, but were you planning to attend? Lunch is provided. Maybe we could meet?”

I smiled warmly at her suggestion, but shook my head. I’m retired now; I no longer carry a mask. “But if you’re ever in Vancouver again…” And yet, even as I spoke, I could sense a change as she rummaged around in her head for an appropriate Saskatoon conference persona.

She nodded, hugged me briefly, and hurried out the door. But I could see her pulling her disguise back on as she left.

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Fake Views

Don’t you think we try too hard sometimes? And yet, in our zeal to project minorities, or those less favoured in our community in a more favourable light, I suppose we could be forgiven for cherry-picking examples of their accomplishments, or glossing over issues in which they do not excel, so long as there is no attempt to deceive. No serious effort to hyperbolize. All of us are multitudes, and usually only context decides what face we show. And that can be a problem when we judge the past by current standards. The danger is, as Shakespeare’s Antony explained about men like Caesar, ‘the good is oft interred with their bones.’

We all do it, although often unconsciously. We pick situations from the past like apples from a tree, and assume that old flavours should accord with current tastes. They seldom match, of course, so the past risks being disappointing unless we paint it differently and demonstrate its relevance and connection to the present.

Usually this involves investigation, verification and interpretation -it is seldom possible to understand a novel by picking a page at random and drawing conclusions about its contents. Especially if the story is one that hasn’t even been written. An article in Aeon, an online publication, delves into the distribution of fake miniature paintings that purport to represent aspects of Islamic science that may be misleading: https://aeon.co/essays/why-fake-miniatures-depicting-islamic-science-are-everywhere

The essay was written by Nir Shafir, a historian of the early modern Ottoman Empire, at the University of California San Diego. And as he says, ‘The irony is that these fake miniatures and objects are the product of a well-intentioned desire: a desire to integrate Muslims into a global political community through the universal narrative of science. That wish seems all the more pressing in the face of a rising tide of Islamophobia.’ But he wonders just what science the counterfeiters hoped to find. ‘These fakes reveal more than just a preference for fiction over truth. Instead, they point to a larger problem about the expectations that scholars and the public alike saddle upon the Islamic past and its scientific legacy.’

But, Shafir does raise an important question of whether the ends justify the means. ‘Using a reproduction or fake to draw attention to the rich and oft-overlooked intellectual legacy of the Middle East and South Asia might be a small price to pay for widening the circle of cross-cultural curiosity. If the material remains of the science do not exist, or don’t fit the narrative we wish to construct, then maybe it’s acceptable to imaginatively reconstruct them… However, there is a dark side to this progressive impulse. It is an offshoot of a creeping, and paternalistic, tendency to reject the real pieces of Islamic heritage for its reimagined counterparts. Something is lost when we reduce the Islamic history of science to a few recognisably modern objects, and go so far as to summon up images from thin air. We lose sight of important traditions of learning that were not visually depicted, whether artisanal or scholastic. We also leave out those domains later deemed irrational or unmodern, such as alchemy and astrology.’

‘Perhaps there’s a worry that the actual remnants of Islamic science simply can’t arouse the necessary wonder; perhaps they can’t properly reveal that Muslims, too, created works of recognisable genius. Using actual artefacts to achieve this end might demand more of viewers, and require a different and more involved mode of explanation. But failing to embrace this challenge means we lose an opportunity to expand the scope of what counted as genius or reflected wonder in the Islamic past.’

It’s an interesting point that he makes. I wonder how many other things are slipping beneath our radars -information we never had occasion to investigate. We still use pictures to disguise our own histories, of course -to freshen them up, and portray otherwise mundane realities in rosy lights. It’s not the same as adding colours to improve an already vaunted past, I suppose, but we often try to dandy up what we’ve boasted about. And the pictures that we take usually seek to portray things as we promised they’d be. Confirm what we want people to think about our lives. A vacation that we hope others would envy, we picture in glowing scenes, that disguise those moments of disappointment in the sites we visited or the food we ate.

My grandfather used to describe his early years in glowing terms, and every photograph depicted triumphs or events that made me envious. But for some reason, my father saw them differently. Life was hard for him, and there were few luxuries when he was growing up. Clearly, history is contextual, and there are as many pasts, as there are participants in it.

But because there are discrepancies in its telling, that doesn’t necessarily invalidate what we’ve tried to illustrate in selected photos. True, it’s unlikely we’ve Photoshopped the pictures, or staged them whole cloth like the Islamic miniatures, but we’re still trying to sell an image of the past that embodies the story we want believed. A story that casts us in a favourable light despite the way our circumstances may appear today.

And yet, the camouflage itself can be a façade. It hides some things merely because there is a belief they need to be disguised -veneered. But it is sometimes the perspective itself that is deceptive -or, perhaps more accurately, selective. None of us see the world through the same eyes; ‘vanquished’ and ‘victorious’ can both describe the same event, and yet colour it with different adjectives.

I have to wonder whether, in the long run, it really matters. Once it is history, it is up for grabs anyway because there is no one, lasting view of anything in that dark and smoky room. As Shakespeare’s King Henry says, ‘Presume not that I am the thing I was’.

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Ur Wisdom

Wisdom, as my Grade 5 teacher Miss Pollock use to say, is knowledge plus experience, and the judgment to be able to blend them together successfully -not the most scholarly way of defining it, perhaps, but useful nonetheless. I always took her to mean the ability to pick and choose from what was available -the ability to combine unrelated items to create a cake, say. Create synergisms that before were only facts. Ingredients.

Call me a flower-child -or a withering bouquet if you prefer- but there is something about the Gaia Hypothesis that has a whiff of the profound. Or at the very least, a soupçon of wisdom. Of course Earth is an organism -inasmuch as Life, and its substrate Earth, are both synergists that interact to each other’s benefit. Not very Darwinian -no apparent competition between individuals for reproductive success- I admit, but nonetheless compelling. Why does everything have to have a purpose anyway? I can’t help but remember Allan Watts, the Buddhist-leaning philosopher so popular in the 1960ies, who once asked what the purpose of dancing was -surely it wasn’t to get from point A to point B in a room… The purpose of dancing, he said, was dancing -it needed nothing else, not even music, to continue. And its meaning was embedded in the activity itself.

But why am I going on about Gaia now? Well, as these things happen, I was scrolling through some essays on Aeon online, and came across a thoughtful article that brought back memories of a more youthful, hopeful me: https://aeon.co/essays/gaia-why-some-scientists-think-it-s-a-nonsensical-fantasy

James Lovelock, a chemist and later, the main proponent of the Gaia Hypothesis, caught the attention of NASA in the early 1960ies when it was trying to detect if there was life on Mars. ‘Lovelock approached the problem indirectly, arguing that there was no need to send rockets to the red planet… He argued that  simply looking at the atmospheric composition of a planet would enable us to know whether that planet was likely to support life… This led to his great insight. The Earth is not just teeming with life. The Earth, in some sense, is life. Earth is an organism!’

His good friend, the novelist William Golding (The Lord of the Flies), suggested that his hypothesis be called Gaia, after the ancient Greek goddess of Earth, and Lovelock went public with the idea in the early 1970ies, and eventually published his book Gaia: A New Look at Life on Earth in 1979. He also teamed up with the microbiologist Lynn Margulis, who was particularly interested in symbiosis and had published a major work on the topic in 1967.

Of course, Gaia attracted major criticism and often contempt. Richard Dawkins (of The Selfish Gene) ‘could not accept that things could happen for the good of the group simply because they were for the good of the group. Plants don’t produce carbon dioxide, he said, for the sake of the Earth. Either it was a byproduct of their functions, or it must be of immediate benefit to the plants themselves. Any other interpretation was contrary to a Darwinian view of life.’

Some of the criticism even targeted their qualifications. ‘Neither Lovelock nor Margulis were evolutionary biologists nor, for that matter, geologists, paleontologists or academics from other disciplines with an expertise in Earth’s history and overall functioning… For them, the chief feature of life was balance, stability, or what is known as ‘homeostasis’ — that is, the maintaining of balance through dynamic interacting processes. Earth is in homeostasis so it is living. On the other hand, for an evolutionary biologist such as Dawkins, Darwin’s mechanism of natural selection is all-important. Life is produced by natural selection, by the competition between individuals for reproductive success. Evolution has no goal or ‘telos’ of making Earth a better place for life. What is more, as far as Dawkins and other evolutionary biologists were concerned, Earth was not produced by natural selection, and hence it is not itself a living thing.’

Gaia was almost more Religion than Science -more hope than fact, perhaps. I was entranced by the idea when I first came across it shortly after the book was published. I had received my Fellowship in Obstetrics and Gynaecology only a few years before, and I suppose that meant that many of my patients were younger, and more… open in those halcyon days -more enlightened, I suspect, than the several years in my training program had allowed me to be.

I still remember the day when an attractive young woman sat demurely in the corner of my waiting room. Short auburn hair and rather prominent horn-rimmed glasses, she was quietly reading a book she’d brought, thinking she’d have a long wait. None of these things would have attracted my attention had she not been wearing a fluorescent green tee shirt with a picture of an obviously pregnant female with flowers for hair. Not only that, but as I crossed the room to greet my patient, I saw that the pregnant bulge on the patient, as well as the flowered woman was actually a planet when she stood up.

I must have stared rather intently at the tee shirt, because the patient -Janna, I think it was- smiled and said “Gaia,” matter-of-factly -almost as if I were so old I needed an explanation. And yes, she was reading Lovelock’s book.

I have to confess that I’d never seen a tee shirt quite like hers, but I tried to pretend that things like that were all in a days’ work.

“I guess an obstetrician would know all about Gaia, eh?” she said with a mischievous little wink.

“The Mother Earth goddess, you mean?”

She was quite a short, slender young thing, and she nodded as she looked up at me with big brown eyes, no doubt magnified by her glasses. “More the symbiosis thing…”

I wasn’t sure what she meant, but I waited till we were both seated in my consultation room before I pursued the concept. “You mentioned symbiosis? “ I asked, wondering if she’d really  meant ‘symbolic’ -the Mother part, at any rate.

She nodded and sighed contentedly. “I’m 6 months pregnant,” she said and her big smile reappeared.

“Congratulations,” I responded with a smile of my own. “Very much in keeping with Lovelock,” I added, although I hadn’t read the book yet.

“More Margulis, don’t you think?” she said, with a twinkle in her eye.

“Oh? Why’s that?” Although I knew Margulis was involved in the Gaia thing, I didn’t know much about her contribution.

“Symbiosis,” she answered, and then when I looked puzzled she added, “You know, organisms coming together for mutual benefit…?” At first, I don’t think I understood until she added “My boyfriend and I -we were both depressed…”

Then I blushed. Maybe that’s why I remember the episode after all these years.

So, the Gaia Hypothesis -is it scientifically valid: verifiable, refutable, quantifiable? Probably not, but maybe it’s a dream, a luscious metaphor, to get us through the ever darkening night of human meddling. We needed that in the 80ies… I think we still do.

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Infirm of Purpose

Conscience is a difficult master, and although few would argue the need for one, I suspect that most would agree that at times it may be hard to obey. As my mother used to say, it’s why guilt was invented.

Society seems to assign great worth to those of us who are able to resist the temptations in which we swim -those of us who emerge dry on the beach I think. We owe a lot of the anxiety we wear to our prevailing ethos, to struggling against a current which would tire even a saint . Indeed, the Christian concept of Saintliness usually implies a rare, single-handed ability to resist the allure of the everyday world.

And the failure to do so, despite our best attempts, often leads to remorse and regret -the unforgiving parents of guilt. But maybe we expect too much of the individual, maybe there’s a better way of looking at the problem. An enlightening article in Aeon made me wonder if Society -and my mother- had borrowed a little too much character-centered virtue from the Greeks: https://aeon.co/essays/aztec-moral-philosophy-didnt-expect-anyone-to-be-a-saint

I suppose in her day, you took what medicine you were given, never expecting there to be credible alternatives. Western virtue ethics -although she probably wouldn’t have recognized the term- were in part the result of the teachings of Plato, and eventually his pupil Aristotle. They believed in what the article calls character-centred virtues, but these were ‘too focused on individuals, too reliant on assessments of character, and too optimistic about the individual’s ability to correct her own vices.’

However, the Aztecs –the people dominant in large parts of central America prior to the 16th-century Spanish conquest- looked at virtue from a different perspective which the author of the article, Sebastian Purcell -assistant professor of philosophy at SUNY-Cortland in New York- describes as a more socially-centred ethic. The Aztecs apparently believed ‘we should look around to our family and friends, as well as our ordinary rituals or routines, if we hope to lead a better, more worthwhile existence.’

And he raises a good point: ‘This distinction bears on an important question: just how bad are good people allowed to be? Must good people be moral saints, or can ordinary folk be good if we have the right kind of support? … it also matters for questions of inclusivity. If being good requires exceptional traits, such as practical intelligence, then many people would be excluded – such as those with cognitive disabilities…  One of the advantages of the Aztec view, then, is that it avoids this outcome by casting virtue as a cooperative, rather than an individual, endeavour.’

I like the idea that everything doesn’t rest on my shoulders alone. That there may be communal resources around to raise bail.

Exercise is a similar taskmaster to conscience, however, yet it wields even more guilt than my mother ever could. And it’s not on my shoulders that it rests -I could probably take that for a while; it seems to pick on my legs and anything that tires easily. But when my joints are talkative and my muscles are already weary from standing around, temptations are convincing liars -especially when I think I can get away with them. Know I can. Okay, am pretty sure I can…

For some reason, a grey and stormy autumn afternoon a few years ago comes to mind. I was living outside a little rural village then, and rain was lashing the roof like a Bollywood monsoon. The windows were shaking with the constant slap of discarded leaves from the dancing trees that surrounded the house, and I remember looking forward to sitting in a comfortable chair with some cookies and a book. It wasn’t that I was tired or anything, but it was certainly better than risking the storm outside.

Sometimes, on a sunless day, discretion has to win out, don’t you think? And I thought that maybe peanut butter chocolate chip cookies would go a long way to expiating any residual guilt for not getting any exercise that day. Retirement was fairly new at that point, but sometimes you have to practice filing away the hours efficiently before they get out of hand and mess things up.

I’d already let the dog out into the back yard a few hours before the storm hit. He had a little house back there and lots of grass to putter around in so I figured he’d be fine. I even peeked through the door at him to make sure, before I assembled the cookies on my favourite plate and turned on the light over the chair. I mean, sometimes dogs just know they’re not going to be walked, eh? And just like us, they don’t always need it. Besides, I could exculpate myself by giving him a few treats later -he’s so easily placated.

Anyway, I remember settling into my chair with a niggle of guilt that even the cookies were unable to dissipate. It wasn’t so much about the dog, I don’t think –he’s pretty good at forgiveness- but I’m still a work in progress, and torpor tends to make me logy and bloated. Anyway, when the plate was almost empty and the book still unopened, I decided that perhaps a bit of wine might help.

I didn’t wake up until I heard the scratching. At first I thought it was just the wind, but when I opened my eyes and looked around, I realized the rain had stopped and there was a bit of sun peeking through the kitchen window. Time for supper maybe…?

The scratching was persistent, however, and coming from the door -coming from the dog, actually. Interesting, I thought -he doesn’t usually scratch- and I opened the door expecting him to come bounding in. But he just sat there, tail wagging, and eyes pleading. I knew what he wanted; dogs talk with their eyes, communicate with their bodies. They have no need for words, and as soon as I reached for the leash, he thanked me with his tail. I reciprocated by offering him the only cookie I hadn’t eaten and we set out together to explore the world -guilt a distant memory, and my mother smiling from wherever…

But I need to be sure. A dog can exhibit social virtue can’t it? A dog can help -I mean, I can still be an Aztec, right?

 

 

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Dress Coda

I suppose it’s time for a confession, but I have to be covert about it; devious -labyrinthine, to the extent that my disclosure may fly in the face of current trends. I may be incorrectly accused of retrograde thinking -or, horrors, of prejudice. Discrimination.

Well, perhaps there is a soupçon of babbling admixed in my preference, but only in my desire to avoid the frequent tendency to judge in advance, or on insufficient, and perhaps even faulty evidence. There comes a time when freedom from must be protected against freedom to. Freedom should not be interpreted as license; I very much doubt that many of us would push for the freedom, say, to drive on the wrong side of the road. Some freedoms, surely, are worthier of advocacy than others.

And in some venues, freedom may have to yield a little space to fairness and justice. Sometimes freedom simply occupies a space that others cannot occupy -even if they wanted to. I’m referring, of course, to that flagship of fashion: the school. Inhabited as it is by those who are still dependent on group-think, still on their headlong dash for identity and, let’s face it, peer approval, it is a cauldron for fashion. A furnace of innovation where nuance triumphs, and failure to adhere to unspoken rules may result in isolation or exile.

The rules often include behavioural expectations, quirks of special language, and dress codes. It is what groups of young humans do; it is part of growing up, and it is expected that they will stretch boundaries and rebel at what they consider to be arbitrary and unnecessary restrictions. It may be frustrating for those of us who have passed unscathed through the tumult of that phase of youth, but not all are so lucky.

Fashions, for example, may be not only capricious, but also expensive luxuries that some parents either cannot, or choose not to afford, leaving the child in a quandary. Being accepted -welcomed- into a group may be jeopardized. Nobody wants to be ostracized; few feel comfortable in being regarded as different.

I was interested therefore, in an article in the Conversation that addressed the problem but approached it from a different perspective: https://theconversation.com/its-time-to-address-the-hidden-agenda-of-school-dress-codes-97600  

It starts out conventionally enough, ‘Normally, what children can and cannot wear in schools is explicitly noted in school policies or implicitly implied by broader cultural or societal norms.’ But then it goes on to assert that ‘The problem with trying to develop a set of guidelines for school dress code policies is that the implementation or restriction of dress is just not about the clothes that kids wear. Dress code policies are mired in larger contested debates that have to do with gender identity, race and sexuality reflective of a broader public discourse.’

Fair enough -there are larger issues than simply reflecting the dominant community ideology. So the author, Dianne Gereluk at the University of Calgary, goes on to acknowledge other facets of school dress codes, namely, ‘Most obviously, the nature of many dress code violations interconnects to issues of gender and sexual identity. The vast majority of cases have targeted girls and LGBTQ youth on the basis that what one might wear reveals too much — that it’s sexually suggestive, distracting for other students or offensive to the local and cultural norms of the community.’ Further, she goes on to suggest that ‘girls have taken the brunt of dress codes’ and that ‘The infractions for noncompliance exacerbate the shaming of girls’ self-perception of their worth.’

And her answer? ‘If educators and policymakers are genuinely worried about the safety of their students or the decorum of dress codes, schools could simply follow the steps of one school administrator from Evanston Township High School in Illinois. The high school’s fundamental “rule” mandated that certain body parts must be covered for all students at all times. Specifically, students must wear their clothes in a way that fully covers their genitals, buttocks, breasts and nipples with opaque fabric. Such a simple yet inevitably provocative dress code policy removes the broader contested aspects of gender, sexual identity, faith or systemic discrimination.’

Really? Merely covering the parts mentioned still leaves an awful lot of provocative skin if anybody chose to show it -and you can bet they would. Also, I think it still panders to the clarion call of Fashion, albeit in an impoverished attempt to pretend the schools are still catering to freedom of choice -however watered-down: “You can dress however expensively, or outrageously as you want… as long as you don’t show those things!”

I suspect I have travelled too widely outside of North America, because rather than looking to Illinois to solve the problem, I would look to… Well New Zealand, for one, is a good model: school uniforms for both boys and girls. Nobody in school can out-fashion anybody else. And since everybody has to wear the same thing, there’s no shame from differing clothing styles. No obvious financial stigmatization. What they wear on their own time, of course, is up to individuals, just as who they decide to hang around with.

I know that many private schools here in Canada and the U.S.A. long ago mandated school uniforms, and although to many people, it is a manifestation of elitism, this would no longer be a problem if every school -public and private- required it. Each school would presumably have its own, unique design, and this in itself might become a source of pride and a perhaps a fashion statement of its own.

It has the advantage, too, of not being able to demarcate -at school, at least- those difficult issues of gender, sexual identity, or even faith about which Dr. Gereluk was so concerned. Perhaps items like the hijab, or maybe even the niqab, could be incorporated into the uniform, although I suspect each school would require community or religious consultation to accommodate their concerns.

And yes, no doubt there would be initial resistance to such a major shift, but it need not be mandated universally, and all at once. Fashions change, styles morph -and people adapt. Allow me to paraphrase a sentence I remember from Shakespeare’s Henry VIII: New customs, though they be ever so ridiculous, yet are followed.

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That way madness lies

To portray something -to make it believable- there has to be at least some understanding by the audience of what is being portrayed. Much in the sense, I suppose, that was suggested in the 1974 paper in The Philosophical Review by the American philosopher Thomas Nagel, asking what it would be like to be a bat. Not so much how it would feel to have the added sense of sonar, or be able to fly in the dark, but more about the consciousness of itself. As Wikipedia explains Nagel’s thinking: ‘an organism has conscious mental states, “if and only if there is something that it is like to be that organism—something it is like for the organism to be itself.”

This is a roundabout way of wondering whether an audience could ever know if an actor is representing something realistically if they cannot imagine what it would be like to be that thing.

Mental illness seems as if it is sufficiently prevalent that most of us would be expected to understand whether or not the author, or the actor, has captured its essence accurately, and yet, for those of us who have not experienced the wide panoply of its manifestations -the majority of us, I suspect- we might be easily mislead. The more gripping or sensational portrayals of illness, might well come to stereotype the lot. To stigmatize the condition.

I was scrolling through the BBC Culture section when I happened upon an article that discusses some of these same issues: http://www.bbc.com/culture/story/20180828-how-cinema-stigmatises-mental-illness

‘… the film industry has generally shown a shaky vision of mental health … It’s not that cinema evades ‘taboo’ themes here; it’s more that it tends to swing wildly from sentimentality to sensationalism.’ To attract an audience -i.e. to make a profit- ‘creative drama is drawn to the complexity and fragility of the mind – but mainstream entertainment still demands a snappy fix. And the definition of ‘insanity’ is inherently problematic.’

I am reminded of the French philosopher Michel Foucault’s book Madness and Civilization -subtitled A History of Insanity in the Age of Reason. He felt that the concept of madness was evolving over time: in the Renaissance, (as a thoughtful summary in Wikipedia puts it) the mad were portrayed in art ‘as possessing a kind of wisdom – a knowledge of the limits of our world – and portrayed in literature as revealing the distinction between what men are and what they pretend to be … but the Renaissance also marked the beginning of an objective description of reason and unreason (as though seen from above) compared with the more intimate medieval descriptions from within society.’

Later, however, ‘in the mid-seventeenth century, the rational response to the mad, who until then had been consigned to society’s margins, was to separate them completely from society by confining them, along with prostitutes, vagrants, blasphemers and the like, in newly created institutions all over Europe.’ (The Great Confinement).

‘For Foucault the modern experience began at the end of the eighteenth century with the creation of places devoted solely to the confinement of the mad under the supervision of medical doctors, and these new institutions were the product of a blending of two motives: the new goal of curing the mad away from their family who could not afford the necessary care at home, and the old purpose of confining undesirables for the protection of society. These distinct purposes were lost sight of, and the institution soon came to be seen as the only place where therapeutic treatment can be administered.’

But, back to the BBC Culture depiction of the role of cinema, ‘our mainstream perceptions of ‘madness’ are still fixated with movie scenes – much more emphatically, in fact, than the novels or memoirs on which they might be based. A classic film like One Flew Over the Cuckoo’s Nest (1975) seals the impression of a soul-destroying psychiatric asylum, where livewire convict RP McMurphy (Jack Nicholson) feigns insanity to escape prison labour – yet is ultimately crushed by the system. The dramatic depiction of patient treatment, particularly its brutal electroconvulsive therapy sequences, had far-reaching impact. In 2011, The Telegraph went so far as to say that the film was responsible for “irreparably tarnishing the image of ECT…’

Unfortunately, unlike many art forms, movies usually require a conclusion, a wrapping up of the story, and a realistic depiction of mental illness may not fit into that convenient format. There may be no black or white: not all characterizations can end either pleasantly or sadly -some are palimpsests, to be sure, but many can reach no definitive conclusions that would satisfy the average moviegoer. Hence the temptation to exaggerate, or at least frighten audiences into an odd manifestation of satisfaction.

The temptation, in other words, to see mental illness as alien, separate -like a creature we could not possibly understand because it is so different. As different, perhaps, as Nagel’s bat. But is it? Or was Foucault really on to something in his analysis of the way ‘madness’ seemed to be viewed in Renaissance literature and art -a view which accepted that at least some of the vagaries, some of the stigmata of mental illness, were merely variations of mental states that any of us could exhibit at times? And indeed, that occasionally intimated unique views on a world from which we might learn some important lessons -a world, though, that we might now discard, or shun as too bizarre. Too frightening. Too… real.

On the other hand, there is a danger of romanticizing the past, of airbrushing its naïveté into soft and reassuring colours; of assuming it was what it was because it had not yet been exposed to the unforgiving exigencies of current knowledge. A time when imagination and reality were sometimes allowed to merge. Encouraged to conflate.

It’s difficult to be certain where present day arts can be placed on this spectrum of understanding mental illness -not the least because it is difficult to know where it should be placed. But, suffice it to say, the more fully the illness is portrayed in all its complexity, the more we might be able to see it as a small, but important part of the tapestry of existence -a fragment of the struggle that marks all our days. And, as for any vicissitude, where there is suffering, we must provide succour and relief, and where there is dissimilarity, offer understanding and acceptance. Tolerance. The soul, says the poet Kahlil Gibran, walks upon all paths. The soul walks not upon a line, neither does it grow like a reed. The soul unfolds itself like a lotus of countless petals.

 

by

Give Sorrow Words

It is fairly intuitive to suspect that parental mental health has an effect on both infant and childhood development. Indeed there is a widespread attempt to address the issue with the use of evaluative tests such as the Edinburgh Postnatal Depression Scale to identify or even anticipate and take action to ameliorate the problem.

It was designed, of course, to deal with the disastrous effects a mother’s depression, especially a postpartum one, might have on the health of the newborn -everything from bonding, to breast milk production, to the safety of the baby itself, could be jeopardized with an untreated depression. But, aside from the obvious issues of domestic violence, the father’s mental state is seldom accorded the same vigilance -after all, he is not the one who has undergone profound physiological and hormonal alterations as the pregnancy progresses, he is not the one who has experienced the rigours of delivery, and he is certainly not the one whose hormone levels change so drastically once again in the postpartum period.

And yet, merely to assign the paternal side of the parental equation to a largely supportive role is perhaps to assume there are few mental consequences of the changes that this newly acquired responsibility entails. It is the woman who is under the watchful eye of the accoucheur, and not the partner -even if he attends most of the prenatal visits. And postpartum period is likely even more of a black-hole for partner surveillance.

But the man, too, can undergo psychological changes after the birth, as an article in the Guardian newspaper reports: https://www.theguardian.com/lifeandstyle/2017/nov/13/can-men-get-postnatal-depression

Although not adequately investigated, previous studies suggested that only  between 4-10% of men developed recognizable post-partum depressive-like symptoms, whereas a Swedish study found that ‘28% of men had symptoms that scored above mild levels of depression. Overall, 4% had moderate depression. Fewer than one in five fathers who were depressed sought help, even though a third of those had thought about harming themselves.’ The discrepancy is likely because, unless it is serious, or obvious, the men are less frequently assessed in relation to their spouses pregnancy.

But the answer might not be as easy as asking the father-to-be to fill in the Edinburgh Depression Scale like his partner. ‘The lead author of the Swedish paper, Elisa Psouni, from the department of psychology at Lund University, says the Edinburgh Postnatal Depression Scale (EPDS) used for both women and men is not so accurate in picking up depression in fathers. Her research showed higher levels of depression in dads because it added in a score more reflective of “male” symptoms of depression such as agitation, anger, irritability, working longer hours and drinking too much.

‘Depression in fathers may be rising not just because researchers are looking for it, but because more new dads are struggling. Psouni believes fathers increasingly face the same dilemmas that mothers do – including trying to combine parenthood with working. Fathers who got depressed often had external pressures, such as job issues, and if their partner was depressed, their own risk of depression doubled. Lack of sleep, having twins and conflict in the relationship can all contribute.

‘A depressed dad will play and smile less with his child. Children are deeply affected by paternal postnatal depression with studies showing poorer measures of wellbeing and more behavioural problems at the age of seven.’

I suppose we are all children of our eras, though, aren’t we. We usually see the world through societal eyes. Indeed, I wrote an essay in my weekly series about this back in 2013: https://musingsonwomenshealth.com/2013/08/09/postpartum-depression-just-words/

I was focussed, as were most obstetricians, on the mother of course, but even then I wondered about the effects of pregnancy on the dads.

*

Julie was sitting in the waiting room fussing with her new baby cradled ever so carefully in her arms. I recognized the older woman seated beside her -I’d met her mother several times before the delivery, and as a watchful guardian in the corner during the delivery- but I’d never seen Julie without her husband, Andrew. He’d come to every prenatal visit, and had hovered over her like a tent during her entire labour -at least those times when I was present, anyway.

They were a team, and as inseparable as a shirt from its tie -too inseparable, I sometimes thought. Each decision she had to make throughout the pregnancy -everything from prenatal supplements, types of analgesia in labour, to when to cut the umbilical cord after birth- was made after lengthy consultation between the two of them. She never seemed to be given the option of deciding for herself and yet she seemed to welcome his input. She basked in his concern; she waded in his eyes.

That day, I remember she insisted her mother stay in the waiting room with the baby while she had her routine post-partum check; it seemed a little unusual.

“You’re looking a bit tired, Julie,” I said, when I had finished my post-partum examination.

She nodded pleasantly, but she looked preoccupied. I assumed it was the usual new-mother state, though, and I was happy that her mother had agreed to stay with them for a while.

“Where’s Andrew,” I asked, more to change the subject than out of curiosity.

Her eyes suddenly surfaced from her lap and flew to my face. “Andrew?” she replied, a little too quickly, I thought. “Oh, he’s… at home…”

But there was hesitation in her answer -as if I was being invited to question her some more. “At home…?” I asked, gently. I could see some tears beginning to well up in her eyes. “Is he okay…?”

She sighed and fixed me with a melancholy shrug. “He’s been stressed a lot at work, I guess -he’s taken some time off…”

I leaned forward a bit on my desk to show her I was listening and her face collapsed.

“Soon after we got home with the baby, he began sitting around pretending to read, but he never turned the page. He didn’t want to go for walks with us, and he only played with his food… He started to argue…” She closed her eyes for a moment before resuming. “And even the baby didn’t seem to interest him anymore…” She stared out the window behind my desk, obviously uncertain how to proceed. I offered her some tissue from the box I keep on the desk and she wiped her cheeks. “He said he was afraid of hurting her…” she blurted out, uncoaxed.

Suddenly, she stared at me. “Can you imagine -he was afraid of hurting his own daughter..!”

I must have looked concerned, because she quickly sat back in her chair and almost smiled. “Yes,” she said, as if trying to reassure me. “I realized he was depressed -I’m a nurse, remember- so both of us went to his doctor a week or so ago. He was referred immediately to a specialist who put him on medications as well as enrolled him in some counselling sessions.” Just getting it off her chest seemed therapeutic, and the shadows of a tiny smile began to surface on her lips.

But nonetheless, she looked uncertain, and also perhaps a little bemused. “I didn’t think men could get post-partum depression, doctor.”

I smiled and relaxed in my chair while I riffled through my head for an explanation. “A new baby changes things for both of you, don’t you think? Only, he just doesn’t have the same hormones, Julie…” I added, not certain what more I could say about it.

She actually chuckled at the thought. “Damn! I was hoping you’d tell me he could do some of the nighttime breast feeding…”