by

All That Glitters

“My uncle wants to come,” Jasmin announced as she sat in the hard wooden chair by my desk, looking worried. She was almost due, and as her obstetrician, I was seeing her for what she hoped might be her final prenatal visit. She wanted to know how many people could be present in the delivery room at the hospital for the birth.

I nodded encouragingly -so far, only her husband and mother were expected to be present.

“Uncle Jonathan used to be one of my favourites when I was younger.” She smiled at the memory. “He was so smart!” She sighed and looked down at her lap. “He was –is,” she corrected herself, “a professor of Philosophy at the university.” She stared at something behind me for a moment. “I was so impressed that he had even published a book… I remember trying to read it,” she added, rolling her eyes for effect, “but it was too abstruse for me in those days.”

I smiled at the idea of anything being too difficult for her -she was a PhD candidate herself, although not in Philosophy like her uncle. “You seem a bit concerned that he wants to be present for the birth, Jasmin.”

She shrugged and glanced nervously at her lap again. “I haven’t seen him for a while,” she admitted. “We… we kind of fell out a few years ago.”

I sat quietly and waited to see if she wanted to explain.

“He… I mean, I don’t like the way he treats his wife –treated…” she qualified her tenses again. Then she sent her eyes over to explore my face to see if she should explain further. “Even Mom was upset with her brother…”

I tried to keep my expression neutral, but I suppose she could see my curiosity.

“He expected her to have a meal ready for him when he came home…” Her eyes never left my face, but had perched on my cheeks as if they were resting. Waiting. “She had to do all the work around the house, you know. He always said he was exhausted from lecturing and writing at work.”

I nodded again, but she could sense I was trying not to judge.

“Mom said it was abusive…” she said in answer to my unasked question. “I… I refused to believe her at first. I always knew he was arrogant, but if anybody deserved to be arrogant, it was him. He was such a brilliant thinker… is, I mean…”

Jasmin seemed genuinely conflicted. I could see it was difficult for her to accept what she saw as imperfections in a childhood hero.

And yet, any hero-worshipping can be fraught, can’t it? I discussed some of the ramifications of this in a previous essay entitled Life’s Fitful Fever https://musingsonwomenshealth.com/?p=10396 , but I continue to be intrigued by the subject…

We all have subsurface faults that could weaken our glossy reputations if exposed. After all, each of us is a book of stories, only some of which we prefer to read -even those exemplary figures we choose to pedestalize.

None of this is a surprise, of course, but it is sometimes important that it be reconsidered in times like this when we are busy tearing down statues of people whose past is not as monolithic as we once assumed -or, at least, not as we wanted to remember it. An essay by the British philosopher Julian Baggini in Aeon provided an interesting counterbalance to our resurgent iconoclasm: https://aeon.co/ideas/why-sexist-and-racist-philosophers-might-still-be-admirable

‘Praise Immanuel Kant, and you might be reminded that he believed that ‘Humanity is at its greatest perfection in the race of the whites,’ and ‘the yellow Indians do have a meagre talent’. Laud Aristotle, and you’ll have to explain how a genuine sage could have thought that ‘the male is by nature superior and the female inferior, the male ruler and the female subject’.

‘We seem to be caught in a dilemma. We can’t just dismiss the unacceptable prejudices of the past as unimportant. But if we think that holding morally objectionable views disqualifies anyone from being considered a great thinker or a political leader, then there’s hardly anyone from history left… However, the idea that racist, sexist or otherwise bigoted views automatically disqualify a historical figure from admiration is misguided. Anyone who cannot bring themselves to admire such a historical figure betrays a profound lack of understanding about just how socially conditioned all our minds are.’

Historical revisionism is an interesting phenomenon: the belief -no, the assumption– that our present day ethos is, by default, the gold standard against which to compare all other eras, and all other societies. But, ‘why do so many find it impossible to believe that any so-called genius could fail to see that their prejudices were irrational and immoral? One reason is that our culture has its own deep-seated and mistaken assumption: that the individual is an autonomous human intellect independent from the social environment… The enlightenment ideal that we can and should all think for ourselves should not be confused with the hyper-enlightenment fantasy that we can think all by ourselves. Our thinking is shaped by our environment in profound ways that we often aren’t even aware of.’

‘Accepting this does not mean glossing over the prejudices of the past. Becoming aware that even the likes of Kant and Hume were products of their times is a humbling reminder that the greatest minds can still be blind to mistakes and evils, if they are widespread enough. It should also prompt us to question whether the prejudices that rudely erupt to the surface in their most infamous remarks might also be lurking in the background elsewhere in their thinking.’ And yet, ‘Many blindspots are remarkably local, leaving the general field of vision perfectly clear. The classicist Edith Hall’s defence of Aristotle’s misogyny is a paradigm of how to save a philosopher from his worst self. Rather than judge him by today’s standards, she argues that a better test is to ask whether the fundamentals of his way of thinking would lead him to be prejudiced today… But there is a very important difference between the living and the dead. The living can come to see how their actions were wrong, acknowledge that, and show remorse. When their acts were crimes, they can also face justice.’

But, as Baggini summarizes in his essay, ‘The dead do not have such an opportunity, and so to waste anger chastising them is pointless. We are right to lament the iniquities of the past, but to blame individuals for things they did in less enlightened times using the standards of today is too harsh.’

Memories of that visit with Jasmin re-surfaced after I read the article.

“Is Jonathan’s wife going to come to the birth as well?” I remember asking.

She stared at her lap briefly. “No, unfortunately she passed away last year.”

I could see it really bothered her, but I sat in silence for a moment. “Were you two… close?”

She nodded and then sighed as she looked at me again. “I just don’t understand, though,” she suddenly blurted out. “The two of them seemed happy, you know… Happy. Content with each other…” She took a deep breath as she tried to expunge the thought. “I suppose he was just a man of his time –is, I mean: his attitude is fairly typical of that era, I think…” Then, after she considered it briefly, she added “But I don’t know how she could stand it: being a slave in the house, I mean.”

She kept scanning my face to see if I agreed -after all, I was probably the same age as Jonathan. Subject to the same biases, the same unrealistic expectations of a wife.

It was my turn to sigh. “You said the two of them seemed happy…”

She nodded. “They loved each other.”

I smiled. “Then perhaps she, too, was a woman of her time, Jasmin.”

She thought about that for a while and then her whole demeanour changed. “I… I hadn’t thought of it that way.” She smiled and sent her eyes to my face to thank me. “I’ll introduce you two in the delivery room. I think you’ll like him,” she said and winked at me as she stood to leave.

 

 

 

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by

More than kin, and less than kind

 

Puberty is seldom easy nowadays, although in fairness, I suppose it never really was. From the Latin pubertas -adulthood- it is a time of eventful and often embarrassing change as children pass through a bewildering array of morphological and psychological alterations on their way to the adults they are programmed to become.

For boys, I think they are largely awkward times -the voice changes, and the soft and downy facial hair that seems to take forever to coarsen enough to become a beard: the apparently interminable and disconcerting interregna between child adult.

For girls, I think, it can be more than merely embarrassing, because amongst other things, they may begin to develop adult contours before their brain has matured enough to fully understand the effects that might have on others.

A few years ago, when my dog was just a puppy, I remember sitting on a park bench trying to read after taking him for a walk. The dog, with his large puppy eyes and waggy tail, was attempting to befriend everything that walked past, however, so I put the book away and was about to leave, when I saw a woman and a younger girl further along the trail glancing our way. The woman pointed at the puppy, but the girl seemed reluctant to approach any closer, although she was clearly interested.

I assumed the girl might be frightened of dogs, but puppies have a way of overcoming that, so I smiled at the two of them and asked if they wanted to pet him. They talked about it for a while, and then the woman gently grasped the young girl’s hand and led her over to the puppy.

“Suzie’s sometimes a bit shy,” she said, smiling at me and sat beside me on the bench while her daughter patted the squirming and delighted dog. Suzie, dressed in a grey sweatshirt, jeans, and a baseball cap, was the mirror image of her mother. Perhaps fourteen or fifteen years of age, she did seem unusually shy, however, especially since her mother had no difficulty striking up a conversation with me.

Rolling around on the grass with the dog, Suzie seemed completely at ease with the puppy, and I thought she might enjoy taking it for a little walk in the field in front of the bench. I offered her the leash, but I could see her eyes change with the gesture. Suddenly suspicious, she glanced at her mother, like an uneasy child.

He mother chuckled, took the proffered leash from my hand and gave it to Suzie. “By the way, my name is Martha,” she said, extending her hand, as we introduced each other. “I’m afraid Suzie’s really shy around strangers -unlike her mother,” she explained, once her daughter had run off with the dog. “And especially around men,” she added, studying my face for a reaction. Then, just as suddenly, her expression softened. “She’s only 11, even though she looks 13 or 14, so I suspect she’ll outgrow her fear…”

“Fear…?” I said, instantly regretting my question, but there was something in her eyes that made me need to ask.

The woman stared at me for a moment, as if trying to decide whether or not to answer,  and then shrugged. “She’s going through puberty a lot earlier than I did…” She blushed, as much at the word, as in disclosing it to a total stranger on a park bench. “So she’s beginning to develop… “ She paused for a moment to find a better word. “She’s beginning to look older than her age, let’s say…” Then she looked down at her lap, and clasped her hands for a second. “And now older boys -and men as well- look at her… differently.” Her eyes suddenly walked across my face before they settled on the field where Suzie was running. “I don’t think her mind has caught up with her body yet, and it confuses her.” I sensed that Martha was more worried than she was willing to let on, though.

When Suzie returned, flushed and breathless from her romp in the field, she seemed more relaxed and thanked me for letting her play with the puppy, but a few minutes after the two of them left, I almost forgot about the incident -it was only one of many encounters I had with the new puppy- and yet I have to admit to a lingering concern about the occasion. Many years later, I came across an article in a BBC Future series that started me wondering again: http://www.bbc.com/future/story/20180611-the-health-risks-of-girls-maturing-early

‘[S]exual harassment of minors remains a less common topic of discussion – though it’s one that may have increasing urgency, as puberty seems to be coming earlier for increasing numbers of girls across the globe. While the average age of puberty onset, defined by breast development, for US girls  was almost 12 years old in the 1970s, it fell to nine years by 2011… ‘Girls who reach puberty earlier are sexually harassed more than their peers, regardless of whether they’re engaging in sexual behaviours earlier.’

‘Enduring unwanted comments and stares may seem minor compared to other types of sexual violence. Still, studies have shown they can be particularly distressing for a child,  putting them at risk of psychological problems that can reverberate throughout their life.’

‘Although puberty presents challenges for all adolescents, girls who mature ahead of their peers are particularly vulnerable. One recent study, which tracked more than 7,000 women over a period of 14 years, found that early menarche (the first menstrual bleeding) was associated with  elevated rates of depression, substance abuse, eating disorders, and antisocial behaviours in adulthood.’ Also, ‘In the UK, one recent BBC investigation found that children as young as six years old have been sexually assaulted on trains or in train stations.’

‘The important thing about puberty is that it’s visible to others. But a young girl with breasts is no less of a child, or better able to handle such a situation, than one who hasn’t yet developed… Sexualisation of girls is especially problematic in cultures where puberty automatically tags a girl as ready for marriage.’ In fact, closer to home, ‘Unchained at a Glance, a nonprofit dedicated to helping women and girls in the US escape forced marriages, has estimated that 248,000 children as young as 12 were married in the US between 2000-2010.’

Of course not all girls are traumatized by precocious development, and ‘Researchers agree that it’s important not to catastrophise about early sexual development in and of itself. The problem isn’t that a girl’s body is changing. It’s society’s response to it. As a result, they say we should think about how we might support girls and their families best.’

Looking back, I wonder now if Martha had just been gauging my reaction? Curious how I had judged her daughter. I hope she saw me as a man merely watching a child playing happily with a puppy. That’s how I saw me, at any rate…

by

The Pleasure of Impermanence

Don’t you sometimes think things are changing too fast? Moving past you so rapidly it’s all a blur? Even mistakes are corrected with other mistakes so quickly it’s hard to know whether it’s all a game. It’s hard to know which is supposed to be the pentimento. And, perhaps more to the point, does it really matter?

When I was a child, I remember being intrigued by a set of bone china dishes that we only used on special occasions, and then only after dire warnings to be careful with our knives and forks on the plates for fear of cracking them in the headlong rush to dissect and ingest our dinners. I don’t know how many different patterns of Royal Crown Derby there are, but ours were decorated with Japanese figures in garden settings, all in rich blue colours. Even the mention of its construction out of bone china made my brother and I sit up straighter at the table -it sounded so fragile and expensive we were both on our best behaviour.

And yet, using sterling silver dinnerware, carried a special risk -cutting with the unusually heavy knives on such a fragile surface often led to excessive force on my part. Then, one Christmas when I was about seven or eight years old, the unthinkable happened: I cracked one of the dinner plates holding an unexpectedly tough piece of turkey. I was mortified and immediately ran from the table in tears.

My mother, far from being angry, followed me up to my room where I intended to hide for ever, and sat on my bed. “It’s okay, sweetheart,” I still remember her saying. “It’s only a plate. Things happen sometimes…” She kissed me on the cheek, led me back downstairs to the table, and carried on as if nothing had happened. And my dinner reappeared, undiminished, on another plate.

That same night, when I saw the broken plate that she was going to throw away, I asked if I could keep it. I spent most of the next day trying to glue it together without success, and only the following summer did my father help me to find the correct glue and cobble together a patch.

And every Christmas for years to come, it became a family tradition that I was served my dinner on that mended plate. It felt special: it was my plate.

Well, unless we rest for a while along its bank, we may never even see the river that is sweeping us all along. We may never appreciate the ‘transient and imperfect beauty’ of something like the fleeting splendour of the cherry blossom in our desperate journey along the shore. The Japanese have an expression for this ability to appreciate impermanence and imperfection: wabi-sabi.

Although I’ve touched upon the concept before in an essay entitled Words, Like the Wind (https://musingsonretirementblog.com/2017/10/15/words-like-the-wind/) I was captivated by an article in the BBC on travel where it was treated more thoroughly: http://www.bbc.com/travel/story/20181021-japans-unusual-way-to-view-the-world

‘Originating in Taoism during China’s Song dynasty (960-1279) before being passed onto Zen Buddhism, wabi-sabi was originally seen as an austere, restrained form of appreciation. Today it encapsulates a more relaxed acceptance of transience, nature and melancholy, favouring the imperfect and incomplete in everything, from architecture to pottery to flower arranging. Wabi, which roughly means ‘the elegant beauty of humble simplicity’, and sabi, which means ‘the passing of time and subsequent deterioration’

‘As to why they sought imperfect, rustic pieces, Prof Otabe [professor at Tokyo University’s Institute of Aesthetics] explained that “wabi-sabi leaves something unfinished or incomplete for the play of imagination”. This opportunity to actively engage with something considered to be wabi-sabi achieves three things: an awareness of the natural forces involved in the creation of the piece; an acceptance of the power of nature; and an abandonment of dualism – the belief that we are separate from our surroundings.

‘Combined, these experiences allow the viewer to see themselves as part of the natural world, no longer separated by societal constructs and instead at the mercy of natural timelines. Rather than seeing dents or uneven shapes as mistakes, they are viewed as a creation of nature – much as moss would grow on an uneven wall or a tree would curve in the wind… Rather than casting nature solely as a dangerous and destructive force, it helps frame it as a source of beauty, to be appreciated on the smallest of levels. It becomes a provider of colours, designs and patterns, a source of inspiration, and a force to work alongside, rather than against… Alone, natural patterns are merely pretty, but in understanding their context as transient items that highlight our own awareness of impermanence and death, they become profound.’

As my adult Christmases wore on through the years, I wasn’t always able to spend them with my parents, but the mended plate was a story I told every year to my children, and then to my grandchild.

At first they would ask me if I was being punished each year by having to use the broken plate.

“But I’d fixed the plate,” I would explain as part of the story. “So it wasn’t broken anymore was it? Just special.”

They would look at each other and then at me. “But…”

It was difficult for them to understand when they were really young. They knew I wouldn’t serve them with a broken plate, or a cracked cup, so why would my mother do that? As they got older, though, they merely accepted the story as one of the tapestries every family weaves around special occasions, and their questions dwindled to patient grins and shared winks as I began to recite the story for yet another year.

It was only when I told it to my grandchild, Kaz, one Christmas, that the magic rekindled itself. By then, I was in possession of the family Royal Crown Derby set, although because of its increasing fragility, had decided to keep the mended plate separate from the other dishes on the table.

It was the first family dinner together since my grandchild had been born four or five years before. They’d all lived in a different city from me, and I was pretty sure my son hadn’t told his child about it -it was my plate, after all. It was for me to weave the chiaroscuro on the family quilt.

We were all seated at the table, and just before we started to eat, I smiled at my son to let him know I was about to tell the story. He nodded with a delighted smile on his face and nudged Kaz to make sure he was listening.

I told the story in the by then traditional fashion, but I didn’t think it had made any impression on Kaz. I saw him occasionally moving the food around on his plate, maybe to see if his was broken, and then looking somewhat disappointed when he couldn’t see the crack. He was also paying close attention to my own plate with saucer-sized eyes that followed my knife through every cut.

When I explained that the plate was now just too fragile to use after all these years, he smiled and nodded, wise beyond his years.

“You don’t want to have to fix it again, do you grandpa?” He stared at me for a moment, his eyes reading the wrinkles on my face. “It wouldn’t be the same beautiful old plate then, would it?”

Sometimes adults think they have a monopoly on wisdom, but maybe we merely enable something the children already possess. Wabi-sabi may be like that, I think.

by

Oh, true apothecary

That we would do we should do when we would, for this ‘would’ changes, says Shakespeare’s Claudius. In other words, do what you think you should when you think of it, or you may never do it…

It seems to me that Medicine has changed a fair amount since I retired. Not only has science advanced, but so has our way of looking at the world. Our way of framing a problem has expanded, and no longer totally excludes extra-Magisterial endeavours.

Boundaries, are dissolving -or at least being redrawn. Who would have thought that we might look to, well, spirit, as an aide de camp? Or exercise as a legitimate medication? I have written about the latter in an essay I published in 2015 about Quebec doctors’ ability to write prescriptions for exercise: (https://musingsonwomenshealth.com/2015/09/12/the-uber-obvious-in-medicine/) but I am pleased to see that the tradition continues -in Montreal, at any rate: https://www.smithsonianmag.com/smart-news/canadian-doctors-will-soon-be-able-prescribe-museum-visits-180970599

‘[A] select group of local physicians will be able to prescribe museum visits as treatment for an array of ailments… “We know that art stimulates neural activity,” MMFA [Montreal Museum of Fine Arts] director Nathalie Bondil tells CBC News. “What we see is that the fact that you are in contact with culture, with art, can really help your well-being… members of the Montreal-based medical association Mèdecins francophones du Canada (MdFC) can hand out up to 50 museum prescriptions enabling patients and a limited number of friends, family and caregivers to tour the MMFA for free…  MdFC vice president Hélène Boyer explains that museum visits have been shown to increase levels of serotonin, a neurotransmitter colloquially known as the “happy chemical” due to its mood-boosting properties. But creativity’s healing powers aren’t limited to tackling mental health issues; art therapy can also help those undergoing palliative care for severely life-threatening diseases or conditions, like cancer, or suffering from diabetes and chronic illness.

‘According to Boyer, the uptick in hormones associated with enjoying an afternoon of art is similar to that offered by exercise, making museum prescriptions ideal for the elderly and individuals experiencing chronic pain that prevents them from regularly engaging in physical activity.’ Of course, there is the usual exculpatory caveat ‘that the museum visits are designed to complement, not supplant, more traditional methods.’ But still, a step forward, don’t you think? It’s a recognition that there are more things in heaven and earth than are dreamt of in our philosophy, if I may slightly paraphrase Hamlet.

“Why do you always want to drag me along to these things, Julie?” I was sitting in the warm and welcoming sunshine on the magnificent array of stone steps of Vancouver’s Art Gallery when the elderly couple hesitated near the bottom. The man looked the worse for wear and was leaning on his cane, already out of breath. Both of them were bedecked in grey hair, but while the woman sported a cool red cotton print dress, the man seemed dressed for church -he was wearing a heavily creased brown woolen suit, a white shirt, and red tie.

She stroked the lapel of his suit, trying to smooth out some of the wrinkles perhaps, but more likely trying to get him to smile. “You need to get out of the house once in a while, Edward,” she said, and then gently touched his cheek. “Ever since you broke your hip, you’ve just been sitting on the couch…”

“It’s hard to get around, Julie,” he said, somewhat irritably. “And I don’t fancy letting everybody in the neighbourhood see me with a cane.”

Even from several steps above, I could see her roll her eyes. “Do you really think they care, dear? They’re not exactly glued to their windows waiting for you to come on stage, for heaven’s sake.”

He stared at her angrily for a moment and then shrugged when she failed to react. “I get tired easily nowadays, Julie,” he said in a husky sort of whine.

She reached out and grasped his hand. “You get grumpy easily, nowadays, sweetheart.” I could see her squeeze his hand reassuringly. “You haven’t been yourself since the operation, you know. And it’s not like you to be tired all the time.”

She seemed so earnest and caring, I could see his expression soften. Clearly, they’d been married for a long time. “Well, I…”

“Come on, Eddie we’re almost there,” she whispered loudly and winked at me when she saw me watching them.

“Well, I guess since we’ve already come all this way…” He shrugged and allowed her to lead him slowly up the steps past where I was sitting. “I just hope there’s some place to sit in there…” was the last thing I heard him say as they inched their way ever upwards.

I promptly forgot all about them as the sun warmed my face while I read the pamphlet about the exhibition on current display. I was looking forward to a lazy afternoon of wandering through whatever was on offer this time. I hadn’t visited since the Musqueam artist, Susan Point’s Spindle Whorl exhibition and I remembered standing transfixed, in front of the hypnotic, wheeled patterns of her Coast Salish art.

But the sun coaxed me into staying on the steps and watching the world amble past -on a warm day, the people outside are sometimes as intriguing as the art inside. I don’t know how long I sat there, but eventually the need for a coffee and a muffin roused me from my aerie on the steps, and I sauntered into the Gallery Café to see what I could find.

There was a table emptying inside, so I carried my tray over to it and sat down. I was just tucking into the muffin when I heard a familiar voice at the next table and recognized the two who’d been standing below me on the steps.

But Edward didn’t seem as grumpy now, and Julie was smiling from ear to ear. “Well, dear, what did I tell you?” she said, stirring some milk into her tea.

“You didn’t tell me I’d see the original painting of that reproduction we have hanging in the living room wall, sweetheart…” He gazed fondly at her for a moment. “It’s my favourite painting, you know…”

Her smile grew even wider, as if, of course she knew. “Surprise, eh?”

“I’ll say,” he said, his eyes alive and twinkling. “Maybe we could look around for some other paintings by him.” He reached across the table and fondled her hand.

“Well, there’s that place on Granville -you know, the one up near the hospital? They may have some reproductions,” she said, leaning over the table and stroking his cheek with her free hand. “Want to have a look tomorrow?”

“That’s a great idea, Julie.” He stared at his cane for a moment. “Maybe we could walk -it’s not that far, is it…?”

“No it’s not, sweetheart,” she whispered, and touched his cheek again. “No, it’s not…”

 

 

 

 

 

 

 

 

by

The time is out of joint

It came as a great shock, of course -Youth  does not easily admit defeat: it lives as if there is always a tomorrow, will always be a tomorrow. The sun will rise after any darkness; day will always follow night. Youth is immortal, although perhaps it is that death is further away than they can see. It is beyond the horizon of a land so vast, it barely recedes as they wander along the rainbow of their still-wet days.

At least that’s how Elissa saw it in the years I knew her. We met at university in our freshman year -some club or other, I suppose -although we also took many of the same classes, I recall. And then after three years, she transferred to another school and I lost track of her -until one day I saw a face that shouldn’t have been where I saw it.

I had just started doing my first ward rounds on a neurology rotation in my fourth year of medical school, and there, tucked in a sunny corner of a four-bed room, was a pair of eyes that suddenly twinkled with recognition. Almost everything else I’d seen that first morning on the ward was depressing: asymmetrical faces, immobile bodies, eyes that stared unseeing, and perhaps uncaring, at the ceiling tiles -a ward of scarred, and time-ravaged bodies.

But there she was: a more mature, but still beautiful version of the Elissa I knew. Her auburn hair was shorter than I remembered -but partly shaved and bandaged near the crown. And her face told me she had gone through a lot since we had last seen each other.

I glanced at her chart. The beds on the neurosurgery unit were filled, and so she had been placed on this ward after her brain biopsy a few days previously, until something became available for her on the surgical ward. The biopsy results were depressing -definitely not encouraging for a 29 year old just beginning her PhD program in Psychology.

“Is that who I think it is?” she asked as I approached her bedside.

“I guess that depends on who you’re hoping for,” I answered lightly, and with a smile.

“So…” She ran her eyes across my face and then over the short white coat that medical students wore when visiting patients in those days. “Are you a doctor now?” she asked, even though her expression told me she knew I wasn’t. “Sit down and tell me what you’ve been doing,” she added, before I could answer.

We talked about our lives for a while -well, about everything other than why we were meeting after all this time in a hospital. Elissa could sense my discomfort.

“It’s okay to talk about it, you know…” she said, after an awkward silence when I’d seemed to run out of things to say.

I smiled weakly and shuffled around in my chair.

“Nobody wants to… They crowd around the bed and tell me how well I’m looking, and if anybody dares to mention my cancer, it’s to tell me I am going to beat it.” She glanced at the chart I was holding and smiled. “But I’m not, you know.” She studied my face for a moment. “I can see the subject makes you uncomfortable, too.” She sighed gently and then reached over and took my hand. “I find myself comforting my visitors more than describing how I feel about dying; they don’t really want to know.” Her eyes landed briefly on my cheeks and then hovered over my head before they returned. “I don’t think they’d understand anyway, you know…”

She smoothed the sheets on her bed with her free hand and sighed again. “The really hard thing is that I’ve accepted my fate, but nobody else has. They won’t let me…” She stared out of the window. “You don’t know how hard that is. I almost feel guilty for letting them down.”

She squeezed my hand. “But you know, what it really makes me feel is so very alone… I can’t talk to them about that -not my friends, at any rate.”

Suddenly she stared into my eyes. “Oh, I don’t mean you!” She smiled like the old Elissa. “It’s just that I’m still entitled to an opinion, don’t you think? And I don’t want to live forever, you know…”

I nodded, and stayed quiet and let her talk. I’d never felt so… so close to her.

Then her eyes began to twinkle again. “I mean I have a few quibbles about the timing and everything, but I think I could accept even that, if they’d only stop trying to console me all the time… and just listen.”

Her face was almost radiant as she poured out her feelings onto me, and we continued talking until a nurse tapped me on the shoulder to remind me I had rounds to do on the rest of the patients.

It was then that Elissa leaned across the bed and kissed me on my cheek. “Thank you, G,” she whispered, using my nickname like it was a caress. “Thank you for just listening… ”

Elissa died only a few weeks later -there wasn’t much to treat brain tumours with in those days, and she slipped into a coma only days after we’d talked. But our discussion has coloured my thinking ever since.

And one topic we discussed -the unfairness of our allotted lifespan- still surfaces from time to time, even all these years later. Most recently, I suppose, in an essay by Paul Sagar, a lecturer in political theory in the department of political economy, King’s College London. He was writing in Aeon, an online publication, outlining the fears that surround both death and its converse, immortality: https://aeon.co/essays/theres-a-big-problem-with-immortality-it-goes-on-and-on

I suddenly remembered Elissa’s feeling about immortality. I don’t want to live forever -just long enough… Until I’m ready, I guess. So I was pleased to learn that the attitude she taught me was neither anomalous nor unusual.

‘[T]he English moral philosopher Bernard Williams suggested that living forever would be awful, akin to being trapped in a never-ending cocktail party. This was because after a certain amount of living, human life would become unspeakably boring. We need new experiences in order to have reasons to keep on going. But after enough time has passed, we will have experienced everything that we, as individuals, find stimulating. We would lack what Williams called ‘categorical’ desires: ie, desires that give us reasons to keep on living, and instead possess only ‘contingent’ desires: ie, things that we might as well want to do if we’re alive, but aren’t enough on their own to motivate us to stay alive.’

I’m reminded, of course, of Bill Murray in that famous movie Groundhog Day where he lives the same day over and over again. As moral philosopher Samuel Scheffler at New York University points out, ‘because death is a fixed fact, everything that human beings value makes sense only in light of our time being finite, our choices being limited, and our each getting only so many goes before it’s all over. Scheffler’s case is thus not simply that immortality would make us miserable (although it probably would). It’s that, if we had it, we would cease to be distinctively human in the way that we currently are. But then, if we were somehow to attain immortality, it wouldn’t get us what we want from it: namely, for it to be some version of our human selves that lives forever. A desire for immortality is thus a paradox.’

And yet, is that it? There must be something else about, well, death -apart from fearing it- that makes us long to avoid it. Sagar mentions the Basque philosopher Miguel de Unamuno feeling ‘outrage and anger that something is being taken away from him (‘they are stealing my I!’). Unamuno is imagining the situation that most of us do when we are contemplating our own deaths: not a distant point of decrepitude, aged 107, trapped in a hospital bed, in an underfunded care home – but rather death as claiming us before we are ready.’

As Sagar concludes, ‘ We are not simply afraid of death, we also resent it, because it is experienced as an assault on our personal agency. We can fully control our own deaths in only one direction – and that, of course, is usually no comfort at all.’

I wonder what he might have thought had he met Elissa that day in the hospital so many, many years ago… Those who are dying may also have an opinion.

 

 

 

 

 

 

 

 

 

 

 

by

I had as lief have been myself alone

Just because something is missing, does that mean it should be there -or would be there under normal circumstances? Suppose someone does not realize it’s missing and has no thoughts about it. Under those circumstances, is it really missing -or does that description apply only when it’s noticed? Is the evidence of absence the same as the absence of evidence?

I have to say, this all reminds me of the philosopher Bertrand Russell’s teapot analogy that attempts to suggest that the burden of proof lies upon the person who is making unfalsifiable claims, rather than shifting the burden of disproof to others. ‘He wrote that if he were to assert, without offering proof, that a teapot, too small to be seen by telescopes, orbits the Sun somewhere in space between the Earth and Mars, he could not expect anyone to believe him solely because his assertion could not be proven wrong.’(Wikipedia)

Loneliness is something like that: a social expectation that in the absence of people, one should feel lonely. Value judgements are seldom provable, and yet it sits there like a normally hidden blemish under a shirt, just waiting for a morning mirror.

Perhaps it is important here to distinguish between solitude and loneliness, and an essay by the writer and historian Fay Bound Alberti in the online publication Aeon helped to delineate the boundaries: https://aeon.co/ideas/one-is-the-loneliest-number-the-history-of-a-western-problem

‘The term ‘loneliness’ first crops up in English around 1800. Before then, the closest word was ‘oneliness’, simply the state of being alone. As with solitude – from the Latin ‘solus’ which meant ‘alone’ – ‘oneliness’ was not coloured by any suggestion of emotional lack. Solitude or oneliness was not unhealthy or undesirable, but rather a necessary space for reflection… Skip forward a century or two, however, and the use of ‘loneliness’ [is] burdened with associations of emptiness and the absence of social connection.’

‘The contemporary notion of loneliness stems from cultural and economic transformations that have taken place in the modern West. Industrialisation, the growth of the consumer economy, the declining influence of religion and the popularity of evolutionary biology all served to emphasise that the individual was what mattered – not traditional, paternalistic visions of a society in which everyone had a place.’ But there has also arisen a social stigma associated with being lonely. ‘While loneliness can create empathy, lonely people have also been subjects of contempt; those with strong social networks often avoid the lonely. It is almost as though loneliness were contagious.’

And indeed, it has long been recognized that belonging to a community seems to be associated with mental as well as physical health. So ‘loneliness can exist only in a world where the individual is conceived as separate from, rather than part of, the social fabric.’ Only in a society, perhaps, where individual efforts are recognized as contributions, not anomalies. A bit of a mixed bag, isn’t it: damned if you do, damned if you don’t.

I like to think that I am selectively ‘onely’ -that there is a choice. But as I get older, and wear my years less confidently than my clothes, I find that the options are sometimes rescinded. People -strangers, often women- smile at me when I am sitting alone. And while I have always enjoyed a smile, lately I have come to see it as a harbinger of something else. Something more than just holding a door open for an older man: I hesitate to call it pity, so perhaps I’ll suggest that it is transference -in an almost-psychoanalytic sense. I don’t really think I look that fatherly, but perhaps sitting alone at a table in a restaurant, I evoke not entirely buried feelings of guilt for the infrequent visits to parents. Or is it a premonitory dread of my own anticipated fate?

I was coming back from a visit to some friends a while back, and decided to stop in a little town for some coffee and a snack. I suppose the place was too small for a Tim Horton’s or even a MacDonald’s outlet, so I opted for a generic version on the only main street. It wasn’t at all busy, and there seemed to be a wealth of tables available, so I chose one in the window overlooking the mildly busy street.

For some reason, a woman walking past on the sidewalk outside suddenly caught my eye and smiled at me. Short grey hair, with a dark red ankle-length coat, she seemed not unlike any of the others who had strolled past unaware of me on the other side of the glass, so I promptly forgot about her until I saw her standing beside my table with a coffee in her hand.

“You must be a stranger in town,” she said, not unkindly.

I smiled as an answer, hoping she was just on her way to another table.

She shook her head slowly, as if trying to decide what to do. “You look so much like my father,” she added. “I thought maybe he had decided to come out for a coffee again…”

“Come out?” I said, wondering if that was a good thing or not.

Her smile broadened. “I had to put Dad in a care home last year because he kept wandering off.” She performed a quiet sigh and sat down in the other seat at my table. “He still walks out occasionally. The staff say he gets lonely and decides to go looking for me.”

I nodded sympathetically. “There must be lots of other people there, though. Don’t they help with the loneliness?” I suddenly realized that sounded terribly naïve.

But she nodded politely. “With Alzheimer’s you can be lonely in a crowd, they tell me.” She stared at me for a moment and then had a sip of her coffee. “Apparently it can be more than just frightening for them,“ she added, glancing at me again. “It makes me wonder what it is about being alone that terrifies them -or the rest of us, for that matter.”

I shrugged. “Being alone isn’t always a bad thing,” I said, sitting back in my seat. “Sometimes it can be a choice.”

Her expression shifted just a little, and I could see she was examining my eyes. “Or sometimes what starts off as a choice turns into a sentence, don’t you think…?”

She smiled enigmatically, and after we engaged in a bit more small talk, she apologized for bothering me and then walked slowly over to another table filled with friends.

I don’t know whether she’d been proselytizing or just being kind, but I kind of envied her, you know…

by

Saudade Considered

There is something bittersweet about the loss of a loved one isn’t there? Sorrow, to be sure: that feeling of floundering in deep, dark, swirling water, the ineluctable pain of absence, and the almost unbearable inability ever to see her, hear her, or touch her again. And yet, peeking through all the darkness and the tears, are the memories: the things she said, and that special smile she saved for you as she walked through the door after a day at work, the twinkle in her eyes when she noticed you across the room at a party, the smell of her clothes in the closet you haven’t yet found the need to use for something else…

The very presence of an absence can be a healing balm: a bower in the middle of a heaving city, a pew that creaks with a little sigh not far off a busy road. I had not heard of saudade before, I must confess; I had not even thought of such a thing until I came across it in an essay in Aeon, by  Michael Amoruso, a visiting assistant professor at Amherst College in Massachusetts: https://aeon.co/ideas/saudade-the-untranslateable-word-for-the-presence-of-absence  And, although it is claimed that the Portuguese word is untranslatable, the ‘presence of absence’ seems to capture the idea. As Amoruso writes, ‘There is a certain pleasure in the feeling. Though painful, the sting of saudades is a reminder of a good that came before.’ It is, in other words, the ‘desire for the beloved thing, made painful by its absence.’

Portuguese speakers ‘complain of ‘dying of saudades’ (morrendo de saudades), or wanting to ‘kill saudades’ (matar saudades) by fulfilling desire. Though hyperbolic, the word’s morbid poetics throw light on how affective ties make for a meaningful human life.’ Interestingly, ‘Saudosismo, an early 20th-century literary movement, was largely responsible for establishing saudade as a marker of Portuguese identity.’

But, although the word may be Portuguese, I suspect the concept, however abstruse on first hearing it, has a uniquely personal resonance for us all. More than nostalgia, and perhaps less than absence, it seems to have the ability to take on loss in different ways, and even at different times. It is not quite longing, and yet all three of these words are embedded like jewels in a ring each of us can wear. I love the idea.

And the more I think about it, the more familiar it seems. I’m retired now, but I spent over forty years as an obstetrician -there is something of the saudade in thinking of that alone, but it also reminds me of the grief I shared with some of my patients over the years. One in particular stands out, I think.

I’d always looked forward to seeing Jessica for her prenatal visits. Apart from early problems with nausea, and some blood pressure issues towards the end, her visits seemed as much social as medical. Sometimes she would arrive with a little bag of cookies for me, and once, a birthday card -although I have no idea how she knew. But that was Jessica: she made it her job not only to brighten up the office with her outrageously coloured maternity clothes, but also with her infectious humour and easy smile.

She never sat alone in the waiting room – she was always reading to some of my other patients’ children while they were being seen, or chatting up whoever was sitting beside her. I could tell when Jessica was there by the laughter.

It was her first pregnancy, and her enthusiasm was hard to ignore. Her eyes danced when she saw me, and if I happened to be behind time, and had come for another patient, they twinkled mischievously, as if she thought I might be teasing her.

I happened to be off call the night she delivered, and so I popped into the hospital the next day to congratulate her. Her short, auburn hair was a little messy, and the glasses she normally wore were folded on the bedside table beside her. The baby was asleep on her breast, but even so, her eyes didn’t disappoint, although they spent most of their time staring at little Matthew, and I could tell that even her smile was divided between us. She was obviously exhausted from the delivery and apparently hadn’t slept in the three or four hours since his birth.

I kept my visit short and after congratulating Jarod, her husband, left to finish my rounds.

“See you in six weeks,” she called after me, as the baby began to stir.

But it’s sometimes hard to keep track of time in a busy office and a call schedule that necessarily mixes deliveries of patients from other obstetricians so we can all have some time off. So I think it was closer to 6 months before I saw Jessica again.

She was smiling when I saw her sitting in the waiting room, but her eyes were not the same, although they warmed a little when she saw me, I think. My secretary threw a warning stare at me as I passed her, but I was too intent on Jessica to pay any attention.

Normally, a postpartum checkup is more of a formality, unless there are specific items to be addressed. So, a pap smear, a quick glance at the perineum to make sure things are healing, advice on contraception and then a bit of small talk about the baby and how things are going.

I was a little surprised that she didn’t bring little Matthew, but sometimes mothers need a break, I suppose, so nothing alarmed me… Until I asked about him, that is.

Her normally dancing eyes suddenly shut and I could see tears beginning to roll down her cheeks.

“He…” she couldn’t speak for a moment, and I offered her some tissue from my desk, afraid of what she was going to say. “He passed away, almost 4 months ago,” she managed to say through wavering lips and then buried her head in her arms.

I wasn’t sure quite what to do. I felt devastated in that moment, and although if I’d just been a friend I would have hugged her, I felt awkward -embarrassed, almost- just sitting behind my desk.

Then, before things became even more uncomfortable, she raised her head, took a deep, stertorous breath, and sent her eyes over to sit on my cheeks. “Crib death,” she said and withdrew her eyes again, to stare at her lap. “We made sure he was sleeping on his back, on a firm mattress in the cot… Nobody smokes in our house… I breast fed him…” She had obviously done a lot of reading about some of the factors that can be associated with SIDS (Sudden Infant Death Syndrome) and was listing them to me out of a still-felt sense of guilt. “I fed him about 3 A.M. and when I went back around 6…” She started to cry again.

But this time, she recovered more quickly. “Jarod and I have been going to grief counselling, and everything…” she volunteered as she saw me about to say something.

And then, there was an almost magical transformation in her face. “I remember he used to gurgle at me, and I think he was beginning to smile -you know, a for-real smile,” she added, to clarify it for me. “And his eyes…” She hesitated for a moment, relishing the thought. “They would twinkle at me -I’m sure of it… And then they’d slip right into my head, somehow, then dance their way out again.” She stared at the wall behind me. “Jarod says my eyes dance, too…”

She was silent for a while as she remembered Matthew. “He gave us so much, you know…” She sighed noisily -as if it helped her put things into words. Then, her eyes crept slowly back onto my face and stayed there. “It even hurts to talk about him in the past tense…” She fought for the right words. “But… His gift was just being in our lives -however short a time.”

Her eyes searched my own to see if I understood, and then suddenly she smiled. It was almost the smile I remembered. She blinked and nodded her head like the old Jessica. “Jarod wasn’t sure there was still a reason for a postpartum visit… But I knew you’d understand,” she said, gathering up her things to leave the room.

I stood up as she headed for the door when she suddenly turned, walked over, and hugged me. I didn’t have the words for it then, but you know, I think we both experienced saudade.

Yes, Jessica, I think I understand.