Scaffolds

It’s exciting to realize that, despite my age, there are so many things that I have not stopped to think about: the seemingly random encounters with anonymous people in the course of a visit to a store or waiting for a bus downtown; inconsequential interactions with strangers on a sidewalk waiting for the light to change; overheard conversations at the next table in a Food Court in an otherwise unimportant mall. They are mostly forgettable, I suppose -background noise- and yet in retrospect, they ultimately form the invisible scaffolds of our lives.

Of course, I guess it’s tempting to dismiss most of these encounters -and anyway, there are far too many of them to remember, and they are far too numerous to catalogue let alone ponder the significance of each. I would feel overwhelmed if I had to remember the details of everything that happened to me in a day; I feel blessed that no one asks; it is not a requirement for old age.

And yet, I sometimes wonder if those forgotten contacts with the world form the hidden webs that bind me to reality: Occurro ergo sum, as it were. They have obviously decreased in our pandemic lockdowns and social distancing of late, but they are all around, if you watch for them. I still have trivial conversations with those lining up the requisite three feet away in the grocery store; I still feel a compulsion to interact with flowers in the woods and I continue to follow mysterious and partially hidden trails to see where they lead. I still attempt to understand the yawp of crows scattered in the forest as they try to stay in contact with their flock; and if our eyes engage, I still smile -masked or not- when I pass a person I don’t recognize on the sidewalk to show them I also am a member of their flock. How else to honour an otherwise forgettable stranger? How else to make sense of my life?

*

An elderly man (I try not to look for comparisons with my own misuse of years) apologized to me for coughing as I sat beside him on a bus a few weeks ago. He was wearing a mask above which, by chance rather than intent I suspect, his nose was almost entirely visible. He clearly had not entirely mastered the art of masking, because one ear also stuck out like Mickey Mouse from the pressure of the straps, and there was a rhythmic indentation of the fabric with each of his laboured inhalations.

“Damned thing keeps making me cough,” he ventured, as he apologized with his eyes and re-buried his nose. “But I’m double-vaccinated,” he hastened to assure me in the same muffled tone as his apology.

And that was that. Two streets later, he got off after stroking me with his eyes as he left -for tolerating him, I suppose.

*

A woman passed me carrying her tray to the drop-off box in the mall’s Food court to which I’d been travelling on the bus. I was sitting, unmasked, at a socially distanced table eating a bagel and lingering over my coffee, when she accidentally bumped into me, dropping a napkin onto my arm as she tried to avoid stepping on her little boy. Her eyes immediately registered horror -partially at the incursion into my space of course, but mainly for the fomitic napkin that had landed on my arm. I imagine the fact that she had also forgotten to don her mask after finishing her meal suddenly occurred to her as an added and unforgivable crime as well.

Ordinarily, I suppose this would have elicited no more than an embarrassed apology, but in this pandemic age, it seemed to her to have been an egregious trespass. “Oh my God, sir,” she muttered sotto voce, so as not to incur the antagonism of the otherwise uninterested patrons. “I’m so sorry!”

I smiled at her as a sign of forgiveness, and merely blew the napkin off my arm and onto the floor. I hoped she would see this as yet another sign of absolution, but she merely blushed, picked up the napkin and hurried off, while looking around the room to make sure no one else had noticed.

*

Much later, I was about to enter a popular pathway leading to the trail around a local lake when a dog rounded the corner. I like dogs -no, actually I love them and stop to pet every dog who will let me, leashed or not. I walk the trail several times a week, so by now, I suspect I know every dog I pass -or is it the other way around? At any rate, the dog I met that day was one I didn’t recognize, and it was attached to an ownerless leash. It was a black Labrador, I think, and as is the custom of every lab I’ve ever met, it started wagging its tail furiously and trotted up to me to say hello.

There’s something incredibly endearing about the look in their eyes as they poke their noses into strangers as if they were long lost relatives; it’s impossible not to recognize that there is something intelligent and curious staring out at you and requesting a pat.

I, of course, can never resist, but before I could reach out and touch its head, the owner came puffing around the corner and screamed at me. “Don’t you pet that dog,” she yelled, her eyes not at all as welcoming as her dog’s.

“He came up to me wagging his tail,” I explained, not a little put off by her attitude. I didn’t recognize the wrinkles I could see on her face above her mask, either; she was obviously not a local.

Her eyes narrowed and her forehead rumpled at my explanation as she grasped the leash firmly in two hands and pulled the dog away. “Dogs can catch human diseases, you know,” she added, shaking her head irritably.

The dog glanced at her and then back at me; I could swear his eyes apologized to me for his master’s rudeness and I could almost see him shrug, as he trotted reluctantly away realizing he had no choice in the matter.

I can only hope he realized that I was left without a choice as well…

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?

 

 

Zoobstetricoses

 

Ever since I was a little knicker I had a dog, or a cat, or both. It was part of growing up –playing with the dog in the park, avoiding the cat’s claws as it grabbed for the piece of wool dangling temptingly in front of it. And then there were the times sitting curled up in the dog house just to see what it was like to live there, or sharing my ice cream cone with it because it looked hungry. Being licked in the face was also easier than washing before dinner… Memories, no doubt aggrandized with time, but nonetheless part of the mythology of childhood. My childhood; my mythology.

But I had somehow assumed that it was just a part of la Belle Époque for people of my age; something that the younger generations had long since abandoned for fear of contagion or changing perceptions of what a child should be allowed to do -or want to do. We live in a much more heterogeneous, sanitary society than we used to: a cultural melange that often accords animals a different role in our lives. Whether this is an advancement or merely a change in outlook didn’t much concern me: I’ve already had my past, lived my childhood.

But several months ago I happened upon a review article in the Canadian Medical Association Journal http://www.cmaj.ca/content/187/10/736.full on ‘Reducing the risk of pet-associated zoonotic infections’ and it got me thinking about my pregnant patients and their unintended risks. Of course, every health care provider –every woman, it seems- knows about not cleaning out the kitty litter in pregnancy (Toxoplasmosis) –and even avoiding the other end of the cat (Cat-scratch disease: gram-negative bacterial infections)- and yes, or the perils of eating some types of raw fish sushi too frequently (Mercury contamination). These all seem to be part of a societal mythos to which we are so often exposed, that one almost wonders if there is a gene that the placenta activates whose sole job is to send avoidance signals to the pregnant brain.

And yet the article outlined many more diseases that animals can transmit to humans (zoonoses) that are more quietly under the radar –multidrug-resistant bacteria as an increasingly worrisome emerging threat, for example. So, in the interests of patient safety, I thought it incumbent upon me to add animals to my list of questions. There was no spot for them on the prenatal form, so I kind of slipped it in under ‘other’. Along with ‘occasionally’, I find that ‘other’ is one of the more important categories of words that I like to use.

One woman, Lorraine, seemed to find the questions objectionable however. It was almost as if she felt I was accusing her of uncleanliness, or maybe petophilia, or something.

“I’ve never owned a cat, doctor,” she said with a bit of a huff in her voice. “I’ve always thought they were dirty animals,” she added, as if to justify her vehemence. “They eat vermin when you’re not around.”

“Sometimes that’s a good thing,” I said, hoping to calm her down a little.

She pinned me to my seat with needles from her eyes. She obviously resented the inference of suboptimal conditions where she lived. I left it lying fallow.

“We do have a dog, however –my husband insists on having one,” she admitted with a little reluctant shrug, obviously wary of my reaction. “But it is only allowed on the rug in the kitchen –far away from the food preparation area- and it sleeps in the garage.” She stared out the window behind me, this time avoiding my eyes. “And he takes it to the vet all the time for its vaccinations and flea medication. Costs him a fortune, what with the price vets charge nowadays.” Her eyes flitted around the room, obviously tallying the cost of the pictures on the wall, and even the knickknacks on a little oak table that patients had given me. Obstetricians were clearly not immune to price-gouging –although in Canada with our healthcare system, the extortion was presumable aimed at the government.

Then she waxed reflective. “I had a dog when I was young, though. Boots was his name and he used to follow me to school –I lived in a small town with not much traffic,” she was quick to explain, lest I think she was careless about its safety. “We used to share everything, I remember.” She risked a quick, guilty glance at my face to see if she had transgressed, even at that age.

“And then I got parasites –cryptosporidium­. My mother made me memorize the word; she says I got it from being licked in the face by Boots. I remember I had terrible diarrhea and cramps, but I also remember her telling me that there was no treatment for it and that because of what I let the dog do, I was going to have parasites for the rest of my life… She had a drinking problem at the time, though, so she soon forgot about it… I didn’t.” She sighed somewhat theatrically and continued. “After that initial attack of diarrhea I never had the problem again, so like about so many other things, maybe she was wrong about that.”

I nodded reassuringly. “People with intact immune systems seem to be able to restrain it –keep it in check. And besides, how certain were they of the diagnosis back then?”

She shrugged. “It was just something my mother told me…”

A sudden look of panic attacked her face. “The immune system is dampened in pregnancy isn’t it?” But before I could explain what that meant, her eyes opened like she’d seen a ghost. “Am I going to give it to my baby?”

The answer, of course, is probably not –especially if the condition is not active during the pregnancy- but using a ‘probably’ would only inflame her anxiety. I find when there is a heightened level of concern that actually looking it up on the computer as they sit and watch, is very reassuring: I am then au courant. So I Googled the Center for Disease Control website for ‘infections in pregnancy’ (http://www.cdc.gov/ncbddd/disasters/infections.html) and printed it out for her. It wasn’t much, but it seemed to help. It didn’t do anything to foster a more tolerant attitude towards dogs, however…

That night, as I sat reading in the living room in front of a crackling fire and my own dog lay dreaming near the fireplace, I got to thinking about my own life with dogs. Was I at risk? But then, when I stirred in my chair and one of his eyes opened and stared at me curiously, I realized it didn’t really matter. The risk was worth it.

Umm, I did wash my hands this time after he wandered over and licked them, however; but I think he was just telling me not to worry about him