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.

 

 

 

 

 

 

 

 

 

 

 

The Feminist Egg

Once upon a time, I suppose that one of the characteristics of Age was its hubris. After a certain age, it was easy to dismiss most new things as mere variations on time-tested themes –additions, clever perhaps, intriguing even, but still accretions. Ecclesiastes lived in old minds: The thing that hath been, it is that which shall be; and that which is done is that which shall be done: and there is no new thing under the sun. And yet nowadays, even the quickest peek over the shoulder calls that into question. Maybe it always did, but without the publicity it now entertains.

New things –truly new things- are often the hardest to accept, especially if they fly in the  face of cherished beliefs sufficiently entrenched as to be regarded as not merely true, but obviously true -common sense, in fact. It took generations to accept evolution –and now it seems only sensible that the random acquisition of those traits that help survival will be the ones selected for in the next generation. It was not an upwardly purposeful spiral that inevitably led to homo sapiens; evolution doesn’t change cows to humans –it just eventually creates cows better able to survive in whatever milieu they find themselves. And randomly –the unfit are still granted existence, but if they are not suited, they pass on little benefit to their progeny.

It’s true that animals –mammals, especially- do attempt to influence desirable traits in their offspring by choosing healthy partners exhibiting those characteristics. Hence various mating rituals and dominance contests amongst the males; hence elaborate male bird plumage, presumably a proxy, recognizable by a receptive female, as indicative of a primus inter pares. And yet it was probably regarded as curious in premodern societies that a female would be accorded any important choice, let alone that of selecting what she wanted in a partner. Although there has always been a cadre of women who have made their marks throughout recorded history, the examples are sadly limited –curtailed no doubt, because it was usually men writing about what they felt was important to document.

Fortunately, times are changing, as is the realization that each side of the gender divide is equipotent. Just how fluid the roles are is a constant source of wonder to me. Even in these days of Darwin, I am amazed at the still unsuspected porosity of the envelope. And while it no longer seems unusual or unlikely that an information-processing organism like, say, a bird might be able to select an appropriately endowed mate based on observable clues, it is still surprising –to me, at least- that selection duties might be conferred on a more microscopic scale: on an egg, for example.

I first encountered this idea in an article from Quanta Magazine: https://www.quantamagazine.org/choosy-eggs-may-pick-sperm-for-their-genes-defying-mendels-law-20171115/  I have to say it reminded me of Hamlet’s rejoinder to the sceptical Horatio on seeing Hamlet’s father’s ghost: ‘There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy.’

The competition in sexual selection was thought to be pre-copulatory –‘After mating, the female had made her choice, and the only competition was among the sperm swimming to the egg. This male-oriented view of female reproductive biology as largely acquiescent was pervasive, argued Emily Martin, an anthropologist at New York University, in a 1991 paper. “The egg is seen as large and passive. It does not move or journey but passively ‘is transported’…along the fallopian tube. In utter contrast, sperm are small, ‘streamlined’ and invariably active,” she wrote.

‘Beginning in the 1970s, however, the science began to undermine that stereotype. William Eberhard, now a behavioural ecologist at the Smithsonian Tropical Research Institute, documented all the ways that females can affect which males fertilize their eggs even after mating.’ For example, ‘Internal fertilizers have their own methods of what Eberhard dubbed “cryptic female choice.” Some female reproductive tracts are labyrinthine, complete with false starts and dead ends that can stymie all but the strongest sperm. Some females, including many species of reptiles, fish, birds and amphibians, that copulate with more than one male (which biologists estimate are a vast majority of species) can store sperm for months, even years, altering the storage environment to stack the odds to favor one male over another. Many female birds, including domestic chickens, can eject sperm after mating , which lets them bias fertilization in favor of the best male.’

The plot thickens. These strategies seem only to select whose sperm to allow access to the precious as-yet unfertilized eggs. But even sperm from the same individual can vary. So, are things just left to chance? Are we still talking Darwin here? And are the combination probabilities proposed by Mendel that depend on randomness still in the picture?

It would seem that the egg itself may have a say in which sperm it uses, and that unlike the voting system in many democracies, it may not be just the ‘first past the post’ -the marathon winner- who gets the prize.

The article presents several theories as to how the egg may be able to ‘choose’, but as yet there seems to be no clear indication as to whether it always happens, or whether it is just able to weed out some potentially damaging or clearly unsuitable ones by the signals they emit –or fail to emit… Sometimes, anyway. Mistakes clearly occur; abnormal genes do manage to slip through, leading to abnormal embryos –some of which are unable to develop enough to survive.

But that there may be yet another layer of protection built into the system –another unsuspected surveillance system- is what intrigues me. And that, once again, it seems to invest the power of a truly critical decision with the female is a cautionary tale for those who cling to the shredding coattails of androcentrism. It is simply another piece of evidence, if more were needed, that Life and all that it enables, is not a zero sum game. It is not a contest between genders, but a journey together. Still…

Let there be spaces in your togetherness.                                                                                      And let the winds of heaven dance between you.
Love one another, but make not a bond of love.
Let it rather be a moving sea between the shores of your souls.
Fill each other’s cup but drink not from one cup.
Give one another of your bread but eat not from the same loaf.
Sing and dance together and be joyous, but each one of you be
alone – even as the strings of a lute are alone though the quiver
with the same music.
Give your hearts, but not in each other’s keeping.
For only the hand of Life can contain your hearts.
And stand together yet not too near together:
For the pillars of the temple stand apart,
And the oak tree and the Cyprus grow not in each other’s shadows. –Kahlil Gibran –

I couldn’t resist.

 

 

 

 

 

What’s Past is Prologue

Sometimes it’s hard to get things right; sometimes it’s hard to get things even sort of right. We pride ourselves on foresight, on our ability to anticipate the future results of our decisions, but it’s often more hubris than skill. Unintended consequences have a way of interpolating themselves like bushes in a forest while we, so focussed on the trees, see only empty spaces –shadows- in between.

Examples are not hard to find. Just think of the well-intentioned introduction of cane toads to Australia from Hawaii in 1935 to control the cane beetles. Unfortunately, the toads contain a toxin that is deadly to many animals so they have escaped effective predation and their numbers have skyrocketed.

But unexpected problems can also arise at work with employers’ attempts to adapt to the domestic problems that occur from time to time in employees with families. Things like needing to take a child to the doctor, or having to pick her up from day care don’t often happen with childless singles in the office.

I have to say that I would have assumed that thoughtfulness of this sort would have few major adverse repercussions for the employer –workers able to balance job and family equitably might well be better, more satisfied employees. After all, a reward given, is a debt owed. So, I was surprised to discover another side to this family-friendly benevolence as outlined in a BBC news item: http://www.bbc.com/capital/story/20170814-how-to-say-no-at-work-when-you-dont-have-kids?

‘Colleagues with children were […] prioritised when it came to taking their preferred vacation dates, […] while fellow single or childless workers struggled to get time off to care for elderly relatives or were asked to go on more frequent business trips.’ It’s obviously a challenge to separate envy –or resentment- from genuine favouritism and ‘While it’s tricky to nail down concrete statistics that prove how much singles might be being indirectly penalized in the workplace, a recent UK study of 25,000 workers found that two thirds of childless women aged 28 to 40 felt that they were expected to work longer hours.’

‘During research for his book Going Solo, Eric Klinenberg, a professor of sociology at New York University interviewed hundreds of single people in Europe and America and discovered “there was widespread perception that singles became the workhorses in corporate offices”’

‘Bella DePaulo, a professor of psychology at the University of California, Santa Barbara, explores the phenomenon in her books and studies, and coined the word “singlism” to pin down the stigmatisation, negative stereotyping and discrimination against singles that she believes is widespread in the workplace and society at large. She argues that many many employers are missing a trick when it comes to single employees, who, far from being lonely and isolated, are actually more likely to be actively engaged in their communities and have strong relationships with friends who “feel like family, even if they are not family in the traditional sense”’.

Unfortunately, the issue is hydra-headed. ‘“There’s a difference in perspective between people who are parents and people who aren’t. If you aren’t a parent, you really can’t see how that changes your life and your priorities,” says Jonas Almeling, a former entrepreneur turned Head of Innovation for a Sweden’s export and trade agency, who is a father-of-one. “I would definitely not have the same flexibility for someone saying ‘oh sorry I am off kayaking’ compared to someone doing a pick-up from kindergarten,” he argues.’

And yet, both parents and singles can be tempted to abuse the kindness –or naïveté- of a forgiving boss. Many years ago, when I was in my salad days and green in judgement, I started my obstetrical specialty practice and hired a young single mother as secretary on the recommendation of a friend. We got along well, and she proved a reassuring presence for my freshling patients. But she seemed to get a lot of ‘colds’ and migraines, however, and often I would only know about when I found a strange woman, a friend of hers usually, standing somewhat befuddled behind the front desk and wondering just who I was when I walked through the door.

I have to say in Martha’s defense, she certainly had nice friends and they all did admirable fill-ins, but I spent as much time coaching them on their duties as I did with the patients. I knew from my training that new mothers had a lot to cope with and, I supposed, especially single parents, so I would usually just shrug, smile at the new receptionist, and introduce myself. After a while, I got to know some of the replacements, and the office got easier. In fact, when change is common, it no longer surprises, and to tell the truth, I normalized it in my mind.

But one of my new obstetrical patients didn’t, and because of some early pregnancy problems she ended up seeing me weekly for a while.

Normally bubbly and talkative, one day Janice was unusually quiet as I led her down the corridor from the waiting area to my office, and before she sat down, she carefully closed the door behind her. “Who is it this time?” she said, and promptly placed a fake smile on her face.

I didn’t understand the question at first and merely raised an eyebrow in response.

“It was Helen last week, and Brava the week before… Come to think of it, I think I saw this one a few weeks ago…” Her eyes hovered over my face for a moment before landing.

“Martha, is supposed to be my fulltime secretary,” I explained. “She seems to call in sick a lot… Single mother, stuff, I think.”

A sardonic smile replaced the fake one. “Have I met her yet?”

I tried to remember, but couldn’t. “She has short, blond hair, and often wears a blue ribbon around her neck, I think…”

Her eyes slid down my face and stopped at my lips –to see if I was serious, I suppose. “I’m a single mother, doctor,” she said and shook her head slowly. “Well, I will be at any rate, I hope…” She sighed and glanced out the window behind me for a second or two. “And even with all the vomiting, I manage to go to work most days.”

I smiled and shrugged. “Martha shows up a lot…” But Janice could see I was struggling with the defence.

She glanced at a picture on the wall. “How old is her child?”

I shrugged again, this time to cover for the fact that I couldn’t remember. But I think Janice understood. “Uhmm, somewhere around 3 or 4 I think…”

“And does she live alone?”

I did remember that –her roommate sometimes filled in for her. “No, she shares a condo with a friend…”

Janice’s eyebrows both crept upward and her eyes twinkled mischievously. “Ever phone to find out how she’s doing?” She blinked as she suppressed a word that I could see being pulled back into her mouth in the nick of time.

I shook my head. “You almost asked ‘to find out what she’s doing’, didn’t you…? No, I trust her.”

Janice laughed. “Sometimes an employer phones because he’s concerned about his staff. Trust has nothing to do with it.” Her face brightened even more. “And by the way, I’m feeling a lot better nowadays. Maybe I can go back to monthly visits, eh?” she added. “I’ve been missing too much work lately.” And then she winked at me playfully. “Phone her, eh?”

But I didn’t, you know. I think I was too embarrassed; I liked Martha, and I suppose I didn’t want to catch her in a lie. Anyway, she resigned a few weeks later, and sent me a little potted areca palm for my desk to thank me for my patience with her.

The next month, when Janice saw it on my desk, she asked about it.

“Present from Martha –my former secretary,” I figured I’d better explain ‘former’. “She sent it as a thank you present when she resigned.”

Janice was quiet for a moment. “You didn’t phone her, did you?” Her eyes interrogated me briefly – but they knew…

I shook my head.

Then she sighed, and the slightest wisp of a smile surfaced for a second beneath those wise, experienced eyes.