Archives for posts with tag: death

If health means avoiding disease, we need to find the best evidence on prevention: how to keep the sickness we dread from creeping up on us.

If health means a broader well-being, we need to find the best way to live. We can live poorly while being free of disease, but we can be fully realized human beings even while terminally ill. 

As a doctor I am rarely asked how to achieve a state of broader well-being. This is probably as it should be. I have not been trained for such all-encompassing life counseling, nor am I comfortable in such a role.

But maybe tomorrow’s doctors should be expected to counsel in this way. There is so much we cannot control. We will all die; but we will not all die in the same way.

Sometimes I trip myself up when talking because I get caught up in the complications. My bias is to see things as irreducibly complex. There were great scholars of the Talmud who found themselves unable to judge questions of rabbinic law because they could see too many sides. Recognizing that I am not in that league, neither in medical nor in Jewish scholarship, I do feel the same way on many occasions. “Should I take medication for high blood pressure?” “It depends.” “On…?” “On your cardiac risk, your tolerance for adverse effects, your potential to lower your blood pressure with diet and exercise.” 

Now I realize, way too late, why all those jokes about “six months to live” are even funnier (or, perhaps, even less funny) than people realize. Of course the point of those jokes is that the doctor is way too sure of himself (it’s always a he in the old jokes). But even deeper, the doctor is wronger than he knows. No one can tell how long anyone else is going to live. 

In a recent daily page of Talmud, the rabbis talk about how the books of Ecclesiastes and Proverbs were nearly kicked out of the canon because they were self-contradictory. Somehow, they managed to stay in: but that’s never said explicitly, since the reader knows that. Rather, what comes directly after the attempted aspersions on these books is a series of exegeses to make all the contradictory verses work out. 

The message for me as a doctor: we are purveyors of narrative in a shifting landscape of multiple truths. To tell a story that works for our patient is being helpful, not deceptive. A story to take our patient through a disease and out the other side is worthy of inclusion in our canon of healing.

The poetry reading at the bookstore was called for 7:30, but when I got there people were still milling around. To occupy myself, I bought a slim paperback of Kant for 5 dollars. He talked a lot about the duty of morals and the human will, but it seemed a grim duty with very little love and a lot of law. At 8:10, someone murmured, “Maybe we should get started.”

First, Karen Rivers Hattrup read an essay, a sweet memento-mori about the transience and beauty she found as a guest at a Catholic girls’ high school dance: “the girl who had cancer and lived, the girl who had cystic fibrosis and did not.”

Jennifer Fortin, who grew up in Gaithersburg and went to Goucher, read work from her 2011 book Miner Muzzle Velocity. This is a collection of postcard-shaped poems written from a narrator, somewhere abroad, to her lover-friend-recipient, addressed only as “Dear.” Each is signed “Yrs.” and each, like a postcard, wends its way in a confined space while referring to the world outside in either oblique or explicit ways. The writer is always on the road, scribbling on the fly while connecting to her correspondent. “On the road again, Dear. Decide on stakes.”

Then came Nate Pritts, who dedicated some of his work to Def Leppard. So is Nate’s work stadium rock poetry, wearing its heart on its sleeve and demanding to be sung? Sure:

Give thanks for what’s beautiful and the fact that it ends
I’m hot with the duty to build it again

That’s the duty we need, that’s what Kant is missing! This is the poet-philosopher: “The assumption we can define the way our surroundings continue/after our absence/is the ultimate arrogance.”

The evening’s host, Jeremy Hoevenaar, read last. A recent chapbook of his is available for free on the website of H_NGM_N, Pritts’s journal. There’s witticism – “You’re not in time. You’re too late. You missed it./ God’s not only dead, he’s completely decomposed.” There is Lucretianism: “Following a series of repeatedly failing gestures,/I hit upon the idea of addressing atoms individually.” In many of these poems, there is also love, disintegration, and anatomy.

To take some of Hoevenaar’s words out of context – the reading was both “a historical moment and an object of entertained fascination.” Let’s build it all again.

Cross-posted to Baltimore Book Talk.

“I’m pretty grim for a comic poet,” remarked Ron Padgett after reading one of his more morbid pieces as this year’s guest of the Joshua Ringel reading series. Padgett’s work is permeated by the influence of his teacher Kenneth Koch, his gentle aphorisms and low-grade epiphanies.  ”Take out the trash/Love life,” Padgett writes in his How to Be Perfect, then disarms his own oracular tendencies with “Use exact change,” and even – elsewhere – “Don’t give advice.”

While Koch seems always to bounce back and forth between the poles of advice and aw-shucks, Padgett has an appetite for the metaphysical, even the memento-mori. “Don’t be afraid of anything beyond your control. Don’t be afraid, for instance, that the building will collapse as you sleep, or that someone you love will suddenly drop dead.” Grim indeed, and perhaps not comic to the sponsors of the series, in memory of a talented young man who died in a car accident in his 20s - himself a poetry student of Koch’s. But for all that, Padgett provided the right metaphysical aspect: engaging, friendly to the audience and their questions, and without an ounce of the preening self-regard that clings to many illustrious literary figures.

The fifteenth reader in the annual series (Koch was the first), Padgett was well received by those in attendance in the half-full auditorium of the Baltimore Museum of Art.  A successful career as a metaphysical comic poet might be worth aiming for, like something out of ancient philosophy. Walking out into the rainy afternoon after the event, one could sense in each Baltimore moment both the certainty of death and the calm comedy of self-effacement.

I saw a patient of mine this week: someone he loved died. He said, “I felt like I went to bed one day and got up the next day a different person.” 

I wonder whether he’ll be happy someday as that new person. Or if that new person, to be authentic, must always have that pain. If the latter is true, to make it better would be a lie. 

Creative Commons image by theilr