Mourning a mistress

Much I learned from Medicine;
Much I saw her healing art.
Much I loved this mistress sanguine;
Much she offered from the heart.

First, the wide-eyed disbelief
In pain, to watch a young man die:
Faceless victim, carved relief:
Steeled—no breath—unseeing eye.

Early on, the ebb and flow
Of flailing heart; a pallid face—
Her story stoked with gasps and woe—
Whispered words and clouded grace.

There were the books, those countless books—
Formulae, facts, learned by heart;
Signs and symptoms, on tenterhooks
Recalled, as required by the art.

Humanness sustained me always;
Grief malnourished sleepless nights.
If not to cure, then listen always;
Don the cloak of second sight.

Then, of late, betrayal, riven;
Bought by value-added verse,
Healthcare digitally driven
By Masters of the Universe:

Enterprising party payers
Snatch their complement of coin;
Ivory-towered emerald cities
Meld the meek, together join.

Long ago I learned the taste
Of bitter copper on the tongue;
Now, at eventide, I mourn
My former mistress, lately gone.

Gone to lie with other lovers,
Spin another golden thread;
Leaving only one silk stocking
Draped across an empty bed.

Much I learned from Medicine;
Much I saw her healing art.
Much I loved this former mistress,
Much she offered from the heart.


Best of times, worst of times

Back in 1983 during my time in graduate school, I took a course titled Community Psychology. Admittedly, I remember little from it; but one concept has stuck with me over the decades of my subsequent career: there are always resources available in the community; you merely need to seek them out. more»

Interested readers can now peruse my latest Musings blogContemporary medical practice: The best of times, the worst of times — at the Journal of the American Academy of Physician Assistants (JAAPA) website.

JAAPA is the official publication of the American Academy of Physician Assistants.

Thoreau-ing out the baby with the bath water

While I don’t entirely agree with every point put forth by Jedediah Purdy in his recent rebuttal of Kathryn Schulz’s vitriolic New Yorker piece on Henry David Thoreau, like Mr. Purdy I do find Ms. Schultz’s argument off-putting as well as off the mark in many respects. In a nutshell Ms. Schulz bases her assessment of Thoreau as a contentious, fallible human being almost entirely on bits and pieces of text extracted from Walden, a book which is every bit as complex as the soul of the man who wrote it.

Ms. Schulz maintains that “any reading of Thoreau that casts him as a champion of nature is guilty of cherry-picking his most admirable work while turning a blind eye on all the rest.” And yet that is exactly what she has done, albeit in reverse: she has cherry-picked some of the more controversial lines and passages in the text and used them to argue that at core Thoreau was an amoral, unfeeling, antisocial, narcissistic coot, who cared only for himself — in short, mere “pond scum.”

When you revisit the entire Thoreau canon (as I have done over the course of my life), especially the journals, a very different picture of Thoreau emerges. Certainly he was inconsistent in his outlook over time — which of us is not? — but there are scores of examples of empathetic interest that Thoreau took in others in his community. (Witness his reaction to the deaths of his older brother John, Emerson’s son Waldo, or Bill Wheeler, a village outcast who died of drink.) As a philosophical treatise Thoreau wrote Walden in part “to brag as lustily as Chanticleer in the morning, standing on his roost, if only to wake my neighbors up” — to goad them into seeing that there is more to life itself than eating and drinking and getting a living.

Much of what eventually became the text of Walden came directly from Thoreau’s journal entries. There is some evidence that even Thoreau was less than pleased with the final result. In his introduction to the 1961 Dover edition of The Heart of Thoreau’s Journals, editor Odell Shepard argues: “In comparison even with Walden, the disconnected jottings of the journals seemed to [Thoreau] in some ways more truly his own.”

With a nearly complete manuscript of Walden on his writing desk, Thoreau himself did not find the result entirely satisfactory. “Perhaps I shall never find so good a setting for my thoughts as I shall have taken them out of,” he muses in an 1852 journal entry. Yet in Thoreau’s defense, Mr. Purdy has written elsewhere that “Walden remains, despite superficial popular characterizations, an extraordinary document of reflection on the extent and nature of personal responsibility for common things.” (Purdy, Jedediah. For Common Things. New York: Knopf, 1999, p. 74)

Mr. Shepard maintains that, taken as a whole, the journals “bring back alive a man who, with all his extravagances, perversities, and fierce denunciations of much that America now stands for, is as quintessentially American as Abraham Lincoln.” It was in his journal writings that Thoreau “achieved a unanimous personality, sharply defined, and marched through life with an unerring sense of direction and goal.”

“With a fit audience, though few,” Mr. Shepard concludes, “[Thoreau] is likely to win a more thoughtful reading now that the superficial critics have had their say, now that individuals are so obviously withering among us, now that men are quite obviously enslaved by machines, now that we have floundered about as far as we can in the bogs of stupidity, greed, and cowering compliance that he warned us against long ago.”

In her opening paragraphs Ms. Schulz makes much of Thoreau’s callous description of the corpses that washed up on the beach at Cohasset after the ship that bore the travelers from Ireland broke up in a violent storm off the Massachusetts coast. “Who was this cold-eyed man who saw in loss of life only aesthetic gain, who identified not with the drowned or the bereaved but with the storm?” she asks.

During a recent sojourn to a secluded bungalow in Wellfleet, steeped in the stark beauty of the landscape and sea, I re-read the greater part of Thoreau’s Cape Cod, specifically the section on Thoreau’s reaction to the dead bodies on the beach at Cohasset after the shipwreck. My thoughts immediately flew to Dylan Thomas’s poem A refusal to mourn the death by fire of a child in London – “After the first death, there is no other.” Like Thomas, Thoreau might have been crushed by the horror of what he witnessed and chose to deal with his feelings in a more objective, philosophical — dare I say “poetical” — way.

In the concluding paragraph of Walden Thoreau muses: “I do not say that John or Jonathan will realize all this; but such is the character of that morrow which mere lapse of time can never make to dawn. The light which puts out our eyes is mere darkness to us. Only that day dawns to which we are awake….”

Had he the foreknowledge, Thoreau might have appended Kathryn Schulz’s name to his list, right behind John and Jonathan.