Magic and Art

In his piece “Snowed” that appeared in last Sunday’s New York Times Magazine (December 24, 2006), novelist Walter Kirn relates the elaborate lengths he went to a year ago to deceive his two young children at Christmastime. Kirn purchased raw leather, a few tin bells and a bolt of red felt, which when strewn about the yard in the snow gave the appearance of a reindeer sleigh accident. He hatched this scheme “to dupe his children about the existence of magic in the world.”

Kirn began to have second thoughts about his deceptive plan on Christmas Eve. Instead of “staging a sleigh crash and forcing us all to dwell in falsehood,” Kirn thinks about giving his 4 and 7 year-old a talk on art: “Christmas is a work of art, and art is a lie that tells the truth.”

In the end Kirn went to bed, leaving the pieces of wreckage in the yard for his children to discover the next morning. When faced with the evidence at hand, his young son begins to vomit. His daughter reasons that there couldn’t have been an accident, because “there’d be blood and fur.”

Not only has Kirn deceived his children; he has also deceived himself. There is a magic at Christmastime, a palpable magic, and its name is love. Art is not a lie that reveals the truth, but rather truth that reflects the Truth.

“Our lies are like gifts we’ve put on hold at Macy’s: the day always comes to pick them up and pay for them.” Kirn’s words ring true. I wonder what payment the piper will extract from him on the day his children learn the truth.

Christmas was meant for children

Even the most mundane things take on special significance at Christmas time. Little Melody Banner’s case was sad to begin with; maybe it was the Christmas season that made her situation seem all the more tragic.

I picked up the new chart from the wall slot and called her name. A dirty-blonde, toothless mother stood up, cradling a weeping, blue-eyed, curly-haired child in her arms.

As I escorted them into my office, it occurred to me that seeing a new patient was like opening an unread book. The story had already been written, the plot lines laid down, the characterizations set. It was my job to discover these secrets. On occasion, I would find myself pulled into the next chapter.

The mother maintained her composure, in spite of Melody’s obvious distress. I still remember the toothless smile, a rarity among my mothers in their 20s.

They had fled their cramped apartment and their small South Carolina town. There, Melody’s father, who did not live with the family, had occasionally visited to satisfy himself sexually. He was usually drunk when he showed up, and Melody’s mother would bear the brunt of his anger. During his last visit, he had beater her soundly, raided the few dollars from the covered tea can in the kitchen and smashed the television.

That’s when Melody’s mother decided she had had it. Before dawn, Melody’s mother and grandmother piled their few belongings into the back seat of an ancient ’62 Chevy, and the family of three headed north.

Four days later they arrived in Hartford, where Melody’s mother had been born 28 years earlier. Unfortunately, she had no relatives left there, so the family made the rounds of the women’s shelters and the Salvation Army soup kitchen, but continued to live in the car.

The mother kept the engine running overnight to heat the car’s interior. She knew enough to keep the window open a crack. She was breastfeeding Melody but produced little milk on only one meal a day. When Melody developed a fever and started vomiting, the mother decided to bring her to the clinic.

I paused from my examination to look at this whining child clinging to a dry, flaccid breast. Temperatures had dropped to the teens this past week, and Melody’s mother had no more money to buy gasoline to fuel the heating system in their car.

Medical records hand-carried by the mother delineated past weights and heights. I glanced at the new chart on my desk. Melody had lost two pounds over the past three weeks. In two weeks she would reach her first birthday.

I almost rejoiced when I saw the inflamed eardrum through the otoscope: otitis media—this acute problem, coupled with the weight loss, was Melody’s ticket to a hospital for the next few days. Fortunately, the local hospital had rooming-in privileges for parents of pediatric patients.

As I picked up the phone to call admitting, my eyes fell on the desk-top calendar: December 22nd. With a little skillful manipulation, I could arrange for Melody to remain in the hospital over Christmas. Normally, I make every attempt to get sick children home for the holidays. But in Melody’s case, the hospital was the only home she had now.

“Uneventful” is the accepted medical description for Melody’s hospital stay. However, from Melody’s viewpoint, the four-day stay was anything but uneventful. During that time, she had regular nourishing meals, a soft bed and a warm room. She even had a visit form Santa, who brought her a teddy bear, the only present she received that year.

Like so many other clinic patients, Melody missed her follow-up appointment with me. The following spring, I received an authorized request from a clinic in northern Maine for the release of Melody’s medical records. Melody and her mother were still running.

Since then, not a Christmas has passed that I haven’t thought about those blue eyes and that toothless smile.

A Poet Gets His Final Wish

Piergiorgio Welby, the Italian poet who suffered from muscular dystrophy for 40 years, had his final wish granted when Dr. Mario Riccio, an anesthesiologist, sedated Mr. Welby and removed the artificial life support that had been keeping him alive for the last three months.

“The case of Piergiorgio Welby is not a case of euthanasia,” Dr Riccio stated. “It’s a case of refusing treatment.” According to the doctor, such cases happen every day—quietly, without the public attention that Welby’s case had received.

The New York Times (December 22, 2006) reported that Italian law “does not allow anyone to assist in a death, even by consent. Two recent legal decisions on Mr. Welby’s case questioned the legality of a doctor detaching life support, while upholding Mr. Welby’s right to decline treatment.”

Emma Bonino, a leader in the Radical Party, of which Mr. Welby was a member, said: “Piergiorgio Welby did not invent a phenomenon. He gave a voice to a reality — voice, body, suffering — to a reality that exists, and to which it is more simple, if more cruel, to close one’s eyes.”

While I think that it’s morally wrong to willfully take the life of another human being, I don’t pretend to be able to speak for the individual patient who finds himself in that dilemma. As the Galician quadriplegic Ramón Sampedro wrote in Cartas desde el infierno (Letters from Hell): “I don’t speak for all quadriplegics. I speak for myself — Ramón Sampedro.”

As I wrote in my review of Mar Adentro (The Sea Inside): “The sea that rages deep within the soul touches upon that universal profound question of what constitutes a human life. For Ramón Sampedro the answer becomes clear. But for many viewers the answer will remain elusively hidden in the heart. Perhaps none of us can know it truly before his or her time.”

Petitioning for the Right to Die

Today’s New York Times (December 20, 2006) carried an article highlighting the cause célèbre of Piergiorgio Welby, an Italian poet, now bedridden and ventilator-dependent after suffering with muscular dystrophy for 40 years. Mr. Welby has petitioned the Italian government to allow him to end his life. “I find the idea of dying horrible,” Mr. Welby says, “but what is left to me is no longer a life.”

An Italian court has denied legal permission for a doctor to sedate Mr. Welby and remove him from his respirator. He says he is not seeking to commit suicide, but to remove himself from medical treatment he does not want. “What is natural about a body kept biologically functional with the help of artificial respirators, artificial feed, artificial hydration, artificial intestinal emptying, of death artificially postponed?” Mr. Welby has written.

“If it is done privately, there would be a way to accommodate his desire to discontinue life support as a burdensome therapy,” said Dr. Myles Sheehan, a Jesuit priest and physician at Loyola University Medical Center in Chicago. “But if it is done publicly, it’s a big mess, because of the direct link to euthanasia.” Dr. Sheehan is an expert on ethical issues surrounding euthanasia.

Welby’s book, Let Me Die, brings to mind another book, Cartas desde el infierno (Letters from Hell), written by Ramón Sampedro, a Galician quadriplegic sailor who petitioned the Spanish government to permit him to end his life. Sampedro ended up committing suicide with the help of a friend. His story is told in the motion picture Mar Adentro (The Sea Inside), which I reviewed in the Summer 2005 issue of Cell2Soul. Interested readers can access my review here.

Can Empathy Be Learned?

In response to my query, a friend recently wrote me on the subject of teaching empathy and compassion: “I doubt empathy or compassion can be taught, though I’m confident it can be learned. Perhaps ‘priming,’ as you say, is the issue. There were enough culture-loving Nazis and far too many devotees of ‘scientific reason’ who supported American misadventures in eugenics and other such atrocities for me to think education, of itself, makes a moral person. I suspect Michael Polanyi’s thoughts on tacit learning are helpful in this regard.”

The wife of a recently-deceased friend allowed me the pleasure of browsing through his personal library to select whatever books might take my fancy. My friend was an English literature professor and had quite a collection. I found a thin tome, Michael Polanyi’s The Study of Man, which I’ve been wading through in an attempt to follow his thinking on tacit knowledge.

The older I get, the more I wonder if we can actually teach anybody anything—the motivation for learning has to come from within. I had a bit of fun with this idea in my essay, “Mirror Neurons—Can Empathy Be Learned?” Interested readers can access it here.

Can Empathy Be Taught?

Modern research has documented the existence of mirror neurons, brain cells located in our frontal lobes that allow us to respond empathetically to another person.

It turns out that the brains of human beings diagnosed with autism by and large are deficient in mirror neurons. This may account for the autistic person’s inability to relate empathetically to others.

Because the human brain is plastic at birth, in theory it should be possible to cultivate the development of mirror neuron synapses to encourage heightened empathetic responsiveness in individuals.

Just how we could go about doing this is unclear, but there is some suggestion that early and ongoing exposure to good art, music, literature and quality mentors may serve to facilitate the development of mirror neurons.

Although we may not be able to teach empathy to others by instruction, it may be the case that empathy can be learned—through imitation.

“Patients Are a Virtue” reviewed in the Yale Journal for Humanities in Medicine

Howard Spiro M.D. recently reviewed “Patients Are a Virtue” in the Yale Journal for Humanities in Medicine.

Maurer “writes about his patients with the skill of Richard Selzer: refreshingly enough, he finds in mundane occurrences, and in patients others might regard as banal, the poetry and pathos of life.”

“Maurer has a gift for recording conversations. His stories flow smoothly and realistically, and they are compelling, at only three pages or so….This book gives brilliant witness to just that kind of humane medicine that attracts those who want to comfort as much as cure.”

Interested readers can access the entire review at: The Yale Journal for Humanities in Medicine.

The Yale Journal for Humanities in Medicine acts as an online clearinghouse for manuscripts dealing with the humanities and medicine.