The Universal Language

Driving home from work this evening, I listened to a piece on NPR about the New York Philharmonic’s debut concert in Pyongyang, North Korea. It was the first time that an American cultural organization had appeared in that isolated communist country.

The audience, largely staid during the performance, politely applauded each rendition, from the opening numbers of the Korean and American national anthems to Dvorak’s “New World Symphony” and Gershwin’s “American in Paris.” But when the orchestra played its final offering, a beloved Korean folk song entitled “Arirang,” the audience was moved to tears.

Several members of the orchestra commented on the warmth they felt from the audience; the emotion was palpable. The New York Times quotes John Deak, a bass player: “It’s an incredible connection like I’ve never seen. They really opened their hearts to us.”

The Times article continued: “The audience applauded for more than five minutes, and orchestra members, some of them crying, waved. People in the seats cheered and waved back, reluctant to let the visiting Americans leave.”

In his recent article on J. S. Bach, Harold Fromm observes that when we hear a piece by Mozart or Beethoven, we think of the person behind the music; but when we hear a piece by Bach, the father of Western music, we think of the music only.

Many of Bach’s musical compositions were considered secular when he wrote them. In Bach’s day, it was largely the lyric that imparted sacredness to the score.

Many modern critics make the same observation: the lyrics enhance the music and give it definition. But Fromm makes a case for the music itself. More than just a mathematical assembly of sounds in varying pitch and tone, a musical composition possesses a power all its own. Music is meant to be felt as much as to be heard. In Fromm’s words: “Music was bred into bone and brain inestimable years ago.”

If that is indeed the case, music may be our first universal language, one capable of cutting across ideological and cultural boundaries, speaking to all of us. At least that seemed to be what listeners experienced in the East Pyongyang Grand Theater earlier today.

Eclipsed by the Moon

“There!” I pointed up into the night sky. “You can see the curved shadow beginning to fall across the moon.”

“Esta guay,” my niece remarked. She had just arrived from Spain earlier in the week. The lunar eclipse turned out to be an unscheduled but welcomed attraction at the beginning of her three-month American tour.

“What does guay mean?” I asked in Spanish.

“It’s just an expression. It means ‘How cool!’ or ‘How neat!’”

We stared up at the moon in the southeastern sky. “It’s guay all right; muy guay!

I dashed into the house and returned with my binoculars. “Here, try these,” I said, offering them to my niece.

“Wow, you can really see it well through these gemelos!” she said.

“See those two bright lights on either side of the moon?” I pointed. “That’s Saturn and the star Regulus in the constellation Leo.”

We handed the binoculars back and forth over the next two hours, periodically stamping our feet and blowing out our warm breath through cupped hands to ward off the winter cold. A neighbor across the street came out and settled into a lawn chair to watch the spectacle. Finally, the entire lunar landscape turned a pale burnt orange, engulfed in the shadow of the earth.

My niece pointed the lens of her digital camera skyward and snapped several photos to record the event.

The next day a photo montage appeared in the local newspaper, depicting shots of the moon in various stages of the eclipse from locations around the globe. The same glowing moon appeared above the Wrigley Building in Chicago; in Marlborough, Connecticut; in the night sky above Tacoma, Washington. A phase of the lunar eclipse hung below a bell of the Guadalupe Temple in Guadalajara, Mexico. There was the moon again, seen partially covered from Montevideo, Uruguay; near Frankfurt, Germany; from Vodno mountain, south of Macedonia’s capital Skopje. The same moon hovered above Guatemala City, in the sky above the emblematic Obelisk in Buenos Aires, near the top of the Bunker Hill Monument in Boston’s Charlestown section, behind the Griffith Park Observatory in Los Angeles, California; and above the Dome of the Rock mosque in Jerusalem.

Looking at the photographs, I recalled that this is the same moon under which countless lovers embrace, the moon celebrated by poets through recorded history, the moon of Lorca and Cummings—our moon, under which we all live and breath and have our being.

February Fertility

In the world of fertility treatment, doctors are attempting to rein in the soaring rate of multiple births.

In vitro fertilization—the process in which donor eggs are fertilized with sperm in the laboratory and subsequently transferred to the womb—has provided a means to what Lori Gottlieb recently referred to as every woman’s desire: to conceive and bear a child.

For decades physicians have used fertility drugs to induce ovulation. From the ovary, mature eggs begin their descent through the fallopian tubes to the final harbor: the blood-rich lining of the uterine cavity. When fertilized, they will implant in the endometrium to grow and develop into first embryos, then fetuses, then fully-formed infants.

Unfortunately, both fertility drugs and in vitro fertilization have left us with other dilemmas, one of which is what to do about the soaring rate of multiple births.

The New York Times article Lowering Odds of Multiple Births was timely, in that it appeared in mid February, close to the time of the lupercalia, that ancient Roman festival of purification and fertility.

According to custom, two youths of noble birth presented themselves naked to the luperci priests, who smeared their foreheads with the blood of two freshly sacrificed goats and a dog. The blood was immediately wiped off with a piece of wool dipped in milk, after which the youths let out a hearty laugh. Afterwards, they participated in a feast of goat meat, consumed with much wine, and donned their nether parts with the skins of the sacrificed animals. The remainder of the goatskins were cut into strips and dipped in blood, then carried by the youths as they ran through the Roman hills, playfully striking any female who desired fertility and easy childbirth.

The goatskin itself was called the februum; the month in which the fertility rite occurred was Februarius.

Some authorities have it that the feast day of lupercalia morphed into the saint’s day of Valentine, patron saint of love. Nowadays, instead of flagellating the objects of our affection with bloody goatskins, we send valentine greetings—offerings of love. In place of goat meat, we offer chocolate, a modern day aphrodisiac. (Wine has remained the old standby over the millennia.) Many times, the end result is the same.

And if not, there’s always in vitro fertilization—although you can get more than you bargained for.

Suicides and Shoelaces

Last September at the second annual Cell2Soul conference, Jim Johnson, a retired advertising executive and host of Mason Hill Farm conference center, told me that he reached a point in his life where he resolved to spend the rest of his days helping folks in need. Johnson made this decision after hearing a story about a young man who was poised to jump off a bridge in the Midwest. As he stood by the railing contemplating suicide, a passer-by happened to look down at the young man’s footwear and remark: “Nice boots.” For some reason that small comment was enough to distract the young man from his obsession at that moment, and he never went through with his plan.

“You never know when even the least little acknowledgment might save the life of another human being,” Johnson told me.

According to a recent New York Times article — Midlife Suicide Rises, Puzzling Researchers — the suicide rate among 45-to-54-year-old Americans increased nearly 20 percent from 1999 to 2004. By contrast, the suicide rate for 15-to-19-year-olds increased less than 2 percent during the same period.

Although the reasons for the increase are not clear, the author of the piece offered several speculations. A prime suspect is the skyrocketing use — and abuse — of prescription drugs. Andrew C. Leon, a professor of biostatistics in psychiatry at Cornell, suggested that a drop in the use of hormone replacement therapy in women after 2002, leading to increased rates of post-menopausal depression, might be implicated. Veterans have been identified as another vulnerable group. Myrna M. Weissman, the chief of Clinical-Genetic Epidemiology at New York State Psychiatric Institute, blames frayed social support networks brought about by a hyper-mobile society.

Perhaps more telling were comments from readers, many of which implicated the downturn in the economy, the war in Iraq, the growing societal obsession with youth and physical appearance, the rise of ageism in the workplace, and a nadir of self-belief and optimism between 40 and 50. As a possible antidote, one reader called for a new revolution, where age and wisdom are valued — not discarded, devalued or diminished.

One poignant comment from a would-be suicide caught my eye: “The loss of a loved one is always painful, and questions will remain forever unanswered.” When this particular reader contemplated taking her life, the one thing that stopped her was she didn’t know who would tie her little boy’s shoes after she was gone.

“He couldn’t do it on his own and I hadn’t taught him that skill yet. His huge brown eyes always looked in fascination as I deftly whipped his shoe laces into perfect bows. He smiled and said he would do that someday, too.”

As in Jim Johnson’s story, a seemingly small and insignificant act saved a life and gained a convert.

“Something that minor to me was awe inspiring to a little boy,” this mother wrote. “I now have five grandsons and I tie their shoes, too.”

Foggy Mountain Breakdown

It has been a long day. Finally, after nine and a half hours of evaluating patients, giving injections, answering telephone queries, speaking with consultants, phoning in prescriptions, jotting notes in charts, and trouble-shooting issues with the staff, I don my trench coat and cap, pick up my briefcase bulging with unfinished business, and step out the side door into the fog.

Although it rained all day, melting away much of the snow, an influx of warm air collided with the frozen ground, generating a thick blanket of early-evening fog.

I throw my briefcase into the back seat of the car, turn the ignition key, ease the wipers to intermittent speed, and flip on the headlights. Yellow cones pierce the nebulous greyness in front of the car. At the traffic light I swing right and proceed down the highway, hugging the shoulder of the road, conscious of the string of paired beams passing me by in the opposite lane.

Traffic lights take on an ominous glow, single eyes burning in the dusk, like sinister orbs glowing through the eternal ether—Cyclopes from another world.

I make my way across the bridge, over the expanse of dark water below. Unlike the river Styx, crossing here requires no toll.

Turning off the highway onto a country road, I leave the lights of the town behind, where humanity rests quietly at dinner tables and in front of television sets. Like ghosts, grey trees materialize momentarily through the mists in the fields; as I drive on, darkness swallows them up.

I pass over a small brook and notice two black silhouettes perched on the arthritic branches of a gnarled oak. Intermittently, the wipers sweep across the windshield, performing their appointed Sisyphean tasks.

I park on the street and walk beneath a streetlight up the driveway to the back door of the house. Dropping my briefcase before the corner hutch, I hang my coat and cap on the rack and trudge up the stairs to my office, where I sit before the telephone. Outside the back window, patches of grey snow lie frozen in the night.

After an hour, when no call comes, I pick up the phone and dial the number I have known by heart my entire life, the number to my boyhood home. “We were just going to call you,” my mother’s voice says. “She was cremated today. They’re having a small memorial service on Saturday for the immediate family. The weather’s supposed to be bad all week—it’s too far for you to come.”

A cousin’s untimely death. Fifty-four years ago we both were born, eleven days apart.

Outside, warm air caresses the frozen ground; fog hangs heavy about the house. Inside, in the upstairs darkness, misty drops form.

“Notes from a Healer” — As You Like It

Every patient presents with a potential problem for the clinician to evaluate; some are more difficult to decipher than others. Either way, it’s always gratifying when things turn out the way we’d like them to.

The latest installment of Notes from a HealerAs You Like It — is now online, newly published in the Yale Journal for Humanities in Medicine.

The Yale Journal for Humanities in Medicine is an online clearinghouse for manuscripts treating the humanities and medicine.