“Notes from a Healer” — Personality is Destiny

In medical practice, perhaps personality is destiny. more»

My latest installment of Notes from a HealerPersonality is Destiny: Self-selections in medical careers — is now online, newly published in the Yale Journal for Humanities in Medicine.

The Yale Journal for Humanities in Medicine is an online journal fostering discussion about the culture of medicine, medical care, and experiences of illness. Interested readers can access a list of editorial board members and regular contributors here.

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A moral flaw or neurophysiologic deficit?

In part one of a two part interview with Oprah Winfrey aired on January 17, 2013, Lance Armstrong admitted to using performance enhancing drugs throughout much of his career, including all seven Tour de France wins…. In part two of the interview, aired the following day, Armstrong said that while doping, he neither felt that it was wrong nor felt bad about what he was doing.

Many who watched Oprah Winfrey’s two-part interview with Lance Armstrong have commented that they didn’t feel that Armstrong’s apology for having doped was sincere. During the course of those interviews Armstrong certainly admitted that he had doped repeatedly in order to maximize his cycling performances to win. What he didn’t do was pass value judgment on his actions. In short, he failed to demonstrate sincere remorse for the actions themselves. Listening to the interviews, you get the feeling that Armstrong’s agenda was to orchestrate whatever would be necessary to allow him to be reinstated as a bona fide competitor in the world of sport.

On October 2, 1996, then aged 25, Armstrong was diagnosed as having stage three (advanced) testicular cancer. His brain tumors were surgically removed by Scott A. Shapiro, MD, Professor of Neurosurgery at Indiana University and Resident Director, and were found to contain extensive necrosis. In February of 1997, he was declared cancer-free.

Armstrong’s testicular cancer had metastasized to the orbitofrontal regions of the brain, the same regions which we now know are largely responsible for the development of our moral sense. These were the regions that were destroyed by an iron tamping rod in the case of Phineas Gage, the 19th century railroad worker. According to eye-witness accounts, Gage underwent marked changes in his personality after the accident.

His contractors, who regarded him as the most efficient and capable foreman in their employ previous to his injury, considered the change in his mind so marked that they could not give him his place again. He is fitful, irreverent, indulging at times in the grossest profanity (which was not previously his custom), manifesting but little deference for his fellows, impatient of restraint or advice when it conflicts with his desires, at times pertinaciously obstinate, yet capricious and vacillating, devising many plans of future operation, which are no sooner arranged than they are abandoned in turn for others appearing more feasible. In this regard, his mind was radically changed, so decidedly that his friends and acquaintances said he was “no longer Gage.”

Could it be that part of Lance Armstrong’s narcissistic and sociopathic behaviors are the direct result of insults to orbitofrontal regions of the brain? If so, to what extent might he be neurophysiologically incapable of demonstrating remorse for lying about doping?

I do not raise this question to justify Armstrong’s actions, which were illegal; but rather to pose the possibility that he might be incapable of showing sincere remorse for those actions.

Wing and Wind

leonardo-da-vinci-bat-wing-with-proportions

The wing was designed for the wind.
It was the wind that carved and crafted it.
And after the work was done, the wind stepped back
To admire its handiwork.
No one has seen the wind, only its effects.
The wing, sensing lift, soars upward:
Tucks, drops, spreads, recovers—
An aerial display of pure delight.
The wing knows the draftsman that designed it
The wing knows the craftsman that refined it
The wing knows,
And as the wind flows,
It shows.

If we would be designers of wings
We should study aeronautical engineering.
If we would fly
We need only lift our wings
To catch the wind.

2013©Brian T. Maurer

A window for the soul

Only a short distance, perhaps four feet at the most, separates me from the tall narrow window.

The window is one of my favorites in this old stone country church. At the top, set against a backdrop of blue sky peppered by wisps of clouds, there hovers a white dove, yellow rays of light emanating from its breast. Below this more sky gives way to purple-brown rolling hills set against a yellow plain, while long-stemmed white lilies shoot up from the foreground. The entire pastoral scene is edged in splintered red. You can imagine how beautiful this composition appears when the morning light streams in through it.

The little country church is packed this particular Saturday, the first of the new year. People from all walks of life have gathered to celebrate the life of a woman who drew her last breath three days short of the turning of the final page of the calendar.

This woman was a teacher, and music was her area of expertise. She coached voice, and many of her former students have come to pay their respects. The choral group she founded has also come to perform one of her favorite selections. Actually, we are told, every selection in today’s service, including the readings, was hand-picked by the woman three weeks before she died.

The service opens with a solo, an adaptation of a song from the Broadway musical Baby, The Story Goes On.

So this is the tale my mother told me
That tale that was much too dull to hold me
And this is the surge and the rush she said would show
Our story goes on

Except in this version the word “teacher” has been substituted for “mother.”

So this is the tale my teacher told me
That tale that was much too dull to hold me
And this is the surge and the rush she said would show
Our story goes on

It is obvious to everyone listening that this young man is a trained vocalist; his performance is practically professional. But there is a bit more to it than that, because his voice carries the emotional crescendos of what can only be described as love.

And all these things I feel and more
My teacher’s teacher felt and hers before
A chain of life began upon the shore of some dark sea has reached to me
And now I can see the chain extending
I am next in the line that has no ending
And thus it is our story goes on

As I sit listening to these words sung with such passion, I think of Mr. Holland’s Opus, the film in which Richard Dreyfuss plays the role of a high school music teacher. When he’s not in the classroom coaching his students, Mr. Holland is at home, working late into the night on a musical score that is surely destined to become his masterpiece. He never publishes it; but in the end we come to see that Mr. Holland’s greatest work was the legacy of love that he passed down through his students. In a sense those students became his masterpiece.

As the song wells up into the final stanza, morning sunlight breaks and streams through the window by my shoulder.

It is as though the sun has risen on a surreal landscape of color.

2013 Trinity Windows 1-10-2013 004

“The Words” — A brief review

It was because he loved the words more than he loved her.

Those were the words of the Old Man. Those were the words he spoke to the young writer who had plagiarized his own.

In the feature film “The Words,” directed and written by Brian Klugman and Lee Sternthal, the Old Man (Jeremy Irons) is a fictional character; but like many characters in works of fiction, he speaks truth — the truth about himself as the Young Man, so much in love, yet unable to forgive his beloved when he learns she has lost the manuscript of his novel in a Paris railway station.

Decades later, the struggling young writer Rory Jansen (Bradley Cooper) accidentally finds that manuscript.  He covets the words the Old Man has written, so much so that he copies them verbatim and allows them to be published as his own. And for this he also pays the high price of losing the woman he loves.

Finally, in this convoluted drama there is the writer himself — the successful author Clayton Hammond (Dennis Quaid), who reads sections from his latest book “The Words” aloud. Afterwards, a groupie graduate student (Olivia Wilde) finagles her way into his penthouse to attempt to learn the truth about what happened to the Old Man and the plagiarist in his book. When Hammond tells her, she doesn’t buy it. She thinks he’s lying, because no one — not even a fictional character — can continue to live a lie and still sleep at night.

“There is a fine line between fiction and life,” Hammond tells her. “They come close, very close, but they never touch.”

All of the characters that a writer creates come from inside his head. They might be based on persons from real life, but in the end he makes them up; and because they come from the depths of his being, ultimately they are part of him and he is part of them. There is no other way.

And so the words of the fictional book “The Words” were written by Hammond. Hammond made up the Old Man just like he made up the Young Man, just like he made up Rory Jansen. He gave them life; he gave them the words to speak.

But there’s more to it than that, of course; because even Clayton Hammond himself was created by Klugman and Sternthal. Ultimately, they are the ones who drafted the words of the screenplay.

Writers of fiction might love their words to such an extent that they are prepared to sacrifice the greatest loves of their lives for their work.

Hemingway was such a writer; he never forgave his first wife for losing his early manuscripts on a train in Paris. The Young Man in “The Words” never forgives his young wife for doing the same; and when the young writer Rory Jansen opts to plagiarize the Old Man’s words to please himself and his wife, he loses them both.

Writing — or any sort of great art for that matter — can be a sickness, in which the artist sacrifices everything for the work, even the most precious of human relationships.

“We all make choices in life,” the Old Man says. “The hardest part is to live with them. Nobody can help you do that.”

Bradley Cooper and Jeremy Irons in "The Words," Jonathan Wenk/Cbs Films

Bradley Cooper and Jeremy Irons in “The Words,” Jonathan Wenk/Cbs Films