The killing fields

As I left the credits of the film “Noah” rolling on the dark screen of the theater behind, a stranger standing outside in the hallway searched my face and asked: “Well, how was it?”

I paused momentarily to reflect, then offered the first words that came to mind: “It was…well — different.”

Back home I spent the remainder of the evening combing through a number of reviews online. Many of them sought to address the discrepancies between the biblical story of the Great Flood and the artistic rendition on the big screen. Most reviewers recognized that poetic license is what art forms are all about; a few weren’t as lenient.

Afterwards, as I revisited the original biblical narrative, the subject of violence crept to the forefront of my mind. The cinematic version is packed with violence — anguished screams, broken bodies, blood seeping up from the ground — all of it conjured up by scriptwriters Darren Aronofsky and Ari Handel; yet there is ample precedent for their imaginings in the biblical text.

“And God saw that the wickedness of man was great in the earth, and that every imagination of the thoughts of his heart was only evil continually.” (Gen. 6:5)

“The earth also was corrupt before God, and the earth was filled with violence.” (Gen. 6:11)

“…the earth [was] filled with violence through them [mankind]…” (Gen. 6:13)

On the big screen dramatic tension is heightened through the contention of the dark Tubal-Cain (here the slayer of Lamech, Noah’s father), Ham (Noah’s son) and Noah himself. Prior to boarding the ark, Ham sets out to seek a wife in the camp of men, but in the violent interlude his efforts are thwarted. In Ham’s eyes his father becomes the scapegoat. Tubal-Cain uses this incident to plant the seeds of revenge in the adolescent’s mind. “If you are a man, you can kill,” he tells the youth. The implication is clear: prove your manhood by slaying your father.

Noah is portrayed as the good father who loves his wife and children and rescues the wounded girl Ila. In an ironic twist, the barren Ila conceives; yet Noah remains convinced that mankind’s annihilation is the will of God. Even though provision has been made for the salvation of his immediate family, Noah prophesies their future demise. Only the birds and animals will be left to repopulate the new earth. To these ends Noah swears to cut down Ila’s baby at birth if it should be female. In the words of Genesis: “the imagination of man’s heart is evil from his youth.” (Gen. 8:21)

Those who would live by the sword die by the sword — “Whoso sheddeth man’s blood, by man shall his blood be shed” — but despite his flawed character, the hand of the good father is stayed.

Justice may be served, but in this cinematic version it is grace that prevails.


The Art of Medicine — After 20 years

I sit at my desk and allow my eyes to drift down over the list of patients I saw today, the last day on a job I have held for 20 years in a pediatric practice I helped to create. more»

Interested readers can now access my latest Art of Medicine column — After 20 years: Leaving a pediatric practice — recently published in the Journal of the American Academy of Physician Assistants.

Please note that all of my previously published Humane Medicine pieces can now be accessed here.

“Individuals and types” republished

In a retrospective review of the origins of Antoine Saint-Exupéry’s Little Prince, Edward Rothstein observes that the children’s book might be ultimately “less about individuals and more about types”….

Originally published on this blog (January 24, 2014), “Individuals and types” has been reprinted in the 2014 winter issue of the Journal of Dermatology for Physician Assistants (JDPA), Volume 8, Number 1, page 47.

Interested readers can also access this piece here.

Infrequent flyer

I fly infrequently; perhaps once or twice a year, if that.

Having just returned home from a recent round-trip jaunt on a commercial jet, economy class, in the interest of documenting the experience of modern travel by air, I offer the following reflections.

From one excursion to the next it seems as though the seats in economy class are being adjusted closer and closer together such that at some point I fear I shall be forced to check my legs as well as my bag at the gate. Should this occur, all passengers will have to be boarded by travel aides, of course.

Although the airlines currently allow one carry-on bag and one personal item such as a laptop, briefcase or purse (to be stowed under the seat at your feet, thus further limiting leg room), most passengers show up at the gate with suitcases on rollers, over-sized satchels and fat backpacks, none of which fit under the seat. Because overhead compartment space is limited, if you happen to be in the latter half of those boarding, chances are pretty good that you will be required to check your one carry-on bag, as there will be absolutely no room remaining for it by the time you get to the cabin.

Airlines board passengers in zones. First class is always first, of course. But after those folks are comfortably tucked into their seats, magazines or books spread leisurely in their laps and ear buds in place, the next zone to be called will be those passengers with seats directly behind the first class section. This means that instead of filling up the aircraft from the rear (which would be most efficient), folks in zones 3 and 4 end up standing in the aisle waiting for those in zone 2 as they attempt to stuff their over-sized bags into overhead compartments too narrow to accommodate them.

(Just for the record, I boarded in the Twilight Zone.)

If you have been assigned an aisle seat and happen to arrive first in that row, you can rest assured that you will have to get up at least 2 times before departure to allow fellow passengers to squeeze into the middle and window seats. After everyone is buckled in, invariably the passenger in the middle or window seat will suddenly recall that it is imperative that they get something out of their bag in the overhead compartment. This means that you will have to orchestrate the entire seating process all over again; but rest assured, practice makes perfect.

Because 99 percent of air travelers will be wearing ear buds or headphones for the duration of the flight, there will be no need to engage in any sort of verbal interchange with another human being apart from perhaps a nod of the head should the steward or stewardess ask if you would like a small pack of peanuts, pretzels or cookies and a complimentary non-alcoholic drink.

At your final destination, as the plane rolls into place at the gate, every passenger without exception (the only exception perhaps being you) will unbuckle their seatbelt. Those occupying aisle seats will immediately rise to their feet, pry open the overhead compartments, wrestle out their over-sized bags and remain standing motionless in the aisle where they will spend the next 10 minutes checking their smartphones for missed calls and text messages. Obviously, there is only one aisle, and no one can exit until those in front have departed first.

Which has me thinking: perhaps the airlines should deplane passengers the same way they board them — by zones.

Of course if they did it that way, they’d most likely start with the zone in the very back — after first class, of course.

A cry in the night

Stirred from a fitful sleep, I open my eyes to a cry in the night. Sharply, regularly, it repeats itself in the darkness. The bedside clock reads 2:45 AM.

I turn my face to the wall and pull a pillow over my ears. Still the cry permeates the room.

When our children were babies they would frequently cry in the night, as babies often do. In infancy, night-time crying usually signals the need to feed. In the latter half of the first year of life, for reasons we don’t completely understand, babies are apt to cry out in the middle of the night, seeking comfort. Toddlers experience night terrors, older children nightmares. Teens might sob in the dark about fights with former friends or fractured relationships, young lovers from lovers’ quarrels.

Crying in the night signals physical or emotional distress. It is comfort that the crier seeks. Comfort might come in the form of a mother’s breast or a bottle, a reassuring touch, a gentle whispered word — or perhaps just by the mere presence of a parent.

We never stop being parents; and as long as our parents are alive, we never stop being children. We continue to function as comforters, and sometimes we require comfort ourselves. Such is the web of life in which we are enmeshed throughout this early existence.

These thoughts rush through my mind as I pull the pillow from my ears and roll onto my back in bed. The cries continue to pierce the darkness.

I swing my feet over the edge of the bed and find the floor. Beyond the door I peer down the hallway to where our black cat sits mewing outside the closed door of my wife’s room.

Suddenly, the door opens; silently, the cat disappears into the black crevasse; momentarily, the cries cease.

I retrace my steps and tumble back into bed under the covers. Outside the window, stars burn brightly in the cold darkness. Soon I drift off to sleep.

The following morning I’m awakened by sunlight flooding the room. I pad down the stairs to find my wife sitting on the divan with a cup of coffee in her hand, stroking the moth-eaten back of our ancient black cat. The cat sits purring in her lap, kneading her clawless paws into my wife’s thigh.

“She insists on sleeping with me now,” my wife says. “If I don’t let her in my bed, she mews and mews.”

No matter how old we become, be it child or cat, we still awaken to answer a primordial cry in the night.