Long day’s journey of the Saturday

At the beginning of this Easter weekend, I will leave my readers the thoughts of George Steiner from the concluding chapter of his book, Real Presences:

“There is one particular day in Western history about which neither historical record nor myth nor Scripture make report. It is a Saturday. And it has become the longest of days. We know of the Good Friday which Christianity holds to have been that of the Cross. But the non-Christian, the atheist, knows of it as well. This is to say that he knows of the injustice, of the interminable suffering, of the waste, of the brute enigma of ending, which so largely make up not only the historical dimension of the human condition, but the everyday fabric of our personal lives. We know, ineluctably, of the pain, of the failure of love, of the solitude which are our history and private fate. We know also about Sunday. To the Christian, the day signifies an intimation, both assured and precarious, both evident and beyond comprehension, of resurrection, of a justice and a love that have conquered death. If we are non-Christians or non-believers, we know of that Sunday in precisely analogous terms. We conceive of it as the day of liberation from inhumanity and servitude. We look to resolutions, be they therapeutic or political, be they social or messianic. The lineaments of that Sunday carry the name of hope (there is no word less deconstructible).

“But ours is the long day’s journey of the Saturday. Between suffering, aloneness, unutterable waste on the one hand and the dream of liberation, of rebirth on the other. In the face of the torture of a child, of the death of love which is Friday, even the greatest art and poetry are almost helpless. In the Utopia of the Sunday, the aesthetic will, presumably, no longer have logic or necessity. The apprehensions and figurations in the play of metaphysical imagining, in the poem and the music, which tell of pain and of hope, of the flesh which is said to taste of ash and of the spirit which is said to have the savour of fire, are always Sabbatarian. They have risen out of an immensity of waiting which is that of man. Without them, how could we be patient?”


Words that heal

Blessed are they that mourn, for they shall be comforted.

There once was a physician who had twin daughters. One grew up to become a psychiatrist. The other developed schizophrenia as an undergraduate. She poured out her anguish through words with pen on paper. Eventually, she became a published poet. Of the two daughters, which one was the healer?

In order to diagnose, a psychiatrist must learn to listen to the patient. Now there are many practicing psychiatrists who base their pharmacological treatments on symptoms alone. Medication regimens are adjusted based upon the patient’s response to the drug. Sometimes the dose is increased to enhance the effect of the drug; other times the drug is discontinued because of untoward side effects. Much of pharmacological treatment comes down to trial and error. Many times medication can help, but in the end a pill cannot heal a soul.

Freud, regarded by many as the father of psychiatry, once wrote: “Wherever I go, I find a poet has been there first.”

Throughout the centuries poets have pursued the art of crying out, of putting pen to paper (or stylus to papyrus), crafting words as conduits to transmit their anguish, their deepest longings, their joys, their sorrows. Many have written in part to help themselves to heal. When we read their words, we enter in to their anguish, their longings, their joy and their sorrow; and when we do, we ourselves may experience some degree of healing as well.

It doesn’t take a college degree to become a poet. One must only open oneself up to the suffering of the soul, to face one’s demons, to record the emotional truth of the spiritual state, to capture the passion (and in this instance I refer to the root meaning of that word: to suffer) in a few brief lines which may, if one is lucky, last for an eternity.

My Cousin Jim

In remembrance

Once again as an extended family we find ourselves gathered together in this place to celebrate and remember the life of a loved one: my cousin Jim.

Jim passed away a year and a week after the death of his beloved spouse Diana, and nearly a year after the passing of his mother, our Aunt Jean. That year, I’m sure, was a difficult one for Jim. Not only did he continue to work in his profession as a dentist; he also continued to receive treatments for his cancer, which had spread to his bones. At the same time I’m certain that he entered a period of extended mourning. Such milestones are not easy for any human being to bear.

We exchanged several e-mails over the course of this past year. In one I asked Jim how he managed to keep himself together. I recall his reply: “by deep faith.” In the end it was his faith that got him through.

As I read through Jim’s obituary, one line stood out. “Many of his patients, family and friends knew and loved him for his gentleness and compassion.” That one line brought a smile to my face.

In a telephone conversation this past week, my mother related to me how my cousin Jim provided dental care for my Aunt Poll and Uncle Skip over the course of the 29 years that he practiced general dentistry. Jim refused to accept any monetary payment from them, although he welcomed my Aunt Poll’s apple pies as a token of appreciation for services rendered. I also learned that Jim provided pro bono dental care to countless children whose families were too poor to afford it.

My cousin Jim suffered quite a bit in his life, particularly over the course of these past several years. But it seems as though he succeeded in spinning his suffering into a tapestry of sorts: a tapestry of gentleness and compassion for his patients, his family and his friends.

My cousin Jim took upon himself the yoke of a wounded healer. He used his pain and suffering to create and disseminate a little bit of goodness and love in this world.

That, to me, will be my cousin Jim’s legacy.

On Fathers’ Day

Suddenly the young man standing one tier below me in the amphitheater sits down and hangs his head. His torso trembles beneath his short-sleeve cotton shirt. The woman I know to be his wife stands beside him, her right hand resting on his shoulder.

On the other side of her sits the couple’s young son. The little boy has picked up a small sprig of clover from among the stones at his feet and nibbles the tiny green leaves, as though he were a rabbit. He squeezes past his mother and climbs up into his father’s lap. The father gives him a big long hug. As the father turns his head, pressing his cheek against the little boy’s face, I notice that the stubble of some of the whiskers is white.

When the boy turns and sits on his father’s knee, you can see the mid-line surgical scar coming down from the back of his baseball cap along the nape of his neck. No hair protrudes from the scalp beneath the cap. As the boy stands up, he seems a bit unsteady on his feet.

The man sits with his head down for a long time. Even after he stops shaking, the woman’s hand remains gently on his shoulder.

Today, on Fathers’ Day, this father is suffering; not because of himself, but because of his son.

When a father faces daily the possibility of losing his only son to a devastating illness, the prospect of an empty ache on Fathers’ Day haunts him for the rest of his life.

Cousas do Mar (Things of the Sea)

“Clemente’s father lost one of his fishing boats,” my wife tells me over morning coffee in the kitchen.  Clemente is the novio of my niece in Spain; they are to be married next summer.  His father owns a fleet of commercial fishing boats.

“Where?” I ask.

“Off the coast of Ireland.  It went down in rough seas.”

I take a sip of coffee.  After a brief silence I say, “How many men were lost?”

“None.  Another boat was close by.  They were able to pull the men from the sea before the boat sank.”

“At least they managed to avert a secondary tragedy.”

“Yes, but—it was first boat that Clemente’s father owned.”

I recall the refrain of an old Galician sea chanty—

Da Estaca de Bares ó Cabo Ortegal
Hay unha lanchiña que vai naufragar,
Que vai naufragar, que vai naufragar,
Non chores Maruxa, son cousas do mar.

At Estaca de Bares or the Ortegal Cape
A little boat is going to sink,
Going to sink, going to sink;
Don’t cry, Maria, these are but things of the sea.

“Naufragouse o barco.”  The boat sank. I repeat the phrase using the heavy accent of gallego, the language of the northwest region of Spain.  “Naufragouse o barco.  Even the words themselves sound tragic.”

My wife pauses the coffee mug halfway to her lips.  “Yes, I was thinking the same thing the other day.  Mine are a morose people; it’s even reflected in the way we speak.  It’s probably been like that for thousands of years.”

“Maybe it’s because gallegos have historically been drawn to the sea,” I offer.

 She regards my face with knowing sea-swept eyes.


I listened to the initial reports of the devastation caused by the earthquake in Haiti while driving home from work Tuesday evening.  Later, I tried to read the lead articles at the New York Times website.  I had a great deal of trouble making it through the first several paragraphs.  Even at the outset the carnage was too much to comprehend—50,000 to 70,000 feared dead in the worst earthquake to hit the country in 200 years.

Normally, when disaster strikes, rescue workers transport the injured to emergency medical facilities for care.  In Haiti the hospitals themselves were leveled by the quake.  The infrastructure of the country had crumbled.  There was no medical care available, no food, no water, little transportation; and chaos reigned in the streets.

Today I scanned photographs of bulldozers dropping dead bodies into dump trucks; piles of corpses lying in the streets; faces looking up holding empty buckets to be filled with fresh water; a bag of IV fluid hung from the branches of a tree infusing into the arm of a woman reclining on a mattress on the grass; faces of pain, faces of grief.

This week one of the women at the office returned from a vacation in the Caribbean.  She brought back a nice tan, stories of the exotic life and stacks of color photographs.  Co-workers oohed and aahed over the sandy beaches, the turquoise waves, the plush hotel accommodations.  It was a dream getaway.  For three days it was the talk of the office.

“Did you see the photos?” someone asked me late one afternoon.  “You have to see them—what a lovely place!”

“Guess she didn’t go to Haiti,” I mused matter-of-factly.

“Oh—why?  Did something bad happen there?”

Auden had his finger on it when he penned his poetic treatise on suffering:

About suffering they were never wrong,
The Old Masters: how well they understood
Its human position; how it takes place
While someone else is eating or opening a window or just walking dully along….

                                    —Musée des Beaux Arts,  W. H. Auden

Pain and Suffering

I spent a few minutes this morning reading Dr. Richard Sobel’s poignant reminiscence Reunion with the Dead on the Cell2Soul blog. For twenty-six years Dr. Sobel had been the physician for an Israeli kibbutz, where he still resides.

One of Sobel’s lines struck me: “Pain could usually be controlled, but suffering involves far more than pain. That suffering can be controlled is a myth we tell to ourselves and our patients.” As clinicians, we can control pain but never suffering.

I had just finished re-reading Thornton Wilder’s The Bridge of San Luis Rey last evening before crawling into bed. The last time I read the novella was in high school. Back then it was required reading. Last night I picked it off the shelf and read it straight through for pleasure and to see if I could grasp the tale as a whole.

As I lay awake in bed early this morning, thoughts of Wilder’s characters drifted through my head. Each one of the five who died when the bridge collapsed had reached a point in life where they elected to dispense with self-imposed suffering brought on by unrequited love and start afresh. Their deaths in turn provoked a new attitude toward life in those significant others left behind.

The first group suffered in life; the second group suffered after their passing. Yet this suffering served to purify their outlook and strengthened their resolve to love.

A high school biology teacher once told his class that as students their opinions weren’t worth much, because up to that point in life most of them hadn’t suffered enough. Years later a college professor would make the same remark to a group of students in his graduate seminar. Both implied that in some way suffering works to mature us.

Suffering may arise secondary to an individual’s attitude or outlook. Sometimes we suffer needlessly through self-pity and throw ourselves into the depths of despair. Sometimes we allow others to inflict suffering upon us. And sometimes we suffer through no fault of our own; it’s simply the hand we are dealt at the time.

As clinicians, we have the pharmacologic tools on hand to relieve pain in our patients. Suffering is another matter entirely. Although we may attempt to alleviate suffering by practicing the art empathetic understanding, many times we fall short of the mark. In some instances it may be for the best.

Suffering provides each of us with an opportunity for growth. It imparts depth to our lives. Although not pleasant at the time, it allows us to ponder our lot, rethink our priorities, and move ahead with renewed strength toward maturity.