When your sister the corporate lawyer starts screaming at you while she’s driving you to the railroad station, your best advice is to adopt the silence of the rabbit, and stare down the halogen dotted road.
Her high end late model silver gray Toyota purrs like a tiger as it eats the asphalt. The long arching branches of the mature trees that line either side meet and seem like the arched vault of an endless tunnel to nowhere, devouring all who dare its neon tormented inky darkness.
"Dad is dying and you’re making it all about you! After all the money he’s given you and he’s on his death bed all you can do is make it about your stupid guitar! Since I notice you like to use the word fucking so much, let me use it too.
"You’re a fucking asshole! All you ever think about is yourself. It’s all you ever did, you fucking asshole. Why don’t you go back to New York and surround yourself with sycophantic assholes to praise you. It’s all you ever wanted anyway you fucking asshole.
"I’ll bet you wish you waited for Larry to give you a ride back to the station now. But you couldn’t wait to get out of there, and now you have to face reality.
"That’s an Intensive Care Unit in there. The person next door died last night. Do you think that person or the family wants to be disturbed by your music? They don’t allow music in intensive care. You know why? There’s serious business there. They don’t want music!
"But no matter what, you turn everything into you and your god dam guitar. And your god dam music. You’ve never thought of anything but yourself, and that makes you nothing but a selfish fucking asshole. A fucking asshole who’s never thought about anything but your fucking stupid self.
"After all the fucking money he gave you, you couldn’t find it in your busy schedule to spend more than forty five minutes with your father! This is our father, and he’s dying and all you can talk about is your fucking music, your god dam precious vacation, and whatever you can fucking say to prove what a know it all you are about everything except why you’re such a fucking failure.
"Well, as far as I’m concerned, you can take all your talk about Gnostics, Bach, Christianity, and most of all your god dam fucking music and go straight to hell!"
The car is silent but for the hum of the wheels on the dark "main drag" of this tiny central New Jersey town.
I figure now is not a good time to talk about this frank display of family values in relation to Christian principles and the integral relation music has always had to the sacred.
I also figure now is not a good time to respond with any words at all because then, dammit, the whole conversation will revolve around me, my values, and how deeply misunderstood they are. Self fulfilling prophecy.
And to ice the cake, I have been more than a bit of an asshole.
And of course, if there’s one thing a selfish asshole would surely dread it would be to be center stage at a discussion about what a selfish asshole they are.
Selfish assholes infinitely prefer to be at the center of attention at a discussion of all the things they are not, but which they have convinced folks they are despite that. Like being President Bush at a convention celebrating brilliant military leaders.
In fact, my own assholianity would more than qualify me to tell my dear sister that she is emulating my standards at this juncture. But what’s the use? Irony, logic, and humor will have to wait for another day.
It’s not so much a matter of not dignifying the diatribe with a response as pointlessly making matters worse. And anyway I’ve got it coming, and I’ve taken better beatings over worse.
Projection, control, and panic underlie the anger. And it is anything but her fault that I was stupid enough to make any remark at all that did not directly pertain to our father’s medical condition.
I am artistic, and I make no money. An old story indeed. She projects on to that the notion that I live my life as one long joyride of a blithe spirit. Now is no time to try to set the record straight.
Because, again, the damn conversation will revolve around me. And worst of all, one of the most tedious aspects of my existence. How hard it has been to maintain this level of commercial failure.
The issues that seethe beneath the surface of uncountable daily inner monologues that she has regarding her family are erupting my way, and I cannot deny I triggered it. And I should have known better than to say anything about music at all. The speech blew out with the velocity of a highly practiced set piece.
Is there any child born that does not carry into adulthood a banshee chorus of unspoken speeches that they endlessly rehearse for family living and dead?
Whether in the privacy of a shower, the middle of a meal, or on one’s routine steps into the place where one works, one never knows when one will find oneself self ambushed into an interior conversation with the parents or siblings, past and present.
Ask yourself whether or not most of these monologues are very negative indeed.
The words we never said because we never found the moment. The words best unsaid anyway. The mere tip of an iceberg of a lifetime’s worth of repressed venom and unforgiven traumas.
Somewhere right now a thirty year old mother of two internally curses her own mother for neglects and abuses, real and imagined, as she bundles her own children into her car and screams at them for dragging their heels.
This will be the same woman who will hurl herself wailing at same mother’s coffin and go into a six month paralysis of grief, because she refused to allow herself to have any kind of conversation with her mother for the last fifteen years of the mother’s life.
Our countless unspoken monologues fester until their miserable perverted echoes amplify and distort themselves when we finally hurl them at an utterly expedient target at an utterly inappropriate moment .
But what does one do as these notions gather and intensify like the electrical build up of charge in a capacitor?
Projection regurgitates them onto the nearest convenient screen. So Hitler painted the Jews as the image of the self hatreds of a generation of WWI war orphans. So Howard Stern and his ilk make easy buffoons of the Arab disenfranchised.
When a parent declines from the all powerful source of authority and terror into helplessness, it rarely brings out anything but the extremity of emotions. We like to believe that somehow this is where we dig deep within ourselves to find unimagined resources of strength, wisdom and saintly fortitude.
However, more often than not, these heroic expectations go straight to hell on the tricycle of panic. Many Christian shields buckle in the moment of truth that we are all souls passing through our incarnations. Short as our physical lives are, we shrink from the promise of eternal life.
Christ promises and delivers us infinite life. He speaks far more eloquently about heaven than of hell. And yet we postpone death till long after living has lost all meaning, and the dying have already lost all semblance of what they were when they lived.
We Catholics squeezed every drop of life from a brilliant and saintly Pope, and set such a yowling at his death that you might have thought we feared for his soul going to Hell more than we cheered his entrance to heaven.
Such was the public Catholic for a Pope. How much more so the private Christian for a father?
She harbors a lingering anger for our father whose tentacles are tightly wrapped around her formative years. Her adolescence was punctuated by incidents that were very close to unforgivable. These scars linger and perhaps never heal. The worst of them only she can tell, and she probably never will.
Children do not come with a manual, and parents make horrible mistakes. When a daughter achieves puberty, the father is confronted with the reality of his dwindling control over her. She certainly is no longer "Daddy’s Little Girl."
In the ruined social structures of later twentieth century America, this became a wild card of psycho-pathology. Despite our gamut of technological wonders and distractions, despite our plenitude of food, and despite all the best and worst that widespread media driven literacy provides, we have lost the rudimentary social mechanisms that are part and parcel of even the most primitive tribal behaviors.
What do you do when the kids are old enough to make babies? Tell them to be good.
Then when the inevitable occurs, be shocked and horrified that they should duplicate the very acts that brought about their existence.
When she became intimate with her boyfriend in a monogamous relationship, she never would have gotten into trouble, if she had not intelligently procured birth control pills.
When her mother found them, the roof blew off the house. In one of the rare moments in their unfortunate marriage, both parents were in complete agreement that this was reprehensible beyond words. From behind the closed door of her bedroom the shouts, thuds and clatter would have brought the arrival of the police if this had been a New York apartment. However, the family had recently made the move to a private house, so these horrors remained private.
The next thing they did was send her to a psychiatrist. Said shrink was left scratching his head.
"I see. You are in a loving relationship with your boyfriend, and you are on birth control. All of this seems both responsible and rational. I think I should be talking to your parents."
Which of course, the parents did not. They paid the bills and blamed her for the expense.
But now the monster that that teenager loved and feared, and hated is trapped in an ICU bed filled with a terrifying array of life support mechanisms. These high tech gizmos beep and wheeze a cacophony of noises like a gang of demons celebrating a dans macabre.
That frightened teenager’s frustration now haunts a well adjusted adult lawyer who has grown accustomed to massive degrees of control over an incredible collection of professional and personal responsibilities far beyond anything the frightened girl ever imagined possible. The experience of control itself has become a deeply ingrained habit and keystone of identity.
The realization of our complete lack of control in the face of the medical chimera after a life of great responsibility probably triggers the terror and disgust of that teenager who took control of her life in a perfectly rational and responsible way only to have it hatefully wrested from her by the man that the patient on the bed once was.
I mention hatefully because despite the fact that the young man in question deeply loved her, was a reasonably accomplished martial artist (suburban brown/black belt) who I believe would have jeopardized his life before hers in a moment of truth, nevertheless he had three strikes against him. They were sexually intimate. He was not an intellectually accomplished student. And he was Jewish.
I will never forget when I heard my father refer to the young man who dearly loved my sister, and seemed to make her happy, and who seemed to be protective of her in a tender and non-controlling way, as "that kike."
Past and present collide in the specter of uncontrollable horror that we call the best of care. Every surgeon happens to be the best in the land. Every facility is far better than we thought we could expect. Even the overpriced food in the cafeteria has to be far better than the normal "hospital food." I suppose we express relief that things are not worse. But things as they are are more than bad enough.
I cannot count how many times I have heard it speculated that what we call health care for chronic degenerative conditions will be viewed in the future in the same light that we view the Medieval Inquisition.
However, that would probably be flattering ourselves. At least the Inquisition had a specific cosmological conception, however laughable, of a relationship between God, body and soul.
And what it lacked in technology, it made up for in merciful brevity. Death came as a relief, and it certainly did not take anything like the time involved in our extraordinary measures.
Just as we had no levers to deal with that little teenager’s puberty, now we have no levers to deal with the inevitable price we all pay for living. The end that must arrive for all that begins.
Despite the ever expanding plethora of gadgets, drugs, and their concatenated bewildering jargon (or is it perhaps because of them?), we are left with greater ambiguity about death itself than ever before. The question that wracks so many family members is ruthlessly repeated. At what point is the family member lost?
I knew a beautiful older New York Jewish woman who was dying of cancer at the age of sixty eight. Within a year she went from a sprightly ex-rock climber, retired editor, and witty lover of the arts to being a seventy five pound piece of gibbering protoplasm. She was under the best of care due to the family’s upper middle class Manhattan wealth.
On any given day she would be visited briefly by an ever increasing number of specialists, as the disease metastasized throughout her body. Each of these highly priced and ultimately futile specialists was devoted to a specific body part’s course of treatment ad nauseum.
Her husband, Sid, was a lanky six foot tall seventy five year old World War II veteran who was with her through the entire process. These two truly were the apples of each others eyes.
A wonderful and terrible defining moment occurred when Sid, who happened to be in excellent physical shape despite his years (he creamed an athletic friend of mine, who was thirty, at tennis the summer prior), was visited in her room by yet another new specialist.
Doctor Rosenzwieg was a toupeed pudgy little pig eyed specimen of about forty who had a moon shaped unlined face. With the brusque commanding tone of a know-it-all he started talking to Sid about her chart and emphasized his points by pointing to certain entries with a baby pink perfectly manicured forefinger.
He reported that it looked like the cancer had invaded her brain, and that an immediate CAT scan was in order. He did not even take the moment of courtesy to verify that I was not an immediate family member. In the interests of human decency I had already turned away and had just made my way out of the room when I heard a dull and ominous thud.
I ran back in afraid that Sid had finally fainted under this final straw of stress. I was greeted by the image of the pudgy doctor thrashing against the wall with a purple face and his feet about a foot off the ground. Sid was supporting him in this embarrassing position with his right tennis hand gripping his throat.
"THERE WILL BE NO CAT SCAN!"
Sid was not the type to roar, and it only made the impression deeper. He was normally such a quiet voiced fellow with a tendency to a dry wit. But in that defining moment I saw the thirteen year old who lied about his age and forged some papers for no other reason than that he wanted to kick Hitler’s ass in 1942.
We can expect no miracles when we enter the land of the godless. A land that sees the human as a set of parts. There was nothing intrinsically wrong with the idea of specialization. But there is something terribly wrong with using specificity of knowledge to advance our cyclopean tendencies.
Issues of this depth and universality of experience provoke questions as to whether how we apply technology overextends its utility. Our experience as a whole is now bombarded with images and sounds that are so alien to the original natural stimuli for which the human animal took uncounted generations to adapt itself to, that it may no longer be serving its initial function, protection of the species vulnerability to brute nature.
It may be employing its own brute force to victimize and terrorize ourselves. This has nothing to do with any abstract aspect intrinsic to technology. This is more how we have allowed our willful use of machinery to amplify our least noble characteristics. We have transformed ourselves, through our inner chimeras, into technology’s servants based upon our terror of the coffin.
Thus we shrink from our pain and make a prison of it in the rib cage. There it paces like a wounded tiger, praying for the moment that the keeper lets down its guard. The hateful anger it projects will pour in a torrent on the triggering recipient, inflicting more pain on the speaker than its object. Blessed are any who confess their helplessness in the face of these forces, for theirs will be the path of blame.
If venom were vitality we’d never fear dying.
If one makes peace with the parent while they are healthy, there is no need to tear down those around you in the hour of their death.
If the apologies come, the hardest part will reside in providing those speaking them with the response that will allow their hollow ring no dignity. There can be no forgiveness until they forgive themselves the opportunities they lost to make their peace with someone while they are still completely alive. Self forgiveness will begin with remorse. The understanding that such actions and/or inactions are utterly irrevocable.
Until then you will live infested with memories that will consume you like ravening ghosts. There will be no just catharsis. You will inflict its toxins upon your children, and they will grow to hate you as deeply as you hate yourself.
Projective behavior, no matter how understandable, will do nothing other than accelerate deterioration.
To take isolated facts and hammer them together into something grotesque, will not further the cause for cultivating truth within yourself.
When we ask or hear someone ask, "why does God allow?" perhaps we should rephrase that as "why does mankind enforce?"
It is in the natural order of things that a parent should die before the progeny. Whatever grief we may feel should be measured against the countless inversions of that natural order, in which a parent loses a child to war, sickness, catastrophe, or accident.
Man is a fallen animal. And as such can be something lower or higher across the arc of one lifetime. Through free will and grace we can aspire and achieve something greater than our animal existence.
Let our awareness of death and our ephemerality be the gateway to our understanding and achievement of that transcendence. Let us, pitiful and forgetful creatures that we are, remember to bring that to as many moments of our lives as is humanly possible.
Okay. So you want to get a picture of an ICU itself? That’s fair. I know I had one picture of one before I visited one and left with something entirely different.
The first time we hear about them it is invariably with a sense of horror. So one is relieved to find that they are not the medieval chambers one first gets the feeling that they are. They are infinitely worse, given the nature and caliber of the gravity of the illusions they project and work in.
At what point does life cease being life? As we magnify and intensify the ocular character of life, somehow the exact moment of crossing becomes infinitely more difficult to determine. This is not infinity of any kind of grand or rhetorical scale. It is more like the infinity that elementary Calculus talks about events converging on. It is the miserable consequence of ruthlessly adding one.
The nature of most hospital care is segregation and observation of those who cannot get around of their own volition. Thus, ambulance derives from the latin ambulare, which means to walk.
Bad fractures, severe pneumonia, and blights of that ilk level are miserable and potentially fatal only if allowed to get worse. Beyond the application of basic medications and common sense dressings, nature takes its course in collusion with the patient’s innate will to heal and live.
They were sent to the hospital because they were pulled from the edge of a cliff. They remain there only long enough to be assured that it is far enough away.
Visitors are a cheerful lot. They bring joke cards, flowers, and the occasional illicit bottle of booze.
This kind of patient is in the hospital for as brief a time as possible. And they normally want it that way. Care is expensive and the conditions boring. They are pretty much left on the bed for the vast majority of the time of their stay. They get television and indifferent doctors, along with a smattering of nurses and volunteers for company.
However, living music from another living animal is viewed with a jaundiced eye at best. As for bringing a beloved pet. Forget about it.
The bad food and relentless TV are only the most obvious of their powerful motivations to get the hell out as fast as they can sign the necessary paperwork.
If those two are insufficient there are always the ubiquitous indignities. I have known of more than one male to make heroic post operative progress towards walking, for no reason other than to get to the bathroom to avoid being on the receiving end of a bedpan enema.
Except for the occasional IV drip, one has no real inkling of the enormous amount of technology the hospital can bring to bear on the patient.
Intensive care is where that all changes.
The saddest thing about this macabre soiree is that none of his wishes while sentient are going to honored at all/
One cannot help but notice that most of the practitioners in this part of the facility have the skulking body language of a bunch of miserable thieves hiding behind respectable lives. Like correctional officers, they act as keepers, except that in the extreme cases, which are the most common, they are keepers of the protoplasm until death has been formally acknowledged.
Perhaps, that which was designated vocation became overly conflated with profession. They might be better viewed as intersecting sets within an individual. Formal medical schooling and professional licensing is the only way to screen the system for those qualified to employ its technology.
Let’s face it, optimistic estimates would indicate there is a ten percent factor of sheer raving projective grandiosity in any given population that could have every cross eyed tattoo artist hanging out a shingle as a healer. Better they have a grip on some organic chem as well.
Still the decadent force by which the screening process becomes a self serving self consuming apparatus must be held in check. Otherwise we repeat the error of Confucian China, in which examinations became more important than knowledge itself.
The first visits I made to ICU’s were for accident victims I knew. There there was hope, albeit, highly qualified. One hoped the victim would live and be able to walk and return to a functioning existence at least somewhat akin to what it was before the bumper of a Mack truck so rudely interrupted it.
In the case of one dear friend of mine who creamed himself on a motorcycle while impaired, we all rooted for him, so that when he got better we could kill him. Or at the very least provide him with the beating he so richly deserved.
ICU treatment for the elderly, chronic and/or terminal is a different matter altogether. For example in the case of the aforementioned editor, these BEST OF CARE practitioners insisted on discussing rehabilitation programs after the successful completion of her treatment even when she was down to a skeletal ninety five pounds, and her face was covered with warty micro tumors.
There is no way of looking inside these creatures and finding out whether or not they believe what they are saying to the next of kin. In the case of the beloved woman mentioned herein, I may be no oncologist, but I certainly know one foot, eg and hip n the grave when I see one.
The trouble is that because of all this information and technology, once things advance beyond a certain point, we don’t know what to do. We can maintain vital functions, but we are not sure of where they ramify away from life itself.
On one side we have the easy philosophers who say one sould stop all treatment and put the loved one out of their suffering, But in the moment of action, who wants to bell the cat? If the hand to pull the plug has a conscience behind it, it must hesitate because there have been cases where people have recovered from situations of unimaginable extremity. Especially the comatose.
On the other side we have those who believe that technology brings with it the moral onus to maintain the individual existence at all costs because that is the responsibility that comes with such knowledge and power.
These two abstractions could battle endlessly were it not for the factor of economics. Hospitals are not going to give loveable old Pops, the homeless guy who’s been living in a cardboard box for the last ten years, the same treatment as a rock star like Rod Stewart.
And unfortunately the horror stories far outnumber the miracles. Living wills are at least part of the answer, but they will not ease the doubts of the executor in the moment of decision. How can one be sure of moral clarity when it is most needed?
Fortunately for most, the decision will be made for them. The bottom line is that the loved one will die when the money runs out. The Pope, as well as countless other wealthy examples, existed long after life as they had known it was over.
The ambiguities surrounding death exfoliate into ambiguities about self and identity. Especially if the patient is incommunicado.
Communication makes all the difference in the world in extreme situations. There was a murder case involving a young man of about twenty who was a very athletic individual.He had virtually no intellectual interests. He had a deep and loving relationship with his younger brother As fate would have it, he was in an accident that left him quadriplegic.
His brother visited him on a daily basis. All the young man on the hospital bed ever did was repeat a request of his brother to kill him. This went on for three months until finally the younger brother broke.
One rainy day he walked into the hospital as he always did. He was an accustomed presence, so no one gave him much notice. Witnesses gave conflicting accounts of details about what happened next. According to his own testimony, he pulled a sawed off shotgun from the sleeve of his raincoat and blew his brother’s brains out after the following exchange.
"Kill me. How many times do I have to ask you? Kill me."
"Are you sure, Mike?"
"How many times do I have to ask you? Kill me."
This one was a prosecutor’s nightmare. Common sense would say temporary insanity or extenuating circumstances or some other legal wild card should be in order. But the case and its issues refuse such simplification.
There was so much to indicate premeditation that the case had be prosecuted as first degree homicide. He waited for a rainy day, so his overcoat provided cover. There is no possibility of claiming overriding sudden impulse.
Any insanity defense fails because he freely admits to not being sure if he did the right thing. He gave every indication of having sharply defined senses of right and wrong, and clearly understood what he had done. Corroborating witnesses were aplenty because he did it at the peak of the visiting hours.
Local newspapers ate this one up because they were popular clean cut types. Op-ed articles proliferated, until the rather anticlimactic end.
He still pled not guilty. Said he didn’t feel guilty, and he did the right thing by his brother. The jury deliberated on the evidence for half an hour after a three week trial. Not guilty.
To be Xian and proud of it. Now there’s an enigma. Sort of like being greedy Rabbi dealing in free ham for the Synagogue.
The only reason some remarks seem prophetic is that they had to be true in the first place. BACK TO THE CONTENTS