Well, in cyber space.
I’m branching out a bit — come see me if you can, and please let me know what you think.
Being Mortal: Medicine and What Matters in the End by Atul Gawande
Picking a doctor’s brain, but hearing his heart – that’s how I would describe the experience of reading Dr. Gawande’s reflection upon how he has learned to practice medicine. The book stirs up uncertainties and memories; it is an easy read, but in the simplicity of the stories he tells, and the research he cites, Dr, Gawande urges us to slow down and think about the medical choices we make – and talk about what we want, and why, remembering that
They come to rest at any kerb;
All streets in time are visited. – Philip Larkin, Ambulances
In western cultures, we have come to expect deliverance from the health problems that killed our grandparents – or great grandparents – but not from the reality that our bodies wear out and we die. Some of us may not make it to the golden years – many are cut off by diseases that rob us of our freedom to “shape our lives in ways consistent with our character and loyalties.” The challenge Dr. Gawande poses that all of us must answer, not just the professionals, is: “[H]ow we can build a health care system that will actually help people achieve what’s important to them at the end of their lives.”(Page 155)
Ideally the system should be about balancing what modern medicine can do to buy time, and understanding what that miracle costs in terms of additional pain and suffering. Being Mortal opens a hard conversation on how to make life worth living even when we’re weak and frail and can’t fend for ourselves anymore.
Doctors are [often] no better prepared to face the brick wall death is than their patients are. Because [t]echology can sustain our organs until we are well past the point of awareness and coherence, we need to have some hard conversations. He was taught better ways of engaging with patients than just dropping information on them – and expecting them to make a smart decision. He admits he has been a slow learner as he recounts interviews with other professionals, and his patients. And he is candid about how slowly he put into practice what he learned – but his experiences edify and encourage readers, as well as caution us. Sometimes, we are just up against the unfixable. (Page 223)
In the second half of Being Mortal, Dr. Gawande describes how asking instead of telling patients enables doctors and nurses to help families to live until they die.
A better way is slow down the conversation about treatment “options” and expression compassion; ask the patient, what is important – given that time may be shorter than they hoped. Don’t shut out other family members from these conversations.
He reinforces his lessons with experiences of courageous people – people who had substantive discussions with their doctors and families about their end-of-life preferences, and spared their family anguish (Page 177)
Not exactly questions we want to spend time pondering – but, during his father’s battle with cancer, what Dr. Gawande and his family all came to witness was the fruit of thinking through these matters, and discovering “the consequences of living for the best possible day today instead of sacrificing time now for time later.” (Page 229)
A grandmother in the hill country of Texas is writing books people pay good money to read, and this grandmother here in Big-D has yet to get on paper an outline of any of the stories I haven’t figured out how to tell. I learned about “Desiree Holt” on a CBS Sunday Morning Show. (“The Rise of Mommy Porn”) She has written 140 novels. That’s one every two weeks!
“Ms Holt has about 10 years on me – so maybe there is time – but how she does it, I can’t speculate; she is more prolific than Will Shakespeare, who wrote only 37 plays and some poems. No, I haven’t read any of her books. However, based solely on the TV interview I am guessing had the Bowdlers gotten hold of her material there might have been more to bowdlerize in her novels than the Bard’s plays.
Lest the aroma of sour grapes overcome any gentle readers – my humble opinion is not based on what Ms Holt has achieved, so much as it is a goad to my own writing aspirations. I confess having a smidge of resentment — OK – a large dollop of envy. Maybe that’s one reason for these ruminations. But perhaps too, is the need for a sheepish confession: writing is hard work.
And the hardest part is truth telling. Not true confessions – but using words to create in a reader’s mind, and heart, the A-Ha! moment of sympathy, empathy, understanding – reaction – but not revulsion. Come to think of it — revulsion works. I mean, think of Lady Macbeth . . .
Sex and murder capture readers!
Successful writers are those folks who convey the pulsation of passions, good and dangerous, without too much information – creating characters whose complicity don’t make a reader put down their book in disgust. No, wait – disgust works: remember Iago?
So, I am a grandma – living in the flatlands of north Texas . . . transplanted from Maryland . . . meeting plenty of new people any one of whom could be a heroine or anti-hero that great, soon to be finished — started, still bubbling on the back burner of my brain book. My Texas characters fitting in nicely with crew already inhabiting my brain, which is filled with people, real and imaginary, whose words and deeds shaped me.
But a work worth reading can’t be about me . . .
It might be about my mother, and her siblings who lost their mother to TB, and their father to domineering aunts who ran him off shortly after his wife died, because his Irish-Catholic roots were tangling him up in drink and failure. Or, so the story goes. What was the real story?
My book might be about that grandmother who died when she was only 28, leaving the love of her life, and her precious 2 little girls and 2 boys, knowing her uptight Anglican family rued the day she married him, pregnant with her first-born. One family member told me that Florence – her name — became addicted to laudanum. Truth or gossip? What was suffering from TB in Baltimore like in the late teens of the 20th century in Baltimore?
And I haven’t even touched my father’s people – whom an ex-sister-in-law called “broken-down Southern wanna-be aristocracy.” Granted, William Faulkner and Tennessee Williams seemed to know some of the characters in my dad’s family – and Harper Lee and John Grisham knew a few more, but a few folks from that small town created lasting impressions on me using very few words.
For instance, my grandmother: Nellie Maude, a widow, always in a homemade dress and large white apron. She wore black, lace-up shoes, wire-rimmed glasses, and long silver hair always done up in a knot on her head. She left home rarely, and who may be said no more than fifty words ever to me in the 23 years I knew her.
Then there’s her sister, Essie, whom I call the city mouse, though she lived in no city. She drove a model T Ford up through the 1950’s, and she drove her adult kids nuts – or so some said, zipping to DAR meetings, lunches, and other places along highway #9 in rural South Carolina, dressed in a fitted mauve suit, broad brimmed veiled hat, and a chain for dead fox chasing themselves around her neck.
Just describing the differences in their houses would make a great short story!
And I haven’t even gotten to my father or mother, or the other aunts and uncles . . . or the cousins . . . or my neighbors! Or, my husband, and his family!
But making readers feel at home in my attic-full of so many characters . . . that’s gonna take some doing!
Writing is hard work!
A friend suggested in his blog that we get off auto-pilot when reading Scripture, and take a well-known verse and pretend it is the first time we have ever read it. He suggested Psalm 23 – a staple at most funerals, a Bible reference many can even quote, perhaps but never ponder.
Today let me look at Isaiah 33:6, a life verse for me –
And He will be the stability of your times,
A wealth of salvation, wisdom and knowledge;
The fear of the Lord is his treasure. (NASB)
That was quite a promise when I first read it – I read the verse mainly from a vantage point of hope what God had done for Israel He did and will do for the church, and the admonition to fear God more than my circumstances – but how personally scary were my circumstances in the early ‘90’s? Bosnia and Herzegovinian and Rwanda were the shot spots of horror; the televised reports on political scandals, gaffs and intrigues were not 24/7; nobody I knew relied on the Internet or cell-phones and I felt secure from foreign invaders.
When I consider this promise that’s comforted me for decades, how do I disengage from autopilot? Asking who, what, why, when and how helps.
Pondering it this morning – with all the bad stuff swirling around I won’t itemize, the promise has never seemed more vital, simple, but elusive . . . stepping on to the solid ground it offers, resting upon it, seems as unfathomable to me as it may have been to the folks who knew Isaiah.
Isaiah wrote to people who could not imagine the troubles that would befall them, their children and their nation – which would be destroyed by the Babylonians, and those who escaped the sword would have been marched hundreds of miles into captivity, most never to return; the Temple in Jerusalem – their meeting place with God — smashed. He wrote to people who forget God, so comfortable were they in their prosperity. In Babylon, they remembered his words – and still later, his words were the foundation of the apostle John’s gospel and letters.
When I first read this promise, I could never have imagined 9/11 or all that has come from it – nor, the rise of evil. (More Deadly than ISIS and al-Qaeda) I would not have believed hotels would chuck the bedside Bibles for a fantasy on bondage. (Source) I couldn’t anticipate some of the conflicts and problems we have lived through in the church, and in our own family. And I couldn’t anticipate the joy of having married kids and their kids while being 1500 miles away! Yeah – my world has been rocked a bit in 20 years
Isaiah’s great guarantee to people who were facing unthinkable ruin is freely available still; it is an infinite pledge and it is personal.
Isaiah saw the Man who was the foundation of his faith, the Messiah. Praying for eyes to see, ears to hear, and a heart that says, Here am I, send me Lord – and the courage to take the next step into a hurting and hopeless world.
Are you tired? Worn out? Burned out on religion? Come to me. Get away with me and you’ll recover your life. I’ll show you how to take a real rest. Walk with me and work with me—watch how I do it. Learn the unforced rhythms of grace. I won’t lay anything heavy or ill-fitting on you. Keep Company with me and you’ll learn to live freely and lightly.”
I taped back-to-back episodes of her interview with Paul Coelho, author of The Alchemist, a book residing on the NYT’s bestseller list for over 330 weeks! (Plot Summary, Spark Notes) According to others on the show, this book has changed the direction of many, many people’s lives, including Oprah and Bill Clinton – giving them the courage to follow their heart’s desires and succeed in accomplishing great and wonderful things.
Mr. Coelho said he wrote The Alchemist in only two weeks in 1987. He told Oprah, what was also noted in Wikipedia’s article about the book, . . . he was able to write at this pace because the story was “already written in [his] soul”.
He did not acknowledge, nor did Oprah question the assertion that,
“The basic story of The Alchemist appears in previous works. In 1935, the Argentine writer, Jorge Luis Borges, published a short story called Tale of Two Dreamers in which two men dream of the other’s treasure. Another version appeared in E. W. Lane’s translation of The Thousand and One Nights. The story also appeared in Rumi‘s story, “In Baghdad, Dreaming of Cairo: In Cairo, Dreaming of Baghdad”. (Wiki on The Alchemist)
I have not read the novel. However, the interview’s emphases on a few quotes, not the plot, piqued my curiosity. I wanted to hear and see a writer whose words have inspired so many. He is intelligent, engaging and humble; the two-hour interview revolved around the meaning of these few quotations, such as,
Skimming other quotes from the novel, I wondered at Mr. Coelho’s ability to weave the wisdom of so many proverbs into a work of words that goads so many to their own personal greatness. (Quotes from the Alchemist) Even as I could see their wisdom, “Yes, but . . . ” bubbled up. As some one note: Every proverb has an equal and an opposite proverb! (Attribution)
As I listened to the conversation between him and Oprah, I thought about dashed desires – dreams the impersonal universe turned upside down and backward – hearts broken because of illness and failure – but not from lack of courage or trying. What of these brave but broken hearts?
I listened — but didn’t hear hope for the hurting. From the corner of this autumn’s garden, talking to my heart is an easier conversation when I use the psalmist’s words:
And Solomon offers ever wise counsel in his proverbs, though some may appear contradictory: Trust in the Lord — Don’t lean on your own understanding! (Proverbs 3:3-5)
Congratulations Mr. Coelho on a quarter-century run! And thanks to Oprah for snagging a unique interview.
But special thanks to God who lifts my head – and urges me to keep writing, and reading when the universe seems uninterested in helping me, or when fear, failure, and discouragement paralyze my heart.
On one level, the novel reminds me of The Great Gatsby – for it is an insightful encapsulation of despair and depravity – and Mr. Beha is an erudite and elegant writer whose dialogue and descriptions capture the world-weariness of many young people. As Scott Fitzgerald chronicled the unrestrained behavior of the 1920’s in his novel, Mr. Beha has revealed what normlessness – anomie – looks like in this generation of 20-somethings.
His characters, especially Sophie, are swept along in emotional floods, some of their own making, many because of others’ making. She is an orphan, her lover, Charlie Blakeman, has no father, and her husband has no mother. And everybody sleeps around. Alcohol and drug use abound – and eventually overwhelm Sophie’s ability to stay afloat after her conversion to Roman Catholicism. Yet, religion makes her a more repellent character than those who have no religion.
Mr. Beha describes how Sophie’s life changed by becoming a Roman Catholic; indeed, he describes the mystery of a soul-stirring under the power of the Holy Spirit.
“It got closest to it to say that she was, for a time, occupied.” (Page 80, Nook Edition)
The heavens show her the reality of God, her conscience, and her need. (Page 121, electronic book) But an occupying force is not personal – nor does it ever help her in her need. Perhaps this is connected to the author’s views of religion expressed in his book, The Whole Five Feet: What the Great Books Taught Me About Life, Death, and Pretty Much Everything Else.
I recommend What Happened to Sophie Wilder because it is as important a window into our world as The Great Gatsby remains. But, I commend it with the caveat, what happened to Sophie Wilder is the story of hopelessness and meaninglessness. Its implied resolution is summed up by Peggy Lee’s Is That All There Is?
Is that all there is?
If that’s all there is, my friends, then let’s keep dancing
Let’s break out the booze and have a ball
If that’s all there is
I selected this book because of the recommendation by Marvin Olasky, in WORLD Magazine, who said it was worth a slow read. (review) The novel has praiseworthy elements, namely Mr. Beha’s use of English; but it has problems – which may be the grist for book club discussion. However, the ending seems as if Mr. Beha got tired of the pain – and stopped the story. Mr. Beha showed us the world he sees – through the eyes of two writers that a large majority of Americans see. Its ending is as grim as Gatsby floating in his pool, and God is as absent in Mr. Beha’s world as He was in Mr. Fitzgerald’s.
Telling a story to which another might listen or read couldn’t be all that hard I reasoned, graduating from high school with the ambition to write the great American novel. But who, at 18, has a story worth reading?
Jane Austen, maybe.
I was no Jane Austen.
Nor did I have the respect for the situation into which I was born and grew up that shaped her animated
description of life in her times. So busy was I to leave my early times, I paid little thought to all that gone into shaping 18 years of one life, and all the lives mine intersected. Busy people miss the details of life that are the strands in stories others like to read.
Details, ample or sparse, are the reason we keep turning pages to discover an author’s point. Details teach, delight, and expand our horizons – both the writer’s and the readers’. Proper use of details is how we get from one-dimensional characters on a page to a three-dimensional person or event that forever changes us. Think of Elizabeth Bennet, or Jean Louise Scout Finch.
How to tell characters’ stories so that others will listen or read is an ability that all the how-to classes in the world can’t teach.
In an essay called “The Fiction Writer and His Country,” Flannery O’Connor put it this way: “The writer can choose what he writes about, but he cannot choose what he can make live.” A tornado would seem a more lively subject [for an aspiring artist] than a nursing sow, but only if you can make it live. If you’re an artist, you do well to ask yourself: what can you make live? (Jonathan Rogers)
But, the writer who knows or imagines the details . . . the writer who knows that words, arranged, rearranged – edited – gets at the heart as surely as music and painting makes alive characters that can change the world. Think of Shakespeare, or Harriet Beecher Stowe, or C. S. Lewis.
Time well spent is time spent remembering details — You can close your eyes to reality but not to memories. — Stanislaw Lec
Has writing helped heal you was a question posed by Heather Holleman.
Writing is a tonic and a goad. And it is a solace. Sir Francis Bacon observed that while reading makes a full man, and conference (discussion) a ready man, writing makes an exact man. Writing keeps showing me how little I know about all upon which I long to be expert – and writing holds up a mirror to my heart demanding I cut out the malarkey and become teachable. Therein I find help and hope – and a goad to keep scribbling. (The Discipline of Writing)
Reading about writers is a handy writing tutorial. I am working my way through Flannery: A Life of Flannery O’Connor by Brad Gooch. Her writing was the fruit of coping with pain – emotional and physical. Her writing is hard to read – startling, grotesque – full of disturbing images.
But, what is today’s news if not also upsetting, monstrous – full of disheartening images? It, too, is hard to read.
A story from last year haunts me – a Dallas woman tortured her own little girl. (Dallas Morning News) It is as the same polluted well from which Ms O’Connor drew her stories – people living out their sorry lots. What would she have said, had she known about this, a child whose young body her mother beat and scarred — a grandmother who could not protect her own?
Ms. O’Connor wrote in Mystery and Memory that
Ms O’Connor believed in God – a real God in the midst of real pain. Reading of her writing struggles reminds me how puny the bond is between my faith and writing can be. Having come to appreciate her life through reading her biography, I am not yet a fan of all her stories. But I admire her courage – in living through the grotesque suffering that is lupus, and in her writing, describing how she saw meanness and mercy.
Writing of the diagnosis of lupus, she said to Robert Lowell, “I can with one eye squinted, take it all as a blessing.” (Brad Gooch, page 193) Although forced back to a difficult and increasing dependence on her mother, Ms O’Connor kept writing and encouraging other writers and friends.
Spending hours alone in her larger front room, among the phantasms of drowning boys, garrulous Southern grandmas, and mean-killer prophets, all created within a six month span, Flannery struggled to make sense of her life . . . For this dedicated writer there was no surer sign of grace than writing a good story . . . (Brad Gooch, page 193)
“Spinning her own life as a parable of the prodigal daughter, forced home against her wishes, and finding a consoling gift,” she concluded that running away in her twenties was a delusion – and had she not become very ill and had not come home, the delusions would have persisted. She said that the best of her writing was done in the home from which she had tried to escape. (Brad Gooch, page 193)
So, while squinting an eye, my hope gentle reader is we will keep writing and reading. And with these unique gifts, and talents, remain a mirror and lens to the crazy, wonderful scary times in which we live.
Artists with faith, O’Connor insisted, have an even more serious responsibility to work perfecting their craft than do unbelieving artists: “your beliefs will be the light by which you see, but they will not be what you see and they will not be a substitute for seeing.” The higher the vision, then, the more determined the artist must be to convince through the senses.” (Mary Mumbach, Invitation to the Classics, pp.353-356.)
Dorothy Smith Walton (unrelated to the TV Walton’s) always dressed with a flair that was planned and polished. She internalized the glamour of the 1930’s and ‘40’s, but she radiated the informality and warmth of the ‘50’ and ‘60’s. Was she perfect? From my limited exposure I would say pretty much. She set me an example of loyalty, kindness, and unfailing cheerfulness. Our friendship lasted barely twenty years. As she coped with painful disability and old age, these two limitations will never be how I remember her.
She was born on February 12 1898 in Minerva Texas, the eldest of her surviving siblings that included three brothers and three sisters. (C.R., C.L. –“Bill” — Burck, Mildred – “Gail” — Flo and Polly) From conversations with Dorothy, I learned her early years were tough – filled with much heartache but much love. Her father, Roy Edgerton Smith, was unstable and prone to wander, but her mother, Marion Burck, was a dynamo of ingenuity, holding the family together. She instilled in her children the principles of hard work and loyalty. The Smith kids all did their mother proud – and Dorothy was ever quick to recount and extol their accomplishments, and the undertakings of their children – and grandchildren. Dorothy was a cheerful chronicler and encourager of the Smith family. She had a kind word for everyone, but no words about her father.
Early on, Dorothy had a knack for sewing and she made clothes for her brothers and sisters. She went to work at Neiman Marcus in their bridal department, and her way with a needle impressed Mr. Marcus who helped her gain an apprenticeship in the garment district in New York in the 1920’s. She mastered dress design, and construction, later opening her own shop in Austin, where her mother still lived.
When she met and married her husband, James Walton, she moved to Charlottesville Virginia. Together they restored an 18th century farmhouse in Barboursville, and Dorothy added decoupage to her skills set. She didn’t talk so much of her accomplishments; she demonstrated them.
When I met Dorothy, she was 74. We first met when I drove my soon-to-be mother–in-law Elizabeth to Charlottesville to visit her. Dorothy’s constancy was apparent in this meeting. Although my mother-in-law had been divorced from Dorothy’s brother for more than three decades, she remained Dorothy’s beloved sister-in-law. When Dorothy discussed the failure of this marriage it was with great tact and understanding — she saw both sides and judged neither.
Driving Dorothy back from Charlottesville to Washington, for a stay with her brother, she began the oral history of the Smith family. Oh! How I wish I had a recorder! She was unfailingly complimentary – doting – about Doug, my husband to be.
We visited occasionally over the years. She was one of our first house guests. Our visits were limited primarily by her bouts with rheumatoid arthritis and the Smith predisposition for privacy. While we were waiting for our son Will to arrive, we slipped down to Charlottesville, but Dorothy felt so bad she was unable to celebrate with us.
Before she moved to California seeking better weather and to be closer to her brother Burck and his wife, Jane, she asked that Doug and I pick up a family heirloom – an enormous walnut wardrobe which collapses to a fraction of its dimensions when assembled.
She told me all about the piece – details I hoped to commit to paper, but never did. It had traveled west by Conestoga and then back east is all I know. When I see it, I remember the weekend Doug and Will and I drove down from Maryland and how it looked in her Charlottesville apartment. Now, when I look at it, I remember how kind a hostess Dorothy was when I invited myself to be her houseguest while Doug went fishing with his Dad. Overcoming reclusiveness and playing hostess at 77 in the summer heat while combating RA were a set of skills I did not then appreciate.
She avidly followed the news and read widely and voraciously. Dorothy recounted what she read and her life experiences with vibrant details. She was a great storyteller, and a better listener. When she visited in our home, she loved to sew and made me a lovely dress, stitching in the zipper by hand.
When we visited her in California, she knew some nifty restaurants and loved going out when she could, or sending us to these places to enjoy them on our own.
She wrote great letters – pages and pages of stories, thoughts, observations and cordial compliments, all committed in her distinctive handwriting to either legal pads, home-made stationary, or cards. And sometimes we would chat on the phone, congenial conversations that always left me with the feeling that I mattered to Dorothy – no distinction of “in-law.”
She had lost her brother Bill in 1979, and her sister Polly around the same time. Flo had died decades earlier from breast cancer. Our last conversation was shortly after her brother C.R. died in April 1990. By then she was no longer in her apartment on Euclid Avenue in Santa Monica – she was in a nursing home – defeated by the RA and age – outwardly focused. She died about two weeks later. I knew an “original” had gone.
Dorothy held onto life lightly. A father who is unable or unwilling to care for his wife and children, consigning them to poverty can teach that. His absence can also teach a child to be the person they longed for their dad to be: present and loving. For all she had seen and all she could do, Dorothy practiced the gift of making others feel they were important – encouraging us to believe she had no greater pleasure than to be with us in the moment.
In August of 2009 I created a blog, Autumn’s Garden. ( http://autumngarden-bwsmith.blogspot.com/2009/08/we-moved-uprooting-ourselves-from-free.html) I began it, perhaps, because I doubted my capacity to write the great American novel, I have intimated I was writing since I was a senior in high school. A friend who looked at my blog said, “You are writing the thesis of your life.”
A thesis may be an academic paper wherein the student seeking an advanced degree defends his or her research to satisfy an examining board of professors. It is also an organizing principle in all good writing – the skilled author has a point he or she wants their audience to get.
Therein lies the rub. Literature paints pictures and portraits with words so we understand a bit more about life and those who live it. Paint on paper or canvas doesn’t always do what the painter expects – words on paper sometimes express ideas that weren’t exactly the same as the ideas in my head.
How can blogging help me write that novel?
My thesis has been that God is, though I struggle with doubt and unbelief; I am, and I [can] believe and do ______. In almost two years, I have written about several propositions, and offer them for many a kind reader’s consideration. Whether I have proved them or maintained them against objections is another matter. The propositions have centered on the wonder of simple pleasures, amidst life’s unexpected and unsettling reproofs, my faith struggles, and my character defects – especially as the sands of the hourglass are piling higher.
As I have written, I realize how hard it is to write what is true, letting go of self-pity, excuses, exaggeration, misrepresentation, or even character assassination.
Self-absorption doesn’t make for appealing reading however.
Jane Austen — to whom I am not likening myself, exactly — has engaged her readers in the simple pleasures and trials of women and men since the early 19th century. (http://www.pds-thirdfloor.com/austen.html) Her “thesis” throughout her gentle writing is nothing is more fascinating than ordinary women and men seeking to make a life for themselves in times that are uncertain for the financially challenged. She says very little about herself even as she created memorable heroines who show commonsense, common decency and good humor; other characters in her novels have little commonsense, scruples or humor.
Can I tell stories about people, places and times as graciously?
Blogging shows me that writing well depends on being truthful, kind, and generous. It has forced me to think about simple stuff – true stuff. William Makepeace Thackeray wrote: “There are thousands of thoughts lying within a man that he does not know till he takes up the pen and writes.” How much more a keyboard?