This Was the End of a Beautiful Relationship

This past week for the last time I traveled 70 miles to have a final physical check-up exam with the family physician whom I have been seeing regularly for 35 years. He is retiring this year. During the past many years I have been his patient for whom he exhibited great patience. Outside of the relationship I have had with my children and siblings and one dear, dear friend, my relationship with this doctor is the longest one of my life. I am seventy-eight years old and it is doubtful that I will have opportunity to enjoy such a long relationship with another physician or really, with anyone else. Our intimacies were profound; I have allowed this man to probe every orifice of my body, and he did so gently and unreservedly at least once every year for each of the thirty-five years; sometimes if my hypochondriacal tendencies flared I visited with whom more than once in a year. I remember once, years ago, arriving home one Sunday evening after a personal trip East and driving directly from the airport to the emergency room of the hospital to relievedly find him there on duty: I learned that he was also an emergency room trauma doctor. I was having difficulty breathing and the admitting nurses thought that perhaps I was having a heart attack. I wasn’t and I almost knew it, though in my hypochondriacal fantasies I could have been experiencing a myocardial infarction having never had one before and knowing only what it looked like from the television shows I watched. And that night in the emergency room—because it was late and I was frantic—he cared for whatever was wrong with me physically and psychologically. Over the years with his attentions, he gave me the freedoms that I sought so that I could think myself healthy, and he supported me when I was suffering actually or hypochondriacally. He listened to my plaints and took me seriously in either case. When I would ask for a procedure—a colonoscopy, repair of a trigger finger, the freezing off of keratosis on various places on my vain body—he would right away order that precise procedure. At some point we actually did discover some real cardiac issues and he sent me to a specialist who was very skilled but was also too busy or disinterested in me as a person to listen. The cardiologist performed an endoscopy, discovered a bicuspid valve and an aortic aneurysm, and made some direct recommendations; I never saw him again nor would he respond to my phone calls. Of late I have experienced an outbreak of eczema and recorded the shortest doctor’s appointment ever—two minutes—and I left with a prescription. But over the years, visits with my family physician did not last less than twenty minutes and often extended to forty-five minutes and sometimes to an hour.. I always left his exam room feeling relieved and healed. On the last visit this past week, at the end of the exam we embraced and said goodbye. We had never done that before.

I had begun my visits with him when I had moved from New York to Menomonie, Wisconsin, the latter a semi-rural town harboring a moderate sized university that was a part of the University of Wisconsin system. I was a member of the faculty there. In New York I had not thought to ever need a family physician—I was young and my body seemed to function as it was supposed to and it did so mostly in silence. I also didn’t have the slightest idea how to find a doctor even if I knew what I was looking for in a primary care physician. I don’t think I ever had heard the term before I settled in Menomonie. In my twenties I became a long-distance runner, and I began to pay greater attention to the states of my body and especially as my body began to make some unfamiliar noises: my knees and feet would hurt and so they said I ought to see a podiatrist. He prescribed orthotics that seemed to work best when I held them in my hands. As a runner I learned to pay attention to my body and it talked back at me regularly. I began to notice every twinge and twist. But back then I did not have a family physician and attributed any ache and pain to the number of miles I had run that week.

 But when I moved to Menomonie with wife, child and two cats, I thought it advisable to seek out a family physician, and I asked my all-in-one holistic advisor, massage therapist and health product dispenser for a recommendation and she advised him because he was sympathetic to alternative treatments and medicines and was a good listener and by reputation a good doctor. I made my first appointment. I suppose our initial meeting was like a blind date!

It is ironic now to consider that it might have been his patience and his proximity that fertilized my hypochondriacal tendencies. He was so close and the clinic so relatively small that at any ache or twinge, slight as it might be, I could make an immediate appointment, drive to the clinic, and he would diagnose . . . usually not much was amiss though he would advise me in a soothing language and tone that, yes, I was going to live. When it became available, I added myself on to the patient portal where I could view a lot of things medical—appointments scheduled, test results most of which I could not understand. On this portal a patient could send messages to their care team and on which they might respond. I took frequent advantage of this means of communication and he patiently and with concern responded within twenty-four hours and usually in much less time, even when he was not even scheduled to be in the office. Though doctors take days off, his care of me knew no pause or impatience. When more serious conditions arose, he either treated me himself or directed me to appropriate specialists all of whom were skilled and none of whom were available as was he. He always was so.

And I am wondering what is now gone, and what does it mean to have lost his care. In that final visit he handed me a xeroxed sheet of available primary care physicians and recommended a few I might try, but really, he did not speak with any great enthusiasm. And it was like an experience of on-line dating: who “looked” right! Maybe he was experiencing a loss as well, not unmoved to arrive after thirty-five years at an end of our times together. During those years he and I have shared marriages, divorces, and re-marriages. We would speak of our children and their growths and difficulties, their marriages and our divorces, and finally our children’s children’s activities. We had never met outside of his office in which we shared intimacies that I do not believe we would have presented outside of the office. In there was sacred space, not, I suppose, unlike that of the confession booth. I am not sure I would have ever wanted to meet outside of the office. No place could ever be as intimate as was that exam room space. We were not friends or lovers; but if love is to care for the other, then he loved me. He was my loving caregiver. 

I think I am now too old to develop an intimate relationship with another physician. Oh, I talk to my cardiologist but . . . well, that conversation is always focused on my heart and its issues and does not begin to enter into the personal stuff I always shared with my primary care physician. In my cardiologist’s office I don’t even have to take off my clothes, though it is true that in the winter when I wear many layers I have to partially de-layer so he can hear my heart! No, over the 35 years of medical visits with my family physician developed an intimacy I expect not to experience again in a doctor’s office. As I age the world around me grows smaller and less populated, and I will miss my relationship with him. 

 

The Pond in Winter

The chill in the air bespeaks the coming of Winter. The time is still only mid-October but the falling rain and gusty winds will soon pull the leaves off of the trees and they will be bare. Thoreau writes in his journal, “I knew a crazy man who walked into an empty pulpit one Sunday and, taking up a hymn-book, remarked: “We have had a good fall for getting in corn and potatoes. Let us sing Winter.” So, Thoreau says, ‘Let us sing winter.’ What else can we sing, and our voices be in harmony with the season?” As for me, I am not yet ready to sing winter, not anymore, and when it does arrive, I hope to be packing for warmer climates. 

But I have been thinking about “The Pond in Winter” a chapter in Thoreau’s Walden. When Thoreau lived on its shores and in winter the pond froze over to a depth of a foot and a half, Thoreau surveyed Walden. There exists his detailed surveying maps showing his considerable skill and thoroughness in the practice of surveying. In fact, Thoreau eventually worked as a professional surveyor, so accomplished in this profession that to support himself he traveled all about New England contracting as a surveyor. Thoreau was hardly an unemployed, unemployable, idle man, as he has too often been accused over the years. It may be that his skill as a surveyor, as Linda Walls suggests, led to his discovery of Walden’s bottom and the fulfillment of his purpose for coming out there to live for two years, two months and two days. That purpose Thoreau declared was “to front only the essential facts of life, and see if he could not learn what it had to teach, and not, when he came to die, discover that he had not lived, living being so dear.” I think that by his thorough survey he had found Walden’s bottom and had found in that bottom what he called reality. Walden Pond, he discovered, was not bottomless but was, indeed, rock solid at its bottom. Though Thoreau celebrates that “while men believe in the infinite some ponds will thought to be bottomless,” he knew that in such belief there would be no “hard bottom and rocks in place” which could be called reality. All would remain ungrounded, unsteady, and in constant flux. If a belief in bottomless ponds is a belief in the infinite, then there would be for the individual no solid ground on which to stand, there would exist no rock-bottom and no reality. I believe that this discovered bottom of Walden was the symbol Thoreau sought. Thoreau knew that it was necessary in and for his life to discover the bottom, to front the absolute essentials. He wrote, “Let us settle ourselves, and work and wedge our feet downward through the mud and slush of opinion, and prejudice, and tradition, and delusion, and appearance, that alluvion which covers the globe, through Paris and London, through New York and Boston and Concord, through church and state, through poetry and philosophy and religion, till we come to a hard bottom and rocks in place, which we can call reality, and say, This is, and no mistake, and then begin, having a point d’appui . . . a place where you might found a wall or a state . . . .” Thoreau declared, “There is a solid bottom everywhere," and one had only to find it. Our rock-solid bottom is discoverable: “We will not be shipwrecked on a vain reality,” Thoreau asserted.

 Thoreau’s sounding and surveying of Walden made the pond for him a symbol for he discovered that when he drew his rule across the greatest breadth and length of the map, he discovered that “the lines intersected exactly (italics in the original) at the point of its greatest depth.” He considered that the law of the two diameters that had been true for the pond might be also true for an individual’s ethics—their personal moral code—as well. As the length and breadth of Walden intersected exactly at the point of its place greatest depth, so that intersection in a person would occur at the point of greatest depth. Thoreau wrote that one could “draw lines through the length and breadth of the aggregate of a man’s particular daily behaviors and waves of life into his coves and inlets, and where they intersect will be the height or depth of his character.” I suppose that the length and breadth of any person’s daily behaviors would intersect at a point of greatest depth, but sometimes that depth would be found not to be very deep and the reality shallow. The artist, Ben Shahn, complained that his own early work lacked the reality of his self. He said, “And then I began to realize that however professional my work might appear, even however original it might be, it still did not contain the central person which for good or ill, was myself . . . . All my views and notions on life and politics, all this material and much more which constitute the substance of whatever person I was, lay outside the scope of my own painting.” Shahn’sr ecognized that his paintings might have come from his skill but not from his reality, and he had to sound his depth to paint that reality, survey the length and breadth of his activities, measure where they intersected, and sound his depth.

I’ve wondered: does one first sound one’s Walden to find its depth. Or does one find its depth by measuring where the length and breadth of activities intersect?  Of course, for a bottomless pond there would be no depth and therefore no intersection of length and breadth would ascertain the place of greatest depth. Indeed, there would be no depth. There would be, then, no knowledge of self. But I wonder what would be the skill required to survey the length and breadth of a person’s action, to find the point of the intersection of the lines and to know the depth of character. I think Thoreau knew that to be good was not an immanence but an effort in the daily life of the individual. In Iris Murdoch’s novel, The Nice and the Good, Willi, a holocaust survivor says, “We are not good people, and the best we can hope for is to be gentle, to forgive each other and to forgive the past, to be forgiven ourselves and to accept the forgiveness, and to return again to the beautiful unexpected strangeness of the world.” That would be one answer, I suppose, but it would not be one Thoreau might profess. He wrote, “It is not necessary for a man to put himself in opposition to society, but rather. to maintain himself in whatever attitude he finds himself through obedience to the laws of his being, which will never be one of opposition to a just government, if he could chance to meet with such.” 

But yes, let me measure the breadth of my daily activities and the lengths to which I go to fulfill them. And where they intersect I will discover my depth, my rock bottom, my reality.

 

Maybe more than the time of year

                       

Maybe it was the time of year or maybe it was the time of man. Rosh Hashanah had ended the previous week and now, ten day later the shofar signaled the end of Yom Kippur, the Jewish Day of Atonement, the most sacred day of the year. Torah says on that day you should afflict yourself, and the Rabbis have interpreted the requirement to mean that for the whole of the day—from sundown to sundown—one should abstain from food and drink, from anointing, from wearing leather and from sexual intercourse. These denials should allow one to focus the mind not on the body but on the spirit. Teshuvah, the act of return after the confession, offers to the world a soul that has been forgiven and that can enter life in a new beginning. Sometimes over the years I have experienced this state, but throughout any number of bygone and recent years not so often. And certainly not lately. The historical materialist in me remains suspicious of this ideology. Freud has suggested that the past is never lost, forgotten or forgiven, and I have long held with Faulkner who had said in his acceptance speech for the Nobel Prize, “The past is never dead. It is not even past.” Nonetheless, at Yom Kippur this year as in sixty-five years previous I have afflicted myself: did not eat or drink, did not anoint myself; I wore leather only on my belt so that my trousers would not fall down and I did not engage in sexual activity. This last was the least difficult, such as is my age. But at the end of my fast and at the blowing of the shofar I was aware that I had not experienced any spiritually transcendent moment, and  I left the shul not expecting my transgressions to have been forgiven and forgotten. I do not know when I might have lost the capacity for the experience, if indeed I ever did possess it, but now it was certainly  . . . unavailable.

            But two evenings later, on that Saturday evening at the concert, I enjoyed just such a spiritually transcendent moment. John McCutcheon’s presence, by which I mean the songs he sang and the stories he told to the room of perhaps 200-300 folks, many of them gray-headed or bald, many hopefully retired and at some peace, all who had been through the wars both social and political and who had come there to be present, John reminded us of the struggle which over the years he had shared with us and spoke and sang of the work still to be done. He sang of the joys and sorrows of this life, and he told stories of the sorrows and joys he had experienced as he traveled and performed throughout the world. I sensed that some of what he said had been scripted prior, but there in his narrative I felt unrehearsed emotion and meaning in the choice of stories and songs he would sing. 

            I have had for almost forty years’ experience with McCutcheon’s work and have attended more than several of his concerts in a variety of venues and states. In my storage unit are a dozen or more of his CDs. I do not listen to CDs anymore, but that situation demands another blog post. But last night my seventy-eight year old body, uncomfortable as a way of life and uncomfortable in the unupholstered bridge chairs at the Cedar Cultural Center, seated between my partner and my 31 year old daughter, who perhaps didn’t know to what experience to which she had accepted invitation and who was perhaps unprepared for what she would hear, but I was overwhelmed by an experience of transcendency at the intensity, sincerity and beauty of his singing and his playing on a variety of instruments, banjo, guitar, fiddle, hammered dulcimer, autoharp and piano. And I mean, not playing as in cursory performance, but singing and playing with a passion and a demand for social justice, for human rights, with an advocacy for the better parts of all of us in the multitude who sat with him. There was love in that room, and I knew somehow that I was not alone.

McCutcheon had created in that not very large room a community where for some brief moments all dissension ceased, and we sat and smiled together as we sang. Oh, we knew that there was an ugly world out there—McCutcheon reminded us of that in his choice of songs—but the songs and singing kept the wolf at bay for just a few moments. I felt warm despite the air-conditioning, secure and almost at peace amidst the chaos. For just a little while as we sang, hallelujah, the great storm was indeed over.
            As I stepped out into the sweltering October night, I knew, the storm that had been ended in there raged still out here. But for just three hours in there it had, yes, been over. And that would be enough for now.