Wednesday, October 3, 2012

egg helmet


In the United States the notion that bike helmets promote health and safety by preventing head injuries is taken as pretty near God’s truth.

-- Elisabeth Rosenthal, "To Encourage Biking, Cities Lose the Helmets"*

In the United States, it's a tenet of the national faith that there is a solution for every problem.  We have no tragic sense whatsoever.  What we have instead is The Church of American Exceptionalism.  No bad things should ever happen.  If something bad happens, it's because somebody didn't work hard enough, or did the wrong thing.  The person who didn't do (whatever) right must be identified and punished.  Or educated.  And if he was not taught what was right, we must blame his teachers, find the person who knows what's right and put them in charge.  And if no one knows what's right, we must have a crash research program to find out.  And when the answer is found we will apply a new technology that will fix things forever.  This American characteristic sometimes makes us very smart and brave, and inspires us to do things that no one else can do.  It also makes us very stupid, inspiring us to do things that no one else is dumb enough to do.

One of our National Idols is Perfect Safety.  Today as I read the Times I learn that, in order to prevent rare injuries to bicyclists, American cities require the use of helmets with their bike-sharing programs, thus dramatically increasing resistance to the use of bicycles, and preventing the many health effects of bike travel (for cyclists and their fellow citizens) from taking hold.  The world's most successful bike-sharing programs have no such mandate.  Bikes are safe, particularly when there are many cyclists in a dense and slow-traveling urban environment.  But somebody somewhere knew somebody who had a serious injury, and therefore technology is required, in the form of a helmet.  And so the easy and normal activity of biking takes on the appearance of an extreme sport, a contest with death for trained daredevils, not to be undertaken by regular people on their way to customary activities like work and shopping.  And people who might have used a bike stay in their cars, losing the exercise, getting fat and diabetic, and making life more dangerous for the few remaining cyclists.  Not a safe life style for anyone.

"If we wear helmets for cycling, perhaps we should wear helmets when we climb ladders or get into a bath," says a professor of actuarial studies.**  Perhaps I shall live to see the perfection of the Walking Helmet; after all, I might encounter a crack in the sidewalk, or stumble down the subway steps.  Or the Sitting-at-My-Desk helmet: I might nod off and hit the keyboard with my head.  (I needed one of those in a meeting I recently attended.)  In recent days I've seen kids stuffed into helmets in order to ride little scooters that might take them to the mind-rending speed of eight miles an hour.  How many days must I wait for the unveiling of the American Child Helmet, that will encase the noggins of our progeny throughout all activities and inactivities from birth to majority?

This afternoon my TV is showing the national sport, a game much adapted in America from one of the world's simpler Ur-games.  We have improved rugby into what we call football (although it has almost nothing to do with the relationship of feet and balls).  Rugby is a rough game, with a lot of crashing and bashing, and a century's worth of American exceptionalistic thinking has been applied to make the crashing and bashing of American football safer.  There are, as far as I know, no specialized items of equipment for rugby players: they wear what soccer players wear.  But the unmediated risks of flesh-on-flesh collisions were not tolerable for Americans.  Over decades, specialized items of equipment were invented: pads for the shoulders and shins, the chest and the ribs; sophisticated helmets with face protection and shock absorption.  Today's football player looks pretty much like the robot in a mid-century sci-fi flick, or -- even better -- he looks like a Transformer in one of those movies named after a toy for boys with accelerated testosterone.

And how has that been working for us?  Well, football is in a crisis.  The injuries are as frequent, and more horrific, than ever.  It's suddenly common knowledge (how could we not have known?) that football players frequently get concussions, and that repeated concussions bring on early dementia and death.  The national game, whose very object is to knock people down and "hit them hard," is seriously embarrassed.  But how is this possible?  We're Americans, and we've spent research, ingenuity, and serious money to protect our assets.

If we had a national sense of tragedy, we'd bring to mind more easily the Law of Unintended Consequences.  We'd know that solutions can become new problems, and that measures intended to keep us safe can pose new dangers.  The helmet, so cushioned, so hard and unbreakable, becomes a weapon.  The sense of invulnerability spurs greater speed, recklessness and violence.  The sport seeks out the gaps in our planning, and penetrates the limits that new equipment cannot contain.  Like Pogo and Oedipus, we have met the enemy and he is us.

No, you can't be perfect; and you can't be perfectly safe, even if you're American.  All you can do is trade some risks for others, running from one danger into the grasp of another, the greatest of which is never to have chosen the risk on which you wager your life.  And thus does the Idol of Perfect Safety seduce us us to surrogate living.

"You're on earth.  There's no cure for that," says one of Beckett's characters.  If you're still alive, you're in danger.  I might have choked to death on my eggs this morning.

After all, it happened to somebody, somewhere, sometime; or to their neighbor; or to somebody their neighbor knew; or to somebody their neighbor's friend saw on television.  Somewhere.  Sometime.  Or other.

"Shall I dare to eat a peach?" asks Prufrock.  I like my eggs.  They help me to feel alive.  Shall I wear an Egg Helmet?


*New York Times (September 30, 2012)

**"There are lots more injuries during those activities:" Piet de Jong, Dept. of Applied Finance and Actuarial Studies, Macquairie University, Sydney, Australia (see Rosenthal above)

Sunday, September 30, 2012

best possible

I am the best possible Arnold Burns.

-- Herb Gardner, A Thousand Clowns

He didn't own a home.  He didn't support a family.  He couldn't hold down a job, didn't apparently even try.  He wandered the streets, and seduced others to do so as well.  His main guy said "We left everything to follow you."*  They say he was a carpenter's son, that is, he owned nothing but the strength of his body; but he had something the starving migrants lacked.  He had a voice.

Crowds came together, in the street or on a hillside.  People left their work, or their search for work, to hear him.  Perhaps he preached outside the vineyard gate -- and every time the owner came out during the day, there were more unemployed men there for him to hire, listening to the prophet.  "Why did you stand around here idle the whole day?" the owner said.  "Because no one hired us," they said.**

He told them there was another way to organize the world; and this new regime was at hand.  The new regime -- not Caesar's regime -- would require a metanoia, a changing of the mind, a teshuvah, a turning around, a repentance.  And wherever the new regime was revealed, at a supper party or in an empire, when the queue reversed itself, the first would be last and the last first.

He was utterly without power.  He didn't know where his next meal would come from, or under whose roof he would sleep.  Yet he so frightened the people who held the power that they felt compelled to kill him, and those who had left everything for him could not go home again, but were forced by the persistent memory of their time with him to carry on his work as best they could; and thereby hangs a tale.

And this is the person Christians tell themselves to imitate.

(Disclaimer: Am I a Christian?  That is a boring and futile question that I no longer answer.  What I am is, in the great tradition of Unitarianism, a reverent and heterodox interpreter of Yeshua's work, looking direct as I can on the source through a miasma of theology.)

You can't build a society on the assumption of universal heroism.  Not even a just society.  Particularly a just society.  A sustainable, just society must be built on the assumption of common decency.

Here's the problem with imitatio Christi.  Just imagine a world composed entirely of people living as Yeshua lived.  Kant would categorically reject it.  No one would hold a job.  No one would raise a family.  There would be no loaves and fishes for prophets to multiply.  No coats to give to our brothers who sue us for our shirts.  No authorities to protect the innocent, and prevent the lion from devouring the lamb.

Yeshua told a young man from the ruling class that to be a follower he must sell everything he owned and distribute the proceeds to the poor.  Let's think about that for a moment.

If I set out today to sell my meager goods and distribute the proceeds to the poor, the first to proclaim my sin against them would be my wife and my children.  Then the truly poor might have some choice words for this parvenu who has come to hang with them and compete for their crumbs of bread, their square inches of warm grating.  The charities and programs that provide relief, if they knew my history, would and should deny me service.  When you volunteer for suffering, it's not oppression, no matter how much you'd like it to be.

This is not my path.  Nor yours I wager.  Our fallen world, to be sure, needs a few heroes, but very few.  The rest of us must leave it to the ones who are called to it, the ones for whom no other way is possible.  Their sins are against the personal life, the life of common decency that justice would protect. And we who cannot leave the personal life behind, who must protect our sustenance and our progeny in order to be good, are not off the hook.  Though we must own our besetting sins, we must also harken to the call of our besetting virtues.

In the Unitarian salvation text of Dickens, the recovering Scrooge praises the moderately wealthy man in whose service he had once toiled. "He has the power to render us happy or unhappy; to make our service light or burdensome; a pleasure or a toil" -- and Fezziwig uses that power to bring happiness.  He is not asked to liquidate his business and give the proceeds away, but to use his accumulation of devotion and fortune to bring hope where there would otherwise be despair.  That is the conversion in which Scrooge labors -- not to become another denizen of the poorhouse, but to use his power for relief of those who are or might be lost.

Justice demands power.  If you're reading this, you have power.  You and I are privileged people; all the most radical theologians say so.  We know what we will eat next, and where tonight's shelter will be.  The question is, what will we do with our power?  If we give our power away to someone else, then that is our mortal choice, for which we will be forever judged.

This is the lesson learned in Gardner's play by Murray Burns, the hilarious and unemployed guardian about to lose custody of his nephew.  It's charming to be the hero (and perhaps, as Murray does, you'll get the girl in the end; or as Yeshua did, have a new religion named in your honor).  But first you must learn a lesson from your dull and sober brother Arnold, who is always asked to pick up the pieces because he has the means to do so.  He is the best possible Arnold Burns.  And that, for Murray's purposes, turns out to be a very good thing indeed.

The Good Samaritan traveled with ready money and had excellent credit.***  Yeshua himself depended on the kindness of strangers.  We are called to be such strangers.

*Lk:18:28

**Mt:20:6-7

***Margaret Thatcher: "No-one would remember the Good Samaritan if he'd only had good intentions; he had money too." (TV interview for London Weekend Television Weekend World (January 6, 1980)

Sunday, August 12, 2012

good laugh

As I remember him, he was a loving man.
I knew it well, because
Where he was,
Life began.

-- Portia Nelson*

One more thing about Porgy.**  He's a cripple who stands up.  When a cripple stands up, he throws everything out of whack.  He spreads ripples in the pond, and everyone, everything will sooner or later move.

Love isn't just a private matter.  Love is political, imposing its duty, taking a toll from the loved one.  The duty to rise into freedom and be someone.  Love disturbs everything.

There's a lot of talk about unconditional love, which we hold to be noblest, but not because it is easiest to take.  Unconditional love is the most intrusive, aggressive kind.  Accepting it, you must rise to its level.  A conditional love leaves you alone in degradation, bribed and bribing -- you do for me, I for you, tit for tat, we're even, see you later, maybe, sucker.  But when love is unconditional, it requires a free gift in return.  When you lift yourself from the exchange of favors that defines our ordinary life and instead give your self to me, you're pulling out of me what I don't know I have to give you.  You're demanding of me my self, and I didn't know I had one.  If I give it to you in return, I rediscover what it is.

The Israelites came to think of themselves as chosen, that is to say, loved by God.  But they found that living up to God's love was not an unmixed pleasure.  God demanded through the first prophet that they leave their slavery behind, but when they found themselves in the wilderness without a food supply, they decided that the master's stewpots had been better.  Manna from the sky and water from a rock are not comfort foods.

Being as we say "in love" is not a quiet business.  We're between two lives, an old one that we'll never go back to, and a new one that may or may not come to be, and if it does it won't be what we expect.  There were birds in the sky, goes the song, but I never heard them singing, and if she doesn't love me what will I do with those damn birds?  Either way, you'll never be the same.  Once you've heard the bells ring, you can't block the sound again.

There are messengers of life and of death.  We all know people in whose presence nothing is possible.  There's at least one in your family.  Some of us have worked for such people.  Many nations are ruled by them.  They're invested in stillness.  We must all be quiet so they can keep hearing their own echoes.  They usually don't have to threaten us, because their presence alone leaves us gasping.  Not all bullying is physical.  They've taken all the air for themselves.  The stare alone is enough to make us forget our thoughts, forget that we had ever been thinking.  Our vision would disturb the regime.

But we also know people in whose presence beautiful things are possible.  When they enter, the colors of your vision come out again, and your thoughts stop stammering.  Such people recall you to life, to your self.  They recreate you in their attention, their presence.  Their love.  If we grow into enough wisdom, we choose to love those whose love will recreate us.  We should love those in whose presence we must be someone we want to be.  Need to be.  If you're not flourishing in it, it's not love.

Love is patient, love is kind, enduring all things; but above all, love makes us whole, demanding the whole thing we are.  It's no wonder that love is so often rejected.  Sometimes we're just not up to it.  To be created again.  The essence of creation isn't in all that showy stuff, the separation of heaven and earth, the confining of waters, the definitions of days and nights.  It's in what follows: six times the creator saw that it was tovah -- good, beautiful.  And then he had to go and make a big deal of it -- a holiday, a sabbath, a day of rest to celebrate the miracle.  And after that of course nothing was ever the same again.  The world was made by love.  That's the outrage, the aggression of it.  Nobody asked the world if it wanted to be loved.  Maybe it was content to be "without form, and void."  But no, somebody with big ideas, demands, requirements, plans, joy burst in and disturbed everything, moved all our stuff around and pronounced it good.  Sang a song, danced a hornpipe and had a good laugh.  "Forgive, O Lord, my little jokes on thee," said the poet Frost, "and I'll forgive thy great big one on me."

I hope that some will remember me as one of those in whose presence life could begin again.


*"As I Remember Him," from This Life (DRG Records, 1996)

**"Marriage vow" (June 30, 2012)

Sunday, July 8, 2012

fiat lux



In the beginning there were no words.  In the beginning was the sound.

-- Toni Morrison, Beloved*


One of my daughters, before she acquired language, babbled articulately.  She understood what I said to her, and answered me with music rather than words.  She lived in a world of advanced degrees and literature, of long sentences that rose and fell, that wandered to conclusion through an epic of dependent and subordinate clauses; so when she answered, she did so with rise and fall, development and recapitulation.


One could have an adult conversation with this toddler.  One didn't have to baby-talk.  She had found the advanced music.  We could discuss the menu, or the day's schedule, or the state of the world.


Then she said her first words.  The music was gone.  And I learned to talk baby-talk with her.  She had grown up, and I was an infant again.


She didn't know that she deprived me of music.  She didn't know she had upset the balance, because it was my balance she disturbed, not her own.  She had moved on, into her future.  If she had not moved on, there would have been something wrong.  It wasn't her job to stay on a balance: it was her job to grow up.


A late book of scripture says that the world begins in words, and a much older story says that those words were fiat lux.  But life does not begin with words, nor does the story.  Even a fundamentalist has to admit that there was something before creation.  "The earth was formless and empty:" therefore there was an earth before creation.  "Darkness was over the surface of the deep:" therefore there was a "deep."  "The Spirit of God was hovering over the waters:"** therefore there were waters before creation.  The elements were there, but had not been named.  Naming things changes them.  When you get a new name, the name creates you and inaugurates you into new life.


My daughter's childhood shows that there is sound before there are words to name it.  She answered the sounds she heard, without words.  She spoke articulately, because the sounds to which she responded were articulated.


Confusing creation with naming is a visual prejudice.  A baby first encounters light at the moment of birth.  Therefore we think that light begins life.  But we all lived before birth and without light.  We lived then ante fiat, in a world of sound.


By sound I don't mean just the selections of Mozart or Sid Vicious that some parents blast at the womb.  Nor do I mean the incidental noise, the sound of subway trains or thunderstorms or lullabies.  These hardly count at all in comparison to the concert of body sounds, rhythm of breath and blood, melody of alimentation, the journey of substance through mother's body.


At the moment when we first received the light, we lost the mothering sound.  We were destined for a world made of words, and alienation of the music was its price.  We are suddenly blinking in the light but out of sound in a first silence, startling and wrong.  We fill the silence with our first cry, and the sound of that grief reassures our parents that we have arrived in their world.  Subjects and predicates and the links between them: that's adult life.  Rhythm, melody and harmony: that's what we give up to grow up.  And it hurts.


It hurts, and we cope with grief through faith, prayer and art.  The Creator told us to pursue happiness, but we're never happy unless the head and the heart know their way to each other.  We approach silence fearfully, because it arouses that first silence, so appallingly empty, so eloquent of what has suddenly withdrawn.  We might  stumble on it in a temple, on a stage, in a lover's arms or in the embrace of a sonnet.  We are tempted to defile the silence with our chatter, but if we choose instead to listen and to wait, we have a chance to hear the music that is no longer there, the music that precedes words, the articulate babble that preceded our baby-talk.  The singer, the poet, the prophet try to show the rest of us through their own articulate babble what that bursting silence was like.


What's the point of articulate babble?  Your shrink might say it models integration of your character.  It's a way of being in one moment both your grown-up self of subjects and predicates, and your unborn self of rises and falls, loudness and softness, rhythm and harmony.  Why would you want that?  If you don't know I can't tell you; but you'll grieve, and not know why.


*(New York: New American Library, 1987), p. 259.


**Genesis 1:2 (NIV)

Saturday, June 30, 2012

marriage vow


This year slaves; next year free people.
-- Hagaddah
Let my people go.
-- Spiritual
How did he do it?
OMG, how did he do it?
When an artist brings the revelation down, when the hem of the Lord's garment fills the temple, that's all I can think to say.  Sometimes not even that.
As when Lear, surfacing from delirium, admits to the daughter he has wronged, "I am not in my perfect mind."
As when the painter carves into his night sky the vortices we never saw but knew were there (and science now confirms).
As when I saw a man sing love to his woman, and win her.*  He deformed in body, she battered in body and soul.  Beggar and whore, rising out of bondage.
I've heard this song with full-out orchestra, the voices arrogant and operatic, no hint of doubt.  But this was so quiet, I didn't know it had started.  He was just talking.  Bess, he says, you is my woman.  You is.  You is.  And she at the other side of the stage looking away.  No words like these have been said to her.  You must sing and dance and laugh for two instead of one.  What you want from me?  Want no wrinkle on your brow.  What you saying? To me?
When she looks at him, it's in disbelief.  And yet.  I am your woman now.  What am I doing?  There's no wrinkle on my brow, nohow.  How can I say such things? To him?  I ain't going! You hear me saying, if you ain't going.  Now she steps toward him.  With you I'm staying.  They don't touch till the last notes.  We two are one now and forever.
Only then do I get what the lyric says, these words sung to me all my life.  We'll go swinging t'rough the years a singing.  These crushed people -- right now -- are marrying.  Morning time and evening time and summer time and winter time.  These words are wedding vows.  The capitalists of flesh had denied marriage to their fathers and mothers, splitting partners and disseminating their children.  So they learned to make their own Promises.  From this minute I'm telling you I keep this vow.  Two raising each other out of bondage into agency.  He must stand up, for his woman and community, against the brutality of Crown.  She must resist, for her man and community, the lure of happy dust and despair.  The history and destiny of America's involuntary immigration run through these words, this song, this vow.  True love makes its demands, and compels them to freedom.  There's more at stake here than sleeping arrangements.
And how did they do it? I ask.  How did the Gershwin brothers, two Jewish boys from Brooklyn, and DuBose Heyward, a Charleston poet who observed black laborers on the waterfront, penetrate the veil?
Well, maybe they didn't.  It's a debate that I must stand away from.  Every writer white or black who takes an inventory of the damage done to people of color by the forms of American contempt will be charged with "painting stereotypes" or "washing dirty laundry in public."
There aren't any Harvard graduates on Catfish Row: Harvard didn't allow that.  There are however honest fisherman and laborers, along with three three other kinds of man.  Crown the killer, Sportin' Life the drifter, and Porgy the beggar: three data from America's long assault on black manhood.  Porgy is not the only one disabled; but he is the one who, in submission to love, can become a good man.  Bess is what she must be, abused and brutalized, used and commodified; yet she hears the call of love and knows what it demands of her.  We do not know at the end whether her life instinct will win out.
I can't settle the ancient debate about about how to describe pains and prospects of a people on their way to freedom.  But I note that Porgy and Bess though degraded are not hopeless.  They are on their way to a heavenly land.  And that must be why so many of the best artists, for three quarters of a century, have taken these roles.  Todd Duncan, Anne Brown, John W. Bubbles, Etta Moten, Leontyne Price, William Warfield, Cab Calloway, Donnie Ray Albert, Clamma Dale, Larry Marshall, Simon Estes, Grace Bumbry, Bruce Hubbard, Robert McFerrin, Adele Addison, Norm Lewis, David Alan Grier, Audra McDonald -- I cannot say to those artists, who have walked a road to freedom through these imaginations of white men, that they are race traitors.  I have no standing that empowers such a judgment.
So I am left where I began, in the presence of revelation.  The foundations are shaking.  How did they do it, these dead white men?  OMG.
*"The Gershwin's Porgy and Bess," Richard Rodgers Theatre, New York City, June 14, 2012 (Audra McDonald as Bess, Norm Lewis as Porgy).

Sunday, June 10, 2012

por que



It is written.

-- Matthew 4:4

Human action can be narrated . . . because it is always already symbolically mediated.

-- Paul Ricoeur, Time and Narrative

There was a scream as I stepped out of the elevator.  Somebody died, I thought.  Wouldn't it be strange if it's Mr. Rodriguez?

I turned to the right, then to the left, had the ward in sight, and by now there were multiple shrieks, new entries of a fugal subject, piling on.  Mi padre, mi padre!  Por que?  Por que?

Yes, it was Mr. Rodriguez.  His three daughters, a sister, a granddaughter, nieces and nephews, in-laws, each in turn closing on the bed, touching the dead man's face, clutching his hands, turning away, extending their arms to the sky, then turning back toward the bed.  By the time I entered the room there were people jumping up and down and stamping the floor with both feet, like toddlers in a tantrum.  There were people going rigid and keeling over backward, requiring others to catch them before they hit the floor.  Some of them believed they had a deal with God -- that if they prayed and kept the faith he would rise from this bed and walk.  They felt personally betrayed.

Every word I just wrote is accurate, but in telling the story I show that I was a foreigner here.  I'm an Anglo-Saxon from New England, poor but genteelly so, with manners if not the appurtenances of old wealth.  The script of my people is the stiff upper lip.  We keep going, and our tears are for later, in a private place.  There would be decorous quiet, with Bach's cello suites in the background, and discrete expressions of sympathy in intimate tones.  I had stepped into a different script and I didn't like it.

"Por que, por que?"  Well, why not?  Did you hope that his ravaged organs would toss off their tumors?  Did you think he would live forever?  Did you want him to be immortal and watch all his children die?  Come now!  This is sad and sorrowful, but it's not a personal insult to you!

This was the voice of a counter-transference, an emotion from my own life taking root in a foreign place and time.  It's my business to spot such invasions, to name, disarm and chart them, so that I can walk around them.  This writing is part of my naming.  Not my will but thine.

A counter-transference may be the engine of compassion, or it may be a warning bell.  Perhaps I see a brother or sister, a parent or child, a friend or (in an alternate universe) lover.  Perhaps I see my old enemy, the bully on the playground, the girl who cut me, the friend who threw me to the wolves, the teacher who held me in scorn.  Good can't be done in the abstract, but the flesh is blemished, and we read emotional topography through instruments of our particular historia, informed and deformed.  I understand you only by metaphor, but I must contain the metaphor.  My love is, after all, not exactly like a red red rose.

As I offered to speak prayers of commendation in the wrong language, the priest arrived and I gladly gave stage to him, to his ecclesiastical authority and his sacraments.  They quieted for him -- calma te -- but as he left the fugue was starting up again.  And now Alice the social worker, as hopelessly Anglo-Saxon as I, appeared at the door.  We locked eyes across the room, dos gringos stranded in a ceremony of grief from a strange land, this cantata risen from the soil of a Dominican village.

So here, professionally speaking, was our problem.  In the old country this score could be played out with all its repeats, to the fullest length of hours and days, till grief's first shock was spent.  But this family, whether they liked it or not -- whether we liked it or not -- had to encounter the mores of the hospital, and the hospital's script of grief was more like mine than like that of the grieving family.  This was not a Dominican village, or the family's home, or even a private room.  Something had to be done for the other patient.  As each new cousin entered the fugue -- por que, por que? -- the other man's peace was violated.  He couldn't share this grief; he had his own problems.  And it wasn't just the roommate -- the whole unit was in turmoil.  The chorus of their hallelujahs resounded down the hallway.  A dozen families were at the nurse's desk, asking for respect, and quiet.

The floor staff rolled the roommate's bed into the corridor.  And this is what Alice and I did.  We spoke, inadequately, of our sorrow at their loss.  We confided in Luz, one of the daughters, who had leadership quality and a little more English than we had Spanish.  Luz alternated between her tears and her guidance of the family, and one by one and two by two, we escorted them to the lounge, where they could commiserate at greater distance from other families.  There they told us they were waiting for Mama, the wife now widow, who lived only a short distance away, was walking here and would say her good-byes in person before the body could be moved.  Who could say no?

Mama came to the bedside, and her grief was a great one, and they all came back in the room to comfort her, and the fugue started over -- por que, por que -- and then, one by one and two by two and three by three, Alice Luz and I brought them back again to the lounge.  And we sat with them.  I met the granddaughter appointed to be health care agent, but who had been overwhelmed by her elders and their powerful scripts of grief.  And I met the grandson, just arrived from Cambridge where he was studying law at Harvard.  And something began to turn.  Conversations in two languages began to flow.  Telephone calls were made to yet more family members, in other boroughs, other states, in the home island.  The funeral director was called.  The body would be moved, and the family would meet at home.  They were moving on.  Mama asked me to pray for her, and with Luz's help and with Mama's hand in mine I said words of blessing and hope, that even now something wonderful can happen.  As Samuel Beckett has written, something was taking its course.

I wasn't the ideal person for the situation.  My empathy was far from perfect.  This was difficult.

Sunday, May 20, 2012

far away



Power tends to corrupt.

-- Lord Acton

Cursed is the ground.

-- Genesis 3:17

A long time ago, in a hospice far far away that doesn't exist any more, I sat in a super-heated atmosphere listening to an official of the state board of health.  We had been through an ugly patch with the board of health, who had made it very clear that they could shut us down if we didn't prove in forty days (interesting, those biblical overtones) that we had fixed certain problems.

These deficiencies of the long ago far away hospice were not of a kind that would raise your blood pressure, reader.  We had not stolen money for crackpot investments, or abused our patients, or shorted the sheets, or worn funny hats to a funeral, or prescribed the wrong medicines.  No one accused us of theft or maleficence.  Our sins were procedural.  But we had been within forty days of being shut down for them.

In hospice, an interdisciplinary team delivers specialist-level palliative medical care.  There are many openings in this legal definition that invite an inspector's probing.  To the regulatory mind, it means we must prove not only that we take care of our people, but that the clinician of each discipline is executing a specific plan for that care, and that our plans are undertaken at all times in collaboration with all the other disciplines, because if we do not collaborate then we are not inter-disciplinary.  (Every time a clinician writes the word "collaborate" in a clinical note, a hospice manager gets her wings.)

We must therefore meet in certain groupings at certain times and talk about certain subjects in a certain order, and we must record those conversations in a certain language on certain forms by certain deadlines.  This all takes a certain amount of time which, we grumble, would be better spent taking care of our people.  But there are agents whose operating assumption is that we are thieves, and we have to defend our virtue and our mission from them.

I was sitting, long ago and far away, around the table with a medical director, nurses, social workers and our supervisors.  There was fear in the room, and there was madness.  This was the interdisciplinary team.  The eyes of the clinicians were weary and shifty.  The eyes of the supervisors had glazed over.  The forty days were now past, we had not been shut down and we were on the road to forgiveness, but the regulators had smelt our fear, and had come back with more suggestions.

This is what the regulator said that morning.  The pattern of our visits was not regular or specific enough.  Each of us had to choose a specific schedule of visits for each patient and stick to the schedule.  If I said I would visit a client twice a month, I had to be appear every two weeks by the calendar, at intervals of neither more nor less than fourteen days.  If I chose the weekly schedule, I had to visit on the same day of the week each time.  If I chose the monthly schedule, my visits had to be twenty-eight days apart precisely (certainly not on the same date each month because, given the occurrence of weekends and the variation in the lengths of months, that would produce irregularities).  No kidding, that is what she said.  Nurses and social workers were to observe similar rigors, according to their different caseloads.  Anything else was non-compliant.  Anything else could get us shut down.

In the silence that followed her leaving, I wish I had said something like this:

"The instructions you've just heard are impossible and toxic.  We cannot do this and we ought not to.  It would be malpractice.  So we must be creative.  We must appease this person's anxieties while protecting ourselves and our clients from her fancies."

Sometime it's a chaplain's job to say that kind of thing.

The whims of regulators are as real as tumors, and as necessary to address; but we can't let whims define the mission.  Sick people's needs don't go by the calendar.  Death doesn't follow doctor's orders or state regulations.

What was said to us ought not to have been said.  Spoken to people who had been through what we had been through, these words were harmful.  There was a drunkenness here, a Speaking While Intoxicated with power of the state.  But how did it come to this?  What had we done to deserve it?

A friend of mine who is an airline pilot says that every dial and display in the cockpit is a monument to some catastrophe.  In the same way, every regulation is a monument to some moral outrage, some theft or perversion of care, some harm done by malice or incompetence.  But whose maleficence, whose incompetence are we paying for?

Not ours, we say.  I'm not abandoning or abusing patients, stealing money or selling pharmaceuticals for profit.  I'm one of the good guys.  I'm not part of the problem.  I'm part of the answer to the problem.  Why must I pay the price?  And why must my clients pay the price of my distraction?

The great sad truth is that we don't have to deserve it, but we'll pay the price anyway.  The ground is already cursed, because someone did terrible things somewhere sometime, and we're all of us potential sinners, if not in our own eyes then in the eyes of others, and we must endure the suspicion of those others in order to win their provisional and imperfect trust.  We dream of working in the freedom of our honesty and virtue, doing what seems best in the moment when it seems best to do it, knowing that we mean well and have some skill to do good, sometimes making mistakes but subject to correction.  But that is a dream of paradise, lost long before the age of $646 toilet seats and of lawyers who chase ambulances and of bishops who protect pederast priests and of banks who grow too big to fail by lying about the value of assets.  So a chaplain or doctor -- or for that matter a banker -- who thinks they can work without regulation is a moral idiot.

I suppose that's what generations of theologians are driving at when they say the words "original sin."  You can't just do good, because that option was lost long ago.  All you can do is the best you can do, deformed as it is by ancient wrong, unassuageable suspicion and institutions created to disarm it.  That's all you have to justify yourself with, and sometimes it doesn't seem like much.

That far away, long ago hospice did not die right away.  It lingered on for a few years, mortally demoralized, but never really recovered from the shock, or from hasty systemic changes demanded by state power.  The wisest course, it seems, is not to let the powers get angry with you in the first place.

You can't recruit hospice clinicians by showing them the forms they'll fill out.  You must attract them by showing them the people they will serve.  We mad folks do the work in faith that our benevolence, diligence and compassion are the client's best protection.  Regulators do their work in faith that regulations are the best protection.  The two faiths are not equivalent, and there will never really be peace between ministry and regulation.  That's why those who rise to management of this impossible abyss deserve our compassion: there's no way to do what they must do.  Yeshua said that we should render unto Caesar what is Caesar's and unto God what is God's, but what if Caesar and God claim both sides of the coin?  The only hope is a sort of finesse -- well, let's call it creativity.

Showtime.