Empty as Lettuce

 "Over the weekend, while the Baby sleeps, the Mother and Husband sit together in the Tiny Tim Lounge.  The Husband is restless and makes cafeteria and sundry runs, running errands for everyone.  In his absence, the other parents regale her further with their sagas. Pediatric cancer and chemo stories: the children's amputations, blood poisoning, teeth flaking like shale, the learning delays and disabilities caused by chemo frying the young, budding brain. But strangely optimistic codas are tacked on---endings as stiff and loopy as carpenter's lace, crisp and empty as lettuce, reticulate as a net--ah, words.   'After all that business with the tutor, he's better now, and fitted with new incisors by my wife's cousin's husband, who did dental school in two and half years, if you can believe that. We hope for the best. We take things as they come. Life is hard.'  

'Life's a big problem,' agrees the Mother....Together, the parents huddle all day in the Tiny Tim Lounge--no need to watch Oprah. They leave Oprah in the dust.  Oprah has nothing on them.  They chat matter-of-factly, then fall silent and watch Dune or Star Wars, in which there are bright and shiny robots, whom the Mother now sees not as robots at all but as human beings who have had terrible things happen to them."  

---Lorrie Moore, "People Like That Are The Only People Here: Canonical Babbling in Peed Onk" in Birds of America (1998)



The title of Moore's story references a comment made by a friend of "The Mother " who is surprised by the "bromides" through which the parents in the ward narrate their experiences. I read that after the publication of the story, that some parents at a hospital near to Moore became upset, thinking that her critique was directed at them.

There is something about Moore's piece that seems to hover at the boundaries of fiction and non-fiction and that could lead an unknowing reader--one unfamiliar with Moore-- to misread her piece and its genre.  I suspect though that these parents correctly surmise that Moore's intent is to expose the conventions of tales of illness (the mandate to "stay positive!"  is fairly conventional these days) to reveal the lack of control that underpins such talk, such posturing.  Yet she also shows that the parents' platitudes serve as important guideposts as they navigate through their harrowing journeys.  For the Mother, who has not yet been fully inducted into this world, they can only seem horrifically discordant, part of the nauseous atmosphere of the ward.

Wine of Christ

"We'll see how the surgery and histology go.  Then we'll start with chemo the week following.  A little light chemo:  vincristine and----"

"Vincristine?" interrupts the Mother.  "Wine of Christ?"

"The names are strange, I know.  The other one we use is actinomycin-D. Sometimes called 'dactinomycin.'  People move the D around to the front."

"They move the D around to the front," repeats the Mother.

"Yup!" the Oncologist says.  "I don't know why--they just do!"

"Christ didn't survive his wine," says the Husband. 

"But of course he did," says the Oncologist, and nods toward the Baby, who has now found a cupboard full of hospital linens and bandages and is yanking them all out onto the floor.  "I'll see you guys tomorrow, after the surgery."  And with that, the Oncologist leaves.

"Or rather, Christ was his wine," mumbles the Husband.  Everything he knows about the New Testament, he has gleaned from the sound track of Godspell.  "His blood was the wine. What a great beverage idea."

"A little light chemo.  Don't you like that one?"  says the Mother.  "Eine kleine dactinomycin.  I'd like to see Mozart write that one up for a big wad o'cash."

---Lorrie Moore, "People Like That Are the Only People Here: Canonical Babbling in Peed Onk" in Birds of America (1998)

Moore's story originally ran in The New Yorker; while there are many passages that more adequately capture the subject matter, tone, and unique style of this piece, oddly enough, this is one that I recall from my initial reading of the piece in the magazine over a decade ago.  Moore's depiction of the typical Oncologist as part mathematician, part "mad, overcaffienated scientist" is exemplified through this dialogue in which the doctor's superficial and somewhat lighthearted description ("Yup!") of the chemotherapeutic agents stands in stark contrast to the desperation, confusion, and enervation of parents in the pediatric oncology ward.

The story is told through the perspective of "The Mother," a writer whose point of view shifts precariously between the darkly comedic and the abject.  Her eighteen month old son has been diagnosed with Wilms' tumor, a kidney cancer, and the reader follows her on her dizzying journey into the pediatric oncology ward and the experiences of parents who endure the ineffable.  The narrator's stream of consciousness disorients and then reorients the reader, revealing that what seems as surreal as a nightmare is actually a reality.

The next entry will also come from this piece. 

A Worn-Out Baseball

"When my father's father died in the French Quarter of New Orleans sixty years ago, the popularly accepted story was that on a humid night in mid-August, he had eaten a dozen bananas and then taken a cold bath.  He was a man of eighty-seven whose life had been a strenuous assertion of his appetites, and this explanation suited him, just as it suited his friends in the French Quarter.  It would be more satisfying to me, it would allow me to feel that I owned my illness, if my urologist were to say: 'You know, you've beat the hell out of this prostate of yours.  It looks like a worn-out baseball.'  Nobody wants an anonymous illness.  I'd much rather think that I brought it on myself than that it was a mere accident of nature." 

---Anatole Broyard, "Doctor, Talk to Me"

Today's selection is taken from On Doctoring: Stories, Poems, Essays edited by Richard Reynolds, MD and John Stone, MD (with Lois LaCivita Nixon PhD, M.P.H. and Delese Wear, PhD). This book is given to all first year medical students in the United States and includes literary works (plays, poems, short stories, excerpts) by dozens of well-known authors on the subject of doctoring and what it entails.  Some of these authors, such as the American modernist poet, William Carlos Williams, were doctors themselves and share their unique insights into the doctor-patient relationship.

Broyard is both wise and humorous in acknowledging the importance of fitting the diagnosis to the patient's needs and personality.  This does not entail misconstruing the illness, but rather shaping the narrative of that illness so that it is consistent with the life of the suffering subject. This is not a small distinction.  In the case of Broyard's grandfather who over-indulged, the tale of  the bananas and cold baths that brought him to his death is wildly improbable, yet nonetheless "fits" the character of the man.  His death, far from happening to him,  is cast simply as the natural culmination of a life lived at a high pitch.   

In the similar case of Broyard himself, it is clear that he desires agency.  He does not want the doctor's reassurance that his prostate cancer is not his fault, a mere chance or accidental happening. Rather, he wants to know that his prostate was expended--hilariously "beat" (got to love that verb choice) through over-use. As Broyard concludes, "If only the patient could be allowed to see his illness as not so much a failure of his body as a natural consumption of it."  

Facing It Part I: Mirror Image

In the first quote from this multi-part series on faces, writer Lucy Grealy describes the "habits of self-consciousness" to which she succumbs in the years following her lengthy bout with Ewing's sarcoma of the jaw.  Diagnosed at the age of nine, Grealy endures 2 1/2 years of chemotherapy, the removal of a third of her jaw,  and dozens of reconstructive surgeries--none of which prove successful.  In this scene, Grealy describes her surprise at seeing her own reflection in a mirror following one of her reconstructive surgeries--an image that immediately dismantles her false sense of confidence by confronting her with a reality that does not coincide with her own perceptions.  What is perhaps most remarkable about this quote is the way in which Grealy uses the mirror image to suggest exposure as opposed to reflection--the gap between how she imagines herself  and how she is seen.  The mirror offers only a temporary answer to the question: "What do other people see when they look at me?":

"Spending as much time as I did looking in the mirror, I thought I knew what I looked like.  So it came as a shock one afternoon toward the end of that summer when I went shopping with my mother for a new shirt and saw my face in the harsh fluorescent light of the fitting room.  Pulling the new shirt on over my head, I caught a glimpse of my reflection in a mirror that was itself being reflected in a mirror opposite, reversing my face as I usually saw it.  I stood there motionless, the shirt only halfway on, my skin extra pale from the lighting, and saw how asymmetrical my face was.  How had that happened?  Walking up to the mirror, reaching up to touch the right side, where the graft had been put in only a year before, I saw clearly that nost of it had disappeared, melted away into nothing.  I felt distraught at the sight and even more distraught that it had taken so long to notice.  My eyes had been secretly working against me, making up for the asymmetry as it gradually reappeared.  This reversed image of myself was the true image, the way other people saw me...That unexpected revelation in the store's fitting room mirror marked a turning point in my life.  I began having overwhelming attacks of shame at unpredictable intervals" (185).

--Lucy Grealy, Autobiography of a Face (1994)

Grealy granted Charlie Rose an interview in which she discusses her book. 

Hair Part IV: High (or Low?) Resolution

In today's quote taken from Margaret Edson's play W;t,  Professor Vivian Bearing reflects on the briefing she receives from her oncologist regarding her upcoming treatment for Stage IV ovarian cancer:


Kelekian: The antineoplastic will          Vivian: Antineoplastic. Anti:
inevitably affect some                           against. Neo: new.
healthy cells, including                          Plastic: To mold. Shap-
those lining the gas-                              ing. Antineoplastic.
trointestinal tract from                           Against new shaping.
the lips to the anus, and
the hair follicles. We                             Hair follicles. My
will of course be reyling                        resolve.
on your resolve to with-
stand some of the more                        "Pernicious" That
pernicious side effects.                          doesn't seem---


Kelekian:  Miss Bearing?


Vivian: I beg your pardon?


Kelekian: Do you have any questions so far?


Vivian: Please go on. 

--Margaret Edson, Wit: A Play, (1999)

Boundaries Part VI: Inconceivable

In this final selection for "Boundaries" I offer you the gift of a poem by Donald Hall from his collection, Without, which documents his wife Jane Kenyon's bout with leukemia and eventual death in 1995 at the age of forty-eight. Today's quote is the third section of "Song for Lucy." It features an object--a tourmaline ring--that underscores the boundary between life and death, the material embodiment of their desperate hope.

     Alone together a moment
on the twenty-second anniversary
     of their wedding,
he clasped her as she stood
     at the sink, pressing
into her backside, rubbing his cheek
     against the stubble
of her skull. He gave her a ring
     of pink tourmaline
with nine small diamonds around it.
     She put it on her finger
and immediately named it Please Don't Die.
     They kissed and Jane
whispered, "Timor mortis conturbat me."

--Donald Hall, Without, (1998)