"The great aim of education is not knowledge but action" -Herbert Spencer

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Once upon a time a Canadian Cowboy met a Californian Carebear and fell into a blissful love affair. Their love blossomed into a nurturing partnership fueled by their mutual dream of a sustainable future built on the compassionate understanding of interconnectedness between all persons, places, and things. Welcome to our rose-colored reality.

Wednesday, February 2, 2011

Joan Didion's 'On Self Respect'

(found this essay through a friend's post about another blog that posted the very same essay and thought it too brilliant not to re-post)

Once, in a dry season, I wrote in large letters across two pages of a notebook that innocence ends when one is stripped of the delusion that one likes oneself. Although now, some years later, I marvel that a mind on the outs with itself should have nonetheless made painstaking record of its every tremor, I recall with embarrassing clarity the flavor of those particular ashes. It was a mater of misplaced self-respect.

I had not been elected to Phi Beta Kappa. This failure could scarcely have been more predictable or less ambiguous (I simply did not have the grades), but I was unnerved by it; I had somehow thought myself a kind of academic Raskolnikov, curiously exempt from the cause-effect relationships which hampered others. Although even the humorless nineteen-year-old that I was must have recognized that the situation lacked real tragic stature, the day that I did to make Phi Beta kappa nonetheless marked the end of something, and innocence may well be the word for it. I lost the conviction that lights would always turn green for me, the pleasant certainty that those rather passive virtues which had won me approval as a child automatically guaranteed me not only Phi Beta Kappa keys but happiness, honor, and the love of a good man; lost a certain touching faith in the totem power of good manners, clean hair, and proved competence on the Stanford-Binet scale. To such doubtful amulets had my self-respect been pinned, and I faced myself that day with the nonplussed apprehension of someone who has come across a vampire and has no crucifix at hand.

Although to be driven back upon oneself is an uneasy affair at best, rather like trying to cross a border with borrowed credentials, it seems to me now the one condition necessary to the beginnings of real self-respect. Most of our platitudes notwithstanding, self-deception remains the most difficult deception. The tricks that work on others count for nothing in that well-lit back alley where one keeps assignations with oneself; no winning smiles will do here, no prettily drawn lists of good intentions. One shuffles flashily but in vain through ones’ marked cards the kindness done for the wrong reason, the apparent triumph which involved no real effort, the seemingly heroic act into which one had been shamed. The dismal fact is that self-respect has nothing to do with the approval of others – who we are, after all, deceived easily enough; has nothing to do with reputation, which, as Rhett Butler told Scarlett O’Hara, is something people with courage can do without.

To do without self-respect, on the other hand, is to be an unwilling audience of one to an interminable documentary that deals one’s failings, both real and imagined, with fresh footage spliced in for every screening. There’s the glass you broke in anger, there’s the hurt on X’s face; watch now, this next scene, the night Y came back from Houston, see how you muff this one. To live without self-respect is to lie awake some night, beyond the reach of warm milk, the Phenobarbital, and the sleeping hand on the coverlet, counting up the sins of commissions and omission, the trusts betrayed, the promises subtly broken, the gifts irrevocably wasted through sloth or cowardice, or carelessness. However long we postpone it, we eventually lie down alone in that notoriously uncomfortable bed, the one we make ourselves. Whether or not we sleep in it depends, of course, on whether or not we respect ourselves.

To protest that some fairly improbably people, some people who could not possibly respect themselves, seem to sleep easily enough is to miss the point entirely, as surely as those people miss it who think that self-respect has necessarily to do with not having safety pins in one’s underwear. There is a common superstition that “self-respect” is a kind of charm against snakes, something that keeps those who have it locked in some unblighted Eden, out of strange beds, ambivalent conversations, and trouble in general. It does not at all. It has nothing to do with the face of things, but concerns instead a separate peace, a private reconciliation. Although the careless, suicidal Julian English in Appointment in Samara and the careless, incurably dishonest Jordan Baker in The Great Gatsby seem equally improbably candidates for self-respect, Jordan Baker had it, Julian English did not. With that genius for accommodation more often seen in women than men, Jordan took her own measure, made her own peace, avoided threats to that peace: “I hate careless people,” she told Nick Carraway. “It takes two to make an accident.”

Like Jordan Baker, people with self-respect have the courage of their mistakes. They know the price of things. If they choose to commit adultery, they do not then go running, in an access of bad conscience, to receive absolution from the wronged parties; nor do they complain unduly of the unfairness, the undeserved embarrassment, of being named co-respondent. In brief, people with self-respect exhibit a certain toughness, a kind of mortal nerve; they display what was once called character, a quality which, although approved in the abstract, sometimes loses ground to other, more instantly negotiable virtues. The measure of its slipping prestige is that one tends to think of it only in connection with homely children and United States senators who have been defeated, preferably in the primary, for reelection. Nonetheless, character – the willingness to accept responsibility for one’s own life – is the source from which self-respect springs.

Self-respect is something that our grandparents, whether or not they had it, knew all about. They had instilled in them, young, a certain discipline, the sense that one lives by doing things one does not particularly want to do, by putting fears and doubts to one side, by weighing immediate comforts against the possibility of larger, even intangible, comforts. It seemed to the nineteenth century admirable, but not remarkable, that Chinese Gordon put on a clean white suit and held Khartoum against the Mahdi; it did not seem unjust that the way to free land in California involved death and difficulty and dirt. In a diary kept during the winter of 1846, an emigrating twelve-yaer-old named Narcissa Cornwall noted coolly: “Father was busy reading and did not notice that the house was being filled with strange Indians until Mother spoke out about it.” Even lacking any clue as to what Mother said, one can scarcely fail to be impressed by the entire incident: the father reading, the Indians filing in, the mother choosing the words that would not alarm, the child duly recording the event and noting further that those particular Indians were not, “fortunately for us,” hostile. Indians were simply part of the donnee.

In one guise or another, Indians always are. Again, it is a question of recognizing that anything worth having has its price. People who respect themselves are willing to accept the risk that the Indians will be hostile, that the venture will go bankrupt, that the liaison may not turn out to be one in which every day is a holiday because you’re married to me. They are willing to invest something of themselves; they may not play at all, but when they do play, they know the odds.

That kind of self-respect is a discipline, a habit of mind that can never be faked but can be developed, trained, coaxed forth. It was once suggested to me that, as an antidote to crying, I put my head in a paper bag. As it happens, there is a sound physiological reason, something to do with oxygen, for doing exactly that, but the psychological effect alone is incalculable: it is difficult in the extreme to continue fancying oneself Cathy in Wuthering Heights with ones head in a Food Fair bag. There is a similar case for all the small disciplines, unimportant in themselves; imagine maintaining any kind of swoon, commiserative or carnal, in a cold shower.

But those small disciplines are valuable only insofar as they represent larger ones. To say that Waterloo was won on the playing fields of Eton is not to say that Napoleon might have been saved by a crash program in cricket; to give formal dinners in the rain forest would be pointless did not the candlelight flickering on the liana call forth deeper, stronger disciplines, values instilled long before. It is a kind of ritual, helping us to remember who and what we are. In order to remember it, one must have known it.

To have that sense of one’s intrinsic worth which constitutes self-respect is potentially to have everything: the ability to discriminate, to love and to remain indifferent. To lack it is to be locked within oneself, paradoxically incapable of either love or indifference. If we do not respect ourselves, we are the one hand forced to despise those who have so few resources as to consort with us, so little perception as to remain blind to our fatal weaknesses. On the other, we are peculiarly in thrall to everyone we see, curiously determined to live out – since our self-image is untenable – their false notion of us. We flatter ourselves by thinking this compulsion to please others an attractive trait: a gist for imaginative empathy, evidence of our willingness to give. Of course I will play Francesca to your Paolo, Helen Keller to anyone’s Annie Sullivan; no expectation is too misplaced, no role too ludicrous. At the mercy of those we cannot but hold in contempt, we play roles doomed to failure before they are begun, each defeat generating fresh despair at the urgency of divining and meting the next demand made upon us.

It is the phenomenon sometimes called “alienation from self.” In its advanced stages, we no longer answer the telephone, because someone might want something; that we could say no without drowning in self-reproach is an idea alien to this game. Every encounter demands to much, tears the nerves, drains the will, and the specter of something as small as an unanswered letter arouses such disproportionate guilt that answering it becomes out of the question. To assign unanswered letters their proper weight, to free us from the expectations of others, to give us back to ourselves – there lies the great, the singular power of self-respect. Without it, one eventually discovers the final turn of the screw: one runs away to find oneself, and finds no one at home.

Monday, January 31, 2011

Doctor Death


Photo by Phil Spiegel

Since a child I could feel a wind in my bones, something stirring under my skin, in my breath, in my bloody, pumping heart. Attention defective, speech impeded, psychologically charged, there were plenty of things to calculate and point to, but above and despite them was that same shapely shivering of my veins, the call of the moon, the hum in the trees. Something else ... something else...

I remember a distinct feeling on my 14th birthday, from nothing in particular, that I was destined for something, that I had a gift to be discovered. Dismissed as wanton importance I forgot about my youthful insight.

Long past the years and with them came too many passings of friends and family...

SR - 15 - leukemia
PH - 42 - Chron's
CA - 49 - heart attack
P - 24 - suicide
PPS - 90 - stroke, old age
ABS - late 80s - heartbreak, old age, diabetes
LEA - late 80s - kidney failure, diabetes
JB - 50 - heart attack
IH - 70s - medical complications
and just last month,
PS - 23 - medical complications

...to name a few. And to become so intimate with Death, comes a change inside, a determined fight weathered by a complacent acceptance. To digest tragedy with such calm sharpness is both a gift and a curse. I oft wonder where go my sentiments seemingly un-felt... do they hover unknown and ominously? do they dissipate in the beckoning winds? do they flutter constantly in my belly and root in the ever myserious faceless pain of my chest? Or is this my staff and sword?

Then some more years passed and I approached the time for my medical school departure. Floating back in time across a daylight dream, I remembered that distinct sensation and uttered aloud, "Oh I see now. I'm a healer."

Though my plate piles high it turns to stone and stands unwaveringly, but curiously weightless. And with each vivid crest I absentmindedly close my eyes and contentedly await the crushing waves, washing and drenching, but recoiling all the same. The ebb and flow of death and rejuvenation that turns the world over both steals my breath and fuels my flames and it is this constant cycling that forms the rungs of my ladder. I fall from time to time but somehow I never lose my ground. This is what keeps me bloody and pumping, this I know and this I trust.

So be it, a graceful torture, my gift: Doctor Death.

I welcome it all.

Monday, January 10, 2011

The Potential

Last week, over a GnT, my fellow clinic officers were giving me the low down on the psych clinic I'll be co-managing for the next two years. As is expected in a bitty place like Cowtown, one officer ran into an old fling at the bar. With mild discontent, she turned to me and asked if I were dating anyone, and, as is expected with a love-drunk, heartbreak veteran like myself, my romance skeptic answered first, "maybe," trained never to assume the best but always the worst (in this case, it's in my head or a ploy of ill intent). Being a third year she instinctively offered my lowly M1-ness some advice, or really, no advice at all, to just "go for it," saying this is the year of exploration. She told me about her first med school interests: the first was "false" and the second was "too good." With the last she explained, "not 'good' in the sense that I'm not worthy, but that I'm too..." and here she quoted an old movie I thought no one watched: Anne of Avonlea. Anne's best friend Diana has just accepted a marriage proposal to a good man, much to Anne's dismay:

Anne Shirley: Fred is... extremely good.
Marilla Cuthbert: That is exactly what he should be! Would you want to marry a wicked man?
Anne Shirley: Well, I wouldn't marry anyone who was really wicked, but I think I'd like it if he could be wicked and wouldn't.

There's a precise moment when you meet someone new when you know beyond doubt whether or not they are going to understand you. This was it. "Exactly," I replied with flourish. It's not that she and I are wicked but we've mischeviously flirted with that edge, well intended of course, and to find a kindred spirit in another would be to match heart to heart, the same potential for... cleverly playful behavior. What is intriguing about this new development of mine, is that, new for me, his cards are played close to chest and I, for once, can't read him with the definitive reassurance I usually have. I suppose this is what everything is supposed to be like, not to know, but to play to find out.

Wednesday, November 17, 2010

Serotonin

"If you're happy and you know it clap your hands..."

As bitty-bye kinderkids, we learn our lefts and our rights, our rights and our wrongs. We learn to share, we learn to care. We learn to stand up and to sit down, to speak up and to speak out, to zip, buckle, and bow. We learn to dot, we learn to cross, and to stay inside the lines. Simon says this and simon says that and we eat it up with our paste and crayons.

As young adults with our growing pains and acne, we learn ego and we learn id. We learn judgment, we learn rejection. We learn to question. We learn to challenge. And we start to change.

As masochistic medical students we learn our limits. Fifty two lectures on a quiz, thirty six hours on a shift, and twenty four usable hours in a day. We learn to count down, we learn to cross fingers, we learn to never give up ever ever ever. But we're never taught how to be happy. We're never taught how to live with life. We're never taught keeping in touch and how to sleep in. We're never taught how to relax. We're never taught what defines friendship. These are things we find, things we pick up, things we cope with.

Slowly I've given up my destracting, destructive vices, one by one, and I'm now left with this gaping void, this vulnerability, just skin deep. I feel a fragility in my breath and slowly am coming to realize that I'm finally catching up with myself. It's like the blood has finally rushed back into my body, as if I've been dead for these past 25 years. It's a peculiar thing to describe. I've been lost for so long, and now that I am finally exactly where I mean to be, I can finally take the world off my shoulders, put down my bags, and call this home.

Time to time when I'm driving home from school the waves crest and crash and it sucks the air right out of my mouth. I cry. I cry like a little baby. And I have no shame about it. Because I made it, despite it all, I made it. It's overwhelming, this gift. And it's becoming harder to forget how lucky I am to be here.

This is home.

This is me.

This is mine, my one and only.

Saturday, October 23, 2010

You, Me, And Everything In Between

(photo: the late Francesca Woodman)
While getting my regular Radiolab fix this morning with Jad and Robert, I began a decent into my introspective meaty bits (I could lose days to this obsession of mine). The selected episode of the day was one analyzing the roots of fate and fortune. In one section, they suggested that good fortune in life may began early on in youth when a child learns about delayed gratification and how that leads to aiming higher and achieving greatness. Now I'm am not a greedy person but I have been known to indulge in the occasional immediate desire. Though I appreciate the benefit of self control and investing in the future, I don't believe in constant denial. All things in moderation, right? At the heart of Buddhist principle is spontaneity and how can one live in the moment if one is constantly focused on an undetermined, unpromised next event? On the other hand Buddhism is all about not giving into desire for desire is suffering ... so in the end I'm just as conflicted as the next kid. I believe in a bright, shiny future, but I have no illusions about entitlement. What I know for sure, as much as you can know anything for sure, is what I have right now and I'm not about to deny that in lieu of a dream, though I dream heavily and dream big. Does that make me less likely to succeed, because I flirt with the present? That seems pretty shitty. In fact, I'd be ok achieving less if it means I get to live a little.

Granted they presented all sorts of convincing data in favor of this idea, success still seems to stem more from a growing sense of self worth and confidence. In effect, good fortune comes from within, from this thing we call self esteem. Growing up and going through all that yucky life stuff like death, rejection, failure, betrayal, &c, I developed this sense that if I wanted anything I'd have to fight for it. Nothing is going to just majestically flutter onto my plate, I'd have to earn it.... and even then it's no guarantee. Hand in hand with that I never gave much thought to how I came off or what people thought of me, I was just too focused on my constant tête-à-tête with reality. Any wax or wane of my self esteem had little to do with my environment and everything to do with my mind, which leads me to my closing argument: perspective is everything.

When realizing that all my previous downward spirals came from an inner battle with myself and not a me-against-the-world phenomena, I had a profound moment of insight. I was choosing to have a shit time with life. Having a bad day was, for the most part, my doing, in the sense that I was choosing to respond with perpetual self deprecation and negativity. What does this have to do with good fortune and success? To bring the pieces together, if I am successful at all, it has little to do with whether or not I deny myself indulgences and everything to do with choice and assuming full responsibility for the ensuing pattern of consequences.

Life is too short and you only get one. So if it hurts, you're doing it wrong.

---

Somewhat related side note: The one thing I can't wrap my mind around in medical school is this notion of prestige. Yes it's a bitch to get in, and yes most people dont, but to me this is just another thing I do. I am uncomfortable with this imagined hierarchy and societal ranking. Maybe I'm missing something but I think we're all tangled up together and that the success of the doctor has just as much to do with the confidence, trust, and respect of the patient and fellow medical staff. They are not mutually exclusive but depend on each other. In relation to self esteem, I suppose this means that if you're feeling low about yourself then I have some shared responsibility to help pick you up again.

We're a team. You, me, and everything in between.

Tuesday, October 19, 2010

Be Cool, Honey Bunny. Be Cool.



What is it about a person that reaches up and grips you, right in the ribs, and holds you? What is it in the look, the touch, the smell of them that peculiarly gathers up the senses into profound liberation? What is it, if a thing, that marks them outwardly to inwardly, for painful lack of expression, as "cool?"

What is this transcending coolness we envy, evoke, and envision? A week or so ago my sister asked me what precisely this cool thing was that we've come to torture over the centuries and what I had to say, I sensed, unsettled her quandary more than quenched. You can look it up, there will be words to dissect words. They have been deemed by Merriam and Webster to be an adequate answer to this inquiry, but if that were all that is "cool," it would soon, in its own due time, fade into a sorted blandness, deprived of all its sensationally capable meaning, as of't becomes of abused vocabulary. It's not merely an aesthetic appreciation, a determined nonchalance, or confronting harmony. It's a breathtakingly pure honesty, rough and raw.

What it is, is something personal, something splendidly oblivious in possession, something that grows in your bones with blood cells, cartilage, and fat. It seeps from your pores and drips from your eyes. It swims under your skin and bounces in your gate. It's unavoidable when it takes you and we all know it, all but you. The most beautiful thing about it is how unaware you are that you have it, and the most excruciating thing about it is how completely aware I am. If it were possible I would pluck out your eyes and exchange them with mine and pull your brain into my bleeding split skull and share my reflections with your blinded hemispheres. Friend, lover, foe, or family, what confirms the suspicion of coolness, just so, is exactly this humbling humbleness, however unintended, however ignorant of that fact. It's a sobering honesty, and enviable oblivion. You just are, and have always been, with suffering justice in terminology, a straight up, brilliant, fucking Cool. Broken, obliterated, fixed, or true, that thing about you that silences the encompassing world is innately indestructible. Fight it and flail all you want, but you'll always be cool.

Thursday, October 14, 2010

Permanence

I have been known to temper my more sinewy thoughts with the occasional free writing exercise on scraps of paper, countertops, book covers, emails, lose them, and then find them years later. And when it happens that I rediscover these portals to a past I claim to forget, I am always caught off guard by how foreign the words sound. It is as if some other force had taken a hold of me and for that moment I am a stranger to myself. The lastest find from mid July 2006 is as follows, from unknown context, unedited, and raw. Enjoy:

If I were to take back my venomous, spiteful, hateful, hurtful, malicious words and pack them in a suitcase, lug that case into the back yard and set it on fire, there would still be ashes left. If I took those ashes and shot them into the ocean from a canon for the whales to suck into their infinite bristles with micro-plankton some Japanese fisherman will harpoon that motherfucker and fry that ashy flesh up and some poor soul will devour that beast only to crap it out into some backed up sewage pipe that'd burst in some field in middle America. Even if the earth were to unite that ashy whale shit with the dirt some plant will sprout out and some cow will eat that plant and that same cow will turn into the bloody lump I eat for dinner with pickles and lettuce. It'll never go away at least not while I keep reminding myself with every night alone, and not while I'm running with no place to go, or searching obsessively for answers in endless pages of fiction. I want to do something stupid. I want to carve my heart out and hang it from my tree. I'll smash it until candy comes out. I'll make soup out of it. Soup's good for you, it's half digested already. Steps one and two are all done, cut and chew, done and done.