Saturday, February 16, 2013

THE JAMA POEMS

Ibergekumene tsuris iz gut tsu darshtellen--Yiddish proverb
(It is good to depict overcome sorrow)


In the last twenty years, I've had five poems published in the Journal of the American Medical Association.  I recently read all of them together for the first time, and decided to include them in an essay.  I came to this decision because all the poems deal one way or another with one theme: death. I thought it might be interesting to document one individual's take on a subject of interest to all, since we all must die. The poems form a progression; my view of death has evolved over the years; as is the case with most people who live long enough  Fear of death gradually has turned into peace and acceptance of the inevitable.  The old witch is shrinking--and, she might add, so are you.  Only one of us, however, smiles.


1. The First Poem

AWAKE

We may be planning a fresh start,
a promise finally to be
the model spouse and parent,
or compensate ourselves with art;
yes, we'll give up our silly jobs
perhaps as early as next year...
Meanwhile, inside arteries,
fat chokes the flow to the heart.

Some day we'll finish War and Peace,
visit China, shout, perform Chopin,
play hide-and-seek through rolling fields
with someone we finally love...
Our hungry minds imagine feasts,
yet body has another calendar:
an invitation underground
arrives as the heart skips a beat.

Brain waves on a deep-sleep E.E.G.
look like whorls of a thousand-year oak;
the archpattern flows, like variations
by Bach, written to put some
insomniac tyrant to sleep...  Awake;
no music stills our tyrant, deaf,
like T-waves rising on an E.K.G.,
ready to strike like a snake.

Thomas Dorsett, JAMA, January 8, 1992




This poem reminds me of someone in a bare room while the walls slowly yet inexorably close in from all sides.  Here death spoils everything; the resultant anhedonia stems from a keen awareness of inevitable annihilation. Life is viewed as being replete with memento mori, such as the heart skipping a beat.  "Our hungry minds imagine feasts"--the present contains no feasts for the poet who is obviously miserable.  No pleasure now; one dreams of pleasure in the future, but death is sure to intervene well before the dreams become reality.  The search for happiness is thus illusory.  Death is faced, but not accepted.

Although this poem was published in 1992, I wrote it several years prior to the publication date, when I was in my 40s.


2. The Second Poem

A BIG YES FOR MARIA KREBS

I told her she needed a measles shot;
she remained calm and said nyet.
Would she like spots on her body
instead?  Would she like to be
a red-eyed monster stuck in bed,
allergic to light for a week?
Da!  Maria on her mother's lap,
stubborn and volatile: Russia,
two and two thousand years old,
wasn't going to take pain lying down-

With needles sharper than an MMR's
longer after her nyets became nos,
this ruddy kukla thrashed about
stabbed by headaches.  We were perplexed;
her migraines were upside-down rabbis
fiddling over Vitebsk.  Atypical, we said--
Compared to hers, most headaches are
small as mice on Russian steppes,
still this cub returned to shore
and shook them off like water.

Six months later, she was dead.  She had
some "congenital metabolic disease,"
a billion bloody wrenches thrown by chance
into her mitochondria.  Did Death
like the Fool in Boris Godunov, cry
"Weep, starving people," and have the the last word?
No--She made us see things differently.
So where is Maria, flux and swirl,
still rising through soulscapes called
"Life" by a cosmic Chagall?  Da

Thomas Dorsett, JAMA, January 5, 2000



Maria Krebs was my patient.  Would it be hackneyed for me to write that she was a delight?  Perhaps, but I will write it anyway, for she was a delight: a very curious, friendly little girl.  We related very well to each other.  The family had a biological son and wanted a daughter, so they adopted her from Russia.  When she arrived here at the age of two, she had to get her vaccinations over again, since the vaccinations she received in Russia were considered to be unreliable.  That is why she received her measles, mumps, rubella (MMR) shot and other shots at the age of two--MMR, for instance, is usually given right after the first birthday.  A few years later, "long after her nyets became nos," she began to have headaches.  They were intermittent but became more frequent and severe.  The work-up was negative.  She became acutely ill on two occasions.  She recovered from the first episode after a few days; during the second brief episode, she died.  The preliminary report (I never did receive the final report) was that she died of a rare metabolic disease that affected her mitochondria, which help provide energy to cells.  I still miss her.

There is a marked difference in tone from the first poem.  Although the death of a little girl is an extremely sad event, Maria's life is what is celebrated in the poem.  The author's view has changed from negative to positive, even though death "struck like a snake" and fatally bit a toddler.  Although both poems deal with death, this one is a celebratory outward-looking poem, as opposed to the claustrophobic inwardness of the first one. Maria is depicted in this poem as the force of life itself, stubborn, healthy and unstoppable.  In stark contrast to the first poem, there is here even a hint of some sort of immortality.  Although the reality of death is not denied, life gets the last word which is a defiant da: yes!


3. The Third Poem

ON A WIZARDLESS WARD

About a billion viruses and one
scared diploid version of God' image
struggle under covers.  Vast Ocean,

I am too young, says a drop of free will
cascading into automaton.  Swell;
come, says the encroaching jungle, swell

despite Lasix and drown.  Who's that?
The woman who's known me for thirty-three years
stares at my bed like a stranger--

All dying people are frogs.
Here he comes, says the other blank side of the wall--
I can't stay like this.  And you won't,

says Death; the Good Witch of the North's
wand in an ancient chthonic hand
waves over his head and transforms him--

Another semi-consciousness traveler
halfway to Oz on a bedpan
falls back to Kansas; then Kansas dissolves.

Thomas Dorsett,  JAMA, October 3, 2001

I must confess to not being a confessional poet.  I usually begin a poem by playing around with words; a theme develops, since words mean something.  Then I try to develop the thematic, sonal  and other elements in tandem.  I'm much less interested in expressing myself than in evoking an aesthetic response in the reader.  (I do make demands on the reader, however; since poetry is heightened speech, the meaning is not always apparent at first.  Sometimes the meaning escapes prose altogether; life isn't always logical.)

This is a generic death scene; the unnamed person could be a plumber or a physics professor.  The important thing here is that he is dying.  He pleads with what he calls the "Vast Ocean" (God?) to spare his life, but it is the "encroaching jungle" (Chaos?) which replies.  "Swell," It says; "you are free to imagine becoming the Vast Ocean yourself.  The truth, though, is that you are merely drowning in your own fluids."

In the last stanza, the semi-conscious dying man imagines he's on his way to heaven; perhaps reverting to childhood memories of the famous film, he imagines it as a celestial Oz.  But in a lucid moment, he realizes it's just a fantasy and falls back to earth.  Then everything dissolves...

It is a realistic depiction.  The poet adds no commentary except one: death is referred to as being the Good Witch.  There is thus a hint here of Whitman's famous line, "And death is different from what anyone has ever supposed, and luckier."  This poem is  much less pessimistic than the introverted first poem  After all, who really knows what the Good Witch is up to?

4. The fourth poem

ANOTHER DAY OF NO ATONEMENT

Rise, foam--rage, virtual particles,
what seethes in so-called empty space
might create a better place.

If God is everything, it was by
God's mercy that my patient John
lay dying from histiocytosis X.

Sponge Bob, Maimonides,
cartoons and ancient texts helped,
yet the fever never left him, or me--

Faith, faith.  Life is almost atoms,
swirling in nobody's court, yet
feeling almost lost is almost worse--

Crumbs and bits of almond on my tongue
days after just another death
on a day of no atonement;

six years of innocence gone, sixty
of near-complete exile on this plagued earth;
yet, almost Godless, I reconstruct

a shelter for unmet desire
built on a world made of sand;
tell me, brief sukkah, where is my home?

Thomas Dorsett, JAMA, January 25, 2006

At first reading, this might appear to be a poem describing a man in despair, but it is not.  The progression from existential despair (poem one) to acceptance and peace continues, as an analysis of this poem will make evident.

The first stanza demonstrates the author's life-long fascination with quantum physics.  At the absolutely small level, the tiny Planck length, less than a billionth of a billionth of a billionth of a centimeter, space breaks down into what has been described as a "seething foam."  Virtual particles come in and out of existence, canceling each other out.  Rarely, it is theorized, a particle has enough energy to become "real"--This results in a Big Bang. The universes created in this way might have different laws; the protagonist of the poem is hoping for a universe in which suffering is less rampant than it is in ours.  (This is, of course, wishful thinking.)

The protagonist--both doctor and patient are fictional--has a religious bent, but cannot accept literal belief in an omniscient, omnipotent, benevolent God due to the cruel afflictions mankind is subject to. (The author agrees.)  The "mercy" of the first stanza is stated with bitter irony.  The doctor almost accepts the reductionist worldview that life is ultimately meaningless.  He is bitter over the death of a six year old patient; he also  realizes that he, sixty years old, is simply the six year old five and a half decades later, and will share a similar fate.  It is all so unjust!

Sukkot is a Jewish holiday; it occurs a few weeks after Yom Kippur, the Day of Atonement.  The holiday was originally agricultural in origin.  The sukkot (singular, sukkah) are booths, little shelters in which workers temporarily lived while they harvested the fields.  Sukkot became a religious holiday even in biblical times.  The shelters are to remind one of exodus, when the children of Israel wandered for forty years in the desert, without any permanent home.  Later rabbis wrote that sukkot are to remind us that we are merely pilgrims on this earth, deciduous plants, as it were, completely uprooted at the time of death.

The "almosts" of the poem are a clear indication that the man's faith, while severely challenged, has not been given up entirely.  He builds a sukkah to celebrate the holiday.  (Almond cookies are a traditional food of Sukkot)  He realizes that suffering and death will never allow him to feel completely at home on earth, yet cannot believe that there is a home for him anywhere else.  He would answer the final question of the poem with, "Not there, not there"--nowhere. Still...

There is a time for intense mourning, and the poem describes a man at such a time.  But the "almosts" of the poem and his continuity of tradition are clear indications that this time will pass, and he will return to life, presumably with joy and love and care for others.  It is implicit in the poem that the biblical injunction which he follows, despite being periodically severely tested, is "Choose life."  This is in marked contrast to the protagonist of the first poem; love of life is implicit in poems two and three also.  What's new in this poem,  in contrast to the others, is that faith, despite evil, death and suffering, is somehow still possible.

5. The Fifth poem

THE SPIDER

The harvestman's diminutive brain
contained in a quarter-inch body
easily moves eight Irishman
eyelashes rapidly upleaf or down
or as now, perfectly still,
spread like the spokes of a leprechaun's fan--

The neurons inside a squirrel
do not add up to 100 billion
and probably equal the few million stars
in a dwarf galaxy, yet are,
shall we say, spectacularly adequate--
While waiting for ants in a shoe

the six eyes of a recluse spider
do not cause synapses behind
to constitute a jealous mind;
he bites a two-eyed creature's foot
in defense and not from spite
because the black widow has eight.

Our brains feel so precarious
they sometimes envy flies'--
Have you ever met a ladybug who cares
whether her extended wings
are caught by a draft or a web?
If so, you have a child's mind.

No tarantula fears being buried
alive with a pepsis wasp's larva
--Yet, like him, I have gone
perfectly beyond despair;
my cancerous, his paralyzed body
at peace, despite being eaten alive.

Thomas Dorsett, JAMA, May 15, 2013

What is striking about this poem is its celebration of creation, its obvious delight in the great kaleidoscope of nature.  The protagonist, perhaps more humble now after the tribulations of a long life, is now more interested in little creatures rather than in lions, tigers and bears.  He has a special reverence for those six- or eight-legged beings which others swat, crush or spray without a second thought. Each is an epitome of evolution, and, like Whitman's tortoise, is not to be criticized for not being something else.  The narrator of the poem admires the animal world for its lack of envy, spite, and other negative human emotions. Insects live in the moment, and do not worry about the past or the future.  They have no knowledge of death.

The last stanza deals with one of nature's most striking life-and-death struggles.  The female pepsis wasp seeks out a tarantula and attacks it.  If she is lucky and is able to sting the tarantula, the latter, though very much alive, is completely paralyzed.  She then drags the tarantula to her burrow, and lays one egg upon the body.  When the larva hatches, it proceeds to eat the tarantula while it is still alive.  Darwin believed that it is hard to reconcile a belief in a loving and merciful God with the knowledge of the spider's fate--how could anything other than chance be so cruel?

The cruelty, however, is only by analogy.  The tarantula has no knowledge of its fate.  Only when we imagine that the spider is like a human being being tortured do we feel horror.  If we believe otherwise, and thus anthropomorphize the insect world, we have, as the previous stanza states, "a child's mind."

The last two lines take the poem in a new direction, into the world of humans.  The person with cancer is being eaten alive like the arachnid, and she, like the spider, is at peace, even though she is aware of her condition.  She has transcended her suffering by fully accepting it.  What is the source of her strength? As spectacular as the non-human world is, there is nothing more spectacular than this.

                                                           *

Five poems about death, five poems about life, which evince an albeit non-linear, yet general progression from resistance to acceptance.  It was a good road to take, I assure you--Full acceptance of the human condition gives rise to a freedom that often leads to a feeling of ecstasy.  Whitman knew this freedom, this ecstasy, and summed it all up with three words, written at the end of his life: Joy, Shipmate, Joy!  I am glad I have lived long enough to feel it.  Hope it doesn't take as long for you.


Addendum: the author wishes to thank Charlene Breedlove, an associate editor, of JAMA who was involved in the publication of all of these poems.

A note about the author:  Thomas Dorsett is a pediatrician and a widely published poet.  He is the author of two volumes of poetry, and two collections of poetry in translation.  Approximately five hundred of his poems have been published over the past four decades.  He has taught courses of French and German literature, and will soon be teaching a course on Walt Whitman.  

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