Stories of Sickness and Sorrow: Learning from Literary Accounts of Plagues and Epidemics

“There have been as many plagues as wars in history; yet always plagues and wars take people equally by surprise.” Camus, The Plague

Every epidemic and pandemic generates story material; writers in all genres become public witnesses. Classic texts like Poe’s “The Masque of the Red Death,” the plague chapters in Manzoni’s The Betrothed, Katherine Anne Porter’s “Pale Horse, Pale Rider,” Camus’ The Plague and Richard Preston’s The Cobra Event are just a few examples of narratives that invite readers to reflect on what happens to whole populations when, as now, a pathogen multiplies and moves across the landscape and kills.

As cases of the coronavirus mount, I’ve heard from a number of people who are rereading stories about plagues and epidemics for the insights they offer, and the depth perspective they add to daily news updates. Rather than post an overview of plague literature and film here (easily available elsewhere) I thought I’d offer for general reflection the study questions I gave students as we made our way through literary accounts of plagues and epidemics. Looking them over now, they seem to me fairly useful questions to reflect on as we try to consider what to believe, whose accounts to trust, and how to stay compassionate as cases and complications continue to multiply. Here they are. I hope they’re useful!

1.  What specific literary problems confront the writer who attempts to tell the story of a plague or epidemic?  What makes such stories hard to tell?

2.  In what sense is an epidemic always a political event?  Correpondingly, in what ways is a story about a plague/epidemic always a political statement?

3.  What complicates the issue of causality both for the epidemiologist and for the historian or taleteller who write about a plague or epidemic after the fact?

4.  In what ways does heroism as defined in war stories differ from the forms of heroism defined in tales of plague/epidemic?

5.  In what was does a serious epidemic serve as a convenient vehicle for articulating ongoing issues in community life?

6.  How do plagues/epidemics challenge existing authority structures?

7.  What are the incentives to stay in denial after an epidemic is visible?

8.  What strategies of self-protection are typical of what groups when the community is threatened by an epidemic?

9.  How have plagues/epidemics resituated the church in community life?

10.  How does the medical problem of containment become a legal problem?

11.  What are some examples of scapegoating in times of plague/epidemic?  Why is scapegoating such a predictable response to health crisis?

12.  What does your reading about plagues and epidemics suggest about the basic issues public health administrators have to face?

13.  In what conspicuous ways does language become a crucial tool or weapon in time of widespread health threat both for good and ill?

14.  In what ways are plagues and epidemics economic/class problems?   

15.  Who has what incentives to secrecy in times of plague or epidemic? 

16.  What theological problems do plagues and epidemics pose?  How do they raise the predicament of competing moral principles?

The Satisfactions of Insecurity

At one point the institutions for which my husband and I worked both offered retirement planning seminars.  He dutifully went. I didn’t, but felt the nagging guilt of a neglected responsibility all afternoon.  I do believe we have some responsibility to take care of ourselves and the future we may have, so as not to burden our children with expensive care, and so as to care kindly for one another and others as long as possible.  Having said that, I’m led to think about the price we pay for the sense of security that comes with careful planning.

You get a lot of points in this culture for being a good planner.  If you plan ahead, you can save money on season tickets, get special rates on vacation rentals, have your Christmas shopping done before the seasonal frenzy, and avoid last-minute trips to the grocery store before weekend company comes.  Good planning can enhance hospitality and good stewardship.  It can enable us to care for those around us more effectively.  So let me here offer due appreciation to all the good planners in my life, some of whom have compensated for (or borne the consequences of) my own failures to plan well.

Having said that, I want also to reflect on how admonitions to plan ahead often lead me to puzzle again over Jesus’ suggestion that we “take no thought for the morrow.”  It is hard to avoid the challenge those words (and all those lovely lilies and birds of the air) pose to the common wisdom most of us live by.  Taking no thought for the morrow seems—doesn’t it?–a little unrealistic.  Not to mention scary.  And impractical.  Possibly a useful guideline for itinerant missionaries in the first century, but not so clearly helpful for us lot who inhabit the suburbs, invite large groups for holiday dinners, and keep track of our multiplying social and professional obligations on devices with names like “oracle” and “palm pilot.”

In his radical way, Jesus does seem to drive to the heart of our most entrenched concerns for our own comfort, safety and well-being.  The world has always been a threatening place and fear lies at the very core of most human conflict.  We want the security of the womb, the parental embrace, the cave, the castle, the stock portfolio.  The need to feel secure drives an astonishing range of behavior, from purchasing household alarm systems to joining clubs, to supporting the mass-marketing of self-help books, to opting for autos with airbags to making war against dubious enemies and allowing our wires to be tapped and our basic privacies invaded in the name of “national security.”  We lay aside money for retirement, live among the likeminded, and move to safe neighborhoods.  We invest in violence to protect national interests.  At our worst, we protect our sense of safety at others’ expense.

But the sense of safety itself may be a dangerous thing.  WH. Auden’s disturbing little poem, “Leap before You Look” opens with a startling assertion:


The sense of danger must not disappear:

The way is certainly both short and steep,

However gradual it looks from here;

Look if you like, but you will have to leap.


And the last line restates the first in a new key: “Our dream of safety has to disappear.”  Auden wrote this poem in late 1940 as he considered the implications of a world at war for private citizens who might well be required to forfeit the comforts of disengagement in facing competing dangers to life and freedom.  With characteristic bluntness and the curious lilt with which he tended to deliver disturbing news, Auden issues a memorable reminder not to invest one’s sense of safety in the wrong things—not to, as he puts it later in the poem, “consent to live like sheep, and never mention those who disappear.”  The poem is a call to courage—not only the courage to resist the evils of oppression and violence, but more basically than that, the courage to recognize our existential situation:  that whether we “look before we leap” or not, whether we exercise proper prudence or not, and even if we lock our doors, secure our money in safes and banks, and cultivate a diplomatic neutrality in the presence of enemies, we will have to commit ourselves one way or the other to a course of action that involves decision and risk.  To act in this world at all is to step into troubled waters without knowing the depth or the strength of the current.

Literature, from Homer and the Bible onward, provides a long, rich record of those who stepped into those waters, forfeiting common securities for the sake of adventure, in obedience, in curiosity, in loyalty, in response to the call of God.  Those are the heroes.  The villains can be recognized by, among other scurrilous traits, their appetite for control, their drive to provide for themselves and their own security over against that of the community.  They protect their territory, their inheritance, their privilege, their interests.

One of the more interesting recurrent stories about longing for security is the Faust myth.  Told and retold by various writers, most notably Marlowe and Goethe, the story chronicles the downfall of a man of great learning who longs, as Paul put it, to “understand all mysteries and all knowledge.”  But that desire is his undoing.  The dark side of his longing to know is his fear of not knowing—and more than that, his refusal to accept the limits of our condition as beings radically dependent on a God who, insistently paradoxically, invites both our curiosity and our trust.  Our condition, the writers remind us who have probed and retold that story as a warning to the power-hungry of their own generation, is one of fundamental uncertainty.  All of us face a basic choice between trust and the struggle to know and control.  To invest our best energies in the kinds of knowledge that seem to hold some promise of control—that will allow us to stave off disease and death or deflect the enemy’s missiles with “smarter” weapons—risks losing, tragically, the chance we are given to learn the great lesson of love.  Knowledge is good; prudence is good; shrewdness is good.  Love and trust are the bigger virtues, and better.

The lesson of going beyond common sense and legitimate self-interest, as Jesus teaches it, is deceptively simple:  “If you brother asks for your cloak, give him your coat also.”  (This is imprudent.  It might be unsafe.  I might freeze rather than he.)  “You shall beat your swords into ploughshares and your spears into pruning hooks.”  (And with what, then, shall I defend myself when the enemy comes?)  We’re not all David, and Goliath is very large, and his armor thick.  It is hard to imagine that the five smooth stones lying in our path might be enough to stop the hostilities where they begin.

Both the biblical story and the vast repository of wisdom literature afforded in folktales and fat schoolroom anthologies return to this theme with abundant clarity: the security this world offers is a delusion.  The security God offers is a promise.  In God’s kingdom—in the final analysis–he little guy wins.  The child pulls the sword from the stone.  Angels protect the blind man.  The escaped slaves find manna outside their tents.  And even in the moment of violent death a song of exultation rings from the throats of martyrs.

Of course poverty and danger and death don’t always shine with such hope.  Even as I write people are being held and tortured and too many of us opt not to know or act on their behalf.  Children caught in political crossfire are killed. Others are held in cages.  The poor die in squalid back rooms, unattended, and unspeakable crimes are perpetrated on the helpless.  So how is it not presumptuous to insist on the value of letting go, being vulnerable, accepting insecurity?

Even for us, who live in the relative (and precarious) safety of a privileged nation, learning not to live in fear can be a long and repetitive process, especially as conflicting, well-funded news sources market fear in the form of daily crises.  The need for security runs deep, and the deceptive attractions of what the world calls safety has powerful allure.  The messages are incessant:  if we’re sexy enough (thanks to particular products) we’ll be loved.  If we plan carefully enough (with the representative at our local bank) we’ll live comfortably.  If we take vitamin supplements, join a health club, and follow the doctor’s orders, that life will be long.  If we consent to this year’s military budget, and support Homeland Security we’ll have another year of what we may be able to convince ourselves still looks like peace in our land.  These are forms of hardcore “common sense” that compete uncomfortably with biblical wisdom.

Those of us who are believers live in this paradox as we live in all the others Jesus insisted upon.  “He who saves his life will lose it.  He who loses his life for my sake will save it.”  “Let not your hearts be troubled [he said, on the night before his execution]; I have overcome the world.”  He sent the disciples off into threatening and inhospitable situations equipped only with sandals and staff—without even (and this hits close to home for some of us) notes for the public speaking they were to do to doubtful crowds:  “Don’t worry about what you will say.  It will be given to you.”

What if we actually believed the counterintuitive claim that spiritual teachers from Jesus on have insisted upon against all concrete evidence:  You are completely safe.  You are safe in the arms of God.  We sing this, (those of us who are still using the old hymnbooks):  “On Christ the solid rock I stand, all other ground is sinking sand.”  “Leaning on the everlasting arms” we are “safe and secure from all alarms.” I imagine that, even if we did keep our retirement plans and our wall calendars, our lives might look significantly different.  They would certainly be more conspicuously countercultural.  Imagine for a moment what it might be like not to live in fear.  We would say what we meant.  Kindly, one hopes, but clearly, without fear of reprisal.

We would give away money, things, time, much less guardedly.

We would make our decisions in a spirit of deep attention to the call of the moment, listening and moving with the invitation of the Spirit to act, without second-guessing.

We would plan less.  We would let things unfold.

We would behave as children do who know their parents’ watchful eyes are on them—in the freedom of knowing someone will catch them if they fall.

And, to do this, our sense of self would have to run deeper than the self-protective ego that needs and wants and craves.  The self (Jung distinguished it from the ego with a capital S) that God loves and preserves from all harm is larger, deeper, more resilient, more mysterious, and more lovely than the ego-personality-time-ridden selves to which we generally confine our attention.  Socrates’ “Know thyself” is not such a simple matter.  Perhaps it’s not possible here, where our vision of ourselves is clouded, like our vision of everything else, by a glass through which we see darkly.  Perhaps it’s sufficient that we are known, better and more lovingly and thoroughly than we can ever hope to know ourselves.  That the watchful eye of our heavenly parent is, indeed, on us, and will let nothing touch that immortal part that came into this world on a breath of life and is headed, always, for home.

If we realized, even now and then, how securely we are held, if we could meditate on Jesus’ words not to fear those that destroy the body (including the ravages of disease, the mad gunmen, the night stalkers, the makers of weapons, and all those who compensate for their own fears with threats, humiliation, and violence) we might, now and then, look around and recognize in our worldly habitat a playground of possibilities.

I think of the people I know who live like this with amazement and gratitude.  I think of a woman who freely and even delightedly gives away whatever is hers whenever she sees a need because “it’s all God’s stuff.”  I think of my outspoken grandfather who, though he stepped on a few toes, spoke timely truths in startling ways, and went on with his day humming, quite detached from others’ defensiveness.  I think of a friend whose freedom from self-defeating guilt, shame, or self-doubt gives her a generous creative energy and appetite for life that offers those around her some measure of what our various insecurities drain away.  I think, too, of what our nation might be if we expended our efforts on making the rest of the world, instead of just ourselves, secure, asking God to bless everyone—not just America.

It seems to me a self-evident truth that there can be no worldly security where some live in fear.  Fear breeds violence.  “National security” might be better served by devoting the bulk of our money and efforts to helping others feel safe from our own weapons of mass destruction, and from the global threats posed by our own patterns of waste and polluting consumption.  What if we were to trade a bit of our “security” for peace?  What if we were to seek a kind of security rooted in the conviction that “everybody does better when everybody does better”?  Or in the conviction that in Christ we are members of one body, and on this planet members of one human family, whose security is a matter of utter, radical interdependence?  That effort, I imagine, would result in a startling, perhaps alarming shift of focus in everything from foreign policy to habits of consumption to forms of worship.

Security of the kind most of us seek much of the time is a delusion fueled by competition and conviction of scarcity.  But real security is not a zero-sum game.  It can’t be achieved at others’ expense.  And even the inner, personal sense of security we seek in our most private thoughts can only come, I believe, with a widening of heart and consciousness beyond what we have learned to call immediate necessities and personal benefits.  In T.S. Eliot’s magnificent final poems, Four Quartets, the speaker returns repeatedly to the theme of radical insecurity, describing, and inviting the reader, to a state of not-knowing that is both terrifying and liberating:


I said to my soul, be still, and wait without hope

For hope would be hope for the wrong thing; wait without love

For love would be love of the wrong thing; there is yet faith

But the faith and the love and the hope are all in the waiting.  (28)


That kind of security feels a lot like insecurity.  Waiting on God, listening into the silence when we want words, hoping for a sign when no risk assessment offers sufficient information on which to plant our next step, daring to love when love seems self-defeating—these are hard assignments—at first.  But there is a habit of mind and heart, attested to by the faithful over the ages, that learns to rest in uncertainty, embrace the silence, and take the risks with downright delight in what looks like foolish abandon.  A mind transformed in this way knows that the security God offers is not a promise about what won’t happen, (we’ll be kept safe from plagues, bombs, and sudden poverty) but about what will happen:  “though I descend into the depths of hell, behold even there they right hand shall hold me.”  The Psalmist appears to have recognized the distinct possibility of descending into Sheol.  His comfort lies not in avoiding that disaster, but in knowing God will accompany him even there, and that his loving presence will suffice.

Investing our hope in the security of retirement plans, smart bombs, or even seat belts is clearly hope for the wrong thing.  Loving our way of life, or even life itself, in this world, in this body, on these terms, is love of the wrong thing.  One reading of these lines suggests that faith, hope, and love, the three great “theological virtues” inhere in the state of waiting that asks not what comes next and how can I prepare for it, but of standing before the Divine Presence in readiness for whatever the moment brings, poised to welcome whatever is next from the Master of Surprises.

A line in William Stafford’s poem, “You and Art,” offers this reassurance:  “you live on a world where stumbling / always leads home.”  We do.  Directionless and uncertain as we may feel, we are led, often despite ourselves and even unaware, toward the arms of a love that will not let us go.  Believing that, our insecurities are transformed into the curiosities and surprises of a journey offered for our learning, whose risks are not ultimate, and whose rewards may reveal themselves belatedly and in unsettling ways that take us beyond and behind every small false hope to what we hardly knew enough to hope for.

Responsible Science

“. . . it is precisely the “objectivity,” the moral neutrality in which the sciences rejoice and attain their brilliant community of effort, that bar them from final relevance.”

                                                                                    — George Steiner

Reading Steiner is a slow business.  Several times on any given page I come upon a sentence so arresting, I can’t go on, but have to pause and take it in and reflect, usually with surprise and gratitude, on what it has disclosed.  This is one of them—not even the whole sentence, but a thought about science that might seem heretical to some of the scientists I know—or a harmless notion that only scientific outsiders would indulge in.  Steiner is a philologist, so, though he is one of the finest minds of his generation, what does he know about science?

But I believe most of us know, and have known for a long time, that science is never morally neutral—that the ways information is gathered and analyzed and assessed and reported and put into practice are morally significant at every step.  Who pays for research, how the experiment is designed, what is excluded, when results are deemed sufficient, and why some results never get reported all matter in more ways, I think, than we are trained to imagine.

We need that training—at least enough of it to ask the questions.  We can do this ourselves.  It doesn’t take expert instruction to teach ourselves to ask the fundamental questions that always deserve to be raised about human endeavor: What is the stated purpose?  Might there be other purposes?  Who is involved and what are their vested interests? What tradeoffs might be involved in pursuing this objective or outcome?

At the beginning of his fascinating book The Poetics of SpaceGaston Bachelard makes the deceptively simple claim, “There is no such thing as neutral space.”  Every space humans inhabit is charged with intention and effect and meaning, or, if you’re inclined to think in these terms, with vibrations and energies, currents and flow and feeling.  There is no such thing as a neutral lab.  But I remember a more or less friendly argument with a scientist I knew who insisted with some vehemence that it was not his job to speculate about the moral implications or possible misuses of the information he managed to uncover.  Einstein would have disagreed with him; his famous “Woe is me” after hearing of the bombing of Hiroshima was one of the more sobering moments in the moral history of science.

The friend who refused moral responsibility worked for a university, as many do.  The results of his work belonged to the university. More and more, information is owned and protected, commodified and sequestered for the use of those who can profit from it.  As soon as it becomes property, it ceases to be “objective,” if it ever was.

We in the West have invested a lot of faith in objectivity, but over the past century the myth of objectivity has given way to different understandings of how we come to “know” what we think we know, how qualified our knowing is, and how mysterious, how at the edge of our knowing we always face “the great mysterious.”  Scientists who acknowledge that, who are capable of allowing for ambiguities and uncertainty, who are able humbly to qualify their certainties, who resist reductionism, are the ones I trust.

They’re out there. They pay attention to their intuitive moments.  They know they’re subjects with subjective feelings and points of view.  They know their curiosities emerge in the soil of personal history.  When they have a choice they choose their research paths out of an attraction we might call love.  They work meticulously with the tools they have, hoping not to do harm, knowing they could, treading lightly on what—even though the university or the industry owns it—is, after all, holy ground.

Watching Others Grow Old

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I’m thinking, I’m so glad this isn’t going to happen to me.

It seems like a terrible fate, to drag out your trash bags

and then head for a facility somewhere.

— from “Jane” in Imperial by George Bilgere

I’ve just reread George Bilgere’s unsettling poem, “Jane.” In it, the speaker gazes across a wintery urban street at an old woman moving her heavy trash bags. He thinks about the difficulties of growing old. He doesn’t want to grow old. He somehow doesn’t think he will. He stays on his side of the street.

The thing about the speaker, I’m thinking (I’ll call him Joe) is that he’s a thoughtful guy. At least he thinks he is. Also probably one of the few who pauses in the street when it’s cold, even snowing, to pay attention to Jane.

He does pay attention. There’s a lot of attention in this poem. That’s the great thing about this poem — how it gets you to pay attention to attention.

Joe (we’ll call him) notices how heavy Jane’s trash bags are. His unusual aesthetic sensibility is worth noticing — how he watches the bags turn white and gradually disappear. How the grey colors of winter provide a kind of setting for this poem. That Joe is composing, even as he watches Jane “taking out her ominous trash bags.”

“Ominous.” That‘s good. It goes with “black” and “vanish” and “terrible fate.” And all those good verbs: Jane is “lugging” “dragging.” He really got something about what’s weighty and dark.

Joe knows how to do point of view. Someone taught him how to situate himself early on, relative to the object of attention — like learning how to establish lines of perspective in “Drawing I.” Jane is across the street. They chat on the sidewalk — a kind of neutral space between his world and hers. Public space, where private lives turn into theater.

And Joe is self-aware. He knows we’ll think the poem is about Jane. Then we’ll see that it’s really about him. How he’s claimed his own life and intentions, how he owns them, how he’s learned a kind of acceptance of what is, of a good life within reasonable limits.

Jane’s a good foil for that. Joe doesn’t want to be Jane. We don’t want to be Jane.

We don’t, I think, want to be Joe either. This poem makes me think about why I don’t want to be Joe.

I don’t like Joe. Which makes me sympathize with Jane. So I start imagining Jane’s life. Jane is old. If I get the blessing of long life I’ve been conditioned to hope for, I’ll be Jane. I think about what it’s like to be old.

Trash bags are heavier.

You don’t take down the heavy bowls, even though you’ve always loved to make the bread in crockery rather than lightweight plastic. You hate plastic. Using it is a concession.

You postpone picking up the socks. Bending has to be budgeted. You can’t afford too many deep bends in the course of a day. You protect your back.

Shopping isn’t fun. It’s mostly a sequence of decisions not to get things — putting them back on the shelf because they’re too expensive.

You refuse kindly invitations. You wonder whether finally tell them you don’t actually like making conversation about things that matter to you less and less, or seeing the look of pity of condescension in the eyes of younger people. Like Joe, across the street.

You like quiet. Quiet is like clear water. You drink it.

You stay in touch with fewer people. You don’t need the news updates. You wish them well.

You spend your words on what matters. You offend some people. You realign relationships. Some fall off the mattering map.

You laugh. You can afford to be amused.

You eat less, and when you want, and the same things, and you enjoy them. People feel sorry for the limits you’ve found you like.

Your doctor looks as though she’s hardly old enough to drive. You match wits with her. You’ve developed strategies for avoiding condescension.

Other lives float a little further out. You find yours in a calm spot.

You love the shade in the afternoon in summer. You even love winter days, though taking the trash out hurts your arthritic hands and leaves you short of breath, and you have to rest afterwards. You take a long time with your one glass of wine.

You drink it by the window. You like being inside, looking out, watching people like Joe diminish into the cityscape, looking up the long street, noticing how the trees soften all the vertical lines of highrises, noticing how the sidewalks, lined with trash, come to a vanishing point.

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You will make me full of gladness with your presence. (Acts 2:28)

The English word glad comes from the Old English glaed, which means “bright, shining, gleaming,” as well as “joyous, pleasant,” and “gracious.” It’s a rich word—deceptively simple, and more domesticated now than it once was. What seems worth retrieving is the frank and surprising awareness our ancestors seem to have had that gladness is radiant—that gladness is a form of light. That when we are glad, we shine. And when we are “full of gladness,” as the Psalmist puts it, and Peter, we are bright with God’s own light.

I have loved the parting blessing with which the priests at our church close the service most Sundays; it begins with the words, “Life is short, and we do not have too much time to gladden the hearts of those who travel the way with us. So be swift to love and make haste to be kind. . . .” Thinking of gladness as a light passed among us, one to another, like the light from the Easter candle, it seems a thing to be received and held with humble amazement—energy and beauty that flows inward, quiets and opens and fills and finally overflows.

It isn’t the same as exuberance. I often find other people’s exuberance a little oppressive when it seems to insist on being met and matched. It can be overwhelming, even overbearing. But gladness invites and welcomes and imposes no requirements. My heart has been gladdened by fleeting expressions, gestures, gracious words, and sometimes when I witness something larger that I would call “the beauty of holiness,” innocent and unconscious, powerful and radiant, that suddenly allows me to see the Christ who “plays in ten thousand places, lovely in limbs, and lovely in eyes not his.”

Repeatedly Scripture directs us to “Rejoice and be glad.” I’m not sure gladness is something I can summon, but I can be willing to be “made glad,” to be “filled.” In those times when my heart is heavy and gladness seems unlikely, and when “gladdening” doesn’t come on command, I can, at least, let my heart be made glad. “Yes” and “thank you” open a crack in even the hardest heart where light can enter, and burn, and shine.

(image courtesy of

Sifting and Filtering






. . . 

This, said our teacher, is the beauty of metaphor.

It opens doors.

What I could not know then

was how being a sifter

would help me all year long.

. . .                               — from “Sifter” by Naomi Shihab Nye

When, in the course of first-year English, it becomes necessary to pause and explain the value of metaphor to the more literal-minded, I often give a little “life is like” exercise: Life is like a branching tree. Life is like a river. Life is like a journey. But also, less obviously, life is like an onion, or the movement of clouds, or a jigsaw puzzle or a filling station. The assignment is meant to offer an opportunity to notice how each image may become a lens or a frame, open a door, invite its own surprising logic.

While the responses are sometimes a little flat-footed, stopping when the obvious has been made even more painfully obvious (rivers move and bend, trees root and branch, life has layers), some of them grow longer, become whimsical, drop into serious personal reflection. Some of the pieces are always moving and memorable.

The last lines of Naomi Shihab Nye’s “Sifter” move me in the same way: a sweet, playful poem about children imagining themselves as kitchen implements suddenly reminds us how a metaphor can open an avenue of self-understanding or grounding or hope. If we are sifters, we live our lives learning how to hold a delicate balance between holding on and letting go—learning to identify as we sift what it is we must hold onto and what we must let go.

My favorite seven-year-old recently completed and proudly displayed her first science fair project. She made different kinds of water filters, noticing how the water looked before it passed through gravel, sand, tiny mesh, coarse paper. We talked about how water comes to our taps through filters, and how we rely on those filters to help protect our health. I don’t think she’ll ever take water quite for granted after this. I also think of how many other things she may begin to notice have to be filtered, and how she may begin to seek and find what it takes to make an adequate filter—one that will keep the conversational detritus, aggressive marketing, bullying behaviors, or other harms from passing into the still well-lit quiet spaces of her inner life where pleasure in her own lovely being is still unpolluted.

We gather metaphors where we find them, like mushrooms. They give us our lives back on new terms. They are a little like mushrooms. You can find them in odd places. Some of them are poison. Some of them are truffles.

The Grief We Carry

“No matter what the grief, its weight,

we are obliged to carry it.”  — Dorianne Laux

One of the paintings on our wall is a palimpsest. Layers of color and design overlaying other layers of color and design, it seems a visual allegory of mind or memory—what we carry beneath the surfaces—beneath what Eliot described as a face we prepare “to meet the faces that we meet.” Grief is always there somewhere—the patch of midnight blue later covered by striations of red, the one brushstroke of pitch black that suggests a faultline in the green. We carry it, more or less consciously, shifting its weight as we go, sometimes gently leaving behind bits we no longer need, acquiring new ones.

A friend has been diagnosed with what is cancer, probably already metastasized. Another has contracted pneumonia in the wake of surgery that removed most of one lung. Another, having lost her husband, is coping with severe behavioral disorders in one of her children. And not many days ago seventeen people, most of them kids, were arbitrarily shot in Florida. Public sorrows and private ones begin to mingle in the disorderly mix of memories, physical shocks, media images and waves of feeling we carry. Grief, disbelief, morbid fascination, horror, dread, puzzlement, unsettled stomachs and wakeful nights lie in crosshatched layers, impossible entirely to disentangle, but always teasing us to return and see what we can piece together—see if somehow old stories might shift toward new resolutions.

Dorianne Laux’s poem, “For the Sake of Strangers,” from which the above lines are taken and which I read immediately after reading an article by a doctor who treated patients gunned down with an A-15, reminds me of how “commingled” our sorrows are with the kindnesses in which we find comfort. None of us knows what we bestow in the course of a day—how the merest gesture or word might fall into a well of need. When the need is mine, I am aware of how often occasions for gratitude go by so quickly, there’s no way to express the thanks, except to pay it forward.

Gratitude doesn’t paint over the grief, but it complicates it in ways that allow us to live more thoughtful, interested, curious, attentive lives where losses are not lost, but held and, perhaps just when their weight shifts a little, healed.

The Time it Takes

British doctors do less of everything, writes Lynn Payer, a medical journalist whose lively comparison of medical practices in France, England, Germany and the U.S. offers compelling evidence of the surprising degree to which medicine is culturally imbedded. American doctors do more. If you’re practicing medicine in this country, you’re very likely trained to err on the side of taking action. What Sunita Puri calls “unacceptable uncertainty,” the lag time between observation and action, the time it takes to listen to the inner dialogue between the trained professional self and the ancient elder who knows things, the time it takes to come to a decision, is very short. Doing nothing is precarious and embarrassing. And dying is a crisis—not a time to do nothing.

What I love about working as a volunteer with hospice—an organization that originated, significantly, in England—is that dying is not a crisis. It is a process to be witnessed. The hospice facility nearest where we live is a house in a residential neighborhood, where families can come and be with the dying, make meals, rest, weep, pray, talk, walk in the garden or—since, as one staff member put it, there is “no judgment” there—watch football if they want to. Medical professionals make sure the patient is comfortable and out of pain. People accept that dying is what is happening. There is very little to do.

I hope the rest of medicine, and certainly medical training, may continue to learn from those who work in hospice or palliative care to expand—even a little—the window of acceptable uncertainty, or the time of doing nothing. In this culture both patients and doctors are conditioned, partly by medical soap operas, partly by pharmaceutical ads, partly by a culture that has made outcomes and measurable results on every front a measure of validity, to see illness and death first as problem, then as crisis. The higher tolerance of the British with their cheerful stiff upper lips and their trust in resilience may offer something we can learn from, especially in emergency rooms where people are doing one of the things all people do—dying of natural causes. Shutting down. In due time. In the fullness of time. Taking the time it takes. The dying take their time. We need to learn, again and again, to take ours.

At the Margins

Milling around at a reception recently I lost track of my husband. Everyone was standing, coffee in one hand, some form of questionable sugar product in the other, chatting amiably. I spoke with a neighbor I hadn’t met, a local artist whose work I admired, a lively woman who is adjusting to a new season of life. All these were conversations that might well have continued happily for some time.

Then I spotted my husband, sitting on a bench provided for those who found it fatiguing to stand. He was talking with a man whose sturdy cane leaned against an outstretched leg. The bench was near the exit door. People who made their way to that corner were shrugging on coats, disinclined to make one more stop on their way out. Expressing his pleasure in meeting John, the man mentioned matter-of-factly that his visiting occurred mostly on the margins of any gathering he attended. So many “coffee hours” or receptions depend upon standing. Those who sit are hidden behind a screen of vertical figures. They don’t “mill.” They learn, if they keep coming, to accept whoever drifts their way and engage.

I began to think about how many social occasions depend upon health, and how even slight disabilities can change one’s social opportunities, objectives, motives for attending festive occasions, notions of what “friendly” looks like. I remembered a good-natured but edgy essay by a man with AIDS who visited an art museum in a wheelchair. He described his view of the paintings with titles like “Still Life Obscured by Large Gucci bag” and “Portrait of the Artist with Obstructed Face” and “Landscape Interrupted by Backpack.” Disability awareness, like diversity, has received wider and long-overdue attention over the past years, but really developing that awareness—the habit of noticing in situational, sudden, flexible, subtle, imaginative, and compassionate ways—is an ongoing education for all of us.

Years ago when I asked a student who came to class in a wheelchair what was the one thing she’d most like her able-bodied colleagues to “get,” she immediately said, “Whenever you can, sit down to talk to me. I get so tired of being looked down upon. I find myself longing to look someone in the eye at eye level.” Perhaps that stuck with me in a particular way because I’m tall and, especially among other women, I “look down” a good bit. But eye-level encounter matters. When a doctor sits to ask me how I’m doing, it changes the conversation. When I squat to talk with a small child I see how they open up, suddenly aware I’m taking them seriously. “Eyeball to eyeball,” as my husband puts it, is where truths may be told that you’re unlikely to hear anywhere else. I left that bench by the door after the reception resolving to find a similar bench at the next public meeting, or a folding chair in an under-populated corner–and change my eye level. There, slightly beyond and beneath the noise and haste, some lovely, lively moments, unavailable at other altitudes, may find room to happen.

Very Particular

Two different caregivers in the “Care Center” warned me as I set off to meet my new hospice patient, “She’s very particular.” One of them said it with a slight lift of the eyebrows. “You’ll find out soon enough,” he seemed to imply. “Don’t be surprised if you find yourself irritated. She’ll drive you a little crazy.” I inferred all this. It was the eyebrows. They made me apprehensive.

The other nurse, the harried one at the station, when I said the patient’s name, looking for her room, told me the same thing. “Well, she does like visitors,” she said, but then added. “But she’s very particular.”

About what? I wondered. Did she complain about her food? About the way people spoke to her? (I remembered how my 94-year-old grandmother, witty, dignified, and kind in her mannerly Old Virginia way, felt affronted by 20-somethings who called her by her first name.) Was my patient—let’s call her Mildred—particular about how you touched her things? Or her? Was she particular about language?

I don’t mind particularity. I have come to appreciate more than I used to people who are particular about their use of words, or about the way they set the table for company, or about where their food comes from. The word means paying attention to the part—the particle—the trees, for the moment, rather than the forest. Or the bark on the trees. Particularity seems to me to provide a pathway to pleasures that can only be had by means of close attention—pausing, noticing, allowing awareness to dawn “a ribbon at a time,” as Emily put it.

Mildred greeted me with a certain curious satisfaction. “I wondered if you’d actually come,” she said. You said you’d be here at 4:30, but I wondered. So. I’d passed her first test. “Sit there,” she said, gesturing toward the one chair in her half-room, tucked under the built-in desk she will never use, bedridden as she is. As I pulled the chair out, she said, “I don’t know what got on that chair. I thought someone had spilled something, but now I think it’s paint spatters from when they painted the wall. You’d think they’d know to cover the chair.” It was an apology, of sorts. I took it as a habit retained from the days when she was hostess and oversaw all provisions for guests. I didn’t see any paint, but I agreed that one had a right to expect that painters would care for the furniture.

Mildred has lost a good measure of her hearing and doesn’t see well enough to read even large-print books for very long at a time. She loves to talk, and does so with clarity and energy that belies her much-diminished physical condition. If I have questions I have to write them down in large letters. She peers at them them carefully, reading them out loud, and answers with entertaining particulars. She gets quite a bit of mileage out of even the most ordinary question—What were you doing while your husband was fighting in Japan? Where are your kids now? Why did you move back from the east coast?

The particulars in Mildred’s memory are like jewels pulled one by one from a chest. She enunciates. She corrects herself to make a point more specific—and sometimes corrects me. She notices things. I like that. I have come to appreciate her particularity as a gift in the middle of an otherwise too-hurried and sometimes scattered day. She takes careful notice of the thing at hand—and the person. When that’s me, I feel particularly honored.