The Suffering Man

He is a shell of a man in more ways than one. Chronic illness has emaciated him and I can see the outline of every one of his ribs stretching against his scarred thinning skin. His hair has been reduced to wisps; a few threadbare cornrows are all that's left. Years of hard living have thinned out his frontal lobes and he spends most of his days wailing and railing his heartfelt dissatisfaction against everyone and everything - mostly incoherently. A life of dope only to be forced into a doped stupor at the very end. He has been reduced to an ill tempered infant, literary banging his fists out of primal rage. He must have been a man at some point, who experienced life in the complex way life is experienced. I can only imagine that it was a difficult life, filled with tragedy and injustice. Now that all the ego and superego have been stripped from him, he is the embodiment of suffering. 

Ironically he has lovely eyes framed by long, curly lashes usually seen on creatures of the feline family or in young girls blessed with exceptional beauty. Such lovely eyes consumed with bitterness. Despite his frailty, he has the fire to hate and hate so deeply. 

He would accuse me of abusing him and then grab my hand and sob. He'd yell at me and then hold me in desperation. The nurses made fun of his antics; he made their lives miserable. 

I felt for him because I don't blame him one bit for feeling the way he does. I think I would feel the same way. Maybe beneath it all I do. 

The Beauty of Letting Go

She had eyes so blue like sapphire stars, her daughter with the same blue eyes. And when she was dying her eyes still sparkled after the chemo thinned her hair to fuzz and the cancer froze and swelled her body. Her daughter just sat next to her bed, looking at her with those same brilliant blue eyes. She had a quiet strength as she watched her mother die. It wasn't about her grief; it was about saying goodbye. What can you possibly be thinking in that moment? And how can you possibly be so strong? 

Books: Gilead (Marilynne Robinson)

"When things are taking their ordinary course, it is hard to remember what matters." 

My colleague gave me the novel, Gilead, for Christmas. He knew I had just gotten a Kindle, and he said this was one of his favorite books, a most thoughtful gift I thought.

I've finally gotten around to reading it now after finishing six months of inpatient wards. The book is so beautiful and bittersweet, it's sometimes hard to read. The narrator is an old preacher, John Ames, who is dying of heart failure. He has a young son, about 7 years old, who's he's writing to in the future so that his son will know who he is after he has passed. It's a pretty heartbreaking premise, and yet it's not meant to be sad.  The preacher spends a lot of time describing the relationship with his own father and his father's relationship with his father before that. He describes the physical world with the wonderment of someone seeing it for the first time; I suppose it's easy to take nature's art for granted when life's distractions fill our days the way they do. Only when our days become numbered do we seem to recognize the awe inspiring beauty of this world and our place in it. Robinson's language is simple and the prose spare, but every sentence seems filled with emotion nonetheless. I think one must write a novel like this in that way. 

Reading this book reminds me of the time in my life when I lived next to beautiful Catholic church called St. Vincent de Paul. I'm not Catholic but for a month or two I'd walk there every morning to catch the weekday morning service at 7am. I remember how sweet the flowers would smell after a summer rain, and how I could never avoid the puddles that drenched my feet with rain water. I'd sit in the farthest pew in the back behind a pillar because I was an outsider, a heathen, I suppose. And once the service ended I'd scurry out of the church lest someone ask me what I was doing there because I wasn't quite sure myself. But I loved the Father who was there and the short liturgy he'd give every morning. I've never felt peace like that before. The other people in the church included 2 nuns, a few older people in the front pews, a person in a wheelchair that would sit in the back with me, and a young Indian doctor, always in his scrubs with his pager hanging on his hip. I wasn't in medical school then but I remember thinking how the sermons probably reinforced his commitment to helping others. 

Today I went to the chapel in our hospital. It is a bare, minimalist space without any kind of religious symbols so as to remain inter-faith. There wasn't a service going on at the time, but the room still felt sacred for some reason. Maybe if I could hear again that Father talking about love, the good of humanity, and our spiritual purpose, I can be redeemed for forgetting beauty, forgetting the sense of mission I so admired in that doctor many years ago. 

War Documentaries: Dirty Wars and The Square

I wanted to write a quick entry on some of documentaries I've seen lately that do a good job on discussing key events of the sociopolitical unrest in the Middle East; both were nominated for the 2013 Academy Award for Best Documentary.

Dirty Wars

This was a documentary based off the book Dirty Wars and features the author himself as narrator, Jeremy Scahill. Scahill is an investigative journalist specializing in war reporting. Just as an aside, I think in another life investigative journalism would have been a dream career for me - it's all about uncovering the truth and educating the masses, what could be better! Scahill is possibly the most serious person I've ever seen; he does not smile once during the entire film, but I think it adds to his serious persona, which works well for this serious subject. One wonders though if he does anything else in his life beyond chasing war stories (so mysterious...), but his dedication and information-oriented approach perhaps gives the film more credibility (which it needs considering its kind of attacking the US government). The premise of the documentary is that the American government has initiated a new military strategy over the past decade or so to fight the global war on terrorism. Instead of the traditional model of US troops fighting enemy troops, this new war employs special forces to target and attack specific dangerous individuals or groups. The special forces given the task is called the Joint Special Operations Command (JSOC). JSOC essentially has a list of terrorist, who are spread out around the world, and work to assassinate all the individuals on the list. I remember hearing on thew news the war on terrorism is different from wars of the past because we (America) are not fighting another country / ruler, rather we are fighting a network of people spread out around the world intent on destroying America. So I suppose America's tactic to approach this situation was to kill off the important people in the network, thereby destabilizing and ultimately destroying this community.
The only problem is that when trying to assassinate people on the list, JSOC sometimes makes mistakes and kills the wrong people / civilians. Scahill brings a couple of these incidences to light including the killing of an innocent, civilian family in Gardez, Afghanistan and another incident in Yemen where a whole tribe of individuals were killed including women and children. Scahill presents these as humanitarian atrocities carried out by the American government (and approved by President Obama himself). The climax of the documentary and really the crux of Scahill's case against the government occurs when he finds out there are Americans on this JSOC list, specifically Anwar al-Awlaki and his 16 year old son. Al-Awlaki was an American born Imam, who supported Jihad after seeing what America was doing in the middle east. It is unknown why his son was targeted as well, but Scahill believes it was to prevent the spread of terrorist ideas. The point the documentary makes is that America is actually creating more terrorists with these tactics that kill innocent people and that operate under a cover of secrecy. 

This documentary made me realize how so much of the way America operates is not transparent to average American citizens. I understand our country carries out these missions ultimately to defend American citizens against terrorists, and I will say to date I and most Americans live in our homes without fear. We have enough food and our infrastructure is intact, untouched by bombs and gunfire. But if the cost of our well-being and safety is the fear and death of innocents in other countries...well, that doesn't seem entirely right either. American citizens in general are at the mercy of our leader's good judgement when it comes to our military presence abroad. While I like living in the comfort of America, I would like to hope we achieve this security through ethical and transparent means. 

The Square 

This documentary follows a group of young Egyptians, who are protesting the government during the Egyptian Revolution of 2011. They are impassioned, idealistic, and determined. Instead of having a narrator (like in Dirty Wars), The Square follows the conversations of these revolutionaries with each other and sometimes with an unknown interviewer off screen. But the focus is always on the Egyptian people and their fight for freedom.
This was a very educational documentary for me because I did not really understand the different parts of the revolution very well and all the different groups of people involved. Now my understanding is this:
The Egyptian people were unhappy with their corrupt government under the rule of Mubarak (who I believe was part of a military power structure that has ruled Egypt for awhile); free speech was stifled, unemployment was high, and quality of life in general was not good. Galvanized by the Tunisan revolution, the Egyptian people began organizing protests calling for the overthrow of their own president. The heart of these protests occurred in Cario's Tahrir Square, hence the name of the movie, which became to symbolize the Egyptian people's fight for freedom.
The protesters' efforts paid off and Mubarak eventually stepped down and Morsi, a member of the religious political group the Muslim Brotherhood, was elected. However, after two years, the Egyptian people ousted him for his failure to move the country forward in the direction wanted by the Egyptian people. The movie ends with the questions, what kind of society does Egypt want and who will lead them?
Just a few days ago, the current Egyptian "government" (the military?) sentenced almost 700 members of the Muslim Brotherhood to death. This hardly seems to be the peaceful overthrow desired by so many at the beginning of this.

It seems only time will tell the fate of the Egyptian people. I find the whole situation poignantly inspiring and also very sad in many ways, much like the movie's theme song The Square (Ya El Medan), sung by Cairokee ft Aida El Ayouby, who has such a clear, sweet yet soulful voice. I find Arabic in general to be a very beautiful, lyrical language, and even more so when sung.

Ya El Medan 

* * * * *
Some Middle Eastern inspired recipes seemed fitting for this post. Here are some good ones.

Mujadarrah and Green Beans

Mujadarrah
Ingredients:
5-6 tablespoons safflower oil
1 large white onion, sliced into rings, a few sliced red onion rings thrown in as well
1 1/3 cups uncooked green lentils
3/4 cup uncooked long-grain white rice
~3 cups of homemade chicken stock (liquid from boiled chicken breasts, 1 packet of chicken bouillon, 2 tsp salt, 2 tsp garlic powder, a few peppercorns from my pickling spices)
salt and pepper to taste
1 1/2 tablespoons cumin
pinch of cinnamon
1/4 cup plain yogurt or sour cream (optional)

Notes: This is my second time making mujadarrah, and I think I got it a little closer to what it's suppose to be like this time. My earlier post of this dish from 4 years ago showed a very soupy looking dish, but this time I achieved the fluffy yet moist texture I'm assuming is more correct. I was making chicken salad for lunch this week, so just used the chicken stock from the boiled chicken breasts to cook the lentils/rice. I fried the onions to a rich brown, and probably could have added another onion if I were planning on feeding more people (the onions really shrink when you fry them). The flavor of this dish was so good this time. The rice and beans themselves are soft, savory with a kind of complexity coming from the cumin/cinnamon. The fried onions are a rich and sweet accompaniment to the rice and beans. I like how this dish is a mix of complex and simple. I put sour cream on it, although I should have used yogurt; both add a cool creaminess. Delicious. Rating: 5/5.

Syrian Green Beans
Ingredients:
1 (16 ounce) package frozen cut green beans
~1/4 cup extra virgin olive oil (I used less)
salt to taste
a few cloves of garlic, minced
1/4 cup chopped fresh cilantro (I probably added 3/4 of a cup)

Notes: I added too much cilantro which made the dish a little bitter. Also it burned the bottom of my pan, and so it was hard to clean. The taste of the green beans were good. Likely will try again with green beans but will use less cilantro. Rating: 3.5/5

Writings: Haunted

I am desperate for morning to come, to hear the distant early bird's song, to have this bedroom filled with living, breathing light. But in the night there is only darkness and my equally dark thoughts - I become frightened that my mind might evoke the spirits that haunt my subconscious. Because in the darkness the boundaries between conscious and subconscious, life and death begin to blur; I begin to think of him, when we used to play as small children, and I can only remember happiness. Now he is dead, and my human brain cannot makes sense of it because I am still here, so why is he not? Things, including people, just don't disappear into nothing, we learned that in science class...will he come back tonight to prove that he has not gone away? I am sad because his passing was senseless, and now so many people will be lost without him. What privilege do I have to stay when he may have deserved it more? I turn on the light and try to sleep with my eyes open, desperately waiting for morning.

* * *

These restless nights happen to me often, as I am now in the business of shepherding the ill to their death. I recently came across an admission note I wrote for a patient, and I could not bring myself to throw it in the shredder like I should have. For some reason it felt like I would forget him if I threw away the papers, and since he died during that admission if felt like I was throwing away his existence. I did not want to associate his death with the paper shredder ridding the world of the obsolete.

He was a young man, who came in with the emaciated look of someone terribly ill. He had a young, devoted wife who stayed by his side and looked at him with such a tender, bewildered concern that it still hurts me to remember it. We did not expect him to die because he was such a young man; because we did not know for sure what was wrong with him; because we did not want him to die. The only person who expected it was the pulmonary fellow, who yelled at us for consulting him for a dead man walking. When we asked him again what we could do, he attacked my resident with such meanness she began to cry, which made me cry because we were just trying to do good. He told us the compassionate thing to do was to save a dead man from an unnecessary workup, but we knew he just wanted to have one less patient on his consult service. We did not give up.

The young man died so suddenly, without warning, that he was in a normal floor room when it happened. I will never forget his death, the way he lay unnaturally bent on his bed with eyes and mouth half-opened, completely and terribly still. His pretty wife was in shock: her face like stone, her gaze fixated on the air, averted in the direction away from her dead husband. She did not move to wipe away the rivulets of tears that dripped madly off both cheeks. We were all speechless with horror. Only the attending could say something because it is his business to do so. He expressed our sympathy and offered the family an autopsy should they want one. The father could only shake his head no, his voice choked by the tears probably brought on by the thought of the scalpel on his son's cold skin. When we left the room, the resident sobbed. I cried too, silently, looking at my computer screen trying my best to find a distraction. I am a professional after all, and the best thing to do is to not think about it.

* * *

But at night, there is nothing but a terrible stillness and a sense of vulnerability. In the darkness, memories come back to haunt me, and I am frightened. Not because I fear evil spirits, but because I am the evil one; because in the senseless struggle of survival I have managed to buy myself more time, while helplessly watching those around me fall. If there is a God, I think there would be a punishment for this injustice.