Notebook: Opal’s Madonna

Madonna and Child, German, 16th century, Metropolitan Museum of Art

Madonna and Child, German, 16th century, Metropolitan Museum of Art Hewitt Fund, 1911.

Another Friday morning. Mim showers in Opal’s salmon-pink bathroom. The smell of Cameo brand soap, wet in her hand, reminds her of kissing her mother-in-law’s fragrant cheek.

Already, though Opal has only been gone for a week, Mim craves her sturdy kindness, her laugh billowing out over the dining table like oceans of acceptance. When Opal opens her side door — nobody but the mail carrier uses her front door — she greets you with the heedless energy of a rough-coated dog who has waited all afternoon for your return. A short, wide woman, her hands wet or floured, a drift of her gray hair falling out of its bun, her sensible shoes polished black and sprinkled with flour. She waves you into her kitchen and bends down to open the oven, where baked cinnamon apples burst out of their skins.

How could a woman like this have died? How could she have faded away? Opal, a woman as lavish in her affection as anyone you’ve met. Shrewd, mind you: an eye for a sound bargain. Mim can see where her husband, Opal’s son, got his head for business.

Mim shuts off the water. She steps out of the shower onto Opal’s plush bath mat. She dries her sad self with a striped beach towel, blows her nose, and shimmies into a set of underwear. Black pants, black top; salmon-pink socks, in honor of Opal, the lover of all warm colors: orange, marigold, cerise.

Then, at the breakfast table: “Sweetheart,” Mim says to Arnold, “shouldn’t I bring the Madonna to the funeral home? I want your mother to feel comforted. Those parlors at McMurphy’s are so impersonal.”

Opal had brought the Madonna home from Austria after the war, along with other treasures she’d found in antique shops in Salzburg. Her husband, Arnold’s father, was stationed there with the U.S. Army of Occupation after the German Reich surrendered. In the chaos of war, so many families had sold their treasures. The Madonna and Child, a devotional figure twelve inches high, was probably German, the antique dealer said, perhaps 18th century, polychrome on walnut.

“I’ll find you a box to put her in, Mim,” Arnold says, shoving his chair back from the table. His mother’s cardboard box collection, like other repositories of useful items, is in the basement.

As Mim lifts the Madonna down from the bureau in Opal’s bedroom, she sees that the Virgin Mary could be any young mother. Her watchful gaze; the mild gesture of her baby’s hand reaching out toward the visitor.

Underneath the statue Mim sees a deep gouge in the base that shows charred wood inside. Has the Madonna come through fire, or been treated roughly for an invasion of wood-boring insects? The unpainted surface on the bottom has darkened, over the centuries, to the color of roasted chestnuts. On the Virgin’s neck, where paint has flaked off more recently, the raw wood glows a soft umber.

Who else, Mim wonders, has prayed before this figure of the Virgin and her son? Who else, praying or reminiscing, has wept for kinfolk lost to old age, war, or execution in the street?

“I am not myself a believer,” Mim says now to the Madonna, “but Opal believed. She loved you; she loved your son. Give her peace.”

Spoken out loud in the quiet room, the words bring Mim a sense of relief so vivid as to be almost tangible. It’s as though nothing else matters. Only this moment. Only one woman, breathing and remembering love.

— Mary Ann Barton

 

 

Safe Space Radio

Guilt When a Parent Dies

Editor’s note: How does a single voice manage to share such rich and heart-grained stories? Listen here, dear readers, to two plainspoken men as they talk about guilt when a parent dies with Dr. Anne Hallward of the Maine radio program, Safe Space Radio. — MAB

We continue our series on hidden feelings this week with two stories about guilt, the kind we feel when we believe we didn’t do enough at the end of a parent’s life.  We’ll hear from people who were troubled by the way they failed to show up for their parents, and discuss the process of finding relief from that guilt. — Dr. Anne Hallward, Safe Space Radio

http://safespaceradio.com/2015/04/guilt-when-a-parent-dies/

Copyright © 2015 Safe Space Radio, All rights reserved. Posted with permission of the author.

Dr. Atul Gawande in Being Mortal, a Frontline documentary on PBS

“Being Mortal” Airs Tonight

“The two big unfixables are aging and dying…you can’t fix those.” — Atul Gawande

Editor’s note: PBS airs a documentary tonight based on Atul Gawande’s book Being Mortal. It promises to be a candid and intimate look at doctors and families coming to terms with the end of life. This article by Stephanie E. Rogers, MD, appears in the blog Geripal. — MAB, 2/10/2015

The True Art of Medicine: Atul Gawande and The Being Mortal Documentary

by Stephanie E. Rogers, MD @SERogersMD

“The two big unfixables are aging and dying…you can’t fix those,” notes physician-writer Dr. Atul Gawande, in a new documentary based on his recent book Being Mortal. The Frontline documentary airs Tuesday, February 10 on PBS, and explores Gawande’s frustration of not being able to “fix” all of his patients.

The Being Mortal documentary examines how Gawande and other physicians struggle to talk with patients and families about death and dying. He explores his own humble journey with the realization that “medicine fails the people it’s supposed to help” at the end of life. It also provides a powerful, intimate look at families struggling with conversations about the realities of aging and death, and the uncomfortable and difficult time even well-trained physicians have at leading these discussions.

One of the most startling aspects of the documentary is watching physicians participate in these conversations with patients and the behind the scenes look at what their thoughts are regarding these discussions. Even with cancer physicians who have these conversations all the time, it is apparent that they too are struggling to be forthright and eloquent. In fact, this is what makes Gawande a skillful storyteller — he exposes his own vulnerabilities both as a physician trying not to be the bearer of bad news and as a patient’s family member during his father’s inevitable death from a spinal cord tumor.

“Hope is not a plan,” Dr. Gawande argues. “We find from our trials that we are literally inflicting therapies on people that shorten their lives and increase their suffering, due to an inability to come to good decisions.” He notes that people may have other priorities besides living longer and that we should not be waiting until the last week of life to have these discussions with our patients.

As a Geriatrics fellow, I have learned that speaking to patients frankly about aging, dying, and their priorities for the time they have left has been the toughest challenge I’ve encountered yet in my decade of medical training. We physicians tend to be overly optimistic and timid about the truth, partly because it is difficult to tell a patient something they don’t want to hear. We want to instill confidence in our patients and hope with them for a cure or more time.

I now realize that the most worthy challenge– one likely to last my entire career – is to improve my ability to have these conversations. Our decisive goal as physicians is not only to know the most up-to-date scientific studies or treatments, but to be comfortable and capable of communicating truthfully and empathetically to our patients about the realities of life — that we will all age and we will all die. The true challenge is combining all our medical knowledge and skills with the art of communication, to allow our patients to choose how they want to live—all the way to the end. Being Mortal, the Frontline documentary from writer/producer/director Tom Jennings, airs Tuesday, February 10 on PBS and will stream in full online at pbs.org/frontlinehttp://pbs.org/frontline.

Source: Stephanie E. Rogers, MD, “The True Art of Medicine: Atul Gawande and The Being Mortal Documentary,” GeriPal: A  Geriatrics and Palliative Care Blog (blog), February 9, 2015, http://www.geripal.org/2015/02/atul-gawande-being-mortal-documentary.html.

In Memory of My Mother

January 14, 2015

Today I am remembering my mother, Lisette Berglund Hyde, who died four years ago on the day before her 102nd birthday. She loved being outdoors, gardening and walking the dog; baking bread; setting a beautiful table; visiting art museums; listening to Vivaldi on public radio. Lisette was born in Bjuv, a small town in the southern tip of Sweden, so I am marking this occasion with a sunlit painting of a breakfast table outdoors by the Swedish artist Hanna Hirsch-Pauli.

Frukostdags (Breakfast Time) by Hanna Pauli

Frukostdags (Breakfast Time) by Hanna Hirsch-Pauli, Swedish, 1887, via Wikimedia Commons.

Commentary about this painting from the Swedish National Museum reads:

To this day, Hanna Hirsch-Pauli’s painting Breakfast – Time from 1887 is still able to trigger feelings of intense sensual pleasure from our visitors. “We truly feel invited; it is just like our very own breakfast ritual. The chairs are waiting for us and we can almost feel how the heavy teapot tilts as we lift it.” The table which is laid with beautiful objects gives associations to family life and domesticity. The image shows a corner of reality, where the bourgeois dining room has been removed to the garden.

This is an open-air painting suffused with light. The subject is dappled with reflections that give the objects a suggestive shimmer. It is a juste-milieu painting, being at once anchored in the classicist tradition with its linear perspective, but also inspired by the way the Impressionists depicted light with colour. Like many Swedish artists at the time, Hanna Hirsch-Pauli studied in Paris and exhibited at the Salon.

The use of light, the lively brushstrokes and the thickly applied paint outraged several Swedish critics at the time. They saw her technique as “slipshod” and one critic meant that the flecks of light on the table cloth were probably the result of the artist “wiping” her own brushes on it. In the late 1880s Breakfast – Time played a major role in Hanna Hirsch-Pauli’s breakthrough as an artist. Already an accomplished colourist, as we can see, she went on to develop those skills in her portrait painting. — Nationalmuseum Stockholm via Wikimedia Commons.

Thank you for reading this post,

Mary Ann

Related post: Remembering Gladys, Remembering Lisette: Three Years On

Thanks for Responding to the Survey for Rest, the Book

May 11, 2014

Dear Readers,

Last week I asked if you would help me write my book about caregiving, Rest, by taking a word-association survey (Want to Help Me Write My Book?).

Many of you took the survey. I am so grateful for your responses. Click on the REST Survey #1 to take it now. Feel free to take it more than once, as some of you have done.

Brilliant, springboard, resilience, woof, idleness, forgiveness, hunger, satisfaction. Why are these eight words important for a book about caregiving?

The words seem chosen arbitrarily, as if I’d opened a big dictionary eight times at random and stabbed down with my finger on the page. Which is true, in a way. I was following my intuition. Your associations to these eight words, I told myself, would be a resource for me in my writing, even though I didn’t know why.

Yet reading your responses, I know so much more about the gut-level process of writing this book for you. Your willingness to read my words has been such a gift to me. Your words, responding to mine, are another gift: sweet, soft, hard, unexpected. Brilliant. Together, we will make a gift that neither of us can make alone.

Only connect,” writes E.M. Forster in Howards End.  “Only connect the prose and the passion, and both will be exalted, and human love will be seen at its height.”

Caring for others can bring us closer to them and closer to each other, even in the raw hardships of illness and frailty.

“My father and mother-in-law died this winter within weeks of each other,” writes meditation teacher Kate Wheeler in her blog post, The Dying Season. “I have been imagining us as orphaned little kids holding hands by an open grave, trying to carve out a little piece of happiness for ourselves as we transit through this life.”

I’m in transit through this life, too.

I’m writing this book because I think that life is precious, rough, raw, and whole.

I’m writing this book because lately it has dawned on me that my pelvic-floor problem is getting worse, and surgery is in my future.

I’m writing this book because Elana Miller, the young doctor who wrote When in Doubt, Write the Truth, has a new post about her life with cancer called Loss. In this essay, Elana hits the ball of truth so hard that I’m still reeling from the blow.

Thank you for being there.

All the best,

Mary Ann

PS: Will you take the survey? Click on the REST Survey #1. Thanks! And Happy Mothers Day.

“When in Doubt, Write the Truth” by Elana Miller, MD

Elana Miller, MD, ZenPsychiatry.com

Elana Miller, MD. Photo courtesy of ZenPsychiatry.com

Editor’s note: Today I have something special for Joyous Paradox readers. Elana Miller, MD, the psychiatrist whose gutsy and eloquent posts I read at her Zen Psychiatry blog, has given me permission to share her remarkable essay about her experiences with cancer, “When in Doubt, Write the Truth.” Elana was diagnosed just before Christmas 2013 with stage IV acute lymphoblastic lymphoma. She wrote about the shock of her diagnosis in a widely read post, “Love Is… (Holy Shit, I Have Cancer).”  

“Hey there,” Elana writes in the About Me page of her blog. “My name is Elana and I’m a psychiatrist based out of Los Angeles, California. I write, I surf, I meditate, and I play ukulele. Here are a few of the things I believe in:

  • Not settling for being ‘not sick,’ but instead pursuing optimum mental wellness.
  • Discovering joy and happiness in everyday life, even amidst chaos and stress.
  • Synthesizing Eastern perspectives on mindfulness and spirituality into the Western view of the mind and brain.
  • Integrating traditional psychiatrist treatments with complementary approaches.”

Telling the truth is one way of finding joy, even in hard times. Read on, and see what you think. — MAB

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I wasn’t going to write a post today.

Usually by the time Tuesday rolls around, I’ve had a burst or two of inspiration and have at least an inking of an idea of what to say. But this week… nothing. Oh sure, there were a few ideas. They felt insincere, though, so I let them go.

This morning I told myself, why stress about this? People will understand if I take a week off from the blog. I figured I’d say, briefly, that I was feeling sick and not up to writing. Then, I’d come back to it next week.

It wasn’t until tonight that I realized what was really going on. The problem wasn’t a lack of things to write about. The problem was that the truth was painful, and I didn’t want to tell you.

But, how could I go wrong by telling you the truth? There is a purity in the truth, a vulnerability, a rawness. When you tell the truth, no one can tell you you’re wrong (or, you can safely ignore the few who try). When you tell the truth, you build a foundation. When you project an image, you build a house of cards.

Oh, and the truth is not an excuse to smugly hide behind while you say careless and insensitive things to others (“But I was just being honest”). That’s called being a douchebag.

Anyway. So, I decided, when in doubt, when I don’t know what to write about, I will tell you the truth.

I just ask you one thing in return. If you can, just stay present with me for this story. There is no need to reassure me, to tell me everything is going to be alright, that everything happens for a reason, that this all will be over soon, that I’ll be a better person for it. Do you really know if these things are true any more than I do?

(Oh, and for the love of god, please don’t tell me to “Be positive!”)

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The truth is that I’m in a lot of pain. By early evening my body aches from the weight of the day. If I’ve had chemo or a shot of Neupogen, it’s much worse. I feel sicker on the days I have chemo, even before the infusion, as if my body knows what’s coming and wants to tell me, “No, thanks!” The pain meds help, but not as much as they used to.

I thought switching from inpatient to outpatient chemo would be a breeze, but I was wrong. I thought the worst was behind me, but it’s not. As my body gets weaker, and less able to recover, the side effects get worse. I try not to think of how much treatment I have left (nine months…), but it’s hard to forget.

I didn’t have any nausea before, but I have it now. Even when I’m not nauseated, I have no desire for food. I’m losing weight, and even my cancer pants are getting loose. (Definition of cancer pants: the fashionable, smaller-sized pants one buys after losing weight from cancer treatments because one looks like a hobo in her regular-sized pants).

I’m lonely. It’s not so exciting anymore that I have cancer.I see people around me returning to their normal lives, and I don’t get to. I wonder if maybe I have to walk this path alone. If I didn’t feel so sick, and therefore emotionally hypersensitive, I probably wouldn’t care as much as I do.

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This hypersensitivity is both a blessing and a curse, because I can now read the subtle differences in how people say, for example, “Let me know if there’s anything you need!”

Because I need so much, I can read when a person means it, and will be there for me in any way that is humanly possible. I can read when the words are said out of obligation, or carelessness, or because a person would like to think they’re generous but isn’t really thinking about what they’re saying and will artful dodge my requests when I follow up. The latter hurts more—a lot more—than if nothing was said in the first place.

I’m tired, all of the time. I used to shoot out of bed early in the morning, even on the weekends, excited about all the things I would do that day. Now, I wake up around 11, and spent most of my time on the couch, watching mindless TV. When I have more energy, I play Sudoku on my phone.

Don’t get me wrong—I’m not bored. I imagine boredom as feeling as if you have nothing to do. I have the opposite problem. I have so much I’d like to do, but I can’t do any of it.

I’m not quite sure why I’m telling you all this, other than I want you to know, and want to remind myself, that there is no shame in being in pain. It doesn’t always need to be fixed. It doesn’t always need to be corrected.

I know that people often try to reassure others in pain for the most well-intentioned reasons. We see another person suffering and it breaks our heart. We want to reach out and make it better. We want to say the “perfect” thing.

If you find yourself in this situation, let me offer an alternative. First, connect with what you’re feeling. What is happening in your body? What emotions are rising up? What thoughts are passing through your mind? Maybe you hate to see them suffer, or your heart goes out them, or you care so much that it hurts.

First, connect with your inner experience. Then, say something true.

When in doubt, speak the truth. When in doubt, write the truth.

— Elana Miller, MD

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Related Post: Staying Mindful While Facing Cancer: A Worksheet from Mindful Hub

You can read more posts by Elana Miller at her blog, Zen Psychiatry.