When Live-Saving Turns Life-Threatening

The wound and the eye are one and the same. From the psyche’s viewpoint, pathology and insight are not opposites—as if we hurt because we have no insight and when we gain insight we shall no longer hurt.
—James Hillman, Re-Visioning Psychology, 1975.

First, a recollection:

About seven years ago, I began taking an anti-cancer medication, Tamoxifen, after months of fretting about whether or not to do so. I had learned that in a very small percentage of patients, it could kindle or worsen depression.  Although it was very rare for that to happen,—my surgeon had never seen a single case, my oncologist maybe one or two—I was indeed one of the “small percentage” to be felled.  It took me some time to identify what was happening, but it really hit me that January when I caught a bad cold and had to stop my vigorous daily exercise routine. That habit was likely what had been keeping me afloat, and the sudden need to forgo it was devastating.  After a period of perilous despair, during which I felt increasingly disinterested in the next week, day, and hour, I realized that the medication I was taking in the hope of staving off a life-threatening illness was itself life-threatening. For me. (Those last two words are crucial.) Fortunately, my doctors understood this and supported my choice to discontinue the medication. Any doubts I had ever had about the chemical aspect of mood were dispelled that January. There are so many debates and opinions in the offing about whether medication is necessary, helpful, virtuous, and so on. Having had such a severe depressive episode instigated by medication—the inverse of the usual—proved once and for all to my bodymind that chemistry can drive mood. I was not as in charge as I would have liked to think. I could not just repair my mental state with talk, toughness, or the right course of action. Sometimes there is no best course of action available. Sometimes one engages in revivifying exercise and finds it helps. And sometimes one gets a cold and realizes that the bank of endorphins has been used up for the time being. Sometimes Whole Foods runs out of fish oil.

think what you are

Next, a reflection:

It’s easy to think we know what depression is and to think we have wisdom about what is best for another who has experienced despair and anguish. But we know little. As many point out, the casual of the use of the d-word,—“Maleficent isn’t playing any more?! I am so depressed!”—hinders understanding. The mysterious and “yin” nature of the disease does too. Its darkness is powerful and seductive. It’s resistant to illumination. Even those who spend their lives experiencing mood challenges, and treating them, acknowledge the limits of their understanding. Some say that those who die of suicide are selfish, or that they failed to ask for help. Some say that pharmaceutical companies are agents of the State, that their medications are designed to break down the body’s natural chemicals, and that they will inevitably lead to a cure worse than the disease. (Tell that to someone who’s planning to take her life this week. A decline down the road might not be a bad alternative.) That one may eschew the word “suffering” and choose spiritual practice over medication, as long as one meditates in the “right way.” These are all things I have read this week, and I have been especially disheartened to hear some who identify themselves as spiritual practitioners reveal such self-satisfaction, such a lack of humility and compassion. I remember when I was diagnosed with and treated for cancer, dealing with (some) others’ responses was infinitely more difficult than accepting my own morbidity and eventual mortality. I’ve felt similarly pained by much of what I have read this week.

I cannot help but think that the persistent misunderstanding of depression and other mental health conditions relates closely to the fear of decline and death that is so evident in US culture. There are so many claims about superfoods and antioxidants and kale. (Oh, right, kale has been dethroned; is that right? Oops!) However, such apparently “positive” possibilities to engineer über-health inevitably reveal a dark side: all too often, such a desire to be well conspires with a similarly American rush to judge others and to express opinions that arise less from knowledge than from unconsidered attitudes—and, I suspect, from fears. Why else would one police another’s kale consumption? I see this in the discussion about cancer as well: the notion that one can outrun it in one way or another, that it can be cured. I have yet to hear anyone besides me ask in response, “And then what? No death? A better one? Worse?”

I find it hard to imagine that such a “police state of mind” is good for anyone’s mental or physical health. Yet there continues to be a cultural emphasis on the transaction: do this, and you’ll get this. Thing is, there is not always a thing to do, and if there is, it is sometimes comes with a heavy tax. Risk more cancer? Or risk suicide with a drug designed to fend it off? Fortunately, I had a reasonable alternative available. But not everyone does.

Considering how common illness is, how tremendous the spiritual change that it brings, how astonishing, when the lights of health go down, the undiscovered countries that are then disclosed, what wastes and deserts of the soul a slight attack of influenza brings to light . . . it becomes strange indeed that illness has not taken its place with love, battle, and jealousy among the prime themes of literature.
—Virginia Woolf, On Being Ill (1926)

An invitation:

For those who have not had the “opportunity” to experience depression personally, or to look into its eyes in some other way, might you consider acknowledging your unknown knowns? Might you be able to tolerate the not knowing, as in Keats’s notion of negative capability? Might you emulate my doctors, who understood that their vast experience did not grant them omniscience, and who were able to accept that, even though it was statistically improbable, a life-saving medication could cause life-threatening side effects? Had they not, I might not be here to be wondering about this.

Here is the invitation, should you choose to accept it: For every opinion you express about depression, or other mental-health issue, read one article or essay about it. Or better yet, talk to someone who has lived with mental-health challenges, and instead of nursing your own opinion about how they should handle it, ask them about their experience, choices, and outcomes. It might be good for your own mental health too.

There’s No Map, But—

Below are some links that regarding mental health, depression, and well-being. They do not all agree with one another or with what I write above. I don’t always agree with myself either.

These two posts from The Belle Jar are especially informative:

When Getting Better Is No Longer An Option

Life as a Mountain Hike (Guest Post)

HuffPo Canada Living has had some good articles this week:

Arti Patel, Robin Williams’ Death Reminds Us Of The Impact Of Words Like ‘Sadness’ And ‘Depressed'”

Shannon Fisher, “Suicide Isn’t A Product Of Not Trying”

Spiritual Practitioners Discuss Depression

Lodro Rinzler, Meditation Isn’t Enough: A Buddhist Perspective on Suicide

Krista Tippett discusses her experience of depression (among many other things) on The One You Feed” (podcast)

“If you know someone who’s depressed, please resolve never to ask them why. Depression isn’t a straightforward response to a bad situation; depression just is, like the weather.

Try to understand the blackness, lethargy, hopelessness, and loneliness they’re going through. Be there for them when they come through the other side. It’s hard to be a friend to someone who’s depressed, but it is one of the kindest, noblest, and best things you will ever do.”

― Stephen Fry

—Posted by Barbara A. White

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See You Next Year, Maybe 

[in memoriam Mary Wright]

“I don’t want to see you for a year.”  These are the words I most want to hear from my oncologist.  This morning I passed inspection: I have been cleared for another twelve months of impermanence.

Yesterday afternoon, I learned that my very first dissertation advisee died the previous Sunday.  I had half-seen a note about her being ill, but had not really digested it, and only when I was able to follow up did I realize how serious it was and that she had departed already.

I have always been uneasy about eulogies and elegies.  Yes, those of us who remain conscious and breathing need to acknowledge our loss.  However, there is the risk of making it into an “enough about you; now about me” rite that not only comforts us in grief but also reassures us what good people we are.  It’s easier to honor people when they are gone, when they ask nothing of us.  I did not know Mary that well, and we were in touch only minimally after she finished her Ph.D., so I do not want to claim a relationship that says more about my own sadness at her passing than about her own experience, which she can no longer relay to me or to anyone else.  As I asked in a seminar I taught last year on music criticism and other topics, why do we so often critique one another while we are here together and then turn to accolades when one of us goes away?  (A note to those who outlive me: be sure to talk about all my annoying traits after I die.  Better yet, tell me about them now and give me the chance to do better, maybe.)

I first met Mary at my Princeton interview in February 1998; I think she was a third-year student then.  When I told her I had heard about her from her mentors, she asked whether it was because she had a child, and I said, no, it was because of the CD recording of her piece “Lizard Belly Moon.”  She was my teaching assistant in one of my first courses, and Paul Lansky “fixed us up” when it came time to identify an advisor for her dissertation.  I’ve long recognized that all of us are, or can be, one another’s teachers; I like how Ben Boretz refers to his teaching career as his “learning.”  Looking back fifteen or so years later, I see even more clearly how Mary was one of the students who, whether they liked it or not, inevitably played the role of “test subject” for me as a newly approved Ph.D. and professor finding my way.  When I joined the faculty at Princeton, a good number of the graduate students were older than I; Mary had five years on me, then.  I was so impressed with the program that I often joked that I should resign and apply to be a student.  I reminded myself frequently that while the students were very accomplished, they had not yet completed a task I had,—writing a dissertation—and so I endeavored to marshal my experience to be of use.  It wasn’t easy for me, and probably not for them either.  I wonder how my own anxieties and uncertainties might have affected Mary’s experience at the time, and I wonder what Mary would say about me if I had been the one who died last weekend.

As so often happens, I wish I had kept in better touch, and I wonder whether I could have been of more use after she completed her Ph.D., but that is really my own regret to manage, not something to lament in public.  I’ll resolve to keep in better touch with friends and colleagues, and I probably won’t.  Mary was one of those teaching assistants who would prompt me for the next organizational task on the horizon before I had had a chance to think about it.  (My teaching assistants regularly praise my organizational acumen, but they also continue to offer such prompts, so perhaps they are just being polite.)  Mary asked a lot of herself: I remember her suffering from a bad cold or bug and pushing herself to get into her class, telling me she kept going on coffee and aspirin.  I worried at the time, even though it is so common for us to put introducing 19-year-olds to Satie Gymnopédies above our own well-being.  I also remember at that time that the graduate dorms were poorly heated, and Mary told me about her efforts to stay warm while working on her dissertation.  Thinking back on  her managing that sort of discomfort gives me a chill.

Mary’s dissertation essay, the first I ever advised, is titled “Fly Flip Music Clip: The Music of Competitive Cheerleading”; maybe it’s not the only dissertation to call upon Debord and Baudrillard and Kracauer to explain the surgically altered clips of Jim Carrey and Guns N’ Roses then used to accompany young women in bright short skirts performing acrobatics to cheer on—no team!  It’s an inspirational cry sent into the void, as weird and sunny as Beckett.  I had not heard of this manic, deracinated sport/art before, and a quick ProQuest search suggests that Mary’s study remains the only one on this topic (though there is one from the 1970s on the effect of cheering on the voice).  Mary brought pompoms to her dissertation defense—in Princeton colors, orange and black—and, throughout the proceedings, she periodically picked them up for a shake and a Mary-like “Yay!”  The pompoms remained in our seminar room for many years, alongside the black-and-white photos of the faculty of yore.  I wonder what Roger Sessions would have made of “Fly Flip Music Clip.”

I often think, “cancer is like . . . a cancer.”  The disease provides its own metaphor, one that reflects its peculiar and deadly manner of effecting decline through abundance.  For various reasons, I do not feel shocked or traumatized by my own cancer experience; I’m more curious and intrigued than I am frightened or repulsed.  I’m interested in impermanence and dismemberment, spiritually as well as physically.

In a poem called “Cell,” Margaret Atwood describes cancer as ravenous and fanatical about its own life:

It has forgotten
how to die. But why remember? All it wants is more
amnesia. More life, and more abundantly. To take
more. To eat more. To replicate itself.

I like that idea, that my tumors might be—might have been, I mean—a sign of excessive enthusiasm more than of decay; though the truth is, despite the oft-stated notion that after cancer “every day is a gift,” I do not always feel that way.  There are various reasons for that, and they change over time.  These days I find myself navigating toxic territory, hostile to growth.  I’m just trying to advance as an ordinary, healthy cell, to contribute to the whole, and somehow,—well, never mind, I’ll just say that it is worse than cancer, truly, outlandish and embarrassing for all concerned.  Is it because of this that I did not see the note about Mary’s illness until it was too late?  Well, I hate to say so, but the answer is, yes, probably.

There is quite enough suffering to go around; why make more?  Why invent unnecessary metaphorical cancers rather than treat the real ones that remain stronger than us?  Why not soothe those who suffer before they leave us to write our remembrances?

See?  I have indeed turned my admiration of Mary back to myself and my own struggles.  Enough.  Just one final memory: in the course of her dissertation research, Mary introduced me to a marvelous and zany film from 1934, Busby Berkeley’s “Dames.”  (Go watch it, right now.)  It’s a riotous example of what we call Mickey Mousing, the practice of joining movement to sound in close synchrony.  Mickey Mousing is often derided by composers, but exploring, even defending it—to a point—has become one of my primary vocational objectives.  (I cannot recall how much Mary’s and my shared interests were correlative or causative.  Eventually all learning becomes one’s own in some way, I suppose.)  In “Dames,” pairs of women rise out of bed (!) to greet the day: then they preen at their respective vanity tables.  We see doll-like ladies approach the screen and smile directly at us: a counter-example to the phenomenon known as “the gaze,” which would be articulated forty years later by scholar Laura Mulvey.  Here women become abstract “material” for visual manipulation, reminiscent of the dancing whisks in Léger and Antheil’s “Ballet Mécanique.”  They fly into the air toward the camera, accompanied precisely by swooping sound effects.  The group of mostly indistinguishable women are chopped up and refracted into kaleidoscopic patterns.  Womanly cells proliferate, make a whole and devour one another.  It’s eerie to watch this with cancer in mind.  I think about unbridled growth.  About dismemberment.  And about synchrony.  About parting, coming apart—and about meeting up again later, hopefully, when circumstance line up once more.

At least I did manage to tell Mary how much I loved this film,—many times, I bet‚—and how much I appreciated her giving me such a gift.  I have thought of her each and every time I have watched it, and she has enriched my own students through me.  That is another kind of growth, expansion, and proliferation.  I shall continue to think of her every time I marvel at those dames.

—Posted by Barbara A. White

Facebook™, is this Shot Obscene?

Breaking News:
Cancer BANNED by Facebook as ‘pornographic.’

Image

Facebook™, is this shot obscene?
What if it were clothed in green?

Facebook™, is this scar taboo?
Would you Like™ with a tattoo?

May I post it on my Wall™?
Or would that incite your gall?

Is it truly crass to Share™?
Some think your rules most unfair.

Is the gauge of blur and grain?
Or which Friend™ exacts the pain?

Is wound-Pink™ indecent too?

(Older, younger, healed or new?)
(Prosthetically out of view?)
(Would you rather I shoot you?)

Some can’t help it.  What to do?

***Pink™ courtesy of Breast Cancer Awareness Month™.  All rights reserved.