Tuesday, January 25, 2005

Cancer and the Ordeal

For oft, when on my couch I lie
In vacant or in pensive mood,
They flash upon that inward eye
Which is the bliss of solitude;
And then my heart with pleasure fills,
And dances with the daffodils.

"I Wandered Lonely As a Cloud"
-William Wordsworth, 1804

There are weekend afternoons when one wants nothing more than to plop down onto well-stuffed chintz, toss a couple of pillows over the weary frame, and rehearse a certain vapid look popularized long ago by the poet of the lake. After scrubbing the pots, carting Junior off to his afternoon game, and enduring another mind-numbing shuffle down the aisles of the mega-market I think one has earned the right to a quiet hour alone. An ambitious soul may find this intermission wasteful and prefer to flit about, solving the problems of the world, or if none are apparent, creating some. Anyone so engaged in such meritorious pursuit who seeks my counsel can find me on the sofa.

Ah, the couch - that horizontal parking space where one can relax the mind and let it wander for hours through fields of lemony flowers, or in my case exactly one daffodil before I lapse into unconsciousness. I would not guess that all practitioners of the art of napping use the pastoral setting for their musings, but it cannot be denied that two centuries after Wordsworth's vivid stanzas were written they remain one of the most beloved depictions of lollygagging ever memorized by a freshman. How delightful it is to replay soft scenes from a lifetime of adulation while thumb-sucking in a quiet corner, the faithful hound or tabby lying nearby in respectful imitation.

I enjoyed a similar repose recently, and between ignoring the interjections of children and the jarring sing-song of the telephone I recalled (pensively, no doubt) an incident from my youth. I had no idea why it surfaced, but soon connected the dots and realized that once again the disease I loathe had invaded my solace.

What I remembered was an event from my Boy Scout days in which certain members of the troop were inducted into the organization's national honor society, called The Order of the Arrow. The induction ceremony, known as the Ordeal, takes place at night. Scouts who best represent the Oath and Law of the troop are secretly voted into the Order by their peers, and on that evening a moving ritual takes place. I recalled how the moon hung just above the trees that night as we lined up in a giant semi-circle. Drums beat out a melancholy march while a guide dressed as a Native American walked silently in front of us. When he passed in front of a chosen scout a hidden signal was given, and the guide would knock the boy out of the line with a mighty push, turn solemnly, and resume his stride. As those honored scouts were taken off into the black forest the remaining members stood by quietly, wondering who was next. I quivered under the stars that night, and it was not from the evening chill - I was petrified that I was going to be tapped by the imposing warrior, yet also desperately hoping that I would be selected.

As I lay on my couch, some thirty years later, I considered the meaning of the ceremony. Standing side by side with friends, one is frightened that a symbol of power would suddenly turn and smite him without warning, before one is able to brace for the blow.

Suddenly the metaphor was clear...

This arbitrary culling of people reminded me of how cancer strikes the innocent.

Many patients who follow a healthy lifestyle have been cut down in their prime by the inexplicable fury of a malignancy, felled like saplings before the woodsman's blade. No explanation can satisfy the question as to why one is singled out for an early grave. Just as the feathered brave passes by each scout during the Ordeal, so cancer floats over neighborhoods and homes, hovering softly before drifting downward toward an unsuspecting sleeper. Why one person is afflicted and another not is beyond my understanding. It is as mysterious to me as the ceremony of the Ordeal.

Eventually I was tapped into The Order of the Arrow - a thrill that over the years has dimmed within the inward eye, as all memories do. Cancer, however, creates memories that last long after those of childhood have receded - sometimes it even intrudes upon these happy reflections. If so, it is better to blind the inward eye, rather than suffer the fate that Wordsworth recalled:

Turn wheresoe'er I may,
By night or day,
The things which I have seen I now can see no more.

The curse of the oncologist is not that he no longer enjoys the visions of his youth, but that he sees this vile disease trespass onto his memories. He rarely finds comfort when lounging on a sunny afternoon. The mind whirls with a vortex of incongruities; his time on the couch is short.


At 5:08 AM, Blogger Hoots said...

Another fine essay. I sense that your weblog is one of the tools in your bag protecting you from fallout from your line of work. You are on the way to a very fine little inspirational book, you know, for a niche market of other professionals.

In case you don't already know of it, you can add to your repository of literary and philosophical resources a Kierkegaard piece that I have always found comforting, A Bit of Spice. Perhaps being in the food business makes it easier for me to understand God's ways in a cooking metaphor.


At 8:05 AM, Blogger Chris Warren said...

I started reading your posts a week or so ago. I have really enjoyed them. I work in oncology clinical research...from the project management side. So much of what I do revolves around data-deadlines, quality assurance, and planning... It's nice to read reflections about the "human" side of cancer care. Keep up the good work.

At 10:17 PM, Blogger Jeni said...

Thankfully I haven't had to work with an oncologist but because my son has type I diabetes, I have spent a lot of time with pediatric endocrinologists. Once upon a time, when I was still somewhat jaded, I was convinced that having little to no personality or emotions and speaking in a constant monotone was a prerequisite for endocrinology.

However, your posts have given me a more personable and real look into the heart and soul of a person who has chosen to take on the role of a physician.

You have impressed me greatly.

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