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The contents of this website are for contemplative purposes only. No medical advice will be given, and emails asking for medical advice will be ignored.

Although patient vignettes are based on my experiences with real individuals, I liberally change details to maintain patient confidentiality.

I also reserve the right to change old postings to correct errors, and to delete comments that include obscene language or that I deem abusive to me or other commentators.  If you are looking for a open mind, I suggest you consult a neurosurgeon.

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Tuesday
04Nov2008

Election Day: The Pro-Life Ultimatum

I’m going to go out on a limb and admit that I am anti-abortion. Nor do I mind using the term anti-abortion instead of pro-life. Pro-life means nothing to me. Everyone likes life, just as we are all pro-money and pro-sunshine. Call me anti-abortion as you like, but in return I demand reciprocity – the opposing view is pro-abortion. Pro-choice is a camouflage. Everyone likes choice, just as they like life. It’s what you choose that matters.

But this is no anti-abortion tirade. In fact, I intend the opposite – to present my grievance with the anti-abortion crowd.

I am a Catholic, and spend a fair amount of time cruising Catholic websites. These days, with the election coming up, the push is on in almost all conservative Catholic quarters. A vote for Obama is a vote for abortion. A vote for abortion is a serious sin. Oh, but otherwise, feel free to vote however you want. Here is a representative comment, courtesy of Deal Hudson, writing for Inside Catholic:

 

What should we make of Catholics who vote for the persecution of their Church and the ongoing killing of millions of unborn children? That's between them and God. I'll just offer this little catechetical reminder: Holy Communion received in a state of mortal sin is itself a still graver sin -- one of blasphemy

 

Janet Porter of Faith2Action puts it even more bluntly:

Then obey Him in the voting booth and out of it. If not, do us all a favor and quit calling yourself a Christian.

 

Numerous Catholics have been threatened with the withholding of Communion for supporting abortion rights. Now the rage is withholding sacraments for simply voting for a pro-choice candidate, never mind the voter’s personal beliefs. One prominent Catholic, Douglas Kmiec, a law professor at Pepperdine University and prominent Roe v. Wade critic, was denied communion at a Mass in April. Denied not for being pro-abortion, but simply for being pro-Obama.

This is a new twist in Catholicism, to my knowledge. It is a sin now not only to perform an act or to enable an act, but simply to vote for someone who supports a legal decision that might allow a woman to choose to have an abortion. Third degree guilt.

The entire argument leaves unexamined the question of what it means to vote. When I go to the polls and vote for a candidate, I don’t consider my vote a stamp of approval. I consider it a raw choice that says I like society’s chances with person A more than with person B. It does not mean I support everything Person A wants to do. In fact, I may, as soon as person A wins, go right to work opposing some of the things he proposed doing. This is how democracy is supposed to work. A vote is neither a blanket approval nor a free pass.

Further, this sticky notion of abortion, the idea that the guilt of abortion rubs off on every person who comes in contact with it, stands in contrast with what I know about Christian theology. Christianity teaches that we are all free to choose to go good or evil, and that the responsibility for our decisions lies with us, to the degree that we are free to make them. As such, the guilt of abortion, however great it may be, stains the people who choose to have them. If stealing were legal, would that make me a thief? A thief bears the guilt of theft, regardless of what the law says. As a citizen I may have the responsibility to try to reduce theft, but if theft happens, that does not make me guilty of it.

I want to make clear what I am saying and what I am not saying. In no way do I condone abortion. I support legal abortion when it is necessary for the health of the mother, and though I am not comfortable with it in cases of incest, I don’t think that is a battle the anti-abortionists are going to win and so would possibly concede it for the greater good. Nonetheless, while I agree with the pro-lifers in principle, something about their methods is deeply disconcerting.

It took a while for me to figure out what the problem is. But as I thought about it, I finally identified my distaste: the intellectual coercion. Presenting a follower with a list of beliefs and calling it doctrine is one thing, but telling people to vote one way or literally burn in hell is quite another. There is something insulting about carefully cultivating conscience in my mind through doctrinal teaching, and then refusing to allow me to vote my conscience.

From experience, I know that many Catholics are hazy on fine points of doctrine, such as the Virgin Birth, the Immaculate Conception (not the same thing!), the Assumption, and the meaning of purgatory. I have never seen a Catholic denied Communion over any of these issues in my lifetime. In such cases, the Church takes the understandable and pragmatic position that it is better to tread softly, re-educating believers and bringing them gently back into the fold. Only people who want to vote for Obama are being shown the door.

Critics of religion often complain about the rigidity of organized faith, how churches brainwash adherents into doing their bidding. As someone on the inside, I have never thought that way.  I have always felt that sharing beliefs with others is what makes believing so beautiful. Believing alone can be very isolating. Believing alone can also tempt a person to feel alarmingly self-righteous.This is the grave danger I see in driving more liberal voters away from the Church. The remaining members will be less diverse, more calcified in their political conservatism, and intolerably self-righteous. Jesus ate with the sinners and tax collectors and the Church has never taught that their sin rubbed off on Him. In fact, Jesus had his own opinion about living with sinners.

Jesus said, 'It is not the healthy who need a doctor, but the sick. But go and learn what this means: "I desire mercy, not sacrifice." For I have not come to call the righteous, but sinners'" (Matthew 9:10-13).

 

This does not mean Christians should hold the hands of women as they have abortions. It means that sinners are out there in the world, and we are called to live with them, not to condemn them as enemies.

I don’t know what the solution to the abortion issue is. But I do know  it is not demonization. Demonization has brought us to the place we are now. Two groups, diametrically opposed, bent on crushing the other. For left-leaning Catholics like me, that leaves a ridiculous choice – I can either vote conservative all the time, which goes against my conscience on most issues except one very important one; or I can vote liberal all the time, which puts me at ease with most major issues except one.

What kind of a choice is that, and why, as a moderate, do I have to submit to such a swindle?

If pro-lifers would loosen their death grip on conservative politics, maybe a few moderate anti-abortion candidates would emerge that I would feel comfortable with. I would be delighted to support a slightly left-of-center Democrat who was serious about reducing abortions. Where is that candidate?

He or she doesn’t exist because pro-lifers swing so hard to the right. To be moderate and pro-life these days is political suicide. Both the left and the right will abandon you.

If Church conservatives want me to start voting pro-life, they need to give me candidates I can support. This means pro-lifers need to start doing what they are asking me to do – support a candidate that does not strictly conform to their point of view if that candidate will help in the abortion fight. In short, they need to be flexible.

Let’s say I bend to their wishes and vote for McCain. If I do, and he wins, will the religious right moderate a little bit and give me some of the things I want, like an end to the Iraq War, and universal health care? The answer to that is no, and hell no.

So if I submit to them, and vote straight pro-life, I can kiss all my other political beliefs good-bye. You will excuse me, then, for my hesitation.

Sunday
23Dec2007

Mr. Finkle

Dear Horace,

Thank you for your Christmas card. I appreciate your remembering me around Christmas, and I know you are quite busy. This only makes the card that much more meaningful. I also appreciated your little note. Your handwriting is quite good for someone who only types on the computer. In my day a young man's character was judged in part by the quality of his handwriting.

I know it is rare these days to get a personal letter by U.S. Post, but this is what I am used to. Perhaps it will be the last personal letter you, or anyone you know, will ever get. You might consider submitting it to the Smithsonian one day.

Your questions surprised me. For some reason I thought your mother had explained these things to you quite some time ago. Perhaps it would have been better if I had simply telephoned, but my mind works slowly these days and it took some time to figure out what I wanted to say, so this seemed the better way. You may be in the habit of opening your mail over the trash can, as I do. However, your answers will take some time, so I suggest you lean against the kitchen counter and rest yourself a few moments while you read.

First of all, the easy one. I had a brother once named Horace. He was a World War II veteran, and rather eccentric. He was eight years older than I, and never had any children of his own. When your mother was pregnant with you she had every intention of naming you Johnny, but Horace wrote (in another one of those annoying epistles!) passionately urging that you be named after him. "I will die without an heir," he said. "Please give me a namesake." He promised to give you his life's savings in his will. He died when you were two, and as for his life savings, we found that he had quite lost his mind to what doctors now call Alzheimer's but at the time we only knew as senility, and someone has swindled him out of all he had. He was a nice man, though. Horace is a good name, although I know in can be shortened to an ugly epithet that you were likely subjected to in grade school. I trust as you get older you will appreciate it more.

Your mother could have answered this question as easily as I have. My guess is that she referred it to me because she knows I like to tell stories about dead people more than she does.

As to the other question. Although you know me now as a sophisticated city girl, when I was a child I lived in a small town named Cairo in the American South. (I don't know why I am in the habit of saying American South; many countries have southern regions but there is only one South, by my accounting.) My father was the town lawyer, and we were fairly well off -- especially after the oil money came to town. I attended a small private school, and led what I can now only call a sheltered life.

One day at school, our teacher announced that a professional pianist would be performing for the entire student body. The teacher handed each of us a card. It read, "Howard Finkle, Concert Pianist." To the left  of the name was a stately treble clef, elegant and assertive as bold handwriting. It was a business card. Now, Horace, I know that in these days of electronic printing business cards are commonplace, but in those days they were the exception, so this item was to us quite an artifact.

We filed into the school gym. Finkle eschewed the stage, instead rolling the baby grand piano into our midst. We sat in a circle around. He wore a golden tie and a fine, dark blue suit of a quality unknown in Cairo. He spoke a few words to us, and then sat down to play. He played only classical music, but when I heard the first note, I no longer believed there was any other kind. He played for almost an entire rapturous hour, then closed the lid on the keys, thanked us, and left without ceremony. Later the teacher told us that Mr. Finkle was new to town, and would be giving lessons to children interested in learning the piano.

Perhaps you can imagine the uproar that ensued. Every child at our school returned home that day and begged his or her parents for piano lessons. I expect the scenes played out in every home as they did in my own: My parents sat at the kitchen table, expressions of skepticism on their faces, saying to me, "Martha, you took piano lessons two years ago. You never practiced. No one has touched the piano in the year since you stopped." "But Momma, Daddy, please," I implored. "Mr. Finkle is different. He is a great teacher. Oh, you have to let me. You just have to."

A few days later Momma called Mr. Finkle and asked him to add me to his list of privileged students. It was a very long list. All of the -- how shall I put this -- well-bred children signed up. Mr. Finkle, it seemed, was an instant status symbol in Cairo.

Excitedly I waited for my first lesson. When the day finally came, I tucked a few of my old lesson books under my arm and walked the four blocks to Mr. Finkle's house. (I know this may be a bit of a shock to you, Horace, but in my day parents thought nothing of letting their nine year-old daughters walk unaccompanied four blocks. Don't ask me to explain it. It was a different time.) Mr. Finkle was living in Dr. Sartoni's house, renting it while the distinguished doctor took a 6 month sabbatical in Italy. The doctor's home was always known as the most elegant in town, but somehow Finkle's presence enhanced even this aura of fineness.

I went in, and waited in the foyer some minutes as Mr. Finkle completed the prior lesson. The student, Tommy, a grade ahead of me in school, left, and Finkle let me in. Finke taught in a remarkably elegant velvet smoking jacket, though he never smoked during his lessons. I presented him my lesson books, but he set them aside. "Martha, I want to see what you can do." I stared at the keyboard, unsure how to proceed.

"Ah, my dear Martha, it is as I suspected. Your teacher taught you scales, taught you to read notes and keep the beat, but you have never learned how to play a song, have you? I want to teach you music, not scales."

And music is what he taught me. He told me to put my lesson books away and he gave me sheet music to practice with. Every week I went, my heart beating eagerly, half because I loved music and half because I had a hopeless crush on the instructor.

Mr. Finkle, rumor had it, came from New York. He had a regular job with an orchestra, the story went, but unfortunate circumstances forced him to give up the job. He was a friend of Dr. Sartoni, and had moved to Cairo for a respite. He was as popular with the adult community as with the children. The adults admired his musical talent and understood that he had led a remarkable career in New York, although, like the children, they lacked knowledge of some of the particulars. One community grandame created a considerable stir when, on a trip to Florida, found a record of Schubert recordings that featured our dear Mr. Finkle as a soloist. The record made the rounds in town for quite some time, adults and children alike crowding secretly around record players to marvel over his interpretations, even though most of them knew next to nothing about classical music.

The maestro himself, as some took to calling him, was seen all over town in the company of some of Cairo's finest ladies. This caused me no end of jealousy, sometimes even to the point of tears. Finkle's taste in female companionship was as discerning as it was in music. I would like to think that eventually I would take my place among Fulsom county's most beautiful and sophisticated ladies, but at age nine I had maturing yet to do. He could be nothing more than my teacher.

Mr. Finkle remained with us for only four sweet months. I will now relate the circumstances of his leaving -- and no, Horace, I have not forgotten your question; your answer is coming shortly. By early November, now known for his exceptional skill, Finkle was approached by several local church congregations to lead their Christmas concerts. He signaled an initial willingness, but when he learned that most of our local churches were fundamentalist and he was being asked to play some of the most stalwart hymns in our repertoire, he declined. After an initial reticence, he at last explained himself. "I cannot participate in your religious celebrations because, you see, I am not Christian. I am a Jew, and not an exceptionally good Jew at that, though I would never go so far as to say that I have abandoned by beliefs. On the other hand, it would be disingenuous of me to pretend to be Christian. 'Jingle Bells' I can play. Maybe even 'Silent Night' if the mood is light enough.  But it would be improper for me to lead you in anything more serious. My apologies."

His apologies were not well accepted. When the townsfolk realized Mr. Finkle was not Christian, they began to withdraw their children from lessons. The best local ladies permitted themselves to be seen with him less and less often. My parents broached the question of withdrawing me from lessons also, but facing an outburst of tears, they backed off.

Horace, I am embarrassed at the behavior of my neighbors, to be sure, but I would be remiss if I led you to believe that the honorable man was ostracized. Nothing of the sort happened. He simply ceased to be the center of attention is all.

At last Mr. Finkle announced to his remaining students that he would be leaving town. I was, needless to say, devastated. As a child who naturally thought the world revolved around her, I had thought my loyalty to him created a bond between us that would never be broken. In my last few weeks I learned as much as I could. Christmas week was nearing, and I practiced at home harder than ever, perhaps with the foolish hope that if I showed enough promise as a pupil, he would change his mind. He and I never spoke about his social situation until the very last lesson.

In our town, citizens maintained a Southern sense of dignity in our interactions with each other, meaning that we pretended not to be curious about each others private lives even as we prodded into every secret. I knew some things about him, therefore, that I never revealed that I knew; but in the end I had to know the answer to the question burning in my child's heart and understood that I would only find out if I asked.

Midway through the final lesson, I burst out: "Mr. Finkle, I hope we are not chasing you out of this town!"

He paused, his fingertips resting on the piano keys. "Oh, of course not, my dear Martha. It is simply that last summer I lost my job in New York, and this fall it was offered back to me. After some soul searching, I decided to accept. I like it here in Cairo, but I cannot pursue the career I want to in a town this small. That is all."

"Mr. Finkle," I said, "You told the people in town that you do not believe in Christmas. If you do not believe, how do you live during the Christmas season? I mean, everyone else is celebrating. You must feel so left out!"

"Sometimes I do, but often I don't. I often find it within myself to celebrate along with the Christians. Up to a certain point of course."

"How can you do that if you do not believe?"

Mr. Finkle got up, and walked over to a bookshelf where he kept a large collection of sheet music. He ran his finger along the shelf, finally selecting an item and sliding it out. He walked back to the piano and stood by the bench.

"Martha, when I was your age I lived in a strict Jewish household. I was learning the piano as you are now, and I heard a piece of music I thought was the most beautiful I had ever heard." He took the music and placed it on the piano. I read the words on it: "Jesu, Joy of Man's Desiring."

"It is still one of my favorites. I think the man who wrote it is one of the greatest composers of all time. He believed the sentiments of this work, and wrote many other sacred Christian pieces. Since I love the man who wrote this, I love his beliefs -- through him. I will always remain a Jew, but I will also have deep respect for the beliefs of those I care about. When I think of Christmas, I think of "Jesu, Joy of Man's Desiring," and pieces like it, and love Christmas through the hearts of the composers who create such unearthly harmonies. This is what music is all about, at least for me."

I left there in tears, and went to visit him one more time before he left town, but that is the main part of my story. Mr. Finkle, I am told, went back to New York and resumed a distinguished career. As a concert musician, I am not sure he ever gave lessons again, and I sometimes flatter myself thinking I was his last student. But I don't know that.

This then, is the answer to your second question. I have no idea why I waited so many years to tell this story to you. You know your Grandma Meyers has never been at a loss for words, but for some reason I have always held this one close to my heart. Now you know.

And so, when you come to your aunt's house on Christmas, you will for the twenty-first time hear your old Grandma labor out "Jesu, of Man's Desiring" with her bony fingers on the old piano, knowing why I hardheadly insist that all of you listen to it. God, I hope your aunt remembered to get the thing tuned this year. Last year's performance was horrible, but it wasn't all my fault. I have been reminding her to call the piano tuner since September.

I look forward to seeing you when you get back from school. Hugs and kisses.

Your Grandmother,

Martha



Wednesday
31Oct2007

The Trial of G. W. Bush

A Halloween Horror Tale

 
He closed his eyes. The image of his family, their faces gathered tearfully around his bed, faded. He drew a breath, his last, and heaved no more. There was a temporary pain, only a few seconds, and then he saw a bright light. Slowly he struggled to his feet and walked unevenly towards it. So this is what I have been waiting for all my life, he thought. My final reward.

The light shone through an open door, and Bush stepped through it. He rubbed his eyes. This was not heaven.

He turned to his left and saw a large man in a guard's uniform standing next to him. Without a word, the guard reached for Bush's wrists and slapped handcuffs on. Bush could feel sharp claws on the guard's hands as he yanked on the cuffs. They were cold, and not the hands of a human. What was going on? Was he under arrest?

Forcibly the guard led him up a dozen steps and into a wood paneled room. This was a courtroom, but no earthly courtroom. The court audience was composed of the strangest mix of creatures he had ever seen -- angels and demons crowded wing-to-horn on bench after bench, packed so tightly that they spilled out into the aisles. To make their way past them, Bush and the guard had weave left and right to avoid an obstructing wing here, an errant cloven hoof there. Though Bush had always thought of angel and devil as mortal enemies, they seemed content to sit together. As the guard marched him towards the front of the court, the gallery erupted, the demons spitting out every expletive known to the netherworld, the angels shrieking like eagles diving upon their prey.

The guard led Bush to the defendant's seat at the front of the court. He looked cross the aisle, and with mute astonishment watched as a huge devil, flames pouring from his blistering skin, took a seat on the other side.

A whisper in his ear. "That's the prosecutor, Mr. President." Bush could hardly pull his eyes away from the hideous creature, but when he did he saw that the whisperer was a man. And not just any man. "Pleased to meet you, Mr. Bush, I am your attorney, Clarence Darrow."

"Mr. Darrow," Bush said anxiously, "I am very glad to see you here. You and I seem to be the only humans in the room. Can you tell me what is going on here?"

"You are on trial, Mr. Bush, for the crimes of your lifetime. There are three charges against you, as you will soon see. The pleas you enter, and the judge's decision on the charges, will determine if you go to heaven, or hell."

"Can we get a continuance?"

"I am glad to see you have not lost your sense of humor, Mr. Bush, but no. This trial continues until it is completed. Since you are now dead all the facts of your life are in evidence. But fear not; I have reviewed your case carefully and think we have a good chance of winning."

Their conversation was interrupted by the pounding of a staff on the floor. A centaur took his place on one side of the judge's bench. "This trial, G. W. Bush vs. the State of Eternal Judgment is called to order. All rise for the judge, the Honorable John Doe." A black robed figure emerged from a door behind the bench. The judge was an absolutely normal looking man, white haired, balding, and thin, someone who could have spent his entire life as a clerk in a customs office.

"Not what I expected," Bush whispered to Darrow.

"He is a common man with a common intellect. You are not to be judged by some superhuman standard, Mr. Bush, but by common sense."

The judge called the court to order, and promptly asked that the first charge be read.

The Prosecutor, the huge devil who had so terrified Bush when he walked in, rose to his feet, and said, "Your honor, the first charge: That the defendant ordered an invasion of a foreign country on false pretenses, resulting the loss of life of many thousands of people."

"Your evidence?"

The Prosecutor waived his hand and with a pop a fire erupted in the middle of the room. Within the blue flames all in the room could see flashes of events from the months leading up to the invasion of Iraq. The audience saw speeches about weapons of mass destruction and public reports trumping up false evidence.

The judge turned to Bush. "How do you plead?"

Bush stood up. "Innocent, sir." He sat down. Then Darrow stood up to speak.

"Your honor, my client is the victim of circumstance. He is dependent upon his minions to deliver accurate information to him. My client is a good man and only wanted to do the right thing. He believed in the people who advised him, and acted on the best information he had at the time. Like any leader, my client had to make a rapid decision based on incomplete information. The war the Prosecutor refers to may have been right, or it may have been wrong, but my client did his level best to come to the defense of the people he led.

"Further, he only wanted what was best for the enemy, the people of Iraq. His goal was to free an enslaved people and bring them democracy. Is this not the height of morality, to seek to bring good to one's enemies? Certainly this is no crime!"

The judge paused a minute. "Counselor, well put. I find your arguments wise, and agree with you fully. Your client is found innocent of this charge."

A cry went up from the gallery. The centaur pounded the staff. "Order!" he boomed out.

The judge said: "Prosecutor, you may now read the second charge."

The Prosecutor stood up again. "That the accused has used his presidential power and the excuse of war to deprive his own people of their civil rights." The demon waived his hand again, and in the flames were images of Bush approving orders to spy on private citizens, and to harass individuals in America and abroad in the name of national security. There were plans to limit access to voting, and efforts to jail people without fair proceedings. Finally, there were the faces of people tortured during interrogation processes.

As before, Bush rose to plead his innocence, and then Darrow spoke in his defense. "Your honor, my client was only trying to protect. As a leader, his primary goal was to assure the safety of his people. Why do people choose leaders? Why do they choose to follow authority, and not to wander the plain like lost sheep? Because leadership offers safety. When a group moves as one mind, under a leader, it is safe. My client was only interested in protecting his followers, and this required moving with determination, and decisively."

There was a murmur in the crowd.

"Any mistake my client may have made in this matter was certainly not his own. Often he had faulty information to work with. The news media distorted his every action. Under the circumstances, his accomplishments have been admirable -- yes, I say -- admirable. His followers, did they object to the tiny compromises in their freedoms that their leader made? No! They did not object. They stood with him. And what of the few who suffered for the many? This is the way of heaven, is it not? Does not the Bible, time and time again, tell the stories of men who are called to suffer for the salvation of the majority!"

Mr. Darrow sat down, and again the judge paused to consider. "Again, counselor, I find your arguments persuasive. Your client is found innocent of the second charge. Prosecutor, please read the third charge."

For the third time the Prosecutor stood up. Blue and gold flames streamed form his body more brightly than ever, and in his face Bush could see an expression of frustration. The terrible Prosecutor could not believe things had gone so well for the defendant.

"That the accused has failed to use the great powers given to him by Providence. That a great hurricane struck the homeland and he went on vacation that very day, not returning to aid the poor and suffering until embarrassment made it unavoidable. That he made no effort to make life easier for the millions of poor under his charge, and was unwilling to help the suffering who had no access to health care."

For the last time the Prosecutor raised his arm. In the burst of flame before the court, Bush could see thousands of stranded people waiting for help, without food and water. There were people standing on their own roofs, weeping, abandoned in a wealthy country. He could see people with terrible illnesses, suffering without any hope of succor.

The crowd gasped.

Bush pleaded innocent to this charge as to all the rest. Again Darrow made his case. "Your honor, this last charge may seem the most serious and difficult to surmount, but it is in fact the easiest. Is it the duty of a parent to protect his child from every scrape and harm? No. A parent should, indeed, must, allow the vicissitudes of life to take their toll. For a child must grow to become a man or woman, and must face and overcome hardships on his own. We begin as children, but cannot forever remain so. We are adults, and responsible each for our own selves. A parent who protects his child from all harm places the child in a bubble, and denies that child the opportunity to grow. For we only grow when we learn personal responsibility!

"My friends, and your Honor, a great leader leads, but he does not always protect. Does God save every child from death? Is it not true that a protector can also be a jail keeper? My client allows his followers to do what they think is best for themselves. He allows them the freedom to choose their own paths. It is reasonable to expect that this loving mode of leadership might occasionally lead to difficulties. A parent expects his child to scrape his knee from time to time. This is how the child learns.

"The defense rests."

The gallery erupted in a conflagration of joy and rage, angels weeping and hugging one another, devils bounding back and forth like animals and hurling balls of flame against the ceiling.

"Enough!" the judge said. The courtroom quieted. "Mr. Bush, you have presented your case well. My compliments to your defense attorney, Mr. Darrow. He has carried the day many times in this court, and recently, more and more often. I find  you innocent of the final charge. You are remanded into the custody of your counsel, who will deliver you to your eternal dwelling."

Bush was elated. Free! He gazed into Mr. Darrow's eyes, and saw within them a hint of confidence and pride. Many men like this one have worked for me in the White House, he thought.

Mr. Darrow took Bush by the arm and led him to the steps outside the courthouse. A throng of reporters had gathered there, angels, devils, and all means of beasts, snapping pictures and asking questions. The trial of the President was big news in heaven and hell. Bush thanked his defender, told jokes and laughed, and said, "I was confident that I would succeed from the very beginning. Mr. Darrow is an excellent lawyer and he did me great justice. I will enjoy spending all eternity in his neighborhood. And so, to you Mr. Darrow, I say: Mission Accomplished."

Most of the reporters laughed heartily, but some of the angel reporters shuffled their feet with uneasiness. Bush couldn't figure out why. But he was too happy to be concerned.

After Bush had answered all of the questions, Mr. Darrow touched him on the arm. "Mr. Bush," Darrow said, "A word with you, please?"

Bush said his goodbyes to the reporters. Mr. Darrow led Bush back into the courthouse and into a small office off the main lobby. He closed the door, and they were alone.

"Mr. Darrow," Bush said, "I cannot thank you enough for keeping me from the clutches of that terrible Prosecutor. I don't mind telling you that, while I knew we were in the right from the first, I was a little nervous."

"Mr. Bush, it has been a pleasure having your as a client." He turned askance and looked off into the darkness out the window. Bush swore he could see something in his eyes. A spark, maybe? Darrow's eyes were so dark, smoky. Something was not right. "It was a pleasure defending you, and now it will be a pleasure receiving you into my kingdom."

"Your wha--"

Darrow began to laugh. The laugh was pleasurable and light at first, and then it deepened and vibrated, and grew very, very cold. Bush could see Darrow's teeth growing longer, transforming into fangs. Horns grew from his forehead and tongues of flame began to percolate from his skin.

"You -- you're Satan! I don't understand! You defended me from the charges! You made me a free man!"

In his transformation Lucifer had grown at least a foot, and now loomed over Bush. "You fool. It was so easy. Didn't you listen to the judge? He did not free you. He remanded you to my custody! You are by no means a free man. What you are, my friend, is a slave."

Bush was numb. He tried to talk, but nothing would come out.

Lucifer turned away and started pacing the room. "Time was," he said,"that the strategy I used on you netted us very few souls. Even in the Victorian era, it was difficult to pull off this trick. Back in the old days, people had a little humility, would admit a mistake if challenged, but no matter. These days, the trick works so very, very well."

"What trick?"

Satan walked over to the desk in the room and picked up the newspaper on it. "In hell, we publish an updated edition every ten minutes. Nothing else to do." He tossed the paper to Bush. On the front page was the story of his trial, with the headline, "BUSH COMMENDED TO HELL. THE PRINCE OF DARKNESS WINS AGAIN WITH THE 'NO PENANCE' GAMBIT."

"What is the 'No Penance' gambit?"

"Oh, just one of my many tools. The Prosecutor, you see, was no devil. He was an angel of one of the highest orders, a serphim, I think. Of course, he looked like a devil to you, but that was the trick." With a clawed finger he pointed to the photograph in the paper. On one side was Bush and Darrow. In the picture, Darrow had a serpent's tail trailing from his coat. Bush couldn't believe he hadn't noticed it before. On the other side of the courtroom, at the Prosecutor's table, was the most beautiful creature Bush had ever seen.

"That is not the creature I saw in the courtroom. He was a beast, a horrible beast!"

"Self-deception. That is my bread and butter, my friend. The angel was accusing you; he was your conscience. You, rather than face your conscience, chose to make him into a devil. The angel was trying to save you. How, you ask? No human is perfect, nor is any human expected to be perfect. You were expected to recognize your imperfections and own up to them. The Prosecutor offered you three chances to admit your error. If you had pled guilty to any of the three changes, even in the most minor way, you would have been sentenced to penance. Penance is the path to purification! If you had admitted your wrong, the road to heaven would have opened up to you.

"Did you do that? No, not you! You placed the blame on everyone else, on circumstance, on your followers, on anyone and everyone but you. Because you did this you severed yourself from forgiveness. There will be no forgiveness for you, not now."

"But, this is impossible. I did not make my defense arguments, you did! Why should I be held responsible for the words of Satan himself!"

Lucifer laughed. "You didn't stop me. If you had hesitated even for a moment, I would have stopped. That is the rule I am bound to: I cannot make an argument my client is not in complete agreement with."

"No ! This cannot be. I have devoted my life to public service."

"Yes, that is what many of your friends said who came before you. Cheney, Rumsfeld, Larry Craig, the entire Supreme Court, Newt Gingrich -- oh, the list is so long. Many of them blamed you for their sins. None of them thought to blame themselves, which is why they are in hell too. You lived the longest, and will be one of the last of your cohort to go in. By the way, I gave Cheney a chance to go back and warn you at the cost of one day of torture. He declined."

There was a knock at the door, and the door opened. Two demons entered carrying a large crate.

"This, my friend, is your slavemaster for the next 91,101 years. She is a spirit that died only a few months before you, but here in hell, time moves a bit differently. She has been tortured for 66.666 years, and is looking forward to returning the favor on a new recruit."

The demons tore open the crate, and a horrible beast leapt out. Her face was vaguely familiar. The beast had a long whip in her left hand, and every few inches the whip bore hooks and spurs intended to dig into flesh. The Slavemaster shrieked, and the sound bore into Bush's eardrums like spikes. She raised the whip over her head.

"Mr. Bush, meet Oprah. Oprah, this is Mr. Bush."

Indifferently, Lucifer turned his back on the pair and strode out of the room. The whip came down with a thunderous clap.

Monday
05Mar2007

The Ambulance Ride

Nora heard it coming into the parking lot. She rose from her seat at her son's bedside and walked over to the window. Through the blinds she could see it. An ambulance, and it was theirs. She knew at a hospital ambulances came and went at all hours, but she felt certain this one was her son's ride. It wasn't simply intuition. She had been through this three times before, and she had the timing down. About two hours ago the ER doctor had made the call, and she knew how long it took for a transfer team to make it from Children's Hospital to St. Tammany General -- two hours. The time had passed, and there was the ambulance. There was no coincidence.

In less than five minutes a team of paramedics appeared in the hallway outside her son's room. A doctor had come with them. The transport team. Nora, standing at the door of the ER exam room, watched them through a small glass window in the door. The window, crosshatched with wire to make it shatterproof, was usually used for the medical staff to look in and size up patients, Nora supposed. She was using it to size up the transport team. A few minutes of observed loitering was enough for her. She walked back to the bed. "Zachary," she said, "they are here to get us."

"Mom, are you coming with me this time?"

"Yes, Zachary, I promise."

She knew what she was promising. This was the fourth time Zachary had to be transferred to Children's  from St. Tammany General, and each previous time the paramedics had told her she couldn't ride. It was against policy, they had said. She would be in the way. Well, Zachary had been in the hospital over twenty times in his eight years of life, and one thing Nora had learned from all those admissions was that most hospital policies could be broken. Hospital policies were often thought up by the staff, and were in place for their convenience, not the patients' or the families'. This is perfectly fine when you are only in the hospital every so often for a C-section. But when you have been in the hospital as often as Zach has been, when hospitalization is not just an occasional thing but a way of life, rules have to bend.

She bent over and kissed her son on his sweaty forehead and then stepped through the door to plead her case. Only she had no intention of pleading. "I'm going with you," she said.

There was a lot of resistance. First the paramedics talked to her, explaining that this just isn't done. Nora permitted herself to fill up with the indignation of someone who had suffered more than the person she was talking to. She knew that until she talked to the doctor, nothing would change. So rather than fight the medics, she said, "I'm not talking to you. If the doctor says I can go, I can go."

After a time she was alone with the doctor, and she was emphatically telling her she could not go. "There is not enough room in the ambulance," she said. "We need space if your son gets into trouble."

"If I am not with him, he will get into trouble," she said.

The doctor tried again. "The ambulance insurance won't cover you if we get into an accident."

"If I am chasing after you in my car and get into an accident myself, I will make sure you answer for forcing me to drive 60 miles across the lake in the middle of the night. If he dies during the ride and I am not with him, you will answer for that also."

She could see her struggling with anger over that one. "You can't go with us and that's final."

"Then he's not going either."

"He will die if he stays here."

"At least he will die with me."

That clinched it. Zach was very ill. His temp had been 104. It had broken, and now he was covered with sweat. He had drips going in from four bags -- an antibiotic, IV fluids, and two drugs to keep his blood pressure up. Zach was in trouble and the doctor finally decided there was no point in putting up a big fight.

Nora went back to Zach's bed. She had to touch him. She silently hoped by touching him she would be forgiven for threatening to let him die if she was not allowed along. Zach had asked her to come, and she had not let him down.

They took Zach out of his room in the ER. She hadn't paid it much attention before now, but that was Nora's way -- seldom did she notice details until things were about to change. It was one of the two children's rooms in the ER, off in a quiet corner, every wall covered with bright colors and cartoon characters. Much like Children's, or Primary Color Medical Center, as she liked to call it.

Zach was on an adult gurney. It seemed that in all the world there was not a single child-sized one. Zach would have looked a lot better on a smaller stretcher. His tiny body, which looked like a five year-old's anyway, seemed all that much more insignificant on in an adult-length bed. After Zach got sick and wound up on dialysis, he had grown hardly ten inches and gained only fifteen pounds. A kid doesn't grow unless he stays well, and when has Zach been well? Not any time that she could remember.

It took some time for the medics to get the four IV bags unhooked from the hospital pumps and transferred to the portable pumps on the ambulance. Then there was paperwork, and the doctor had to write out some notes. After that they were ready to go. They rolled Zachary to the ambulance and pushed him in. One of the medics motioned Nora to get in first. There was a friendliness in his motion. It seemed that once Nora had won the fight and the decision to bring her along was made, everything was forgiven. That was one thing Nora respected about medical people. They were decision-oriented. They could argue and argue a question, but once the choice was made everyone was usually able to put matters behind them and go ahead in good humor. Sticking together and working from the same plan was more important to medical people than worrying about the past.

There was a long bench on one side of the ambulance, and Nora slid to the end of it. She was a few feet from Zach's head. He could see her if he looked up a little, but she needed only slide a few feet to her right to be well out of the way if the team needed room. The transport doctor was finishing a conversation with the ER doc. She collected a few final bits of information and stepped in last. The driver slammed the door.

The ambulance jerked forward. The ride would be fifty minutes long, the greatest part of it over the 24-mile Lake Ponchartrain bridge. It was night, and the traffic was light, allowing the driver to raise the siren only at red lights. In a moment and with a loud clank they shot through the toll plaza, and the ambulance was skimming across the lake on the bridge.

Nora could not clearly see the speedometer, balanced as it was from her perspective just barely above the driver's knee, but she thought they were going at least eighty. As they accelerated out of the toll plaza, the ambulance began to pulse as it hit the steel strips that separated the concrete slabs making up the length of the long bridge. At first the pulses were soft, but as the vehicle picked up speed they got louder and louder, drowning out most of the noise inside.

The regular beats could not have done more to lull her to sleep. She shifted around to say awake. Zach had dropped off. This was the third time she had taken this particular trip, but Zach had been in the hospital many more times than that -- twenty-six, twenty-eight? She couldn't remember.  Her ex-husband had moved out after hospitalization twelve, and the divorce was done at eighteen. After that, she lost count.

This poor child had suffered so much. And so much, she knew, on account of medicine, and on account of her. Zach had been three when he came home from preschool one day with a very bad cold. The cold itself was not so bad, but after a week Zach started to swell up. First in his face, then from head to toe. Over one weekend, he seemed to bloat more and more by the hour. Finally she and Tom brought him to the emergency room. In the blue-white fluorescent hospital light, Zach had looked so much paler than he did at home. She had felt intense remorse that they had waited so long, but neither she nor Tom wanted to be another one of those silly anxious parents bringing a kid with a cold into the ER at midnight, only to be sent home and with an instruction sheet on how to give fluids and Tylenol. That night, a couple of doctors had looked him over, then a couple more, and he was in intensive care. A few weeks later she and Tom were in a room with a nephrologist who was telling them that Zach would need to be on dialysis. They learned a new turn of phrase that night. Focal segmental glomerulosclerosis. It had been dialysis ever since.

Sometimes Nora would sit in the lobby at Children's Hospital and watch the parents of other sick children go in and out and wish Zach had someone else's disease. She knew it was silly to wish Zach could trade his kidney failure for leukemia or muscular dystrophy. It was just a mental trick. Every serious medical problem has its own specific challenges, but the problems of dialysing a child were so wearying that she just wanted to trade a new set of problems for the old ones. Maybe chemotherapy for a few months would be easier to bear, maybe not. But it would be a different set of worries. By now, it was not only worry, but the fatigue of worry, that was hurting so much.

The doctor sat at the end of the bench near the door, her head bent forward, trying to write. The pulsing from the bridge was so regular that she had gotten the timing of it, and could write three or four letters, pause to let the shock pass, then write three or four more before the next shock. She wrote by a dim white light screwed to the wall of the ambulance. Nora could not understand how she could see anything.

Outside it was completely dark. They were midway between the shores of the lake, and land was not visible in either direction. The amber streetlights blurred out the moonlight with their glare. She wondered if she were doing the right thing. Even this wondering only elicited fatigue. She had wondered this so many times before. Was it fair to him, to keep going, going? Zach never asked, and she was sure he was too young yet to even understand his options. Zach probably thought this was how life was, to suffer and suffer. He certainly didn't remember anything else. If there was anything that was unfair about this endless misery, it was that she had to face the possibility that it might be time to give up. It may be unnatural for a mother to bury her child, but for a mother to consider giving up the fight and allowing her child to die was unbearable.

She remembered when Tom had brought up the subject. It was during their last fight -- not a fiery, angry fight but one of the most soft-spoken arguments they had ever had. It was nonetheless the one that ended with him moving out. "Do we have to keep fighting for Zach?" he asked. "We could let him go." Tom had made many mistakes, had said so many awful things, but this was not one she held against him any more. She knew what he had meant, and she knew where it had come from. Zach was an eight year-old in a body the size of a child half his age. If he lived to adulthood, if he made it through the episodes of septic shock he seemed to get once a year, what kind of adult would he be? Four and a half feet tall, thin, sickly, little chance for a job or a spouse, forever tethered to a dialysis machine. What were they saving him for?

It is not as if Tom hadn't done everything he could have. When Zach turned six, Tom donated a kidney. They both thought this would be the end of all the hospitalizations, but instead it made things worse. Zach rejected the kidney after four months, and it was in and out of the hospital with kidney biopsies, switching and titrating medications in increasingly desperate efforts to save the transplant, and then finally back to dialysis. The return to dialysis had been so painful for her that she was not certain she could endure it again. She and Tom held out an entire year before they listened to the doctor and considered putting Zach back on the transplant list.

No, she did not hold it against Tom that he was willing to give up. Given all that had happened, it was logical, and for Zach, it might be merciful.  The doctor told her, and even her parish priest confirmed, that it is not morally wrong to stop medical treatment if the treatment is doing no good. She could see the dialysis was slowing destroying him. At eight, Zach could live another seventy years if he had even one good kidney, but Zach's nephrologist admitted to her that he had never seen a patient live thirty years on dialysis. Ten to twenty was more like it. Tom was not wrong, and she knew that he could love Zach very much and still say what he said.

Abruptly the pulsing stopped. They had reached the end of the bridge and were on dry land again. The driver resumed raising the siren each time they reached an intersection.

The problem for Nora was not the logic, or the mercy, or even the morality of it. Zach was her son, and she was his protector. It seemed to her, especially with Tom's doubts, that she was the only one defending his life without question. There had to be balance. Someone had to be arguing for keeping up the fight, for doing everything possible. She was terrified that if she gave up her determination no one else would have faith in Zach. The balance would tip against him. Somehow if both arguments, for and against fighting on, were not passionately argued she was afraid that some cosmic equilibrium would be lost and Zach would suddenly die. Logically this could not be true, but in her heart she thought that if a feeling were not passionately expressed that it would cease to be an argument. Like an old creed never prayed ceases to be religion.

And what mother ceases to be her son's avid advocate? What kind of a mother would she be if she did not praise even his most glaring weaknesses to the skies? It is the job of the rest of the world to objectively dissect her son. Not hers. Her job was to see him as perfect, even if he wasn't. Because if his mother did not see hope in his survival, no one would. If she did not feel unreserved hope for him, would even God?

One last bump and the ambulance was in the hospital parking lot. For the fifteenth or so time they would be admitted to this place, and usually when Zach was this sick it meant a month here. Provided he lived at all. A month of in and out of the ICU, drips, dialysis, maybe even a ventilator if things did not go well through the night. No one had to tell her this. She knew it. One month, minimum, sleeping on hospital floors and walking up to a coffee shop on Magazine Street each morning between ICU visiting hours to get a little daylight. A month in the hospital probably meant she would be fired from another job.

The driver backed the ambulance up to the ER bay. The medic at the foot of the bed pulled the latch on the back door and swung it open. The doctor and one of the medics climbed out, and Nora followed. The one man still in the ambulance raised the bedrails on both sides of the gurney and started pushing Zach forward. When they had the gurney almost completely out, they held it aloft for a moment, waiting for the wheels to drop down and lock in place.

For some reason, Nora stared at one of the wheels as it dropped to the asphalt. The paramedics pushed the gurney forward, and she watched the wheel as it started to turn.

Go, she thought.

Tuesday
10Oct2006

Death Comes to an Atheist

With a pained determination Frau Braun raised herself out of her wheelchair. A physical therapist was at one elbow, an aide at the other; and Frau Braun, between them, labored over the scant four feet between the chair and bed. She had just had her fourth heart attack, a mild one thankfully, but these things add up. Each heart attack was killing off a sliver of vital muscle in the wall of her heart, replacing it with non-contracting scar. As time passed there would be more and more scar, less and less muscle, and then death.

She seemed to be taking it well. It was not what she wanted, but she accepted her fate with dignity. "Not much longer for me now," she said in her thick German accent. She struggled onto the bed.

"No," the physical therapist said brightly, "you are almost finished your exercises." She looked at me, and her eyes said, Who is this dummy? I saw she was satisfied that I knew what she had meant.

It was the beginning of the end — at least her end. She was getting admitted to the hospital every two weeks now, so often that I almost expected to see her when I was covering on weekends. She lived in a nursing home in Arabi, very near the town I practiced in, and the night nurses at the home had a hair trigger when it came to chest pain. She would complain just once of the chest tightness, a page would go out to the on-call doctor (one out of three nights, that was me), and moments later she was out the door in a stretcher.

"Why can't they just give me a pain pill and let me go to sleep?" she would complain. (I think she meant sleep in the concrete, rather than the metaphorical, eternal sense, but who knew?) She always regretted telling the nurses in the home about the chest pain. But after awhile, she couldn't bear the pressure on her chest any longer, nor the "sense of impending doom" medical textbooks predict patients with angina will experience, and she would tell them. And then it was the emergency room.

I had seen her many times in that home. Though I did not regularly go to nursing homes, I sometimes rounded at hers as a favor to my then-partner, Dr. Gold. I had mixed feelings about her. She was crisply courteous and accepting of her lot in life, but she liked to talk and was full of petty complaints. Extraordinarily, she could minimize life-threatening chest pain and yet prattle on for an hour about the food, or about how the nurses at the home were not bringing her sleeping pill to her at 8 pm on the dot. She would fuss endlessly about her fluctuating blood sugars. Not that this was a bad thing, but it was incongruous for a person who otherwise had come to such a determined acceptance of approaching death. Blood sugar obsession might have paid off for her ten years ago, but not now.

After the therapists had guided her into the bed, she looked at me through very thick wire-rimmed glasses. "I talked to the cardiologist this morning," she said. Or maybe she said heart doctor, I don't know. Most educated patients say cardiologist; the uneducated say heart doctor. Or in her case, Doktor. "He told me he would like to do a balloon in my heart to open up a blocked artery. But he already did the balloon two months ago. Why would it work now when it didn't work then? I just had another heart attack. Why would it work now when it didn't work then?"

"I don't know," I said. "He is just trying to do what he can for you. But you are right. It might not work. Angioplasty does not always work." Actually, I was lying. There is no proof than angioplasty ever prevents heart attacks. It can abort a heart attack in progress if the artery is unblocked at very moment the heart muscle is dying. In non-emergent situations, angioplasty reduces chest pain and decreases hospital admissions. But there is not any proof that it affects mortality. Which is the reason I rarely press a patient to get an elective angioplasty when she expresses grave doubts.

"I told him I didn't want it. I don't think it will help. So I asked him if he thought I was going to die. He said, 'That's up to the Man Upstairs.'"

"Well, I would have to agree that . . . "

"I told him, 'There is no Man Upstairs.' There is no one who can help me now."

I can't say her remark surprised me. I had been seeing Frau Braun on and off for the last year, and she had left me with the strong impression that she had no religious beliefs. Some of the hints were superficial, and, I freely admit, merely a matter of prejudicial interpretation. She was German, and there was no escaping the association of Germany with assaults on faith. Hegel, Feuerbach, Nietzsche, Marx, Engels, Heidegger, Frau Braun. And she had ridiculous, out-of-fashion black wire-rimmed glasses that looked like something a bolshevik would wear in a bad movie about the 1930s; their thickness obscured her eyes and thus gave her an expressionless look that a pair of sunglasses would. The glasses also made her look like an out-of-touch intellectual.

Was she an intellectual? I couldn't tell. She was bilingual, obviously enough, and she spoke English, her second language, with a precision that many of my monolingual patients could not. However, when I visited her in her room at the nursing home I could not help but notice how barren her space was. She lived in the northwest corner of a room with six beds in it. She had a portable TV at her bedside, and almost nothing else. No Bible, the ever-present inhabitant of night stands elsewhere at the home — a sign of her unbelief, perhaps — but also, no newspapers, no history books, no novels, no music collection, no artwork, nothing, nothing at all. Taped to the wall was an out-of-focus photo she indicated was her son, but the image was sufficiently blurred that it could have been anyone with brown hair. No traces of an intellectual, a spiritual, or even a personal life.

I had always associated religious unbelief with intellectualism. It takes some doing to reject God — divinity seems a simpler and more natural explanation for the universe — and to decide there is not one usually requires a scientific evaluation of the facts and a rational decision making process that ends in the exclusion of the Man Upstairs. In a certain sense, it takes commitment to desert from the Army of God.

How can someone who has the air of an intellectual have no physical signs of it? Though she looked and acted like someone I should happen upon with her nose in Goethe, I never saw her reading anything, never saw a book or a sign of interest in something besides her TV, what time she got her medications, her blood sugars, and the quality of her food. It is as if the trappings of an intellectual life had abandoned her like her God. If I were to size her up I would say she was a woman who was well brought up, thoroughly educated, who decided shortly after she finished her education that she had learned enough. College-level education, and not a minute more.

It may have been the wearying experience of living in retirement home. In the United States, I know of no more destitute a life. No privacy, sharing a shower with 5 strangers, three miserable meals a day, and a nursing staff that might help you out of your own feces if they are not too busy with paperwork. People in nursing homes have nothing. They cannot — anything worth more than a dollar is going to get stolen. In that same nursing home Frau Braun lived in there was a patient who kept all of her valuables in a grocery sack under a pillow on her wheelchair because she was afraid to leave them unattended in her room. In a nursing home, if you have nothing you can lose nothing.

One of Frau Braun's favorite concerns was her bladder and bowel control. On three or four different occasions she told me she would rather be dead than incontinent, because incontinence left her at the mercy of the nursing staff.

I had asked her on several occasions about her son. He was born German as she was, had married an American woman and lived somewhere in New Orleans. She did not remember where he lived; she had not been to his home in years. They had a son, her grandson, but she had never seen him. Her son apparently visited her in the home from time to time, but not too often I guess because I never saw him in the home or during any of her hospital stays.

After that last heart attack, she waited in the hospital a few more days. Waited for the chest pain to stop, or to die, whichever came first. Finally the chest pain gave in to what vigor she had left and faded away. The next day she went back to the home.

She died a few weeks after that. From my point of view it happened the same way it did with most of my patients — she dropped out of sight. Rarely in the course of my medical practice am I notified of a patient's death. Families think to call every imaginable relative, but rarely the doctor. Perhaps they think that knowing the fine details of the patient in life, I would naturally sense the death. Sometimes I will read an obituary in the paper; sometimes a death certificate will cross my desk, begging my signature. But often the patient will just disappear, leaving nothing but a chart behind. The person's name disappears from my appointment schedule, calls for prescription refills cease, and the medical records move to the archives. Unless I know the patient well, and am accustomed to the rhythm of regular visits, I may not notice at all.

I rounded at Frau Braun's nursing home two months later, and that is how I found out. I was working my way down Hall A, seeing patient after patient, when I arrived at her room. There was no forgetting her room, the door before which I had taken a deep breath so many times in preparation for what I knew would be a thirty minute lecture on the deficiencies in the nursing staff. She was never rude about it, but once she had started on her complaining there would be no stopping her until every single offense was expressed. This time, though, was different. Her name had been stripped from the plate on the door. Her bed was empty, and the mattress bare. If not for the missing sheets, I might still not be convinced that she was gone. She had almost nothing to her name that I could remember, except a TV set and clothing, so barrenness would have been expected. Then I remembered the photo of her son, now gone from the wall.

She was dead then. I wondered if she had a funeral, if she had been buried, or if her body went unclaimed to the city morgue. There was nothing left of her, nothing at all, and her bed waited patiently for some Christian woman to take her place (had to be a woman, since 3 other women occupied the room also; almost had to be a Christian, because in this part of Southeast Louisiana that was simply how it went). The next person to come in and die.

I had to give her credit. She was, to my knowledge, faithful to her unfaithfulness to the end. She stared down death, certain that nothingness was on the other side. Perhaps in her last moments she panicked and asked for a priest, or beseeched the Almighty, but I doubt it. She was close enough to death when I saw her in the hospital after her heart attack, and there was no beseeching then.

When a person of no belief dies, what is to be said of them? Unfortunately, the price of dissolving into nothingness is that those left behind are free to say whatever they want. At least when a patient dies under the banner of a faith, the survivors know what prayers to say, and what symbol to stamp on the grave. For the faithless, there is only embarrassed silence.

Or maybe memories. We carry with us the memories of everyone we have ever known, and in a way, the deceased live on in others' memories. So she lives on as a meme in my brain, and now I pass this meme on to my faithful readers.

Some of us would prefer to pray for her. I think Frau Braun would not object — she was not a confrontational woman — but she would probably prefer the meme.