The Edge of Sadness

“When you live next to the cemetery, you can’t weep for everyone” Russian proverb.

 “We can stand only a certain amount of unhappiness; anything beyond that annihilates us or passes us by, leaving us apathetic.” Goethe. Elective Affinities. 1809

The Greek aphorism γνῶθι σεαυτόν, transliterated as gnōthi seauton, is rendered as “know thyself”. Attributed to various sages, it remains simply one of the three apocryphal aphorisms inscribed at the Temple of Delphi. Regardless, it carries depth and meaning that few pursue and fewer still live by.

Driving through a small Southern town in 1959 I stopped and offered a ride to Black young man about my age. During the drive he seemed conflicted; how could this White kid be doing this, or was he taking me to a lynching? I was enjoying the gaping stares from the White folks as we drove through town. If I got his name I don’t remember it. I confess that, in large measure, he was a means to an end, my way of deflecting the rejection I felt surrounded him – where “him” stood for an entire people.

This act had not come from a void, though I probably had not examined its roots by that time. Being brought to the United States and growing up in parochial and monastic boarding and college preparatory academies, I quickly learned the derogatory terms and even the physical hostility the Anglo Über-Rich applied to “foreigners” such as me. I also learned  that “different from” encompassed a lot of things. Never gregarious, I had few acquaintances. In fact, it was only much later in life that I realized my acquaintances, my friends, were all in some way peripheral. The kids from other countries who barely spoke English, kids with some sort of mental or physical disability, kids who would now be called Nerds. These were my friends. One kid in prep school had fought his way out of an Iron Lung and into a wheelchair that was almost more a small hospital bed. Few even looked at him; I routinely emptied his urinal. Another boy had Gran Mal seizures in class. I pulled desks and books away from his thrashing while the others laughed. Afterwards, they taunted him to “do it again.” Another boy had pronounced cerebral palsy, making him very difficult to understand and sometimes difficult to face as he drooled while trying to talk. Yet, we talked. A lot. Had we not been an anti-group group we might have called ourselves “The Others”, or perhaps something darker. But labels, by their nature, are declarations of identity to other people, and for those we did not care. We simply were.

But we go on with our lives, don’t we. They move, we move. Different places, different people, but something was beginning to gel. Those who are less powerful relative to their surroundings, including non-human animals and the spectrum of the human periphery were practically involuntary triggers for a supportive response from me. Of course, there can be boundaries as I learned in college. Walking between buildings I saw a young man, apparently a polio survivor, who lost control of his crutches and sprawled on the grass amid his books. I rushed to help gather the books, only to be angrily told “I can do it.”

There were times I could not help everyone, or even one. In a North African country I saw a man mercilessly beating his horse. He stopped when I put a riot gun to his face. Could I ensure he would not resume once I left? Of course not. Could I roam the countryside to stop other such perpetrators? No. Walking to my car late on a Saturday night a frantic dog ran up to me, just as I saw his buddy?, mate? lying mangled but alive at the edge of the street. I had no doubt the dog was pleading for help. In a small town, with no knowledge of any all night emergency vet clinics and no money to pay, I could only walk away. I still see that clearly.

And so we return to Know Thyself. Early in my Thanatology career I was asked to provide seminars for Emergency Room personnel, from intake clerks to physicians. The circumstances played out among incoming patients, families, and sometimes people wanting to “finish the job” are often appalling. I stressed that deep within that glib phrase, Know Thyself, was the admonition to find and understand our limits. We need to understand that succumbing to the feelings that arise from dealing with the shattered child lying on gurney #1 disables us in our ability to respond to the concurrent patients or the next patients on gurneys 2, 3, and however many more there may be.

Yet, pretense that these feelings do not arise is simply fooling one part of the self. Although I had never knowingly been there, I proposed the demarcation between the bright side and the dark side of the Moon, with no atmosphere to diffuse the light into a twilight “between.” I advocated strongly for a twilight zone, an institutionalized setting within which E.R. staff could decompress free of professional shame, free to identify and own their feelings. And, of course, a setting in which to realize they may need to alter their profession before succumbing to the substances which would eventually make that choice for them.

I’ve had my dark side of the Moon moments. One occurred while I was at the Royal Victoria Teaching Hospital in Montreal, Canada. Having answered Dr. Elizabeth Kubler-Ross’ request to join her there for a workshop to bring Hospice to North America, I was acutely aware of her session with a 12 year old girl dying of leukemia. In the mid 1970’s childhood leukemia had a predictable outcome. And, pain management was nowhere what it is today. Yet this child lingered days past when she should have died, in as much physical agony as she was mental anguish. Elizabeth was a psychiatrist. In sitting with the girl she frankly asked her why she had not yet died. The girl explained, in terror, that the nuns had told her that if she loved anyone more than she loved God she could not go to heaven. She loved her parents more.

Calling upon the decades of intricate negotiations that only a handful of psychiatrists ever master, Elizabeth helped the girl overcome this hurdle. She died the next day.

I, on the other hand, plunged headlong into the dark side. I was ready, with verbal riot gun in hand, to confront, disarm and defrock every nun I saw. That has never totally left me. I found my limits anew each time I tried to discuss this in the college Death & Dying classes I taught. I broke down. I still do.

These moments on the edge can catch us unaware; even the slightest stimulus can become a hearty push. In the Fall of 2001 I was on the 95 person investigative team sent to Washington, D.C. immediately upon the Anthrax attacks. 94 physicians, microbiologists, and logistics personnel – and me, the Crisis Interventionist. My job was to accompany the various sub-teams to the affected sites and observe the impact the situation may be having on them. Several had just been pulled in from the World Trade Center attack. Should a person begin displaying what I considered psychologically disabling effects, I was to immediately relieve them of duty, provide immediate care, and arrange secure AirEvac as needed.  

I did relieve three physicians and one microbiologist, sending one home to NYC, two to Atlanta, and releasing the fourth to the custody of her family who had driven in from Pennsylvania at my request. This last one, a young physician, presented both logistical and philosophical problems. The lobby and common areas of the downtown hotel housing the team were infected with vile journalists 24/7 hoping to overhear loose talk, even to hack into our cellphone conversations. They followed team members to identify eating establishments we used in our several week deployment, hoping to sit nearby to overhear and “get the career making scoop” no matter the cost to the public or to our efforts.

The young woman in question, a physician, broke into repeated and agitated verbalizations, loudly asking obsessively “How could anyone do something like this to us? Why? Why?” There being no question of letting her out of her hotel room or of leaving her unattended, I stayed in the room with her throughout the night until her family finally arrived the next day.

The breakdown was not surprising, given the attrition 23 hours on and one hour off can bring. What surprised me was her question. I wanted to say to her, “Where have you been all your life? There are some bad ass people out there and you better get used to it.” Was I on the dark side? If so, how long had I been there? Since the military and the subsequent parallel career I concealed from almost everyone else? Mission creep?

My daughter has always been of immense help to me, though she likely does not know the extent. She reminds me at times, “You did what you did based on what you knew at the time.” Grounding.

Capitulation to sadness is the admission of being overcome by a generalized impotence. Yes, I can sit here for more beats than my heart has left enumerating events any one of which might bring the lump to the throat, the tear to the eye. But I will not step through the looking glass. I will not shun the bright side that illuminates things I yet have the opportunity to do. With what I know at the time I will do the best I can at the time, all the while understanding that there are other places, people, and non-human friends that are elsewhere on this giant disco ball we call the universe, and they are not within my reach.

Yes, that saddens me. But it does not defeat me.