"We Can't All Be Mother Teresa" - Or Can We?

The recent publicity about Mother Teresa: Come Be My Light, the soon-to-be published journals and letters of Blessed Teresa of Calcutta, surprised me. One author called the revelations of her profound doubt and sense of God's absence "stunning," but I am not stunned at all, except to learn that others are stunned. I am surprised, not only by the surprise of others, but also by the complete lack of understanding some people appear to have about spiritual struggle. Is it so impossible to imagine that people for whom spirituality consists of deep, intimate relationship will struggle with that relationship?

Jacob wrestled with God. John of the Cross wrote about his "dark night of the soul." Many truly holy people who actually bother to WORK on their spirituality find that the work can be hard, painful, dark, and daunting, that their faith can waver to the point of buckling.

I think this is especially true among humanitarian workers, who have to gaze upon the face of the Suffering Christ on a daily basis. Whether or not you believe God exists, that Face certainly does, and it hurts to see it, live with it, try to make it better.

I've read that some have reacted with disdain to Mother Teresa's inner battles, suggesting she was hypocritical to profess a faith that, in reality, eluded her. First of all, I think anyone who has lived a life as generous as hers can feel free to cast stones - after all, you've been in the trenches; you know what it's like - but everyone else can shut up! Secondly, what a total misunderstanding of the nature of a life in faith. Doubt and near-despair are part of the process of, and perhaps essential to, becoming a fully integrated human being - integrated, whole, holy. The words of Madeleine L'Engle are worth revisiting: "Those who believe they believe in God but without passion in the heart, without anguish of mind, without uncertainty, without doubt, and even at times without despair, believe only in the idea of God, and not in God himself."

I get annoyed when people of one faith - and I include atheism as a faith, as I would any other system of thought centered around something that cannot be revealed by proof - gloat over perceived deficiencies of another. The childish arrogance of being absolutely certain and of believing oneself to be incontrovertibly right, and the cloying superiority with which the "right" people criticize the people they believe to be "wrong," are divisive, unproductive, and morally inferior means by which to "edify" society. The irony of any glee detractors might have over Mother Teresa's faith crises lies in the fact that her humility and human pain actually have a greater power to teach and reach others, who might be going through some spiritual striving of their own.

A Time article points out, "Teresa found ways, starting in the early 1960s, to live with [darkness within faith] and abandoned neither her belief nor her work." I think this is the true meaning of holiness or sainthood, right here. It's what Harper Lee described in To Kill a Mockingbird as the meaning of courage: going on despite obstacles, lack of support, the risk of defeat, and near-total loss of hope. If Mother Teresa made mistakes, had imperfections, and lost faith time and again, what right does any one of us have to criticize, resent, or judge that, or claim she is a less holy person because of her struggles? Can any of us claim we know and understand what lies in the depths of anyone else's heart? I think these journals and letters are the closest we are going to get, and if they reveal a person who experienced unspeakable loneliness and pain but tried her best anyway to live a loving life, then we could learn something from her - about our humanity, our spirit, ourselves. Such an individual is just what our church might declare, in a spirit of hope, to be a saint: not a perfect person, but one who poured herself out completely, in yearning and in hard work, to reach the perfection of love to which every human being is called.

The Rounding Orb

One of my ICU attendings during residency, whom I will call Dr. Cool, was not only a multi-talented, brilliant academic - English lit major at Amherst, francophone, thoracic anesthesiologist, critical care specialist, musician - but also a very funny guy, in a dry sort of way. Some people might have seen him as stern or crotchety on the outside, at least at first, but he was deeply compassionate underneath it all, and fair. During rounds if we said something stupid he would offer grumpy but, unlike many attendings, highly constructive criticism. Occasionally he would even crack a wry smile. I thought he was great.

One day when we were wrestling with some issues involving several patients, he suddenly broke away from the team muttering to himself, "Where's the orb...we need the orb..." and disappeared into his office, where we had once taken a break as a team and watched hilarious GI Joe spoofs on his computer (with him). We all stood there stupefied looking at our notes and flow sheet, murmuring to ourselves about this much IV fluid in, that much urine out, propofol infusion still at 1 mg per kilo per hour, weaning vent settings...Finally he emerged and rejoined the group carrying a small, spherical, bright orange, plush object with a face embroidered onto it. Its name, according to the tag, was Tiffany. (I'll try to reconstruct the ensuing conversation but it'll be more accurate as to the tenor of the thing rather than the specific details.)



"Now, where were we?" Dr. Cool began. "Oh yes - who wants to transfuse Mr. So-and-so in Bed 1?"

"His crit's 27. I think we should," said one of the residents.

He hurled Tiffany against the desk in front of us as hard as he could, and she emitted a loud, sarcastic, high-pitched "I don't THINK so!"

Without changing his expression Dr. Cool announced, "The Rounding Orb has spoken," and respectfully challenged the resident who had spoken up, asking for a defense of the suggestion in light of the patient's currently stable blood pressure, heart rate, and oxygen saturation. Soon our group was discussing the various problems Patient So-and-so was also facing. Another one of us made another suggestion, and this time accompanied by an almost imperceptible smirk from Dr. Cool, The Orb went hurtling once again to the desk top and then yelled, in the same, sarcastic, Valley-Girl tone, "Loo-ZER!" The resident had to smile too, but bravely began to defend the suggestion, as did others, and after a minute or so of us arguing different points back and forth Dr. Cool slammed the orange toy down a third time, eliciting from it an attitude-filled "What-EVERRRR!" The cycle was repeated several times during rounds that morning, with "What-EVER," "I don't THINK so," and "Loo-ZER!" audible from each bedside at least once.

For this memory alone I could almost look back fondly on my ICU time during residency. I hope one of these days Santa brings me a Rounding Orb for Christmas. Silly Slammers, as these toys are really called, seem pretty hard to come by these days, but I have faith. Someday I'll have an Orb of my own with which to tease hapless students or colleagues and make sure they don't fall into the trap so many folks in medicine fall into, that of taking themselves way too seriously.

What You Get Is What You See

One time I was doing post-op rounds, dressed in regular / street clothes but with my hospital ID around my neck. One of the women I was visiting spoke only Spanish and was in the midst of sharing a very painful, personal story with me when a medical team of some kind walked in, also on rounds. I was sitting at eye-level with my patient, speaking Spanish to her in a low voice when the group walked in: an elderly male physician in a long white coat; a younger woman, also in a white coat; and a young man, probably a student or a resident, in a short white jacket. The woman in the white coat looked at us for a moment, then turned to me and said in a loud voice, in an exaggeratedly deliberate pace, "HI. We're from ONC-OL-O-GY. Do YOU speak ENG-lish?!"

For a moment I looked at her in a state of complete confusion. Do I speak English? I work here! I thought. My mind raced through why this woman was speaking to me as if I were both deaf and uncomprehending. I don't even LOOK like I come from a Spanish-speaking country - or do I? I've always thought I was too Asian-looking to be mistaken for Latin American, though I've seen some Latin Americans that I've actually mistaken for Filipino, so I suppose the lady wasn't way off-base.

Anyway, we got that sorted out, but it made me realize how easy it is to fail the Rorschach tests we get all the time in day-to-day life.



***

Here's what I've learned so far about interpreting the world: Every social exchange or situation is a Rorschach test. The way you read - or, the way you rewrite for yourself the story you hear or see, the life of the other person, the meaning of what's in front of you - says more about you than about the "text" or "inkblot" you're interpreting. Mauriac explored this idea in the novel I just finished (Vipers' Tangle): the kind of reader you are is the kind of person you are. Character and interpretation of meaning are interconnected.

Making assumptions is human nature and often a necessary part of arriving at some kind of understanding of a person or situation. Assumptions fill in the gaps. It's a well-known phenomenon that, given part or parts of a particular recognizable whole, the human brain fills in details so as to create for itself something it can perceive and interpret. I think that among our faults and failings as human beings, making some wrong assumptions is one of the most understandable, and perhaps one of the most insidious.

The one example I'll never forget of a doctor making assumptions about a patient - and getting the "inkblot" all wrong, because yes, there was a right answer and a wrong answer - also concerns a patient who was a native speaker of Spanish. I will call him Juan de la Cruz, in honor of the great Spanish mystic.

I was a resident assigned to provide anesthesia for Juan de la Cruz. I won't say what type of surgery he was about to have, but I will say that it was a somewhat unusual procedure, one you don't see every day in the O.R. I'll call it the Calvary Procedure, not because it involved a lot of suffering, but because the name reminds me of something in the procedure.

As I was looking over Juan's chart I noticed under the heading "Social History" something like this, after a description of his smoking and drinking habits and marital status: was a physician in his native country; currently works as a building custodian.

My heart ached to learn this, but I had a more practical problem at hand: should I address him by his earned title, "Dr.," and take the risk of dredging up a possibly painful past or of sounding insincere, or call him "Mr.," and take the risk of sounding condescending or disrespectful?

I don't remember how I handled the conversation. I remember our preop conversation only the way one remembers a hazy dream just at the edge of being forgotten. My memory cuts to the O.R., then, after I've induced general anesthesia for Juan, and someone asks me to say the final procedure verification out loud. I say, "This is Dr. Juan de la Cruz for a Calvary Procedure."

The attending surgeon was a woman with an Eastern European name but the accent and affectations of someone whose illustrious parents had sent her to study at Oxford or Cambridge. She was smug and imperious, and she turned to me with a look of annoyance when I said this. "He's not a doctor, he's a JANITOR."

I was a resident, but I wasn't her resident. I looked into her eyes and said, "He may be a janitor now, but he was a physician in his own country."

The lady surgeon appeared irate and protested again at the idea that Juan should be anything other than a janitor. Then she added, "He never told me that. Where are you getting this information?""

"From the chart," I said somewhat curtly. I wanted to ask if she'd even bothered to read it. Her tone and arrogant air and faux British accent were getting to me.

"Well," she muttered. "Goodness knows what it means to be a 'physician' in his country."

That pretty much killed the conversation in the O.R. for a while.

I knew I was supposed to learn something, a bunch of things, from the interaction, and I chewed on that exchange for a long while. One thing I needed to work on was to avoid letting snobby people get to me. But the more important lesson, I think, was again a lesson about human worth: how we judge others, the assumptions we make (or fail to make) about the stories that underlie human faces and circumstances, if and how we even see our fellow human beings.

We're surrounded by inkblots, texts, stories, mysteries. Someone please remind me every day to make the effort to read, and to practice good reading - the lectio divina of life.

Just a Quick'un About Home Cookin'

We're all feeling a little alien back on American soil. My little girl said wistfully, "Everything seems smaller..." She explained that she was thinking of the Gothic cathedrals of France. My reaction was everything seemed so unbelievable new. No trace of the 13th century here. I found everything so modern and loud and crowded together, and all you could see and hear was the same language. The Red Sox announcer on the radio sounded so...AMERICAN. We're all still thinking in French; some of our word-choices in English are clearly not the first-choice English words but rather translations of the words a French person would use to express the idea. Weird! I haven't felt the need to adjust to any U.S. locale like this in a long time.

I tried to comfort my daughter's sense of yearning for France by telling her that her own country had treasures of its own - the Grand Canyon, Big Sky country, the Pacific Northwest - and that someday we would see them together. But it must have sounded a little half-hearted to her: I left a big piece of my heart behind across the Atlantic too. I was starting to feel at-home there.

No more baguettes from the neighborhood baker for breakfast, or 2% milk that tastes like cream. No more being surrounded by the most beautiful language in the world. No more village life or ancient historic sites. But now that we're home, we can turn on television channels that are actually broadcasting something worth watching, or find store that's open for 24 hours on a Sunday, or go to our local diner and grab breakfast for dinner, which we did tonight just for fun. Tomorrow it's back to work, back to our regular lives. Strangely my usual Sunday Night Syndrome is quiet. I think it has jet lag.

Gourmand Goodbyes

I'll admit it. Leaving this place is hard.

The other day we celebrated 50 years of my husband's family at La Morinière with a buffet. Dessert consisted of tarts made with fruit from our trees and sorbet made with berries from our bushes. People are going to think all we did on this vacation is eat till we couldn't breathe. That wouldn't be too far from the truth.

We did just ordinary family things on our last day here, but because it was our last day, the ordinary took on special meaning.

My kids and I hung laundry out to dry on the clothesline. I hadn't done this in years before this trip, and it's quite therapeutic!

I finished François Mauriac's brilliant novel Vipers' Tangle (Le Noeud de vipères).

I talked to my daughter a little bit about Apollinaire, and she made a calligramme. Can't see it that well because it's in pencil, but it's about her teddy bear.

The kids and their cousins, who have the summer place next door, played signal, a variation of hide-and-seek, after lunch, for which my husband's aunt had made a delectable charlotte.

For our last goûter we threw my son a small birthday party, with multiple generations of cousins and siblings, cakes from the bakery in Pacy-sur-Eure, a musical birthday card from his great-aunt, and a few presents from the toy store in Pacy - a medieval knight, some trading cards, and Monopoly Express. He turns 7 on Monday.

Tonight for our last family meal Oncle G. (the priest who helped marry us and who makes all our sorbets) made us a divine fondue with Emmental cheese and white wine. The kids put on a little show afterward.

Before leaving the U.S. I was concerned about how this trip would go. A colleague at work jokingly told me her "motto" for such circumstances: "Wine, and indifference!" Wine is good here. But indifference I've never been good at...so what can I say? It's sad for us to pack up and leave what for my husband and his family, and now me, is truly a home.

Au revoir, then: until the next time we see each other again.

The Mystery of Joan of Arc; Rouen; and Louviers

On our way to Rouen yesterday (yet more toll collectors resembling fashion models - what is up with that? It's nationwide!) my husband and I were trying to see how many French saints we could name. There are a lot of them! A few we came up with were Bernadette, Thérèse, René Goupil, Isaac Jogues, John Vianney (the Curé d'Ars), Louise de Marillac, King Louis, Jane de Chantal, Francis de Sales...and of course, Joan of Arc.

I have always felt ambivalent about Joan of Arc. From a medical standpoint someone who hears voices commanding her to do things sounds pretty undeniably psychotic. She had visual manifestations as well, however, which as far as I remember from my remote psychiatry rotation in medical school are not quite as common as auditory hallucinations in states of psychosis. Also, the transcript of her infamous trial reveals fairly organized thinking and speech on her part, a strong internal logic to her statements, and a tone of conviction to her defense statements, which suggest considerable lucidity and soundness of intellect.

In any case, a psychiatric condition wouldn't preclude holiness. Sainthood is not a legal case: mental competence is not necessarily a requirement for sanctity, nor is mental "incompetence" a disqualification. I actually have more trouble accepting her warmongering, though of course in the context of her own times, it may have been seen as necessary, even inevitable. If she was open to Spirit, on fire with trust in God and willing to respond to God's call, and full of living hope, she could probably be considered holier than most...but people who believe in so-called "holy war" might also be described in these terms, and I wouldn't consider such people vessels of God's love at all. I don't know. But that's okay.

Rouen is a large city with an exquisitely charming older portion, whose storefronts still show the traditional Normandy exposed beams of centuries past, and whose cobbled pedestrian streets are reminiscent of illustrations in story books about medieval times. Good thing we were able to see the cathedral for miles - we had to navigate our way into town sans map, as usual.

We visited the cathedral, of course, to see the subject of Monet's well-known work. It's quite run-down and in terrible need of cleaning. The surprise find for us yesterday morning was the Église Sainte-Jeanne-d'Arc in the old market square where Joan was burned at the stake. Designed by architect Louis Arretche in the 1970's, it resembles an enormous fish. It's supposed to recall Normandy churches made to resemble upturned boats. At first it struck us as a modern monstrosity in the middle of the old marketplace, but as we walked across the square we grew more and more impressed with its unique design. It's brilliant. On the other side of it, some attached buildings by the same architect look like smaller fish, so that from that side of the square I felt like we were looking at a small school of fish next to a gigantic one, or a small company of boats. The interior made us draw our breath in in surprise and admiration. It is beautiful, with its wall of stained glass salvaged from the church that had been on this spot but destroyed during World War II, and its curved ceilings. What an interesting piece of architecture.

Outside a patch of flowers marks the spot where Joan was executed, and next to it, one can still see the ruins of a medieval stone wall built to protect spectators from the fire. How morbid. I'll never understand how people can watch or place someone in a state of agony. Burning someone at the stake says to the condemned not only, "You don't deserve to live," but also, "You deserve to die as horribly as possible." I fear this dark side of our humanity, this capacity for hate and for willfully inflicting suffering.

***

On our way back to La Morinière we passed through Louviers. I have been reading Susan Loomis's memoir On Rue Tatin with great enjoyment, and have successfully made her Stuffed Tomatoes from that book, much to my family's appreciation. Of course we had to see the places she talked about in her book, and pick up something from her neighborhood charcuterie or épicerie. We came home bearing a dozen chipolata sausages for our upcoming celebration of 50 years in La Morinière.

In the afternoon the younger kids wanted to bake something after gathering fresh raspberries, blackberries, and mirabelle plums in the garden, so we had an ad hoc baking workshop and came up with a fruit crumble which we served for dessert after dinner. My husband's uncle and godfather, a parish priest who concelebrated our wedding mass (saying his part in French) eleven years ago, arrived just in time for the treat, so we had yet another evening of good food and great company after a successful outing.

Ether, Anyone? (And other Paris thoughts that didn't fit into a coherent blog post)

I haven't forgotten about anesthesia entirely, and finding ETHER in the medicine cabinet certainly brought its memory back with a jolt! I know it's used in many countries as a disinfectant; in fact, I grew up on its scent, which greeted all visitors to the hospital in which my mom had her office. But it's still jarring for an anesthesiologist to find a bottle of anesthetic in the bathroom!

The mayor in Paris has made efforts to create a "cleaner and greener" Paris, and I applaud them. An example is the implementation of public rental bikes all across the city - drop a coin in the machine, take a bike, return it to a bike station near your destination, and voilà - fewer emissions, though motorists have grumbled about the increased volume of bicyclists in the city. Another thing we could learn from the French is how to do the groceries. It's BYOB, bring your own bag, over here - much less wasting of plastic bags.

I couldn't leave the country without taking a shot of an adorable pot de yaourt - those cute, little 2-person cars they have here that look like you could almost put them in your pocket.

This plaque about Picasso painting Guernica in this building on the rue des Grands Augustins reminded me of the ghosts of great artists that haunt this city. Just a stone's throw from here Gertrude Stein held her salon, as I recall. I was astounded to be reminded by the interesting book Literary Paris just how demonic some of the greatest artists were. Baudelaire was a complete misanthrope, and Rimbaud was about as horrible and piggish (in public) as could be.

My brother-in-law and his girlfriend had a chance to dine at Le Procope, hang-out of so many famous Paris writers, philosophers, intellectuals, etc., and the oldest restaurant in the city, having opened its doors in 1686. Says its website: "Voltaire, Rousseau and Diderot were loyal regulars and the Encyclopaedia was born under the crystal centre-lights of the Procope. During the revolution, Danton, Marat could all be found here. Benjamin Franklin even fine-tuned the American constitution here."

I noticed at the metro stop for the Sorbonne that instead of having the usual sign with the usual lettering, theirs had to be special. :)

Finally, there's the Paris no one talks about. When we were going through the Écluse de l'Arsenal in Eric Vincent's boat, we saw someone's tent set up against the wall there, out of most people's sight. I also walked by a squatter at the Cambronne metro on my last morning who, unlike the tent-dweller, made a public display of his plight. Paris isn't paradise for everyone.