Wednesday, 27 April 2011

Rolling rocks

Iain is usually charming and friendly, and has a good joke to tell about his time managing a pub. But not today.
He’s come to see me in my morning surgery, with a lot on his mind. His feet are playing up again. Then it’s ‘some funny do’s I’ve been having, you know like blackouts or something’: three or four of them in the past month
When I ask him to tell me more, he says (with a sheepish smile), ‘Well, I guess I’ve been drinking too much again’.  Indeed he has. Without much prompting he tells me he’s getting through at least half a litre of vodka a day, and doing so mostly on his own at home. And he is smoking more than 50 cigarettes a day. I know Iain has other medical problems. He has diabetes mellitus, which (unsurprisingly) is not well controlled, and high blood pressure. He retired five years ago. His three children are all now grown up and living away from home. 
Using my best consultation skills, I ask Iain to tell me more about his worries and concerns. He has a long list. Apart from his ‘blackouts’ and binge drinking, he reminds me about his painful feet. His teeth hurt a lot.  He is sleeping badly and is often irritable. He has little interest in ordinary things, such as watching television or reading. He rarely goes out of his house, partly due to the pain of walking. And he is distressed because he can no longer be bothered to see his children.
He leans forward and says, ‘You see doc, basically the problem for me is I just can’t see any point in getting up in the morning any more’. 
He talks about his loss of ability, his painful feet and the complications of his diabetes, both present and to come. He talks about his loss of purpose, how he used to be a successful pub manager and a caring father. But now he has no role, with either work or family. His life is futile, a relentless trudge through pain and disability. All he can see is a slow, inevitable path towards death.
Iain’s problems seem to me to be beyond the reach of medicine, and way beyond the relevance of any possible formal diagnosis.
Iain and I are facing a profound, existential question.  What, actually, is the point in his being alive? 
I find myself thinking about Sisyphus, condemned by the Gods to spend eternity rolling a huge rock up a mountain, only to see it fall down again as soon as he’s reached the top.  And then about Bruce Springsteen’s exhausted night shift worker:
I get up in the evening and I ain't got nothing to say. I come home in the morning, I go to bed feeling the same way. I ain't nothing but tired. Man, I'm just tired and bored with myself’.

In my next post, I’ll tell you how our conversation went on.  Meanwhile, I’d love to know how you’d respond to Iain.  Maybe you’ve been there yourself, or maybe you know other people who just can’t see any point in it all. What would you say, or do?  
Over to you, dear reader......

Friday, 15 April 2011


My friend Odd Steffen died a few days ago.  It was a shock. He was wise and solid. I’d expected him to always be there.
I’ve been remembering all the good times we spent together.  A big research conference in Birmingham: his plane was late, we were all panicking. Then he strolled in, calm as you like, just in time to deliver his presentation. Dinner in a Blues bar in Chicago. And a weekend in Ville’s woodland retreat on the south-west coast of Finland.  It was June, daylight lasted for ever. Sunshine, sauna, swimming, Sibelius, sailing.
A magical time.
Memories matter. When life is difficult or sad, we can draw on memories of good times. They help us to get through the troubled present, and nourish the hope that good times will return.  
Memories do more than that. They give us an awareness of continuity. They build our sense of coherence, our identity, our ideas about who we are and where we belong.   
Proust was a delicate creature, who spent most of his adult life in sealed room in Paris, in a state of severe health anxiety. He was also a wonderful writer. He has important things to say about memory and continuity. Tiny, apparently insignificant events – a cake crumbled into a cup of tea, catching sight of a church tower, the smell of mildew – can be triggers that recall lost times, bringing them together with the present in a continuous reality.  
Memories keep us connected with our past, with where we have come from in this unique life we are leading. These connections help us survive and flourish, and build for the future.
‘That’s all very well’ I hear you say, ‘if you’ve got a store of good memories to fall back on. But what if my memories are mainly bad ones?’  
Sometimes memories can be cruel. The Russian writer Dostoevsky was haunted for years by the memory of the moment when he stood before the firing squad waiting his call for execution, before his reprieve was suddenly announced. Many people who suffer trauma in childhood find dark memories returning to haunt their lives and thoughts.  Or maybe your memories are of failures, unrealised dreams, of things that might have been.
Fortunately, memories are not fixed. We can change them.
We can turn memories into sources of energy and hope. We can draw new implications from old memories, or expand them by adding in the experiences of others.
In his Intimate History of Humanity, Theodore Zeldin tells of his friend Olga who used her fearful memories of life as a political dissident as a stimulus to change – given the opportunities provided by glasnost and perestroika – into a life as a commercial statistician. This gives her financial security and the freedom to dress well, travel frequently and indulge her passion for Proust.

And there is Quoyle in The Shipping News. His earliest memory is being a disappointment to his father, because he almost drowned when he was supposed to learn to doggy-paddle.  He grows up as a fat, lonely loser. But new experiences of friendship, creativity and love alter his awareness of the past. His memories expand, enriching his past and his imagined future.
He remembers how he saved a bird his daughter had found, and how thrilled she was.  
‘If a bird with a broken neck could fly away’, he wonders, ‘what else might be possible? It may be that love sometimes occurs without pain and misery.’
What about you? What memories keep you going through bad times? What helps you increase your supply of good memories?