Monday, January 13, 2014

Bill Keller's "Heroism"

Heroic Measures?

400-odd years ago, John Donne took on a topic that still ignites controversy today: what is the right way to die? And by “right,” I mean socially acceptable, which is to say, most considerate of our friends and loved ones. In “A Valediction: Forbidding Mourning,” Donne praises those who are capable of managing their deaths in such a gentle fashion as to make the fact of their passing unclear. Such people are “virtuous men,” who “pass mildly away,” by “whisper[ing] to their souls to go.” Less appreciated by all concerned are those whose passage to the afterlife is a far more tempestuous journey.

Bill Keller, in his NYT article “Heroic Measures,” paints a carefully-phrased criticism of Lisa Adams’s cancer blog which details her battle with metastatic cancer. In it, he sides with those who prefer a model of death managed by palliative care rather than “heroic measures.” He quotes Steven Goodman, an associate dean of the Stanford University School of Medicine, who says that Adams’s blog “shouldn’t be unduly praised” for being an adherent of the “combat metaphor.” Equal praise,” he says, “is due to those who accept an inevitable fate with grace and courage.”

It is clear that Keller’s opinion has been shaped by his own father’s death from cancer, where in England, he was provided with “a humane and honorable alternative” by being “unplugged from everything except pain killers and allowed to slip peacefully from life.” Certainly, Keller sides with Donne here, and why shouldn’t he? No-one wants to see their loved ones suffer in their last days.

But his article has caused controversy because of the implied suggestion that a) the American model of managing death as a kind of “frantic medical trench warfare” is wrong, and b) that people have a choice when it comes to these things. What Keller critiques is an expensive universal protocol that really ought to provide more leeway for dying people to manage their ends — but what gets him into hot water is the notion that individuals can somehow escape the system.

For a start, it’s not always easy or possible for a dying person to think clearly enough to make decisions, especially about something of which they are likely to be profoundly afraid (and afraid of admitting: that they are indeed dying). It’s not easy for the dying person, and it isn’t easy for their family, who are often the ones making end-of-life decisions which err on the side of doing everything they possibly can to extend the life of their loved one, cost be damned. It feels unseemly to think about finances when someone’s life hangs in the balance. Then there is the overwhelming opinion of the medical professionals to whom we turn in search of answers to questions we probably have not ever had to consider. They, too, err on the side of the preservation of life (and the hospital’s bottom line).

Keller cites a study that “suggests that patients given early palliative care instead of the most aggressive chemotherapy not only have a better quality of life, they actually live a bit longer.” While this may indeed be true, what he may not be sensitive to is that for the person with the cancer, all decisions loom like the sword of Damocles over the precariously thin kite-string that has become their life: one wrong decision and whoops! there you go floating into a tree. Deciding whether to have “aggressive chemotherapy” (all chemo is “aggressive,” BTW), or forego it for palliative care is a tough call for those who may have been dealing with this disease for years. Choosing to opt out of the clinical cycle, even if it may provide more time, inevitably feels like giving up.

So much about handling cancer is about attitude: maintaining control over your treatment is seen as being proactive; hopeful; strong — and it will seem odd for someone to make that switch from choosing action to deciding against taking action and leaving one’s fate to the gods.

Susan Sontag wrote artfully of the way in which language and vocabulary has helped shape our comprehension of disease, especially cancer. When one considers the way in which the language of warfare dominates the conversation, it is no surprise that people view cancer as a battleground with winners and losers. Keller’s article maintains this metaphor even while quoting Goodman, who “cringes” at it.

Ultimately, there are no winners and losers when it comes to cancer, and dying. There are only folks standing around, like Donne’s “sad friends,” arguing over how well you went.

Sunday, January 12, 2014


Back when I was an undergraduate, there was a very funny guy who was so deadpan and understated in his humor that you kind of felt guilty popping a laugh when he inspired laughs, and who you secretly thought was a Total Genius in the guise of an ordinary fellow.

Turns out I was right (duh), and in the 20-ish years since we graduated, John Biggs has made a big splash in the tech and online worlds. He still writes, and I love that he has written this lovely novel, Mytro. I also love that he's exploring alternative ways of publishing it.

Check out his crowdfunding campaign and publication options.

Mytro can be found here. 

Tuesday, January 7, 2014

A Poem To Celebrate Polar Vortex Day!

The blessed intersection of two of my great loves — poetry and extreme cold weather conditions (writing about them, not being in them!) has produced this rather clunky poem! I couldn't help myself. 

The Polar Vortex

Twas the day of the vortex, and all through the town
Folks huddled in blankets and long dressing gowns
The children were happy and thought it was cool
That safety prevailed and cancelled all school.

Cool it was, to be sure, in fact it was frigid
Things that bend in fine weather now were quite rigid
The taps that had given us hot water galore
Now were iced up, and gave us no more.

Furnaces burned and chimneys they smoked
As we tried to keep warm with the fires we stoked
Ovens were lit and cookies were made
Though some stayed in bed and there they remained.

The sun it shone bright but gave off no heat
The white misty haze on the windows was neat
Breath the cold air rapidly captured
And turned into ice which fell and then fractured.

And even though snow lay deep on the ground
No snowballs were thrown, no snowmen were found
For the arctic blast had turned it all hard
Each snowflake now sharp as hexagonal shards.

Thank goodness the birds have all flown away South
And squirrels and chipmunks all stuffed their mouths
With nuts they had saved when the food was a-plenty
Now that the wind chill’s become minus twenty.

Tomorrow we’ll return to weather more seasonal
When highs of freezing will seem more reasonable
In the meantime be sure to wrap up all tight
So your extremities don’t fall off with frostbite! 

by: Me

Monday, January 6, 2014

Polar Vortex

The English are famous for being unable to conduct any discourse whatsoever without a nod to the weather, and as such they have an entire coded language for conveying weather-related information in such a way as to be comprehensible only to other English people. It wouldn’t do for the foreigners to be given any advantage when it comes to describing current conditions or predicting future ones.

Anyone who has spent any time (at any time of the year) in England will soon surmise that this obsession has arisen from the sheer sameness of the weather; it’s all degrees of the same shade. The jet stream has kept our little island protected from any major atmospheric events which would really challenge the vocabulary.

Looks cold in Fahrenheit

So how would an English person describe the Polar Vortex currently beggaring the American lexicon?

“It’s a bit nippy,” they might say. “There’s a touch of frost in the air.” With air temperatures in the minus teens, they might say it’s “decidedly chill.” The wind drives those numbers down to where it can be “downright brisk.”

You might find yourself advised to “pull your hat tight and button up,” or to “put on a cardie.” If you have a particularly old-fashioned wardrobe you might “doff your woolens.”

Looks even colder in Celcius

Of course, the English language wouldn’t be where it is today if it weren’t for the rapid integration of new words and phrases into the lexicon. An English person might borrow the name for the weather condition and play with it. Thus one could conceive of putting on a nice anorak made from Polar Vortex; having a spot of bother with one’s Polar Vortex in the morning when it won’t start; or it being so cold the air hits you right in the Polar Vortex. A conversation would be so terribly dull that you get sucked into a Polar Vortex, or you could find yourself at the back of a queue so long you have discovered a new Polar Vortex.


The English seek relief from the cold by drinking a hot cup of tea (with a biscuit), wiggling their toes in front of a fire (or two-bar heater), and cuddling up with a hottle-bottle (hot water bottle). A hot bath might be called for.

If that doesn’t suffice, you could always just fly to the Costa del Sol and sip a pint at a bar overlooking the sea.