On the Responsibility of Doctors

There is a story getting a lot of attention in the media these days about a woman in California who gave birth to octuplets earlier this year. That in itself would be newsworthy enough, but the fact that the mother already had six children, two of whom are disabled and require special care, is unemployed, unmarried and living with her mother in a house that is about to be repossessed has made the story the subject of numerous dinner conversations, ours included.

In thinking about it more I have come to wonder not so much what the mother "was thinking," for I believe that the mother's right to choose means that the mother may choose to have her children. No, what I'm wondering is: what in fact were the doctors thinking? Now, this is not to say that I think the doctors should have counseled the mother to remove some of the embryos nor that they should have done so against her will as many have suggested.

What I do find hard to understand is what the doctors thought would happen after they delivered all eight babies. Naturally, they spent a great deal of time thinking about and planning for the deliveries, since that required so many coordinated efforts from so many professionals to actually accomplish safely. For them, it was a very 'cool' assignment; a challenge to their skills.

But I have to wonder, did any one of those skilled professional stop to consider--and therefore, plan for--the circumstances into which these eight babies would be delivered? I mean, did anyone give any thought to what would happen to them after they were released from the hospital?

Well, now the doctors are thinking about it. They say that they cannot in good conscience release the infants to the mother's care because they--rightly, alas--fear for the babies health and safety. Well, ok, why didn't we--erm, they, the docotrs--think of this before? Whose responsibility is it to think of such matters?

The mother, of course, had--and still does, by the way--a very key responsibility here. Not just to take care of her children, but to inform her caregivers of the environment into which she was obliged to take them. Perhaps she did this. However, even if she didn't, I still think it is incumbent on the doctors to do more than arrange for the safe delivery of the children.

Now it can be argued, that this--what happens when the patient goes home--is not the responsibility of doctors. Doctors cannot be held accountable for what their patients do after they leave their immediate presence and care.

Or can they? If, say, a patient who has received a heart transplant is not monitored closely after he leaves the hospital, he's very likely to have complications and die. So, the physician naturally takes responsibility to inform the patient of the special needs that the operation will impose on him and even help him to meet those needs. Things like medical equipment, nursing care and medicines are all administered at home or in a rehabilitation setting under the doctor's supervision.

Why has this multiple pregnancy failed to rise to the same level of attention as, say, the heart transplant patient? I suppose that it can be argued that both measures are extraordinary, but by the same token, it can be argued that those measures are justified as necessary; required by extraordinary circumstances.

This is my key point. Of all the people involved with this case, the doctors knew just how extraordinary this situation was. They were not only the best informed participants in the process, but they were also in the best position to make decisions that would have been the the patients best interest. They could have, and should have done this long before it became front page news and they had to announce measures that will effectively punish the mother instead of help her.

After all, with some planning and coordination, money could have been raised to pay the mother's mortgage, sponsors could have been lined up to renovate the house and provide the equipment and supplies necessary to raise eight--or right, fourteen--children at once, and caregivers could have been arranged; all this long ago, certainly well before the proverbial diaper hit the fan. Now the doctors are trapped--hoisted by their own petard, as it were--protecting the children at the expense of the mother, whom they previously 'helped'.

Makes me wonder what the doctors have in mind this time. Oh wait, I know. Nothing.

Pride and Shame

It was a mixed bag today.

As I walked to work this morning, I thought about President's Obama's speech to the joint session of Congress that I watched on television last night. I recalled with a slight smile how he had once again moved me to tears with the power of his words and the skill with which he delivers them, wondering how long it would be before I could listen to him speak without becoming emotional. Perhaps never, but that would be no loss, certainly for I felt the power of his optimism and strength in my own stride across campus in the cool early morning sunlight. I was proud of him and of the people who call themselves Americans, because I believe, even as Gov. Jindal (author of the Republican response to the President's speech) does in his 'loyal' opposition, that we "Americans can do anything".

Then I turned the corner.

Down the street, no closer than a thousand feet away, I saw it. I couldn't help but see it. it was a graphic color image of a bloodied aborted fetus, at least four to six feet tall and two feet wide, not to be missed nor mistaken for anything else. Even though I've seen this before and I knew how hard it is to deal with it, I found myself stunned, blindsided and taken advantage of, all in the instant that I perceived that first, most painfully obvious image.

The photograph was mounted on a large framework, which towered over the street and was visible from two blocks away between the innocent and benevolent trees. It is part of a display that some anti-abortion group has brought to the campus for the past several years. The first time they came, they set up on the West Mall, and the event was marred by protests and a lot of angry shouting across a hastily constructed barrier. Subsequently, the display (though threatened with being banned, it was deemed protected speech) was moved to the street (Speedway) in front of Gregory Gym, surrounded by fence and given police protection. Today, they were back, this time still on Speedway, but now dominating the intersection with the East Mall.

I have two basic problems with the display. First of all, I find the graphic imagery to be unnecessarily offensive and insensitive to the people who were forced to see it. Make no mistake, these images were meant to ambush viewers with an inescapable presence. The very size and color of the pictures meant they were impossible to avoid seeing from as far as two blocks away. In response to past protests to this issue, they had put up tiny little signs that read "Warning! Graphic Images Ahead", but predictably, they came far too late for any passerby to avoid the sight of violence. Plus, the fact that the display (with barricades) took up the entire intersection meant that some of us were literally forced to pass by it in order to get to work or class.

I doubt that these same individuals would put up massive pictures of genitalia or graphic images of dead U.S. soldiers in Iraq, but somehow they feel that the impact of the images (which they readily acknowledge is drastic) is justified, and that the rules of common decency and respect for others therefore do not apply this bit of 'protected speech'.

Or, it would seem, these simple rules (do unto others; love thy neighbor) must be set aside in this admittedly extreme case. Either way, the unsuspecting sensibilities of good and decent people--even those, who, like me, are personally opposed abortion but respect the right to choose--were callously disregarded by the people who erected this egregiously offensive display.

Secondly, I find this type of behavior to be shameful. There is no other word for it. All day I thought about it and this is the best I can come up with for now. I believe it is shameful because the act of displaying disturbing imagery in this way is so very divisive.

I realize that this--abortion--may be one of those issues that people on either side feel so very deeply about that there may be no way nor, for that matter, no real need to agree upon it. Nevertheless, I am still optimistic enough to believe that even if we cannot agree on anything, we can at least agree to stop arguing about the things on which we know we will never agree. Oh! There it is, another one of those rules that are so simple they are now simply cliche: we must agree to disagree.

We must do more than that, though. We must agree to stop hurting and insulting each other unnecessarily. I mean really. This display made me feel as if I can't and shouldn't say anything, for fear of an irrational confrontation (likely on my part, unfortunately). I don't want to feel this way, but I am forced to, having been unexpectedly confronted by this display. It has me feeling bad even now, with no way to express it.

I couldn't bring myself to approach the display, let alone talk to the people who put it up. I guess that were I to have words with someone who felt it necessary to insult me in so brazen a manner without warning, I feel I would be only further legitimizing their position with a response. Simply said, I truly believe that there is no civilized response to this type of behavior other than shame.

So, as I walked away, I was ashamed for them, ashamed for people in general, ashamed of myself. After all, I did nothing, said nothing. Instead, I turned my head and sucked in my breath. I don't feel too good about that, for sure. Coming so close on the heels of my own personal re-examination, I guess still find it hard to bring myself to confront those whose behavior I think has crossed the line of decency and respect for others. Yet, why didn't I speak up?

This is something I need to change. I must not only find my voice, but I must use it. Somehow, some way, I need to find an outlet--a real outlet--for these feelings of pride and find work--real work--for my hands to erase these feelings of shame from my heart.

On the Day

It's odd. I've been thinking about Pierre a lot this week, of course, as it has finally--or should it be already--been a year since he died. In a previous post I wondered how this would play out; what we would do; how to mark the day without being morose about it. After all, this moment really marks a sense of accomplishment in my life, having made it back to the world after being laid low.

The answer, it seems, is not to choose between the sorrow of our loss and the joy of our recovery, but to do a little of both. It is fitting, I think, that we actually get out of the house, not because it's where 'it' happened, so to speak, but because we want to think of him in a way that is more universal, connected to the larger whole and not the particular place.

So, we are off to spend a couple of days at Enchanted Rock. To those who have been there, I need say little more, but to those who do not know of the place and have not felt the intense spiritual energy that is focused there, I need to explain that this is one of the places--perhaps even the last--where we went, as a family when we felt the need to re-connect to the earth. Physically, Enchanted Rock is an enormous dome-shaped granite outcrop about an hour from Austin. Spiritually, it has been a place of healing and regeneration for people from the very earliest times till today. It is hard to describe the calming energy that this place resonates. You simply have to go there and feel it.

So we will. At the top of the warm granite dome on a late February morning, we will raise our eyes to the open sky and allow its free expanse to lift our hearts as we remember Pierre. I have, in a year, come to this conclusion: He is gone but not lost; I have him here in my hands and heart forever.

The Day Elvis Died, or How I Learned to Speak French: Part I

I remember the day that Elvis died. Although I have nothing against his music, I am not now, nor was I then a fan of the King, but I remember that day--August 16, 1977--very well indeed.

That summer, I was working in Toulon, in the south of France, at the S.T.E.F.--the Societe de Transports et Entrepots Frigoriques--as a manual laborer, trying to learn how to speak French and earn a little money for the fall when I returned to school in Paris. I was attending the American College in Paris during the years 1976 and 1977, and this was the summer between the two years.

During my first year in Paris, I lived in an American ghetto. My girlfriend was American, as was my roommate and were all of my friends. This narrow cultural affiliation was considered to be acceptable by me despite the fact that I was living with a French family ostensibly to increase my contact with French people and culture, but even as I made excuses for it I knew this state of affairs had to change if I was ever going to learn French.

Now, when I came to France, and Paris specifically, I didn't come with the intent of learning the language or even, to be honest, with a desire to become a francophile, even though that was the outcome. I came for more mundane reasons, though to give my Mother credit, those were but excuses for me to take advantage of being twenty years old and living in Paris.

It is safe to say that this is something she would have done herself, given the chance, and it was, in a way, a vicariously lived dream for her to send me to school in Paris. I thought I was getting away from home and starting to get the college degree I'd abandoned just two years earlier, but in fact I was setting out on one of those sea-changes I was to shortly read about in my freshman literature class with Dr. Pelen.

My desire to become more integrated with French culture, started, ironically enough, in Pelen's class, which was, appropriately enough, "Expatriate Writers in Paris". This meant that I was reading "The Sun Also Rises" in the Cafe Select, which was just down the street from where I lived. Of course, it was no accident that I should be reading that book in that place, since it was Dr. Pelen's intent to impress upon us the long tradition to which were just being introduced in our early youth. Impressed I was, not just with being an ex-pat, but gradually, slowly, with the French language and culture.

If it was to Pelen that I owed gaining a sense of my time in this place, it was to another professor at ACP--now called, quite pretentiously, the American University in Paris--that I owed my interest in French culture and in learning the language: M. Delagis. We called him the Dancing Bear, because he reminded some of us Baby Boomers of that character on Captain Kangaroo. Mr Delagis would come literally dancing into the room each day, singing a song and trying from the very first moment of class to engage us in learning to speak French.

For some of us, this technique had some positive effect. I for one had so little ability to speak or understand that I was in the very category of student he preferred most. Like a baby, I did what he did, said what he said, and moved my mouth the way he told us to, all without shame or embarrassment.

Not so for the students who had been French majors at home in high school. They came with the preconception that they already knew how to speak French, even though when it came down to it, they were the ones who froze up when asked a question by the produce vendor or a waiter in the cafe. They were the ones who cried in class when Mr. Delagis refused, on point of principle, to speak English even for a moment just to explain something that they were not understanding in French.

This gave rise to the rumor that he couldn't actually speak English, a rumor which I found to be untrue when I met him once on a ferry from England to France. While in England he told me in perfect English, he preferred to speak the language of the land. It was his principle at home as well as away, and it served me well in the classroom.

I learned to speak with a very good accent--something confirmed when I went south to live in Toulon--and I developed a habit of asking for help when I didn't understand or couldn't express myself fully.

Neither of these behaviors were of much use, it turned out, however, when I found myself in an environment where everyone spoke only French all the time. True, I could fool some people for a minute with a well practiced speech and my passable accent, and I could and would ask for clarification when the words came too fast, but the chances to use a pre-planned speech were few and far between, and asking for a repetition just meant that I didn't understand twice in a row. Fortunately for me, people are very generous when you are trying to learn their language, and I had plenty of opportunities to reverse my first-year tendency to speak French only under duress.

I didn't have much choice really. In a place where, when an Irish truck driver broke down outside the S.T.E.F., no one could communicate with him so the fetched me, asking only if I could also speak Irlandaise (Irish), every day daily conversation was by its very nature forced upon me. I couldn't back away or mumble. I had to speak up to do my job and get along with my co-workers.

It was very stressful at first, especially because even the forced -full French' environment was requiring me to speak the language, I just wasn't fluent. I still had to translate every word, every sentence to and from English every time in my head. If you've ever done this, you know it is very exhausting and a little frightening, since each encounter is a new one in a way, and the chance of screwing it up and embarrassing myself were very high at every turn.

All that changed the day that Elvis died.

Next: Part II: August 16, 1977

I Don't Have the Strength

It was just a year ago today
When I first heard someone say
'I'm sorry for your loss.'
Then I didn't realize the cost
That I'd still have to pay.

I have the strength
To bear the load
To feel the pain
To tread the road
Of life again.

I have the strength to hold my ground.
I just don't have the strength to break down.

When he died I just lost my way
Till in a dream I heard him say
I want to come back now
I just don't know how
Until you say I may.

I have the strength
To stay the rage
To now forgive
And act my age
while I still live.

I have the strength to dig six feet down
I just don't have the strength to break down.

It was just a month ago today
When I first heard someone say
We no longer have to choose
No Freedom will we lose
When we lead the way.

I have the strength
To serve the cause
To save our house
And this because

I have the strength to turn my life around
I just don't have the strength to break down.

I See Dead People

Well, from my previous post you may have discerned that I am--for the time being anyway--a still-inquisitive 'newbie' in the world of Facebook. I am still too new to it to have formulated anything like a comprehensive review, but I have had mixed feelings that I will here attempt to explore.

First of all, here is the positive part. I like the fact that it allows for another level--at another speed, if you will--of communication. It is on another level because it allows connections that were otherwise rather weak, like with my friends at work and old school friends and friends of the family to flourish without an elaborate 're-connection' process. I find that I like the way that the flow of communication moves at what might be described as a languid pace, quite a bit slower than the phone, texting or IM but not so slow as email or a blog. I like the fact that I can tell everyone what I'm doing without having to tell them; I can find out what they are doing without having to ask. It's paradoxically personal and impersonal all at the same time.

This brings me to the downside. In what I assume to be an attempt to make the experience more personal, in the same way that Amazon will recommend books that I 'might like', Facebook helpfully suggests 'friends' that I might like to make. Ok, so that might work except that one of the first suggestions that it made was, in fact, Pierre.

Bang! There was his picture and a link to his page. Ironically, because I've just joined, Pierre and I are not officially 'friends', and because he is dead, although I can send him a 'Friend Request', he is not likely to approve it any time soon.

So in this place, we find ourselves in an electronic purgatory, where the dead are not quite gone and we--the living--cannot be sure if the people we see still alive. Perhaps they are yet shades or just our overactive imaginations and the incarnation of our secret desire to have them with us forever?

Thus it is that I wonder: How many dead people are there in this place? And how can you tell? Who takes down the sites for the dead, and at whose request? Like the county whose ballot box set LBJ on the path to the Presidency, Facebook may not be as populated as it seems.

Almost a Year

In a Facebook group that Dan set up last year to share thoughts about Pierre, Sonja started a thread to observe that it has been almost a year since Pierre died. In response to that, Valery then posed the question: What to do on the day of?

Here is what I posted in reply:

It's safe to say that no day has passed since last February 20th when I have not thought of Pierre, but at least as that anniversary approaches, I know that the pain of losing him has lessened and the joy of living has returned.

So, how indeed to mark the day? Do we mark it at all? I have to work that night, so it's not like we can leave town and I don't think we even desire to. There's no sense that we need to escape the house on that day, even though we know that the time is coming that we will leave this place behind.

There is, on my part anyway, a desire to remember what was good and joyful about Pierre. It is my resolution to enjoy the memory of our son. He was a good person and I am glad to have had him in my life.

Although I must perforce acknowledge that the rest of my life is now shaped by his death, it is not to my detriment, but quite the opposite. Because of his life and death, I am who I am, now stronger, wiser and hopefully more compassionate. I am resolved because I wish to recover, to forgive and hopefully be forgiven.

In this way I know I will forever think of Pierre as my beautiful and radiant son, one whose flame perhaps burned brighter than my own, and from whom certainly my own flame now burns more intensely. I lost him in one sense; but in another, most real way, I still have him with me always. His essence is in my hands, my visage, my voice.

So, a year has mattered, but how to say so?

St. Valentine's Day Massacre, Part II: They Start Coming!

It is not often-this is the first time actually-that the other reader of this journal will request, let alone demand I write even more words. Given the rarity of this event and my eager ego, it should not surprise either one of you that I would accede to the other's earnest request. Should it prove too lengthy I suggest simply reading every other word. ed.

I've said it many times before: There is no easier way to crush a budding romance than to go out to a restaurant for a romantic meal on Valentine's Day. There are two reasons for this, neither of which is directly related to my personal distaste for the Day as a function of my profession.

The first way that a Valentine's Day date can extinguish an emerging love affair is if it goes well. This is because, if it does indeed go well, then there will now be an expectation on both parties to forever after have a romantic Valentine's Day. Of course, this is no accident. This is precisely the evil plan upon which Hallmark and it's spawn have loosed upon the world. It is like a virus. It's not alive, but it replicates. It invades the host and infects it, bending it physically to submit to it's will. And a 'good' Valentine's Day is like the Vampire's Bite. Once Bitten you cannot go back. At least most people know better than to invite them in!

Of course, the other way that Valentine's Day can and will most often wreck a romance before it can even get messy is when it doesn't go well. Now, notice that the fist way was an 'if' and the second was a 'when'. This means that although you may or may not get the first--a nice romantic evening--but if you persist--as Hallmark so desires--you will surely get the second, which is, quite naturally going to be a disaster.

Now, it won't make a bit of difference if the disaster is of your making or your partner's. It also won't make any difference at all if the disaster is created by the restaurant. It certainly didn't that night, for those romance-seeking couples whose first Valentine's Day Date was ruined that fateful February eve in 1999.

Now, in part one of this cautionary tale, I observed that it, given the date, Valentine's Day is often cold, but to observe the attire of the couple in attendance that day--may I say, particularly, the ladies--you might never have know that they were expecting to walk about in what, for Texas anyway, were fairly low temperatures: the 50's. Wearing strapless gowns and short dresses, high heels and in the absence of coats or wraps to hide their finery, these ladies no doubt expected to be whisked from their warm chariots into the equally warm and cozy restaurant--how about that table in front of the fire?

They were not expecting to wait in line, and most certainly not planning on queuing up outside, but that is exactly what happened. In order to seat as many two-tops in the restaurant as possible, we had converted all four-tops to twos and re-arranged the tables to accommodate as many more tables as would fit into the space. We had also converted the lobby and the patio, with it's plastic drop-down walls meant to ameliorate but not prevent the cold, converted into a dining room, and had consequently moved the hostess stand just outside the patio door.

This meant that we are able to seat the first wave of diners, but alas, the overbooking rendered this first little 'victory' moot. As soon as the restaurant was filled to capacity, there was still a line of couples out the door and into the garden and parking lot. It reminded me of one of those children's Bible illustrations of Noah's Ark, with the line of animals, two-by-two, snaking off into the distance for miles. Except that these pairs were shivering and getting progressively angrier by the minute.

Sadly, even those who were seated, immediately or after a long wait, were in for a(nother) rude surprise. The effect of adding tables without increasing the number of waiters leads to the very situation that waiters dread so much that they have nightmares about it. This was no nightmare, unfortunately, as we pinched ourselves repeatedly to no avail and kept on living it.

I personally was assigned to a section in the back of the restaurant. It has since been walled in, but at the time, it was like the front patio, with drop-down plastic walls and a flagstone floor. In this section, where normally at most six table would be placed--one of them a large, 6-12 top--there were now fewer than ten tables, all of them two-tops. Now, that would be ok, except for how they were seated. Recall that we were able to 'absorb' most of the first wave in our first seating, but note that they were all seated pretty much at once.

That single fact, more than any other, is what made the nightmare for me. It was, "Excuse me," and "O waiter!" over and over and over again as I literally ran between tables and winced each time another one was sat. It's a simple math problem, really, and there is no disputing the numbers. Ten tables times a two-minute greeting/order taking session adds up to twenty minutes, and that turns out to be just beyond the physical capacity of even the best waiter, which I naturally consider myself to be.

I just could not get the job done, and believe me, the patrons knew it. Those customers who did not leave waited for what seemed like hours. They waited for a table, then they waited for their food. There was not enough alcohol in the world to cover the bad feelings that evening, and, unfortunately, I had none to at least mellow me out until much later, much too late.

I was certainly not alone in this. Each player in this macabre little drama had his or her own personal nightmare. The hostess, for example, could hardly stand at podium without being attacked by impatient, and justifiably angry and cold customers. The kitchen was inundated by a flood of orders as each waiter struggled to turn in multiple tickets before running back to get more. The bartender was flooded with drink orders not just from the tables, but from all the people waiting in line.

In short, on this night, everyone waited for everything and no one was happy. It was a complex, interlocking and devastatingly difficult few hours for us all, and I'm not forgetting the patrons, either. Some of them actually came back, some of them even for Valentine's Day. One couple who was there even got married and came back to show me the ring one night. Go figure.

To this day, those of us who were there cannot recall it without a shudder. We take a definite pleasure in recounting it to the 'new' staff, those who were not there, but believe me, none of us would ever want to repeat it in real life.

After all, we still have the 'waiter dream'.