The Year of Magical Thinking
Page 4
This “dying” aspect had been documented, in study after study.
I began carrying identification when I walked in Central Park in the morning, in case it happened to me.
If the telephone rang when I was in the shower I no longer answered it, to avoid falling dead on the tile.
Certain studies, I learned, were famous. They were icons of the literature, benchmarks, referred to in everything I read. There was for example “Young, Benjamin, and Wallis, The Lancet 2:454–456, 1963.” This study of 4,486 recent widowers in the United Kingdom, followed for five years, showed “significantly higher death rates for widowers in first six months following bereavement than for married.” There was “Rees and Lutkins, British Medical Journal 4:13–16, 1967.” This study of 903 bereaved relatives versus 878 non-bereaved matched controls, followed for six years, showed “significantly higher mortality for bereaved spouses in first year.” The functional explanation for such raised mortality rates was laid out in the Institute of Medicine’s 1984 compilation: “Research to date has shown that, like many other stressors, grief frequently leads to changes in the endocrine, immune, autonomic nervous, and cardiovascular systems; all of these are fundamentally influenced by brain function and neurotransmitters.”
There were, I also learned from this literature, two kinds of grief. The preferred kind, the one associated with “growth” and “development,” was “uncomplicated grief,” or “normal bereavement.” Such uncomplicated grief, according to The Merck Manual, 16th Edition, could still typically present with “anxiety symptoms such as initial insomnia, restlessness, and autonomic nervous system hyperactivity,” but did “not generally cause clinical depression, except in those persons inclined to mood disorder.” The second kind of grief was “complicated grief,” which was also known in the literature as “pathological bereavement” and was said to occur in a variety of situations. One situation in which pathological bereavement could occur, I read repeatedly, was that in which the survivor and the deceased had been unusually dependent on one another. “Was the bereaved actually very dependent upon the deceased person for pleasure, support, or esteem?” This was one of the diagnostic criteria suggested by David Peretz, M.D., of the Department of Psychiatry at Columbia University. “Did the bereaved feel helpless without the lost person when enforced separations occurred?”
I considered these questions.
Once in 1968 when I needed unexpectedly to spend the night in San Francisco (I was doing a piece, it was raining, the rain pushed a late-afternoon interview into the next morning), John flew up from Los Angeles so that we could have dinner together. We had dinner at Ernie’s. After dinner John took the PSA “Midnight Flyer,” a thirteen-dollar amenity of an era in California when it was possible to fly from Los Angeles to San Francisco or Sacramento or San Jose for twenty-six dollars round-trip, back to LAX.
I thought about PSA.
All PSA planes had smiles painted on their noses. The flight attendants were dressed in the style of Rudy Gernreich in hot-pink-and-orange miniskirts. PSA represented a time in our life when most things we did seemed without consequence, no-hands, a mood in which no one thought twice about flying seven hundred miles for dinner. This mood ended in 1978, when a PSA Boeing 727 collided with a Cessna 172 over San Diego, killing one hundred and forty-four.
It occurred to me when this happened that I had overlooked the odds when it came to PSA.
I see now that this error was not confined to PSA.
When Quintana at age two or three flew PSA to Sacramento to see my mother and father she referred to it as “going on the smile.” John used to write down the things she said on scraps of paper and put them in a black painted box his mother had given him. This box, which remains with its scraps of paper on a desk in my living room, was painted with an American eagle and the words “E Pluribus Unum.” Later he used some of the things she said in a novel, Dutch Shea, Jr. He gave them to Dutch Shea’s daughter, Cat, who had been killed by an IRA bomb while having dinner with her mother in a restaurant on Charlotte Street in London. This is part of what he wrote:
“Where you was?” she would say, and “Where did the morning went?” He wrote them all down and crammed them into the tiny secret drawer in the maple desk Barry Stukin had given him and Lee as a wedding present…. Cat in her school tartan. Cat who could call her bath a “bathment” and the butterflies for a kindergarten experiment “flybutters.” Cat who had made up her first poem at the age of seven: “I’m going to marry / A boy named Harry / He rides horses / And handles divorces.”
The Broken Man was in that drawer. The Broken Man was what Cat called fear and death and the unknown. I had a bad dream about the Broken Man, she would say. Don’t let the Broken Man catch me. If the Broken Man comes, I’ll hang onto the fence and won’t let him take me…. He wondered if the Broken Man had time to frighten Cat before she died.
I see now what I had failed to see in 1982, the year Dutch Shea, Jr. was published: this was a novel about grief. The literature would have said that Dutch Shea was undergoing pathological bereavement. The diagnostic signs would have been these: He is obsessed with the moment Cat died. He plays and replays the scene, as if rerunning it could reveal a different ending: the restaurant on Charlotte Street, the endive salad, Cat’s lavender espadrilles, the bomb, Cat’s head in the dessert trolley. He tortures his ex-wife, Cat’s mother, with a single repeated question: why was she in the ladies’ room when the bomb went off? Finally she tells him:
You never gave me much credit for being Cat’s mother, but I did raise her. I took care of her the day she got her period the first time and I remember when she was a little girl she called my bedroom her sweet second room and she called spaghetti buzzghetti and she called people who came to the house hellos. She said where you was and where did the morning went and you told Thayer, you son of a bitch, you wanted someone to remember her. So she told me she was pregnant, it was an accident, and she wanted to know what to do and I went into the ladies’ room because I knew I was going to cry and I didn’t want to cry in front of her and I wanted to get the tears out of the way so I could act sensibly and then I heard the bomb and when I finally got out part of her was in the sherbet and part of her was in the street and you, you son of a bitch, you want someone to remember her.
I believe John would have said that Dutch Shea, Jr. was about faith.
When he began the novel he already knew what the last words would be, not only the last words of the novel but the last words thought by Dutch Shea before he shoots himself: “I believe in Cat. I believe in God.” Credo in Deum. The first words of the Catholic catechism.
Was it about faith or was it about grief?
Were faith and grief the same thing?
Were we unusually dependent on one another the summer we swam and watched Tenko and went to dinner at Morton’s?
Or were we unusually lucky?
If I were alone could he come back to me on the smile?
Would he say get a table at Ernie’s?
PSA and the smile no longer exist, sold to US Airways and then painted off the planes.
Ernie’s no longer exists, but was briefly re-created by Alfred Hitchcock, for Vertigo. James Stewart first sees Kim Novak at Ernie’s. Later she falls from the bell tower (also re-created, an effect) at Mission San Juan Bautista.
We were married at San Juan Bautista.
On a January afternoon when the blossoms were showing in the orchards off 101.
When there were still orchards off 101.
No. The way you got sideswiped was by going back. The blossoms showing in the orchards off 101 was the incorrect track.
For several weeks after it happened I tried to keep myself on the correct track (the narrow track, the track on which there was no going back) by repeating to myself the last two lines of “Rose Aylmer,” Walter Savage Landor’s 1806 elegy to the memory of a daughter of Lord Aylmer’s who had died at age twenty in Calcutta. I had not thought of “Rose Aylmer” since I
was an undergraduate at Berkeley, but now I could remember not only the poem but much of what had been said about it in whichever class I had heard it analyzed. “Rose Aylmer” worked, whoever was teaching this class had said, because the overblown and therefore meaningless praise for the deceased in the first four lines (“Ah, what avails the sceptred race! / Ah, what the form divine! / What every virtue, every grace! / Rose Aylmer, all were thine”) gets brought into sudden, even shocking relief by “the hard sweet wisdom” of the last two lines, which suggest that mourning has its place but also its limits: “A night of memories and sighs / I consecrate to thee.”
“‘A night of memories and sighs,’” I remembered the lecturer repeating. “A night. One night. It might be all night but he doesn’t even say all night, he says a night, not a matter of a lifetime, a matter of some hours.”
Hard sweet wisdom. Clearly, since “Rose Aylmer” had remained embedded in my memory, I believed it as an undergraduate to offer a lesson for survival.
December 30, 2003.
We had seen Quintana in the sixth-floor ICU at Beth Israel North.
Where she would remain for another twenty-four days.
Unusual dependency (is that a way of saying “marriage”? “husband and wife”? “mother and child”? “nuclear family”?) is not the only situation in which complicated or pathological grief can occur. Another, I read in the literature, is one in which the grieving process is interrupted by “circumstantial factors,” say by “a delay in the funeral,” or by “an illness or second death in the family.” I read an explanation, by Vamik D. Volkan, M.D., a professor of psychiatry at the University of Virginia in Charlottesville, of what he called “re-grief therapy,” a technique developed at the University of Virginia for the treatment of “established pathological mourners.” In such therapy, according to Dr. Volkan, a point occurs at which:
we help the patient to review the circumstances of the death—how it occurred, the patient’s reaction to the news and to viewing the body, the events of the funeral, etc. Anger usually appears at this point if the therapy is going well; it is at first diffused, then directed toward others, and finally directed toward the dead. Abreactions—what Bibring [E. Bibring, 1954, “Psychoanalysis and the Dynamic Psychotherapies,” Journal of the American Psychoanalytic Association 2:745 ff.] calls “emotional reliving”—may then take place and demonstrate to the patient the actuality of his repressed impulses. Using our understanding of the psychodynamics involved in the patient’s need to keep the lost one alive, we can then explain and interpret the relationship that had existed between the patient and the one who died.
But from where exactly did Dr. Volkan and his team in Charlottesville derive their unique understanding of “the psychodynamics involved in the patient’s need to keep the lost one alive,” their special ability to “explain and interpret the relationship that had existed between the patient and the one who died”? Were you watching Tenko with me and “the lost one” in Brentwood Park, did you go to dinner with us at Morton’s? Were you with me and “the one who died” at Punchbowl in Honolulu four months before it happened? Did you gather up plumeria blossoms with us and drop them on the graves of the unknown dead from Pearl Harbor? Did you catch cold with us in the rain at the Jardin du Ranelagh in Paris a month before it happened? Did you skip the Monets with us and go to lunch at Conti? Were you with us when we left Conti and bought the thermometer, were you sitting on our bed at the Bristol when neither of us could figure how to convert the thermometer’s centigrade reading into Fahrenheit?
Were you there?
No.
You might have been useful with the thermometer but you were not there.
I don’t need to “review the circumstances of the death.” I was there.
I didn’t get “the news,” I didn’t “view” the body. I was there.
I catch myself, I stop.
I realize that I am directing irrational anger toward the entirely unknown Dr. Volkan in Charlottesville.
Persons under the shock of genuine affliction are not only upset mentally but are all unbalanced physically. No matter how calm and controlled they seemingly may be, no one can under such circumstances be normal. Their disturbed circulation makes them cold, their distress makes them unstrung, sleepless. Persons they normally like, they often turn from. No one should ever be forced upon those in grief, and all over-emotional people, no matter how near or dear, should be barred absolutely. Although the knowledge that their friends love them and sorrow for them is a great solace, the nearest afflicted must be protected from any one or anything which is likely to overstrain nerves already at the threatening point, and none have the right to feel hurt if they are told they can neither be of use or be received. At such a time, to some people companionship is a comfort, others shrink from their dearest friends.
That passage is from Emily Post’s 1922 book of etiquette, Chapter XXIV, “Funerals,” which takes the reader from the moment of death (“As soon as death occurs, someone, the trained nurse usually, draws the blinds in the sick-room and tells a servant to draw all the blinds of the house”) through seating instructions for those who attend the funeral: “Enter the church as quietly as possible, and as there are no ushers at a funeral, seat yourself where you approximately belong. Only a very intimate friend should take a position far up on the center aisle. If you are merely an acquaintance you should sit inconspicuously in the rear somewhere, unless the funeral is very small and the church big, in which case you may sit on the end seat of the center aisle toward the back.”
This tone, one of unfailing specificity, never flags. The emphasis remains on the practical. The bereaved must be urged to “sit in a sunny room,” preferably one with an open fire. Food, but “very little food,” may be offered on a tray: tea, coffee, bouillon, a little thin toast, a poached egg. Milk, but only heated milk: “Cold milk is bad for someone who is already over-chilled.” As for further nourishment, “The cook may suggest something that appeals usually to their taste—but very little should be offered at a time, for although the stomach may be empty, the palate rejects the thought of food, and digestion is never in best order.” The mourner is prompted to practice economy as he or she accommodates the wearing of mourning: most existing garments, including leather shoes and straw hats, will “dye perfectly.” Undertaking expenses should be checked in advance. A friend should be left in charge of the house during the funeral. The friend should see that the house is aired and displaced furniture put back where it belongs and a fire lit for the homecoming of the family. “It is also well to prepare a little hot tea or broth,” Mrs. Post advised, “and it should be brought them upon their return without their being asked if they would care for it. Those who are in great distress want no food, but if it is handed to them, they will mechanically take it, and something warm to start digestion and stimulate impaired circulation is what they most need.”
There was something arresting about the matter-of-fact wisdom here, the instinctive understanding of the physiological disruptions (“changes in the endocrine, immune, autonomic nervous, and cardiovascular systems”) later catalogued by the Institute of Medicine. I am unsure what prompted me to look up Emily Post’s 1922 book of etiquette (I would guess some memory of my mother, who had given me a copy to read when we were snowbound in a four-room rented house in Colorado Springs during World War Two), but when I found it on the Internet it spoke to me directly. As I read it I remembered how cold I had been at New York Hospital on the night John died. I had thought I was cold because it was December 30 and I had come to the hospital bare-legged, in slippers, wearing only the linen skirt and sweater into which I had changed to get dinner. This was part of it, but I was also cold because nothing in my body was working as it should.
Mrs. Post would have understood that. She wrote in a world in which mourning was still recognized, allowed, not hidden from view. Philippe Ariès, in a series of lectures he delivered at Johns Hopkins in 1973 and later published as Western Attitudes to
ward Death: From the Middle Ages to the Present, noted that beginning about 1930 there had been in most Western countries and particularly in the United States a revolution in accepted attitudes toward death. “Death,” he wrote, “so omnipresent in the past that it was familiar, would be effaced, would disappear. It would become shameful and forbidden.” The English social anthropologist Geoffrey Gorer, in his 1965 Death, Grief, and Mourning, had described this rejection of public mourning as a result of the increasing pressure of a new “ethical duty to enjoy oneself,” a novel “imperative to do nothing which might diminish the enjoyment of others.” In both England and the United States, he observed, the contemporary trend was “to treat mourning as morbid self-indulgence, and to give social admiration to the bereaved who hide their grief so fully that no one would guess anything had happened.”
One way in which grief gets hidden is that death now occurs largely offstage. In the earlier tradition from which Mrs. Post wrote, the act of dying had not yet been professionalized. It did not typically involve hospitals. Women died in childbirth. Children died of fevers. Cancer was untreatable. At the time she undertook her book of etiquette, there would have been few American households untouched by the influenza pandemic of 1918. Death was up close, at home. The average adult was expected to deal competently, and also sensitively, with its aftermath. When someone dies, I was taught growing up in California, you bake a ham. You drop it by the house. You go to the funeral. If the family is Catholic you also go to the rosary but you do not wail or keen or in any other way demand the attention of the family. In the end Emily Post’s 1922 etiquette book turned out to be as acute in its apprehension of this other way of death, and as prescriptive in its treatment of grief, as anything else I read. I will not forget the instinctive wisdom of the friend who, every day for those first few weeks, brought me a quart container of scallion-and-ginger congee from Chinatown. Congee I could eat. Congee was all I could eat.