Mourning: Raging, Diamonds & Stained-Glass Windows
By Daniel J. Bressler, MD, FACP
Published in San Diego Physician Magazine, July 2005
Of course, in the long run we can’t win. Our battle against disease is really a battle against time itself. In this conflict we are seriously outgunned and out-maneuvered. Time invariably triumphs over our best-laid plans. Entropy is its secret weapon. Its Gatling gun sprays our cells with seeds of chaos. Chromosomes whittle off their telomeres; proteins glycosylate; hemosiderin bivouacs in our cytoplasm; replication errors commandeer our nuclei. Some critical mass of cellular bewilderment coalesces into organ dysfunction, disease, and after all our temporizing interventions are exhausted, death.
At a time of minimal technological intervention, Dylan Thomas, the great Welch poet, called on his tired, dying father not to surrender to death’s tempting invitation. At the time, there were no pressors, no ventilators, no sophisticated antibiotics, precision surgeries or omniscient imaging. Willpower was then the most important survival factor. Thomas pleads:
Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.
Though wise men at their end know dark is right,
Because their words had forked no lightning they
Do not go gentle into that good night.
Good men, the last wave by, crying how bright
Their frail deeds might have danced in a green bay,
Rage, rage against the dying of the light.
Wild men who caught and sang the sun in flight,
And learn, too late, they grieved it on its way,
Do not go gentle into that good night.
Grave men, near death, who see with blinding sight
Blind eyes could blaze like meteors and be gay,
Rage, rage against the dying of the light.
And you, my father, there on the sad height,
Curse, bless me now with your fierce tears, I pray.
Do not go gentle into that good night.
Rage, rage against the dying of the light.
Thomas’ call, however eloquent, seems archaic now as an accurate depiction of a hospital drama. The deciding factor in the ICU is no longer the patient’s raging intensity but rather the comparative power of the doctors and disease. Nevertheless, the poem’s power lives on for both its rhythmic imagery, and also for its still-current enumeration of the frustration that arises in the face of loss of a life however well or powerfully lived.
A poem that is weaker rhetorically and at times perhaps too sweet in its sentimentality is nevertheless one of my favorites dealing with the topic of mourning. This piece by Mary Elizabeth Frye, (1904-), lends itself to the common, quiet belief that death involves a natural reunion with Everything…
Do not stand at my grave and weep,
I am not there, I do not sleep.
I am a thousand winds that blow.
I am the diamond glint on snow.
I am the sunlight on ripened grain.
I am the gentle autumn rain.
When you wake in the morning hush,
I am the swift, uplifting rush
Of quiet birds in circling flight.
I am the soft starlight at night.
Do not stand at my grave and weep.
I am not there, I do not sleep.
Do not stand at my grave and cry.
I am not there, I did not die.
Frye’s reassurance notwithstanding, cry we must. As I often tell my patients and their survivors, “grief is the healthy response to loss.” Both the believer and non-believer have the fundamental human need to express their sadness. Sometimes when I stop by the beautiful chapel at Mercy Hospital for a brief respite from a busy day, I will bear witness to this expression. I tried to capture the feeling of that experience in these few lines:
Quiet the hospital chapel.
I hold a consoling palm
Flat against my breastbone
And pray with the rhythm of breath.
The touched file in from every creed
To petition the stained-glass Spirit.
For the ailing, they beg remedy;
For the dead, eternal peace.
Even the most faithful weep.
Though the soul may ascend
(And that thought comforts)
Heaven’s gain is forever our loss.