Consider Seals
“ Let us go then, you and I,/When the evening is spread out against the sky/Like a patient etherized upon a table;” - T.S. Eliot, “The Love Song of J. Alfred Prufrock”
“Neither shall there be any more pain.” - The Book of Revelations
When I was in my early twenties, I went on a work trip to Boston. One day, my coworkers and I played hooky from the conference to do a little sightseeing. We hit up Alcott House, Walden Pond, Boston Public Gardens.
What I learned at the Alcott House was that Louisa May’s great-uncle was a judge in the Salem Witch Trials who later hung himself; what I learned at Walden was that Thoreaus’s mama often brought him sandwiches down at the pond; and what I learned at Boston Public Gardens was that there was a forty-foot tall monument to ether.
While the factoids about Alcott and Thoreau lingered in my memory bank, the statue in Boston Public Gardens, the Monument To Ether/The Good Samaritan, resonated with me. There was this man in robes, a turban, holding a naked, unconscious man. In the unconscious man, I could see myself, all the times I had been rendered that acutely vulnerable in medical situations.
Then, in my early twenties, I was little more than a decade past my experience as a teenage patient when medical malpractice resulted in a months long hospital stay and numerous additional bone surgeries to treat an infection I contracted during surgery numero uno.
Standing before The Monument to Ether, in my early twenties, I was fairly certain that early medical calamity, back when I was fourteen, would be the worst (if not only) medical calamity to befall me in my life. Breast cancer was less than ten years off, waiting in the shadows, whispering, “Hold my beer.” Though admittedly, my medical experiences as a breast cancer patient have never reached the kind of lows my medical experiences reached circa 1990. Like, in 1990, I got my Last Rites and all. It’s never yet gotten that crazy in my breast cancer care, and I hope to keep it that way.
I read the inscriptions on the monument, and after each one looked again at the statue – the surgeon, the naked man.
“To commemorate that the inhaling of ether causes insensitivity to pain . . . “
“In gratitude for the relief of human suffering . . .” and Biblically,
“Neither shall there be any pain.”
Yeah, I thought. Ether was a big fuckin’ deal. I knew from history how it was done before ether, before anesthesia. I knew patients before me had been wide awake, buzzed on whiskey, biting sticks. And in that moment, in my early twenties, I felt a new kind of gratitude – gratitude that I lived in a time where it didn’t have to be whiskey and sticks, in a time where if I needed an operation, I would not be awake to experience it. What a mercy, indeed.
Having already known what it was to be the naked patient, comatose, vulnerable, I felt moved by the statue. What a vulnerable place, to be under a virtual stranger’s knife. What a scary thing, I thought, to trust like that. What an incredible leap of faith.
***
While studying English/English Literature in undergrad, I developed a strong and abiding attachment to the work of American and European Modernist poets. My predictable favorite among them, and still, was TS Eliot. I loved close/analytical reading, and Eliot offered the analytical reader so very much.
I went on to become a teacher – at the college level, at the secondary level – and often used Eliot’s “The Love Song Of J. Alfred Prufrock” as a text in our courses. What can I say? I love this poem. I love “The Wasteland” more, but we never had time for that. And in my teaching, I am certain I always spent a little too much time on that arresting opening simile: like a patient etherized upon a table. I spent maybe too much time unpacking that one, considering the many connotations, considering what that state is – to be etherized, anesthetized – how it is not sleep exactly, nor is it death, but a timeless, dreamless lapse, somewhere smack in between living and dead.
I would perhaps linger too long on this one poetic flourish because on the patient’s face, I could see my own face. By the time I was in my mid-thirties, I’d had additional surgeries, owing to breast cancer, and was old enough during those surgeries to be more mindful of what was happening to me and how it felt. How isolating it felt. How raw it felt. How acutely terrifying it felt. The last time I taught The Love Song, I already had been diagnosed with stage iv cancer; I was in my mid-forties with a nice and even eight total surgeries under my belt. I felt, by then, that I at least had a Bachelor’s in being a patient etherized upon a table – even though we don’t use ether anymore, thank god.
By the last time I taught Prufrock, I was closer to Prufrock’s age than I was to being in my twenties. The last time I taught Prufrock, I had a real and urgent sense of my own erasure, of the forward march of time to my grave. Not just because of the metastatic breast cancer, though that was a part, but because of what was happening in America then – the pandemic, the political discord, the sense that everything was starting to bust apart at the seams, including my marriage.
I felt, and still feel, a strong tie to the Modernist poets. I felt connection in their response to the changes brought on in the early 20th century – Freud, Darwin, Industry, the first World War. And I believed, and still believe, that maybe those who lived through the shaky dawn of the 20th Century, the shock of the first World War, are the witness voices we need to guide us spiritually, intellectually, creatively through these times through which we are all now living. I don’t think anything, since World War I, has caused such great collective psychological trauma as The Pandemic, Trump, American political madness. This is not even to mention foreign wars, climate change, global poverty. We are collectively shook, just as the people of the early 20th century were no doubt collectively shook by the change and horror to which they bore witness, too. For my money, only a Modernist poet can capture the spirit of my times.
In the past five years, as I’ve weathered the storms of this life, I have often sought out poetry the way some seek religion in times of crisis. I have looked to the old and dead for ideas and wisdom about how to live now. The day after I met Dr. Dupree, still chewing the facts of my case – stage iv, incurable breast cancer – I wrote in my journal: not merely survive. Dr. Dupree had introduced the idea to me that although I had an incurable disease, my life was not in fact over. Dr. Dupree had planted a seed of a thought, a “what if?” A what if I don’t merely survive this, but I live a full and happy life – however short or long – with this?
Nothing has taught me more about survival than the last two years of my life. I spent many years inside of an emotionally and financially abusive relationship. When that relationship ended, I had zero dollars and zero cents because that is the end game in financial abuse – if the target gets too out of control, you can always destroy them financially. I had to take help from social programs, and I had to learn how to live at a level of poverty I had never before known in my American life. I had to do this on the heels of a brutal divorce, after a cross country move back to Chicagoland, while keeping up with my treatments for metastatic breast cancer so I didn’t, you know, literally die. For a while, when I first came back from Arizona, I could do little more than survive.
Survival mode is necessary, but it is no way to live. If I was in charge of everything, no one in this country would spend their lives in survival mode, as so very many do. Constant survival mode is not freedom. I knew this before my ex ghosted me. I knew this before I fell upon some really hard times. I knew mere surviving was not enough, but when we’re talking about affording groceries, accessing healthcare, paying rent, mere survival takes precedence. Once, however, I had a means for those things – groceries, healthcare, rent – I was able to focus on healing myself back to a life that I loved, not merely endured.
That I knew how to bring myself back, was courtesy of meeting Dr. Dupree, who offered me countless healing opportunities through The Healing Consciousness Foundation (HCF). Yes, I took Western meds, psychiatry, psychology, but my inroad to helping myself through traditional channels was the work I did holistically with healers I connected with through HCF — that healing work laid the foundation I needed to live a better life.
A better life means I’m not waiting for “the next good thing,” and instead am mindful of all the good in all of the things, experiences, circumstances that I am in right now, today, at this very second. A better life means I neither live in the hallucinatory past or the imagined future, but in the here and now. Of course a little future is planning is necessary, even when you have incurable cancer, because modern medicine is helping those of us, particularly with metastatic breast cancer, live longer.
A better life is a healing life.
***
In March of this year, I will have the eleventh surgery of my life when I undergo an elective thyroidectomy. My thyroid is trash, and has been trash for years, and I’m sick of undergoing needle biopsies all the time, so trash thyroid is going in the trash. This is not a new thing, nor is this a “surprise” for thing. I was born with a garbage thyroid. What can I say.
I mention this only because I want to show you how I am now, and how I was before. Surgeries, which I first began having in my early teens, used to upset me greatly. Like entire days in the lead up would be lost to incessant anxiety. Like I’d cry and lie awake considering all the ways I could possibly “die from this.” High on my list of surgical fears/dislikes was the dreadful (in my estimation) experience of being “put under.” Of being anesthetized, etherized, if you will (and I know you will), upon a table.
Nevertheless, I’ve had surgeries. Up to and including eyeball surgery which was maybe the one that wigged me out most. Thank god it was a success and is in my past. Ever since I saw Un Chein De Andelou in undergrad, I’ve had a thing about knives and eyeballs. Call me old fashioned.
In March of this year, I will have my eleventh surgery. When my endocrinologist and I discussed the matter, I did not become tearful, I did not start to sweat, my hands did not shake, and I did not immediately start thinking of ways to get out of having surgery. My pulse didn’t even quicken, reader. I discussed the matter of my own trash thyroid with all the calm detachment (not disassociation) that I might discuss plans for a writing workshop.
In winter, 2020, I had my eighth surgery in Verde Valley, Arizona. Cornville, maybe? And yes, there’s a town in the desert called “Cornville.” Story goes that the town was founded by a man named Cohen. The people of the area couldn’t bother to learn to pronounce Cohenville. So they started calling it “Cornville” and everyone was just like “okay, that’s fine, too.” Such are the stories I knew in the southwest.
So in Cornville (maybe?), Arizona I had my eighth surgery, I was forty-three (I am now 47 and proud of every year) and my surgeon — Dr. Beth Dupree — was going to remove a cancerous tumor from my chest wall. The bit that had metastasized to my spine would be radiated later in a building that shared a parking lot with the parking lot where the hospital was building makeshift morgues for the covid dead and dying.
But then, in Maybe Cornville, Arizona, The Pandemic was still a few weeks away. I was so fixated on “fuck. Now I have stage iv cancer” that I could hardly pay attention to things my students had been telling me about the hospitals being haphazardly erected in China. Who can think of Chinese hospitals when I have incurable cancer? One is never more ego-centric than when one is first truly confronted with their own, very factual and actual, mortality.
In Maybe Cornville, I had no idea what was about to happen to me, much less my profession (teaching), much less my marriage, much less to my country. All I knew is that there was cancer in my back, and I needed someone — anyone at that desperate point — to take it out of me. And I was happy that day to know Dr. Dupree would be the one to remove this cancer. Having met her, I knew I felt a strong connection, not only did I respect her, I actually liked her. No offense to all previous surgeons, but I’ve never “liked” a surgeon. I’ve never thought, “I would like to have coffee with this person and pick their brain.” And I have never, ever found a surgeon to be “hilarious” the way Dr. Dupree could sometimes be hilarious.
There are some people you meet, in this life, especially if you are lucky, who are not trying to hide themselves. There are some people you meet, in all professions, who are not merely “having a job.” There are some people everywhere — even out on the streets — who are just glowing and authentic and their light lights something up in you. Dr. Dupree is such a person.
When I’ve spoken to young surgeons at Dr. Dupree’s conferences, I have told them they cannot aspire to be Dr. Dupree, they can only aspire to be authentic. That authenticity, particularly when rooted in compassion, is the gateway to connecting in real, meaningful ways with patients, students, other human beings in your neighborhood, and beyond. That authenticity builds bonds of trust. Connection through trust? What a thought!
***
Every surgery before and since Dr. Dupree goes a little like this (and probably for you, too):
Arrive early.
Disrobe, put on a rag with shoelace ties
Get in pre-op room bed. Wait there while people come in and out and hook your body up to various drips.
Wait for the sweet, sweet mercy of whatever anti-anxiety drip they’re giving you that day.
Get wheeled to the operating room in a tranquil confusion
See your surgeon just long enough to maybe say “hiiii . . .” before you are down for the count.
Wake up in post-op. Say weird shit. Go on with life.
I wasn’t in the pre-op room for more than fifteen minutes before Dr. Dupree appeared that morning, in the winter of 2020, juggling papers and so many cell phones I jokingly asked her if she was a drug dealer. I felt I could joke with her because the first time I met her she showed me who she was, and she was a person who could take a joke. I never joked with a surgeon (of my own) before this. Never had an opportunity to joke.
She stayed with me in pre-op. She was working, mostly, but she was there. She was there the way a friend or family member would be. She didn’t have to be in pre-op with me, but she made that choice because she knew that just the presence of the doctor is an acknowledgment, a way of saying, “I know you’re probably scared, but I’m here, and I’ve got you.”
When the anesthesiologist entered, she introduced me to him and said, “He’s gonna take you on a trip. Where you wanna go?”
As she had perplexed me the first time I met her, she perplexed me then. I was a surgery-pro. The timeless, dreamless “sleep” of anesthesia was far from a “trip,” but despite my initial skepticism there were drugs coursing through my body that made my mind a little more pliable.
“He’s gonna take you on a trip. Where do you wanna go?”
I said La Jolla. I wanted to go swim with the seals. I’d seen them once during a happy trip with my ex. I watched them bark away tourists. The big mamas sunned themselves on rocks, fat babies on their bellies. Their size utterly belied their grace in water. I loved them.
“I want to swim with the seals,” I told Dr. Dupree, as I was wheeled down the hall toward surgery. She was beside me, holding my hand, just the way no surgeon had ever done before. I was smiling and thinking of seals. Not of impending surgery, but of the seals in La Jolla, diving for fish, waddling the rocks, resting like silver hills all along the pier.
When I went “out,” I went out on seals. When I woke up in recovery, I was still thinking about the fucking seals. I didn’t have a chance that day, but years later I would have a chance to ask Dr. Dupree why she did that, why she played with me ahead of surgery, got me thinking about seals.
Dr. Dupree does something similar for all her patients. For an example, check out THIS VIDEO and note that Dr. Dupree conducted this surgery the day after her own mother had passed away. I’m telling you, she’s not your average doctor.
As it turns out there is science backing her approach to patients in the moments leading up to the operating room. If you’ve done any time reading about the human body and human physical wellness, you’ve certainly encountered the subject of inflammation. Alcohol, sugar, dairy, hormone laden meats (which is to say most meat you and I can afford) — inflammatory. If we have done even a little thinking about our physical health, we know that avoiding inflammatory foods is better for our bodies, as inflammation in the body can lead to all sorts of medical calamities from heart disease to cancer.
Many of us discuss such matters with our healthcare professionals, as we should, and try to make better choices about what we put in our mouths so that we don’t get sick. What we seldom pause to consider is to what degree the mind creates inflammation in the body.
Stress, anxiety, fear — inflammatory. We must feel these feelings sometimes, but if we drench ourselves for prolonged periods of time in anxiety/fear/stress the body will become inflamed. I know now, through knowing Dr. Dupree, there is plenty of evidence to suggest connections between cancer and anxiety, heart disease and mental stress, past trauma and bodily sickness.
As a holistic practitioner, Dr. Dupree takes into account all dimensions of the patient’s wellness: physical, mental, spiritual. She does this not just because it feels better (and it does), but because there is a growing body of evidence to suggest that mental states have as much of an impact on the body as what we eat off the menu. Patients who go into surgery calm, relaxed, thinking of things like seals, or perhaps dancing (as in the previously linked video), or in some way with their mind trained on something that they live for (we don’t live to be patients; we are patients so that we might live), that patient has a greater chance of a faster recovery time, that patient is less likely to develop post-surgical complications, and as it turns out — in my case — it allows patients to make decisions with their doctor that are not fear-based, but healing-based.
***
”I’m starting a metal band,” I texted my friend Levin the day my endocrinologist and I decided to remove my thyroid. “It’s called Trash Thyroid.”
My endocrinologist was wearing thyroid socks. They were pink, and I complimented them and he pulled up his pant leg to reveal “thyroid socks.” This detail mattered to me. Small, but it showed me that this guy is really into what he does. And that’s what I want first in a surgeon — someone who is truly into what they do. I don’t expect telemarketers or workers at the DMV to be dewily thrilled/interested in their day jobs, but I expect it of doctors and teachers.
I love where I am now receiving my healthcare. I feel lucky because for a few years in Arizona I could not get adequate healthcare to (literally) save my own life. That’s where suffering sometimes pays off — you learn to better appreciate the good in what you have in the here-and-now. And while I love the hospital where I receive care, I have not met a Dr. Dupree. I will not meet a Dr. Dupree because she is not there. However, working with her as a patient made me think about all doctors differently. I could see their humanity more. I could figure out ways, as patient, to bring my providers out of the doctor role, so I could catch a glimpse of their true selves, their authenticity. The day I got my Very Serious oncologist to laugh, really laugh, felt like a big accomplishment. I’d made all the jokes. Thought it was never going to happen.
And this is where the practice of compassion is mutually beneficial. When patients feel connected to even one doctor, they are likely to alter their negative perceptions of others in the profession. When patients know their doctors are whole, authentic human beings, patients feel more comfortable, are more willing to comply, and are likely going to treat their doctors, nurses, and healthcare staff a lot better.
And if I may, I want to address my fellow patients: if we want our healthcare providers to practice compassion with us, we have to practice it with our providers too. Especially those phlebotomists. You better be nicer or I’m going to have to organize a Phlebotomist Uprising, and I’ve damn near done so on at least two occasions.
The first time Dr. Dupree invited me to speak at one of her young surgeons conferences, I got up in front of the room and said, “I am scared of you.” I did it for a laugh, and also because it was true. Early medical ptsd, and the medical ptsd from what went down circa 2020, made it hard for me to trust doctors. I wanted to, I really did, I knew it was easier that way. My body resisted, though, and often did a little hard coal of anger in my heart. That little coal of anger belonged to Teen Me who was still skulking about, smoking cigs, kicking at pavement in her Doc Martens, stealing her dad’s flannel shirts, fresh off a medical trauma that, once ended, none of the adults wanted to talk about. Or if they talked about it, it was always in relation to how the experience had made them feel. For a time, that teenager believed what happened to her at the hands of careless medical providers was the source of her entire family’s suffering ever after. She felt guilty about that and she felt angry that she “had” to feel guilty.
That hard coal was put out, crushed and blown away during the trauma therapy I received through The Healing Consciousness Foundation. I plan to write about this particular therapy, known as TRTP, next week. What I can say is that it revolutionized my thinking about the past, the present, and the future and helped me become the kind of grown-ass woman who can calmly discuss a thyroidectomy, her own, with the doctor and still be interested in his socks, still go on to have a perfectly good day, still dance in my car, still sing to the cats. If I could show you, in words, the places I’ve been in my mind and heart, you would know what a personal miracle this is.
***
I think of the twenty-something who stood before the Monument to Ether and reflected on a recent past where she was the patient in the arms of the Moor. I think of the scared forty-four year old I was, teaching Prufrock on Zoom during a pandemic, lingering long on the simile “like a patient etherized upon a table.” They are parts of the river I have dragged with my net, seeking treasures, gifts, coping mechanisms, love . . .
I think of the Joan Didion quote, “I have already lost touch with . . .”
Maybe you think of that, too. Change over time is nothing extraordinary. We do change over time. Tis true. Tis pity tis true? I don’t think so. Change is what makes us, what designs our life, and what we do with change will be how we live. I’m not merely writing here to tell you about changes in my life. What a boring story. I’m writing here to tell you the story of specific years — 2022 to now — and how I got up off my knees in a very short amount of time thank, no doubt, to the holistic care I was offered to compliment my western care as a perma-cancer patient in America. Gonna keep on writing about this. Can’t stop. Won’t stop. You know how it is.
Non-medical advice: next time you have surgery, consider seals.
Be good