1. Connections and Additions

“The connection is there—our blood is connected with the sea. It’s the recognition of that connection. It’s the sense that we are absolutely, intimately connected with every living thing. We don’t have to be sentimental and pious about it, but we can’t turn our backs on that fact and survive. When we destroy the so-called natural world around us we’re simply destroying ourselves. And I think it’s irreversible” 

-W.S. Merwin, The Paris Review 

One reason I have committed myself to memorizing poetry throughout my life is simple: I do it in order to be able to “carry” these memorized poems and “use” them as a resource in my heart and spirit without having to carry anything else. On a walk through New York’s Central Park shortly after hearing of a young friend’s passing, my mind was drawn to a poem by W. S. Merwin called Place. At times of loss, the poem has reminded me of the cycles of loss and renewal that one probably must remember in order to keep things “in perspective”. 

In any case, Place has been a loyal literary companion to me for over two decades. I began to recite it as I walked: 

On the last day of the world

I would want to plant a tree

what for

not the fruit

the tree that bears the fruit

is not the one that was planted

I want the tree that stands

in the earth for the first time

with the sun already

going down

and the water

touching its roots

in the earth full of the dead

and the clouds passing

one by one

over its leaves

In this poem, Merwin manages to link the idea of finality (an ending) to a moment of renewed beginning. The last day of the world and the tree that stands in the earth for the first time evoke a sense of naturalistic eternity that puts everything into perspective. Elements of space and time are so skillfully manipulated in this poem that attempting to define them would almost register as an unnatural intrusion; a rude interruption of the scene of eternity that the poem offers us. 

Why plant a tree in the face of such an overwhelming force as the last day of the world? In describing his intent (what for/not for the fruit/the tree that bears the fruit/ is not the one that was planted) the poet reminds us of these lines from the Bagavad Gita that instruct us to attend to our duties with regard for the action rather than the transactional focus on the fruits of our labor. We work to simply work and take pleasure in the work and in sustaining ourselves. The main concern of work is work: 

“कर्मण्येवाधिकारस्ते मा फलेषु कदाचन |

मा कर्मफलहेतुर्भूर्मा ते सङ्गोऽस्त्वकर्मणि

Which translates as: 

“You have a right to your actions, but never to your actions’ fruits. Act for the action’s sake. And do not be attached to inaction.”

One has the right to perform one’s prescribed duties, but one is not entitled to perform and reap the fruits of one’s work simply “for the fruit” since that has been demonstrated to be destructive to oneself and to others. 

It is disastrous when an attitude takes hold in which people regard profiteering as the main concern, aim and final goal of human labor. This has nothing to do with reaping the fruits of one’s labor; working and being rewarded for one’s work is important and natural. Competing in good works is also natural. The problem arises when the work is done for the profit and not for the sake of the work. It is work that makes human beings into living souls. The work in nature (of planting, fishing or farming) as well as the work in art (of creating and building) is what sustains the individual well-being of human beings as well as the spirit of every human beings. Responsible treatment of a vineyard as well as maintenance and construct of fair and balanced cities are not political questions to be debated but constructive attitudes to be distinguished from games of blame and shows of false sensitivities. Creative work is inextricably linked to the livability of every habitat that humanity has settled into or built. This sustainability is something that every human being relies on for survival. It is a crisis-point of regard for our own humanity when human beings place profit above survival and the well being of their fellow man (in which they should see themselves). 

I should note that Merwin’s poem involves an act that is profoundly natural to human beings; that of cultivating the earth on which the human race lives. There is no such thing as the “common good” and Place is not a “self-help” poem or an advertisement for human or personal improvement. It is not  a grand exhortation calling for the “betterment of man.” In the 1970s, Merwin bought a plot of wasteland and set a course that would take him far away from the important noise of human enterprise. “I had long dreamed,” he said “of having a chance, one day, to try to restore a bit of the earth’s surface that had been abused by human ‘improvement.’ I loved the wind-swept ridge, empty of the sounds of machines, just as it was, with its tawny, dry grass waving in the wind of late summer.”

Merwin’s narrator in Place speaks with the tone and presence of experience. In the eternal place of the poem, the articulation of the narrator is as immediate and clear as someone standing right before us. The opening lines are simple and simply beautiful. The voice rings true in a profoundly old and timeless way. 

In an interview with the Paris Review, Merwin said that “The kind of writing that matters most to me is something you don’t learn about. It’s constantly coming out of what I don’t know rather than what I do know. I find it as I go. In a sense, much that is learned is bound to be bad habits.” 

Merwin’s poem awakens a human being relating to nature in its most primitive and unadulterated state. If I was to attribute any spatial or temporal features to my reading of the  poem, I’d imagine that Place comes from a time and space that is pure and simple. The poem lives in an atmosphere that  the reader can imagine to have inhabited before human beings grow up and learn the “bad habits” of destructive corruption. 

If a poem is supposed to (or understood to) set a tone at it’s opening, a look at the first two lines of Place should help us to understand the poet’s commitment to a profoundly simple form of expression. Merwin works hard to show the reader that the narrator is speaking simple plain-spoken truth: 

On the last day of the world

I would want to plant a tree

The poet has constructed a hauntingly rich opening that also reads as profoundly simple. Merwin accomplishes this through the deployment of several techniques of which I’d like to point out the two which are most obviously musical. Not a single word in the two lines above is permitted to consist of more than one syllable. These two lines maintain their symmetry in this way but also through the length of the lines themselves. Merwin makes two compositional choice: to employ seven words on each line and ensure that each word consists of only one syllable.

I would like to add a thought which the poet added to his reflections on artistic technique and construction that is germane to this poem’s evocation of the beginning of time as well as the end. Though this particular observation has been repeated often and by many artists across the continents and centuries, it is repeated because it bears repetition: “You’re always beginning again,” said Merwin.

The poet needs an object to function as a “thread” that he uses in order to realize and anchor something (an object) in the temporal space that exists between the beginning of the world and the end of the world. Those are the only two pieces of temporal information that the poem gives us. “The first time” and “the last day” are both indications that use words which convey a time that exists in our imagination rather than a concrete time which we could place. That these two lines are presumed to be a far distance apart from one another makes the need for such an anchor essential if the temporal ambiguity is to come across as plausible let alone plain-spoken. The fact that the “last day” occurs at the start of the poem and that it happens before the “first time” (as far as the  sequence of the poem is concerned) means that the presence of a poetic image that communicates something grounded is even more needed: 

On the last day of the world

I would want to plant a tree

what for

not the fruit

the tree that bears the fruit

is not the one that was planted

I want the tree that stands

in the earth for the first time

with the sun already

going down

and the water

touching its roots

in the earth full of the dead

and the clouds passing

one by one

over its leaves

It is through his instinct for recursive and cyclical form that Merwin accomplishes one of the most touching effects in Place. On the surface, it may seem as though the poet utilizes an artistic object (the word “tree” and the natural thing that it evokes) but he uses the tree as a connective thread (what we call an “axis mundi”) that links the end and the start and coaxes our temporal senses into cyclical repetition. 

The connection between the end and the beginning lies in those lines of Merwin’s poem that are closest to the Bagavad Gita. It is the action that life happens. It is that action that activates the thread. In Place, Merwin does not simply speak to us of a “tree” in stasis. The tree might be the only object in the poem but there is, after all, also the narrator of the poem. It is through the narrator that Merwin activates the object through a verb: the action is that of planting a tree. Mewin’s verb has the poem planting in a cycle that encompasses all of time and then invites us to repeat it through an endless continuation of what seemed to be so modest. Place is poetically compelling, it’s language is evidently true and beautiful and it’s design is for the narrator to appear as plain-spoken as the story-telling creative spirit in Copland’s setting of Genesis. The cycles of creative work continue. 

Place is a poem of Merwin’s that I hold dear as technically brilliant. But the poet doesn’t simply have his narrator speak to me and convince me to trust in the plain tones and practical experience of their language because the poet employs monosyllablic expression and techniques of temporal cycles, linguistic mirrors and symmetries. The narrator’s tones succeed in part because they come from a true place in the poet. 

In 1977, Merwin started to plant one tree a day and continued this devotion every day that he could manage it for years to come. Today his hand has brought us 2741 palm trees over 19 acres of land. As far as the trees are concerned, Merwin is fully aware that the “fruits” of his labor are not for him to possess alone but for all of humanity to cherish and nurture. “We decided,” said the poet as he entered his ninth decade on earth, “to leave this property to everyone’s children and grandchildren, not just our own.”

When I happened upon a poem that was composed by a young American poet named Michael Bembenek Jr, I was moved to read a new growth out of the spirit of Merwin’s poetry. The techniques were individualistically employed and the voices of the poets unique to each of these two individual poets. But Merwin was present in Memento’s temporal coaxing as well as the use of a narrator in an elusive way for which I could only refer to Place for a literary parallel. Both poets send us on a journey backwards and lead us through the annals of memory only to have the reader discover the present as fresh each time this cycle is restarted and each poem is reread. Bembenek’s poem is titled Memento: 

Fresh corpses line the boulevard

as the streetlights do

and thrushes sing a requiem

for the old man who

lights a candle each morning.

With the appearance of this work I saw a poet who is several generations Merwin’s junior and yet seems to be working in tandem with the elder poet’s simple truth as well as the techniques with which he communicates that truth. And so I was able to read another circle as closed and a new circle as beginning it’s creative work. 

Merwin, for his part, has left more than his precious property on which he worked in planting trees for us. Bembenek’s intuitive, tender and plainspoken tone as well as his apparent sensitivity are evidence that Merwin’s poetic spirit has been passed down to kindred poet just as his trees remain as the result of the work of his hands. 

Bembenek’s poem brought the following lines from Place to my mind. These lines seem devoid of human beings and our presence. We are told of “fresh corpses” and an “old man” who is temporally ambiguous by virtue of the fact the he is the subject of a requiem in Memento. Merwin, meanwhile, told us of the “earth full of the dead”: 

I want the tree that stands

in the earth for the first time

with the sun already

going down

and the water

touching its roots

in the earth full of the dead

and the clouds passing

one by one

over its leaves

A tone of loneliness is palpable in both poems. The narrator is remote The temporal mechanics of both poems are also alien to us if we are to measure them by our normal and perceived experience (that of a continuum of time and space). But the potential mystery and ambiguity is dispelled by both poets through the natural plain-spoken narration that is just that: natural. Neither poem is affected. Neither puts on airs. In Place, the reader is firmly oriented by virtue of Merwin’s tree and the action of planting. In Memento, Bembenek’s thrushes are the object on which the poet focuses his loving energy. And he activates the thrushes through a verb that is as natural and striking as the planting hand of Place. The thrushes in Memento sing.


2. Applications

“ARTIST” “In a line that might be as explicitly political as the Met show gets, art historian Tim Barringer concludes his catalogue essay with a question that he attributes to Cole’s work: “Must the accumulation of wealth always entail overweening greed, leading to imperial exploitation and violence… causing environmental and social ruin?” The implication is that this is still a central question today. But the Met seems to grasp for relevance as many institutions have over the years, creating a Thomas Cole for every moment. The curators ignore the contradictions and issues in his work in favor of pure valorization. In “Atlantic Crossings,” Cole also becomes an “economic migrant” in the introductory video Sting narrates.”

“In this age, when a meager utilitarianism seems ready to absorb every feeling and sentiment, and what is sometimes called improvement in its march makes us fear that the bright and tender flowers of the imagination shall all be crushed beneath its iron tramp, it would be well to cultivate the oasis that yet remains to us, and thus preserve the germs of a future and a purer system. And now, when the sway of fashion is extending widely over societypoisoning the healthful streams of true refinement, and turning men from the love of simplicity and beauty, to a senseless idolatry of their own follies–to lead them gently into the pleasant paths of Taste would be an object worthy of the highest efforts of genius and benevolence. The spirit of our society is to contrive but not to enjoy–toiling to produce more toil-accumulating in order to aggrandize. The pleasures of the imagination, among which the love of scenery holds a conspicuous place, will alone temper the harshness of such a state; and, like the atmosphere that softens the most rugged forms of the landscape, cast a veil of tender beauty over the asperities of life.”

In the period of 2008-2016, we discussed an proliferation of what we now call “social media platforms”. The words “social media platforms” do not have meaning in themselves but, rather, convolute several meanings. Discussing these definitions is essential. 

These three words are used to describe objects as diverse as Facebook, Twitter, Instagram, Snapchat, Pinterest, Tumblr in addition to many other objects which are commonly described as “dating applications” like Grindr, Tinder, Swipe, OKCupid, Hinge and others. These objects are not “media,” a word which, in it’s natural definition describes organic things (organisms) growing in their natural habitat and, when applied to that which is artificial, simply signals a means of communication. By that measure, Twitter and Grindr are “media” but so is the act of a person speaking to another person (“social media”). This is also true of a cat meowing at a person (or at something random); the “meow” is the medium of that cat making a noise.  These objects are not platforms in the sense of a “raised level” on which one stands in order to say something. Neither are they platforms in the technological definition of the word (“a standard for the hardware of a computer system, determining what kinds of software it can run.”).  They are “social” but so are most human activities and every human settlement (this is a byproduct of the fact that human beings are naturally social animals). These objects are programs.

culture | ˈkəlCHər |

1 the arts and other manifestations of human intellectual achievement regarded collectively: 20th century popular culture.
• a refined understanding or appreciation of culture: men of culture.
2 the customs, arts, social institutions, and achievements of a particular nation, people, or other social group: Caribbean culture | people from many different cultures.
• [with modifier] the attitudes and behavior characteristic of a particular social group: the emerging drug culture.
3 Biology the cultivation of bacteria, tissue cells, etc. in an artificial medium containing nutrients: the cells proliferate readily in culture.

• a preparation of cells obtained from a culture: the bacterium was isolated in two blood cultures.

4 the cultivation of plants: this variety of lettuce is popular for its ease of culture.

verb [with object] Biology

maintain (tissue cells, bacteria, etc.) in conditions suitable for growth.

pottery, typically that of a specified type: blue-and-white majolica ware | (wares) : Minoan potters produced an astonishing variety of wares.

manufactured articles of a specified type: crystal ware | aluminum ware.

(wares) articles offered for sale: traders in the street markets displayed their ware

hardware | ˈhärdˌwer |


tools, machinery, and other durable equipment: tanks and other military hardware.

the machines, wiring, and other physical components of a computer or other electronic system. Compare with software.

tools, implements, and other items used in home life and activities such as gardening.



It is now worth considering the same question in terms of the development of these tools: “what’s the intent?”

application | ˌapləˈkāSH(ə)n |

1 a formal request to an authority for something: an application for leave | [as modifier] : application form | [with infinitive] : an application to join the forum.

2 the action of putting something into operation: the application of general rules to particular cases | massage has far-reaching medical applications.

[often with negative] practical use or relevance: this principle has no application to the present case.

3 the action of putting something on a surface: paints suitable for application on fabric | a fresh application of makeup.

a medicinal substance put on the skin.

4 sustained effort; hard work: the job takes a great deal of patience and application.

5 (also application program) Computing a program or piece of software designed and written to fulfill a particular purpose of the user: a database application.


applicational | -SHənl | adjective


Middle English: via Old French from Latin applicatio(n-), from the verb applicare (see apply).


early 15c., “the bringing of something to bear on something else,” from Old French aplicacion (14c.), from Latin applicationem (nominative applicatio) “a joining to, an attaching oneself to; relation of a client to a patron,” noun of action from past-participle stem of applicare “attach to, join, connect,” from ad “to” (see ad-) + plicare “to fold” (from PIE root *plek- “to plait”).

Meaning “sincere hard effort” is from c. 1600. Meaning “a formal request to be hired for a job or paid position” is by 1851. Computer sense “program designed to carry out specific tasks or solve specific problems within a larger system” is a shortening of application program (1969).

In February of 2009, Jack Dorsey (the founder of Twitter) spoke to the Los Angeles Times fhttp://latimesblogs.latimes.com/technology/2009/02/ twitter-creator.htmn Explaining how the he settled on the name “Twitter” for his newly designed program:

“…we wanted to capture that feeling: the physical sensation that you’re buzzing your friend’s pocket. It’s like buzzing all over the world. So we did a bunch of name-storming, and we came up with the word “twitch,” because the phone kind of vibrates when it moves. But “twitch” is not a good product name because it doesn’t bring up the right imagery. So we looked in the dictionary for words around it, and we came across the word “twitter,” and it was just perfect. The definition was “a short burst of inconsequential information,” and “chirps from birds.” And that’s exactly what the product was.”

The definition was “a short burst of inconsequential information,” and “chirps from birds.” And that’s exactly what the product was.”

“The whole bird thing: bird chirps sound meaningless to us, but meaning is applied by other birds. The same is true of Twitter: a lot of messages can be seen as completely useless and meaningless, but it’s entirely dependent on the recipient. So we just fell in love with the word. It was like, ‘Oh, this is it.’ We can use it as a verb, as a noun, it fits with so many other words. If you get too many messages you’re ‘twitterpated’ — the name was just perfect.”

twitter (v.)
late 14c., twiteren, in reference to birds, of imitative origin (compare Old High German zwizziron, German zwitschern, Danish kvidre, Old Swedish kvitra). The noun meaning “condition of tremulous excitement” is attested from 1670s. The following is considered an unrelated word of obscure origin:

TWITTER. 1. “That part of a thread that is spun too small.” Yarn is said to be twined to twitters, when twined too small, S. Hence, to twitter yarn, to spin it unequally, A. Bor. Ray.

2. It is transferred to any person or thing that is slender or feeble. It is said of a lank delicate girl: “She is a mere twitter,” S. [Jamieson, “Etymological Dictionary of the Scottish Language,” Edinburgh, 1808]Mr. Dorsey states his intent. He first tells us that he searched for it (in a “wordstorming” session) and, later, in a dictionary. It was there that he found the definition of his intent (the meaning he was looking for) when looking up the word “twitter.” He found the word to mean “burst(s) of inconsequential information” and “chirps from bird.” It was after finding this definition that Dorsey deemed the word “just perfect” in terms of describing the program which he had developed. Please understand that this process is not simply one of looking up a word in a dictionary. 

Mr. Dorsey was looking for a word that would describe the meaning of the thing which he had created. He had created an object (an “application”) and then proceeded to find a word with the “perfect” meaning in the dictionary so that he could then attach (or apply) the meaning to his product (“meanings is applied by other birds”).

Here are three dictionary pages that contain the word “twitter” and also the word “twitch.” I have selected these at random but the reader may elect to repeat this process using other dictionaries.

Mr Dorsey tells us that “we looked in the dictionary for words around it, and we came across the word ‘twitter’…” 

One can look for words which follow or precede a word in the dictionary (the chronology of an alphabetical list will always function in this way if the function is programmed to be alphabetical). The word “twitter” is [x words in relation to] the word “twitch.” That immediate proximity would mean that pages were hardly turned in the process of finding a meaning to attach to the creation in question. An illuminating, if inexact, analogy would be the selection of a “proper name” if considering the naming of a child. That analogy is inexact because an artist is supposed to know everything about the object which he has created (in terms of design and, at the end of the process, in terms of the meaning as well). 

Mr Dorsey expended minimal effort in finding this meaning. He does not tell the reader that, after minimal effort, he found something satisfactory. He tells us that he found perfection: “and it was just perfect.” He then tells us that the meaning he found was one which connotes meaninglessness: “The definition was ‘a short burst of inconsequential information,’ and ‘chirps from birds.’” Finally, he tells us that the newly-applied meaning   is exact and not simply approximate: And that’s exactly what the product was.”

It is also relevant Mr. Dorsey does not call the program that was to become Twitter a program. He calls it a “product.” The object in question is also meaningless to Mr. Dorsey as he refers to it in the past tense “what the product was” rather than “what the product is.” Twitter, so to speak, had “meaning” to Mr. Dorsey when he looked up the meaning which he would attach to it. The object is now a product that “was.”

This lead me back to a 1982 essay titled Bursts of Meaning in which Edward Said assesses the artist John Berger’s essay on art criticism titled Different Ways of Seeing. Said begins by tasking Berger on the value of subjectivity:

“From this primary suppression of the social function of subjectivity, other suppressions follow: of meaningful democracy (replaced by opinion polls and market-research techniques), of social conscience (replaced by self-interest), of history (replaced by racism and other myths), of hope—the most subjective and social of all energies (replaced by the sacralization of Progress as Comfort).”

Said then continues:

In control systems and in scientific investigations, photographs supply identity and information respectively. In advertising or journalism, photographs are used as if they belonged to the same order of truth as science or control systems; the communications industry would like to press viewers into accepting the photograph as evidence either of buyable goods or of immutable reality. Buy this product because it will make you happy; the poor are sick and hungry, and that’s the way it is.”

All this brings us to a key point: marketshare is impossible without a ready and willing market of consumers. As far as “the whole bird thing” is concerned, Ornithologists have studied the singing of birds. The composer Olivier Messiaen was obsessed with the complex forms they evoke and the functions of those forms. Birds have intent, method and technique of delivery that is incredibly consistent. Human beings have composed complex works of musical art inspired by different calls and songs. We have studied their structural design and have considered their geographic variation. None of this mattered to Mr. Dorsey who was so pleased with his own branding of “the product” that he didn’t seem to mind his suggestion that, unlike birds, human beings (presumably the more sentient animal in this situation) would actually be engaged with sharing inconsequential information.

For years, Twitter overstated the number of their users thttp://monev.cnn.com/2017/10/26/tech- nologv/business/twitter-earnings/index.htmn in order to deceptively impress prospective investors on Wall Street but they hardly needed to do that. A survey over less than a decade shows growth from roughly 30 million users in 2010 to over 300 million in 2017 lhttps://www.statista.- com/statistics/282087/number-of-monthly-active-twitter-users/

“A hookup culture is one that accepts and encourages casual sexual encounters, including one-night stands and other related activity, without necessarily including emotional bonding or long-term commitment.[1] It is generally associated with Western late adolescent behavior and, in particular, American college culture.[2][3][4] The term hookup has an ambiguous definition because it can indicate kissing or any form of physical sexual activity between sexual partners.[5][6] The term has been widely used in the USA since at least 2000.[6] It has also been called nonrelationship sex,[7] or sex without dating.”


“It is generally associated with Western late adolescent behavior and, in particular, American college culture.[2][3][4]” 


“The term hookup has an ambiguous definition because the definition must be ambiguous because the nature of the word I’m trying to use indicates a stated non-commitment and lack of knowledge of WHAT I WANT”













“Norms”: There are behavioral norms here. “This is normal (even natural) behavior.”
4.3: “My friends made me do it.”
5: “Drugs and alcohol made me do it
6: “‘Wider culture’ made me do it”
6.1 “The ‘Media’ made me do it.”
6.2 “Extra effects or causes (ie extracurricular things) made me do it.”


This is totally devoid of ego.

ego | ˈēɡō |

noun (plural egos)

a person’s sense of self-esteem or self-importance: a boost to my ego.

Psychoanalysis the part of the mind that mediates between the conscious and the unconscious and is responsible for reality testing and a sense of personal identity. Compare with id and superego.

Philosophy (in metaphysics) a conscious thinking subject.


egoless adjective


early 19th century: from Latin, literally ‘I’.

In just a few years, we would have an app for video streaming called “Twitch” after all. Between that and the countless other apps for instant online streaming, an unprecedented number of people have channels and microphones. It is not simply that the technology (technique; technae) is there without everything else (intention, method and meaning) that makes journalism what it is and art what it is. In the case of Mr. Dorsey, there is the admission that the vessel for delivery would be developed without too much concern as to how the form of the content would fill that vessel or, indeed, how the content (whatever it ended up being) would be delivered from the vessel.

In 2018, everyone has the tools to launch their own “media trial” in an environment that is confused, suffering a deterioration of content and unconcerned with finding the meaning it lacks.


 3. Inspiration 

Let us begin this lesson with a simple exercise. For this, the reader will need a mirror. 

Please look at yourself the mirror. Point to the object which you see in the mirror and identify that object. If one were to ask the reader “who is that in the mirror,” the correct answer, provided that the reader is looking at him or herself in the mirror, would be “that is me.” That (“me”) is your “self”. 

Now answer the following question: “What do you see to be the first and largest and letter in the following Snellen Chart?”












The correct answer is: “I see the letter E.” The “I” in that sentence (and in sentences such as “I believe you,” “ I want ice-cream , “I can do this,” “I hate you” and many other sentences like these ones) is your ego. Let us look at the root of this word. 

The word “ego” came into English-Language use by 1707. The reader will find the word in use in studies concerned with metaphysics to describe “the self that which feels, acts, or thinks.” The word ego quite simply is the Latin word for “I.” When it passed into Old English, the word came to be used to mean “cognate.”

Ibn al-Nafis was “is related to the entirety and not to one or a few organs.” “The soul,” said Ibn al-Nafis “does not have a primarily relation to the spirit” (the word “nafs” or “spirit” in Arabic also means “breath” in the Pulmonary sense pf the “breath of life”) “nor to any organ, but rather to the entire matter of a being whose temperament is prepared to receive that soul.” Ibn al-Nafis defined the soul simply. 

It is nothing more and nothing less, he said, than “what a human indicates by saying ‘I’.”

Ibn al-Nafis was the first physician to coherently state and support the knowledge that the brain, rather than the heart, is the organ which is responsible for thinking and sensation. At the age of 29, he published a work titled “Sharh Tashrih al-Qanun” which is translated as “The Analysis of Anatomy in Books I and II of Ibn Sina’s Kitab al-Qanun) in which the functions of respiration and the circulation of blood were discovered and described for the first time. He is also commonly described as having opposed the view which Aristotle had enunciated in the 4th Century that designated the heart as the source of the spirit. Addition and multiplication are the only functions which can become part of the life-blood of any great person’s work while division and subtraction do not factor into construction or anything constructive. This is as true of Aristotle and Ibn al-Nafis as it is of all the other examples we have seen or considered. As might be expected, the reality of the situation is additive rather than disputative or conflicted. Ibn al-Nafis writes the following: 

“Blood from the right chamber of the heart must arrive at the left chamber, but there is no direct pathway between them. The thick septum of the heart is not perforated and does not have visible pores as some people thought or invisible pores as Galen thought. I hold that the correct cause will be found in the circulation of blood and the interactions of circulation and respiration. The  blood from the right chamber must flow through the vena arteriosa (pulmonary artery) to the lungs, spread through its substances, be mingled there with air, pass through the arteria venosa (pulmonary vein) to reach the left chamber of the heart, and there form the vital spirit…” 

The lungs and the pulmonary system (also referred to as the respiratory system in some anatomical texts) must work in tandem with the heart and the cardiovascular system (also called the “circulatory system” in some texts). There is an integrity to the whole which cannot be fractured in order for the human being to remain an entire and complete being. 

nor to any organ, but rather to the entire matter of a being whose temperament is prepared to receive that soul

 I would like to look at the unity of systems working in tandem by looking at one of Ibn al-Nafis’ artistic works. Between 1268 and 1277 Ibn al-Nafis composed his fictional masterpiece which drew on his extensive scientific knowledge to create a work of harrowing and terrible brilliance. The Treatise of Kāmil on the Prophet’s Biography (Arabic: الرسالة الكاملية في السيرة النبوية) is also known as Risālat Fādil ibn Nātiq (“The Book of Fādil ibn Nātiq”) is a novel set on a deserted Island and imbued with a tone of seclusion which may seem untenable as well as unbearably true and beautiful to any reader. The novel should be read for it’s literary brilliance alone as well as for the truths which Ibn al-Nafis’ story communicates to the reader. 

It is on the aforementioned desert island where the reader encounters the protagonist (and lone figure) of the story who is called Kamil.

Kamil is an adolescent feral child who is spontaneously generated in a cave and lives in seclusion. He eventually comes in contact with the outside world after the arrival of castaways who get shipwrecked and stranded on the island. Later in the novel, the castaways escape the desert island and they take Kamil back to the civilized world with them. The plot is gradually developed into a description of Kamil’s coming-of-age. The novel reaches its climax with a catastrophic doomsday. This apocalypse is catastrophically described (by this I mean that it is described with a scientific precision which renders it tenable). 

Well before his encounter with other human beings, Kamil begins an autodidactic process. He teacher himself and learns things himself (thus the fact, which is suggested by the title, that he is a “prophet” in the story). Kamil learns in much the same way which Langston Hughes describes so movingly in the following poem on Helen Keller: 


In the dark,

Found light

Brighter than many ever see.


Within herself,

Found loveliness,

Through the soul’s own mastery.

And now the world receives

From her dower:

The message of the strength

Of inner power. 

Here we must not understand this poem to endorse whatever it is which people mean when they utter the phrase “it’s what’s on the inside that counts.” 

The first and second stanzas of Hughes’ poem begin with “She” alone. But “She”, of course, is not alone. She breathes and is aware of her breathing and therefore of being alive. The first stanza of Hughes’ poem mirrors the progression of Genesis. In the process of creation, the earth begins “without form and void” and we are told that “darkness was upon the face of the deep.” How does Keller “create herself” in the poem? To make the answer palpable, we must invoke another harmonic cycle, namely the cycle of breathing:










The “inner power” (that which allows Keller to find loveliness through “the soul’s own mastery”) which Hughes referring to is not an abstract thing and certainly not something undefinable and chaotic (she, beginning in the dark, “found light”). 

In the poem, Keller (as observed by Hughes) learns through inspiration. This is wonderfully expressed through Hughes’ use of the words “inner power” to suggest “inspiration.” Ibn al-Nafis’ prophetic autodidact learns in the same way: through inspiration. 

“The soul,” said Ibn al-Nafis “does not have a primarily relation to the spirit.” The reader will recall the the word Arabic word “nafs” means “spirit.” It also means “breath” in the pulmonary sense of the “breath of life”). Ibn al-Nafis observed that the soul is not primarily related to the spirit “nor to any organ, but rather to the entire matter of a being whose temperament is prepared to receive that soul.”

“It is nothing more and nothing less than what a human indicates by saying ‘I’.” 

The reader will recall the “mirror” exercise with which we began this lesson. Pointing to oneself in the mirror and recognizing oneself with the words “that is me” (in which “me” is the self) should be established at a young age. Children as young as six months have been observed to begin recognizing themselves as an object which is reflected (ie they recognize their own reflection) from six months old. Most people (if healthy) will recognize their reflection in a mirror by the time they are two years old (this is at the very latest). The ego (“I”) develops in tandem with the self (“me”). It is inseparable from the self. 

The reader will recall my discussion (Lesson I, part 2) of Aaron Copland’s setting of Genesis. In it, I recalled the musical setting of those words which describe the making of man from the first chapter of Genesis (“And God said, Let us make man”) as having been scored in such a way which I perceived to be rigid and barbaric. 

It is at the very start of Genesis that the Spirit of God moves upon the face of formless waters. The waters are then separated from the waters and then divided from the firmament. It is not until the waters are defined into a cycle (the water cycle of evaporation, condensation and, finally, the first experience of precipitation) that Copland composes the melodically brilliant ending to his work. It is in that vital movement of water formed into a harmonic cycle that connects the ocean, land and atmosphere that we are also introduced to the harmonic cycle of breathing. This is in the second Chapter of Genesis:

“And every plant of the field before it was in the earth, and every herb of the field before it grew: for the LORD God had not caused it to rain upon the earth, and there was not a man to till the ground.

But there went up a mist from the earth, and watered the whole face of the ground.

And the LORD God formed man of the dust of the ground, and breathed into his nostrils the breath of life; and man became a living soul.”

The human is made and then becomes a human being. The self (as “me”) exists as an object but is only realized (as “I”) through thought and inspiration which lead to one’s identification as a unique human being with a soul. The ego must be understood in it’s strict and classical definition before it is understood by people to mean what it is so revealingly defined to mean in  contemporary dictionaries: 

ego | ˈēɡō |

noun (plural egos)

a person’s sense of self-esteem or self-importance: a boost to my ego.

“I” as Ibn al-Nafis observed it and defined it, is not related only to the breath of life “nor to any organ,” (here I hasten to add that he means any organ whether “outside” or “inside”) “but rather to the entire matter of a being whose temperament is prepared to receive that soul.”

Ibn al-Nafis’ novel is filled with observations which have become part of humanity’s scientific body of knowledge as well as being artistically supreme. This is fact has lead some to describe his novel as “science fiction.” If the reader agrees with the author in finding the genre to be strange enough when applied to Asimov in his own time, it is left to the imagination of the reader to decipher how I feel about it’s retroactive application to a novel written in the thirteen century. 

There is no “inside” or “outside.” There is a single human being in which “I” and “me” cannot be fractured and in which no system of anatomical function can be removed. There is nothing “on the inside.” This is simply a phrase which is used to describe everything which is not made clear to the senses (whether they are one’s own senses or those of others). The phrase also denotes everything which is not defined or expressed is as well as everything which is  ambiguous or kept intentionally or unintentionally hidden from oneself and others. For the insecure, “what’s on the inside” is a place to hide the roots of their fears and inadequacies rather than to address those things. 

Here is a line from Ibn Nafis’ novel expressing something which the previously feral autodidact learns on his path to becoming a prophet:

“Both the body and its parts are in a continuous state of dissolution and nourishment, so they are inevitably undergoing permanent change.”

This is an observation which anyone can make: We grow weary and sleep. We grow hungry and then eat to nourish ourselves. We grow older. This sentence is also the first time these changes had been expressed in terms of a body and it’s parts “in a continuous state of dissolution and nourishment, so they are inevitably undergoing permanent change.” It is the first example we have of the concept of metabolism.

Here is another line from the novel:

“Its left ventricle is filled with spirit, and this ventricle contracts, thereby sending this spirit in the arteries to the organs. Then it expands, and this spirit returns to it.”

The child knows oneself and knows oneself to be real and to be a real object; this is not simply a subjective knowledge of the variety which surrounds Descartes (“I think therefore I am”). It is an objective knowledge in which we recognize our bodies and not simply exist because of cognition (or doubt). We regonize form. Only then can we, together and inseperable from the form which is one and the same with every other aspect and system of our being, start to develop, grow and be nurtured. Roald Dhal writes the following of one of his most beautiful characters, Matilda, in his novel which shares it’s title with it’s protagonist: 

“So Matilda’s strong young mind continued to grow, nurtured by the voices of all those authors who had sent their books out into the world like ships on the sea. These books gave Matilda a hopeful and comforting message: You are not alone.”

There is something extraordinary about the statement from Ibn al-Nafis which we have considered and will now consider for a final time. 

“The soul, does not have a primarily relation to the spirit nor to any organ, but rather to the entire matter of a being” he says. That statement, one which has not been questioned in centuries of inquiry into his work on all five continents, assumes an existence of every soul before anything material is even born or conceived.

And so it is that all human beings, as Dahl writes, come to find that we are “not alone.” We  discover that we are alive through the inspiration of the voices of all those authors who sent their books out into the world like ships on a sea.” We find it as Kamil and Hellen Keller  found it, through inspiration within ourselves; an inner power which is as perceivable and definable as the very act of breathing. We are as aware of it as we are aware that we are alive. Not cognitively aware. We sense it and, through sensing it, this inner power tells us that we are alive and allows us to master our souls. 

Every soul is there to be claimed before we even materialize and will exist long after we have physically decomposed. While we are physically alive, it is the continuation and continuity of  inspiration that leads to a life of growth, nurturing and learning that leads a mere human to grow into “a being whose temperament is prepared to receive that soul.”


4. Operations

In 2015, a book titled “Medical Humanities” was published by Cambridge University Press. The book’s  three authors are listed (together with their main credentials) as follows: 

      1. Nathan S. Carlin, an Associate Professor at the McGovern Center for Humanities and Ethics
      2. Ronald A Carson, a Professor Emiritus at the Institute for the Medical Humanities, University of Texas Medical Branch at Galveston.
      3. Thomas R. Cole, McGovern Chair in Medical Humanities, Director of the McGovern Center for Humanities and Ethics at the University of Texas Medical School at Houston and a Pulitzer Prize nominee for a previous book on the “history of aging and humanistic gerontology.” 

It is now reasonable to ask about the field of study that these men profess. What exactly is (or are) the “Medical Humanities”? The authors, themselves, describe the book which they have written but avoid offering a definition of it’s titular subject (Medical Humanities) in the Preface to their volume: 

“This volume represents the first textbook in medical humanities. After decades of teaching in both medical and undergraduate schools, we wrote the book because there was still no single resource for interested students and faculty. While there are edited volumes in medical humanities, these books do not offer a coherent vision of or engagement with the field. We wrote this book to present such a vision and engagement.”

The authors tell us why they “wrote the book” in terms which negate the efforts or presumed efforts of others. Where others have failed, the authors tell us, they remedy the situation; presumable by offering the coherent vision (which one must assume is their idea of a definition) by which readers and students can engage with the field in question. What, then, is the field that they are professing or, at least offering a “vision” which they lament is lacking to students of medicine (as well as the “undergraduate” students) whom they teach? 

The authors begin by stating (explicitly) that the promised definition will be a private one before proceeding to attempt something even more ambitious (this is from the Introduction which follows the Preface): 

“While we offer our own definition of and vision for medical humanities below, perhaps it is best to begin by defining not medical humanities but the humanities more broadly. What are the humanities? Why do they matter? And how did they come to be engaged with medicine and health care?”

By the time that the reader arrives at a point in the text where the authors give the impression of readiness to finally attempt a definition (or reveal their vision) of “Medical Humanities” they abort the operation on the border of this illusion. This is done in the fourth subsection of the introduction (or series of introductions); a series which in itself (as the reader will recall) follows a preface. 

Just as they stated (in the preface) that the book-in-hand “represents” a textbook rather than simply writing to inform us that the book is a textbook, the field in question is similarly obscured from being represented as a real thing. The book is not described as a real object (“this volume represents the first textbook…”). The field is not in question is not described as a real subject but rather as a “conceptualization”, “theorization”, possible definition or subject of (indefinite) debate. Here are the authors’ own words on the topic (this is from the fourth section of the introduction or, alternatively, the second large portion of the introduction depending on how you read it and also depending on whether you are still keeping count of the sections which are, in any case, not defined in the text itself).

We have been charting winding passageways as Elliot does in The Lovesong of J Alfred Prufrock. 

Let us go then, you and I,

When the evening is spread out against the sky

Like a patient etherized upon a table;

Let us go, through certain half-deserted streets,

The muttering retreats

Of restless nights in one-night cheap hotels

And sawdust restaurants with oyster-shells:

Streets that follow like a tedious argument

Of insidious intent

Only to then provide a poetic masterstroke of deceptive cadence; the mysterious “lover” has something to say. The streets have lead us through restless and seedy joints; winding streets of insidious intent… muttering retreats… we have endured it all and what have we come to? Where does it lead us? “Streets” says Elliott, “that follow like a tedious argument”: 

To lead you to an overwhelming question …

Oh, do not ask, “What is it?”

Let us go and make our visit.

And so it is with the writers of Medical Humanities (although their attempts at expression can hardly be characterized in the same breath as Elliott without a blush from even the present author). 

“The field of medical humanities” write these authors, “can be conceptualized, theorized, defined, and debated indefinitely. We offer here a few of the major ways of thinking about the field as well as our own definition that will guide our presentation of and approach to the topics covered in this book.”

We are offered “ways of thinking” about a field; meaning that the authors are going to (somehow) tell us how other human beings think (“about the field”) before they present us with an actual definition of the field. The reader will find that this definition (the only one given) is (as described by the authors themselves): “our own definition.” 

This means that, merited or not, the only definition which is promised by the authors is to be a definition which is private to these three authors. And incidentally, should we address the question of merit (if such a question demands to be addressed by any reasonable person who is not already disillusioned by the text) the authors will soon show us that theirs is a vaguely lyrical dissertation of the most remarkable “narrative vision” (or, to embrace the spirit of ill-definition at hand, “as you like it”). 

The next sections are spent in a discursive attempt to conflate and confound disciplines of study in such a way that would, if the conflations were believed or an attempt was made to practice any of the disciplines in question under such false pretenses or misguided impressions, negate the functions of those disciplines.

In order to provide the present reader with an example of the anti-dogma which is contained in a good number of the texts that the authors of Medical Humanities drew upon for their considerable collection of citations, I would like to take the approach of recounting the experiment which I have now conducted too many times to count and which the reader is welcome to try for themselves “at home.” 

I select a citation at random (the reader is welcome to repeat this exercise with any of the citations in Medical Humanities or, indeed, any of the content in the book itself and subject it to rational observation and simple common sense). My finger has landed upon a 2004 book by Eric J. Cassell, a man whose career in medicine began with time served at Bellevue Hospital and in the United States Army (he was a stationed to France in the 1950s as part of the Medical Corps). The book cited by the authors of  Medical Humanities is titled The Nature of Suffering and the Goals of Medicine which was published in 2004 by Oxford University Press. 

Allow me to now relate my experience following one link to another (not as links of fancy unto fancy but as real links in the real world of resumes and medical profiles).

Dr. Cassell’s official website features a biographical sketch which begins, as expected, with a listing of his medical credentials; nothing is out of order except for the strange (and somewhat juvenile-delinquent) expression with which he punctuates his final statement about his service in the US Army’s Medical Corp: 

“(how delightful)”












The words stick out about as much as my lime-green highlight of the words stick out against the grey-brown-black website of a (at the time of writing) 90-year-old doctor sporting a black and white picture of this doctor (who appears in his portrait as a bearded and bow-tied eminence). “Perhaps the commentary is a sign of a quirky nature that is totally acceptable if not somewhat endearing,” I said to myself as I gave our good doctor the benefit of the doubt. 

Then I kept reading. Dr Cassel’s biographical sketch continues as follows: 

“In 1971, a generous fate (and something I had written) placed me on The Task Force on Dying at the Hastings Center. I became a founding Fellow of the Hastings Center. That literally changed my life, broadened my horizons, pushed me to become literate, and gave substance to a genetic predisposition to philosophy. I began to wonder whether a doctor could actually treat patients in a successfully useful and special way because they were dying. I started doing that in the fall of 1971. Now we know you not only can, but you should.”

The scientist or artist who speaks (or writes) of “fate” invites suspicion from the present author. The scientist or artist who writes (or speaks) of their own accomplishments in laudatory terms without mentioning the accomplishment in question invites suspicion from the present author. Here is a man who has managed to combine the two errors: a simultaneous betrayal of class and reason (“In 1971, a generous fate (and something I had written) placed me on The Task Force on Dying at the Hastings Center.”)

Dr. Cassel proceeds to write of a life-changing event using the trop of the “sea-change conversion” (“seeing the light”). This sort of non-event (one which we have seen as a Cantus firmus among anti-poets) is by the very non-structure of such a non-process one which exudes irrationality. How does such a sudden revolution of the soul and mind allow for the time required for rational thought? How does it allow for the process of rational discourse and scientific method that brings scientists to discovery? How does it allow for the application of the creative techniques required in any process of artistic creation and making? 

It does not because it cannot. 

But even in this instance (where Dr Cassell “sees the light”), he again manages to commit a double-error by betraying that which is literal with that which is figurative. In a concerted and, by this time, familiar mixing of wires, Dr Cassell writes that “generous fate” (and “something” he had written) were responsible for a “literally changed” life. He then writes the these non-events (movements of mystery) had “pushed me to become literate.”

The change that Dr Cassell describes simply cannot admit being defined as “literal” because that which is literal is understood by poets and poetic writers as being separate in function and meaning from that which is metaphoric or allegorical. In the hands of great artists, the play on this ambiguity has revealed truths that have enriched the entire human race. But that sort of play is hard to accomplish. Shakespeare, for example, manages to describe a literal situation in the following song from Act I scene II of The Tempest:  

“Full fathom five thy father lies;

Of his bones are coral made;

Those are pearls that were his eyes:

Nothing of him that doth fade

But doth suffer a sea-change

Into something rich and strange.

Sea-nymphs hourly ring his knell

Hark! Now I hear them – Ding-dong, bell”

One of Shakespeare’s most enduring inventions, the character of Ariel, sings this song to Ferdinand, Prince of Naples who mistakenly believes his father to be dead; killed in a storm at sea and consigned to the deep. The audience also has reason to understand the song literally and to believe such an event to be true. The tempest is described here in literal terms as Shakespeare engineers Ariel to sing of a drowning and transformation five fathoms (30 feet) in the deep. 

But Shakespeare makes his play (as a whole) whirl and revolve around a storm that is summoned by the Ariel at the request of Prospero. 

Prospero was betrayed by his brother has conjured this storm conjured with the intent of drowning his brother’s (Antonio’s) and sinking his ship; the which also happens to have been carrying the King of Naples (a man who, as it turns out, had assisted Antonio in his quest for power and his betrayal of Prospero). The ship also carries his son, Ferdinand. 

The storm leaves Ferdinand stranded on an island together with Prospero and his daughter, Miranda. Ferdinand is brought before Prospero and as he arrives Ariel sings ‘Full Fathom Five’ which seems to tell the story of what has happened to Ferdinand’s father and as far as he knows this is true.  We find out,  later in the play, that the King of Naples and Antonio have actually survived the storm revealing Ariel’s chant to be fictitious. 

At the very end of the play, Ariel appears before Prospero to inform him that we have arrived at the “sixth hour” (the appointed time for Ariel to cease in his spirt’s labor). Prospero acknowledges Ariel’s request and asks how the king and his followers are faring. Ariel tells him that they are currently imprisoned, as Prospero had ordered them to be imprisoned. We are then given the brief on the dramatis personae of the play a whole: Alonso, Antonio, and Sebastian are mad with fear… Gonzalo, Ariel says, cries constantly. 

In the final scene of the Tempest, Shakespeare writes a communion of the entire cast of the play’s characters who are placed on stage together for the first time in the entire evening.

Prospero speaks of relinquishing his sorcery in this scene which is driven by the presence of this very magic which is said to be given away. 

Prospero, according to Shakespeare’s stage direction draws Alonso and the rest of the characters “into a charmed circle” and proceeds to freeze time as he holds them in place for fifty lines of enchanted speech.  When the fifty lines are over, we understand that the magician is releasing these men from the spell and, in a moment which sends chills through every nerve of my being every time I experience it, Prospero engages in the most magical of spectacles: that of “unveiling Miranda and Ferdinand behind a curtain, playing chess” (V.i.173, stage direction). Prospero’s last words of the play are a command to Ariel (the spirit whom he can only command through his sorcery). He asks Ariel to ensure for him a safe voyage home. 

Here is the end of the play: 


I’ll deliver all;

And promise you calm seas, auspicious gales,

And sail so expeditious that shall catch

Your royal fleet far off. [Aside to ARIEL] My Ariel,


That is thy charge. Then to the elements

Be free, and fare thou well!-Please you, draw near.



Following this stage direction, in which Shakespeare dispatches Ariel for the last time, Prospero is left alone on stage and, after the play ends, delivers this epilogue which, as Shakespeare himself marks it and defines it, is consistent only of the following words which are, again by direction of Shakespeare, “spoken by Prospero”: 



                        Spoken by PROSPERO

Now my charms are all o’erthrown,

And what strength I have’s mine own,

Which is most faint. Now ’tis true,

I must be here confin’d by you,

Or sent to Naples. Let me not,

Since I have my dukedom got,

And pardon’d the deceiver, dwell

In this bare island by your spell;

But release me from my bands

With the help of your good hands.

Gentle breath of yours my sails

Must fill, or else my project fails,

Which was to please. Now I want

Spirits to enforce, art to enchant

And my ending is despair

Unless I be reliev’d by prayer,

Which pierces so that it assaults

Mercy itself, and frees all faults.

As you from crimes would pardon’d be,

Let your indulgence set me free.”

As I type these words from memory (words which I will carry with me for the remainder of my memory’s existence) I am, once again caught on the brink of tears. What Shakespeare has accomplished here is no easy task and what he has taught me (and countless other artists) may only be outdone by the truth he has revealed to us and to humanity writ large of the many tempests within The Tempest. 

The honest reader will permit my sharing of personal feelings regarding what this play (built by Shakespeare on this masterful interplay of the literal and literary) means to me. I share these feelings because they are shared by many in the world (some people who I know and many people whom I do not know love Shakespeare; while artists have learned from him and loved him). Why, then, permit the casual cheapening of these meanings to occur in the hands of such amateur and misguided men as Dr. Cassell; men who have no business speaking of the literal and literary to begin with let alone claiming transcendence in a realm which they cannot touch or understand? 

Dr Cassell then writes of a un-enchanted but negatively mystical “genetic predisposition to philosophy.” I would like to present an extended passage from one of Dr Cassell’s books in order to show the reader what is meant by this sort of language. 

Here is an excerpt from a book titled The Nature of Healing (the very title of which is an affront to science and truth) which I hope that the reader will consider seriously. The passage (like all the other passages which I have read in the books which I can find to be authored by this man) is convoluted and I would posit that this convolution is maintained on purpose in order to cover up the indefensible and unpublishable (the book is, again, published by Oxford University Press) disfigurements to definition and betrayals of art and science that the author is pushing: 

“The place of science in clinical medicine must also be clarified before starting out. The promise of science when it entered medicine in force before the Second World War was that medicine would be based solely on scientific fact.   The statistical methods that have been so crucial in the development of new medical knowledge have smoothed out the differences between individual rather than emphasizing them.  Scientific medicine, then, would be freed of the problems raised by individuality, subjectivity, opinion, and the weight of authority.  This is the way people speak of evidence based medicine now.   One hears this currently in the often expressed belief that the only evidence that is valuable is objective evidence and only that which can be measured truly meets the standard.  This means that patient reports of their illnesses and their symptoms, which can only be subjective, and the reactions in thought and throughout the clinician in response to the patient which are also necessarily subjective will always be suspect and can never be granted full citizenship in scientific medicine.  The specter of failing the test of scientific adequacy seems always to be present.  In this book and the definition of sickness on which it is based, subjective reports from patients about their goals and purposes and the functions required for their achievement can never be scientific, yet they are essential.  

In fact, the sick-person-in-full who is our major concern (each of whom is distinctively particular) is not and cannot be an object of science.  This is neither bad nor good, it simply is.  On the other hand, many aspects of sickness, particularly those in body parts, can fit within the canons of science and should be held to such rules.   Persons’ meanings, whose cardinal importance I just discussed, cannot ever be anything except subjective.  What of other dimensions of sickness?  What of goals and purposes, or desires and concerns, or affective responses to illness, or pain, dyspnea, or other symptoms?  For that matter what of utterances and opinions and anything else about sickness including prognostic statements by physicians?  None of these is measurable but that does not mean the information cannot be accurate.  The information can be exact, precise, and replicable when obtained with care.  It can also be valid, correct, and point to the truth.  Bemoaning the subjective nature of all these things or complaining about the lack of science when it comes to meaning and what patients say is like deploring the fact that patients are human.”

The words “subjective nature” are abhorrent but, consider that Dr Castell does not display any evidence that he regards the study of personal experience and personality as something which others are engaged with. The humanity of the doctor himself (on the other hand) should be inherent and, in fact, is inherent, natural and cherished by many fine doctors of medicine (including my own father). I have the pleasure of counting several doctors as friends of mine and have known these men and women to be cultured individuals who, knowing of their humanity, cherish the pursuit of truth and the care of human bodies and spirits that they engage with when practicing medicine. Many of these individuals are also cultured men and women who know that the experience and sensory observation of humanity is not the domain of science and, because of these facts, seek out art as a source of richness in their lives (they attend our arts as human beings and also have found the arts to provide a window by which they can contemplate their own abilities in managing the, often very difficult, situations which arise as part of caring for the injured and those who are terminally ill). 

Dr Castell is operating as an anti-doctor as well as in opposition to the arts (by the very nature of the anti-civilized outlook he is betraying by writing about the “philosophy” he sees and, more importantly, in the way that he engages in attempting to make a case for these “philosophies”) 

“This prologue comes before anything else because it is about appreciating and keeping in awareness two basic and automatic influences on thought—meaning and the role of science in clinical medicine— that get in the way of understanding the ideas here as well as the accurate assessment and appreciation of patients.   The assignment of meaning to percepts is a cognitive function that is virtually instantaneous, invisible, precise, accurate, fundamental—and individual.  Look into the woods and you see a bunch of trees.   Yes and no.  You actually see a bunch of colors and shapes but the meaning, trees, leaves, (and etc) immediately comes to mind.  In the clinic you see an old man with yellow skin and sclera and a big abdomen.  In a flash you register a jaundiced old man with ascites (probably).  The assignment of meaning even made a probabilistic statement in the same instant.  For trees as well as the jaundiced man, although we assign the same label, you and I mean something different because our experiences that shape the labels we assign have been necessarily different.  Maybe just a tiny bit different or perhaps even greatly dissimilar.   

If I had to choose a single sentence in this entire web of idiocy, I would like to highlight this one: “The assignment of meaning to percepts is a cognitive function that is virtually instantaneous, invisible, precise, accurate, fundamental—and individual.”

Dr. Cassel, I wrote earlier, told us of a life-changing event using narrative devices characteristic of the  mystic: “sea-change conversion” (“seeing the light”). 

I would like to remind the reader of the questions which I posited about this non-event: 

“This sort of non-event (one which we have seen as a Cantus firmus among anti-poets) is by the very non-structure of such a non-process one which exudes irrationality. How does such a sudden revolution of the soul and mind allow for the time required for rational thought? How does it allow for the process of rational discourse and scientific method that brings scientists to discovery? How does it allow for the application of the creative techniques required in any process of artistic creation and making?”

It does not, I said, because it cannot. And now, dear reader, we are in a position to appreciate Dr Castell’s anatomy of this “sea-change.” How can such a non-event exist if it does not allow for any process? 

“The assignment of meaning to precepts” writes Dr Castell, “is a cognitive function that is virtually instantaneous, invisible, precise, accurate, fundamental—and individual.” 

“Precepts” means anything that a person perceives. Dr Castell tells us that he gives meaning to things that he perceives through “cognitive function.” There is no such thing as a cognitive function that can be defined by scientists and I know of no artist who would attempt such a definition at the present time since such an attempt would result in failure.  Why would the failure be so certain? Because of the individuality of human beings and the unique personalities present in each and every human being. 

Dr Castell, who wrote the following words in the same seemingly-jumbled prologue of the same seemingly-jumbled book should know: “Bemoaning the subjective nature of all these things,” he said referring to experiences, senses and emotions, “or complaining about the lack of science when it comes to meaning and what patients say is like deploring the fact that patients are human.”


Dr Castell then extends his “cognitive reach” into an assault on the natural sciences more generally: 

“Look into the woods and you see a bunch of trees.   Yes and no.  You actually see a bunch of colors and shapes but the meaning, trees, leaves, (and etc) immediately comes to mind.  In the clinic you see an old man with yellow skin and sclera and a big abdomen.”

Soon enough, the reader is told that we cannot (for example) know that an oak tree is an oak tree “unless we sit together to study the issue” before adding that such a sitting is (gratefully) “very unlikely”: 

“Unless we sit together to study the issue (very unlikely) we will not know our differences of meaning.   If meaning was only the assignment of labels with various complexities of content it would merely be an admirable (and very helpful) function of thought.  Meaning is much more than that.  Because the word itself has many meanings, let me clarify what I am talking about.”

The statement is made that meaning in science is not limited to the search for truth and the healing of ailments based on that which a scientist seeks in the realm of learning about and expanding the field of medical knowledge (this is what doctors do). According to Dr. Cassell, a person who perceives something can then proceed to assign “meaning” to that thing: 

The identification and labeling of perceptions is an assigning of meaning.  We look out and see an angry appearing bunch of people coming and we say “that is an angry mob.”  We have assigned a meaning to what we see.  This is the most common kind of meaning because it is the labeling of experience.  The two examples that I gave—the trees and the jaundiced old man—are that kind of meaning.  Labeling experience is a judgment in that it could, after all, be wrong.  That labeling experience is a judgment also implies that two people may assign different meanings to the same experience.  They can both be correct because the same experience may have different meanings for different persons—sufficiently unlike to require different labeling.  Or one can be correct and the other incorrect, yet they will have been exposed to the same external experience.  We would expect that in the two examples given people would agree, but that is not necessarily true.  You look out and see trees; I see the same scene and say, “Isn’t Spring wonderful.”  I look at the jaundiced old man and I say, “Look at that abdomen.  He probably has a belly full of tumor.”    

The terrible mistake (or, more accurately, “perversion”) is expanded by confusing the role of science and misunderstanding it to the point of promoting (openly) the statement that scientific knowledge can be knowledge of human experience. The very function of science prevents it from studying the issues of human experience or subjective sensation that are the domain (and, more importantly, the function) of artistic knowledge: 

“The opposite face of the labeling of experience is the one most commonly associated with the idea of meaning, the meaning of words and symbols.  The dictionary definition of, for example trees, uses other words to define the symbol.  More important in everyday life, however is the connotation of a word.  The connotation of a word is the sum of the properties, attributes, or implications of the word apart from its strict definition.  In everyday speech, those attributes of words—their emotional loadings and other meanings, as in a house is a home with all the ideas associated with home—are why language can be used to communicate so much.  Of course, strictly speaking, the attributes are not of the word, but of what the word symbolizes.  Much of the impact of the word on the person comes from its connotation.  I have previously shown1 that the many attributes of meaning include virtually every level of the human condition.  There is, of course, the cognitive content; the stuff we use when we reason from one idea to the next.  And images, where the word brings to mind what something looks like.  This is why we can label visual experience.  And the sound of things to allow the labeling of auditory experience—in fact, all the senses, major and minor that track both the outside world and inside the body from joints to viscera.  Perhaps you think I have gone too far, included too much as part of meaning.  

“But if not, how will you label the experience of certain foods and beverages and the pleasurable feel of them going down?   Or label the feeling that foretells the onset of diarrhea (the cramps).”

Dr Cassell covers the subject of “experience” and makes sure to mention all of the cardinal senses. His mention of “the major and minor senses” evidences a basic problem with understanding regarding that which is sensory — not an intellectual deficiency that I would want to discover in my own doctor. 

Having made this revelation, Dr Cassell proceeds to inform his readers of experience (again, in the sphere of the subjective and emotional human experience): 

“Experiences evoke feelings—emotions—from love and ecstasy to despair and rage and so also do the words that label those feelings—these feelings are part of the meaning.   Feelings are not just things that happen in your head, they have effects on the body.  Think of the physical feelings that are part of love, sorrow, joy, anger, amusement.  Notice that I said, ‘are part of,’ the emotions.  The emotions do not cause the physical reaction; the physical reaction is part of the meaning.  The smile is a constituent of amusement, the heavy feeling in the chest is a part of sorrow, and scared feelings are an aspect of fear, and so on.  We know the flow of catecholamine, hormones, endorphins, and so on accompany these physical sensations; these are also part of the meaning.   

At the end of this paragraph, Dr Castell cites his own work (and describes “meaning” as a “phenomenon.”): 

(2 For a more complete description of the phenomenon of meaning, see The Nature of Suffering.  New York: Oxford University Press. 2nd ed 2004. Chapter 13 3 Ibid  p.239)”

Priorities are addressed in the following section: 

“Another element of the meaning of experiences (and their descriptive vocabulary) is importance.  The importance of something is always importance to someone.  To say something is more or less important is another way of saying that it has greater or lesser value to that person.  In ordinary conversation adjectives and adverbs modify nouns and verbs so as to make their meaning more explicit.  They also, however, intensify or diminish the meanings of the words that are modified.  As in a beautiful, lovely, nice-looking, ordinary, spavined, or useless horse.  Or, for a person, as elated, happy, even-tempered, angry, sad, or depressed.  Someone runs speedily, swiftly, or clumsily.  By so modifying they add a dimension of value or importance to the nouns or verbs.  Feelings, as we have seen, are an element in meaning.  They can be of variable intensity.  The word cancer can strike terror into the heart of one person, merely frighten another, or arouse interest in someone else (the oncologist).  The emotional response to the sensory component of meaning may also be variable, thus introducing a variable element of importance.  In general terms, therefore, we can say that there is always an importance or value aspect of meaning, which is contributed by all of its components.”

We are told of “ample evidence” regarding “some aspects of meaning” which are “hidden from conscious recall or awareness” which places us in the realm of either the metaphysical or the memory-oriented experiences and events which human beings experience (to engage with the former, I would recommend taking up theology or joining a church, going to a mosque, attending a temple or a synagogue or some other outlet for communing with the sacred; in the case of the desire to study the latter, simply pick up a book by Proust or Mahfouz or any artist who addresses memory and it’s role in experience in a way that will resonate with you more readily than the following quackery): 

“There is ample evidence that some aspects of meaning are hidden from conscious recall or awareness because of their association with painful or even forbidden (usually childhood) memories.”

No statement of subjective meaning as instant fact is possible without speaking of the “no-no places” of shame that prevent human beings (according to this doctor) from allowing meaning to “operate out of awareness”:

“As a consequence, the experience that is labeled by a word or phrase, may includes not only cognitive content, but body sensations, images, sensory information, and emotions whose origins are inaccessible to consciousness.  It is also clear that the assignment of meaning, manipulation of the content included in meaning, and thought employing meaning  can operate out of awareness.  Sometimes it stays behind your eyes, so to speak, and at other times presents it conclusions to consciousness. However and wherever, meaning is part of the processes of thought.”

This “Anti-prospero” assigns instant-meaning to everything and anything that is thought or sensed and his meaning is factually and scientifically so because he says so. By the time his charms are overthrown, however, what strength a patient (or the profession of medicine as practiced in his vicinity) might be left with is up to the whims of fancy that Dr Cassel and his ilk regard to be absolute by virtue of their blessings, feelings and “thoughts.” 

It is also up to others who do not regard the arts (the province of all creative and defining human activities) as their “field.” Definition and meaning are (objectively and subjectively) the province of every human being. If, in the vicinity of these lies, any reader is tempted to conclude that this headache is “not my problem,” then I would ask the reader to consider how many cancers and ailments could have their cure if anti-doctors did not hinder the progress of medicine through their time-wasting activities; activities which they propagate because they believe in their “contribution.” Their belief in themselves is based on their feelings and juvenilia rather than on reason and common sense. 

To any person who regards oneself as a mature adult (an adult who would like to maintain one’s claim to common sense and one’s grip on reality) I would like to posit the question: is (or is not) an engagement with poetics (definition and construction) important enough to qualify as a pre-requisite to one’s claim of common sense and also a prerequisite to one’s avenue leading to a shared and common reality? 

I would like to leave the question above in the hands of the reader.

Here is the excerpt from Medical Humanities in which I found Dr. Cassell’s work cited: 

“Likewise, in 1991, Cassell also attempted to legitimate non-biomedical forms of data – specifically, data related to suffering as distinguished from pain (bodies feel pain, Cassell argues, but persons suffer.” Both of these medical humanities approaches are clinically focused.” Additionally, efforts to bridge the gulf between science and experience have been greatly strengthened by the philosophical distinction between “disease” and “illness.”

“Disease – what happens to the body – is understood through science. Illness – what the person experiences – is understood through eliciting patient stories,46 and by asking questions such as, “What has this heart disease done to your family?” Providing opportunities for conversations about such questions makes possible emotional and spiritual healing, whether or not physical curing (to use another important distinction) is possible.”

“Having made some initial comments on the origins, goals, and conceptions of medical humanities, we offer here our own definition of the field and its implications for how the book is organized and presented. We define medical humanities as an inter- and multidisciplinary field that explores contexts, experiences, and critical and conceptual issues in medicine and health care, while supporting professional identity formation. Our definition, then, has four main components:

1. Context;

2. Experience;

3. Conceptual and critical analysis; and

4. Formation.

We do not suggest that every piece of scholarship in medical humanities attends to all four of these categories; a given piece may focus exclusively on, say, context. Still, these categories, taken together, enable us to make sense of various bodies of knowledge that constitute the field. A few words about each of these categories are in order.”

“The arts – short stories, poetry, novels, memoirs, sculptures, music, painting, film, theater, and other forms – can help us address these “experience-near” questions in concrete and particular ways. These questions often may have very little to do with decision making in medicine, but they are essential for educating the emotions and strengthening the capacity to care and the ability to empathize with those who suffer. Other disciplines and approaches, such as phenomenology and religious studies, also can shed light on the experiences of illness, medical education, doctoring, and other forms of health care. Medical humanities attempts to examine narratives of medicine and frameworks of meaning in whatever form they may take”

“While the book is a textbook and its chief aim is to provide an overview of and introduction to medical humanities, we nevertheless do have a point of view. Put simply, it is this: Medical practice and medical education today are the victims of their own success. The very science and technology that have brought enormous advances in curing disease, relieving suffering, and extending longevity have also outstripped medicine’s moral bearings and overwhelmed the human dimensions of caring and learning. Medical humanities attempts to restore the balance, to help re-humanize medicine. But (and this is one of the original contributions of this book) it is not just patients who suffer from the dehumanization of medicine. Under today’s stressful conditions of practice, physicians, nurses, allied health professionals, biomedical scientists, and students all find themselves at risk for becoming alienated or separated from the ideals that drew them to health care in the first place. These conditions lead to high rates of burnout, depression, impairment, and even suicide. Hence the re-humanization of medicine involves enhancing, restoring, and attending to the humanity of students and caregivers as well as of patients.”

In the 14th Chapter of Medical Humanities (titled Goals of Medicine), the authors of the text state the following in unequivocal terms: 

“Our views about right and wrong, about what is permissible and what is impermissible, are acquired (socially constructed).

To begin with, the authors clearly state that issues pertaining to what is “right and wrong” as well as “what is permissible and what is impermissible” are views (“Our views about right and wrong…”). This would mean that all codes of medical ethics from the Hippocratic Oath to the International Code of Medical Ethics as well as all national and local boards which license doctors are irrelevant to doctors. 

It would mean that a doctor could, for example. borrow money from a patient and then diagnose the patient with a serious mental condition when the patient asked for the money back; they doctor could say that they believe in the correctness of their diagnosis (and they could indeed believe it to be correct) even as the patient is clearly in command of their mental capacities and it is clear that the doctor (who should not have taken the loan to begin with) made the diagnosis in order to evade paying the patient back when the money was requested. The doctor could simply say that this was their view  and that their action was permissible. 

This is, of course, not the way things work in reality. Take, for example, the following case reported in the Nashville Tennessean on October 24, 2018: 

A Tennessee doctor has retired her medical license after it was discovered that she borrowed a hefty loan from a longtime patient, then diagnosed the woman with dementia when she asked for her money back, according to state discipline records.

Lee, 79, an internal medicine specialist in Columbia, retired her license last month in a peculiar case before the Tennessee Board of Medical Examiners, which is responsible for disciplining doctors throughout the state. Government attorneys said Lee borrowed $300,000 from a patient when her medical clinic fell on hard times, and when the patient later requested repayment, Lee diagnosed her with dementia in an apparent effort to escape the debt.

The patient — identified in records only as E.W. — had been treated by Lee for 25 years and was also a personal friend and a co-worker. State records say that Lee sent a letter about E.W.’s diagnosis to the patient’s daughter, who in turn forwarded the letter to the patient’s financial company, which resulted in her being denied access to her assets.

The doctor (Dr. Suellen Lee) viewed her patient as demented and made the diagnosis on that basis and on that basis alone: 

“When Lee was questioned by investigators, she admitted that she diagnosed E.W. purely “on observation,” without the use of any testing method or a second opinion from a mental health professional, according to state records.”

A mental health professional was, indeed, asked to review the case and, according to the paper, “later assessed E.W., finding ‘no indication of dementia,’ the records say.” Dr. Lee had her license retired and was subjected to a fine (on top of having to pay back her patient).  

And still, Dr Lee did not accept this outcome. She blamed the state (among others) and then lied to the paper: 

“During a phone interview with the Tennessean on Tuesday, Lee  said the state of twisted the facts of her case to make it appear as if she was scheming to escape the loan. Lee said she borrowed the money from the patient approximately 20 years ago and has been dutifully repaying the debt in installments.”

Dr Lee also stood by her “diagnosis”: 

“Lee also stood by the dementia diagnosis, which occurred about two years ago, saying E.W. exhibited erratic behavior and signs of memory loss. Lee insisted her former patient later misled the psychologist so the dementia diagnosis would not be confirmed.”

The report contains a passage which illuminates our main concern with anti-poets. In this line, Dr Lee makes it clear that this issue is personal: 

“She wanted to hurt me because she was so angry with me, because I had said that she was demented,” Lee said.

This conduct resulted in Dr. Lee’s license being retired, in her name becoming questioned by her profession and, on top of all this, it earned her a story in the local paper and a slot as “Moron of the Morning”: 











Most medical students will, therefore, already be quite wary of the words spoken by the authors of Medical Humanities and will understand their words to be those of non-professionals. 

The authors of Medical Humanities speak of views of right and wrong which “embed themselves” in habits and practices. They “seem inherent and indispensable (essential)” write the authors. These are “views” which “seem” inherent and indispensable. 

“Our views about right and wrong, about what is permissible and what is impermissible, are acquired (socially constructed). To the extent that they embed themselves in our cultural habits and practices, they seem inherent and indispensable (essential). As such, they provide direction and guidance for as long as they seem serviceable or until they conflict with other equally valid views.

“When a customary medical practice, such as routinely prolonging the life of dying patients, even in the face of futility, no longer seems sensible to some, the question of goals arises. What is the purpose of the practice? To answer this question requires that we examine the rationale for doing what we had long considered the best way to treat dying patients, even though, admittedly, we were harming them in the process. Essential values – rescue the perishing, do no harm – are pitted against each other. At this point, we must step back and ask: What are we trying to accomplish? What is the end in view toward which end-of-life care practices should be directed?’”

Once again, let us leave all views which might be held on the topic at hand aside and focus on the main sentence which is of interest to our study of anti-poetics; this one: 

“Essential values – rescue the perishing, do no harm – are pitted against each other.”

These directives (not “essential values”) of “rescue the perishing,” and “do no harm” should seem to go hand in hand (because “rescue the perishing” will be understood by most to imply the healing of illness and relief from pain). The anti-poet, seeking conflict in everything, says that these “essential values” are “pitted against each other.” 

The reader is invited to survey the main benchmarks of medical ethics; (I have revisited the Hippocratic Oath, The American Medical Association’s Code of Medical Ethics, the Declaration of Geneva and the World Medical Association’s International Code of Medical Ethics among others). One will find no mention of a directive to “rescue the perishing” or anything which even vaguely resembles such a directive. The authors of Medical Humanities state that “rescue the perishing” is no less than an “essential value.” This places their essential error regarding the subject at hand in the close company of the essential errors which are the trademark of anti-poetic writers in their chosen subject of imitation/attachment. 

The authors then go on to describe an exceedingly vague venue for an imaginary activity of “dialogue and debate” and finally declare that the goals which have been obscured are clear: 

“Dialogue and debate of just this sort has been occurring in commissions, committees, congregations, courts, and at countless bedsides of the dying over the past four decades. As a result, practices that are reasonable and sensible in preventing premature death are increasingly considered inappropriate in caring for dying patients. Now that we are clear about the goal of such care, we are finding better ways to reach it.”

The authors, in the very next paragraph, negate their own conclusions (of clear goals) by stating that the scope of medicine (in treating patients) can be attained on a case-by-case (patient-by-patient) basis (“by thinking through and getting clear about medicine’s ends and purposes will happen policy by policy, practice by practice, and procedure by procedure in open dialogue and debate”): 

“This story contains an object lesson in how we might proceed to clarify other putative goals of medicine. Recalling Hans Jonas’s (1903–1993) admonition to beware of “automatic utopianism” (see Chapter 16), there are likely to be no universal principles and few bright lines demarcating medicine’s legitimate scope and limits. Instead, thinking through and getting clear about medicine’s ends and purposes will happen policy by policy, practice by practice, and procedure by procedure in open dialogue and debate.”

The reader will also note that the authors describe their own chapter as a “story” (“this story contains an object lesson in how we might proceed to clarify…”); one must reach this conclusion because there is no “story” to be found in the preceding paragraphs of their text (or indeed the chapter itself). 

Lest any reader mistake the authors as being concerned with the arts in any way, I should point out the insipid content in the book when it comes to any discussion of the arts. 

They ask questions which range from the kinder-gartenesque (“do you like poetry”) to the meaningless “What do you think it means to have “moral imagination?”) and the anti-human (question four about the usefulness of poetry could be rephrased “Are you convinced that human beings can be useful? Why or why not”) in a chapter titled Poetry and Moral Imagination (Chapter 10 of Medical Humanities):

“Exercises for Critical Thinking and Character Formation

Questions for Discussion

1. Do you like poetry? Why or why not?

2. How do you think the language of poetry might be different from an essay or a short story?

3. What do you think it means to have “moral imagination”?

4. Are you convinced by Marianne Moore’s claim that poetry can be useful? Why or why not?”

This is a sample of the authors’ contribution to poetics: 

“We are taught to distinguish poetry from prose by the form it takes on the printed page, most commonly the use of stanzas, which are groups of two or more short lines, as you see in this picture. The form of poetry on a printed page also highlights the qualities of the art of typography.”

They then print, and I am being serious here, the following image as a figure in their “textbook”:














The reader will now observe the authors speak at some length about the difference in typeface between the title of the poem and the poem itself before moving on to more concerning material: 

“How are they different in height, width, letter style, use of upper and lower case, spacing between letters, and spacing between lines? Examine the paper. Imagine rubbing the page between your thumb and forefinger. Would it feel smooth”

Compare the letters in the title of the poem Musée Des Beaux Arts to the letters in the first stanza. How are they different in height, width, letter style, use of upper and lower case, spacing between letters, and spacing between lines? Examine the paper. Imagine rubbing the page between your thumb and forefinger. Would it feel smooth or textured? How does the paper of this book feel between your fingers?

Compare the typography of this poem with any other printed form you have near you – this book, other books, a business card, the label on a bottle of prescription medicine. How is the typography of the poem different from other typography around you, even on your computer screen? Why might the typography of a roadside billboard be different from the typography of the Physicians’ Desk Reference?

The publishers of this volume (Cambridge University Press) should be ashamed of themselves for printing such obvious idiocy. The authors, on the other hand, are cause for alarm in their conflation of the physical appearance and typeface of the poem on the page which, as they indicate, is something that they actually confuse with the form of the poem (poetically)!

They also conflate feeling (emotionally) with feeling (sensationally). The sensational is, of course, perceptual while the emotional is abstract and conceptual. This places the authors in explicit (unprintably explicit) proximity with other anti-poets who speak only of what they perceive and not of what anything might mean.

The text then continues by suggesting that handwriting could be an artistic discipline (it is not): 

“Does your handwriting approach art in the way you shape letters? Can you imagine drawing each of the letters in this poem by hand and trying to put into each letter something of the poem itself ”

The authors then mercifully release their readers from the text at hand by suggesting that they should go  away and google the history of fonts: 

“To pursue these ideas, search the web for the history of printing, Johannes Gutenberg, Aldus, Manutius, and typography. For terms to describe typography, search for “white space,” “serif and sans-serif,” and “monospace or proportional type.”

I trust that any notions of the authors as artistic creatures has been dispelled by the reader. So who, as the question must be asked, are these people? 

The three authors of Medical Humanities are listed (in the book) as follows: 

“THOMAS R. COLE is the McGovern Chair in Medical Humanities and Director of the McGovern Center for Humanities and Ethics at the University of Texas Medical School at Houston. Dr. Cole has published many articles and several books on the history of aging and humanistic gerontology. His The Journey of Life: A Cultural History of Aging in America (1992) was nominated for a Pulitzer Prize. His book, No Color Is My Kind, and accompanying film, The Strange Demise of Jim Crow (1997), were nominated for a National Humanities medal. His work has been featured in the New York Times; on National Public Radio, Voice of America, and PBS; and at the United Nations.

NATHAN S. CARLIN is Associate Professor at the McGovern Center for Humanities and Ethics and Director of the Medical Humanities and Ethics Certificate Program at the University of Texas Medical School at Houston. He has coauthored two previous books, Living in Limbo: Life in the Midst of Uncertainty (2010) and 100 Years of Happiness: Insights and Findings from the Experts (2012). He has also published more than 100 journal articles, book chapters, and book reviews in about a dozen different journals.

RONALD A. CARSON is Professor “Emeritus at the Institute for the Medical Humanities, University of Texas Medical Branch at Galveston. He has received fellowships from the Institute on Human Values in Medicine, the Council for Philosophical Studies, and the National Endowment for the Humanities. He is an elected Fellow of the Hastings Center, a former president of the Society for Health and Human Values, and a recipient of that society’s annual award. He has written many articles, chapters, and book reviews. He is coeditor of four books, including Practicing the Medical Humanities: Engaging Physicians and Patients (2003).

In the opening sentence of the book (and in many others throughout the text), the authors of Medical Humanities (“This volume represents the first textbook in medical humanities. After decades of teaching in both medical and undergraduate schools, we wrote the book…”) write about themselves in such a way that  would cause most people to understand them to be doctors of medicine. 

Dr. Cole’s PhD is in History (with an MA in History and a BA in Philosophy). Dr Carlin’s doctorate is (again a PhD and not a Medical Doctorate) in Religious Studies (with an MA in the same and a BA in History from Westminster College School of Divinity). Dr Carson is similarly demarcated as Dr Carson, PhD and speaks of being “educated in Indiana, New York, Germany and Scotland,” and of spending time as a “visiting scholar at the Nietzsche Archives in Weimar” while he wrote his “Ph.D. dissertation in the University of Glasgow’s Faculty of Divinity.”

The authors of Medical Humanities, at the very end of their (self-defined) “textbook,” are sure to state the importance of their text explicitly; as well as to tell us that their “textbook” (defined as “a book used as the standard work for the study of a particular subject”) are fit to lecture doctors-to-be as well as “practicing physicians” and other “health care practitioners” on the “Goals of Medicine,” “Ways of Knowing,” “the Doctor-Patient Relationship,” “Health and Disease,” “Technology and Medicine” among an array of other topics (the topics mentioned are all chapter titles in the text). Here is the opening of the Epilogue: 

“Medical humanities is a field for undergraduate and premed students, medical students and students in other health professions, as well as practicing physicians and health care practitioners. Medical humanities asks the most important questions. It asks existential questions about suffering and hope, life and death, the goals of medicine, the nature of disease, the experience of illness, the distinctions between curing and caring. And it asks moral questions about power in medicine, poverty and illness, just health care, and ethical issues in care of the dying. It uses the tools and methods of the humanities to engage these questions. As we articulate in the Introduction, medical humanities is an inter- and multidisciplinary field that explores contexts, experiences, and critical and conceptual issues in medicine and health care, while supporting professional identity formation.”

The authors then go on to address the subjects of “character development and critical thinking”: 

“Character development and critical thinking are complementary goals of medical humanities. This flows, to repeat our point in the Introduction, from our view that medical humanities is – or should be – fueled by the pursuit of humanitas, that compassionate stance toward others that ideally emerges from education in the liberal arts.”

Having addressed many examples that attest to the basic the lack of critical thought in Medical Humanities (and having  identified the anti-critical currents which are pervasive this text), allow me to briefly address the question of “character.” 

Thomas R Cole is identified as follows on the website for the University of Texas’ Mc Govern Medical School: 









Dr Cole’s CV also is clear as far as stating his field of study is concerned. Here is the front page of the CV:













Dr Carlin is clearly identified in the same way as the reader will see in the highlighted passage from his biographical sketch which I have recovered from the University of Texas’ website:




















Dr Carson is similarly identified in such a way (this identificthat nobody would mistake him for a doctor of medicine:













Not a single one of the three authors in question is in possession of a medical degree or a license to practice medicine. They could have easily made such a fact clear to their readers but did not. 

And it’s not simply that they opted not to do so (thus concealing the truth “passively” as it were). They actively opted to conceal the truth. 

Here is the listing of the authors as they appear in the inner-title of Medical Humanities: 














It would have been a simple matter to list some mention of their background by printing the simple letters “PhD” as those letters appear in all mentions of their names. 

In the half title page of the book, the letters are missing and there is no mention of any qualifications in any of the biographical sketches which are printed in order to described the authors of this “text book”:














I’m not saying that the authors simply left that information out. They actively removed it (or allowed Cambridge University Press to do so). Had Dr Cole simply copied own bio from med.uth.edu and pasted it onto this page, the text would begin as follows: 


Thomas R. Cole is the McGovern Chair in Medical Humanities and Director of the McGovern Center for Humanities and Ethics at The University of Texas Health Science Center at Houston (UTHealth). Cole graduated from Yale University (B.A., Philosophy, 1971), Wesleyan University (M.A., History, 1975), and the University of Rochester (Ph.D., History, 1981).

Any way you cut it, the fact of the matter at hand is that any text which detailed the authors’ qualifications were not simply omitted. 

This text was actively removed. The representations of the authors in Medical Humanities is fundamentally and professionally removed from their representation in public (on their professional documents which are presented before their own colleagues as well as before medical professionals). 

To make one final push at clarity regarding the anti-poetic nature of this discourse allow me to state that the authors do not simply conceal their lack of medical degrees. They conceal their actual degrees. 

These men are not simply concealing the fact that they are not doctors. They are omitting their qualifications (as historians or theologians) by omitting mention of their advanced degrees in those subjects. They also omit or neglect any mention of these degrees in the text-at-large.

The duplicity (or lack of care) regarding their basic function should be taken into consideration by students and practitioners of medicine as well as by anyone else whom the authors of Medical Humanities would target as subjects; and who would then be subjected to these people’s “education” in matters pertaining to ethics and character. 


6. Hell 




















      What was even more unusual, and unexpected, was finding a few survivors who felt that there disfigurement was an asset in some important ways. Trisha felt she became more open to others whom she did not know when she met people in social gatherings. She felt that she became less shy and introverted than she had been before she was injured. Because she is facially disfigured, she believes that some people are reluctant to approach her. Because of this, she will go out of her way to say hello to strangers, a sentiment expressed by Eric and several others as well.

      Alan Jeffrey Breslau, mentioned previously, described how being facially disfigured has been positive for him. Initially believing that his appearance could be restored by plastic surgery, Alan discovered that this wasn’t to be. He was especially concerned about his nose which had been destroyed by the fire. His plastic surgeon had discussed the process of rebuilding his nose and Alan thought that he could finally have the type of nose he wanted:  since adolescence he had considered plastic surgery for the correction of a bump, something that he had considered a defect. Like many others, he didn’t fully appreciate what plastic surgery could and could not do:

Alan:  Little by Little I became aware that it wasn’t going to be like that at all; when all was said and done, I would be unpleasantly disfigured. Soon, I began to discern some satisfying advantages to this condition. For one thing, recognition is instant and total. As a result of that plane crash, I have become a personality; I am no longer anonymous. When most people return to a place after a few days, they are generally unnoticed nonentities. But now when I [his emphasis] return even a year or more later I am greeted with, “Hey, where have you been?” Wherever I go I get the feeling that a red carpet is being rolled out for me; the receptions I get are warmer and friendlier than any before the accident. This familiarity makes people feel more comfortable and it makes it easier for me to form bonds of friendship with them….Since my disfigurement, men are considerably more open and friendly with me. They accept me more now because they think that since I’m disfigured I’m not a sexual threat to them.

Women are more receptive to me since the accident than they were before. It isn’t fair to say that they find me more or less attractive now than before, but they notice me because I am disfigured. Once they have picked me out and we get to know each other in a more informal way, they see what they want to see. Since they know this is not me they’re looking at, the only real me they see is the one in their mind’s eye [my emphasis]. They paint that picture themselves and they react to my personality rather than to my appearance. (Breslau 1977, 216-217)

For many of the survivors in the study their experiences in the hospital seem to be at least an hour if not more so than where their initial burns experiences for most there initial experience of being burned lasted only a few moments during that time they were absorbed in surviving and getting away from the fire the situation for a few those burners children and those were unconscious when they were burned there is no recall actually being burned but for others there are short like memories pieces of images that are the cold shoulder for cute. When they were heavily sedated and critically ill. Some of what is recalled is vivid; these are memories of anguish and unrelenting, interminable pain. These men are memories of oneself no longer in control of one’s situation condition or life.

“Sectors from personal experience in the first days or weeks in the burn center are, for many survivors, difficult to recall in any full detail. What can be remembered is available to them, insignificant measure, only through accounts my relatives who visited them and from reports by nurses who cared for them. They do not directly recall what happened to them excepting bids, pieces, and fragments of dimly recalled, hazy experience, which has a dreamlike quality. The accounts and reports by others serve to fill in missing sectors of experience for many survivors. Information supplied by others was used by survivors to make sense out of what they experienced during the acute phase of their hospitalization. Reports by others serve to define, objectify, and make real experiences that were found to be distant, remote, and only partially accessible to their own consciousness.

Part of the survivors on biographical history and identity is therefore available on the second hand, there accounts, reports and information supplied by others. Self historyHere he comes inherently intersubjective, meaning that the survivor becomes aware of the fact that without such information supplied by others, they would not know or understand what happened during specific periods of time. Unrecognized periods of time, they do really experienced as the absence of the Celts consciousness in the world, I stated by several survivors as being “periods of lost time,” Denoting the subjective feelings that I telling to lose consciousness of the cell, or identity, suggest losing time because the reflectively objective fied self is defined, perceived and experienced as being absent from the world and absent from the passage of events into time.”

“To be absent is to lose any perspective on time. Absence is not experienced as uniforms are consistent for a bride, retrospective block of time; rather, it is punctuated and contrasted by remembered fragments, often vividly recall, others only dimly sense, of things that occurred during thisperiod. Following burger and Lachman, they keep face of injury, during those periods when the survivors little aware of what is occurring, is conceptualized as some universe is a meaning that are distinct from the typical wide-awake consciousness which characterizes every day reality. The meaning of the symbol with sub universe is uniquely contingent as noted above, and information supplied by others. The reality of the hospital, SC you need to subuniverse of meaning, is starkly and frighteningly different from the persons every day life. Time into routine become dictator not by the persons self and post projects, but by the institutional regiment of care that is mandated by burn center staff invite tending positions. Once life become centered around the “program” in 1985 of care in recovery, open to the frustration, protestation, and anchor of the critically injured patient.”

Those elements of the subuniverse that stand out for the survivor is directly experienced and as reportable, serve to anchor the information apply supplied by others. Those experiences will be treated as concrete, objective, and reel in fact and until further notice, that is, they are provisional and subject to subsequent articulation. That the survivor had such experiences will not necessarily be problematic in itself, but the meaning of the experience, the how and why of occurrence, maybe inherently problematic for the survivor. Intern information supplied by others will provide a sense or rationale for the concrete the perceived experiences. For example, the survivor may report having nightmares about people chasing him with your project; he may recall screaming about pain it vividly remember being immersed in staying hot water all nurses pull the skin off his body. You may recall dreams about being skinned alive or she may recall dreams about being chased by “death.“ He or she may recognize that some of these experiences were dreams and nightmares but others were not, but the survivor may be on able to differentiate clearly between the two. Is our experiences that stand out; they recalled with different chilling clarity, but they are recalled as subjectively available lived experiences. In “waking up“ and reporting such experiences, or an asking family members are nurses about what has been happening, the patient may learn that he or she had been having hallucinations, often softly crying or yelling incoherently about pain; and that he or she had been taken to grow pro bass we’re dead skin was removed. This explanation can then be “attached“ to the subjects own experiences, thereby establishing a coherent meanings of the experiences that were originally perceived as disconnected, nightmarish, and in comprehensible. Both the remembered experiences and that was reported by others will potential he be integrated with the elements open together as if they were tapestry, it was a relatively coherent biographical history for the survivor. As such, the person is constructing situated Definition of identity and self that can be displayed and reported in reference to the question “what happened to you in the hospital?” Questions about what happened in the hospital or not only of importance to others; they are critical to the survivor is he or she tends to uncover what happened, thereby recovering missing experiences of self. Questions about self and identity or contingent on discovering what happened.

The subjective experience of lost time, the loss of feeling of a Tonna me and self-control, experience of pain and suffering, fears of death for some, or wanting to die for others, and the slow recognition that one is going to be forever transformed by being burned are all emergent teams, stated by survivors of concrete, subjective experiences during the period of hospitalization. He seems and others will be examined below in specific survivor cases.

Trisha Carson: vehicle accident

Tricia did not recall the accident, nor did she know she was burned until she woke up in the burn center at Grove County Hospital, a teaching hospital affiliated with the University. Trisha was burned with the car and when she was a passenger was rear ended. For traffic signal. She did not recall any of the initial care she received at the accident site, or in the emergency room. Trisha’s last recollection is being in her boyfriends car. Her next recollection was finding her so badly injured in a burn center. She did not know that you’ve been burned, I’ve been told that she was burned was not comprehensible in reference to the routine possibilities of her world. Routine understanding pertain to her being burned, except as a victim of her thermonuclear war, did not seem to exist for her. Big bird just did to Trisha that she must of been burned in a war:

D:  so you were conscious when you were brought to the hospital?

No. I was unconscious the whole time, I never regained consciousness all through the emergency room. And I don’t remember a thing until I woke up in the hospital. And I was up in the hospital in bed and I said, “where am I and why am I here?“ And they said, “well you’re in the hospital, and growth medical center burn center and you have been burned.“ In my mind, the only way I could’ve been burned by nuclear war, and I said, “oh, there was a war?“Well, he thought I didn’t have all my senses about me.


Kevin Davis: chemical burn

OK, this day I say, “I’m gonna look at myself.”There’s the bathroom, there’s a mirror straightahead. So as I approached the door to the bathroom, I could start to focus in and see in because I can see that much further as far as real clear. So as I got to the door, I could start seeing my face. And everything is just down, you know, discoloring here, discolored there in the sky, it didn’t have no lid on it, it was just white, I pictured it as a fisheye.

And then I got scared. Because I look like one of those horror movies that I pictured a long time ago and I was kind of afraid to them when I was small, so that automatically kicked in and I backed out.

D: as a nurse with you then?

This was something I was going to do by myself so I didn’t say nothing. It scared me enough for me to back up. So the next day I say, I’m going to look at myself, go into details, look and see what’s happening. So the next day was all right. I just seen I was hurt real bad on the side. Now we’re really felt like Mod on my face, like a blob or something. He didn’t have no feelings and I could get rid of it, I was just there.

D:  what do you think when you saw yourself the second time?

I thought the surgery was going to put it on right. I know it was going to have plastic surgery. You know, 33 years of looking like Kevin. You know, the Kevin Davis I know. I’d lost it. I didn’t know the extent of losing it, understand, until later Ron, not really. I didn’t know the extent that I lost it. I just know I lost my face, and everything was going to be all right.


that sexuality remains closet it is perhaps not surprising. Some survivors had problems discussing this aspect of themselves it it was of singular interest and importance. It was clear that survivor some selves, frequently a trouble, even among other survivors, and bringing up matters that referred to their most intimate concerns. When the topic came up in group, it usually seem to be suggested rather than being directly articulate it. This is not surprising. Being burned doesn’t facilitate communication about deeply personal and potential he discrediting matters, even among a group of relative strangers with been on the same journey. Similar to the patient who doesn’t ask to see a mirror, staff apparently leaves well enough alone if the patient does not rain specific questions about sexuality. This chapter will examine some of the issues, feelings and fears with survivor stated in the interviews. It will examine the construction of self and meeting in the lives of survivor so fine, or wish to fight, but they are acceptable as sexual beings and that, as before they were burned, they can be loved by someone pussies past the scars and disfigurement and will except them as well.

For most, self as experience as continuous rather than discontinuous or fragmented. Discontinuous sectors of the persons life or subject explanatory remedy to his or her construction of accounts, excuses, or justifications would serve as bridging devices between what is and what should have been. To the construction of accounts, involving biographical reconstruction, troubling discrepancies are made sensible incoherent, at least for the moment, and until further notice. Memory is crucial to biographical construction; my Morock reconstruction of self, the feeling of gaps, recasting the self in a specific light, ignoring some details were stressing others, all of these are commonly utilized produce what seems like a continuous self.

Biographic reconstruction is situational; it is not every day that the survivor, or anyone else for that matter, is called upon by cell or other to reestablish he or she is. Most of the time the survivor, like others, goes about life without needing to examine the past. Special situations, such as discrediting and embarrassing confrontations with rude more inquisitive others, may necessitate identity repair, but the situations are certainly not continuous problems at every turn in the survivors journey. They are, rather, special occasions in which identity becomes problematic, and sometimes massively so, and they may involve intimate relationships between the survivor and others. The person who is visibly just figured may have deep concerns about being rejected initially and in total, but those whose cars are normally hidden blue clothing at the problem of deciding when and how to tell the other about their scars, fearing that when they normally get and scars or seen, they will be rejected. In either case, it’s survivor faces the possibility of being rejected by those with whom he or she desires to establish an intimate relationship.










Most importantly, what a person takes himself or herself to be is, in a deep sense, contingent upon how others to find the person, and how they “mirror“ the persons identity. In particular, significant others are specially crush on this process. Significant others are those with whom we are most familiar and intimate, those with my most important relationships are forged. Referring to the reciprocal in her penetration of selves and lives, Schutz…


Eric Matthews: vehicle accident

Eric was transported to a large print center column is excellent. This burns covered approximately 95% of his body. Much of the burn was deep, and some places down to bone. Somethings are so so badly burned that they had to be amputated. His nose was destroyed and was subsequently reconstructed, as was one island. Here, Eric is discussing his hospitalization.

I remember the ambulance drive There, but that was in and out. I was talking to them, and I thought that was bizarre knowing how much I was burned. And then, at the hospital, one of the nurses just happen to come up and grab me. There was so much pain that the incident was just to get away. Because of the adrenaline that was been pumping from being in shock, I just tossed her across the room. Some woman grabbed me and it was just automatic. She thought I was on PCP, and stuff like that but it was just natural. The graph to me to put me down on the table and stuff like that. It was just instinct on my part just to get away from the pain.


Eric Matthews continued

Q: before you were burned, did you realize you were in pain?

That’s part of the problem. It was covered over by activities and drinking and having fun. Yeah… And that manifested in trying to show [his emphasis] How happy I was: look at what a good time and having, see? So that was pretty much a result of it. ‘My identity of who I was, I was no longer. So then it was a complete search’ [my emphasis].

In other parts of the interview, Eric stated that before he was burned, you never looked forward to where he was going, at least, not seriously. It always looked back, but even then, he never confronted the serious questions that could’ve been raised. After he left the hospital, he recognized that he was in a “bad situation,” 

“In James Dickey’s (1923–1997) poem, we encounter a girl who lies hugely bandaged (“her face, buried”) as the result of an accident that threw her face first into the windshield of the car in which she was riding. Just prior to the accident, “the windshield held” – it was intact, it shielded her in the vehicle, and it framed a bucolic scene. In a flash, at the moment of impact, this pastoral scene, this peaceful life, was needlessly, painfully broken. The poet metaphorically conflates the girl’s face and the car’s windshield. They splinter simultaneously. We know that a shattered windshield cannot be repaired. We infer from the poem’s title that the girl’s face cannot be restored to seamlessness. But in spite of the brute facticity of brokenness here, this poem speaks, finally, of restoration and reconciliation.”

“Indeed, in recent years persons planning funerals have abandoned traditional classical music, like “Amazing Grace” or Mozart’s Requiem, in favor of more modern songs like “Highway to Hell,” “Stairway to Heaven,” or Frank Sinatra’s “My Way.” American death practices have even seen the rise of virtual forms of grieving: some websites offer a “virtual cemetery” in which a deceased’s loved ones can log on and contribute photographs, stories, poems, and memories – a sort of Facebook for the dead.49 Today, it seems, there is no single way to die well

The Scarred Girl

All glass may yet be whole 

She thinks, it may be put together

From the deep inner flashing of her face.

One moment the windshield held

The countryside, the green

Level fields and the animals,

And these must be restored

To what they were when her brow

Broke into them for nothing, and began

Its sparkling under the gauze.

Though the still, small war for her beauty

Is stitched out of sight and lost,

It is not this field that she thinks of.

It is that her face, buried

And held up inside the slow scars,

Knows how the bright, fractured world

Burns and pulls and weeps

To come together again.

The green meadow lying in fragments

Under the splintered sunlight,

The cattle broken in pieces

By her useless, painful intrusion

Know that her visage contains

The process and hurt of their healing,

The hidden wounds that can

Restore anything, bringing the glass

Of the world together once more,

All as it was when she struck,

All except her. The shattered field

Where they dragged the telescoped car

Off to be pounded to scrap

Waits for her to get up,

For her calm, unimagined face

To emerge from the yards of its wrapping,

Red, raw, mixed-looking but entire,

A new face, an old life,

To confront the pale glass it has dreamed

Made whole and backed with wise silver,

Held in other hands brittle with dread,

A doctor’s, a lip-biting nurse’s,

Who do not see what she sees

Behind her odd face in the mirror:

The pastures of earth and of heaven

Restored and undamaged, the cattle

Risen out of their jagged graves

To walk in the seamless sunlight

And a newborn countenance

Put upon everything,

Her beauty gone, but to hover

Near for the rest of her life,

And good no nearer, but plainly

In sight, and the only way

“After its initial print run, Face was reprinted as a Contemporary American Fiction paperback but Viking-Penguin had no plans for keeping it print, and despite a letter-writing campaign from scholars, professors, some prominent critics and from one of Viking’s most distinguished novelists, the copyright was to revert to me. Over the next six years I parcel posted cartons of xerox reprints to scholars, academics, and bookstores all over the country, from Massachusetts to Wisconsin, from Connecticut to Texas, and all over California for teachers who, despite its having gone out of print, still hoped to include it in their syllabi. Finally Wings Press and its editor Bryce Milligan took up the cause: Face has come home at last, the cornerstone of the uniform Wings edition of my works.

The good news is that, despite its curious history, Face has survived.

“I take great pleasure from giving readings; in a way, they satisfy a chronic nostalgia for the lost world of the theater, but what pleases me most is the question period when people offer their own interpretations of what reading Face means to them. I have received comments from people who are severely handicapped who credit Face with having changed their lives. Once a woman raised a timid hand (in rebuke, nonetheless): “Why did you choose a man as your protagonist?” “What makes you think I have?” was my reply. I want to invite each reader to look beyond surfaces, and look again. And again. Because a worthwhile reading, for that matter, reading anything of worth, is always a process of negotiation.”

I a book, The Flames Shall Not Consume You, by Mary Ellen Ton

January 4, 1980. A date as indelibly engraved on my mind as the day of my birth. It began like so many other days. The alarm went off at 5:45 A.M. I dragged my body to the shower to the music of WXTZ—the “old people’s radio station,” my rock fan sons called it.

By the time I had my makeup on and was blow drying my hair, I was wide awake and looked back at my reflection with satisfaction. I felt no conceit in admitting that I liked the way I looked. After all, I was God’s handiwork.


In the period before the accident, Ms. Ton refers to a slowing down of time:

“As the minutes turned into hours, I found myself becoming even more deeply engrossed. Having worked on two jobs where interruptions were ordinary and confusion reigned, I had learned to block out everything around me. I only vaguely took a notice when LaVern Young, the administrator’s assistant, stuck her head in my door to tell me she and Frank Shirly, the program associate at Woodruff Place, were going to pick up supplies and then get some lunch. I turned down an invitation to join them, explaining I would just finish the report I was working on and go home to get ready for our weekend guests.

Returning to my columns of figures, the rhythmic clicking of my calculator blocked out everything else.”

In the first sentence from the paragraph quoted above, Ms Ton does not tell the reader what it is she is deeply engrossed in: “As the minutes turned into hours, I found myself becoming even more deeply engrossed.”

What exactly is Ms Ton engrossed with or engrossed in? The answer is not hard to guess at.  Far from it. Ms. Ton broadcasts her answer to that question throughout her book. Just a few paragraphs later, she hints at an answer in her actual description of the moment she sustained injury:

“The heat and smoke pursued me out the window, clutching me in their searing arms as I tried to escape the holocaust inside. With the flames drawing rapidly closer, the superheated gases devoured the skin on my hands. I desperately tried to maintain my hold on the windowsill as the burning heat feasted on pieces of the face that had smiled back at me from the bathroom mirror just a few hours earlier.”

She also speaks of that which obsesses her at the very opening of the book: 

“January 4, 1980. A date as indelibly engraved on my mind as the day of my birth. It began like so many other days. The alarm went off at 5:45 A.M. I dragged my body to the shower to the music of WXTZ—the “old people’s radio station,” my rock fan sons called it.

By the time I had my makeup on and was blow drying my hair, I was wide awake and looked back at my reflection with satisfaction. I felt no conceit in admitting that I liked the way I looked. After all, I was God’s handiwork.”

Ms Ton woke up that morning obsessing over her appearance in the mirror. She also mentions looking into the mirror with satisfaction at work (presumably only a few hours later than the time at which she woke up and stared in the mirror and a few hours before her injury). 

It is not simply that Ms Ton is obsessed with her self (by this I mean her shell); she dotes on her body as her only source of satisfaction. 

Ms. Ton is not concerned with the report itself; she is simply withdrawing into herself. She does not speak of anything that is relevant to the report she is filing or what makes this report so urgent that she would shun the invitation to . She does not even speak of numbers and figures. Ms Ton speaks of “my columns of figures” and speaks of the sound of “my calculator”: 

“Returning to my columns of figures, the rhythmic clicking of my calculator blocked out everything else”

The lack of detail is actually unusual for Ms. Ton. This is evident to any reader who even glances Ms Ton’s book. One does not need to delve too far into her text either. Take, for example the very opening sentence of the book (after she states the date she is speaking of in long form); it is, Ms Ton recounts this as “…a date as indelibly engraved on my mind as the day of my birth. It began like so many other days. The alarm went off at 5:45 A.M. I dragged my body to the shower to the music of WXTZ”

And it was kept locked. Where was the key? On my desk? In my purse? Again I had the instinctive feeling there was no time. No time to call the fire department. No time to unlock a gate. No time to run down the hall, down the stairs, and out of this place. I was trapped!

The noises I had assumed to be other persons at work were actually the crackling of a fire working its way towards me. To this day, when I sit near the fireplace in my home listening to the flames sputter and sizzle, I cannot fathom why I did not immediately recognize those sounds drifting down the hallway.

I had the incredulous feeling I was watching a television show. This couldn’t be happening to me. But it was. I knew I had to get help. The window. I would call out the window. I turned the handle and pushed the window open for the second time that day. With a great whooshing sound and a roar like a dry Christmas tree burning, the heat and the smoke leaped to the open window and began their destruction of me.

For a brief instant, I thought someone had come to rescue me. The impact of the intense heat on my body made me think a huge and powerfully strong person had lunged at my back, pounding his weight against me, slamming me with arms that encircled me and pushed me against the window. My arms shot upwards as if to signal my surrender as every muscle and sinew tightened to ward off this assault. A giant convulsion shook my body as I turned from person to pain.

There was no pulling away from the grip fastened on me as I might have done from contact with a hot burner on the stove. I could not quickly drop the offender, like a hot spoon handle. There was no escape. My enemy was merciless as it ate away at my flesh, destroying forever the image I had known.

A woman’s voice was screaming:  “Help, help, somebody help me.” It was my voice. The alley, usually filled during the lunch hour with kids from Arsenal Tech High School across the street was empty; the school was still closed for the holidays. Only the broken asphalt of the alley and the bricks in the wall of the next building heard my screams.


The heat and smoke pursued me out the window, clutching me in their searing arms as I tried to escape the holocaust inside. With the flames drawing rapidly closer, the superheated gases devoured the skin on my hands. I desperately tried to maintain my hold on the windowsill as the burning heat feasted on pieces of the face that had smiled back at me from the bathroom mirror just a few hours earlier.


“The first day back in the tank I began to scream—inside. From then on, I screamed for months. But I would not let the screams come out, not here, not yet. Instead, I began to sing. And the nurses and therapists sang with me. The words that came out were, “Do, a deer, a female deer; re, a drop of golden sun. Mi, a name I call myself; fa, a long, long way to run. So, a needle pulling thread; la, a note to follow so. Ti, a drink with jam and bread, that will bring us back to do-oh-oh-oh-oh.”

We sang other songs, some the nurses suggested, some I thought of. “Amazing Grace” was one hymn nearly everyone seemed to know, that and “Jesus Loves Me.” Most of the words eluded me, even though Gene helped me make a list of familiar hymns, recalling lines for me. But, no matter how well rehearsed I was, they were difficult to remember once I was in the tank. If I had to think about the words, the effect just wasn’t the same. So, I stuck with “Do, a deer,” sometimes ending with a great crescendo. The more it hurt, the louder and more fiercely I sang. “Do, a deer, a feMALE DE E EEEEEEEEEEEEAHHHHHHH!” In that way I harnessed my screams to a song. Whenever I stopped singing, one of the nurses would pick up the refrain and others would urge, “Sing, Mary Ellen, come on.”

Once when I remained silent a long time, one of them said, “You’re not singing today.

“I think I lost my song,” I replied through gritted teeth.

“Let’s see. ‘Do, a deer—‘“ she sang to encourage me.

What kind of person can day after day inflict agonizing pain on another human being? What is the person like who routinely scrubs, scrapes, pulls, and cuts burned flesh from a screaming body?”

Ms. Ton finds  inspiration in a book written for children; it is called The Velveteen Rabbit:

The excerpt from The Velveteen Rabbit came to me…

… At the very point in my life when I most needed to hear the affirmation made by the old Skin Horse, the words came to me from my “wordless” son.

“What is REAL? Asked the Rabbit one day. “Does it mean having things that buzz inside you and a stick-out handle?”

“REAL isn’t how you are made,” said the Skin Horse. “It’s a thing that happens to you. When a child loves you for a long, long time, not just to play with, but REALLY love you, then you become REAL. It doesn’t happen all at once. You become. It takes a long time. Generally, by the time you are REAL, most of you hair has been loved off, and your eyes drop out and you get loose in the joints and very shabby. But these things don’t matter at all, because once you are REAL you can’t be ugly, except to people who don’t understand.”


My cocoon was being taken away.

Exclusively natural word. 


How could I sit at the table with him? I, who had always brushed my hair and put on fresh lipstick and sometimes even changed clothes, just to look nice for my husband. How could I make my way into the kitchen now with my hair all but burned off, my lips thick with dried, peeling skin, wearing a dumpy, stained housecoat?


“We must walk this lonesome valley,

We have to walk it by ourselves,

Oh, nobody else can walk it for us,

We have to walk it by ourselves.”


“I’m getting worse, not better.”

Those discouraging words spoken so often lately to Gene were like an epitaph. As the burns healed, the scar tissue began forming contractures. I sat and watched my fingers grow together, my left arm fasten itself to my trunk, and my neck thicken and grow stiff. I could neither force my arms down to my sides nor raise the left one more than a few inches above my waist. My eyelids pulled down exposing the red mucous lining, and each time I tried to turn my head the contractures pulled them down more. When I tried to do exercises to loosen my body and retard the contractures, it grew increasingly difficult and the tightness of my skin twisted and contorted my face into monsterlike grimaces.

Night after night I went to bed with one prayer on my lips. “Please, God, heal my face. Don’t let it be scarred. Please, not my face. I can handle all the rest if you’ll just let me have my face.” But as my face refused to heal and infection broke down every hint of new skin forming, I knew in my heart that my face would be badly scarred.

This, more than anything else, haunted my day and night. I never thought much about scarring in the hospital. I don’t know if that was because all my body’s energies were focused on survival, or if I was blocking it out, or it if was simply naivety. Actually, I didn’t consider the future much one way or the other.


When I had hidden in the attic as little girl, I would sometimes hear my mother calling me, “Mar-eee… Mary Ellen.” But I had pretended not to hear because I wasn’t ready to leave the security of my hiding place. Now, I heard Gene’s voice calling, “Mary, Mary, we can make it. Let me in so I can touch you. Let me help you. We’ll just take it one step at a time.” But, I was too hurt, too afraid to come out.

“This is it,” I told him. “This is how it’s always going to be. Nothing can ever change it. You ought to leave. There’s nothing here for you anymore. I can’t be your wife; I can’t even be a human being.”

“You’re still here. I love you. I love the person you were.”

“But, don’t you see, I’m not that person anymore. Mary Ellen Ton died on January 4.”

Nothing will touch Ms Ton who is, in a very real way, trapped in the cell of herself on the brink of being able to see some twisted light that would almost convince her of her freedom. 

In his recollection of the what he calls his “First Operation,” Mr Ariely describes the procedure in depth: 

“Midmorning, one of my physicians enters my room accompanied by two nurses. He informs me that my right arm is so swollen that the inside pressure is preventing blood flow to my hand. He neatly arranges a tray of what seems to be dozens of scalpels and explains that in order to reduce the pressure, he has to cut through the skin to drain the liquid and reduce inflammation. I cannot help but think of the ancient British barbers that used to bleed patients as a form of medical treatment. The physician also informs me that since my heart and lungs are not functioning very well, he has to perform the operation while I am in my hospital bed and without anesthesia. I am frightened to no end. In an attempt to comfort me, the physician explains that since most of the nerves in my right arm are dead anyway, I should not experience much pain—but he is not very convincing, and, in fact, turns out to be so very wrong.”

“One of the nurses holds my left arm and shoulder in place, the other holds my right shoulder and arm and presses it down with all her weight. I watch the scalpel advance slowly along my arm, creating a deep tear. I seethe physician cutting me with the sharp scalpel, but I feel as if he is tearing me open with a blunt garden tool.The intensity of the pain catches me by surprise and leaves me gasping. It is unbelievable, unlike any pain I could have ever imagined. It begins at my elbow and advances slowly until it stops near my wrist.Then it comes again, a second time, starting at my elbow and moving upward. I scream and beg them to stop, “You are killing me!” I cr y out. No matter what I say, no matter how much I beg, they do not stop. The pain grows stronger. “Stop!” I scream over and over again. I tell them I cannot stand it any longer, but they only hold me tighter. Finally, the physician tells me that he is almost finished and that the rest will pass quickly. He tells me to count slowly to 10 and that when I reach 10 it will be over. I start counting as slowly as I can bear. 1, 2, 3…Time slows down. The pain captures ever y aspect of my being. All I have is the slow counting. 4, 5, 6…The pain moves up and down my arm as a new incision is made. 7, 8, 9…I will never forget the tearing flesh, the excruciating anguish, and the waiting…as long as I can…before yelling…TEN!”

On cue, Mr Ariely describes the physician’s pause upon his mention of the arrival at the number 10 which he has just yelled out:

“The physician stops cutting.The nurses release their hold on me. I feel like an ancient warrior who has conquered his suffering with brave nobility. I am exhausted. ‘Very good,’ the physician congratulates me. ‘I have made four incisions in your arm, from shoulder to wrist; now we just have a few more seconds and it will REALLY be over.’”

If there is one thing that brings a composer close to impossibility, it is the fact that we have the infinity of time and meter to use, respect and keep as our tool (in an analogy to the painter’s affinity for cherished light and shadow, the composer must love Kronos and, in loving him, revere him).

Did Mr Ariely’s count to ten resemble the following ten-note pattern? 






Or is Ariely’s countdown better represented like this eleven-note pattern (correctly taking into account the number “seven”’s problematic bi-syllabic structure?






How about this?






Perhaps the following representation (one which deviates above the tick-tock of a clock and breaks the second hand of the clock through a decimal)? Is such a musical rendition more “realistic”?





What if Mr. Ariely attempted the same thing as above but applied it in the following way? 






Were I to mount the scene on a stage, I would be able to go on positing rhythmic inventions based on this narrative for a long time. I could sit here for the rest of my life sketching and suggesting infinite possibility.

But that word above, “Rubato,” bring us closer to the picture (that of the need to recover stolen and not simply lost time). 

It is possible that the surgeon in question told Mr. Ariely to count to ten in a manner keeping with his best approximation of the second hand of a clock and, thus, avoiding all quickening or slowing of time. It is possible but, if he did indeed instruct Mr Ariely to do this (and therefore offer Mr. Ariely a compass by which he could navigate the distance between the current moment and the end of his torturous ordeal) then Mr. Ariely does not tell us about any such instruction. 

It is possible that the physician told Mr. Ariely to do this (count in seconds from one all the way up to ten): 





It is possible… but it is unlikely. It is improbable that such an instruction was ever given or received; the objective measure of time remains an implication in the reader’s mind (it is what we assume when people tell us to count to ten; we do not count minutes or hours or micro-seconds; we could seconds to the best of our ability). 

The physician and Mr Ariely are inhabitants of a dark place where time is subjective. If the physician told Mr. Ariely to count time conventionally then it simply would not be practical in this situation. Mr Ariely goes on to describe recursive count-ups; a veritable rhapsody of metric rape: 

“My imagined brave warrior dissolves into a patient defeated. I have used all of my energy on convincing myself to hold on as long as possible, certain that the 10-count would bring the end. I perceive the impending pain, which a few seconds earlier seemed manageable, with full-blown terror. How can I survive this again? Now? “Please, I will do anything. Just stop,” I beg. The repeated cutting terrifies me. I am helpless. I cannot control myself. I scream, cry, and shout all at once. But, I have no say in the matter. This time they hold me even tighter. “Wait, wait,” I try for the last time, but the doctor proceeds silently with his cutting. He “finishes” the arm and then makes two cuts in each of my fingers. I do not know how much time is passing but I continue to count 1, 2, 3, 4…and shout when I reach 10. I count over and over until the physician finally stops cutting. My hand is unbelievably sensitive and the pain is endless. Bleeding and crying, I am left to rest.”

One can understand the pain causing such feelings of defeat; being cut up alive… what could possibly be worse than that? A talented filmmaker or painter could render such a scene in a  celebration of squirm-inducing artistry. But, what, if we may stay with the question a moment longer, could possibly be worse than this surgically tortured nightmare? 

This physician and Mr Ariely are, as I have pointed out, inhabitants of a dark place where time is subjective. If I was to render Mr Ariely’s count-up in the ways akin to the sketches above (add to this the many more concurrent and strange deforms of time that I could deploy even before I began to combine the different disfigurements with one another) there is a hint to an answer. 

Mr Ariely is cut off from objective time; the harmonic motion of a ticking clock; the basic unit of a second; the rotation of an hour and twelve hours; a day, a night, a cycle of the Earth around the sun in a year and the celestial cycles of moon falls and moon rises… 

Mr Ariely, in brief, is cut off and removed from the rotations of every universal body known to man as well as from the circulation of his blood and lungs; he is cut off from the entire universe atomically and celestially. Mr. Ariely, a faceless patient wrapped in bandages is relegated to his own inner cell within a burn unit. 

He is alone; time will never tell anything. He will count to “TEN!” again and again with no inclining that there is objective agreement between his count and the count of the rest of the universe. The doctor might meet him there to ease him of his pain and apply the comforting words (a true balm in Gilead): “it’s over, Mr Ariely; you suffered that like a strong man… a true champion.” 

But what are the chances of that meeting happening? They are as many as the chances that I will exhaust all of my rhythmic rhapsodies on a countdown… It is terrifying to experience the hell of  burning alive or to experience the surgery of being cut up and crafted before one’s very eyes. The only thing more terrifying than that is if one is cut off from everything predictable and confined to a solitary cell; a unit of the self form which there is no telling when the agony will, or if it ever will, finally come to an end. 

In another section of her book, Ms Ton writes that “I had always needed Gene’s reassurance that he loved me.” She writes that she had always “needed” rather than “desired” her husband’s love. This confounding of time is another evasion tactic which I would use in a dramatic work to enhance a character’s manipulative credentials. Ms. Ton, however, is writing these words earnestly. When was this time when she “had always needed” these things from her husband; that is not clear. She writes all this even as it is painfully evident from her own recollections in her own book that she still requires this praise and reassurance in too many forms to recount here without transcribing the entire book. 

Nevertheless, here are a few highlights. At the outset, allow me to quote this passage from slightly later in the book: 

“For months, my response to Gene’s affirmation of his love for me had been a quick, sharp rebuff. Each time he had tried to touch inside me with the words, “I love you, Mary,” I had angrily retorted, “Don’t say that. It just isn’t true and I don’t want to hear it.”

Given that kind of rejection, it is no wonder the words had come less and less frequently. And their scarcity had reinforced what I already believed:  it was impossible for Gene to really love me.

But, that same evening as we drove home from the Janses’, discussing what Mary had told us, Gene tried again. “I really do love you, Mary. I really do.”

“I don’t know how I can believe what isn’t true,” I argued.

“You don’t know what is true for me,” Gene said. “You only assume you know. If you want to know how I feel about something, you need to check it out with me.”

“Do you really love me? I’m so ugly.”

“I really love you.”

“If that’s true, it’s incredible—incredibly wonderful.”

“It’s true babe,” Gene affirmed again, turning to glance briefly into my eyes as he drove.

“Tell me again.”

“I love you,” he laughed.”

“I let his words wash over me in waves,” concludes Ms. Ton, “accepting them without allowing myself any discounting remarks or thoughts. As each wave receded, it carried away some more of the debris littering my beach.”

Had she understood his words and reasoned with them (actively), Ms. Ton may have formed a meaningful relationship with her husband. I cannot imagine a more passive engagement with another human being’s sentiments and words than the passivity expressed by Ms. Ton telling us that she “let his words wash over me in waves, accepting them without allowing myself any discounting remarks or thoughts.” 

The words “Jesus loves me,” are used by Ms. Ton in a literal sense; she also describes her relationship with God in literal terms:

 “Once during this time I had tried to describe to a friend how I felt. “I loved God and trusted him and gave him the best that I knew and he betrayed me,” I had told her. “He left me hanging on a window ledge screaming for help.”

Those readers who might be tempted to make generalizations regarding the “type of Christianity” practiced by Ms. Ton as a means to write off those around her should not give in to such temptations.

Ms. Ton herself freely informs the reader that her comments are badly received (as is perhaps to be expected): 

“My friend had sadly shaken her head,” says Ms Ton before writing eight more words that indicate her level of misreading and delusion “and I had known she felt sorry for me.” 

Ms. Ton continues beyond assuming what her friend felt as she shook her head and into the realm of telling us why her friend felt the way she did: “Not so much because I had been badly burned, but because my faith had not been strong enough to carry me through.”

She does all this only to contradict her friend’s sentiment (the sentiment does not, I remind the reader, exist but is invented by Ms. Ton):

“That’s where she was wrong! I have never been a pacifist in my relationship to God. Our at-one-ment has been hammered out blow by blow,” writes Ms. Ton. 

“After I first met him in my teenage years,” (I would like to interject only in order to remind the reader that Ms Ton is, indeed, speaking of God here and not a high school crush), “there were times when I had doubted his reality, questioned his existence and my own experience with him. But, no more! Packed in the trunk of my experience was strong and deep belief in God. I never questioned he was with me through the fire; I simply did not understand the role he played in it. I had much to learn.”

Here is the sentiment as a whole: 

“I had always needed Gene’s reassurance that he loved me. In fact,” she continues, “it had been impossible for him to give me enough love, enough attention, enough assurance, to ease my apprehension.” 

This entire sentiment above can be re-written to simply read: “I needed Gene’s love but made it impossible for him to love me.” 

 “For years before the accident,” recalls Ms Ton, “we had traveled the same route over and over:” Ms. Ton then composes a dialogue between her and her husband (I have highlighted Ms. Ton’s part in this dialogue in bold text while her husband’s part remains in plain text): 

“But honey, you know I love you,” Gene would insist.

“Yes, but…”

“Have I ever given you any reason to doubt that?”

“No, but…”

“Then why can’t you just accept it? I know you love me. I trust you. Why can’t you trust me?”

“I don’t know. I don’t want to feel this way. It’s awful! But I can’t help how I feel.”

Round and round we had gone, with me continually picking open this lone sore spot in our marriage and Gene trying to heal it once and for all.


Something I did not understand was happening inside me. I was walking through an inner fire, and the emotional agony of it was more than any pain I had experienced on January 4. Again late in May I gave way to the unbearable rage I was feeling.

“I can’t handle this,” I told Gene. “It’s too much. I wish I had died. I want only to die.”

Perhaps Gene had had all he could bear, or perhaps he thought I needed a kick in the pants. I don’t know, but his heated retort struck pay dirt. “You didn’t die. You lived. You are alive, whether you want to be or not. You can become bitter and ugly inside or you can fight back. It’s up to you. I can’t help you. I would take it on myself, if I could, but, I can’t. You lived. You are alive…It’s up to you.”

Later that same night I stood looking into the bathroom mirror as I clumsily attempted to brush my teeth. How could I live looking like this? Everything I had absorbed from the world around me told me I was a reject—a deviant, as one medical book stated. To be successful, indeed to be lovable, was synonymous with being beautiful.

But beautiful would never again be used as an adjective to describe my appearance. Indeed, not even pretty. Although my hair was beginning to grow, it still did not camouflage the bald grafted areas or my misshapen ears. The graft across my forehead was yellowish brown. I had not realized before how the color of my own skin varied. On my stomach the skin looked just right. On my face the same skin looked like what it was, a patch. I knew I would have patches under my eyes when surgery was done to release the scar tissue pulling them down. My face, aside from the grafts, was fiery red.

From observing other parts of my body that had been healed longer, I knew that the extreme redness would fade somewhat. But I also knew the telltale scars would always be there. I was filled with the same recurring panic as I faced the mirror and was confronted with the body I was imprisoned in forever. I was ugly. It hurt too much to live.

I was consistently receiving contradictory messages from other people. The strangers I encountered when Gene took me to the clinic were appalled. As I stepped onto an elevator, a heavy silence fell. Even clinic and hospital personnel hushed their friendly chatting to take furtive glances. Once when I stood talking to Ernie in the lobby, a receptionist openly stared the entire time. When I mentioned it to Ernie, he said, “That’s her problem.”

But it wasn’t other people’s problem, it was mine. I had no idea how to cope with being a freak. When I had lost the familiar facial characteristics I had grown so accustomed to, I lost my identity. I felt like a Jane Doe wandering in a vast no-man’s-land. I wondered if this was, in some smaller way, like death when we lose our physical bodies. If it was, and if I really believed there was life beyond death, then I must somehow get in touch with the very essence of me. But how? How was I to grab hold of the reality of me in a world where I was stigmatized?

One is regarded as a “freak” due to the behavior of others.

“How was I to grab hold of the reality of me in a world where I was stigmatized?”


Perhaps I had played that game all through childhood and on into my adult years, packing into my trunk each life experience:  every learning and growth, each decision, insight, and gift. Perhaps, unknown to me, God had joined in the game with me, helping me to pack everything I would need for my present journey out of the fire.

Once during this time I had tried to describe to a friend how I felt. “I loved God and trusted him and gave him the best that I knew and he betrayed me,” I had told her. “He left me hanging on a window ledge screaming for help.”

My friend had sadly shaken her head, and I had known she felt sorry for me. Not so much because I had been badly burned, but because my faith had not been strong enough to carry me through.

That’s where she was wrong! I have never been a pacifist in my relationship to God. Our at-one-ment has been hammered out blow by blow. After I first met him in my teenage years, there were times when I had doubted his reality, questioned his existence and my own experience with him. But, no more! Packed in the trunk of my experience was strong and deep belief in God. I never questioned he was with me through the fire; I simply did not understand the role he played in it. I had much to learn.

I had spent a lot of time looking through photo albums during those early spring days of 1980. It was a heartbreaking experience to see myself as I had been, and yet there was a deep need in me to hang onto that person, too. The visible image had a hypnotic effect. When I looked at my smiling, pretty, blemish-free face, my smooth arms and hands, the rings on my fingers, and my frosted blonde hair, I could almost be that woman again in my mind. Gene had been willing to bring my picture to the hospital and hang it on my bulletin board, but now he was bewildered by my need to haunt the present with the past.

“Put the pictures away, Mary,” he had urged. “Don’t torture yourself this way.” Whenever he found pictures laying out, he carefully picked them up and put them away in a new place.










It struck me that I was doing exactly the same thing using my pictures to hand on to someone who was dead. The lady in those pictures had died in a fire. I had to let her go. Maybe in some deep inner part of me I had known this all along.

Slowly, methodically, crying aloud like a small child, I tore every picture into pieces:  pictures of Gene and me at seventeen and fourteen, when we had first started dating; our wedding pictures; pictures of a young woman with a baby and then two, three, and four little children. Finally there was the twenty-fifth anniversary photo Gene had brought to the hospital and a lovely portrait Gene had had finished after my first book was published. My life history filled half of a large grocery bag, fragments of a woman who had been and was no more.

An image of myself based on the way I used to look, and a self-esteem and confidence grounded on my appearance, was no longer useful to me. My womanliness and sexuality seemed to be bound to this lost image. Before I completely discarded this woman, I knew I needed to work hard to coax these parts of my personality to live in my new, strange body. Without them I had to come to think of myself as an “it.”


There was no great theological revelation in those moments. I learned no new truth about Christian faith. I simply felt the presence of God in a way that for me was quite different than normal.”

I had had a similar experience once before. It was in 1956, when I was twenty-three years old. Gene and I were living in married students’ housing on the Northern Baptist Theological Seminary campus in Chicago. I had just hauled Jill who was one and a bag of clothes down four flights of stairs to the laundry room and back up to our apartment, when the pain came suddenly as I was unlocking the apartment door. I put the baby on the floor and quickly sat down to catch my breath. But it would not be caught! The room, the children, floated in front of me. I found myself doubled up in a ball on the couch, clutching my stomach, observing everything around me as through a bubble of pain.

Then, as abruptly as it had begun, it had stopped. As the day passed, I was certain it could not have been nearly as bad as I imagined at the time. And then it struck again with fierce intensity.


The doctor had suggested a drug to ease my extreme depression. But instead, a furry, little black puppy became my antidepressant. I will never forget the day, later that summer, when Muffie and I were out in the backyard and got caught in a sudden summer shower. It wasn’t until I was in the shelter of the screened-in porch that I suddenly realized I had run. I had actually run across the yard and onto the porch! I laughed for the sheer delight of it.

Little Miss Muffet will never look like a proper schnauzer. When the time came for her to have her ears cropped so they would stand erect like a well-groomed dog of her breed, I didn’t have the heart to do it. My own badly burned ears were still covered with open, seeping places and were unbearably tender just to touch. I couldn’t bring myself to have her little ears cut. So, Muffie’s ears flop, which isn’t proper. But, then, I don’t look proper myself.


But then the prince had problems. I confess I was afraid when the man I married, who always knew just what to do and when to do it, didn’t. He was the strong one, the dependable one, the one who had it all together, the one the kids and I believed could hold all of us up, and himself, too. I didn’t want him to have any problems. I didn’t want him to have any doubts. I didn’t want him to be afraid. It was all right for me; it was all right for the children; but it was not all right for Gene.


When one night as we lay side by side in our bed he had confessed, “Sometimes I feel like a scared little boy. I feel like my whole world is crumbling, “ I didn’t want to hear. My theme song for over twenty-five years of marriage had been, “I am weak, but Gene is strong.” In no way was I prepared to have this role reversed.

When Gene had withdrawn to spend more and more time by himself to search for answers to the questions that burned in his soul, I had thought only of my own exclusion. When he had acted in strange and unfamiliar ways, I panicked. When in response to my incessant barrage of probing questions, he had admitted it was for him a time of doubting his job, his calling, his abilities, and himself, my lines of understanding had been jammed with my own disillusionment.

Had that been the extent of it, I probably would have hung on to at least a part of my dream; but when at last he had told me he doubted his love for me, I had felt the dream shatter. I had done everything wrong. I ranted, raved, argued, cajoled, begged, and pleaded—and at last resorted to throwing stones. I had pelted this beautiful man, who had stood by me through the crisis between Jill and me with love and encouragement, with accusing questions. I had the strength to hurl large rocks:  “What would your former congregations think of you now? What about all your crisis counseling? What did all your sermons mean if they can’t help you? Were they just empty words”

But I had not had the strength to offer him gentleness, patience, or understanding., much less a little acceptance.

I had done a lot of reading during that time. The most helpful book was Men in Mid-Life Crisis by Jim Conway. It had helped me to identify what was in all likelihood happening to Gene at that point in his life and as a result to me. I had also developed a little compassion for friends who no doubt were experiencing the same crisis, though it went unnamed. I had gained some insights into the mysterious nature of men, and, I hoped, some understanding of the problem. But, at that time, I held no understanding for Gene. There had been times when I had reached out, time when my mouth said the right things, but in the end I flunked the course.

We had come into the new year of 1979 with the storm behind us, but had found our lives cluttered by the debris left in the wake.


Sometimes I felt as though I was riding a giant roller coaster. I would reach a peak from where I could look back and see how far I had already come. From up there I could look out on my world and see all the beautiful things far and near. But then with horrible speed, I would careen around a curve and plunge down into a valley. The bottom would drop out of my stomach as I clutched at the safety bar that broke loose in my hands. Cradled in the pit, I could see only the debris-littered ground and the puzzling structure supporting the whole elevated railway. The girders looked cracked and unstable and the long uphill climb ahead looked unmanageable.

In on of those dips, I thought about the day of the fire and wondered where my angel had been. When Shadrach, Meshach, and Abed-nego were thrown in the fiery furnace, God sent his angel to rescue these en who served and trusted him. I had served and trusted God, but where was my angel?

In despair I had cried out, “I hate you, God. I hate you for letting this awful thing happen to me.” The flames of my “why’s” burned my insides.

When I related some of my agony to our friends Larry and Nancy Sayre one summer afternoon, telling them how I had literally screamed at God, Gene quietly said, “God wasn’t threatened.”


Later, it occurred to me to read again how Jesus faced his crucifixion. He wanted to run away, too. He felt betrayed and abandoned exactly as I did. He prayed, “Please, please let this cup pass from me.” And in the heat of his pain he had cried out, “Why… why… why… why have you forsaken me?”


Robert Keck’s book turned into a mirror, reflecting back at me not the ugliness of my body but some images of the person within. I began my own little ritual. Each time I went into the bathroom, I looked into a small mirror hanging on the wall and said, “I am special. I am unique. I am still God’s child. I am loved.” Over and over I repeated the same phrases, sometimes with tears coursing down my cheeks, sometimes with sarcasm. But always I tried to outshout the image in the mirror that taunted me, “Beauty is only skin deep… but ugly goes clear to the bone.”

Slowly I began to reconstruct my OK-ness. It was there in the ashes in my trunk. I first packed it when I worked so hard on my self-image during our crisis with our daughter, Jill. I had taken it out and worn it when my marriage appeared to be threatened, although it didn’t seem to fit very well then. It needed to be restyled now before it could be worn to good advantage again.

I realized how much of my OK-ness had been fashioned out of my good looks and what I was able to do, rather than the fabric of who I was. It was a major job, but I had learned how to make alterations long before the fire.

One day, something blew up out of the ashes quite unexpectedly. Gene and I had contacted Upjohn Healthcare Services again, this time for some homemaker assistance. Keeping up with the housework had become more than Gene could handle, and I was still unable to do very much. So Angie came to help us. That night as Marinel did my dressing change I very solemnly said, “Some people will do anything to get out of doing housework.”

“Mary Ellen,” she said, amazed, “that’s the first time I’ve heard you joke about what’s happened to you.”


I had heard of kids growing too big for their britches, but I had never heard of anyone being to big for his skin. This was precisely what I felt like. It seemed as though my skin had shrunk, and there was no longer enough elasticity to allow me to move about. My arms still wouldn’t hand down at my sides or reach up over my head. Bending over or stooping down was a painful process, which might send me sprawling. My neck wouldn’t turn. My face was so tight that any movement distorted my mouth and eyes. People continued to sympathetically ask, “Are you still in very much pain?”

Rather than crybaby all the time, I stole the perfect response from a television show, “No, only when I am sitting, standing, or lying down!”


Memories of walking down a corridor, heels clicking on the tile, and turning a male head or two. Memories of dressing up for a celebration with Gene and feeling as Maria did when she sang in West Side Story, “I feel pretty. I feel pretty. I feel pretty and witty and wise.” There were memories of swimming and playing volleyball and working all spring to acquire a suntan. And, always, there were the memories of making love.

“I feel pretty and witty and gay.”


From the bottom of a dresser drawer, I resurrected an old copy of the Royal Canadian Air Force’s Guide to Physical Fitness


We all know it’s the inner person that matters…. What we look like outside isn’t important. I had been reminded of that many times by friends and acquaintances. But when the comment was casually made to me one day by an attractive woman as she carefully rearranged a few stray wisps of hair and applied fresh lipstick, I had a strong urge to ask her if she would like to change places with me. I knew she could not have glibly spouted that trite expression if she lived in my skin for even one minute.


“What we do not understand,” says Mary Ellen using the projective “we” to tell us what “we” do and do not understand, “ we tend to ignore.” She goes on to mistake disfigurement with ugliness:  

“We understand little about ugly except that it is bad. From childhood on we read of the ugly stepsisters who are mean and cruel, ugly witches who cast horrible spells on people, and stepmothers who disguise themselves as ugly, old hags as a ploy in their devious plots.” “Makeup artists skillfully apply scars, open wounds, and distorted features on the faces of the ‘bad guys’ in films.” 

“This stigma,” she laments, “is the lot of the disfigured.”  That last sentence explicitly conflates ugliness with disfigurement. Having accomplished this, Ms. Ton then takes the spears and arrows upon herself. “We are,” she writes, “society’s deviants.” 

In the very next sentence, Ms Ton flows right back to writing of “the stigma ugliness” rather than “the stigma of disfigurement” after performing a linguistic feat which seems intended to conflate the two. The level of manipulative content in Ms Ton’s writing reaches heights that would be difficult for even an intelligent manipulator (a Shakespearean creation like Iago, for example) to execute and maintain. This fact alone should indicate the evident fact: Ms. Ton is using language like this because it reflects the way that she thinks and not because she is trying to manipulate anyone. 

“There are exceptions,” continues Ms Ton. She then turns her eye to another evil: it is sexism that is, apparently, to blame now: 

“Under certain circumstances being ugly is OK… if you are a man. Beauty loved the Beast and the beautiful princess did kiss the ugly (male) frog. Is there a fairy tale about a female beast who is loved in spite of her ugliness? And where are the female counterparts to the not-so-attractive actors like Walter Matthau, Humphrey Bogart, and Telly Savalas? We have been so indoctrinated we don’t even think of these men as homely; women think they are “cute.” But their leading ladies are usually younger and always attractive, if not beautiful. Men may be allowed to be homely, even ugly, if they have other compensatory attributes. I saw the movie Elephant Man, but if there are any female ‘elephants,’ I think we will never see them on film.”

“To be deviant (when we think of deviance we mean permanent differences that are never fashionable) in a culture that worships beauty is terribly hurtful; to be deviant and female is to know inexpressible agony. Please don’t tell me to take two aspirins and go to bed.”


“I began to list my assets,” writes Ms Ton later in the book. “My appearance had certainly been one,” she writes (note that she lists her body as an “asset”) “but it was destroyed.”  

She continues with the following self-assesment: 

“There were others that the fire had not touched, or only scorched slightly. I had a great sense of humor. I was sensitive, caring, understanding, forgiving, creative, thoughtful, imaginative, and loving. I was a neat person and fun to be with.”


For months, my response to Gene’s affirmation of his love for me had been a quick, sharp rebuff. Each time he had tried to touch inside me with the words, “I love you, Mary,” I had angrily retorted, “Don’t say that. It just isn’t true and I don’t want to hear it.”

Given that kind of rejection, it is no wonder the words had come less and less frequently. And their scarcity had reinforced what I already believed:  it was impossible for Gene to really love me.

But, that same evening as we drove home from the Janses’, discussing what Mary had told us, Gene tried again. “I really do love you, Mary. I really do.”

“I don’t know how I can believe what isn’t true,” I argued.

“You don’t know what is true for me,” Gene said. “You only assume you know. If you want to know how I feel about something, you need to check it out with me.”

“Do you really love me? I’m so ugly.”

“I really love you.”

“If that’s true, it’s incredible—incredibly wonderful.”

“It’s true babe,” Gene affirmed again, turning to glance briefly into my eyes as he drove.

“Tell me again.”

“I love you,” he laughed.

I let his words wash over me in waves, accepting them without allowing myself any discounting remarks or thoughts. As each wave receded, it carried away some more of the debris littering my beach.

With my opinion of myself slowly growing better, I was able to accept more and more of Gene’s love offerings. At last I could respond to his “I love you” with “I know you do.” He could reach out with embraces and kisses and tenderness because his own fear of rejection was eased. And, of course, the natural result of increased physical touching was bound to reawaken other deeper, quiescent feelings. We journey on toward more complete wholeness in our relationship. There are still unanswered questions, gray days, and frustration, but for any couple to feel they have arrived at their destination in their marriage is a tragic mistake they may soon regret.

Certainly progress was when I could sing to Gene, “Do you love me because I’m beautiful, or am I beautiful because you love me?”


I had already accepted my anger as a useful tool for prodding and pushing me. Now I began to see that my times of despair and depression were not all bad either.


I’m not much of a “pray-er.” I just sort of talk to God as I walk along. So as I discussed with God the amazing truths that had just dawned on me, the conversation went much like this.

“Well, God, I guess it’s just you and me, huh?”


“And, you’re not gonna do it for me, are you?”

“What can I say?”

“I just want to tell you that I don’t like what’s happened to me. I don’t like it one bit. I hate looking like this, and I think I will always hate it. I think I will always mourn what I have lost.”

“I understand; I know what it’s like to be scarred, you know.”

“I know… but I forgot. You really do care about what’s happened to me. You really do understand, don’t you?”

“You’ve known that all along.”

“Yes, I guess I have. But, there is something even more important to me than my scars.”

“I know, Mary Ellen.”

“You do?”

“Yes, but tell me anyway.”

“It’s you, God…. You’re more important to me than those scars, and more than anything else, I want to be your person. I want you to be proud of me.”

“I am.”



“I love you.”

“I know.”


I realized that day that my body had not made me a prisoner. I had chosen my own prison—my house. And I had made Gene a virtual prisoner, too. He just had the privilege of work-release time.


Each time I entered a shopping mall or went to church, I would take a deep breath and say to myself:  “You are a special person. You are a child of God. Gene loves you.”


Then I regained enough courage to march into “Canned Ego,” Lazarus Department Store’s beauty salon. It was a shattering experience.





     “In other parts of the interview, Eric stated that before he was burned, he never looked forward to where he was going, at least, not seriously. He had always looked back, but even then, he never confronted the serious questions that could have been raised. After he left the hospital, he recognized that he was in a “bad situation,” and he also knew that he didn’t want to stay there. So he had to search for answers, he had to search for and take responsibility for his future. He finally had to confront the situation he was in:

Eric:  You’re thinking that people don’t get over the “Why me?”, they’re not willing to look at what’s going on right now. There’s a lot that happens with the acceptance of, “This is who I am, this is the situation I am in.” Most of the problems, people can’t identify that. They’re in their illusionary world of, “This is how I want to be,” and not looking at how it is.

     “ To take responsibility for what his life was going to be, he was forced to recognize his concrete situation, a task that many people, not just burn survivors, find difficult to achieve. Finding out exactly where he was, and who he was (each of which is relative and open to further elaboration and interpretation), is an achievement made over a period of time, through intense introspection, meditation, and therapy, and through periods of doubt, depression, and despair.” 

“Of significance is the fact that the latter experiences, while temporarily painful and probably disabling, were seen by Eric as leading toward his transformation and metamorphosis.”

Here is the next section of the “Q&A”: 

“Q:  This can be very crushing, being forced to examine these issues.

Eric:  If this is how it is, that I chose this, then I can choose something else. People have the ability to direct and control their lives. If they have that they’ve always been out of control and “it’s the world’s fault for me doing this, it’s God’s fault, it’s my parents’ fault for me doing this,” they never accept the fact that, well, they had a part in their life. In fact, they had the main part of choosing some of these things.”

Mr. Stouffer’s “Q” can hardly be said to be a “Q”; where is the question here? There is no question. Mr. Stouffer makes a statement. “This can be very crushing,” he writes with blissful unawareness shining through every word, “being forced to examine these issues.”

On that note, he proceeds to ask his next question: 

“Do you feel you have more control now then you had before?” and not “Do you have more control now than you had before?”

Eric:  I would say that before, I wanted to be out of control. Because I couldn’t control how my parents acted; I couldn’t control what they did to me, how teachers acted toward me, or so I thought. Therefore, I felt like I did not have the control in my life as much as now, because I wasn’t willing to accept the pain that goes with it. Afterwards, I had no way but to accept it:  “Hey man, this is a painful situation.”

“Prior to being burned,” writes Mr Stouffer, “Eric’s life consisted of going to classes in college, working part time, and frequently partying. He had a drinking problem and he was using marijuana. His biggest problem was with alcohol. He had been jailed several times as a minor for being “under the influence.” His father also had a long-term problem with drinking and, for years, this had caused embarrassment for Eric. Family problems often revolved around his father’s drinking. Eric resented what his father’s drinking had done to both him and his family, yet Eric was following in his father’s footsteps.”

Eric is then quoted as follows:  “I was the youngest of four children. My dad had a drinking problem which caused conflict in the family, which was part of the things I wasn’t ready to accept. We never talked about it, never discussed it. It didn’t exist. We had our own lives outside the family and I would exclude everything from coming into the home. I wouldn’t consider bringing anybody over.

And then the embarrassment that would come from that. So a lot of those factors, which were reasons for me to be out [drinking], another good excuse for me to say, ‘Well, at least I’m not as bad as he was.’” 

Mr. Stouffler then asks Eric the following question: “Did you see a relationship there?

To which Eric responds as follows: 

 “No. at that time, he was a good excuse. For me, I think it was an excuse, “Well, even if I do, I’m not as bad as him. Look how much he does.” One of the catch-phrases afterwards, when I was thinking about it, was “Well, I had what?…twenty years to go catch up to be as bad as he was.” And that was kind of the path I was taking. And so [before the burn] the alcohol and the drugs and whatever else was a means of getting away. I didn’t want to be in control. I wanted to be out of control. I was good at turning away emotional pain which hurt, was a matter to be avoided, to be ignored. And then at the time of the burn, it set me down and I had no where to run, but to look inside [my emphasis]. When I looked inside I had some pretty big skeletons, things I didn’t want to admit about myself. Again, “Why me?” might be a result of not accepting responsibility. Why did I do these other things to other people? I had no answers, but it was time for me to look and evaluate myself, what I’ve done, and then try to make amends for that, just to be sorry for the things I did to people.”

“So,” says Mr Stouffer, “you were forced to look at yourself?”

Eric responds with clarity and candor: 

“ Exactly, and there was nowhere to run. I had to sit down, I was like, “Well, regardless of what he did, or anybody else did, what am I?” And that’s pretty much the thing I had to get to. You’re looking at the world. How can the world be happy when I’m in so much pain?”

Mr Stouffler dutifully moves on to his next question. “Before you were burned,” he asks, “did you realize you were in pain?”

Eric’s response deserves commendation and praise. The consistency of his awareness is reason to be hopeful: 

 “That’s part of the problem. It was covered over by activities and drinking and having fun. Yeah…and that manifested in trying show how happy I was:  Look at what a good time I’m having, see? So that was pretty much a result of it. My identity of who I was, I was no longer. So then it was a complete search.

For his part, however, Mr. Stouffer transcribes Eric’s response with assumptions about his thoughts (“his emphasis”) and then, as though the reader needed it, a reminder from Mr. Stouffer of the fact that it was he himself (Mr. Stouffer) who decided to italicize the second emphasis contained in this short sentiment: 

“That’s part of the problem. It was covered over by activities and drinking and having fun. Yeah…and that manifested in trying show [his emphasis] how happy I was:  Look at what a good time I’m having, see? So that was pretty much a result of it. My identity of who I was, I was no longer. So then it was a complete search [my emphasis].

One is grateful here for the presence of an awareness on the part of one member in this conversation; that member, of course, being the young and injured boy who now realizes that he is a man. Eric should be applauded for the courage of facing reality squarely and taking charge of his life. It might be too late for Mr. Stouffer and many others in this chapter to do the same.