The wounded healer.

The wounded healer. THE WOUNDED HEALERLost in America: A Journey With My FatherBy Sherwin NulandKnopf, 2003. 212pp. $24.00Readers of Sherwin Nuland's creepily powerful How We Die:Reflections on Life's Final Chapter (1994) will have noticed anumber of contradictions, loose ends, and silences in that blend ofvivid popular science and gripping case histories. Nuland claimed hewrote the book "to demythologize de��my��thol��o��gize?tr.v. de��my��thol��o��gized, de��my��thol��o��giz��ing, de��my��thol��o��giz��es1. To rid of mythological elements in order to discover the underlying meaning: the process of dying ... not todepict it as a horror-filled sequence of painful and disgustingdegradations, but to present it in its biological and clinical reality,as seen by those who are witness to it and felt by those who experienceit." But in fact the only myth he systematically demolished was thegenteel fantasy of "death with dignity." With what seemed likeunrelenting animus Animus - ["Constraint-Based Animation: The Implementation of Temporal Constraints in the Animus System", R. Duisberg, PhD Thesis U Washington 1986]. , he kept reminding his audience that 80% of them werelikely to die in the impersonal sterility of a hospital (quite possiblyin the awful high-tech isolation of an ICU ICUintensive care unit. ICUabbr.intensive care unitICUsee intensive care unit.ICU) and that exiting through thevarious "doors of death" (heart attack, stroke, trauma,Alzheimer's, AIDS, cancer, etc.) was often, if not usually,"painful and disgusting." Though not shy of flauntingelsewhere (e.g., in How We Live, 1997) his medical acumen and surgicalgifts, Nuland ended this book with two accounts of his ownwell-intentioned malpractice: when he cruelly extended the lives ofpatients (one of them his brother Harvey) with pointless chemotherapyand other desperate procedures. The brilliant Dr. Nuland, professor ofsurgery at Yale and National Book Award winner, obviously had some majorattitude problems.Despite its supposed pragmatic, objective purpose, How We Dieturned out to be a deeply, if murkily, personal book. Born into a familyof Russian Jewish immigrants in the Bronx, Nuland dismissed hisreligious roots as "the load of emotional detritus detritus/de��tri��tus/ (de-tri��tus) particulate matter produced by or remaining after the wearing away or disintegration of a substance or tissue. de��tri��tusn. pl. I noweuphemistically call my heritage." Though he gave a long, movingaccount of the death of his nonagenarian non��a��ge��nar��i��an?n.A person 90 years old or between 90 and 100 years old.[From Latin nn Bubbeh from a series ofstrokes, he skimmed over the death of his beloved mother from coloncancer (when he was only eleven) and said nothing at all about hisfather. He briefly alluded to the fact that he had been divorced andthat his second wife was a Christian. And, for a final puzzle, hededicated the book to Harvey Nuland and a man named Vittorio Ferrero,both of whom he called "my brothers." Who, one wondered, wasFerrero?All these questions and obscurities have now been cleared up inthis almost unremittingly painful memoir, where Nuland appears not asthe omni-competent, formidably eloquent (How We Die is studded with aptliterary quotations) master physician, but as the bleeding, battered (bydeaths in the family, etc.), guilty, anxiously surviving son of animpossible father, whose journey to di goldene medina led to a lifetimeof misery and heartbreak. While Nuland's career eventually assumedmany of the familiar comforting contours of an American triumph (frompoverty-stricken Shepsel Nudelman to much-feted Dr.-Professor Nuland),it never did, and never could, wholly emerge from beneath thedecades-long shadow cast by the wretched Meyer Nudelman, the ferociouslyirascible i��ras��ci��ble?adj.1. Prone to outbursts of temper; easily angered.2. Characterized by or resulting from anger.[Middle English, from Old French, from Late Latin garment worker, hypersensitive hy��per��sen��si��tiveadj.Responding excessively to the stimulus of a foreign agent, such as an allergen; abnormally sensitive.hy , undemonstrative, ignorant,speaking only Yiddish and incomprehensible broken English, a manbedeviled by fate and a mysterious debilitating de��bil��i��tat��ingadj.Causing a loss of strength or energy.DebilitatingWeakening, or reducing the strength of.Mentioned in: Stress Reduction disease that dragged himto his death after countless agonies, indignities, and operations.Throughout How We Die Nuland gave many broad hints that in becoming adoctor he was trying to play savior to a world racked by the diseasesthat swirled around him when he was growing up. In Lost in America herecords the devastation wrought by those diseases and his often passive,helpless response to them.Nuland begins in medias res [Latin, Into the heart of the subject, without preface or introduction.] with the crippling bouts of depressionthat lasted from his late thirties to his early forties and landed himin a mental hospital for over a year (1973-74). In the course of thiscrisis his wife left him and the medical staff wanted to do a lobotomy lobotomy(lōbŏt`əmē, lə–), surgical procedure for cutting nerve pathways in the frontal lobes of the brain. The operation has been performed on mentally ill patients whose behavioral patterns were not improved by other on him. Only the spirited resistance of a young residentpsychiatrist--Vittorio Ferrero, who became Nuland's lifelong friendand mentor-rescued him and then brought him back from the abyss, mainlythrough twenty sessions of electroshock electroshock/elec��tro��shock/ (-shok) shock produced by applying electric current to the brain. e��lec��tro��shockn.See electroconvulsive therapy.v. .All this ties in with his father because, as Nuland sees it, thekey to his depression was the "dark, enfeebling en��fee��ble?tr.v. en��fee��bled, en��fee��bling, en��fee��blesTo deprive of strength; make feeble.en��feeble��ment n. seduction to makemyself what he [Meyer] was." What right did he have to escape themaw of debilitation debilitationbeing in a state of debility. and death that swallowed up his father? But escapehe did, though he still has occasional afterclaps of his illness. In anyevent the mostly tragic memory of his father will never let go.Meyer Nudelman's story could be crudely summarized as anon-stop run of very bad luck. Born in the Bessarabian shtetl shtetlany small-town Jewish settlement in East Europe. [Jewish Hist.: Wigoder, 552]See : Rusticity ofNovoselitz, he apparently quarreled with his family there. He came toAmerica on his own in his late teens (1907). He later learned thateveryone in Novoselitz had been machine-gunned by the Nazis. Neversuccessful at anything he tried, he eked out a hand-to-mouth existence,often helped by cash from relatives or landsleit--which he bitterlyresented. His wife's family couldn't stand him; he lost hisfirst son to pneumonia at the age of three. His Judaism was a matter ofgrinding obligations, and it brought him no visible consolation.Finally, and worst of all, after what must have been a thoughtlessone-time dalliance or visit to a brothel he contracted syphilis, whichtook almost a half-century to kill him as it inexorably wrecked his bodyand mind.Nuland didn't discover the true cause of his father'sstaggers, shakes, kidney stones, infections, loss of bladder control,"lightning pains," moodiness, and violent outbursts until hewas a first-year medical student at Yale. (Meyer himself and Harveynever learned the truth.) By then he had already endured and hated hisfather's weird behavior for all his conscious life. He had oftendone dutiful service to Meyer, had visited him constantly in thehospital and helped him year after year to negotiate the treacherouswintry streets between the 183rd St. IND subway stop and his apartmenton Morris Avenue. But he had always been deeply ashamed of his father.He had fought the old man's bossiness; and on one harrowingoccasion he had flatly refused to enter a movie house his father had allbut crawled to because he had already seen the show. "Pliz,Sheppy," Meyer begged, "I eskink you pliz. So fah fahNounMusic (in tonic sol-fa) the fourth note of any ascending major scale we cumminkand voz fa me hodt. Pliz dun't be lak det." In a fit ofgratuitous sadism, "Sheppy" wheeled around and pulled Meyerback home through the snow.And so it went, year after year. Nuland had his share oflife-threatening experiences: from sticking his father's watchchain into an electrical outlet, from diphtheria diphtheria(dĭfthēr`ēə), acute contagious disease caused by Corynebacterium diphtheriae (Klebs-Loffler bacillus) bacteria that have been infected by a bacteriophage. It begins as a soreness of the throat with fever. and an ingestedfishbone. Apart from that, however, he went from strength to strength,culminating in his being chosen as one of the two chief surgicalresidents at Yale Medical School. But, for all his intelligence andcharm, Nuland failed to appreciate either the depths of hisfather's travail TRAVAIL. The act of child-bearing. 2. A woman is said to be in her travail from the time the pains of child-bearing commence until her delivery. 5 Pick. 63; 6 Greenl. R. 460. 3. or the fact that nakhes over his youngerson's achievements was about the only good thing in his nightmarishlife. (In a miracle of perfect timing Nuland brought the news of hiscoup at Yale to his father on what proved to be Meyer's deathbed inMontefiore Hospital.)The secret, then, that readers of How We Die never could haveguessed was the complex layers of what Nuland almost mockingly called"my heritage." That legacy, it develops, included fluency inYiddish and much deeper attachment to Jewish ways than one might haveimagined in the man who described himself as a "confirmedskeptic." Nuland now tells us that he kept kosher until his senioryear in medical school, that even then he continued to don his tallitand read the Shabbes service in his dorm room. He and his brother did,to be sure, change their names (just as he was finishing high school),in an archetypal desire to flee both their embarrassing past andanti-Semitic bias. But now in his own old age, "on every RoshHashanah and Yom Kippur morning" Nuland continues to remind hischildren of "the dread, awe-inspiring prayer (the Untaneh Tokef) that is about to be recited on that solemn day of divine judgment and atonement for sin. I do it as a kind of memorial to my father, because he would invariably poke me in the side at that dramatic point in the service, to be sure that I was aware of its towering significance in the life of every Jew."Lest that sound like Fiddler on the Roof sentimentalism sen��ti��men��tal��ism?n.1. A predilection for the sentimental.2. An idea or expression marked by excessive sentiment.sen , it has tobe noted that Nuland also compares the solemn prayer to "the songof the Lorelei, trying to lure me back to the destructive reefs ofobsessional thinking, guilt, and depression." But at the same timehe insists that, "Formalized religion, formalized prayer,formalized observance--they are all part of the heritage of my family,and I cherish the sustenance they give me. More than cherish--I needit." Sustenance? Cherish? Need? Go figure. Is this the same man whowrote in How We Die, "Nothing would please me more than proof ofHis [God's] existence, and of a blissful afterlife, too.Unfortunately, I see no evidence for it in the near-deathexperience"? Or anywhere else, he might have added.The explanation is, of course, a simple one. Nuland was, andcontinues to be, forever bound to everything his father stood for,including, however tenuously, Judaism: As a child in the synagogue on Yom Kippur, I would stand alongside my father in tremulous awe as we intoned the ancient formula before the heavenly decision is made as to who shall be at peace and who shall be tormented. But penitence, prayer and good deeds can avert the security of the decree. The Hebrew word translated in the prayerbook as "penitence" is tschuvah, whose literal meaning is "return." I have owed Meyer Nudelman recompense for the ravages inflicted on his years, and for my inability to perceive his unhappiness. It is by returning to memory and to my father that I have sought to comprehend my own severe decree against myself, the guilt and sickness whose ravages are not to be forgotten. My quest has been to perceive what he really was.So there can be no tidy conclusion here, no--the inevitablepsychobabble psy��cho��bab��blen.Psychological jargon, especially that of psychotherapy. cliche--closure. Nuland is too honest and too faithful tohis father's and his own unredeemed experience for that. Andhonesty is a crucial element in Nuland's riveting narrative. Hestops at nothing: he admits that he never took his father seriously,that starting in his sophomore year in high school year in high schoolhe wanted Meyer to die; that for years his father lived in the sameapartment with his wife's mother and sister Rose, but never spoketo them or looked them in the eye; that Meyer was in many ways an awfulhusband to Vitsche: joyless joy��less?adj.Cheerless; dismal.joyless��ly adv.joy , domineering dom��i��neer��ing?adj.Tending to domineer; overbearing.domi��neer , emotionally tongue-tied (asidefrom passing on his syphilis to her); that as a young boy Shep wasbothered by the stench, first of the menstrual pads soaked inVitsche's infected blood, but then for years on end of the ragsthat Meyer wore beneath his trousers to stanch stanch?1? also staunchtr.v. stanched also staunched, stanch��ing also staunch��ing, stanch��es also staunch��es1. To stop or check the flow of (blood or tears, for example).2. his incontinent in��con��ti��nentadj.1. Lacking normal voluntary control of excretory functions.2. Lacking sexual restraint; unchaste. bladder.Everything at 2314 Morris Avenue may not have been awful (Meyer managedto say to Vitsche--and his son managed to hear him say it--when X-raytreatments made her hair fall out and she asked, "How can you stillcare for me?" "It was not for your hair that I fell in lovewith you"), but the texture and tenor of the lives recorded hereare almost unremittingly grim.Still, bleakness, however truthful, hardly guarantees a greatstory. What puts Lost in America in the same class as EdmundGosse's Father and Son (1907) and Philip Roth's Patrimony PATRIMONY. Patrimony is sometimes understood to mean all kinds of property but its more limited signification, includes only such estate, as has descended in the same family and in a still more confined sense, it is only that which has descended or been devised in a direct line from the (1991) is the astonishing a��ston��ish?tr.v. as��ton��ished, as��ton��ish��ing, as��ton��ish��esTo fill with sudden wonder or amazement. See Synonyms at surprise. detail and (mostly frustrated) tenderness ofhis memory. In How We Die Nuland claimed to have an eidetic memory; andhis ability here to reconstruct snippets of conversation, vanishedscenes and topography from his boyhood (e.g., parts of the Bronx thathave long since been urban-renewed out of existence) seems to back thatclaim up. Yet when he comes up against blank spots (who was thatterrifying ter��ri��fy?tr.v. ter��ri��fied, ter��ri��fy��ing, ter��ri��fies1. To fill with terror; make deeply afraid. See Synonyms at frighten.2. To menace or threaten; intimidate. wild drunk who came pounding on the apartment door in themiddle of one night when his father was away?), he leaves them blank--asunknowable un��know��a��ble?adj.Impossible to know, especially being beyond the range of human experience or understanding: the unknowable mysteries of life. as Meyer's life in Novoselitz.The picture that emerges is heartbreaking: of unfulfilled energies(beautiful Aunt Rose, slaving away forever at a sewing machine), ofinnocent mistakes (Harvey never recovering from the excessive bed restand massive overfeeding overfeeding,n feeding behavior in which infants and children are given more food than they can optimally digest. Not as common in breastfed infants, because a mother's milk production is limited naturally. he was subjected to after contracting rheumaticfever), of lives crushed by circumstance (Nuland's dead brotherMaischl, by all accounts a marvelous child). Now happily married to aGentile (In How We Die Nuland talks positively about "Sarah'stradition" and quotes St. Paul's encomium en��co��mi��um?n. pl. en��co��mi��ums or en��co��mi��a1. Warm, glowing praise.2. A formal expression of praise; a tribute. to love from 1Corinthians) and lionized by Gentiles, Nuland still can't forgetthe jeers jeer?v. jeered, jeer��ing, jeersv.intr.To speak or shout derisively; mock.v.tr.To abuse vocally; taunt: jeered the speaker off the stage. and raw hatred the faced the day in the late 1930's whenhe walked through an Irish neighborhood with his father and other Jewsfrom his congregation en route to perform the ritual of Tashlich atPugsley's Creek.Americans, especially believers, like to think that, as in"Amazing Grace," the lost will be found and the wounded willbe healed. The beauty of Nuland's book is the way, at oncepassionate and sober, it presents the commonplace tragedy of theirrecoverably lost and the incurably wounded.