Suffering’s Generous End: From “Veterinary Lessons” to William Cass’s story “Gentle Breezes,” a reflection by poet Jane Desmond

Jane Desmond is a poet and scholar who writes about the intersections between veterinary medicine and human medicine, as well as our relations with non-human animals. Her poem “Veterinary Lessons” appears in the Fall 2019 Intima.

William Cass’s short story, “Gentle Breezes” (Fall 2019 Intima) captured so much complexity in so few words. Casting us into the end stages of the long-term caring done by divorced parents for their severely and chronically ill son, we look back to imagine their twenty years of struggle and their increasing heartbreak as debility encroaches more and more on his quality of life.

Finally, as their son appears to lose nearly all of his abilities to interact with his environment, they meet on a park bench and agree to change their custodial Advanced Care Directive for him to “Do not Resuscitate.” As they sign the papers, the poignant counterpoint to their moment of surrender is a young couple with a newborn strolling by in the park, glowing with new-parent joy and “full of anxious delight and hope” as Cass puts it—for a life yet to unfold.

In my poem in the same Fall 2019 issue, “Veterinary Lessons,” I consider the physical intimacies of palliative care for my rabbit, of providing daily fluid therapy, and the wish that the peaceful end of suffering I know her veterinarian can deliver “when the time comes” would also, someday, be available to me if I too became, like the son in Cass’s story, just a sliver of myself.

Of course, a desire for the availability of assisted suicide in the face of incurable, painful illness, is different than the burden of ending treatment for another—not our self—and different still across species. We have the option to choose euthanasia for a pet, and when we make that choice we do so out of love for our animals, although that doesn’t lessen our grief. The veterinarians know what a struggle this decision is and counsel us to consider “quality of life” in making this choice. They even provide scales for us to use to assess this life, to note activities and pleasures our sick pet still enjoys. How much “quality” is still “enough”? And enough for whom? Many veterinarians fear the client who will “never let go,” subjecting their terminally ill pet to every imaginable treatment no matter how unlikely a cure.

Many physicians too, I imagine, struggle with this issue because for humans we don’t have the transferable concept of actively choosing “a good death” that is available to veterinarians. The closest we come is the “Do Not Resuscitate” order to allow natural processes to take their course without further intervention. The ethical and political quandries of negotiating end-of-life decisions with and for humans are daunting—legally, ethically, and culturally complex. But as we become more and more able to extend human life through dramatic medical interventions, how can we also grapple with the “quality of life” issue in a rigorously ethical way that begins to approach the question of “suffering’s generous end,” as I put it in my poem? Are there “veterinary lessons” worth studying?

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Jane Desmond is a poet and scholar who writes about the intersections between veterinary medicine and human medicine, as well as our relations with non-human animals. A Professor of Anthropology at the University of Illinois at Urbana-Champaign, she also holds an affiliate faculty appointment at the College of Veterinary Medicine, and is the author of several academic books, including “Displaying Death and Animating Life “ (U. of Chicago Press, 2016). Her poetry has appeared in Persimmon Tree in the U.S. and in Words for the Wild in the U.K.

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© 2020 Intima: A Journal of Narrative Medicine

“Daily life is a massacre”: A reflection on “Now and Then,” John Jacobson’s essay about caregiving, by Marilena Vimercati

Marilena Vimercati, author of the research paper "Embraced by Words" (Fall 2019 Intima) with Rossana Di Renzo, lives and works in Milan where she collaborates with ISMU—Initiatives and Studies on Multiethnicity, an independent scientific body—to carry out projects focusing on interaction between migration processes and training paths for professionals.

“Nobody knows our daily life. Daily life is a massacre.” That is what we were told by one of the caregivers we interviewed and the detailed description of that burden is exactly what I found in “Now and Then,” John Jacobson’s Field Notes essay (Fall 2018 Intima). Jacobson, a caregiver who assists his wife Claudia, lives days that are marked exclusively by the care for her: There is no room for his personal life.

He, who had a career for years, now uses vacation days to accompany his wife to the doctor; he, who was always on time at work, now often calls to say he will be late. He does not want to know anything about his friends’ holidays, or their career advancements, or the changes they have made to their homes.

“Meaningful” is what he said when he met a friend recently, who had returned from a holiday in Europe: “While you were away, I emptied bedpans!” As much as he would like Claudia’s help in the kitchen, now he must do everything by himself. (“I both had Claudia and didn’t have her.”)

The weight of now is really palpable in his narrative: Jacobson cannot imagine his future because on the one hand he feels crushed by the duties of everyday life—the same feeling that another caregiver interviewed by us calls ‘roller coaster’— that is a daily life full of tiring climbs, free falls, suspensions, and turns that could lead to derailing if not managed well. On the other hand there is the weight of the loss of what Claudia was and meant to him: “Now I spend too much time counting losses. I remember coming here with Claudia, holding hands as we walked along this path. I feel guilty to say it, but I wished I had someone holding my hand now.”

For Jacobson, as well as for the many caregivers we met, the emotional burden to be a caregiver is so heavy that the future is annihilated by the present. “I don’t want to think about tomorrow. I’m scared of that. My mantra is here and now.”

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Marilena Vimercati, author of "Embraced by Words" (Fall 2019 Intima) with Rossana Di Renzo, lives and works in Milan where collaborates with ISMU – Initiatives and Studies on Multiethnicity—an independent scientific body—to carry out projects focusing on interaction between migration processes and training paths for professionals.

Capturing the Ordinary: Writing about illness and the everyday by Yoshiko Iwai

Yoshiko Iwai is a writer and dancer from Japan, living in New York City. She is a master’s candidate at Columbia University for her MFA in Creative Nonfiction and MS in Narrative Medicine. At Columbia, she is a Chair’s Fellow for the Graduate Writing Program and teaches creative writing in prison facilities as a member of Columbia Artist/Teachers. Her non-fiction essay “The Witness’” appears in the Spring 2019 Intima: A Journal of Narrative Medicine.

I’ve been particularly drawn to illness narratives that capture the unexpected. As modern readers, I think we’ve been primed for—in books, film, music, even commercials and PSAs—certain characteristics in stories about illness. Even in my own writing about parental cancer, I often catch myself invoking similar, predictable images: taut skin, falling hair, brittle frame. I’ve found that one way to capture a different angle of the illness experience is by giving space for ordinary moments, and Steve Street does this well.

In Street’s nonfiction piece “Hey Hey Hey Hey”, he tells the story of his experience with cancer. What strikes me about his writing is the ability to capture the interruptions his illness has on his everyday life—he subverts our expectations.

He writes: “I love everybody now, even when they don’t love me. A guy behind me in the donut shop line, the beleaguered woman who slid over my burrito order for minimum wage—I chirp at them. They both scowl back.” We see, through this scene, with Street’s love for the man behind him in donut line, the subtle and specific way illness creeps into life. We feel his warmth, despite his illness. Later he writes, “I have a million things to do, and one by one, I’m getting them all done: errands, will arrangements, getting a tattoo—small, tasteful, inside left forearm—so the phlebotomists have something to look at when they draw my blood.” I love that tattoo. I love the urgency of this sentence, and of his illness, that manifests in an unexpected way.

In my own short nonfiction essay, “The Witness” I wanted to capture the ordinary. Not being able to go to the theatre to see Harry Potter because the oxygen tank is annoying to lug around, is a real problem. It’s something the doctor or anyone on the caregiving team may not recognize, but it’s still an interruption to life, to something good.

I am interested in finding ways to capture these quirky, sometimes peculiar, but honest moments in illness narratives. And I think reading writers like Street can help us, as readers, see a bigger picture of a person’s experience beyond their physical condition.

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Yoshiko Iwai is a writer and dancer from Japan, living in New York City. She is a master’s candidate at Columbia University for her MFA in Creative Nonfiction and MS in Narrative Medicine. She graduated from the University of Michigan with a BFA in Dance and BS in Neuroscience, and was also an editor/writer for The Michigan Daily. At Michigan, she was the recipient of the Earl V. Moore Award for Excellence in Dance and the Hopwood Nonfiction Award. At Columbia, she is a Chair’s Fellow for the Graduate Writing Program and teaches creative writing in prison facilities as a member of Columbia Artist/Teachers. Her non-fiction essay “The Witness’” appears in the Spring 2019 Intima: A Journal of Narrative Medicine.

©2019 Intima: A Journal of Narrative Medicine