A Bookseller Reads a Magazine

[Images unrelated to today's text]

Part I. A Dark Vision!

I’d slipped a slim, aged paperback into my bag before leaving the bookstore that day, but once home a magazine on the table caught my eye. Amazingly — because while I do read a magazine from time to time, it’s as likely to be two or three years old as the book in my bag is to have been published in some long-ago decade — this issue of The Atlantic was current, and the cover story, “What Jeff Bezos Wants,” dark matter with an insulting, impersonal gravity, pulled me into its force field.

Be it here recognized by all my half-dozen readers that when it comes to online shopping, RESIST! is my middle name. That the online behemoth cannot count my household among its far-flung dominion of eager, satisfied vassals. That unsolicited e-mails from the behemoth’s robots are not simply transferred to the very ordinary virtual wastebasket labeled TRASH in my mail program but summarily relegated to the JUNK! file. 

Such is my storm-battered position on a shrinking island which I hold and defend with my very life. Thank heaven the Artist is right there with me! We have chosen to live in the slow lane.

But now I read on. Does anything in the article surprise me? Statistics of the corporation’s market share, internal memos and “Leadership Principles,” punishment of sellers who do not bow to its will, the fact that it pays no federal tax? Infuriating but not either unknown or unsuspected. Thinking of the Pentagon storing all its files in the behemoth’s cloud is alarming in a surreal, nightmarish, downright dystopian way but hardly astonishing. 

For me, though, writer Franklin Foer hits pay dirt when he reveals the ultimate Bezos goal, which is nothing less than the colonization of outer space, made necessary by the ruin and despoliation of earth, that ruin hastened by the glorious, unbounded consumerism encouraged by none other than the behemoth itself. Because, as we all know, earth and its resources are not boundless. Bezos, no fool, recognizes the fact. And so world domination is for him only an intermediate challenge.

Oh, on and on it goes, but read it for yourself: The Atlantic, November 2019, Vol. 324, no. 5, the Tech Issue. Or here it is in paperless form. 

And if steam isn’t coming out of your ears yet, take a look at what this kind of retail does to communities. Yep, huge tax abatements — huge community investments in infrastructure — thousands of tractor trailers a day — roads the towns can’t afford to maintain — millions of dollars of community debt — temp jobs with no security or benefits — until robots replace even the human temp workers. Ask yourself: Do you want to invest in this kind of future? Because our choices will decide the planet's future.

Intermission

That long magazine article brought painful thoughts and memories to mind, but we were meeting friends in town for dinner, so retreating into gloom was not an option. And as we drove through the darkness, my mental clouds lifted. We’re alive. We’re together. We’re here now. Which served as a reminder that everything is temporary and all lives mortal. 

Part II. A Lighter Side

Back home again, later that same evening, I picked up the magazine again and turned to a different article, this time an interview/sketch with and about children’s book author Sandra Boynton, “The Bard of Bedtime.” I’d vaguely heard of Sandra Boynton before but had never focused on her work. Now, however, I learn that she was a student of Maurice Sendak, and I am intrigued. Says the writer of the article, “Boynton’s books oscillate between orders and disarray, wisdom and nonsense.” Boynton addresses her youngest pre-reader children with respect and is not afraid to use a word like “intone” in her minimalist text. She makes every syllable count. Her animals are really people, and not all people or even all kids are the same. 

I read on and on, carefully, skipping not a single word, and long before I reach the end of the article I have resolved to order Sandra Boynton board books the very next day, feeling much better and also feeling confident that I will have appreciative customers for these books in Northport. I can make small contributions in my little world, and this is where I need to put my mental energy.

Intermission

I don’t have anything special to say here but for consistency’s sake another break seemed indicated. Take a deep breath. Look around. What do you think so far? You don’t need to tell me. 

Part III. Everything Ends

The final piece I read in the magazine that night, three narrow columns in length and taking up less than a single page, was about endings, echoing my thoughts up in that first intermission. It was Ben Healy’s “Study of Studies” feature, this one titled “All Good Things …” Yes, all things will come to an end, but “even endings may be better than expected,” Healy finds, and that’s a good reminder, too. Maybe for some among us it’s even more than a reminder. More like a novel insight, one we need to reflect on for a while. 

In the old days, wars used to end, and that was a good thing -- wars ending. I am still curious and still learning but no longer have an obligation to spend my days in a classroom, and I feel good about that. All men are mortal. Socrates was mortal. Socrates died. The biggest ego, the loudest voice, the richest man on earth — all are mortal. As am I. As are you. 

My question (again) is, when our lives end, what kind of world do we want to leave behind?

I could say much more about endings as they relate to books and bookstores and all kinds of businesses, but right now I feel the end of this post approaching. Ah! Here it is! What a relief!

The Perfect Moment Is a Soap Bubble

A year has gone by already!

Our little great-grandsons are normal, healthy, active children and love to run after soap bubbles floating on the breeze. This photo, though, is over a year old. The bubbles in the picture are long gone, the boys much grown, talking up a storm, running even faster this year.

Like the realization of happiness, the experience of perfection is ephemeral but no less precious for its will-o’-the-wisp nature. I started thinking about this in the wee hours of the morning, lying awake listening to my partner, the Artist, breathing regularly in his sleep beside me and our dog, our darling old Sarah, breathing quietly on the floor next to our bed, all of us alive and safe and together in the dark. We are aging, all three of us but Sarah fastest of all (although we assume she is oblivious to the fact), and so awareness of our time together is a frequent topic of conversation these days. On Labor Day, I gave Sarah a bath, then washed my hair, and afterward the two of us (dog and I) spent much of the remaining afternoon outdoors, relaxing in the sun while the Artist worked nearby and came and went. The warmth and light of the day were like a benediction. Later the whole pack rode in the car up to Christmas Cove to watch Lake Michigan waves crash against the shore. 

Day arrives

Waves crash

Day departs

There have been many lovely moments in recent months, many light-filled, memorable, heart-stopping scenes along life’s way. There was that sandhill crane on the back road one morning and what was probably a once-in-a-lifetime sighting of a fisher right in my own yard. There were wonderful hours of wandering back roads of woods and waters in Barry County with my son last spring. The annual but never dull parade of flowers from trillium and marsh marigold to Joe-Pyeweed and goldenrod. Sunrises, sunsets, clouds, precious visits to mares with this year’s adorable foals, peaceful evenings on the porch, and the sight of a late friend’s face in her daughter’s smile. 

Whenever I’m driving to Northport or home at the end of the day, my mind is usually perusing a mental calendar and working down a lengthy to-do list. When I stop, however, and turn off the engine and get out of the car, if only long enough to frame one particular photograph but especially when Sarah and I can take our time, if only for ten minutes of rambling, then my breath slows and deepens, my mind clears, and my senses awake to the nuances of my surroundings. 

Nothing lasts forever

As I reflect on moments of awareness and happiness, I continue to think also of the nature of the soap bubble. The way it drifts and wobbles and catches the light and lets us see the world through it. The way we can sometimes let one alight on our skin for a moment or two. The inevitable pop! If you are the kind of person who wants all the scientific facts, you may want to follow this link and read about evaporation and surface tension. If you’re more like me and see metaphors everywhere you look, you will simply rejoice in the fragile, momentary loveliness, maybe sigh over its disappearance but, still, be glad you were there to see it, very glad you had your eyes open.

Book Review: BEING MORTAL

Being Mortal:

Medicine and What Matters in the End

by Atul Gawande

NY: Henry Holt/Metropolitan, 2014

Hardcover, $24

I learned about a lot of things in medical school, but mortality wasn’t one of them. ... Our textbooks had almost nothing on aging or frailty or dying. How the process unfolds, how people experience the end of their lives, and how it affects those around them seemed beside the point. The way we saw it, and the way our professors saw it, the purpose of medical schooling was to teach how to save lives, not how to tend to their demise.

So begins Gawande’s latest book, important and well worth reading, as his writing always is, and particularly relevant to individuals in what the French call the “third age” of life (think of the riddle of the sphinx) and those who are or soon will be caring more and more for that generation as time brings about the inevitable.

Every doctor, every nurse, sooner or later must confront death, but Gawande notes that until recently few in modern medicine were given tools to deal with the situation. Instead, American medical training has focuses on testing, recording, gathering facts, prescribing drugs, and offering patients an increasing number of choices among an array of procedures with hoped-for but unclear outcomes. Death was the elephant in the living room, the one everyone knew was there but no one wanted to mention.

Medical costs in the final year of life are astronomical, as everyone knows but equally unfortunate (perhaps worse), Gawande believes, is the harm inflicted when people are “denied ... the basic comforts they most need.” And “basic comforts,” it turns out, are more than food and shelter and safety.

The most frequent complaint Gawande hears from nursing home patients is, “It just isn’t home.” However homelike in appearance (appearances often geared to appeal to residents’ adult children rather than residents themselves), in most facilities designed for care of the frail elderly, residents lack the privacy and autonomy most of us take for granted all our lives.

Gawande traces the history of the “assisted living” movement from its origin in the vision of a West Virginia coal miner’s daughter. When Keren Brown Wilson’s mother, Jessie, needed help with the basic tasks of living, there was nowhere for her to go but a nursing home. The daughter, a college student at the time, never got over her mother’s frequent plea, “Take me home,” and because of those pleas, Keren Wilson developed an interest in issues related to aging and eventually earned a doctorate in gerontology. What her mother had in mind for “home” was not a place designed for her health and safety (placement considerations important to most children of the elderly) but a place where she could be herself again, not a patient, but Jessie the person. Dr. Wilson wrote a paper to outline what such a place might look like.

The key word in her mind was home. Home is the one place where your own priorities hold sway. At home, you decide how you spend your time, how you share your space, and how you manage your possessions. Away from home, you don’t.

For a variety of reasons, Wilson’s original idea became diluted beyond recognition as “assisted living” facilities popped up all over the country, but Gawande visits and describes a few places where privacy and autonomy, key to Wilson’s original vision (rather than regimentation) are the rule.

Paramount at every stage of aging, whether or not it involves terminal illness, is “how to make life worth living when we’re weak and frail and can’t fend for ourselves....” What makes life worth living will vary from one individual to another, and the point of the “hard conversations” with family members and medical staff is to determine, in each case, what makes life worth living to this particular individual. For one man, being able to eat chocolate ice cream and watch sports on television was enough. “My dad,” Gawande tells us, in one of the passages focusing on his own experience with his frail, aging surgeon father, “didn’t think that would be good enough for him at all.”

Not surprisingly, there is a lot in Being Mortal about hospice and palliative care. The idea of offering “concurrent care” actually came from an insurance company. Instead of having to choose between hospice and other treatments, policyholders with less than a one-year life expectancy could continue their regular treatment and receive hospice care. Since they did not have to give up anything, enrollment in hospice jumped from 26 to 70 percent. More surprising were some of the other results:

They visited the emergency room half as often as the control patients did. Their use of hospitals and ICUs dropped by more than two-thirds. Overall costs fell by almost a quarter.

Gawande cites a 2010 study from Massachusetts General in which patients with stage IV lung cancer were randomly assigned to two different groups.

Half received usual oncology care. The other half received usual oncology care plus parallel visits with a palliative care specialist ... The result: those who saw a palliative care specialist stopped chemotherapy sooner, entered hospice far earlier, experienced less suffering at the end of their lives—and they lived 25 percent longer.

In other words, not only was it cheaper to add hospice care to other treatments, but terminally ill patients lived longer, had fewer emergency incidents, and their quality of life was higher. Gawande attributes much of the difference to the open conversations that hospice encourages and the focus of its staff on the person and his or her individual values and goals rather than on hope for recovery.

Conversations about end-of-life choices, he admits, are not easy. They take time and may “unleash difficult emotions” for all involved. In the end, however, they can make all the difference. The battle analogy he uses to make his point comes from the 19th century and pulls no punches:

Death is the enemy. But death has superior forces. Eventually, it wins. And in a war that you cannot win, you don’t want a general who fights to the point of total annihilation. You don’t want Custer. You want Robert E. Lee, someone who knows how to fight for territory that can be won and how to surrender when it can’t, someone who understands that the damage is greatest of all if all you do is battle to the bitter end.

The author of Being Mortal shares with readers not only his medical experience and the fruits of his research into how society deals with aging and dying, but also his own personal story, that of a loving son distressed to see his father losing ground.

My only wish – I will not call it a complaint – is that an index would have been helpful. I highly recommend this book.