My patient was in his mid-eighties, mentally sharp like a jaguar, with the mouth of a Navy sailor (though he was Army), and the optimism of a Mother Theresa with none of the requisite morality.
He captivated, with his stories, me and the patient in the bed next to him. An hour-and-a-half had passed, an absurd amount of time for a daily SOAP note interview, but I just couldn’t leave. The stories kept coming and I was enraptured. Moonshining with his uncles in the countryside. Speeding drunk down the highway with his college friends in a brand new car – back in the day anyway. Exploring new cities without money on the Pacific Coast in his twenties. He was some Kerouac creature – the same amoral solipsism, the same inwardly focused joy that seems un-empathic only because it cannot see anyone else but itself.
I couldn’t help but ask it. He had done so many things, some crazy things, that surely must have been wrong. He had been imperfect. He had hurt others. And other times he had brought them great joy.
“Do you have any regrets?”
He grew quiet at that one. Stroked his chin thoughtfully with his thumb. And then he got that lopsided, manic smile of his, looked me right in the eye – this man who had fought off cancer for fifteen years, FIFTEEN WHOLE YEARS – and said, “No way. I’ve lived a craaaaazy life. Damn, it makes a good story.”
A good story. I’ll never forget that.
A month or so ago, I read an essay in the New Yorker titled “Shut Up and Sit Down,” which discussed, and I quote, the “lionization of leadership.” You’re probably thinking that’s a gross and pretentious phrase - and you’d be right. But it is talking about a deeply American, a deeply human mythology, that the historical movements, successes, and failures, of corporations, nations, political movements… they always are credited to some sort of leader. In the article, there is evidence that is put forth which suggested leaders often have very little role in how organizations or nations perform. But we credit people with changing the entire course of history. In some ways, this is a fact. Singular people have had huge effects on the forward track of history. One need only think of Einstein or Issac Newton.
But in some ways, it is the opposite. It is a human way to deal with extremely complex phenomena and systems. Leaders, the article suggests, are not so much extraordinary people as NARRATIVE DEVICES. They allow us to construct stories around information that would otherwise be hard to grapple with. Some historians do something similar in their history-writing, explaining, say, WHY the civil war happened, WHAT led to the racial tensions in 21st century America, WHO was responsible for apartheid in South Africa.
At the end of the day though, their explanation is nothing more than a story. It appropriates fact, but is not, in and of itself, ‘true.’
As is known by many neuroscience geeks, in certain patients with refractory epilepsy – severe seizures which cannot be controlled by medical therapy – we consider a procedure called a corpus callosotomy. This involves cutting the corpus callosum, the major highway of nerves that connects the two halves of the brain – right and left – so that they can no longer communicate information. The theory is that seizures begin in a small area and then spread outwardly, until in some people they grow to involve the whole brain. If you sever the corpus callosum, the electrical activity may spread to involve the entire right or left hemisphere, but it will not cross and spread to the OPPOSITE hemisphere. Only half the brain will seize at any given time.
Two researchers, Robert Sperry and Michael Gazzaniga, studied these so-called ‘split-brain’ patients to see if they could learn more about the function of the human brain. The most interesting study to me was an image-presentation test. They would present an image of, let’s say, a rooster, on the patient’s left so that only the RIGHT side of the brain would see the image. The left side of the brain would have no information about what was seen. NONE.
When asked what image they saw, the patients would say they didn’t see anything at all. But when the patients were given a pen in their left hand (controlled by the RIGHT brain) and instructed to draw what they had seen, they would draw, without fail, a rooster.
But wait, didn’t they say they HADN’T seen any image? The study gets even more curious. When asked why they drew the rooster, they would say things such as, “Well, the walls in the entryway to this building are red, which made me think of a barn, so I drew a rooster.” And they would earnestly believe these explanations for their behavior. Their left brain, after all, had not “SEEN” the rooster in any literal sense, but it still had to explain its behavior.
The researchers conclusion, a bit more philosophical than scientific, was that humans have an innate need to tell stories. We take all the information we see, and when we can’t explain it, we make it up. Gazzaniga proposed a further extension, which is a bit more controversial. He thinks consciousness is nothing more than this narrative function in action. He thinks the brain executes a behavior and then the left brain comes up with an “explanation” for what we did and why we did it. But in reality, our consciousness never does anything. It just explains why the brain did what it did.
To him, we are nothing more than elaborate liars telling fantastical, completely absurd stories.
I once tried a thought experiment with a friend of mine, which I’ve since repeated many times (it has been borrowed since by a friend for AmeriCorp training sessions). The premise is this: “It’s 15 years in the future. You come home from a long, long day at work. You open the door and… Describe everything you see and everything you do, in as much sensory detail as possible.”
Why 15 years? It’s a time frame after which most people, at least younger individual, think they will “have it made.” They’ll have “figured it out” and achieved that level of comfort we’ve always, somewhere, desired. The long day of work means one is too depleted for pretense. It creates a more vulnerable place and scene.
No matter how well I think I know my friends, the answers almost always shock me. There can alternately be silence or noise. Conversation or action. Objects are described in words of comfort – soft, silky sounds and scenes – or clarity – clean, objective, lined, firm. It is a way of taking something personal and hard to convey – values – and making them clear. What you’ll often find is that previously incongruous elements of a person’s actions, such as why she always tries to date “those guys,” or why he always has those “strange hobbies,” or how someone so loud and extroverted seems drawn to the most humble of people… You see it.
In that story they tell about an unreal future, you realize that most of the time people make choices with reference to that story. That narrative. That vision of a worldview and set of values and a dreamscape 15 years in the future, and everything we do is trapped, guided, informed by that vision.
It’s as if we were nothing more than people responding to this fairy tale that had consumed our mind and we could not escape.
A few years ago, I read a novel, ‘Gilead,’ in which Marilynne Robinson, author and self-proclaimed atheist, writes from the perspective of John Ames, a 76-year-old preacher in rural Gilead, Iowa. In the story, Ames has a son late, in his old age, and knows his boy is too young to remember him when he dies. The entire book is a confession, a lesson, a letter, written from a dying man to a son who will never know him. And it is one of the most beautiful novels I have ever read.
There is one passage though that struck me, one that I have never forgotten. Near the end of the novel, Ames talks about one of his favorite theologians, maybe Bonheoffer – I am paraphrasing from memory here, and thus imperfectly – but he states that there’s this passage in one of his theological works where he proposes that God is a member of an audience and all of us are actors on a stage. And thus – and this is the beautiful part to me – God’s judgment of man is aesthetic rather than morally judgmental.
Aesthetic… As if our lives didn’t have to be perfect, they only had to be beautiful, beautiful art. And all the joy and all the sadness and all the sin – it was all just part of the performance.
Just a beautiful story.
Two summers ago, I backpacked Europe alone. Naturally, I kept a journal during the process. On re-reading it, which I’ve done many times, I'm struck by the same themes I often write about now – direction, identity, my place in a world where one can be both famous and anonymous and alone, why I have these needs to fulfill certain benchmarks, certain projects, certain…
So I wrote about these things quite a bit. Yet, it wasn’t until the end, while sitting in a rainy airport in Limerick, waiting for my return flight, that I wrote these words, which I paraphrase here: “I think I get it now. I’m not looking for this job, or those friends, or that relationship in and of themselves. I want them because having them will prove that the things I desperately want to be true about the world are possible. It’s not about me or some job or some guy to date – it’s about saving a worldview.”
And maybe it is. Maybe my whole life story and all my actions are drawn around this one simple, human need. Not only to tell, but to BELIEVE a story, a story about myself and this world and…
Just some deep desire to create something beautiful.
I hear my patient’s words.
“I’ve lived a craaaaazy life. Damn, it makes a good story.”
Internal medicine resident at NYU in New York City with an interest in heme / oncology (cancer care).