Dear David
From: Alan Archibald <alanarchibaldo@gmail.com>
Date: Fri, Dec 13, 2024 at 1:47 PM
Subject: What was happening on your birthday in 1977 at Cook County Hospital, Chicago
To: Kevin A
28 January, day 18 of my internship at Chicago's Cook County Hospital - 6 PM
It looks like before the night is over, I will have my first patient death. I had finished my call night and was ready to go home at the end of my post-call day, which means I had been working for 33 straight hours. As I was leaving, I got a page from Ward 24. I was tempted to just ignore the call because I had signed out and was “off duty.” But, I knew the only patient I had on ward 24 was an old Hispanic steelworker who spoke very little English. I am one of the few people in the hospital who can communicate with him, so I returned the call and went back to see the patient. He has prostate cancer, which has spread to almost every bone in his body. No further treatment available. He’s in severe pain and there’s nothing else to be done other than try to relieve the pain. When I saw him, he had a big bruise on his hip and an obvious bony protrusion. He had no specific history of injury, but his bones were so weakened by tumor that they would break with the slightest stress: a pathologic fracture. I ordered a bedside x-ray to confirm the diagnosis, snowed him with narcotics and called the orthopedic surgery resident. He said there was probably nothing to be done, but that he would look at the x-rays later. A hip fracture, even without cancer, is often a “terminal event” in an old person, and I can’t see this man lasting much longer. I called the family, had a difficult telephone conversation in Spanish, and placed him on the critical list. At least he is “no code blue.” Then, I went home… Ran through a snowstorm all the way. My body now gives me no choice but to sleep.
Alan: Speaking of "snowing patients with narcotics..."
Decades ago, nurse Nancy Hardies told me that it was a "secret" of the medical profession that terminal patients in extreme pain were -- essentially -- euthanized by inserting a bolus of narcotics in the patient's mouth which would slowly dissolve, thus depressing cardiac function until the heart stopped beating. However, since the primary purpose of inserting the bolus was to narcotize the patient's pain, the side effect of "death" was just that - an unintended side effect.
As we "old folk" fall increasingly prey to "the thousand natural shocks that flesh is heir to," I find myself wondering (from time to time) about "The Fermi Paradox," and whether there might be an element of conscious decision in the hypothesized "self-extinction." It is clear to me that "Christian" "conservatives" would rather die than "lose their religion," and so they "unconsciously" constellate events -- like "global warming" and "God-ordained" end-time nuclear conflagration -- to prevent the existential angst that would result from a more clear-minded assessment of humankind's circumstances in light of Reason and Science.
I hasten to add that I can also see how denial and wishful thinking may be successful "survival techniques."
After all, in pre-scientific times, our Irish, English, German, Dutch, Danish, Celtic and Scandinavian ancestors survived enveloping temptations to despair by virtue of "valorizing suffering," bringing into play huge doses of faithfulness to different sources of meaning, including the belief that the suffering of Jesus, the Man-God had elevated the acceptance of painful sacrifices ("offering it up" as was said in our childhood) to a greater, transcendental, mysterious end that would witness "kingdom come" and the apokatastasis in which EVERYTHING - including the conversion of Satan himself - making all things whole and good, and loving and unitary.
As Julian of Norwich put it so beautifully: "And all shall be well, and all shall be well, and all manner of things shall be well." https://en.wikipedia.
- This theory suggests that intelligent civilizations develop the technology to destroy themselves but don't establish the political structures to prevent it.
- This idea suggests that other intelligent civilizations exist, but an unknown event prevents them from surviving long enough to expand beyond their planet.
- This idea suggests that some alien civilizations might become aware of the unsustainability of their growth and choose to transcend it.
- It's too expensive to spread physically throughout the galaxy.
- Earth is intentionally isolated.
- It's dangerous to communicate, so civilizations hide.
I will conclude by pasting a recent writing about the fusion of "God the Father" and "God, the Son."
I suggest that the matrix in which we are embedded has a time-line that goes something like this.
Hamlet, Act III, Scene I [To be, or not to be]
To be, or not to be: that is the question:
Whether 'tis nobler in the mind to suffer
The slings and arrows of outrageous fortune,
Or to take arms against a sea of troubles,
And by opposing end them? To die: to sleep;
No more; and by a sleep to say we end
The heart-ache and the thousand natural shocks
That flesh is heir to, 'tis a consummation
Devoutly to be wish'd. To die, to sleep;
To sleep: perchance to dream: ay, there's the rub;
For in that sleep of death what dreams may come
When we have shuffled off this mortal coil,
Must give us pause: there's the respect
That makes calamity of so long life;
For who would bear the whips and scorns of time,
The oppressor's wrong, the proud man's contumely,
The pangs of despised love, the law's delay,
The insolence of office and the spurns
That patient merit of the unworthy takes,
When he himself might his quietus make
With a bare bodkin? who would fardels bear,
To grunt and sweat under a weary life,
But that the dread of something after death,
The undiscover'd country from whose bourn
No traveller returns, puzzles the will
And makes us rather bear those ills we have
Than fly to others that we know not of?
Thus conscience does make cowards of us all;
And thus the native hue of resolution
Is sicklied o'er with the pale cast of thought,
And enterprises of great pith and moment
With this regard their currents turn awry,
And lose the name of action.—Soft you now!
The fair Ophelia! Nymph, in thy orisons
Be all my sins remember'd.
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