In November of 2004, when I visited the psychiatrist in Yarmouth, he came into the waiting room, where I was waiting alone, looked around, and said “You’re not Bogart.”
I might have conceded sharply, “Then it’s worse than I thought.” But I didn’t have the nerve.
I’m not sure what he expected me to look like, based on what little he knew of me. (That my wife is a doctor, for one). Should I suffer more elegantly? More perversely?
Settling into our business, I dutifully and truthfully described my desire “to disappear”. He dutifully noted it, gave me seven days of Lexapro and collected a hefty check.
At first I was pleased to be invited back. Soon after, recalling our forced rapport, I canceled.
That was how I was first diagnosed with depression.
My depression of “disappearing” was a stultifying, languishing depression. I seemed incapable of hunger or desire, and turned to the idea of death with only faint and passing interest.
With anti-depressant medication I recovered a functioning baseline depression: a familiar mix of regret for the past, and doubt of the future, stiffened with the occasional fantasy of oversized achievement.
There were times when regret itself was too fine an emotion to penetrate the shell of my deep despair, driven by instinct, by a perversion of lust to self-consumption; when it was not in me, or me, but I was in it.
On rare occasions I settled into a calm, reflective and somber mood. I have felt, at such times, that I “was myself”, and though I doubted the coarse assertion that “Life Is Good”, I thought the mood might well remain after guilt, regret, fear and anger were subtracted from its weight.
In the months before my diagnosis, my depression assumed yet another form: a confusion and unsteadiness of both mind and body. Indefinite illness seemed to be gnawing at the very basis of everyday experience.
It’s fair to say, nearly two years after brain surgery and a terminal cancer diagnosis, that my life and my depression continue to change. Early in my recovery, as I emerged from the fog of pain and considered the future, I was struck by the harrowing proximity of death. I felt ill-equipped to live happily or even sanely in its shadow.
It seemed almost unjust that from a place of safety and repose I would see the inevitable, final end of my life approaching on the heels of a year. I felt an unsettling, almost convulsive kind of fear, as if dangling above a canyon: a very primal fear of death, fear in its raw substance, though in doses shy of panic.
And yet I felt my fear maturing as I lived with it. The savoring of life’s moments which was at first a forlorn grasping of vapor became an experience not withheld from death but informed by it. Somehow the vastness of time itself, which in adolescence had troubled me so deeply, assumed a more intimate scale. The feeling, from my old life, that “I’d best be on my way” to the future, was gradually replaced by a feeling that “I’d arrived” there.
I found myself more and more often appreciating the mundane, peeling back the cover of the moment and imagining that I had never seen anything like it, that every atom of it was composed by a consummate magic. (What a sorry ruse to have believed such an experience could only be achieved by recreational drugs).
Of course I would be lying to claim it was all bliss and wonder. I think I would describe that feeling of the refreshment of my outlook as “poignance” instead: a sense that I was losing the moment, indeed every moment in turn, even as I savored it fondly.
I was not always provided with the time and perspective to reflect on my life. The practice of releasing time, and with it life’s deeds and material, while acquainting me with absence, did not help me engage with the rest of the poignance-free world at hand. I have felt burdened at times by the very typical demands of family and society, despite having no job.
I felt such a burden on that day in early August 2011, when I went with my wife and son to visit a friend and his family at their lake house. I’m still mystified by how uncomfortable I felt in that idyllic setting with beautiful views, perfect weather and apparently nothing to stress me. Am I embarrassed, or in fact remorseful, to suggest that if alone in the same setting I would have heard my soul singing?
It was an event which revealed an anti-social aspect of my personality which I knew existed but perhaps had hoped was discarded with my tumor. Ironically, with renewed strength after completing the radiation course, I felt the return of a familiar restlessness in social situations, a very strong desire to be by myself which festered into squirmy resentment when I could not escape or outlast it.
Indeed my solution for that day’s restlessness was to flee into the water, which I did without a word to anyone. I swam about a mile and a half until I finally turned around. Regardless of whether or not such flight was healthy, mentally, or merely an appeasement of neurosis, it did calm me. As a result, I adopted a general self-treatment for stress: exhaustion.
Another key ingredient, which I identified immediately but still do not sufficiently understand, is water. There are of course the elementary symbolic explanations, but whatever explains it must also accommodate the other critical ingredient: thrill. It seems that I require danger or hardship in order to feel well-served by any optional activity I would choose for myself.
The loss of such an outlet, with the coming of cold weather, returned me to a state of anxiety. Within the full grip of Temodar’s gut-wrenching side effects, my attention narrowed and subtle existential concerns jelled to a simple wish to end the pain and the nausea. But in the intervening weeks I regained the longer view and found my perspective shifting yet again.
I found the nerve, or simply the interest, to research the progression of brain cancer to the point of death. I found detailed descriptions of the typical course of decline, and though it enumerated the kind of suffering I expected, the starkly unredemptive certainty of it drove me to tears. I knew at the time that it was something I needed to see and to integrate into my thinking. At that point, the fact that I would die was not as scary as the way.
With the return of nice weather I continued to practice (without routine or conscious effort) my pondering on the subjects of life and death. Rather, I should say, “the subject of life and death.” Somehow, remarkably, I began to feel a growing comfort with the idea of death. The vertiginous sort of angst and primal fear of the early post-surgery days seemed to have evolved little by little into a sense of familiarity, almost as if a continuous conversation or debate had been reduced by repetition to a standard argument.
Strangely, along with a sense of the intractable nature of some questions came a growing feeling of acceptance of the unknown. It seemed bizarre to find myself believing, with ease and calmness, that death, in any of its myriad guises, was neither “evil” nor merely “bad” but a condition so utterly essential and familiar that it pains us not to think of it more often. Rather, it pains us not to realize, consciously, the unimportance of the answer.
I have my ideas about the metaphysical aspects of death, which may be summed up by saying “there aren’t any.” But in a broader sense I’d prefer to concede, with no sense of failure or regret, that we simply don’t know. I almost feel the need to retrace my steps back to point in my deliberation of this topic where the utter absence of meaning in death seemed so alarming.
Yet I concede the folly of saying so now, at a time of relative health. If the likely course proceeds, every fiber of strength, will and insight will turn to mush in proving the point. Illness has a way of adorning oblivion, abstractly, but in sensing the grip of death shall I surrender first to madness?
I have a bias for ease. I allow myself to disregard the consequences of my illness, and am perversely blessed with the statistical near-impossibility of surviving it. Though my future is picked clean by the harrowing odds, that emptiness is not without tranquility. In the process of accepting that life owes me nothing, uncertainty becomes miraculous.
Not that I’m planning on a miracle, or waiting for a miracle. I’m living it.
