The great teacher Marpa was grieving. His oldest son had been killed. One of Marpa’s students came to him and said, “I don’t understand. You teach that all is an illusion. Yet you are crying. If all is an illusion, then why do you grieve so deeply?” Marpa replied, “Indeed, everything is an illusion. And the death of a child is the greatest of these illusions.”

If my son, Joshua, had lived, he’d be nearly twelve now. But really I don’t know what that means. It’s a thought with dark wings that drag the ground. I push it off the edge of my mind and it falls and falls, turning like the seasons, smashing against the rocks below.

Born prematurely, Joshua was kept alive for three days. I’m not sure how much he suffered, or why he was born too soon or died too soon; these thoughts, too, fall into the mind’s abyss, screeching their “ifs” and “onlys.”

A hundred years ago, Joshua would have died between his mother’s legs. A decade ago, machines kept him warm, breathed for him, extended for a while his life, our life together. I wanted him to live, desperately. I wanted bigger machines, technological miracles. I wanted the Industrial Revolution by my side as I chased death down the hospital halls and out the big glass doors. I wanted the illusion those doors offered. I wanted the doctors wakened from sleep to rush to his side, and pull from their little black bags every trick.

My brother-in-law, Jeff, wrote out the Sanskrit symbol for “Om” and taped it to Joshua’s incubator. I was moved by the gesture, though I didn’t really understand; I’d only recently begun the slow drift away from conventional views and into the depths of myself, the roiling blackness and uncertainty I called spirituality, a darkening whirlpool taking me down. My old life was breaking up, drifting, dying, and my son’s birth and struggle for life was a storm that broke yet more of me, wave upon wave of pain like cold rain. To keep him from dying, I would have done anything — had someone with a knowing look told me to sacrifice the neighbor’s cat I would have been out at midnight with a knife between my teeth — but I could do nothing: like Jeff, with his strange incantations, or the doctors with theirs.

The truth is, I couldn’t even pay the bill. It cost more to keep Joshua alive those few days than to feed countless hungry children for countless days. I didn’t care. It was futile, we all knew it. But the doctors didn’t care. I mean, they did care. I mean, I don’t know. Here was Medicine, down in the dirt with Death, fighting for my son’s life. Here was an act of love, wasn’t it? Here was sacrifice, but whose? Here was faith, but in what?

I was sure of one thing: this was the greatest pain I’d ever known. My fortress mind was taken completely by surprise, overrun by grief. I used to hide when life knocked with its big fist on the door — up high, inside the turrets, taking aim with words. Words were useless now. And so my life seemed useless. The pain was more real to me than my writing, my marriage, my future. My life had been full of possibility — choices that spiralled dizzily into clouds, ambition’s endless horizon. And this, this choiceless pain, this was the end of the world. Not really — I ate, slept, slept some more. I continued. But something had died in me — and that is what I grieved. I’d reached into my little black bag, and for the first time come up empty-handed.

 

Two years later, in another hospital five hundred miles away, my father lay dying of cancer.

In the beginning, he thought the pain was from intestinal gas. “Why can’t they do something for the gas?” he asked. It wasn’t gas; it was the tumor, advancing on his liver. The doctors assured him they were doing all they could — except telling him the truth, which he finally figured out for himself, or telling him how to get well.

I tried. Stop eating foods with preservatives, cut down on meat, I told him, while he sipped a Pink Grapefruit No-Cal, unimpressed. Turn off the television, I said. Reluctantly, he lowered the sound. Every few months, I swept into his life like an airplane dropping leaflets; surrender or die, they said; drop dead, said he.

What was he supposed to do? Give up his life so he could live? To change his ways seemed to him like just such a sacrifice; it must have seemed that way to the doctors, too, who never even suggested it.

It was early morning, when hospitals are most like monasteries. A bell chimed softly. In the dimly-lit hall, ghostly figures made their rounds, intent on salvation, of bodies if not souls, passing by my father’s room where a real ghost hovered, unsure whether to return to its condemned house, the windows broken, rotting timbers showing, the body a slum now loved by no one, once proud, now pissed on and ruined, like the old city he loved, Broadway with its lights and the high buildings reaching higher. What the politicians had done for New York the doctors had done for him.

When my mother and I arrived, he seemed asleep, his eyes half-open, face bathed in sunlight. I hadn’t seen him this relaxed. Then it dawned on me. “Mom,” I said. “I don’t think he’s breathing.” I reached for her; she took my hand; for a moment, we stood motionless, awed by the mystery of his lifeless body. Then she called for a doctor, who told us to wait outside. We did, as another doctor arrived, and another. It was ten minutes before one of them spoke to us. They’d done all they could, the doctor said.

 

The occasion for these reminiscences? This Fall, my wife will enter medical school. As a college freshman, ten years ago, she decided she wanted to be a doctor. When she graduated, she got married instead. She had a son and five years later got divorced. The boy’s father moved away and she lost a court fight to keep the child. The wheel turns. Saddened, seasoned, she gets her chance again; I get a chance, too — to get out of the way.

It hasn’t been easy. I have my reasons for not wanting her to go, and I have my other reasons, fears curled within fears, dark flowers that bloom at night, the past’s thorny kiss.

This is my third marriage. I want it to last. And medical school doesn’t leave much time for marriage, or anything else. It’s an initiation into a priesthood, meant to separate the elect from the rest of us, so the higher mysteries remain mysterious, so doctors can keep fooling not just us, but themselves.

I don’t like the profession. It reduces the body, like a machine, to its parts, instead of dealing with the whole person, the passions, the spirit that moves us. Its emphasis on the so-called building blocks of life, on the intricacies and behavior of cells, is intellectually stirring but misses too much; it’s like trying to understand the heart of a great city by studying its traffic patterns. Medicine “works” the way engineering principles work — the principles by which we build a highway through a decaying, still lovely old neighborhood, oblivious to its human ecologies, its history, its inner life. How strange, too, that medicine, which brings its big guns down on little germs the way the United States trounces on Grenada, which rolls its depth charges into the murky seas of us, cuts and slashes through the jungles of us, lays down with death and even in dreams lays ambush for death, how strange that medicine so denies death, tries to cheat it by doing everything possible to delay it, for years, months, hours, for ridiculous minutes, cheating us of a good death, not to mention a good life, magnifying our fears instead of helping us face them, I mean doctoring the heart, too; the soul, too; healing us. And then, with Olympian arrogance, boasting that medical advances are responsible for our longer lives, ignoring the combined effects of better nutrition, cleaner water, sewage treatment, and more, much more. This is like your car mechanic boasting because you’ve bought a new car. I could go on.

And I have, many times — about not wanting my wife gone for ten, twelve, fourteen, God-knows-how-many-hours a day, married not to me but to her work, in a man’s world where I don’t speak the language and don’t want to — my voice cutting the night like an ambulance siren, racing through my mind’s back streets, picking up speed, taking shortcuts . . . but who am I trying to save?

Myself? Haven’t I learned better by now? Our marriage? On the contrary. The more I try to nudge Norma off her chosen path, the more I push our marriage toward oblivion. I’ve been going about this the way doctors try to treat an illness, interfering with a process they think they understand; imagining they know what’s best; avoiding, at all costs, suffering.

The poignancy of it all is that I’m really not against her being a doctor. My intuition says she’ll be good, the exception to the rule: independent; challenging the conventional wisdom; motivated not by the desire for wealth or status but the yearning to help.

No, the truth is simpler: I fear being left alone. I fear living without a woman’s constant companionship, approval, affection, depending on her like a pill taken at regular intervals, like visits to the doctor.

That’s the crux of it: my fear, not her career. My buried pain, its ghoulish hand rising up at night to seize me by the heart . . . and no one there to save me, with sex or conversation.

This pain of separateness could teach me something. Like a pain in the body, I can acknowledge it or deny it, deal with the symptom or the cause. Doctors give us antibiotics and our bodies lose the strength to fight infection on their own. So have I relied on women — not to do my laundry or cook for me, not to think for me or feel for me, but to protect me from the thoughts and feelings that hurt the most. To cushion the heart from grief — for a dead son or a dead father — and the daily, unremembered disappointments. To save me from my own judgments, the iron opinions, the certainties forever changing.

This is bitter medicine. My ego doesn’t want to swallow it. It would rather go on lying to itself until one day I wake up with cancer. Does that sound melodramatic? I think every psychological ailment has its physical counterpart; the distinction between the two exists only in our fragmented mind, and may not show up for a while. But we’re far more unified than medical science imagines. Our bodies are capable of healing themselves, if only we trust their deep wisdom. What are we, anyway, but the signature of spirit in flesh? Why would spirit forge its name? Why should we be incomplete, needing knives to cut us, pills to cure us, someone always to hold our hand?

— Sy