Winter Blues: I begin to discern the profile of my death

Oliver Sacks has just revealed that he has terminal cancer. This sad news from the voice of humane medicine put me in mind of Marguerite Yourcenar’s Memoirs of Hadrian, an account of the last days of a great man, looking back and forwards, in a letter to Marcus Aurelius.

The letter opens

Today I went to see my physician Hermogenes…I took off my cloak and tunic and lay down on a couch. I spare you details which would be disagreeable to you as to me, the description of the body of a man who is growing old, and is about to die of a dropsical heart. Let us say that I coughed, inhaled, and held my breath according to Hermogene’s directions. He was alarmed, in spite of himself, by the rapid progress of the disease…

Hadrian is 60/61 years old as he writes this letter. I am exactly the same age. In reading Hadrian’s memoirs and learning of Sack’s terminal illness, I am confronted by the inevitability of my own mortality. Aside from love, this is the most significant subject that human’s encounter, the fact of the limited span of our lives. And, this is amplified in the clinic as we face a doctor’s scrutiny

It is difficult to remain an emperor in the presence of a physician, and difficult even to keep one’s essential quality as a man. The professional eye saw in me only a mass of humours, a sorry mixture of blood and lymph. This morning it occurred to me for the first time that my body, my faithful companion and friend, truer and better known to me than my own soul, may be after all only a sly beast who will end by devouring his master.

In the clinic, despite the best intentions of the physician, naked, we are stripped not only of the garments that clothe us but also of the dignity that shields us from the slough, the mud & clay from which we come and to which we shall all return. This body which becomes a ‘corpus’ when it ails, an object that is distinct from us is, in the clinical encounter, objectified, “a mass of humours, a sorry mixture of blood and lymph” and suddenly it is alien, a foreigner who surprises!

It took Marguerite Yourcenar a quarter of a century to write Memoirs of Hadrian. She said

It did not take me long to realize that I had embarked on the life of a very great man. From that time on, still more respect for truth, closer attention, and on my part, ever more silence.

What is inescapable for the reader is that Marguerite Yourcenar was herself a “very great” person. She was able to circumnavigate, to encompass and then to narrate in the first person, this extraordinary life. The writing was itself as challenging, and as courageous as the lived life of Hadrian. Again Yourcenar said

The sorcerer who pricks his thumb before he evokes the shades knows well that they will heed his call only because they can lap his blood. He knows, too, or ought to know, that the voices who speak to him are wiser and more worthy of attention than are his own timorous outcries.

Here, I thnk, Yourcenar is acknowledging that a) in speaking in another’s voice, b) doing this with honesty, and c) in imagining the authentic voice of the subject, the writer has to give something of herself, perhaps a drop of blood as sacrifice and as magical ingredient, perhaps even her own life. She writes of Hadrian’s illness and of his dying with the same intensity as of his love and his triumphs. There is a message here for doctors, psychiatrists in particular: full engagement and understanding of the patient comes at a price. It requires losing oneself in the world of another person, it requires sacrifice, perhaps even a drop of blood!

Hadrian’s medical condition deteriorates and we have that gradual but yet surprising disjunction between self and body

All my life long I had been on best terms with my body; I had implicitly counted upon its docility, and its strength. That close alliance was beginning to dissolve; my body was no longer at one with my will and my mind, and with what after all, however ineptly, I must call my soul…In fact my body was afraid of me…

And, then the question of death

One desires to die, but not suffocate; sickness disgusts us with death, and we wish to get well, which is a way of wishing to live. But weakness and suffering, with manifold bodily woes, soon discourage the invalid from trying to regain ground: he tires of those respites which are but snares, of that faltering strength, those ardors cut short, and that perpetual lying in wait for the next attack. I kept sly watch upon myself…Meditation upon death does not teach one how to die; it does not make the departure more easy, but ease is no longer what I seek.

In describing his attitude to his approaching death Oliver Sacks quotes David Hume

“I now reckon upon a speedy dissolution,” he wrote. “I have suffered very little pain from my disorder; and what is more strange, have, notwithstanding the great decline of my person, never suffered a moment’s abatement of my spirits. I possess the same ardour as ever in study, and the same gaiety in company.”

The last word to Hadrian/Yourcenar