Sunday, June 26, 2022

Candide's Garden

 

Spring in the Catskills arrives late, then lush.  Vegetable beds in the garden, a bank too steep where meadow meets lawn, spots unreachable by garden tractor in the meadow itself, edging about the house, space between the stones in the walk to the house, all sprout tall grass and weeds almost overnight.  Keeping things under control, indeed from being overgrown and overtaken requires my attention, my time, and my weed whip. Some call it a string trimmer, others a weed whacker. By any name, it is one of the most important pieces of equipment in this country homeowner’s maintenance arsenal. For years mine was a heavy-duty “pro” model, a tool to make my engagement with intrusive vegetation a fairer, if not fair fight.

 

While renewing the struggle this spring my machine began making funny noises, then overheating enough to scorch the housing, and finally an alarming rattle. It was a Stihl FS 80R, described on the internet as the “best old school string trimmer.” Worrying the weeds would overtake my vegetable beds, I made a beeline to my Stihl dealer. An old-time gentleman, he patiently explained that the alarming rattle was my FS 80R’s death rattle. The screws and the socket holding the muffler in place were worn beyond repair or replacement. “How long had I had it.?” “A long time.”  The dealer speculated Stihl hadn’t made them much after 2000.  I guessed I’d had mine before then.  

 

Time for a new one. A quick calculation suggested that if a new machine lasted as long as my now-defunct model, I’d be able to manicure my property until I was somewhere between 95 – 100 years old. The clear question became what would give out first, man or machine.

 

I left with a new machine and set right to work once back home.  Weed whipping is a chore that allows plenty of time to meditate, dream, contemplate life, and reflect on where I’ve been and where I might like to go. Working with my much more efficient new machine it didn’t take long before my thoughts drifted back to the day before last Thanksgiving when I’d been given a diagnosis of Parkinson’s disease.  My immediate response was, “Am I doomed?” My regular doctor and a neurologist assured me I was not.

 

A couple of years ago I noticed some shaking in my left hand when I rested my arm on a desk to type. Or when I had to grasp a piece of paper. Or, a lack of facility with my fingers when trying to clean my hard contact lenses. Or, more frequent keystroke errors and loss of speed when typing. Left side only.

 

I kept these annoyances to myself, passing them off as a consequence of age. I confess to musing about them while working in the garden, or mowing our meadow, and Yes, weed whipping.

 

My wife, Margot, eventually picked up on some of the shakiness and insisted I mention it to my doctor at my next physical. I did. Upon examination, he believed my affliction to be something called Essential Tremor and prescribed a drug, Primadone, to alleviate the symptoms.  I took it faithfully, as prescribed, for a year.  It did nothing.

 

Ever so slowly my symptoms worsened.  Ever so quickly my imagination, like my garden, sprang into action and bore fruit..  My father died of a brain tumor.  I’d outlived his three score and ten…but still?  My mother died of a massive stroke, having apparently had some smaller, unrecognized events along her path to age 94.  Would I fall more than a full score short of her?  Did I have a benign brain tumor, a small lime inside my skull to match the one Margot herself had had successfully removed a decade ago?  Was my insomnia due to anxiety over having any of these conditions? Or was it Parkinson’s Disease? Worry beat a path to Google. Parkinson’s can result in insomnia. Hadn’t my doctor ruled that out?  ALS? That can keep a fella awake for a while.   

 

In the year between physicals, I lost sleep, wondered why my handwriting was smaller (micrographia), noticed facial tremors, felt my voice sometimes weaken, seemed to tire more easily, denied anything was wrong, only to plant my besieged head on a pillow nightly for more worry. Was that twinge I felt normal?  Nothing? Essentially a tremor?  Or death come knocking at my door? My faithful servant Denial couldn’t hear the banging.

 

Primidone may work well for Essential Tremor.  I couldn’t tell you from my experience.  It does nothing for Parkinson’s.  My next annual physical arrived.  I was as healthy as can be. Except for those symptoms I couldn’t wish away.  My doctor offered no diagnosis…yet.  Within a week I spent a day getting a DaTscan brain scan to share with my doctor and a neurologist to “rule out” Parkinson’s. A week later, after a thorough examination, I left the neurologist’s office with a new prescription in hand.  By mid-afternoon, I’d taken my first dose of Carbidopa/Levodopa to treat Parkinson’s Disease. That medication works. My symptoms are much relieved and I appear, by and large, normal.

 

Still, underneath the jocular comments over whether the weed whip or I will expire first lies fear. The fear of death. Fear over a financially secure future. Fear over capabilities lost to time. Every time the fix engine light in the car goes on, a faucet drips, a board on the porch loosens, a tree blows down in a windstorm and needs to be cut up and removed, something as simple as removing the cover on a fixture to replace a light bulb calls, fear pushes forward. As the world around me breaks down and requires routine maintenance, it triggers fear over how I might break down. When does that maintenance become anything but routine?  Something more than just a simple daily regimen of medication to hold back what is undeniably a neurodegenerative disorder. 

 

I’m reminded of a lyric from “Non-Stop” in the musical Hamilton.

How do you write like you're running out of time? (Running out of time?)
Write day and night like you're running out of time? (Running out of time?)
Every day you fight, like you're running out of time
Like you're running out of time
Are you running out of time?”

 

In fact, I am writing something I want to get out into the world.  This December will mark the tenth anniversary of my son, William’s, death from an accidental heroin overdose.  I’m creating a memoir that can be presented as a solo dramatic performance.  That means writing and memorizing.  Memorizing something approximately 80 minutes long seems daunting, a task that feels like it will require the life of several weed whips. 

 

I remain vigorous and productive. Pleasingly so. To date, only my mind races ahead to other dates, or THE date.  I have three extraordinary granddaughters who live nearby. Josephine Hope – 8, Willa Joy – 4, and Julia Love – 3. I take great joy in watching them develop: swimming, riding bikes, becoming literate, expressing themselves as artists, dancing, cartwheeling, and somersaulting through childhood. Often while doing meditative chores, I speculate on what they will become, and what their lives will be like.  And, how much and for how long will I continue to be a participant/observer.  

 

Approaching twenty years ago, I found myself taken by an opinion piece in The New York Times by Verlyn Klinkenborg. He began:

“The most famous line in Voltaire's ''Candide'' is the final one: 'We must cultivate our garden.' That is Candide's response to the philosopher Pangloss, who tries again and again to prove that we live in the best of all possible worlds, no matter what disasters befall us. Ever since ''Candide'' was published in February 1759, that line has seemed to express a reluctance to get involved, an almost quietist refusal to be distracted by the grand chaos of earthly events. And that reading might make sense, if Candide hadn't already lived through a lifetime of woe. In fact, that line is the summation of Candide's wisdom, his recognition that no matter how you choose to explain the world, the garden still needs cultivating.”

 

I return to Candide’s response every time the check engine light goes on when I need to replace a light bulb when the light of our democracy flickers. Beans need to be replanted when something sneaks in and helps itself to young sprouts. Little girls need bedtime stories. Letters to the Editor still need writing. Things will always need repair. As I contemplate life’s disasters, threats, and challenges while weed whipping, mowing, and cutting wood, I eventually return to Klinkenborg and Candide. I must cultivate my garden.  

 

 

 

 

 

 

 

 

 

 

Thursday, February 17, 2022

Mourning David Poses

 I was honored a few months ago when David Poses @davidthekick asked me to write a blurb about his book, The Weight Of Air. Here are several offerings I sent him. They may not have worked for the publisher, I don't know. David appreciated them. That I do know.

"As a parent who lost a son to heroin, I am unfortunately all too familiar with the failings of a primitive, stagnant, often inaccessible treatment system. David Poses tells his story of a lengthy and tangled recovery that ultimately, blessedly, points us forward toward evidence-based treatment, the use of medicine in treatment, and harm reduction – none of which were available to David at the outset of his recovery journey. We are lucky to have a writer who is so gifted and giving, easy to understand, and full of common sense thinking on the epidemic that persists in our midst. David, I am sure, would agree he is lucky to have survived to tell a story both harrowing and illuminating. A story set free by truth. A story that will save lives. "
“An antidote to our still too primitive, stagnant, often inaccessible, sometimes corrupt treatment system. A story set free by telling the truth. A story that will save lives.”
“David Poses is a writer gifted and giving, easy to understand, and full of common sense thinking on the drug epidemic that persists in our midst. If we pay attention, this story will save lives.”
“David Poses tells his story of a sometimes harsh, lengthy, and tangled recovery. Also, blessedly, he points us forward toward employing harm reduction, medically assisted treatment, and evidence-based treatment. Above all, compassionate treatment that will save lives.”
Now, grievously, there is more to David's story. It points more than ever to the hard work still ahead of us. It must be done, in David's name, and the name of so many others.
Celebrate David by reading his book.

Wednesday, September 8, 2021

Letter to New York Governor Kathy Hochul

The Honorable Kathy Hochul

 Governor of New York State

 NYS State Capitol Building

 Albany, NY 12224

 

Dear Governor Hochul:

 

There are four crucial bills sitting on your desk right now that will ensure that ALL New Yorkers, regardless of their insurance provider or involvement with the criminal legal system, can access the life-saving addiction treatment they need.

In particular, I write to urge you to sign A.533(Rosenthal)/S.1795(Bailey) to mandate the use provision of medication for the treatment of substance use disorder (SUD) in all New York State’s jails and prisons. 

Why do I write?  Addiction treatment in New York’s correction facilities is sadly lacking and/or misguided.  Passing this bill will be a small step toward  larger remedy.

In July of 2016, I attended the sentencing of a young upstate New York neighbor who had committed a burglary in thrall to his drug addiction. As a friend of his family, as the father of a son who died from a heroin overdose, and in my role as an activist, I’d written a lengthy letter to the judge requesting the young man be provided every opportunity to receive the most up-to-date addiction rehabilitation services the State of New York corrections system could provide, both immediately and throughout the duration of his sentence.  I asked the court to direct that his file demonstrate that it was imperative he receive the best drug treatment available.

 

I went into some detail to demonstrate that “afflicted with the disease of addiction, [he] had been ill-served by a lack of proper treatment providers and by insufficient or ill-informed treatment when any was available.  A case that should have been a public health problem with reliable public health solutions fell instead to an overburdened criminal justice system.”

 

Lest one think I was proposing some wildly radical idea, consider what Dr. Nora Volkow, the director of the National Institute on Drug Abuse at the National Institutes of Health, wrote in Scientific American in March of 2018. “Informed Americans no longer view addiction as a moral failing, and more and more policymakers are recognizing that punishment is an ineffective and inappropriate tool for addressing a person’s drug problems. Treatment is what is needed.” 

 

I am not suggesting treatment instead of prison for a crime.  I am saying effective treatment could have averted the need to commit a crime in the first place; that effective treatment while incarcerated can prepare someone for a responsible, productive life upon release; or at the least will help prevent a return to prison following a repeat offense related to drug use. Or substantially reduce the chance of death soon after release.

 

Little did I know then, indeed only until I stumbled upon this information most recently, that our nation’s jails and prisons operate under the "inmate exception". When Congress established Medicare and Medicaid in 1965, it specifically prohibited either plan from paying for health care in the nation’s jails and prisons. “This explicit exclusion…has contributed to a significantly under-resourced correctional health care system that is isolated from mainstream medicine and shielded from critical accreditation and external quality oversight mandates.”[1]Was the judge aware of the “inmate exception” when he handed down his sentence?  How familiar was he with drug and alcohol treatment in New York’s prisons? How na├»ve was I to ask the court to recommend the best treatment available thinking that there were real options?

 

What has happened to the young man in question?  From January 2016, when first arrested until the current time, he has been locked up in one county jail and SEVEN different state correctional facilities. Following the county jail, he has bounced from Downstate, to Great Meadow, Eastern, Coxsackie, Mohawk, Woodbourne, and Fishkill.  In his estimation, the best treatment he got anywhere was as an outpatient while in the county jail. He did enter one six-month treatment program (ASAT – Alcohol and Substance Abuse Treatment). As he has advised me, ASAT is “a standard program for anyone who mentions any drug or alcohol use when entering DOCS in reception or is convicted of either as a part of their crime.” He participated in ASAT at Great Meadow at the beginning of his sentence for three months before being transferred to Eastern. “I tried to get into ASAT to complete it for the Family Reunion Program and to have it out of the way.  [Instead]…I was transferred in a quick fashion to Coxsackie due to the counselor knowing me from the Recovery Center and outside AA/NA groups.”  Now he will have to start the program all over again, most likely at the end of his sentence, which is typically how the system operates.  Once in ASAT, a prisoner is segregated and only able to avail themselves of job programs or study opportunities on a part-time basis.  ASAT can be as corrupt and corrupting as it is beneficial, oftentimes conducted by inmates under the supervision of counselors.  

 

The young man I write about has spoken intermittently with overworked counselors at each facility. He’s had little access to AA meetings, and no group work at all during the Covid pandemic. Complaints or outside interference are of no use, as they may well bring on retribution. It appears he will have to wait things out for at least three years still ahead of him. A tough row to hoe for anyone, much less someone who may still need to resist the call of a substance, without a strong support network. In the meantime, he works at welding in an Industry program where he recently earned a 26 cent pay increase, is described as a “great welder” by his supervisor, “a pleasure to have in Industry.” 

 

One can only hope he can weld himself a drug-free future so that he can enjoy the pleasure of freedom in society once he obtains his release.  In August 2016, I wrote the judge to thank him for his consideration. “Mr. [Doe] is but one thread in the connection that ties us in the fight against drugs and addiction.  As I sat in court and those about to be sentenced shuffled in, I could not help but notice how close they all were in age.  You, of course, see this scenario over and over.  For me, it was a refreshing and disturbing reminder of work that needs to be done.” How long will it take for New York State to build a truly comprehensive drug treatment program, both in and out of our prisons and jails? 


 

 

 

The state needs your leadership to start the building of a comprehensive program.  Signing A.533(Rosenthal)/S.1795(Bailey) will be an important first step.

 

Respectfully yours –

 

Bill Williams

102 High Meadow Road

Livingston Manor, NY. 12758

 

E-mail: briobrio33@gmail.com

 

 

  

 

   

 

 

   



[1] The Inmate Exception and Reform of Correctional Health Care

Kevin Fiscella, MD, MPH,  Leo Beletsky, JD, MPH, and  Sarah E. Wakeman, MD

  

Saturday, August 14, 2021

Kratom and Harm Reduction

Kratom and Harm Reduction

 

“More than a decade in the making, America's opioid crisis has morphed from being driven by prescription drugs to one fueled by heroin and, increasingly, fentanyl. Drawing on historical lessons of the era of National Alcohol Prohibition highlights the unintended, but the predictable impact of supply-side interventions on the dynamics of illicit drug markets. Under the Iron Law of Prohibition, efforts to interrupt and suppress the illicit drug supply produce economic and logistical pressures favoring ever-more compact substitutes. This iatrogenic progression towards increasingly potent illicit drugs can be curtailed only through evidence-based harm reduction and demand reduction policies that acknowledge the structural determinants of health.”  Leo Beletsky

“Regardless of the specific facts about particular drugs, however, for more than 100 years, the main strategy America has used to deal with drug problems is prohibition. With the exception of alcohol, caffeine, and tobacco, nearly every substance that has publicly been associated with recreational use has either been banned entirely or strictly confined to medical use. Prohibition policy—such as the war on drugs—assumes that restricting drug sales and possession will solve the problem, period.” – Maia Szalavitz

 

https://www.scientificamerican.com/article/the-fda-shouldn-rsquo-t-support-a-ban-on-kratom/?fbclid=IwAR3dJOKZpTIjj-bdJ9Yc82xs7x9X7Yg98T0zjXTiasaFecSD1mkbttwK2bg

  

Monday, July 12, 2021

Well Done CC Sabathia

 Reading this about CC Sabathia reminded me of something I wrote about him just after he entered rehab to confront his relationship with alcohol. https://www.cnbc.com/2021/07/05/cc-sabathia-on-battling-addiction-while-finding-success.html  Thanks and well-done CC!

“On Labor Day of 1955, my family moved to New Jersey.  That October, as I walked to the school bus a neighbor stopped his truck, leaned out the window, and asked whom I was rooting for in the World Series, the Yankees or the Dodgers.  Nine years old, I tried to guess what answer would please Mr. Miller the most.  I guessed right.  Yankees!  Thus began a relationship that continues to this day, momentarily melancholy as it may be as I write after a playoff loss to the Astros.  As a boy growing up in the ’50s and ’60s, there were Octobers of great excitement and happiness as Mickey Mantle, Roger Maris, Yogi, and all my other heroes walloped “Ballantine Blasts” out of Yankee Stadium, the House That Ruth Built – after beer baron Jacob Ruppert purchased the team.  Knickerbocker was the beer of the New York Giants and Schaefer a sponsor of the Brooklyn Dodgers.  The Schaefer sign on the Ebbets Field scoreboard would light up with an “H” or an “E” to help those scoring at the ballpark or at home.  Later the Mets arrived with Rheingold as their official beer.  

October was always a time to follow ballplayers in their joy and despair.  At least until October despair became trivial three years ago when our son and brother, William, succumbed to what proved to a fatal heroin overdose. That loss brought my wife and me to the Mall in Washington DC this October 4th.  We joined 30,000 other people from all across the country to participate in the Unite To Face Addiction rally.  The rally made history in part by declaring the event “The Day the Silence Ends.”  No more will any of us tolerate or accept secrecy, shame, and silence about the disease of addiction. Celebrities from all walks of life were there to share their stories of recovery, to reinforce the message that recovery is possible, and to speak out against the stigma of the disease.  We were reminded again and again that there are 23 million Americans in long-term recovery from alcoholism and substance use disorder.  Among those speaking was former Yankee (and yes, Dodger, Giant, and Met) Darryl Strawberry.  His struggles have been well documented, but there was Darryl looking fit and trim, speaking persuasively from the heart about his recovery and proud of the two recovery centers he has established.  A ballplayer offering a different kind of hope in October.  

Later, the rally included a photomontage of celebrities who lost their battle with addiction.  There was my boyhood hero, Mickey Mantle, bigger than life, again, taking one more swing on a giant screen.  

The following day was Advocacy Day.  Nearly 700 people from all over the country went to Capitol Hill to talk with Congressmen and Senators in the interest of making elected officials more aware and proactive in the fight against addiction in all its ghastly guises. We were part of the New York delegation that spent time being well received in Senator Chuck Schumer’s office.

As we gathered outside the office for a quick “team photo” and goodbyes, I checked my e-mail. There was a message from my friend Mark, also a Yankee fan and a bit of a baseball historian, letting me know that CC Sabathia had just entered an alcohol treatment program.

My mind went back to Mickey Mantle.  Then to Billy Martin.  The more I thought about it, the more Yankee names came up:  Dwight Gooden, Whitey Ford, Steve Howe, Jim Bouton, the Sultan of Swat himself, Babe Ruth, and once again, Darryl.  Men whose lives may have even been celebrated as real men who could drink hard and play hard at a time when there was less discrimination over a swing and a swig.  Men whose substance use was denied or protected, sometimes even by the sportswriters who sat at the bar with them. How many more Yankees are there I don’t even know about?  How many ballplayers all across the game?

Now there was one more.  But there is something different this time.  CC Sabathia is to be commended.  He’s not hiding.  To me, he’s a hero for saying, “It hurts me deeply to do this now, but I owe it to myself and to my family to get myself right.”  No silence.  No shame. Just honesty in the first important step on what one hopes will be his road to recovery.  Honesty in making that first step more important than anything else in his life.  We owe him the same understanding and compassion we would offer him if he were dealing with any other life-threatening disease.  Not everyone believes that, of course.  Our culture remains primitive and judgmental when it comes to alcohol and substance use disorder.  Someday soon one hopes we see he is the kind of role model our kids need, a new kind of October champion.

CC is helping spread the message we heard on the Mall.  The silence needs to end.  The silence will end.  30,000 people were there to change the attitude of America about a dread disease. We will spread our message. We WILL prevail.  If we build it they will come.  Thanks for your help CC.  

 

      

 

Tuesday, July 6, 2021

Fighting Stigma

I’ve had two interviews with TRT World Now, a Turkish media outlet. https://www.trtworld.com  One in March of 2018 and one in June of 2021.   Both were arranged on relatively short notice.  Take a look at each.  NOT because of what I have to say, but because of the stock images they employ during each interview.  They recycle the same stereotypes; in fact, employ some of the same visuals in each segment.  If we are to have any constructive discussion about drug use and addiction, we need to climb through and beyond the bog of stigma that inhibits a broader, more compassionate understanding of how we deal with drugs in our society. My issue is not with TRT World Now in particular, though I don’t dismiss the idea that they may have an agenda.  Rather, they happen to be a striking example of what we still see far too often across all media.  Use these links to see what I mean.  2018 - http://bit.ly/2GL2NIA  2021 - https://bit.ly/3x15JtL

 

 

  

Sunday, July 4, 2021

From The Episcopal New Yorker - 2017

I was invited to write about our story and our son, William's, death due to heroin.  Here's what I wrote:

It’s easy for me to think of prayer as a request for guidance or help or perhaps prayer offered as thanks.  I speak as one who does not exercise prayer in my day-to-day life, indeed as one who questions the power of prayer.  When I was a boy my godmother gave me a plaque, Albrecht Durer’s “Praying Hands”.  I still have it. Though it has been safely stored out of sight for decades now, I’ve not forgotten it.

 Four years ago, our son and brother, William, suffered an accidental heroin overdose. That was followed by six weeks of hospitalization, either heavily sedated or comatose, before it was clear he would never recover. We arranged organ donation (indeed were even with him in the operating room, watching as the tube that supported his breathing was removed). Unfortunately, once removed from life support, he did not expire within the short time frame necessary to harvest serviceable organs.  Rather he lasted another 21 hours before he died in our arms.  Determined that his death not be in vain we donated his body to Columbia's College of Physicians and Surgeons. To a person, the doctors that we asked about doing so commented on how important anatomy class was in their own development as physicians. The head of the program that "accepted" William (Getting a deceased 24-year-old into medical school, even as a cadaver, isn't as easy as you might think.) was emphatic that an anatomical donation could ultimately be even more important than an organ donation. Our donation was balm and comfort, as well as encouragement to follow my son when the time comes. 

Every year the first-year anatomy students at Columbia organize an Anatomy Memorial Service to express their gratitude for the donations that become the foundation of their medical education and to convey a sense of the impact donors’ gifts have on their education and their lives.  It is a beautiful service with student offerings of music, written and spoken tributes, observations offered by their faculty, and a chance for donor families to respond and offer their reflections and thanks.

So it was that in early April of 2014 we had the opportunity to remember and celebrate William along with all the other donors recognized.  Both at the time and as I’ve reflected since I’ve been struck by how often these budding doctors mentioned hands.  

One student wrote: “It was not at all a rare thing for me to overhear a classmate accidentally bumping against a cadaver and saying without thinking, ‘Oh! I’m sorry!’ Nor was there a day when I didn’t see a classmate’s hand resting – comfortingly, automatically – on the shoulder of a cadaver as we stood by their sides.  And on the day when we dissected the hand, I feel sure I cannot have been the only one who – before we began our work – furtively held our donor’s hand in a brief clasp of reassurance, squeezing it as if to say, ‘It’ll be alright,’ despite the fact that he was dead, in honor of the fact that he had once been alive.  I say all this to emphasize that the donors, although we didn’t know them, they were people nonetheless, and there was no way for us not to feel that.  The lab was a place of respect, and the donors taught us that.  In the presence of their generosity, there was no way not to feel awed.” 

Cadavers were honored donors.  The students, who worked in teams of four referred to them as their first patients.  “…my second encounter with the donor’s body left me feeling an array of confusing emotions.  For the first time, I saw his hands.  Hands that still had fingernails and hair on them.  Hands that reminded me of the hands I love to hold.  And I thought to myself, ‘This person had someone who loved him, and who held his hands.’ This simple and seemingly insignificant thought truly left me feeling quite inspired. It also emphasized the reality that this body was a living breathing person.  That realization serves for me as my first difficult moment in treating my very first patient.” 

 “The first day wasn’t as rough as I was anticipating. It wasn’t until the second dissection when I saw her pink and chipping nail polish that it really hit home.  The benefit of having such a personal experience in the lab is the sense of pure respect and admiration I feel for our donor.”

From another, “On the first day we met, as I held your hand and noticed the faded pink nail polish you wore, I wondered if, as you applied that once-shining coat, you knew it would be the last time you would do so.  And if so, were you afraid?  Or had you found peace in the limitations of our profession and the natural course of life and death?  I’d like to think that you received some solace in the knowledge that you would go on to guide my colleagues and me in our pursuit of medicine. And for that reason, I want to say thank you.  I have met you without us having ever exchanged a word.  As you have paid tribute to my scientific profession by the donation of who you once were, may I pay tribute to your life and death by reaching my fullest potential as a caregiver to others.” 

These words strike me like a prayer, a prayer of thanksgiving, a prayer of hope, a devotion.  A statement of devotion. A prayer offered with the prayer giver’s full intention to make the prayer manifest. I like to think that our hands need not always be clasped to pray, as beautiful as Durer’s rendition is, but that the spirit of prayer enters the flesh of our hands as we attempt to mold hope and thanksgiving into reality, as we devote ourselves to that cause.         

The students’ memorial comments were also prayers of thanksgiving, though perhaps not directly intended as such. “I didn’t have a nameless, faceless empty vessel to examine every week; I was in the presence of a work of art, shaped by decades of experience and work.  The hands I explored looked nothing like the textbook because, unlike that picture, these hands had made music, done work, caressed loved ones….Years from now, if I am fortunate enough to donate my own body I hope another medical student is asked the same question.  And I hope she thinks the same thoughts.  What have these hands done?  And even though she may never know, the hands she explores, my hands will have (hopefully) eased the suffering of others:  all thanks to the hands, heart, and presence of another.  Thank you.”

One thing we’ll never know is how many times the hands these students studied were themselves clasped in prayer.  What guidance did they ask for?  What thanks did they offer?  Certainly, the very fact that those hands were in an anatomy lab made them an act of devotion.  

“Being a student in Anatomy and working with the bodies of real people, has inspired me to always remember that the gift of trust that patients place in their physicians is too precious to ever be expected or earned; it is simply a gift, always.”

With all my doubts, sparing as I am with prayer, I did send the doctors and nurses who cared for my boy William over those six long weeks a prayer I composed for my father’s memorial service.  A prayer thanking them for their devotion.  

            Dear God,

            We give thee thanks for all those who tend to the sick.

                        We thank thee for those who heal.

                        We thank thee for those who nurse.

                        We thank thee for those who counsel.

                        We thank thee for those who pray.

 

            Inspire their minds when they seek new answers firm their hands when their strength falters, lift up their hearts when hope seems faint, hear their prayers when they call to you.

 

            Grant that in their time of need they may receive as generously as they give, remembering always that through their time, their talent, and their tenderness do we see your love.

                                                                                    Amen

 

Prayer, for me, may be like that Durer plaque, tucked away but not completely forgotten.