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The horror of darkened hearts

Steve Adelman, MD
Physician
April 20, 2022
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In 2016, I published A Tale of Two Epidemics in the Harvard Health Blog. Sadly, our current pandemic has joined with health professional burnout and the opioid epidemic to gobsmack us with virus-infused spittle. Although doctors and nurses have stepped up heroically to save lives, many of us are depressed and dispirited. We’ve gotten sick. Some have died. Political nonsense has overshadowed reason – some have been attacked, and lives have been threatened. A T-shirt reading “I Risked My Life & All I Have to Show for it is an Armed Guard” is tragically on message.

Personally, I identify with the disquiet and distemper of so many of the physician clients I endeavor to assist.

Some of us are bailing; some stay the course out of necessity; others lean in and continue to derive meaning from our sacred work. Occupying ourselves with minutiae distracts us from the uncomfortable, unanswerable questions, the ones that stupefy us as we ponder them: How could this happen? What’s the point?

Believers wonder where our belief systems fit in. Are we able to sustain soothing aspirations like mission and purpose? What about reassuring concepts like divine providence, cosmic justice, and the afterlife? Are these realities or mere conceptual ploys devised to inoculate us against the absence of being that is “The Horror! The Horror!” referred to by Kurtz in Joseph Conrad’s “Heart of Darkness.”

I try to slow myself down and think about an eternal truth or two (we avoid these by moving too fast). Memorable one-liners that show up in Judaism’s sacred texts depress, as they help us maintain perspective:

Hillel said: “Doubt yourself until your very last day.” When he saw a skull floating by, he spoke to it, saying, “You were drowned because you drowned others; so too, will they be drowned.”

Akavia ben Mahalel said: “Know your place. You emerged from a stinking drop of scum … And it is your destiny to be turned back into dust by the maggots and the worms.”

Ecclesiastes, the spiritual godfather of existential philosophy, wrote: “There is nothing new under the sun.”

“Everything, but everything, is vanity and vexation.”

The nakedly ephemeral human condition stands before us. The miracle of birth, stalked by the shadows of death.

During the pandemic, my wife and I lost three parents and gained four granddaughters. This cosmic reboot propelled me into a state of deep reflection. As humanity wrestles with the indignities and uncertainties of the here and now, I have looked backward and inward in a feeble attempt to make some sense of it all. Even the very best lives are painfully bittersweet.

If we’re lucky, we make a difference, and the decades pass. Many loved ones die, as do many patients, also loved.

When we open our eyes, we see that our lives are littered with loss and death.

I once consulted with a psychoanalyst, the son of members of Freud’s inner circle. Though I was awed by his aristocratic origins, I listened intently when he pronounced, “The only thing that is certain about relationships is that they will end.”

Relationships will end.

On the other hand, Margaret Schlegel, the protagonist of EM Forster’s “Howards End,” exhorts us to “Only connect … live in fragments no longer.”

And anthropologist Mark Zborowski may have said it all with the title of his book “Life Is With People.”

Life-threatening infections. Diseases engendered by surfeit or lack. Misinformation. Death. Birth. War. Destruction. We do our best to maintain perspective and sanity as we tiptoe through the minefields until our strength gives out.

Steve Adelman is a coaching and consulting psychiatrist and can be reached at his self-titled site, AdelMED.

Image credit: Shutterstock.com

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