People in a gallery
One must live with great seriousness like a cat — a play upon an utterance by Nazim Hekmat
Dear friends and readers,
I’ve been meaning to tell of one last adventure Yvette and I had while in NYC: Friday morning until lunchtime we wandered all about the Metropolitan Museum of Art, exhausted ourselves there too, for me seeing paintings and art work I regard as old friends and with her looking at new art.
Well, we happened on an exhibition of photographs by Thomas Struth. The ones used to advertise his work are like the one above: people looking at vast art, people making things, not just beautiful art, but everything one might think of in an industrial building, wandering in and out of cities, esplanades, woods filled with twisted branches: ephemeral beings given some kind of larger meaning against the shape of seemingly permanent or continuing structures. I’m told that Frederick Wiseman’s latest documentary where he filmed the worlds of people doing things, talking in the institution in the UK called the National Gallery is rapturous. By contrast, Struth shows a family of artists whose living is made by restoring pictures working in the basement of an old church thus:
So (or but) if you go to one of Struth’s actual exhibits (not spread across the globe on the Net), you find there is another sort of photograph among them:
People submitting to technology: the above is a surgery for hymenoplasty. I melted into quiet crying upon seeing one of a woman on a table covered by surgical lines, with IVs all over her, bags of liquids, long sharp instruments all around, of course sheeted: she was having an operation for some dire cancer. I cried because I wished I had seen that image before I agreed to agree with Jim he would have that esophagectomy that made his last 8 weeks of life a living hell of nausea, starvation, pain. On the wall was a little plaque assuring you the woman as still living as of some date. Right. I can’t find a replica on the Net of that photo or a couple others in the Met that day. I knew that the photo was invasive and voyeuristic, but I wish everyone could see that or the other photos before they agree to a surgery. Since the advent of anesthesia people submit to operations with their eyes closed — metaphorically as well as through drugs. We ought to imagine these; maybe we will agree less often.
This is prompted by my having overheard a man at the Toyota Dealer this morning on the phone for over half an hour scheduling a series of appointments for what was clearly a major surgery, which was to be proceeded by a visit to the famed Mayo clinic (for cancer), and a number of other visits to this or that doctor. The man was all eager docility, cooperation itself. He looked about 70, white, had a briefcase thick with papers (perhaps a college professor). I was there waiting for my PriusC to be inspected so I could get my yearly sticker attesting to the safety of my car: it’s put on one’s window shield in Virginia. I wished I had the nerve to ask him what kind of cancer it was.
Don’t misunderstand me. I felt jealous. I sat there remembering how I could not persuade Jim to try to go to Boston, Massachusetts, where we were told we might be able to see a super-famous, (probably) super-expensive oncologist who never did esophagectomies (as he thought them horribly maiming) but poured intense chemotherapies into people to try to subdue, diminish, put the cancer into remission.
I realized that I never saw Jim being active on behalf of his health that way. In life for other things he was often a person who made many phone calls, set up all sorts of schedules for us to travel, engineered itineraries. But when it came to his health he often just submitted to doctors, didn’t question them. He did read about his cancer when we were told, and early on told me what the Kaiser people were doing was common protocol. Was what doctors did when the case was esophageal cancer.
At Kaiser there was no need beyond minimum appointment making. They found for him a man trained at the Mayo clinic (a surgeon outside Kaiser), a radiation doctor, another to do chemotherapy (in the event we never had them because the cancer metastasized into his liver before the series could start). Jim was I know not just thinking of the price, but thinking it would take time to go to Boston, precious time to try to reach this doctor, have his advice, and then maybe go for Kaiser anyway. He didn’t want to stop what was set up already.
I wasn’t sure of myself so I was afraid to say no, let’s not do this operation, let’s go to Boston, let’s insist on chemotherapy first, lest I was wrong — and he suffer from it, he die.
I worried about the worried looks in the eyes of the non-surgical doctors: did they think this guy a jock eager to cut Jim up and that he’d be better off doing chemotherapy first? Maybe he would have lived had he had chemotherapy first and the cancer would not have metastasized? It was a judgement whether to do the operation first because chemotherapy could burn the tissues and then the operation afterwards might result in dangerous complications as parts of the organs would not heal readily at all. So he said.
I found myself wishing I had persisted and made some kind of intense effort to for once listen to me — would he be alive today?
I was like am now a person walking down a stairway where the handrails have been taken away
I asked myself, Is this man I am watching and listening to, going to be alive 10 years from now because he’s doing this? I envied him. I should not have. Sitting there doing that so politely was an ordeal he was controlling. We do not see the terror inside other people. He will be like the people in Stuth’s photographs. I do not know; maybe he’s having his pancreas removed. He was determined the operation should not be put off and all his appointments fit in. I will remember his aging face, short hair, thin body and briefcase.
My car passed inspection and the honest people at Toyota (I’ve been there before and the people there have been all courtesy to me too) charged me $16. I drove home listening to Simon Vance reading aloud Trollope’s Dr Thorne and all day and until now (many hours later) had this man’s image in my mind and knew I would write this blog about Struth’s photograph of a woman having a cancer operation at last.
Struth, Milan Cathedral, 1998
Sylvia
Under the Sign of Sylvia II 
Ellen, I hate to see you torment yourself with this question yet again. Perhaps Jim shouldn’t have had the operation which made his last weeks more miserable than they might have been, but chemo might have had its own horrors. Don’t you remember that when it was first diagnosed he already had a “large tumor” in the esophagus? It wasn’t stage 1, it wasn’t early at all. What’s more, it turned out to be an extremely aggressive cancer, too. He had no chance, and from what you say about his behavior, he knew it. It was swiftly terminal and perhaps the best thing that could have been done was just to try to keep him comfortable – not that there is any “comfortable” in that condition. Aggressive chemo wasn’t going to disappear a large tumor of that virulent sort, and it had doubtless already spread microscopically before diagnosis. He was a dead man already, though you didn’t realize it yet; no one spelled it out. The medical professionals knew, which is why he was treated like a dead letter in the Post Office. Dead men make everyone feel bad because they can’t save them; it means the doctors have lost. It’s also a ghastly thing for anyone to be around. What a harsh, harsh roulette wheel. Neither the operation or chemo would have saved him, by diagnosis time he was already inevitably doomed to a ghastly end and everyone knew it. So please never think you didn’t do your all-out best because you did. There WAS no real hope, and that’s the thing hardest to conceive or accept. I know how it must rise up and affect you all over again when you see a man like the one you encountered. His story, his illness, may have been entirely different though. Try to think about something else…hug a warm living cat…
Yes sometimes I think what I saw in the eyes of the gastroenterologist and others was a sense of hopelessness and pity when they looked at us. They were not registering that they were against the operation coming first. Why then did that surgeon do the operation? He said after the cancer metastasized he hoped that it would take a couple of years and that it was not usual for the cancer to metastasize so quickly. My investment banker friend who urged the Boston doctor has a sister who took these terrific bouts of chemotherapy, he said very harsh, for a year; she was stage 3 esophageal cancer and she was still alive 3 years later. Statistics on wikipedia show 40% people still dead with this within a year.
I torment myself with the thought he maybe still could be alive had he and I been smarter, more pro-active. I just want him so to still be alive.
The photos in the exhibition are devastating. The one on the Net is relatively neutral and unshocking. They are meant to function as a warning. The exhibit is about technology: people caught up in it at different stages of civilization from Renaissance to today. Shots of mid-town Manhattan at dawn, people coming to walk, small against the vastness again, dawn in the slivers of sky. Quite remarkable. All the photographs are enormous. They take up much wall space.
If they had felt sure he was going to be dead inside a year no matter what, they should have told us; if they were looking at us so gravely because the chances he’d live beyond 6 months were so slim, they should have told us. By not telling us they upped their fees (the surgeon was paid $8000) and did not give us a chance to decide what he should do with the limited time left.
I now feel the man who warned me against the operation did me the best favor of anyone. I could not listen to him because Jim wouldn’t listen.