Rx 6 / Dust
Paul Thek, Dust, 1988. Courtesy of Philadelphia Museum of Art.
Everyone succumbs to finitude. I suspect I am not the only one who reaches this pluperfect state. Most ambitions are either achieved or abandoned; either way, they belong to the past. The future, instead of the ladder toward the goals of life, flattens out into a perpetual present. Money, status, all the vanities the preacher of Ecclesiastes described hold so little interest: a chasing after wind, indeed.
― Paul Kalanithi, When Breath Becomes Air
In the posthumous memoir, When Breath Becomes Air, Dr. Paul Kalanithi is diagnosed with stage IV lung cancer during his final year of neurosurgical residency. Likening his new reality to quenching interminable thirst with salt, Dr. Kalanithi struggles to find comfort in realms beyond scientific pragmatism and prognostication. He turns to his love of great writers —Tolstoy, Kafka, Frost, Nietzsche, Hemingway— for solace, underscoring the palliative nature of literature and the humanities for grief and reflection. Poignantly ascribing Samuel Beckett’s antiphon, “I can’t go on. I’ll go on,” for a bittersweet return to the operating room before his death, Dr. Kalanithi imparts an indelible legacy of learning how to live while dying.
The work of American painter and sculptor Paul Thek considers similar notions of life’s materiality and specificity amidst the ephemerality and perpetuity of death. Thek arrived on the New York art scene during the counterculture movement of the 1960s. After several years abroad in Europe, Thek returned to the U.S. in the late 1970s to find the avant-garde community had mostly forgotten him. Until his death from AIDS in 1988, Thek struggled with depression and turned his focus to sculpture and small paintings, composed of perishable material: candles, flowers, eggs, and newspapers. For Thek, such mediums reflected worldly pursuits, preceding our eventual passing into an elemental eternity.
“i can’t go on. i’ll go on.”
In Dust, Thek uses a spread from The New York Times as a delicate foundation for his painting. Swirling blues redolent of a velvety midnight sky are layered on a background of white. The visible, encroaching white in the periphery alludes to slow, inevitable decay. At the center of the newspaper, the word “dust” is written faintly in lowercase cursive. The word is a whisper, barely perceptible on the dark background, obscured by a smattering of particles. Dust is a plaintive meditation on death, the transience of art, and the relentless progression of time.
Courtesy of Mark Hanlon and Stanford Medicine Magazine.
Reflections…
Ars moriendi, or “The Art of Dying,” are two related Latin texts from the fifteenth century that provided comfort to the dying and guidance to the clergy. A dialectic manual of how to die well, the texts contained biblical meditations on grace and repentance, and affirmation of faith to prepare the individual on their deathbed. In this way, Dr. Paul Kalanithi and Paul Thek crafted their own renditions of these texts.
How do historical constructs of dying well diverge from a contemporary perception of a good death with respect to autonomy, control over destiny, connection and proximity to loved ones? How can physicians consciously explore their own attitudes and beliefs towards death and what it means to die well in order to respond respectfully to the needs and desires of their patients?
As physicians living with a chronic or fatal illness negotiate the transformation from doctor to patient, what are some of the moral dilemmas they might face? Consider the toll of cutting short a decades-long career after years of preparatory study and training; coming to terms with a career that may lack the luster once imagined; erosion of job stability; coming out as a patient to colleagues; confrontations with loneliness, anger, frustration. (Klitzman, 2008)
What useful strategies could be implemented to relieve these dimensions of suffering? How might these doctors view and approach patient care and/or scientific data differently?
sources
Cotter, Holland. “Believing Is Seeing (Or, the Meat Of the Matter).” The New York Times. The New York Times, 21 Oct. 2010, https://www.nytimes.com/2010/10/22/arts/design/22thek.html
Gubar, Susan. “A Cancer Memoir of Literature and Science.” The New York Times, 12 Jan. 2017, www.nytimes.com/2017/01/12/well/live/a-cancer-memoir-of-literature-and-science.html.
Kaitlin Pomerantz. “Into Dust: Traces of the Fragile in Contemporary Art.” Title, 19 Oct. 2015, www.title-magazine.com/2015/10/into-dust-traces-of-the-fragile-in-contemporary-art/. Accessed 15 May 2020.
Kalanithi, Paul. When Breath Becomes Air. First edition. New York: Random House, 2016.
Klitzman, Robert. When Doctors Become Patients. New York: Oxford University Press, 2008.
Myers, M, Gabbard G. The Physician as Patient. Arlington: American Psychiatric Publishing Inc, 2008.
“Paul Thek: Diver, A Retrospective.” Whitney, 2010, whitney.org/Exhibitions/PaulThek.
Segal, Gregg. “Before I Go.” Stanford Medicine, stanmed.stanford.edu/2015spring/before-i-go.html
“Time Is a River.” Philadelphia Museum of Art, www.philamuseum.org/collections/permanent/87007.html?mulR=1451224895%7C16.
Thornton, K., and C. B. Phillips. "Performing the Good Death: The Medieval Ars Moriendi and Contemporary Doctors." Medical Humanities 35.2 (2009): 94.
