broken

My laptop fell against the wooden table in the dining hall and the wireless card cracked, so that the covering doesn't seal the metal beneath. I Scotch-taped it, and lodged a book underneath it to keep it semi-stable. My internet flickers in and out. I have to reconnect, both to wireless and to Yale's private network each time. Don lent me a wireless card until I get a new one, but I've yet to use it or to order a new one. I'm waiting for this one to completely die out. My cell phone got caught in the rain, and wouldn't turn on. When it finally did turn on, I couldn't dial or receive calls. When I can hear someone, there's a lot of static. It sometimes turns back off, and is stubborn about returning to me. I check on it every few hours, nurse it and hold out hope that I will not need to replace it.

I have a neurotic thing about using up all my toiletries, a habit that didn't develop or become evident until I came to college and had to move each year. I like to finish my soap, toothpaste, shampoo, laundry detergent down to their last sliver, pea-sized blob, drop and so on, before I go on to another place, and in the rare case that I time it incorrectly, I bring these things with me. I can't throw them away. I have old folders whose sides I've taped up repeatedly to use again. I'm also obsessive about recycling paper, and it has little to do with the environment, more about making use of things. I keep most things, and often not out of sentimental value but out of pure value. I still have my first pair of flip-flops, from high school. And it's not about being frugal. They probably cost four dollars and I definitely got my money's worth after the first year of constant wear. I still have them because I can still wear them and because I still like them. Their jean-blue is interrupted by lines of white as their fabric's worn, and I've scruffed the layers down near the sole. I keep most anything that still fits no matter how old, I re-use and re-use.

Yesterday I wanted to write about how amazing anatomy has been. Working on her foregut pre-lab in my room, Allison mentioned how "hardy" the body is. How so many things go wrong but we find ways to survive, imperfectly. You don't REALLY need a gallbladder because bile can go from your liver to the duodenum fine. Every place in your body has at least two sources of blood, just in case one goes astray. It might make the vessels in your abdomen protrude like the head of Medusa, but you'll be alive. And of course we learn about syndrome after syndrome. Marfan, Wilson's, Horner's. Have seen patients with kidney transplants, spleens five times the normal size, cancers of the kidney and blood and so much. And each person functions in their own way, a little broken in places in the body and sometimes, most painfully, in heart.

The frail woman with Wilson's sat so still, clenched her hands so tight, stared out at us without blinking and little fear. When the light of the projector flooded her face, she squinted slowly and covered her eyes matter-of-factly. For all that calm, it felt at times like she was hiding, and how much of it was her illness and how much of it was her, I couldn't tell. I came out of that lecture thinking that my body's built better but she's stronger. With her, the way the pieces fit differently was visible, and you feel that with every patient who tells you that this or that is wrong, and it made something else wrong, and they're trying to put themselves back together but things might be missing or awry but they just want to be kept together somehow. It's okay, things have to be moved around. Scotch-taped.

And so it's hard for me to let go. I understand the difference between a quality existence and a mere existence for existence sake, but I believe so strongly in giving something its fullest life, to finding what lies in between the broken pieces. And the thing is, I do believe in an inherent, inexplicable value in just existing, continuing.

Today we had class about patient autonomy, the right of a patient to refuse treatment, to be treated as he wishes. We watched part of a documentary about Dax Cowart, a man who was severely burned in a freak explosion. Words could never conjure the image of his pain in that aftermath; it looked and felt excruciating. He wanted badly to die. He felt his life would so decrease in quality, that it wouldn't be worth going through the pain of rehabilitation to get there. He was a versatile athlete, and those days would be long over. His shrunken figure, with skin so foreign you could barely register it except for when a limb moved beneath it, begged to relieve its burden. I don't think anyone watching his whole self asking to be gone wanted to say no.

We talked for awhile about Dax. Then we saw a clip of him years later. After rehabilitation and two suicide attempts, Dax became a married lawyer. He'd lost his sight, but could live independently and actively. He fights for patients' rights to autonomy. He says that he doesn't blame his mother for keeping him alive, but that he should've been the one to make the decision. He emphasizes quality. For example, he says, if he lost his hearing, he would see that as a lesser life and he wouldn't want that. I didn't buy that, though. If he'd lost his hearing first and still had his sight, he'd probably value his sight in the same way. But because he'd already lost it, he learned to live without it. And yes, who am I to judge whether he is living as fully as if he weren't like that? I do respect people's choices, and I know that how I see life is different from how each person sees life. And of course there are boundaries and limits to how much pain a person can bear, and it depends on what lies ahead, and quality does matter because life is the non-necessities, the more-than-breathing. How I feel about this isn't a straightforward statement about how I'd want to treat a patient or even Dax himself; I still have much to learn.

But what I think about most is this. He's still living; each day he chooses to live. Do the pieces fit differently? Yes. Do they hurt, jamming into each other and sliding past and reorganizing? Yes. But do they continue? Yes.