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The intern who cared for Vincent van Gogh after he severed his ear. The painting was a tributary gift. While Dr. Rey was quite fond of Van Gogh, who mentioned the physician favorably and intimately in his letters, Rey did not appreciate the painting, at least not at first. His parents used it to cover a hole in a chicken coop. Nevertheless, Dr. Rey clearly appreciated the essential role art played in his patient’s life, and recommended Van Gogh continue to pursue it. At this time, of course, Van Gogh’s painting was for the most part unknown and/or dismissed.

Haus LebensWert is a philanthropically developed and supported facility in Cologne, Germany where patients may receive oncology services free of charge.  An integral part of Haus LebensWert’s vision and mission is to vigorously help cancer patients cope with life both during treatment and afterwards.  Another key component is the use of alternative and complimentary therapies.  These therapies are made available to patients in addition to traditional measures as part of a seamless whole.   Examples include psycho-oncology, art & music therapy, gymnastics and other exercise, voice instruction, Feldenkrais training, Nordic walking, dance therapy, massage and aroma massage, Tai-Qi, Qi-gong and acupuncture.   The Haus LebensWert, which complements a more traditional hospice, has been well received by both patients and practitioners, including those who refer their patients from outside (Hematology Am Soc Hematol Educ Program. 2009:320-5).

Critics of “complimentary and alternative medicine” (CAM) frequently complain of a double standard, and a lack of rigor in its evaluation.  Some feel this looseness encourages bloat and charlatanism, and risks distracting patients and practitioners from the path to “good outcome.”

“Academic medicine integrates three of the most honorable human activities: treating the ill, teaching, and research. The quality that all three share is persistent quest for truth. However, there is reluctance of academic medicine today to openly defend scientific truth by challenging the arguments and the very existence of “complementary and alternative medicine” (CAM). There is no sound proof of CAM effectiveness, no hypotheses on the mechanisms of their action, nor scientific reports testing them. The fact that patients are charged for these “healing” activities makes CAM a plain fraud. With these facts in mind, the name “complementary and alternative medicine” is undeserved and misleading. CAM advocates maintain that CAM should be recognized precisely because it is widely practiced and very promising, that it has a special holistic/human approach, and works at least as a placebo in situations where medicine can do nothing more. As it seems that the public interest in paramedicine will only grow stronger before it grows weaker, scientists must raise their voice and question the truthfulness of CAM more openly.”
Croat Med J. 2004 Dec;45(6):684-8.

While a truth-centered paradigm is difficult to dispute, there is more than scientific truth at stake in the quest for human understanding.  There is also existential truth.  While physician-scientists optimize therapeutic regimens by evaluating their effects on controlled trial populations, each individual patient attempts to grapple with his or her radically changed reality both in terms of life, and death.  Quantity—be it months of survival, tumor size, or fraction cured—can be measured with increasing accuracy and predictive value.  Quality can’t be so easily parameterized.  Moreover, even attempts made to evaluate “quality of life” tend to fall short because experience transcends subjective criteria when they are too rigidly circumscribed.  Patients exist within the larger communities of other patients, clinicians, family, and the omnibus of culture.  If society views the sick as mechanisms in need of repair, and devalues anything regarded as “touchy feely,” then those in charge will cut the funds that allow physicians to spend time talking with patients or considering the larger life outside the body, while adding to the already glutted ranks of surgi-centers and MRI scanners.  Certainly the possible advantages of reinvigorating the art of medicine, or even expanding it to include real art, such as expressive writing, or speaking, as therapy,will be viewed as unworthy of “serious” exploration.  This is what has happened so far.  The impersonal and alienating experience of illness is nearly a truism, at least in the U.S.

Hospitals, especially large referral centers, can be daunting and soulless places.  As we move necessarily towards more “cost-effective” healthcare it will be important not to lose sight of the fact that quality and quantity exist to a large degree as orthogonal axes.  Designing healthcare to have a more empirical and inclusive approach to alternative healing strategies assures a better chance at quality of life, and should be encouraged as long as these don’t induce patients to forego proven treatment.   A life of fear and despair may be nearly as much a lost life as for the patient who dies of his or her disease.

Haus LebensWert, by the way, means House for a Life Worth Living.

Poet Valeria Tsygankova gave this review of Primitive Mood in the literature and arts magazine Philadelphia Stories:

“In his newest book, Primitive Mood, David Moolten picks at humanity’s darkest tendencies and deepest capacities for suffering. Like a patchwork quilt of the twentieth century, the poems in this volume handle violence and loss, questioning and disillusionment, determination and resilience. In quiet, authoritative and incantatory language, Moolten probes the fabric of culture in the West – from the Brothers Grimm to Arshile Gorky – for material that bears his project witness. What emerges is a densely woven and engaging collection of poems, delivered with rhythmic diction, and sometimes reminiscent of spoken word poetry in its rolling momentum and charged endings. With all of the darkness of war, genocide and internment that Moolten lays bare in this volume, there is also a light that enters through the “aperture” of his writing to illuminate the everyday people silhouetted against the dark backdrop of history, reworking their own suffering into beautiful stories. It is this creative power of narrative that stands against the destruction evident in human history in Primitive Mood, and which is also present in Moolten’s powerful and intelligent writing. Moolten’s language is crisp and evocative, and lends itself well to his project of storytelling and remembering.”

Philadelphia Stories, Fiction, Art, Poetry of the Delaware Valley, Winter 2009/2010

This will play right into Obama’s hands. Humanitarian, compassionate. They’ll use this
to, to burnish their, shall we say, credibility with the black community, the both
light-skinned and dark-skinned black community in, in this country. It’s made-to-order
for him. That’s why he couldn’t wait to get out there, could not wait to get out there.

                                                                                     –Rush Limbaugh

A man carries on in the ruins, carries an old woman
Clear of the broken stone, everything broken,
The world indescribable simply because it’s smashed
Beyond recognition. We talk
Of magnitude–well, on the scale of misery this weighs
More than everyone’s imagination. The world comes
Down to this, comes down like building blocks,
The camera closing in
Until you only see his face.

We keep expecting that other aftershock
We hope will cause the right stone to break
And with a softer resonance as from a body
Trembling joyfully, all by itself,
Because a black president
Is more an event than a man, belongs
To the simple facts we gather together
And call a world.
                                        We stand poised, greased and waiting
To leap headfirst into the waters
Of change, which are warm like the Caribbean
Though we know the help will be tepid,
Less than close to enough because of pictures
Like this, the people in them who didn’t choose to be,
Who lack the luxury to decide whether they care
For the color scheme.
                                                 But still they visit
The television that is our president,
Always alone or in groups still small enough
To distinguish those in them
Which is how survival happens, even triumph.

So he appears wretched and still humbly, oddly proud
Carrying his wounded neighbor
Like something essential, bond receipts, a television,
A pail of food, or water
As in that painting by Lois Mailou Jones
She called The Water Carriers,
Too few pipes after all, too little cultivation
On the little voodoo island
That bears the brunt of our curses
Because it freed itself. Jones carried herself
Like water, entered contests anonymous
As water so they wouldn’t know
She was black.
                                   Her painting doesn’t show you
The river, not even the little bit by her side,
Just a bright hat and a face that resembles hers
And ours. Some day there will be people like that
On Haiti, people whose misfortune will move
All of us like the earth. Everyone will act
Indifferent as a river, which can’t tell its own
Smooth stones from a hand or a mouth.

                                                          —David Moolten

They tell you with their stark solitudinous eyes
How much he loved them, women of all kinds,
Black haired, blondes, brunettes, redheads, how much he loved
To stare at them, paint them, take them to bed,
So many nights to make wet with absinthe,
So many colleagues in vice, models
Of dissipation strewn across rumpled linen,
Real women with hair in their armpits
And generous pubes, getting up to casually piss,
Cantilevering a coy hand against a door frame
As they smoked. Even Jeanne who backed out
A window for him or Anna who shared
His brilliance, or any he painted and fucked,
Fucked and painted, scolded, mocked, their outrageous
Perfection sincere artifice like his weeping,
His self-cursed efforts to reform, kindle
A family, shouting Dante in the alleys
As bacilli roamed his brain. Their eyes say love,
But you know it was sex, and more sex, sex
Sometimes maybe as preamble to love, but sex
In the meantime, a binge of the dark other,
The handsome taboo, poor man, sybarite, Jew.
They did it for him. They said schtupping
Let him paint, relieved him of small frustrations,
No clothes, no heat, no food, and torrid rows,
Fought fire with fire, four, five times a day
Because he was obsessed and they were satisfied
Only a short while, spoiled, used to it,
Even the whores taking care of him for free.
It was unabashed madness, all wrong with all,
And if he’d lived he’d never have lasted.
He had to succumb to filth just to keep
His romantic reputation. He spread beauty’s legs
To bless it, sacrificed himself for the sake
Of creation like Dionysus, became with each nude
Dumb cliche, a shooting star, a fresh cut rose,
A pig in her mud, and out of unctuous sweat,
Those indiscriminate moans came not art but death,
And like a lover who wades into pants as
He lets the door click shut, he was gone, his scent,
His voice, his hopes. The paintings stand on their own.

                                                          —David Moolten

                                      After Chagall

A man grips a woman by the shoulders
On a bed in the open air, a courtyard
With a wall no taller than their knees stopping
No one from getting in or seeing them there
In the middle of a town blue as the sky,
An anxious overcast blue, both of them clothed,
Both of them solemn and seated, halfway
Between sleeping and walking, love and goodbye.
A man with wings glides towards them with all
The speed a painted angel can muster—
That is he moves not even an inch,
Only wishes to, such the conundrum of dreams,
The dreamer paralyzed as he acts, eyes flitting
Beneath their lids. Why does he embrace her
Like this, poised for something closer but also
To shake her into sense, you don’t ask
Because you know, have found the answer
Still in your head as before you lost consciousness
In one world and regained it in another,
The dream a warning that comes after
Catastrophe, a ripple in the waters of sleep,
A tremor in the voice of breath, visual
Echo, the mind reminding itself. Stubbornness
Disguised as hope, the dream expects the body
To revolt, do something, anything, miracle
As a compost of facts. I want you, he says
To his wife, and the angel never arrives
With the message of ruin, which is ruin
Without the flames, the soul immunizing itself
Through a little grief, the dream one of them
Wearing the wings of time and not arriving
In time, not going back in it, budging
A single second. But in the dream, it’s 1939,
The world about to lie back and die,
Let the Jerusalem of the body fall
For the ten thousandth time, and afterwards
You’ll wake, you’ll dream it hasn’t happened yet,
Hasn’t happened, everything real, everything right.

                                                          —David Moolten

My favorite city in the world is Florence
And not just any Florence but the tiny one
On a shelf in a photograph from which I laugh
At myself seated in a chair at a desk
In an office that lacks Florence
For an address, so that people when they come
In to say hi or with a work-related question
Sometimes wonder aloud where and when
And though I answer, I never tell them
I’m terrified to have traveled so far
Away from Florence, my face a calendar,
My face a clock. The wife leaning against me
I left on that street, that Florence of an afternoon,
Of a quick cafe and a bit of rain
And a beggar boy who didn’t merit
The camera’s stare, selling sweets from a bag
In a plaza that didn’t make the cut in Baedekers,
The droplets in her hair composed
Of the same dull drizzle as anywhere
So that when it rains in the office parking lot
I am soaked with the rains of Florence
Though no one knows, not even my wife,
To whom Florence belongs equally,
A Florence that hardly matters except to us
No history, no wars or plagues, no inferno
Or paradiso, just two people standing
In the one place on earth no one cares, no one asks
About Florence because they’re already there.

                                                          —David Moolten

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