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Here is a recent podcast interview I did in anticipation of the screening of “Astronaut Goes From Migrant Fields To Outer Space” at the WILDsound TORONTO Film Festival this Saturday, May 1st.

I’m happy for the publicity, both for the film and hopefully the compassionate, coherent side of the immigration issue, given the current experiment with codified racism and a Geheime Staatspolize version of the American Dream in Arizona.

Sadly, hatred and ignorance remain omnipresent and galvanizing forces despite the sublime milestone of a black president and our unique history as a nation of immigrants.

From the Associated Press: “Key provisions of Arizona’s immigration legislation, signed into law by Arizona Gov. Jan Brewer on Friday:

Makes it a crime under state law to be in the country illegally by specifically requiring immigrants to have proof of their immigration status. Violations are a misdemeanor punishable by up to six months in jail and a fine of up to $2,500. Repeat offenses would be a felony.

Requires police officers to “make a reasonable attempt” to determine the immigration status of a person if there is a “reasonable suspicion” that he or she is an illegal immigrant. Race, color or national origin may not be the only things considered in implementation. Exceptions can be made if the attempt would hinder an investigation.

Allow lawsuits against local or state government agencies that have policies that hinder enforcement of immigration laws. Would impose daily civil fines of $1,000-$5,000. There is pending follow-up legislation to halve the minimum to $500.

Targets hiring of illegal immigrants as day laborers by prohibiting people from stopping a vehicle on a road to offer employment and by prohibiting a person from getting into a stopped vehicle on a street to be hired for work if it impedes traffic.

The law will take effect by late July or early August.”

The New Colossus

Not like the brazen giant of Greek fame,
With conquering limbs astride from land to land;
Here at our sea-washed, sunset gates shall stand
A mighty woman with a torch, whose flame
Is the imprisoned lightning, and her name
Mother of Exiles. From her beacon-hand
Glows world-wide welcome; her mild eyes command
The air-bridged harbor that twin cities frame.
“Keep, ancient lands, your storied pomp!” cries she
With silent lips. “Give me your tired, your poor,
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore.
Send these, the homeless, tempest-tossed to me,
I lift my lamp beside the golden door!

–Emma Lazarus, 1883 (Inscribed on a plaque inside the Statue of Liberty)

Alexander and his Doctor, about 1648-9, Eustache Le Sueur

According to classical anecdote, Alexander the Great suffered from mysterious maladies and from his own mystique. No one dared to treat him for fear that a bad outcome would doom the would-be healer to certain persecution by Alexander’s wildly solicitous minions. Finally, Phillip, Alexander’s physician, frustrated by the young king’s decline, offered care in the form of a salubrious potion. But a general had already impugned Philip in a letter to Alexander, which claimed Philip to be acting seditiously on behalf of Alexander’s Persian enemies, and not to be trusted. Despite this warning, Alexander boldly drank the medicine, as he did so, handing the letter to Philip to read.

In the painting, Philip stands above a recumbent Alexander, as the doctor-patient relationship would demand. But Alexander’s broad chest and raised eyes reveal his power, while Philip’s stooped posture and frown expose the frailty of his position. The painting reveals, perhaps unwittingly, the vital duality of the relationship, each risking himself, proffering his full commitment to the other. Here the physician assumes the role of servant rather than patriarch, though his experience and wisdom are evident.

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.

Understanding how a patient makes sense of chronic or disabling illness can be critical to the effective treatment of that illness.  Repairing the body doesn’t necessarily repair the life. Patients must confront changes to their bodies and in how they live their lives, psychological dimensions of disease physicians and allied practitioners have appropriately tried to address more vigorously.  But human beings, perhaps uniquely, not only live in the here and now but also in a larger narrative of their existence that includes their past and also projects a future.  Our identity and self-esteem are not only tied up in what we see in the mirror, but in what others see, and in who we see ourselves becoming: our plans and expectations for ourselves in the context of a long and healthy life.  All of this helps us tell the story of who we are. The term “biographical disruption” has been applied to the pernicious ability of disease to damage this narrative.   To fully treat disease one must also treat the damaged story.  There is evidence that poetry can be part of such treatment, allowing patients to creatively frame and perhaps modify their story through dialogue with themselves and with others.

Below is a poem written by a young woman afflicted with severe arthritis, reprinted from Cases Journal (Cases J. 2008; 1: 153).

Where have I gone?

Where’s the woman who weighed less than 9 stone?

Who wore a dress size 12 and didn’t need to wear shapeless clothes or jogging suits?

Who had shaped and tidy eyebrows that would complement her latest hair colour and style?

Whose painted nails, with manicured hands and feet, were perfect for holidays in the sun?

Where’s the woman who had a vocation not just a job, but who exists on benefits, a step away from poverty?

Where’s the woman who owned her own home that gave her safety and privacy, it was her pride and joy?”

Where’s the woman whose hobbies include travel, gardening, decorating, furniture restoring, sewing, reading and studying at home?

Here I am and life before my impairment has gone, the only thing I can do is hold a pen with a special grip and writing is agony.

Where has she gone?

Where has she gone?

WHERE HAVE I GONE?

Do you see me?

How can you ever know me, when all you see is my chair?

My limitations are all you see and you say they complicate your life.

Will you ever see the deep pools of love in my eyes for you?

When you half close yours with pity and turn away from me.

The beating of my heart in expectation of your closeness isquickly cooled by your fleeting hug or, worse, patting my shoulder.

I wait in anticipation remembering the taste and softness of
your kiss, you offer me a warm ‘peck’ on the cheek.

I smell your aftershave … you say I smell clean!

I remember running my fingers through your hair,

Ripping buttons off your shirt but that’s difficult when you
stand behind me pushing my chair, we can’t even hold hands anymore.

The power of my emotions makes me feel strong,

Then I catch that pitying look in your eye,

They die in my heart.

I do not speak, my smile fills my face but you will never know …

You’ll never see the real woman who is me

Who sits and is seen by the world framed by a wheelchair

Cut off emotionally just because I cannot stand or walk.

Thank you

Thank you to those who take the time to listen to difficult and unclear speech, for you help us to know that if we persevere we can be understood

Thank you to those who walk with us in public places, ignoring stares and whispers from strangers, for in your friendship we find enjoyment, laughter and happiness

Thank you for never asking us to ‘hurry up’, but even more special is you don’t snatch our tasks from us or offer ‘Care’ in such a way as to make us feel that we are still children, with no control and respect

Thank you for standing beside us when we enter new experiences and try new adventures
Though our success may be outweighed by our failure, the experience will stay with us forever and there will be many occasions when we surprise ourselves and maybe even you!

Thank you for asking for our help and expertise,
As self-confidence and awareness come from being needed by you and others

Thank you for giving us respect

You acknowledge our value as experts in our fields and that we require to live with equality in society

We shouldn’t have to ask or have laws to enforce it or remind you

Thank you for assuring us that the things that make us individuals are not our medical impairments, as everyone has those and they don’t define ONE’S SELF, it’s people’s attitudes that create barriers that exclude us from you.

Treat us as we treat you.

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

When I get off the phone with my wife I think
Of DNA, the great lengths that don’t matter,
That even its magniloquent scholars call “junk,”
So much that if you listened to the language
Of life you’d hear the ums between words, confabulation,
What we say when we’ve nothing to say,
As when she calls at lunch and asks How are things?
And I claim, Fine, as I would with the building
In flames. We ping pong pleasantries for five minutes
Then I return to putting out the day’s fires
Only now pondering lives we spend mostly
Apart just to make enough to have a life,
Something like divorce with marriage spliced in
Mornings and nights. I.e. she’s a stranger
And how do I know she’s not disbursing government
Secrets in coded want ads, begging exegesis
From her cult’s high priest, or running a house
Of ill repute by the shipyard? Mingling
Our loose strands, we become a stranger strangeness
Though scientists have begun to guess
At the hidden purpose in those stretches
Of fallow chromosome they also call introns,
A refreshingly arcane and important name
I attach to this break I take from a day
That started as the pieces we call hours
And put together by staying whole. The part
Where the phone rings isn’t the story’s moral,
Just abiding distraction, as if Sisyphus let go
Of the stone whose rolling went unnoticed
As he flipped open his cell and told his wife
What would bore anyone else, scientists
For instance studying mating rituals in fruit flies,
Or G-men eavesdropping through a wall.
But such twaddle sufficiently scrutinized turns out
To be a cipher for life, itself the redundant
Though universal meaning, as if at the most
Intimate level, nothing is everything.

                                                          —David Moolten

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