Crito, we owe a cock to Aesculapius. Pay it and do not neglect it.”
– Socrates’ Final Words
When I woke in the recovery room my clothes were in a clear plastic bag that had been dropped on my legs. Inside the bag was an envelope. I presumed it had my results, so with semi-anesthetized fingers and dazedly pinwheeling eyes, I tore at the bag to get to the report. I was not in the least bit concerned. After a year of managing a major health crisis, I knew that the endoscopy I’d just received would have benign results. There would either be slight or significant improvement in the varices in my esophagus. This envelope held only good news. I felt bulletproof on this point.
That is not how it turned out.
A varix is an abnormal dilation of a vein, caused in my case by hepatic hypertension. I’d developed varices in my esophagus as a result of liver cirrhosis, which in turn had been caused by an iron overload in my body due to a genetic condition called hemochromatosis. The iron overload had caused my heart to swell three times its normal size and had scarred my liver badly over many decades of silent toxication. This placed unsustainable pressure on my portal venous system, which blew that pressure forward to the capillaries in my esophagus. They, in turn, became distended and varicose — but none of this was a problem in my mind as I finally managed to tear open the plastic bag on my lap. Although I’d been in multiple organ failure only a year before, I’d been gathering strength and vitality. Truth be told, I felt better than I had in many, many years. My liver, heart and pancreas were healing now that I’d reduced my iron load significantly through a year of therapeutic phlebotomies and I was certain that the days of considering radical surgeries, organ transplantation or imminent death were safely in the past, for now.
It’s an odd thing to live through a health crisis of that magnitude. On one hand, there is a tremendous sensation of ferocity that comes with rallying from a place so low that I couldn’t hold my arms above my head without putting my heart into a serious arrhythmia. Today, as I jog up hills or put in an hour sprint at the gym, there is a taste again of adolescent immortality, that feeling of timeless passion abiding not just inside of me, but vibrating through the universe as I move. That feeling has sent me diving into mosh pits for the first time since my twenties and cliff jumping just for the barbaric yawp of it. Yet, having been that close to the edge, there is also a persistent carrier wave of information, endlessly whispering in my ear, “You’re going to die someday, boyo. Someday you’re going to die.”
Most of the time I make a sparring partner out of the voice. I goad it to battle in my increasingly martial view of life and mortality. I picture myself at war with this voice and I do so because I know, deeply and penetratingly, that death is going to come around again — and that I need to be ready to fight like all the furies to keep my stake in the eroding surf of time. I made it to the edge of life and death in this journey, and once seen, as goes the internet meme, it cannot be unseen. That means more exercise than I’d have pushed myself to before. It means neither drinking nor smoking and trying to eat healthy. I used to find romance in the self-consumption of cigarettes and mezcal, and I do miss the abdication of vigilance required to embrace the moment in that way, but these days I know another truth: There is a fight coming someday and I will lose it, but I must lose it well.
It is a matter of will to prepare every day for a battle you know you will lose, to prepare for a war in which you will be eradicated, only for the rampage of the battle and the joy of the living struggle. Before all this, I never viewed myself as a warrior. Now I do, and part of my warrior’s code is to try and count coup on the reaper a second time before I go. Every day I conjure that image of battle and I hold it in front of me. I mean to keep it there always, to brand it upon my consciousness, to make it an autonomic part of myself, so that I’m not taken by surprise when death comes for me again.
I thought I was there, and then either a nurse or an orderly at Mt. Sinai Hospital dropped a plastic bag of clothes and an envelope on my lap while I was under anesthesia and all of that intention flew right out the damn window.
The report was four pages. The first page of findings was a slightly disheartening report on my varices. Even with the significant recovery of my liver over the past year, they had not diminished. So, with some resignation, I turned to the second page and read, “Moderate to severe portal hypertensive gastropathy: Pervasive.”
This was entirely new information. I read it again and it was still there. The words “severe” and “pervasive” glowed on the page. I scanned past most of the information, writing it off as discursion, searching for the brass tacks of protocols and prognosis. They were on the third and fourth pages of the report. Treatment begins at medication. If that is unsuccessful, the next option is surgically implanting a shunt into the primary hepatic vein, the portal vein, to redirect blood flow from the stomach, thus lowering the gastric hypertension. If that fails, liver transplantation is recommended. The mortality rates were presented at ten to forty percent.
My heart sank absolutely. I could feel it. I could see it disappearing under miles of increasingly dark ocean waters. I had no fight. No martial spirit. No ferocity. I was a negative space, blank and empty.
Elisabeth Kübler-Ross did yeoman’s work in tracing the five stages of grief, but she blew it on the front end. The first reaction to devastating news is not denial, it is complete cognitive collapse. Maybe I quibble, but denial seems a choice, and my experience has been that profound trauma just flips all the breakers and, for a time, nothing processes. I think that is one reason we become aware of the slowness of the world in a crisis, why time seems to expand and distort. Our minds are so used to processing charging rivers of information – from the ambient temperature of the room to the sound of a songbird three blocks away to the shape of a nose on a previously unmet face to the memory of a girl in homeroom that nose, songbird or ambient temperature just caused to arise in our hippocampus – that when a trauma occurs, that secondary processing stops. Or most of it does, and so we become minutely aware of each heartbeat, of how distended a moment can feel when it swells to bursting with the capacity to destroy our world, our hopes and dreams, our love and intent. Only when that moment passes does the flood come.
As it did in that recovery room, where I discovered that I can navigate the remaining stages of grief in no time at all. Denial lasted about five minutes. “No big deal,” I thought. “I’ve been through worse. I can beat this standing still.”
Liver shunt. Transplantation. Debilitation. Forty percent mortality.
Under that weight, denial gave way to anger before I could even begin to outline a plan of action. My inner vision gave a wicked side-eye to the God in whom I do not believe and I thought, “This is how you do me? I crawl back from nothing. NOTHING. I crawl back from death’s door. I crawl back to hope, to love, to life, to my family . . . and now this? Reduction back to the nadir. Screw you, sick bastard.”
That rage was red hot and it burnt out quickly. I didn’t have the heart for it. I also discovered that whatever bargaining I had was used up the last time I ran this rodeo. There wasn’t even a scent of it. Ten minutes after I’d read that I’d likely need surgery to insert a six-inch-long metal tube into my liver, or have it replaced, or die, I collapsed inwardly into depression. The emotion was as dark as the cognitive collapse, only it was fully aware. It was the realization in the attempt to swim back to the surface: You know you’ve got a few kicks left in your legs, but the rescue boat is so small, so shimmering, so far away. Too far away. Futility ran, unbridled, through all things.
I looked at my hands; I looked at the veins raised above the fascia of my muscles, stretching the thin border of my skin. All of this still-extant life was soon to be dried, desiccated autumnal leaves. I could sense the deadness of my fingernails forcing its way into my life like fallen tree limbs burrowing with rain and gravity into the humus of a black and silent forest floor.
Maybe it was the trees that I saw out of the corner of my eye that drew me towards that soulless place. If so, that would be fitting, as those trees also brought me home. I turned my head and looked out the window of the small recovery room. I was on the sixth floor of the hospital overlooking Central Park at 101st Street. The park is forested there with walnut, pine, oak and ash, each species with leaves that crowd together around a conceptual, central hue. Their colors are varied subtly one from the other, but of a living family you know as intimately as the many blues of morning or the white stillnesses of moonlight on snow. I could hear nothing from the outside world, so I watched in silence as the wind circulated the branches of those trees through one another in sweeping, graceful gestures. Around and around. Around and around. Around and around. Each circulation different in form, but similar in gentility and strength. It was a perfectly loving, absentminded caress of the living Earth. I felt the same spiraling gentility through my hair from my father’s fingers when I was a child, by my partner last night.
I idled with the universal empathy of the moment, watching the world being moved so affectionately, so remotely and yet presently. Then the image blossomed into a metaphor of astounding beauty. I imagined the God in whom I don’t believe as a painter, standing at His easel and staring off into middle space while His brush idly swirled through the greens of His palette, twining and lacing them through one another, mixing them into precise, but accidental, combinations of light and form. In my imagination, as He did, all the colors on the Earth that corresponded to these shades moved in that rhythmic, cyclic sway, eddying small, free vortices of life into existence to be perceived by silent observers all over the world. Some of those whose eyes were turned to the forests and grasses and algae blooms of our planet were children without history, in gallop and at play. Some were young and in love. Others were soldiers after the battle. Many, like me, were dying. All of us, in my imagined truth, felt our eyes well with the same tears, the same abiding and ineffable love of all that remains alive.
It was poignantly beautiful, more melancholic than any psalm that had arisen in my heart for years and as I wept, I knew why I was dying. For one brief moment, and a moment is all it takes, the God in whom I do not believe lost me in the flow and beauty of wind through leaves.
What was I supposed to remember? Ah, it will come back to me soon. I’m sure it’s nothing.
It will happen to us all eventually. Nothing to be mad about. No sense in cursing or screaming or blaming or even believing. It just happens, is all. We’re here, then we have to go, and that’s all right.
Acceptance, and perhaps something more. All I’ve ever truly wanted in life was to create, apprehend and share beauty, and that gentle image, I believe upon reflection, may have been the stirring of the warrior after being stunned by the swiftness with which the battle will come. Perhaps the warrior is there for when the grieving is done, perhaps he is there to end it, acting as a reassertion of self into the battle that is already lost. For me, that battle is to cast light, and to do so, I must be ready to burn.
I do not know where those thoughts would have led. I don’t know how long I would have been able to fight. That I will have to discover on another day. Just as the poignancy of the moment was about to send me spiraling into tears of a deep and abiding love for life, my doctor entered the room. He reached out to shake my hand and said, “Everything looks pretty good. See you in three months for a checkup and we’ll do the endoscopy again in a year to see if anything changed.”
He repeated that everything looked fine, glancing at his hand which I’d left hanging in the air. I reached out and shook it.
“The varices haven’t disappeared, but they haven’t grown, so we’re fine. Go enjoy your weekend.”
I said, “Yeah, but . . . page two. The hypertensive gastropathy thing. That’s new.”
He was not at all perturbed and said, “We probably just missed that last year, but it couldn’t be getting worse. If it were, we’d see it in the varices, and they’re no different. Don’t worry about it. You’re fine. We’ll take a look again next year.”
I suggested that dropping reports on anesthetized patients’ laps that have the express term “forty percent mortality” in them was a pretty bad idea. He agreed, but also seemed equally concerned that it was five o’clock on a Friday and traffic out of the City was going to be a nightmare. I had dressed by the time he entered and my chaperone had arrived to get me out of the hospital after anesthesia, so we walked to the elevator bank together and talked baseball. The Yanks looked better at this point of the season than the Mets.
Who would have believed that in May?
In Phaedo, Plato recorded the trial and death of Socrates. It was in this book that Socrates famously postulated that all philosophy was preparation for death. For the past two-and-a-half-thousand years, scholars have wrestled with the weight of that statement. So have pikers like me. Phaedo means “on the soul,” and in the book, Plato lays out Socrates’ arguments for the permanence of the spirit. They are beautiful, elegant proofs and his final conceptual offering to the world is of value to consider here. Students know it as the Argument of the Form of Life and it holds that the Fixed Ideas — the Forms — that things occupy are eternal and unchanging. An analogy can be drawn to mathematics. Consider the number four, written on a page. It is a manifestation of the Form of Even Numbers and even numbers are an imperishable concept. The number four participates in the Form of Even Numbers as an individual soul participates in the Form of Life, and thus, as a part of that permanence, it can never die.
It’s enchanting sophistry, but I’m not swayed. None of Socrates’ arguments (or those of Augustine or Aquinas) move me much. They didn’t when I was acutely dying of multiple organ failure, they didn’t when I briefly returned to that spiritual space in the recovery room of Mt. Sinai Hospital this past summer, but I am glad that I know the arguments. Those words and thoughts buttress my internal cathedral. The arguments on the perpetuity of the soul are like unto the Gospels or the Sutras or the lyrics, melody and harmonies of Love Reign Over Me off Quadrophenia. They are, in and of themselves, as gratifying as the memory of patterned wildflower colors emerging from a Burren hillside on a drive two decades ago with a woman that I will always love. Yet, they mean nothing when taken out of the internal context of a living mind, a point of sentience passing through this world, gathering sound, fragrance, images, memory and potential . . . to do what?
When that answer comes, acceptance and the need to battle merge into one. The martial becomes the spiritual. We gather these rosebuds so that we too may explode and do so well. Simple as that, and as simple as it is, it means that each second counts, particularly those as we near the end. Socrates’ final actions indicate that he understood this truth profoundly.
There is an agonizingly beautiful scene at the very end of Phaedo, when the old man takes the cup of hemlock in his hand. He inquires if he may pour a libation to a god and is told that he may not, as the poison has been measured for him alone. Socrates then asks only for a moment to pray and his request is granted. Silently the old Gadfly introspects, communes and finds his resolve.
Then he raises death to his lips, drains the cup to the lees – and he smiles. He then walks the courtyard, lost in an internal dialogue. He did not speak his thoughts, but I believe I know them. He was in metaphor. Likely it was very different than mine. Perhaps it shared features. Surely, it was of dreams, nature’s blush and the beauty of this life we share so briefly.
When the numbness of the poison was headed for his core, Socrates lay on the ground, just propping up his head and he spoke his final words, a last command to his closest friend, Crito. It was an order.
“Crito, we owe a cock to Aesculapius. Pay it and do not neglect it.”
I never understood that line until now, and in this new light it seems to me the bravest, most noble salutation of any man who ever lived. Aesculapius is the God of Medicine and the Curative Process. It was to him that Socrates offered his final, silent prayer and a sacrifice needed to be made. Knowing he would die imminently, determined not to run from his punishment, no matter how unjust, Socrates brought poison to his own lips — but first he entreated his god for the strength to heal even as the hemlock stole his breath. He prayed for the strength to fight for each fading lumen until the end. His last act was willful, martial, beautiful, truthful and filled with a poet-warrior’s light.
May we all have the strength, and the sense about us, to do the same.
Rise as you fall.
Rise as you fall.
Rise as you fall.
Michael Tallon is the Editor-in-Chief of La Cuadra Magazine. Visit him at Café No Sé on Wednesday night, while his soulful friends Thom, Willie and Mercedes play music that will make you believe in something bigger and more beautiful than you believed when you walked through the door. Also, join him every month for live storytelling with The True Fib. Ask around for details, or drop a line below.