A Certain Verticality

My husband as a CME?  It was Suessical-ly strange to see.

Jim appreciated impromptu poetry of dubious quality, and endlessly humored me; I promise he would have approved such an introduction, though the occasion was solemn.

And he would greatly have appreciated today’s actual introductions to an inaugural annual memorial lecture in his honor.

When both knew he had little time left, the CEO of my husband’s hospital discussed with him what he would like his legacy there to be.  The hospital’s trustees honored him by establishing a lecture series in cutting-edge health care issues, which is something I know pleased Jim to contemplate.

A decade earlier, my husband had acquired his ideal job: maintaining opportunities for direct patient care while overseeing, envisioning, implementing and improving new health care initiatives and systems.  As a colleague of his observed, “Jim was a visionary that way.”

Today’s topic was “Reorganizing Healthcare Delivery”; in health care lingo, the objective for Continuing Medical Education purposes was for physicians to “Understand how an integrated health system operates.  Learn about how to merge multiple medical information systems.”

Jim knew a copious amount, and constantly spun out new ideas, about such issues.  I know little more about such subjects than I do about signal processing, although my involuntary immersion in health care following my husband’s diagnosis with pancreatic cancer somehow left me alarmingly able to grasp much of today’s discussion.

As with Jim’s Closing Ceremonies; it was gratifying to see so many people he knew, thinking about issues which were so central to his professional life, and in a sense being there for him.

Today two things caught my attention above all others, both courtesy of a physician colleague and friend who inherited some of Jim’s tasks.

First was something he said in introducing the lecture, because I had not heard it said before:  in the years when Jim would no longer be there to share ideas with his colleagues, Jim had indicated he “wanted people to hear new things.”

It seems simple, and perhaps should have been obvious to me, that Jim would have wanted that from these memorial lectures, but I had not thought of it that way.  It struck me that this was the core of Jim in every facet of his life, and not just his work: he truly listened for and to new ideas, and conducted himself in a way that helped others to be open to them as well.

More than anyone else I ever have known (though echoed in our children, including our  globe-trotting, fiercely independent daughter–the one who is not yet twenty but already on her second passport), my husband was able objectively to see every side of a complex issue; he strove to look at things in new ways, to solve problems by adaptation and invention, to learn more. . . .and to bring others along on his adventures.

When something new and interesting was to be tried, Jim dove right in….sometimes literally, as when, fewer than three months before he died, he–and our peripatetic daughter–took running leaps from the top of a boat into Ecuador’s aqua water, to swim among white-tipped sharks.

Today I was offered the chance to speak for a few minutes (a dangerous offer to make to an attorney, in the best of circumstances).  I tried to say that Jim’s legacy was not only of substance, but of a unified style: at work and at home, he was the same person, and he sought change by encouragement and example, not by edict.  In the words of the poem one of our daughters read for him, he was “for counsels rather than commands.”

It so happened that last night I re-read a favorite book.  The author wrote about a man getting an elephant to stand: he “carefully intimated” to the elephant “that it was time to make a small effort and get to his feet.  He didn’t order him, he didn’t resort to any of his varied repertoire of flicks and pokes with the stick, some more aggressive than others….It’s the difference between a categorical Get up and a tentative What about trying to get up.  There are even those who maintain that jesus actually used the latter phrase and not the former, which provides absolute proof that the resurrection was, ultimately, dependent on lazarus’s free will and not on the nazarene’s miraculous powers, however sublime they might have been.  If lazarus came back to life it was because he was spoken to kindly, as simple as that.”

And thus, in that instance, the gentleness worked: “straightening first his right leg and then his left, restored” the elephant first “to the relative safety of a rather uncertain verticality,” and soon to “a sprightly pace toward” his next goal.

Last summer another of Jim’s physician colleagues and friends had told me Jim left his organization with a foundation of steel, presumably helping equip it for more certain verticality.

A second part of today’s proceedings stopped me cold.  It was an excerpt from a film made just days after we returned from Ecuador to the snow-deluged Northeast.

The short film was produced by the hospital as a tribute to Jim, its first Chief Medical Officer, and was shown at a gathering at the end of January.  By then Jim had only weeks left.  The symptoms of his cancer had started to overcome even his pace and energy, though never his spirit.

I had not seen the film since then.  Nor had I seen any other (literally) moving images of Jim.

But today,  there he was, sitting at our kitchen table, speaking thoughtfully, clarifying that it was not the colloquial “survival of the fittest” concept that governed Darwin’s findings, but the idea that whatever was best suited to adapt to change would endure.  He spoke of his belief that the hospital and organization to which he was so devoted was equipped to adapt to whatever came next.

I couldn’t take my eyes from that face.  I drank in the deep, carefully measured voice I have not in reality heard in slightly more than a year.  Bob and I both saw the fleeting trademark right-ear finger-flick that accompanied Jim’s “work face.”

Although my threshold for seemly behavior is not extraordinarily high these days; had there been no one else in the room, I would not have hesitated to go up to the screen and touch it, as I do photographs of that handsome face.

Had it not been for all those unfortunately persistent laws of physics, I would have taken a running Ecuadorian leap into the screen and back to that time, just a week after seeing penguins on the equator, when Jim’s eyes were still lit and his face animated with interest in what was to come, though he knew he wouldn’t see it from here.  I am not sure if I imagined a far-off look, a softened aspect in his eyes, some measure of the distance by which he knew the rest of us would have to hold him.

I hope he knew he had provided much of the foundation–not just the work, but the true devotion, the intellect, and the heart–that would allow both his organization and his children to hold steady, to adapt, and even to thrive.

(c) 2012 Stephanie M. Glennon