a solstice on the border of life and demise
I as soon as traveled unexpectedly to Newgrange in County Meath, Eire. It’s an historic passage tomb that has marked the solstices precisely for over 5,200 years, and I’ve thought so much about tombs and transitions within the yr main as much as this winter solstice, each as a result of I didn’t count on my husband, Jake, to outlive to see it, and since it marks the tenth yr I’ve spent as an attending emergency doctor. My work patrolling the border between life and demise is uncommon, and I’ve borne witness to almost 100 sufferers’ final moments on Earth.
People have been grieving for our lifeless and constructing monuments to their lives for so long as we’ve been human, and Newgrange is one instantiation of the life-death course of. The Newgrange webpage describes it:
Newgrange is a Stone Age (Neolithic) monument…Above the doorway to the passage at Newgrange there’s a gap known as a roof-box. Its function is to permit daylight to penetrate the chamber on the shortest days of the yr, round December twenty first, the winter solstice. At daybreak, from December nineteenth to twenty third, a slender beam of sunshine penetrates the roof-box and reaches the ground of the chamber, steadily extending to the rear of the chamber.
Because the solar rises larger, the beam widens throughout the chamber in order that the entire room turns into dramatically illuminated. This occasion lasts for 17 minutes, starting round 9am. The accuracy of Newgrange as a time-telling machine is outstanding when one considers that it was constructed 500 years earlier than the Nice Pyramids and greater than 1,000 years earlier than Stonehenge.
The passage tomb was darkish inside after I visited, and I imagined a fireplace flickering within the massive, blackened stone bowl on the bottom, which guides speculated was used for burning: maybe the cremation of stays, or of symbolic choices. Possibly the fireplace illuminated faces performing a ceremony. Runes are carved on nearly each floor of the construction, and if you happen to search for that means within the writing there, you’re more likely to discover indicators of no matter it’s you wish to discover. These symbols meant one thing to somebody standing there 5200 years earlier than. The individuals who lived right here are actually a part of the information set of “those that as soon as lived right here throughout [insert era here]”, simply as my distinctive life will turn into a part of an information set at some point. All locations maintain the tales of ghosts, and we’re linked, figuring out that our personal tales will most likely disappear in the identical means—until we grasp the expertise to stay in area, construct a Dyson sphere, and turn into as gods.
Jake and I’ve been spending the final 5 months writing so furiously partially as a result of we’re a tiny a part of the larger story of the human expertise, one that somebody may think in a thousand years. Writing connects us to the opposite folks now, however writing may protect us for the long run, too; lots of Shakespeare’s sonnets deal with this high quality, as when he writes to a girl:
“However have been some little one of yours alive that time [in the deep future] You ought to stay twice—in it and in my rhyme.”
Maybe we’ll handle to print our writing on acid-free paper that resists time’s ravages. The voices that emerge from the previous are the recorded ones. Twenty-six letters are the symbols now we have proper now (our runes?), and we’ve made a ritual of writing day by day.
I take into consideration all the opposite rituals that’ve been a part of our yr: twice every day trache tube web site cleanings, peg tube care, every day bulleted lists of medicines and the time they’re administered, scheduled infusions of Liquid Hope—but additionally walks across the block, sharing ice cream at the kitchen counter that Jake drinks as a slurry and I nibble off a spoon, studying aspect by aspect on the sofa that we purchased years in the past with cash from an inconceivable aspect gig. These rituals are all to protect Jake’s (and my) life. Individuals don’t have to face the place we’re standing to grasp that one thing highly effective is occurring to us. Individuals can learn our essays and stand with us, whether or not we’re within the hospital, or our condominium, or at a scientific trial web site (and a few persons are studying us from hospital beds; we all know as a result of they’ve informed us so). The Web hyperlinks us to them—us to you, actually. We’ve been making an attempt to shine our personal gentle on the darkness within the hope that it’d join us to different individuals who really feel like they’re within the void.
In First Light: The Origins of Newgrange, Robert Hensley proposes that the idea of an otherworld, which could possibly be embodied by and accessed by way of passage tombs was a central motivator in passage tomb development from its earliest beginnings. The tomb would alight on the solstice, throwing gentle on the connection between the residing and the lifeless.
I’ve by no means been to a different passage tomb, although as I write this I ponder if that’s not precisely proper. It’s true I haven’t visited different locations with the anthropologic label of “passage tomb.” However I step into different liminal areas connecting the worlds of the residing and the lifeless each time I am going to work within the ER. The ER is probably not as architecturally historic as Newgrange: the lights are all the time on regardless of the time of yr, the construction most likely isn’t constructed to final 5,000 years, and the incinerator is positioned some other place within the hospital. However clusters of docs, shamans of modernity, carry out our rituals with stethoscopes and lab checks, ceaselessly bearing witness to the passage of sufferers from residing to lifeless. As I discussed above, I’ve presided over that transition for therefore many, and that’s unusual not solely to pals, however to many different docs, who lose sufferers, sure, however don’t witness it.
The hospital is a transitory place: typically you enter and by no means depart, prefer it’s the Hotel California. Typically, although, you enter, and also you go by way of and out, returning to your property even once you by no means anticipated to. When Jake went into the hospital for his Could 25th surgical procedure that removed his tongue, we didn’t know if he’d survive the operation, not to mention return to our apartment. With out him, I’d feel homeless. When his tumors recurred and metastasized on July 21, every spherical of chemo and every ER go to may’ve been his final. Typically, I do the whole lot proper within the ER and I nonetheless can’t save my affected person, and I’ve the horrible activity of delivering that information to their household. I see sufferers whose many years of unlucky life-style selections have caught up with them, and I typically can’t repair many years of life-style selections within the ER. I additionally see sufferers whose time is just up. Typically, one other physician, whose affected person is the particular person I really like, succeeds in saving Jake, or prolonging his life, and we get bonus time.
On December 12th we celebrated Jake’s 40th birthday, a milestone that in July neither of us anticipated him to succeed in. As I’m penning this, his tumors have shrunk an overall 12.5% in response to the petosemtamab. In response to examine tips, he’s not technically achieved “partial response,” for the reason that definition of response is a 30% discount in tumor measurement. As a substitute, he presently is assessed as having “secure illness.” Regardless of the official trial place, final night time he stood on the kitchen counter and made lentil soup for dinner, then we went on a stroll, and edited one another’s writing and held one another in mattress. Holding the road towards such an aggressive tumor appears like a strong response to me. It’s greater than a response, it’s an surprising doorway opening. He’s nonetheless hurting and struggling in some ways, however his vitality has improved a little bit, since petosemtamab is simpler than chemo, and he’s nonetheless alive and making artwork (and soup).
We ready a lot for Jake’s demise by what we anticipated can be yr’s finish. Jake said goodbye to friends and family, and we’ve been saying a protracted goodbye to one another. We’re not fools, we all know his present remedy is borrowed time—the median size of response to petosemtamab is six months, and he’s been on it for 3—and although borrowed time is in a means all any of us get, the belief of how a lot much less time Jake will get to borrow than his friends is acute. For therefore many months, every day has been about planning for a future with a man who won’t be in it. However now, we get to ask one other query: What if he lives?
Jake may cease responding to petosemtamab and never discover one other trial that works, however there’s a seeming renaissance in R&D for head and neck cancer, and consequently he may hop from scientific trial to scientific trial for years. A remedy is unlikely, however managing his illness is feasible. If we will preserve him alive lengthy sufficient for Moderna to finish their mRNA manufacturing unit (scheduled for 2025), which precludes requesting FDA approval, and, perhaps, provide the Moderna mRNA-4157 vaccine to HNSCC sufferers, may the mRNA-4157 vaccine trigger remission? That’s like staring on the solar, so I’m not keen to look simply but—I can’t let that a lot gentle in with out blinding myself to cause. However I can see that remission will not be unattainable, merely inconceivable, that are larger odds than I’d chanced earlier than. Jake’s 40th birthday had felt unattainable, too. What I can do is go searching and all of a sudden see extra than simply the faint shadows of the subsequent yr. Jake simply wrote an essay about this, “What if things go right with the carcinoma treatment? How long we expect to live affects how we live,” by which he asks: What may his place on this planet be if he lives 5 months or 5 years? What’s going to our place be? How can we plan? As Jake likes to say, this can be a high-quality downside.
This yr, fortunately, the solstice gentle isn’t a lot an incredible transition as a seeping consciousness of what has been preserved and deepened, when it appeared that these issues can be misplaced. Jake didn’t die, nor did we fling open the home windows to disclose a whole remission, flooding our lives with daylight, like we’d simply turned on one of many dragon light corn bulbs Jake purchased me to unravel my grumbliness at early sunsets and a low-light apartment. Even now, Jake hears me and tries to repair my issues. This yr, the illumination has crept in slowly, its mild gentle suffusing the whole lot after we bought the information that Jake’s tumors have been shrinking in response to petosemtamab. Each bonus hour has turn into the golden hour. We haven’t been round so long as Newgrange, but it surely appears like, simply by attending to this solstice, we’re a monument to one thing. Possibly a monument to how a lot love can do. We’re lovely on this gentle.
I’m reminded of a line I really like from a Ram Das speech (set to music by East Forest)
“In every of us there was as soon as a fireplace. And for a few of us there appear as if there are solely ashes now. However after we dig within the ashes we discover one ember. And really gently we fan that ember. Blow on it, it will get brighter. And from that ember we rebuild the fireplace. Solely factor that’s vital is that ember. That’s what you and I are right here to have a good time.”
Winter solstice is the shortest day of the yr, a time to pause quietly, wrapped at the hours of darkness, and ask your self the way you wish to let the sunshine again in: by way of one deliberate passage, or by way of all of the cracks within the basis that the lengthy yr has shaped? Winter solstice appears like the actual New 12 months’s Eve, as a result of the method of rediscovery and regeneration begins once more, with every day providing extra time with the solar. Little by little, the sunshine reenters our lives. Not with a single flash, however slowly, cautiously, till we’re illuminated.
This solstice, I have a good time a means ahead that wasn’t there earlier than, a smooth glow to have a tendency to love an ember, to take pleasure in longer than we anticipated, earlier than all of us return our tales to the darkish.
When you’ve gotten this far, consider the Go Fund Me that’s funding my husband Jake’s ongoing cancer treatment.
Readers: How will you be letting the sunshine again into your life as the times develop longer? What’s going to you illuminate on this coming yr? Let me know within the feedback.
A video of the winter solstice at Newgrange:
The passage:
My last-minute journey companions (who didn’t homicide me and who’re very good folks!) and I in entrance of the opening to Newgrange. Stairs are a contemporary addition. Photograph from July 2018:
