Well, that poem talks about an old man who is dying.
And I'd like to read an awfully unpleasant poem about him.
He was an old man.
I saw his name today on a store in town here.
It really shook me up.
His name was Fritz Jarck, and I saw the name Jarck on a store
someplace, J-A-R-C-K. I haven't seen it since this man was
my patient.
I used to work in a Veteran's Administration
hospital in Iowa City while I was a student there.
And I went to work there thinking
it was a good kind of work to be doing.
I was a recently converted Quaker, convinced,
and thought that was a good kind of work to be doing.
I thought most of my patients would
be boys who'd been shot up in the Korean War which was just
then ending, if it ever ended.
And was very much amazed to get there and find out
that the hospital wasn't at all what I thought it would be.
We only had-- let's see.
The whole time I was there there was only one patient
from the Korean War and he was on a ward
I wasn't even allowed to enter.
We had five or six patients from my war and everybody else
was from World War I, very elderly men
for whom there was very little you could do.
They just needed continual care, good food, a lot of rest.
It made it a very different kind of hospital
than anything I had anticipated and one that made it
a great deal harder to somehow sugarcoat
the very bitter pill of ever having to work
or ever having to do anything I didn't want to do,
anything that meant serving someone else.
And in this case you couldn't get it up
under some kind of rationale about helping
somebody who had been damaged in a desperate case.
No, it was just dirty ugly work.
When you came to a man like Mr. Jarck,
it got dirtier and uglier and began
to make less and less sense the more you did of it.
Mr. Jarck was not expected to live out the first night
that he came there.
Three months later, I came to work there
and he was still there.
I took one look at him and thought
he was dying of his bed sores but no, he
was dying of lung cancer still.
And he lasted out about eight or nine months.
Toward the end of that time, as many as eight of us
were pouring our full working day
into only keeping him alive.
And you know you get to asking yourself if you're
making any sense at all.
Are you saving him for anything but more pain?
Or for more drug, more deadness.
He's had so much drugs at this point
you know he can never be well.
He can never go home.
You'd known long ago he could never
be well enough to do anything for the culture that might pay
back that kind of care, that other people's work
to that extent.
As a matter of fact, Mr. Jarck didn't even have anyone at home
to go home to.
There wasn't even anybody who wanted him.
There was nothing but his will to go on.
And of course he had no enemy but himself.
There was nobody killing him but himself.
And it was a mighty grand and heroic struggle toward the end.
But one I'd have been glad not to have had any hand in.
And you get to asking yourself more and more questions
to which you don't find any satisfactory answers.
I'd find myself coming off after a night of being with--
you couldn't special him all night.
Even the nurses who were much tougher than any of us--
the men who worked there, the aides, the nurses were
much tougher than any of us.
And they were really, really sort of great girls.
But they couldn't they couldn't special him all night.
You simply couldn't stay in the room with that much pain
that long.
They had to sit out in the hall.
I'd come off after one of those nights
and I was also teaching at the university
and I'd have to go meet my class.
And I'd get on the elevator and go down
my relief man had come on and I'd hear myself thinking,
die today, on his shift.
And then you think boy, how trivial can you get?
I mean, that man is dying in such pain
that it's just incredible and you
care whether you have to dress his body or not?
Well, maybe you shouldn't but you really do.
I suppose there's some good reasons
for identifying with him.
Maybe you like him or if you don't like him,
maybe you've come to even to be close to him
whether you liked him or not.
In a way you have to admire the toughness of the side of him
that won't quit.
But there's surely bad enough reasons
to why you identify with him in the long run.
I think I just ended up deciding that surely the only reason we
were doing that was to indulge him in the fantasy
that he could live forever.
That he didn't have to face what we all have to face.
And we're making it that much worse for him
by what we were doing and vicariously
indulging our own similar fantasy
and that surely is a bad reason.
But there's good reasons too.
In any case, you do identify with him.
You're the only one he's had.
There's a strange moment maybe after he's had his shot.
Most of the time he's weeping for his shot.
After he's had it, he has maybe what 15 minutes out of pain.
So you feed him during that time and you
got a few minutes left and you light him a cigarette.
He's dying of lung cancer and you light him a cigarette.
And he lies back and you talk to him.
And after that don't want to have to dress his body.
Well, the man who speaks this poem gets the body to dress
and he's not very happy about it and he's not
very happy about the situation.
I think he decides the kind of thing that I did.
Probably it's immoral to keep that man alive that way.
It isn't a moral problem at all.
For you, not as an aide, it's the practical problem.
How are you going to live with your feelings?
You're in no position to--
somebody ought to be making a decision about that man
and that we all could use our energies to better
purpose somewhere else, to help somebody
who might grow up into something different on account of it.
But since no one's making a decision,
nobody wants to take that kind of responsibility.
You certainly can't and you've just
got to learn how to live with your feelings in the meantime.
There's one other thing I'll have to tell you about in order
to read the poem.
Unless you're familiar with hospitals and I hope
you never get that way.
This man is on what's called a foster frame bed.
And it looks like a medieval torture device.
It isn't, it's a modern one.
Well, as a matter of fact, it can
be used for very good purposes.
One just saved my son-in-law's life.
But he's a young man and had something to do with his life,
someplace to go with it.
The reason he's on it is that a man
has to be turned over 6 or eight times a day
or he will die of his bed sores.
And this man was so ill that he couldn't be turned over even
by the doctors and nurses without damaging him.
So that many times a day, he's on a narrow frame
made of black iron and it has Canvas stretched across.
It's so narrow there's no place for his arms.
And so if he's lying on his back,
you clamp separate arm pieces on out of the side
and he looks like a man crucified
on a kind of weird torture contraption.
Well, six times a day or so, you bring the other half of it
and you sandwich him in the middle.
You clamp him down with big heavy screws
all the way around.
Well, after you've done all--
first of all, you have to coat him all over in salves and foam
rubber and turn off all the tubes going in
and turn off all the tubes coming out.
And then you sandwich him in there,
clamp it down, loosen the central screws
on the whole machine, take a good purchase on it,
and do the whole thing at once.
You go for eight months on a thing like that
and you really want to not die.
I mean.
This is called "A Flat One."
That's slang for a corpse.
If you're coming on duty, the guy who's going on
says, hey, got a flat one on your ward.
That's bad news.
"A Flat One."
"Old Fritz, on this rotating bed for seven wasted months
you lay.
Unfit to move, shrunken, gray, no
good to yourself or anyone but to be babied,
changed, and bathed, and fed.
At long last, that's all done.
Before each meal, twice every night, we
set pads and your bed sores, shut your catheter tube off,
then brought the second canvas and black iron bed frame,
and clamped you in between them tight, scared,
so we could turn you over.
We washed you, covered you, cut up each bite of meat you ate.
We watched your lean jaws masticate as ravenously
your useless food, as thieves at hard labor in their chains
chew, or insects in the wood.
Such pious sacrifice, to give you all you
could demand of pain.
Receive this haddock's body, slain for you old tyrant.
Take this blood of a tomato.
Shed that you might live.
You had that costly food.
You seem to be all finished.
So we'll plug your old recalcitrant anus
and tie up your discouraged penis in a great snow
white bow of gauze.
We wrap you, pin you, and part you down below, below,
below because your credit has finally
run out on our steel table.
Trussed and carved, you'll find this world's hard working
starved teeth, working in your precious skin.
The Earth turns in the end by turnabout
and opens to take you in.
Seven months gone down the drain.
Thank God that's through.
Throw out the 4 by 4s, swab sticks,
the thick set for bed sores, throw out the diaper pads
and drug containers.
Pile the bed clothes in a wad, and rinse the cider jug half
filled with the last urine.
And empty out the cotton cans, autoclave the balls and spit
pans, unhook the pumps and all the red tubes, catheter,
suction, oxygen.
Next, wash the empty bed.
All this dark age machinery on which
we had tormented you to life.
Last, we collect the few belongings, snapshots,
some odd bills, your mail, and half a pack of Lucky's.
We won't like you after meals.
Old man, the seven months you've lain
determined not that you would live, just to not die.
No one would give you one chance you
could ever wake from that first night, much less go well again,
much less go home and make your living.
How could you hope to find a place for yourself
in all creation.
Pain was your only occupation.
And pain that should content and will a man to give it up.
Nerve due to grind your clenched teeth
breathing, till your skin broke down, your calves went flat,
and your legs lost all sensation.
Still you took enough morphine to kill a strong man.
Finally, nitrogen mustard.
You could last two months after that.
It would kill you then.
Even then you wouldn't quit old soldier yet
you must have known inside the animal
had grown sick of the world, made up its mind to stop.
Your mind ground on its separate way
merciless and blind into these last weeks
when the breath would only come in fits and starts that
puffed out your sections like the parts
of some enormous damaged bug.
You waited not for life, not for your death,
just for that deadening drug that
made your life seem bearable.
You've still whispered you would not die.
Yet at the nights I heard you cry like a whipped child.
In fierce old age you whimpered, tears
stood on your gunmetal blue cheeks,
shaking with rage and terror.
So much pain would fill your room
that when I left I prayed that if I came back the next day
I'd find you gone.
You stayed for me, nailed to your own rapacious
stiff self will.
You've shook loss.
Finally, they'd say this was a worthwhile job
unless they tried it.
It is mad to throw our good lives
after bad, waste time, drugs, and our minds,
while strong band starve.
How many young men did we rob to keep you hanging on?
I can't think we did you much good.
Well, when you died none of us wept.
You killed for us and we kept you
because we need to earn our pay.
No, we'd still have to help you try.
We would have killed for you today."