Thursday, March 28, 2013


     My last two posts, on the Newtown massacre and the movie "Amour," have gotten me thinking about mortality and my close contact with it every two weeks at the hospice hospital where I volunteer.  The "Wilderness Rejoined" subtitle above is a follow-up to my earlier Consolation Four, "The Wilderness," posted May 19, 2011, in which I define wilderness as every natural object, event, and evolution that has or will come to pass in post-Big Bang, cosmic spacetime.  There I also define mortality as a rejoining of the atoms and molecules that comprise every percipient being after it dies with this cosmic wilderness and further argue further that the human species, like all other species, randomly evolved from inorganic matter and merges back into it at death.
     Now that I'm approaching my seventy-seventh birthday, I feel like giving mortality more attention than I have in the past and hence in future will probably write occasional posts like this one that focus on it.  While I realize that relatively few people choose to ponder their own extinction much, I hope that those who do and who happen to read this blog will be joined by others interested in seeing an aging materialist like me wrestle with the subject.  So until I'm either too depressed to write about dying any more or have said all I have to say about it, I'm afraid my readers will have to put up with posts like this from time to time.
     Every two weeks I spend Wednesday mornings at the hospice hospital sitting with actively dying patients.  Patients who are "actively dying" have been so classified by the medical staff because they're within minutes, hours, or at most a day or two of the end.  Though normally comatose and unresponsive, these patients often show signs of restlessness or discomfort.  Sometimes their sounds or gestures are nothing but neurological cycles repeating themselves over and over and needing no help.
     But occasionally they're distress signals.  In that case, I call the nurse to come and decide if additional help or medicine is called for.  Of course I'm also there simply to keep the patient company, as has been customary in many cultures for millennia.  None of my patients have relatives or friends with them when I arrive, and I move on to unattended patients if anyone like that shows up.  Either in alleviating pain or by just being in the room, I find the work satisfying, despite its lack of communicativeness and sociability.  Helping dying people through their final ordeal gives me a greater sense of fellowship with them than anything else I can imagine doing, especially since, as has so far always been the case, they're total strangers to me.  Having now sat with more than a hundred such patients, half a dozen of whom have died in my presence, I'm convinced that, given proper medical care, no one needs to fear death.  It can be, and in my experience as a witness has been, an easy process, like a cup of water cooling or a spark burning out.
     That said, I'm also sure it's never easy nor anything but cataclysmic for the person going through it.  Death is no fun to look forward to or experience.  Everything evolution has built into our brains and bodies fights it.  We're hardwired as infants to assume we'll live forever, and even after lifetimes of watching plants and other animals die, we have a hard time applying such evidence to ourselves.  Most people in fact choose to  believe they'll personally survive death in some way.  It's hard not to hate and fear the impending annihilation of all we are and all we feel, sense, and know as conscious organisms, even if we find comfort, as I do, in the fact that the material elements we're made of survive us.
     My mornings at the hospital are part of my own effort to understand and accept my own annihilation.  Seeing death up close and personal or a regular basis helps me appreciate how mundane, unspectacular, and unavoidable it is.  It's also absolutely impartial.  Wealth or fame exempts no one from it.  When we die, we pass through the same portal from consciousness to oblivion that every other brain-equipped animal in the planet's history has already passed through.  We human beings are in this sense indistinguishable from countless other terrestrial organisms that have died and will continue doing so as long as life on earth exists.
     Death's impartiality and even-handedness was driven home especially clearly during my hospital shift this week.  When I arrived and checked the status board in the staff room, I found only four of the thirty-odd patients in the building marked as "actively dying" by a green dot or yellow triangle next to their names.  Since I prefer sitting with the same patient as long as possible, I followed my usual routine of arbitrarily picking a green-dot or yellow-triangle room from the status board and going there first to see if friends or relatives were present.  What I found was a large, well-built black man in his early forties alone, breathing oxygen through a nose tube.  He was slack-jawed and profoundly unconscious.  No cards, flowers, or other mementoes indicated he'd had any visitors.  The ceiling fan was on high, and I turned it off to warm up the room.
     After an hour, two aides came in to clean and reposition him, and I followed protocol by leaving.  Back in fifteen minutes, I found the aides had laid damp cloths on his forehead and arms and restarted the fan.  I located them a few rooms away and asked them why, and they told me he was running a fever.  I also learned  later from the duty nurse that he'd suffered some kind of brain damage, but exactly what kind and how she didn't yet know because she'd just begun her shift and hadn't had a chance to check the charts that came with him to the hospital twenty-four hours earlier.  All she knew was that his temperature was above a hundred and three.
     I'd never seen a patient like him before.  Much younger than most, he looked physically fit and free of external signs of disease or injury.  Though his breathing was slightly convulsive, sometimes restarting with a gasp after stopping a while, and his arm, leg, and face muscles never moved, he seemed quite healthy.  But like all comatose patients, he looked so helpless and vulnerable that he was more like a sleeping child than a grown man.  I wanted to help him, but I knew there wasn't much I could do but watch his breathing.
     As usual, I sat next to his bed and read a book, glancing up now and then to see how he was doing.  The hospice doctor dropped by, said hello, and asked me if I'd noticed anything unusual.  I said not during my shift, now going on three hours.  He nodded, checked the patient with a stethoscope, examined his hands and feet for mottling, thanked me, and started to leave.
     I stood up and said I had a question.  As is customary, we stepped out of the room, and, to my query what had brought the patient here, the doctor said he'd suffered massive brain in a fall at the Baltimore city jail, where he was an inmate.
     I paused.  "The city jail?  What kind of fall?"
     "I'm not sure," he said.  "Some kind of fall."  He added that he'd been taken from the jail to a nearby hospital, then, when judged to be terminal, transferred here.  I didn't think I was getting the whole story, but I didn't press it further.
     I thanked him, he thanked me, and he left.  Alone again with the patient, I studied him with new interest.  Never having had personal contact with a prison inmate before, I was doubly struck by how innocent and childlike he looked.  Except for his youthfulness, he was no different from any of the scores of other comatose patients I'd sat with.  He was no more menacing or menaced, troubling or troubled, unworthy or worthy than any of them.
     Was he a hardened criminal?  Rather than a fall, had some kind of fight or attack at the jail landed him here?  While probably relevant to his former life, whatever it had  been, such questions now struck me as meaningless.  Lying there clinging to an existence he was no longer aware of, he seemed archetypically human, a modern Everyman accidentally born from the wilderness and destined to rejoin it soon.  Nothing else about him was significant -- whether he'd  been likeable or unlikeable, lucky or unlucky, fairly or unfairly judged.  All that mattered now was that he was dying, and I was with him.  He died next day without regaining consciousness.


  1. (meant to reply to 27, not 26!)This is not a response to this specific consolation, but having been a regular reader for some time, I was moved to respond to Consolation 27 because it crystallized my intuitions about Dr. Vitzthum’s brand of atheism. I think an extract I recently read of a soon to be posthumously published book, Religion Without God by atheist Ronald Dworkin, who died Feb. 14, triggered a recognition of the actual concrete foundation for my own (fairly amorphous) atheism, and helped me understand why I have been drawn into reading Dr. Vitzthum’s Consolations.

    In the excerpt from the book’s first chapter, published in a recent issue of The New York Review of Books, Dworkin comments upon the “religious” habits of mind typical of many well known atheists throughout history, including Shelley and Einstein, and comes up with his concept of “religious atheism,” which, apparently, his book will argue is NOT an oxymoron. Dworkin comes up with two key criteria for what constitutes a “religious attitude,” both of them based upon the individual’s foundational acceptance of “the full independent reality of value.” The first affirms that human life has “objective meaning or importance”—each of us has a responsibility to try and live well and accept ethical responsibilities to ourselves as well as towards others. The second affirms that “nature” (the universe and all its parts) has intrinsic value and wonder. He calls these the biological and biographical assertions of “inherent value.”

    None of this, for Dworkin, requires the existence of God. I guess for some atheists the “dicey” part might be the potentially “specious” foundational assumption that value is real and fundamental—“just as real as trees or pain.” Dworkin argues that this assumption in no way requires “metaphysical” support, since we test and affirm our value judgments on the basis of experiment and observation, just as we do our scientific claims about the universe, the existence of which even scientists cannot indubitably “certify.”

    (One ultimate aim of Dworkin’s book appears to be to support an argument that the notion of “religious atheism” can help bridge the divide in our culture between theists, who think we need a God to support TRUE values, and atheists who, according to his theory, need no God as the source of value. He thinks theists and atheists could mutually embrace one another’s convictions regarding the two HUGE value commitments that he thinks constitute Religious Atheism—the meaning of human life and the value and wonder of nature. I actually don’t think that this “bridging of the divide” would be greatly facilitated by wider cultural recognition of the “religious atheist,” for reasons he himself acknowledges.

    But just the same, I still think the way Dworkin conceives of the religious atheist is crucial (I guess because I could find in his argument a clear reflection of my own heretofore amorphous convictions!), and also a resounding echo of what I have been reading in Vitzthum’s consolations. Of course Vitzthum believes in the value of human life, or he would not be spending so many hours contemplating how humans can deal with the crisis of death or about the significance of the full bodied convict at his hour of death. And, of course, he repeatedly and joyfully consoles us regarding the opportunity that awaits us all to merge our elements with the “cosmic wilderness” of the awesome universe. Because of these two ultimate value commitments, he strikes me as Dworkin’s consummate “religious atheist.)

    So I guess I am just wondering, Dr. Vitzthum, what do you think of Dworkin’s concept of “religious atheism.” (The full book is to be published by Harvard UP later this year.) JH

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    1. JH: Thanks for your thoughtful and intelligent comment, to which I'd like to reply as follows. I'm not a "religious atheist" in Dworkin's sense at all. To the contrary, as a philosophical materialist I assume that ultimate reality, whatever its material substance is, is not only indifferent to and oblivious of all human concerns but is itself essentially non-human, although it obviously has the potential to produce human life randomly and accidentally, as our planet proves.

      I also assume that value is a human invention and that the cosmos as a whole has no inkling of it. I explain this in some detail in Consolation Two, "Morality," which I invite you to read if you're interested. I am awed by nature, of course, but deep down I know the awe is a subjective projection of myself onto nature and not intrinsic to nature itself. I'm convinced it neither shares nor reciprocates any of the awe, wonder, or value we human beings feel towards it or anything else.

      Yet none of this means human values aren't hugely important to humanity itself and necessary to human existence, merely that they carry no weight beyond the human sphere. The planets, stars, and galaxies will continue their strange, random dance with or without us. Thanks again. RCV

  3. RCV: Thanks for clarifying your sense of your distinction from the "religious atheist." ("religious" in Dworkin's usage, I'm assuming, is a secular or at least a non-theistic experience.)

    Does the non-humaness of nature make it any less awesome? Isn't its indifference the source of the awe--the thing we can not appropriate.

    When I read the following from your Consolation Two, I sense the fact that "human values carry no weight beyond the human sphere" in no way diminishes their consummate significance:

    "Yet as an atheist I'm much reassured and comforted
    by our capacity to reason morally. Odds are, no such
    capacity should have developed from the inorganic stuff
    we're made of. Evolving it was an incredible, perhaps
    unique, stroke of luck. It enabled us to choose not
    merely how to interact with our fellows but whether to
    interact with them at all. In this sense, our moral
    freedom is absolute."

    [Sometimes you imply that the lack of any source beyond the human or material sphere means "we need to suck it up and accept a lesser good," whereas in another strain -- you assert that very lack as the necessary condition for genuine insight regarding the actual terms/limits/potential of being human.]

    Perhaps the seeming contradiction is a manisfestation of those terms and limits.