War Requiem

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War — the cost of war — seems worth consideration on the occasion of Memorial Day 2010. Perhaps you have seen the movie Brothers. It will be in the same spirit, I hope, that I reflect a bit on the cost that any war brings, however necessary it might be. I will do this by quoting two poems and directing you to some wonderful music using poetry as text.

World War I,  “a war to end all wars” according to President Woodrow Wilson, generated lots of verse. British poets, in particular, found the pity in wartime, and as Wilfred Owen wrote, “the poetry is in the pity.” Owen fought and wrote about fighting, as in a letter to his mother just after his arrival in France:

“I can see no excuse for deceiving you about these 4 days. I have suffered seventh hell.

I have not been at the front.

I have been in front of it.”

The 25 year-old Owen was to die in battle just one week before the armistice on November 11, 1918.

When Benjamin Britten, the pacifist English composer, was commissioned to write music in honor of the reconsecration of Coventry Cathedral in 1962 (which had been destroyed in World War II), it was Owen’s World War I poetry and the Latin Mass for the Dead to which he turned. The piece, for large orchestra (with the addition of a chamber orchestra), three vocal soloists, and chorus, alternately rages against and laments the ravages of wartime.

The War Requiem ends with the Owen poem Strange Meeting, sung at the première by an English tenor and a German baritone, no coincidence as England and Germany fought against each other in both World Wars.

In this poem (excerpted below), the narrator finds himself in the bomb shelter and sleeping quarters below the trenches of the enemy, “down some profound dull tunnel,” as part of a night raid where he encounters dead and dying soldiers. There, he and his enemy recognize their shared human bond:

…Then, as I probed them, one sprang up, and stared
With piteous recognition in fixed eyes,
Lifting distressful hands as if to bless.
And by his smile, I knew that sullen hall
By his dead smile I knew we stood in Hell

“Strange friend, ” I said, “here is no cause to mourn.”
“None,” said the other, “save the undone years, the hopelessness.
Whatever hope is yours, was my life also…
For by my glee might many men have laughed,
And of my weeping something had been left,
Which must die now. I mean the truth untold,
The pity of war, the pity war distilled.
Now men will go content with what we spoiled,
Or, discontent, boil bloody, and be spilled…

I am the enemy you killed, my friend.
I knew you in this dark: for so you frowned
Yesterday through me as you jabbed and killed.
I parried; but my hands were loath and cold.
Let us sleep now…”

The English language changed because of World War I. Phrases and references to the word “trench” became part of common parlance, as in the phrase “in the trenches” which still refers to working at a hard, grinding task; and even the phrase “trench foot,” which led back to a type of frost bite common in the muddy, cold, wet, and verminous condition of those dark places inhabited by the warriors.

Or, how about “trench fever,” a bacterial infection associated with the lice that bred there. The expression “No Man’s Land,” plays back to the space between the trenches — between you and the enemy trench — which could be a few hundred yards. It was the place belonging to “no man” or side in the conflict, and it was the place where no man could easily survive. So too, when one army decided to launch an attack on the other, they had to go “over the top” of the trench and into hostile fire.

But it was to a much earlier use of the trench in warfare that the poet Patrick Shaw-Stewart would refer.

Patrick Shaw-Stewart was born on 17 August 1888 in Wales, and fought as part of the British Expeditionary Force at Gallipoli on the Chersonese peninsula during World War I, not far from the site of the Trojan War.

Gallipoli was a disaster for the British. Shaw-Stewart was on three days leave from the front on the island of Imbros when he wrote the untitled poem that follows. It refers to the Trojan War as represented in The Iliad, so a little background is required to better understand it.

The war began soon after the Trojan prince Paris abducted Helen, the most beautiful woman in the world, but the wife of one of the Greek kings (Menelaus). The Greeks organized their own expeditionary force and followed Helen to Troy so they might retrieve her.

Many years into the conflict, Achilles, the greatest of the Greek warriors, stopped fighting because the leader of the Greeks (Agamemnon) had taken away Achilles’ concubine. Achilles’ rage and his decision not to fight is called “The Wrath of Achilles.” In addition, Achilles knew if he returned to battle he would not survive the war. Despite this, he resumed the fight and turned its tide, with the goddess Athena beside him, both shouting in a trumpet-like, horror-inducing scream to make the Trojans flee.

Achilles and Athena stood at the ditch in front of the wall built by the Greeks to protect their ships. Achilles’ head was surrounded by an aura of flame created by the goddess (to which the poet refers in the heart breaking last stanza), so better to terrify the Trojans, who panicked and ran away.

Shaw-Stewart tells his own Illiad-like war story from the standpoint of his temporary leave from fighting:

I saw a man this morning
Who did not wish to die
I ask, and cannot answer,
If otherwise wish I.

Fair broke the day this morning
Against the Dardanelles ;
The breeze blew soft, the morn’s cheeks
Were cold as cold sea-shells

But other shells are waiting
Across the Aegean sea,
Shrapnel and high explosive,
Shells and hells for me.

O hell of ships and cities,
Hell of men like me,
Fatal second Helen,
Why must I follow thee?

Achilles came to Troyland
And I to Chersonese :
He turned from wrath to battle,
And I from three days’ peace.

Was it so hard, Achilles,
So very hard to die?
Thou knewest and I know not-
So much the happier I.

I will go back this morning
From Imbros over the sea;
Stand in the trench, Achilles,
Flame-capped, and shout for me.

Much like Achilles, Patrick Shaw-Stewart survived the Gallipoli campaign, but not the war.

He was 29 at the time of his death.

Moral Choices

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It is easy to judge others, but are not without blind spots in judging ourselves. In the domain of moral choices, this becomes particularly problematic. How many times have you heard or thought to yourself, “If I were he, I would have done that differently.” Or perhaps, “If I were he, I wouldn’t have done what he did.” But how many times have you said to yourself, “If I’m honest, if I were in the same situation, I really don’t know what I would have done.”

I’ve listed below a few such moral dilemmas, some drawn from real life accounts. I hope you will put yourself in each one and ask yourself three questions:

1. What is the right thing to do?

2. Would I do the right thing?

3. Am I absolutely sure what the right thing is?

A. If you have seen the 1957 movie Abandon Ship, you know the moral quandary in which Alec Holmes (Tyrone Power) finds himself. Holmes is second in command of a luxury ocean liner which strikes a mine. He takes charge of a life boat when the captain (Lloyd Nolan) dies from injuries sustained in the explosion. The small vessel is seriously overcrowded (including numerous people who are hanging on from ocean-side), has limited supplies of food and medicine, and is in shark-infested waters with only small amounts of  shark repellent in hand. Those hoping to survive include the young and old of both genders, some of whom have been grievously injured as the ship went down.

Soon they become aware that no SOS was sent, because the explosion destroyed the radio. Concluding that no rescue ship will be looking for them, Holmes determines the infirm and weakest must be ordered off the so that the remaining individuals can have a chance at survival by rowing the very great distance to the nearest land mass, with enough food to sustain them until they reach it. What would you do if you were in charge?

B. This comes from the oral history of a Holocaust survivor as described in Holocaust Testimonies: The Ruins of Memory by Lawrence Langer. Imagine that you are one among many Jews swept up in the Shoah (the Hebrew word for the Holocaust). You have been separated from your parents. You aren’t certain whether they are alive or dead. In fact, the Nazis have taken a large group of Jews, including your mother, to a place in the forest. They have required these people, at gun point, to dig a long, deep trench. While doing this, the soldiers are joking, smoking, and drinking. Once the trench has been dug to an adequate depth, a handful of the soldiers shoot their machine guns at the diggers along the line of the trench. Some are killed instantly, some dive into the trench to escape the gun fire, and others are wounded to various degrees of severity.

Meanwhile, you are far from this action. Perhaps you heard the gun fire in the distance. But once it is finished, the Nazis assemble a group of Jews to fill in the trench, to cover over their dirty work, quite literally. You are in this group, assigned to this grisly task. The soldiers have their guns on you and your co-workers, reminding you to work quickly or else. Much moaning and screams of pain are heard from this place. And one more thing: From the trench in front of you, a familiar voice is also heard, quite distinctly. It is your mother’s voice. She is telling you that she is not wounded and pleads for your help. What should you do? What would you do?

C. You are Agamemnon, the leader of the Greek expedition to Troy, provoked to war by the abduction of Helen of Troy, the wife of your brother Menelaeus. Before you and your 1000 ships can reach Troy, however, your fleet is stuck in place, stopped by the intercession of a god named Artemis. Time passes. Your supplies of food and water are dissipating. In addition to your family responsibility to defend the honor of your younger brother and help him retrieve his wife, you are aware that Zeus, the most powerful and important of the gods, has demanded that you sail to Troy. A seer is consulted to determine what might be done to appease the god Artemis and enable the fleet to be launched. You are told that you must sacrifice your virgin daughter, who is not far away. What should you do? What would you do?

D. The economy is tough. You have been out of work for some time. You don’t want to lose your home or apartment, and you are afraid that if you can’t find work soon, that might eventually happen. But, you’ve been networking, and it finally pays off. You are offered a job selling AK-47s, assault weapons that fire 600 rounds per minute, whose principal use is to kill people. While you would only be expected to sell these arms to “legitimate” buyers, you are also aware that the AK-47 is one of the world’s most frequently smuggled weapons and the rifles you sell are likely to get into the hands of criminals and drug lords. Should you take the job? What would you do?

E. An elderly aunt dies, one you have not seen in many years. She has named you the sole beneficiary of her estate, a total of $600,000. You are doing well financially, so the money is not a necessity for you, but you can certainly imagine an enormous number of uses for it (including charitable giving), not to mention the fact that it would allow you some peace of mind, knowing that you will be even more financially secure. You also have two siblings and two cousins, none of whom were more or less close to your aunt than you were. You are under no legal obligation to share the money with them, but you wonder whether you should. What would you do?

F. You are politically “pro-life.” You have campaigned for candidates who believe, as you do, in the sanctity of life from the moment of conception. You believe that abortion is murder, without qualification. Financially stable, you have donated money to prevent abortion. A young woman approaches you, someone you know, and who knows and respects the aforementioned beliefs. She is pregnant out-of-wedlock. She would like you to adopt her child. She knows that your two children, who you had when you were quite young, are grown, and believes you would be just the right parents for the new life she carries inside of her, in part because of your moral stance against abortion. She is terrified to give up her child to someone she doesn’t know and who might not provide the kind of home that she believes you and your spouse can provide. But the two of you had decided some time ago that you only wanted two children and, in fact, you have been looking forward to any empty nest and to the freedom it would permit you while you are still in your 40s. What should you do? What would you do?

G. The Holocaust again. This time you are a German gentile. You have a spouse and children. You are not wealthy, but you are getting by. You are not sympathetic to Hitler, but well aware of how the Gestapo works, and that anything seen by them as disloyal to Hitler and the Reich would likely cause you to be interrogated, perhaps sent to a concentration camp, or worse. Your family depends on you for their livelihood. A Jew comes to your door after dark. You know him, but only very casually. He asks you to hide him. You have heard rumors about what is happening to the Jews once they are sent away and, in fact, have been told by a witness that they are being murdered. What should you do? What would you do?

I am not here to give you answers to these questions, assuming that I would be able to come up with just one acceptable moral choice; or that I am some sort of moral authority, which I am not. It can be argued that some of these situations do not allow for a “right” action; not all situations in life offer absolute clarity. Life can be complicated, as these examples demonstrate.

To be sure, none of us are as good as we could be, but that does not mean what is good is always apparent. Indeed, in Aeschylus’s telling of Agamemnon’s story, the title character utters the words “(Which) of these things (choices) goes without disaster?” in describing the the conflict between his public responsibilities as leader of his troops, head of his (and his brother’s family), and the demands of the gods Zeus and Artemis versus his private responsibility as the father of young Iphigenia. The heart break is readily apparent in this man’s dilemma of whether to honor all the aforementioned interests except the one closest to his heart in “such sacrifice of (the) innocent blood…(of) the beauty of my house.”

On a daily basis, we can only do our best to lead moral, principled lives. Not just to talk about it, or formally worship a deity on a holy day, or even to donate some money, but to weave those beliefs into the fabric of daily, commonplace interactions, and try not to fool ourselves when we fall short; to minimize the everyday fibs, moral compromises, and inconsiderations; to show kindness, be forthright, go out of our way for others. To do what is right when no one is looking.

On the other hand, if we want to find out if our morality goes the distance, then we have to be tested — confronted with something difficult and costly, if not dangerous, if not horrible in its implications, as in the examples I’ve given you above; and until then, be humble, not knowing exactly what we would do.

Being a “nice person” is easy enough … until the chips are down.

Most of us won’t ever know the answers to the kinds of questions I have posed, that is, what we would do if actually faced with them.

Best not to know, I think.

The photo above called Choices, choices… is the work of Duncan Lilly, originally sourced from geograph.org.uk, sourced for this blog from Wikimedia Commons.

What Do Antidepressants Really Do?

I believe that the oldest reference to an antidepressant medicine comes in Homer’s Odyssey, which “could not have been completed much before the end of the eighth century B.C” according to Richmond Lattimore. The reference occurs when Menelaos (brother of Agamemnon),  Telemachos (son of Odysseus), and others are grieving the loss of friends and relatives in the Trojan War. Helen, the wife of Menelaos, is also present. It was her departure to the walled city of Troy with Paris that triggered the assault on that fortress to retrieve her. Having since returned to her husband, she wishes to salve the emotional pain of the men who are gathered at her home. The passage reads as follows in Lattimore’s translation:

“Into the wine of which they were drinking she cast a medicine of heartease, free of gall, to make one forget all sorrows, and whoever had drunk it down once it had been mixed in the wine bowl, for the day that he drank it would have no tear role down his face, not if his mother died and his father died, not if men murdered a brother or a beloved son in his presence, with the bronze, and he with his own eyes saw it.”

That would be a potent brew indeed. But the idea of it prompts me to say a few words about what an antidepressant can and cannot do, for there is much misunderstanding on this point. And, by the way, the first real antidepressants only became available in the 1950s.

An antidepressant does not make you giddy about your life or impervious to emotional pain; it doesn’t make you forget bad things. In other words, it is not what Helen of Troy administered. If an antidepressant is working well, it helps put a floor under you. That is to say, many people with depression feel as though there is nothing holding them up (metaphorically speaking), no bottom to their suffering.

An effective medication creates that bottom, relieving them of the sense that they are without any support underneath them. It reduces their suffering too, makes them less prone to crying, less exhausted, and less subject either to over-eating or having no appetite, and usually able to sleep better. In other words, the medicine helps you tolerate life and helps normalize that life.

Some people, including quite a number who shy away from psychiatric medications or medication or any kind, actually are attempting to “doctor” themselves with drugs or alcohol.

There is danger here, naturally.

You probably know some of the dangers, but one I want to mention in particular is the depressant-effect of alcohol. It might make you feel better in the short-run, but in the long-run it is likely to fuel your depression, not to mention create a dependency.

As the old Chinese expression goes, “First the man takes the drink, then the drink takes the man.”

I suspect that you know someone who believes that psychotropic medication (and perhaps psychotherapy too) is a crutch. There is no denying that being treated for emotional problems can produce negative judgments and a stigma. Moreover, historically speaking, insurance companies have paid less well for therapy and psychotropic medication than for “physical” illnesses. That has just changed in 2010, but the stigma won’t be legislatively erased by the US congress, as was achieved by “parity” legislation that now requires equal insurance coverage of both physical and “mental or nervous” conditions.

Yet some categories of depression are certainly just as “physical” as an imperfect gall bladder is, for instance. Specifically, Bipolar Disorder, also called Manic-Depressive Disorder, is one such biologically-based psychiatric category where medical intervention is often enormously helpful, if not essential.

Would you want your severely diabetic loved-one to avoid the “crutch” of necessary medication? If your answer is “no,” then you shouldn’t be put-off by treating a biologically-based depression with a proper medication to stabilize his mood.

Nonetheless, it is true that many depressed individuals do not have any biological flaw or chemical imbalance, but rather are reacting emotionally to difficult life circumstances such as repeated losses (e.g. divorce, job loss), unfinished grief, or abuse of one kind or another. Very often psychotherapy is able  to successfully treat these people without the benefit of medication. Indeed, sometimes patients are too quick to obtain antidepressant prescriptions which take the edge off their feelings enough to reduce their motivation to address difficult life circumstances, including repetitive patterns of behavior that lead to unhappiness.  In that event, they will risk having to stay on antidepressants lest they fall back into depression.

For those patients, on the other hand, who successfully address their issues in psychotherapy, antidepressants may never be needed or, if they are used, might be required only temporarily.

If you are seeing a therapist for depression, talk with him about medicine for your condition, especially if you feel that you need immediate relief or are having suicidal thoughts. Beware equally of therapists who never want their patients to go on medication, as well as those who always do.

I should mention that while many depressed people obtain medication from their family or primary-care physician or general practitioner (GP), this isn’t always the best source of psychotropic mood-altering substances. While some GPs are both comfortable with and experienced in prescribing such medication, some are hesitant or unsure. The latter group may be less adept at identifying the precise antidepressant which is best for you given your particular symptoms; moreover, their hesitation can cause them to give you too low a dose to obtain a therapeutic benefit.

A good psychiatrist, by contrast, is absolutely up-to-date on everything about the medications available to treat you, adept at identifying which of the available antidepressants is the best fit for your particular situation, and knows how to get you to a therapeutic level of the medicine as quickly as possible. Since those in pain so often feel as if there will be no end to their suffering, and since antidepressants often take a several weeks to produce relief, getting the medicine right as quickly as possible is very important.

If you do choose to obtain medication, be sure to educate yourself about your condition and the possible side-effects of the medication being suggested. Not all physicians are good about describing those side-effects before-hand, even including the sexual side-effects produced by some antidepressants. Be your own advocate. Don’t be passive in treatment. It is your body, it is your life.

Last I heard, you only get one of each.