The Oath

for Jonathan

While I don’t expect you to derive any meaning from this overture, Jacques wrote,—it is not a story that will, in the words of my former mentor, save lives—you may nevertheless find in its narrative architecture a simulacrum of your own indescribable pain, even if the tale’s initial teller—whom I met on a railcar whilst making my well-chronicled sorties into the American southwest in search of a certain cactus whose nectar was rumored to increase longevity—seemed strikingly oblivious to his narrative’s broader implications.

In any event, at the time this traveling companion of mine had met the Doctor, he (i.e., the Doctor) had already garnered a reputation as the world’s foremost diagnostician, and individuals with symptoms ranging from run-of-the-mill heartburn to sudden onset tissue necroses that could curdle the blood of the most hardened trauma surgeon all flocked to him, “flock” being the most connotatively accurate formulation here given the fairly obvious religious undertones of these many-thousand highly encumbered and by-no-means-effortless peregrinations to the clinic at which the Doctor—who at that time was still using his unusual birth name, Misty Bakhtin—toiled long hours and, if the rumors are to be believed, pro bono, in an effort to diagnose the multifarious sad and desperate mutants who lined up outside the clinic at all hours, their ranks stretching for half a mile or more down the main thoroughfare of the smallish town of Pittsville beneath an effulgent and basically terrible Southern sun that, in midsummer, had the capacity to ignite the paper or nylon sheathing of the ladies’ parasols, a detail that is as well documented as it may be difficult for those of us blessed by more northern latitudes to believe. In fact—if you will excuse a brief digression—in one case a woman who had already suffered from what could only be classified (at least without the Doctor’s diagnosis) as a kind of spontaneous leprosy, this woman having watched several of her own toes and the lower half of one arm instantaneously blacken and, as it were, fall away right before the observing eyes of her several young children whose resulting psychological afflictions would themselves later provide diagnostic fodder for Doctor Bakhtin—but anyway this young and serially-unfortunate woman was sheltering beneath such a parasol whilst admiring the redoubtable statue of Pittsville’s founder and first mayor, a man who had according to local lore coined the phrase, “Desire always exceeds the object,” when the parasol suddenly caught fire and incited in this brave pilgrim—who, remember, had already lost select portions of her morphology to her as-yet-undiagnosed disease and who thus persisted in a state of perpetual anxiety with regard to her remaining extremities (I’m sure that many of you in the audience today, given the serious nature of your own afflictions, can appreciate the sense one has of the illness as a separate, conscious thing, something quite literally living inside of you whose ire you would go to great lengths to dissuade)—but so the woman’s initial reaction to the incoming data-stream that ought to have informed her that she was holding aloft not a lovely Japanese-patterned paper parasol but rather a lollipop of deadly flame was not to release the burning object but instead to tuck it beneath her arm which—due to a byzantine series of earlier maneuvers on her part that included assisting as best she could (given her deficiency of limbs) an old man in his attempt to siphon fuel from the bottom of Pittsville’s infamous community gasoline-well—was coated in petroleum, and her unexpected fire-dance among the other parishioners became a kind of metaphor for the lengths to which the afflicted would go to make contact with the Doctor, and for the record the woman survived her wounds just long enough to receive a diagnosis and to pass easily from the horrific pains of her burns to the peace and acceptance that was at this time the reliable result of a consult with Dr. B. You can by the way read about this anywhere assuming you did not witness it firsthand, it’s well documented even if it has inexplicably failed to serve any sort of didactic function in our movement’s lore. The point though being that these individuals who lined up for an audience with the Doctor did so at the general expense of much hardship and at significant risk of exacerbating conditions that any audience other than this one would shrink to hear described. I know you are in no need of lessons on the nobility of enduring such suffering though in fact I could share many such parables that emerged fully formed from the ranks of those lined up for days in a human chain that stretched from the mouth of the Doctor’s clinic door all the way to the Community Drug Store at the Pittsville town limits whose wares were unfortunately useless in the treatment of the myriad as-yet-unidentified diseases that had brought them so far because—and again, many if not all of you know this deep in your likely-tainted bone marrow—until they knew what was wrong with them, until the suffering they held deep within their private selves was fully seen by another, pharmaceutical interventions might alter the contours of their pain but could not eliminate it. Instead these half-ruined wayfarers survived on little allegories framing the dignity of the spirit and the necessity of trust in higher powers, which we know are more necessary to the despairing than any physical treatment or anodyne. I’ll spare you much further comment in this vein but just imagine for one instant the insistence among our own friends and families—when encountered with the impregnability of our sickness—that “everything happens for a reason,” which as an English sentence is no more than an evasive bromide, but that is nevertheless, as an idea, a vital buoy to a human spirit otherwise sinking into the existential abyss of Absolute Powerlessness. Remember, I have traveled the same route as you and I know of what I speak.

Now of course the way I am relating this story to you, Jacques wrote, is not the way it was related to me by my traveling companion—who (I then supposed) was not a native speaker of our language and who was thus at times forced to either employ halting, translation-dictionary-assisted English or else to draw pictures and diagrams on the backs of the damp napkins whose concentric circles bespoke the many bottles of beer he and I had consumed over the course of our journey, these diagrams providing a much-needed clarification of (or augmentation to) an otherwise blocky and nebulous narrative—but is as much an interpolation of the actual events occurring there in Pittsville as was my companion’s own narrative, which I later learned was culled in large part from an account he had himself discovered in a newspaper story written by a man whose journalistic principles were some time later brought under scrutiny by a group of moralistic peers whose suspicions forced the journalist’s retirement and subsequent relocation to a country whose denizens are far less eager than ours to know the so-called “truth,” which need to know may itself constitute the worst of our many very bad diseases, if you will excuse the aphorism. The crux of the story is this: Doctor Bakhtin could diagnose any affliction—many of which, in diagnosing, he was also discovering—but he was unable to treat a single one. Common headaches, sinus discomfort, achy joints, all eluded his ability to prescribe or ameliorate as surely as did the various cancers and neurological failures and cardiac malfunctions to which he bore witness. He possessed—and, if rumors are to be believed possesses still—a great gift, but a singular one. In fact, it might be argued, as my traveling companion may have been arguing, that the Doctor was as irresponsible as he was gifted, for his so-called patients might well have left his office with a knowledge to which they had been previously barred, but did they not also depart with all of their despair brought into a baleful sort of focus? Was it not true that all that had been revealed to them was their ephemerality and the multivalent suffering that would be theirs to endure up until the moment the coffin lid sealed them into their private eternity?

Now to understand why this was not the case—and why Doctor Bakhtin’s consultations invariably filled his patients with light and not darkness—it is necessary to relate the likely apocryphal tale of the Doctor’s own past attempts to develop, as it were, a method of curing rather than of merely identifying the terrors joined to the human animal at its many morphological and/or ontogenetic stages. The Doctor, Jacques wrote, had spent a good many years in some of the most Godawful equatorial shitholes on the planet, many of them on an African continent whose reduction in the American imagination to a patched terrestery of blanched earth and febrile jungle dotted with starving children and tribal ignorance turned out to be, to Doctor Bakhtin’s chagrin, more accurate than he had hoped or assumed, though of course he was making the common error of extrapolating wildly from his own very limited experience and a travel itinerary that naturally—because it was after all the travel’s purpose—brought him into contact with the very worst in human sickness and its contingent disease-gestation geographies, the point being that his task, performed under the supervision of more senior medical personnel, many of whom had seemed to “find their calling” there in the malarial wastelands of a faraway perdition, was to provide solace, information, medication—in other words, treatment—of all sorts to villagers who were so accustomed to death and disease that many hardly seemed to care whether they lived or died, which I mention to all of you because, again, it is in stark contrast to our own vocational obsession with immortality and continuance and puer aeturnus. My travel companion, when he came to this part of his tale, went to great trouble to be sure I understood that there was a time when Doctor Bakhtin had in fact been interested in the idea of palliative care, having taken the oath and followed the common course of his profession. He was not, my traveling companion seemed to be insisting, if I was reading his flailing gestures with any degree of accuracy, Jacques wrote, some sort of ideologue. Like everyone around him in that burning fecal tin-hut perdition perched at the edge of a great metaphorical pit of despair, the Doctor sought—like each of you in this audience today—only to do the best he could with the givens, and he was committed to the same bland dictum that drove his colleagues and that to this day propels the behemoth of our movement forward, i.e. he believed that things could get better and that the purpose of a man in his position—a man who had endured the years of training, the sleepless nights huddled over textbooks, the long days trailing professional superiors through endless fluorescent hallways whose light seemed tainted with or responsible for the substantial sickness all around him, the loveless exhaustion of his ten-thousand hours of commitment to his craft, sustained by countless packages of Ramen noodles and cheap red wine and coffee brewing nonstop in such a way that he began to associate coffee with concepts like infinity and immortality and also with their opposites (death, attrition, etc.)—his purpose, he assumed, was to relieve pain and bring a modicum of peace-slash-prosperity to a community of heinously unfortunate persons who would line up outside the medical tent at the edge of the jungle beneath the hot uncanopied sun—in a phalanx that darkly presaged the one that would a decade later stretch from the kinder-seeming wooden façade of the Pittsville office from which he would do God’s work—there in the equatorial village whose name my traveling companion was unable to spit forth or else his glottal half-stops were themselves an approximation of the village’s name, but in any event they would line up to await pronouncement of a reality they knew as well as all of you here today in this audience know, namely that sickness is ubiquitous and that pain is not a state through which we pass but a mode by which we live, and that without the intervention of God (or His equivalent) their deterioration was guaranteed. Now let me be clear about something. I am aware, Jacques wrote, that many of you traveled to this convention because you believe in our profession in the same way that Doctor Bakhtin once believed in his, i.e. you have each hoped to become that intervening God and to heal a sickness deeper than any visible on that Pittsville line, all through the power of your own highly polished artistry. But the Doctor’s character was, at the outset, similarly progressive in nature. In fact, the journalist whose suspicious accounting of those early years in the evolution of the Doctor’s so-called methodology was—according to my traveling companion—very careful to establish certain root facts or what we in this room might call logical certainties about the Doctor’s character and his motives which began pure and only became purer. Because he began to notice something about those whose afflictions he sought—albeit in a junior, apprenticeship-type role—to understand and relieve. Namely that those who passed through the canvas medical pavilion could be separated into two basic categories: the treatable and the terminal. And of these two types, only the latter—to whom the Doctor’s senior associates had just delivered the ultimate “bad news”—left with any kind of discernible relief or contentment. The sick did not want to be healed. They merely sought confirmation—from the finest stewards of the American nonprofit organization that continues to send its best and brightest into the darkness of a ruined world, into malarial forests and tin-shack mining colonies and slum cities built literally from fecal bricks extruded from the rectums of wandering ruminants—that their sickness was real and that it would destroy them. It might be helpful here to compare this situation to the one reported by literally millions of individuals incarcerated here in our own domestic penal network for a duration described by the judiciary with a comedic sort of deadpan simply as: Life. These multitudes report almost without exception that as soon as all their many appeals processes are exhausted and all hope for freedom is finally lifted from their hearts they begin for the first time to spiritually heal, hope having all along been the primary cause of their pain. This factoid also being well documented by any number of reputable statisticians and represented in a myriad of print and online media forums, including journalistic articles, biographical novels, doctoral dissertations, political screes, humanitarian pamphlets, the most reputable sectors of the blogosphere, et cetera. What the Doctor was discovering, Jacques wrote, was that hope was cruel, and that the medical establishment’s principle assumption—that life was inherently valuable and must be extended in perpetuity or at least for so long as its “quality” endured (this so-called “quality” being the quintessential shifting-target)—was itself built upon an unquestioning belief in the sanctity of love and charity, concepts without primacy in nature. Here I must confess to appropriating the formulations of my traveling companion, who seemed eager to deduce a Theory of Everything from the story of Dr. Bakhtin and who insisted that, while the assumed responsibility for the meek’s protection serves as an ideological cornerstone in what many of us would call “advanced” societies, it is merely an organizing schema that is, as Thrasymachus says in The Republic, “to the advantage of the stronger.” I will be discussing this phenomenon later this evening in room 912 for any of you who have the strength. But to return to the issue of the Doctor’s character and the nature of his epiphany out there in the African jungle, there is an anecdote written about extensively by the journalist whose series of articles on Doctor Bakhtin so inspired my traveling companion that may illustrate the Great Shift better than any additional exposition on my part, if the many words I have thus far delivered can be properly classified as expository.

You’ve all been very patient, Jacques wrote, and I ask you to bear with me just a little while longer.

This involves a gaunt man who stumbled into the canvas-draped clinic one humid dusk—a time when enormous fruit bats took to the sky unleashing squeals that were oddly porcine and chill-inducing—and identified himself as an envoy for a large family that occupied a domicile (of sorts) approximately one mile distant, just beyond the verdant selvage of the forest whose interior Doctor Bakhtin had infiltrated exactly once prior to this encounter—as part of a tutorial for all arriving personnel on herbal remedies proven efficacious by the representatives of our Western pharmaceutical conglomerates—to find himself completely unamenable to its alienness. In any event this family of eight or nine or ten individuals, some of them children, had apparently—if the Doctor was interpreting the gaunt man’s gestures correctly—been afflicted by a fever of paralyzing intensity that had caused a milky white sweat to well up from somewhere deep inside these burning bodies, and while this latter symptom was unknown to Doctor Bakhtin from his existing travails he could easily see it was no fabrication for the deep brown flesh of the gaunt young man was itself coated in this same dun-white perspiration which had an almost opalescent quality. The man had essentially limped and dragged his way to the clinic hoping to retrieve the Doctor on behalf of his much sicker siblings-slash-offspring-slash-parents, which given the Doctor’s antipathy for jungle excursions and his very junior status he quickly demurred and offered to instead locate his attending physician and settle upon a plan of action, which suggestion raised a flurry of objections from the febrile patient who seemed to be insisting—if my travel companion’s interpretation of the journalist’s interpretation of the Doctor’s rendition of this encounter was accurate—that it was not any doctor that was needed, but Doctor Bakhtin specifically, because he had (though he would only realize this later) in his four months there on the African continent developed a reputation for benevolence and was known among the natives for his acceptance of the incurability of the village qua village, which while it was true that the Doctor accepted mortality more readily than most of his good-intentioned but easily-outraged colleagues, it was also true that he had up until this moment assumed that his laissez faire approach to the Problematic of Terminal Sickness had and would only continue to be perceived as blithe callousness or worse, outright ineptitude, so that the young man’s wild insistence that the Doctor accompany him back toward the shacks that housed his dying brood was as moving to him as it was unexpected. Despite what amounted to a carnal fear of the jungle’s multifarious predators he grabbed his leather satchel and several flashlights and motioned to the man to lead them along the edge of that crepuscular forest whose five-thousand shades of green seemed to glow slightly as if lit from within or held under a black light like the one that had once spookily illuminated the velvety illustrations depicting dragons and unicorns that had adorned a much younger Misty Bakhtin’s bedroom walls. My traveling companion at this point became quieter and clutched his sweating beer bottle with an intensity I had not previously suspected him capable, given his laconic and deeply sad modus operandi, Jacques wrote. He may at this point have shed a tear. It was difficult to know with any certainty what was happening inside him. In any event, I will leave out much of what he had to say about the ambient terror endured by Doctor Bakhtin during that 90-minute flashlight-assisted trek. I won’t for instance go into detail about the cries of the spider monkeys that approximated nothing so much as the wailing of tortured human children. I won’t tell you about the epic-seeming passages of total silence in which the Doctor could sense an ancient predation at work, a Watcher determined to spill blood that night, or how that silence had a kind of low bass rumble hidden away inside itself that seemed to be the magnetic, molten rattle of the earth’s living core, or how the canopy’s fluttering suggested an infinitude of unknowable organisms reborn in darkness to hold dominion over the world of sleeping men. I won’t waste your time by relating what I took to be the Doctor’s terrified calculations—upon hearing the quick scurry of insect-activity across the foliage underfoot—regarding just how large an insect would be required to raise those particular decibel-sets, rumors of certain tarantulas as wide across as a man’s face or of the deadly bite of three-foot centipedes still fresh in the Doctor’s mind from the late-night fraternization with drinking colleagues who had been stationed there for far longer than the Doctor and were thus armed with all the proverbial war stories one would expect of these Samaritans, and which seemed to accumulate in direct proportion to their cynicism. Let it suffice to say that these 90 minutes contained within themselves a lifetime’s portion of fear, even if it was merely a prelude to the night’s still-pending Main Event.

The doctor did not so much come upon the dwellings as they came upon him. A collection of huts—if that term suffices for the ramshackle abodes that comprised this unlikeliest of communities, constructed from a bizarre variety of scrap rubber and tin and thatch and mud and what seemed to the Doctor to be the salvaged parts of a classic American automobile—seemed to congeal from the growing darkness, as if whatever power had thus far quelled his impulse to flee not just back to the canvas medical pavilion that housed his colleagues and their wisdom but all the way back to the eastern United States where his extant university-subsidized apartment contained any number of palliatives for his current vertiginous state, including an electric tea kettle and a pine desk on which he’d left a textbook open so as to resume his learning from the very point of its interruption immediately upon return, as if this power had now decided that he had passed its test and thus permitted these huts to materialize. Though there was no change in the low non-silent silence of the earth’s breakneck rotation through the great darkness that many of you in the audience today have thought about more often that you’d care to admit. The village seemed abandoned. Reclaimed by the jungle. A curiosity but not a habitat. Et cetera. But when the Doctor’s guide led him into the largest of these shelters—as large, perhaps, as your own private room in this very hotel—when they pushed through the thatched door and into the straw-covered space itself the presence of human life was revealed in terrific fashion. The one detail that has stayed with me from my traveling companion’s description of the tableau the Doctor thus encountered is this: upon stepping within this house of pain the Doctor felt overwhelmed by a rush of heat, which he could not compute given that the temperature inside this barely functional structure replete with seams and window-openings screened with cheap and hole-riddled netting that could have done nothing to dispel the squadrons of malarial mosquitoes that have spelled pyretic death for billions of human souls, really ought to have been identical to the temperature of the jungle itself on this cool and humid night. In fact the Doctor scanned the space for an artificial heating source before understanding that the heat emanated from the ten bodies strewn in various poses around the interior, some on crude straw cots and others on the thatch-covered floor, living breathing furnaces of suffering covered in the same milky white sweat which was not unlike the sap of the milkweed plant, for those of you acquainted. The Doctor turned to his guide who only smiled weakly through his own rolling fever. In a sudden rush of understanding—this is one of those rare instances when the word “epiphany” really does seem apt—that owed itself as much to an instinctive or empathic connection to these suffering humans as it did to whatever knowledge the Doctor had absorbed through his careful reading and retention of the various assignment-related materials cataloguing many thousands of diseases and afflictions and et cetera endemic to these latitudes, the nature of this illness exploded within his consciousness where he felt himself commune with it, as if he were remembering a haunting childhood dream and, in so remembering, exorcising its power over him. The lactic sweat, the raging fever, the immobility, the jaundice in the iris—it was a clear case of Callahan Syndrome, which was thankfully not contagious once symptoms were manifest though who knew how many other villagers unknowingly carried the contagion. The Doctor turned to his guide and said simply: “I know what this is.” He crouched down and began to rummage through the leather bag that retained—even after these months on the continent—a rich smell that bespoke chocolate and cigars. But before he could withdraw anything from this proverbial bag of tricks his guide placed a burning hand on his wrist and stayed his efforts. The Doctor rose slowly. He met the pasty invalid’s yellow-tinged eyes. “But you will all die,” the Doctor said, to which his summoner merely nodded and smiled. In fact, Callahan Syndrome has no cure, though some of the sulfur salts in the Doctor’s satchel may have briefly slowed the disease’s brushfire progress through the internal landscapes of this moribund clan. The heat in that thatched abode was oppressive. The heat of disease is unique and has what some physicians call a “bite.” I see many of you nodding, Jacques wrote. But it was in this case all too ephemeral. The Doctor assented to his guide and then sat on the floor among the dying, right at the center of this tiny inferno, while one after another—like hot lights being extinguished in a post-performance theater—their lives expired. With each death the room grew markedly cooler, or perhaps the Doctor only imagined it that way, or perhaps my traveling companion merely invented that detail, or perhaps I am myself misremembering or misinterpreting this oral history, Jacques wrote, but in any event by the time the sun rose the hut was cold enough that the Doctor shivered. At one point in the night—his exhaustion overridden by a sense of duty—he was sure that something very large was padding in circles around the hut. But it never entered, except perhaps as a metaphor. In the morning all were dead but the original guide, who sat beside the Doctor on the thatched ground, held his hands in his own, and said very clearly in the Doctor’s language: “Thank you for knowing us.” Then he whistled through his teeth, expelling a tiny jet of steam, and quietly ceased to live.

Now it seemed to me as if many months passed between my trip through the American southwest—which never did locate the longevity cactus, though I have often thought that, if things really do happen for a reason, my fool’s errand was only a necessary bit of saguaro-related stupidity that would necessitate my trip aboard that railcar where I would absorb the Doctor’s tale and consequently rotate the axis of my philosophical investigations—and my eventual and inevitable trip to Pittsville, where one sunny mid-week afternoon I took my place in line, having made a promise to my traveling companion to verify the most powerful and-slash-or suspicious aspects of the Doctor’s tale, which I think of as my own oath, one not so very different in spirit from the one the Doctor himself took those many years ago. Though to be entirely honest, Jacques wrote, I may have delayed my sojourn indefinitely had my despair not been reignited, if you will, by an ostensibly uplifting event that occurred some two months after my fateful trip aboard the desert-traversing locomotive on which (i.e., the trip) this outrageously lengthy diatribe turns, and the consequent return to so-called “ordinary life.” I spent those two months ensconced in the domestic paradigm I had fled and which centered itself around a 19th century clapboard home situated within a small hamlet in the northern part of our nation’s northeast, many hundreds of miles from Pittsville and all it had now come to represent. Many of you may be surprised to learn that I am, in addition to or despite being a member of our suffering brood, a father, and it was to my two children—girls, 7 and 5 respectively—that I returned. I knew, in some deep part of myself I had yet to reckon with, that the edifice I immediately began to rebuild—and that took as its central pillar a kind of composite platitude regarding the beauty of children and the nobility of sacrifice—was merely dilatory in nature. I would have to go to Pittsville, of course I would, I had made an oath, but I tried desperately to believe my offspring could heal my sickness and thus render its diagnosis by Doctor Bakhtin moot. I threw myself wholly into the role. I prepared the sandwiches. I ran the warm, rubber-toy-strewn baths. I encouraged and endured hideous renditions of American standards as arranged for Recorder. I played the soul-deadening games, including the game cynically called “Life.” I fell into a kind of parenting stupor that I convinced myself could stave off the need for longevity cacti and suffering-palliatives. I sought to become the “better man” so often alluded to in stories of personal improvement. Of course it is with great shame, Jacques wrote, that I depict for you the moment that woke me from this stupor.

I had been sitting on a blanket with my two daughters beside the river that defined the river town that I called home. We were watching one of the child-friendly films that my sleepy hamlet screened on a weekly basis during the long and lazy summer months. I was sitting with my legs crossed and my little girls leaning into me, one on either side, with a second blanket thrown across their laps and up to their chests, their body heat warming me right to my core, warming my heart is what I want to say here, though in so doing I am reminded of that other human warmth as described by my traveling companion via the journalist’s stories describing Doctor Bakhtin’s encounter with those white-hot souls expiring one after the other within their ramshackle domicile. I do not remember the film’s title but it featured the young son of a family of immigrant mice (animated in a style that suggested the second-to-last decade of the 20th century) who falls overboard during the steamship passage from Russia to American and is presumed to have perished by his mouse parents and young mouse sister, though in fact the little scamp survives in a bottle and upon reaching the shores of Ellis Island embarks upon a quest to rediscover the family whose grief over the young scion’s assumed death is near-total. Of course there are the predictable trials and tribulations including many demonic felines determined to destroy not just our young protagonist but any rodent unlucky enough to enter their shadowy purview, this elevation of the mouse to a pinnacle of innocence and kindness and the parallel or consequent demonization of cats a trope not exclusive to this particular film but in fact pervasive within the children’s film pantheon—a conundrum given actual human attitudes toward vermin on the one hand and cats on the other—but in any event the film flirts with the protagonist’s destruction as it (i.e., the film) slowly swings toward a reunion as necessary as it is inevitable and that, as it approached, brought my little girls’ coiled bodies ever more tightly against me. I kissed their heads and their cheeks and breathed their sweet smell as the penultimate scene, in which—according to the rules of penultimacy—all seems lost, unfolded. Out beyond the movie-screen barges traversed the dark river beneath a bright full moon, prodded or pulled by tugboats whose bright lights seemed suspended above the water like angels or faeries or other mythical luminous creatures of light and air. It all seemed drinkable, or edible, or breathable. You wanted to protect the moment from everything it was not. When the young mouse finally hears his father’s violin—right at the moment that he has surrendered his quest and given himself permission to cry—we rush toward a closing of such emotional intensity that a roar of applause irrupted from an audience enshrouded in moonlight and hungry for the safety of all children everywhere. I will admit to you all, Jacques wrote, that I myself cried real tears, as if I had forgotten for the moment that I had only witnessed an animator’s dream designed to elicit from me this precise response. In my herd-like submission to the community’s joy I was only revealing how much need existed within my so-called soul at every moment of my life, a need so needy as to latch onto whatever inane entertainment was brought into its massive gravity before swallowing it within its lightless vortex. Worse still: a need that was shared by every adult in the purview of that glowing fiction. I was being reminded in that moment, Jacques wrote, that the world I shared with my children and that held me pinned to its crust above a molten core of unimaginable violence was at any given moment hosting millions or even billions of phenomenological experiences identical to my own. Did Doctor Bakhtin, I wondered, with my children pressed to me, igniting a storm of pleasure and fear synapses deep within my skull-box, ever feel as if he were diagnosing a single organism? What was a person to do with the knowledge that every last thought and experience was so bromide as to render our entire profession a bad and unnecessary joke? I had arrived in that seemingly tender and lovely moment at the same Problematic that had sent me in pursuit of the longevity cactus those many months prior. Hoping that mortality was itself the foundation upon which the hideous edifice of human suffering was built, and that without the specter of my own impending demise the rest of the Suffering Apparatus might be more adeptly managed, I’d gone chasing more life. That’s why I was on board that train on the fateful day that the Doctor’s story was related to me by my increasingly shitfaced companion who, it turned out, had not been sober even at the beginning of our conversation, this having been a rare sort of holiday for my companion from the work he had himself been doing without thanks or cessation for years—more on that later for those willing to endure the increasing heat of this room to arrive at the end of this account—and after my night at the movies my own drinking kicked into high gear (again) and my suitability for parenting, to the surprise of exactly no one who knew me well, dropped precipitously and I decided that an oath is an oath is an oath, and that it was time to head for Pittsville, where I would stand before Doctor Bakhtin—assuming there was a Doctor Bakhtin— Jacques wrote, and ask him in no uncertain terms what the fuck was wrong with me, and why I could not be happy for more than a few minutes of each day and why no work, not even the work to which those of us in this room are conjoined despite our sickness, seemed able to sustain my belief in the legitimacy of the Life Project that the universe’s multifarious and unfortunate conscious creatures had been ordained to complete.

What can I tell you about that line of human beings that stretched through the Village of Pittsville like a snake seeking its own tail and that exposed to earth’s atmosphere every variety of human damage imaginable? I had never before in my lifetime experienced the pleasure of being one of the most physically gifted members of a crowd and during those hours that stretched into days beneath the bright sun of that blessed town I was often tempted to congratulate myself for my basic bodily wholeness and my outstanding motor skills which, as a boy struggling to succeed at the various sporting events that defined the social hierarchy at my grade school as sure as any other, had been consistently subpar. But then I would remember that my damage ran far deeper than the merely superficial and observable damage made manifest in these multitudes, and that if I was tempted to think of them as baleful freaks who ought to have been destroyed by the state it was only because I was grasping for proverbial straws in my own effort to feel a little better and maybe even convince myself that a consultation with the Doctor was unnecessary after all, and that I was in fact living one of the best of all possible lives and that my time aboard that rattling train had no more significance than one of my frequent nightmares about bats that feed on human kindness. I knew that I needed something from the Doctor but I did not want what I needed, a condition that many of you are likely intimately familiar with, Jacques wrote. I hoped that my consult with Misty Bakhtin would help me feel what I in essence already knew, namely that there was no difference—not little difference, but literally no difference—between my so-called phenomenology or innerness or selfhood, and that of these destitute monsters with whom I shared a steadfast determination to be diagnosed. I may have thought that abandoning my family so as to embark on a futile quest for longer life—the irony here being that the ongoing quest itself consumed no small portion of the time allotted to me by God or Fate or Chaos—constituted a form of soul-searching, but in fact it was this time spent as a member of a community that knew itself simply as The Line that truly brought me up against my own need in a way that changed me, if you will forgive my resorting to this particularly insidious cliché. Being in The Line was itself an experience that I feared would dwarf the experience of meeting Doctor Bakhtin, if (again) there really was a Doctor Bakhtin, and if there was anything in my traveling companion’s story that was not apocryphal, because it began to seem plausible that The Line existed solely to sustain itself and to enable the very process I was then undergoing, whereby an initial perception of the suffering of others as being out there and my own suffering as being in here would cede to a truer conception of a universal pain-wire that ran through and united all phenomenological experience. If this truth could be embraced rather than despised—I had after all been repulsed by my latest whiff of it, there in front of the cartoon mice—then the suffering itself (I surmised) might drop out of the equation. But then I would remember my traveling companion’s tears as he told me the story of the Doctor’s descent into the jungle and subsequent discovery of that febrile clan hungry to be seen and known in their horrific pain, and I questioned anew my seeming epiphany about the egalitarian nature of pain and the old smugness-slash-pity-slash-aloofness would again course through my healthy veins, these fluctuations between the poles of total awareness and consuming self-awareness being familiar perhaps to those of you who have sought to derive meaning from your experience without venerating it.

Somehow, too, the intoxicating effect of The Line obscured a curious reality about its membership, because while there had been many stories shared—both by my traveling companion and by those of us taking up space in Pittsville—of contented post-consultation humans walking back down the ranks of those in waiting, no such individual ever materialized, so that while it was obvious that The Line was making slow progress in the direction of Doctor Bakhtin’s office, it was equally obvious—to anyone able to briefly break the spell of hope and anticipation that The Line itself seemed to generate—that those entering the office were not leaving the office. I will confess to you all that I considered the possibility that the Doctor’s office was in fact nothing more than a slaughterhouse, and that the “diagnosis” that had been promised to me by my traveling companion, or that had been promised by the disgraced journalist whose story had so swayed my traveling companion, was in fact nothing more and nothing less than Death Itself. Death as diagnosis, not as cure—a notion I found equally horrible and hilarious. Of course we ought to be skeptical of this suspicion of mine, Jacques wrote, because as you can see I am standing behind the mahogany shield of this rostrum and delivering my hard-earned address to all of you on this fine and momentous occasion, and I seem to be very much among the living, regardless of the, shall we say, moribund quality of this oration.

In any event I did finally reach the front of The Line to stand before the unpainted wafer-board door of the office itself, a barricade through which I could hear the muffled voice of the hadji who had occupied a place in The Line one position nearer to the Doctor than myself for a duration that is difficult to now determine, given that my time—as already alluded to—was (and still is) spent in a kind of penitent trance. The Line as chrysalis and me as the moth. The Line as airlock and the office as void. Et cetera. I stood separated from Doctor Bakhtin by nothing but a thin sheet of the cheapest poly-resin fiber on the market and tried not to listen too closely to the voice of the gentlemen who had preceded me into what I could only suppose was the actual Doctor’s company, a young man named Friedrich who I had come to know quite intimately and whose bulbous full-body rash had even begun to fade from my imagination such that I was able to look on Friedrich as if he had no condition at all. By the time Friedrich entered the Doctor’s office he appeared unblemished to me, or beyond unblemished, he had in fact nearly ceased to exist for me as an independent entity and had become, like all of my nearest neighbors on The Line, merely an extension of my own purpose. As another example I offer up the woman destined to enter the office just after me—my aft neighbor—who went by the name Virginia Kitten and suffered from a twitching disease so extreme as to appear histrionic (as if she were mocking someone else’s actual twitching disease). Virginia had not, over time, ceased twitching, but the twitching had come to seem softer and more expressive, not an affliction at all but merely Virginia’s way of articulating an innate kindness and empathy. I mention these things because, given the space I was about to enter, Jacques wrote, the true nature of these linemates would soon become a matter of some ambiguity, and the very possibility of the existence of other minds would come under a certain kind of assault that would demand the slow and steady construction of this address that you so generously continue to endure, Jacques wrote.

After some time the man I had come to know as Friedrich stopped speaking, and then I could hear the voice of another human, Doctor Bakhtin I presumed, though by now I understood that the name “Doctor Misty Bakhtin” did not really apply to whatever magical hominid awaited me behind the wafer-board. It occurred to me that I had no idea what I would say to that hominid. No protocols had ever been established and, given the aforementioned absence of exiting parishioners who might have advised the waiting multitudes of how to approach the consultation itself, Jacques wrote, I was very much “in the dark” as to what was about to transpire. I knew that I had been in The Line for a very, very long time but I seemed not to have aged or to have experienced the ordinary needs and privations of living. For instance I do not remember having eaten anything while on The Line, or sleeping, or urinating. Why this had not struck me sooner as unusual is perhaps evidence of the transformational experience of The Line itself, and the bovine stupor that we all enjoyed—present company not excluded—during our time as beads on its ever-growing rosary of hope, even if that hope was ultimately for the cessation of all hope. I’m not sure what suddenly alerted me to the fact that I had been living in a kind of walking trance, though it may have been the presence of that second long-anticipated voice behind the waferboard… a voice soft and vaguely foreign. Perhaps I should have been awed by the Doctor’s voice, or by my proximity to a diagnosis that would—assuming that my former traveling companion’s rendition of the disgraced journalist’s tale of the Doctor’s equatorial epiphany contained real truth at its jungle’s core—for the first time in my life relieve me of my aloneness and a pain that seemed stained darker with each passing year. But I was not awed. I would like to say that I felt the impending relief that ought to be the inheritance of any man who has stood and waited on The Line for the right to enjoy the exact moment in space-time that I was on the cusp of enjoying, but I did not feel that relief. I would like to say that I was jubilant or nervous or giddy with fear or with anticipation, but I was not any of those things. As I listened more closely, Jacques wrote, as all of the universe’s noise collapsed down to the singular aural output passing through Doctor Bakhtin’s door, I felt a sheer incendiary rage welling up inside me, a rage so intense that it brought with it other physical manifestations that I did not immediately recognize as consistent with a pathology already described in brief in this keynote address. The milky-white perspiration, for instance. The “bite” of viral fever—the same bite that has in the last several minutes sunk its teeth into those of us here in this chamber. My psychic disease seemed suddenly rendered—by proximity to The Doctor, perhaps—in bold physical strokes.

But of course, I recognized the voice. I knew what would happen before it happened. It was at this very moment, in the seconds before the Doctor’s door opened, in the seconds before I recognized that Friedrich was not actually there in the Doctor’s room—which was not a room at all but only the terminus of the mirage I had been experiencing for months upon months, years upon years—it was in this moment that I began mentally composing this very address, aware that I would ultimately deliver myself into your presence, that I would take this stage on what I am told is a glorious bright-sunshine day out in the world beyond this hallowed auditorium that holds our disease, a day replete with flying birds and swaying trees and all of the bizarre esoterica we associate with the Creator’s matrix, Jacques wrote, longevity cacti notwithstanding.

The door opened and my fury dissipated so swiftly that it seemed it had merely been en route to some other target. The vista that unrolled before me was so vast that it rendered all of Pittsville, by comparison, a mere wardrobe closet. Dunes of brilliant pink sand rose and fell like ocean waves beneath a sun whose red-tinted penumbra indicated the approach of evening, and in the middle distance an oasis or its mirage sparkled wetly, a glowing Technicolor pond surrounded by palms and ferns and, if my eyes did not deceive, small deer dipping their heads like fine reeds beneath the placid surface. I made to approach that desert miracle only to discover that I was not standing but kneeling, my clothing tattered and my skin parched, and I would have registered my shock at that reality, reality being perhaps a more fluid term than I had presupposed, Jacques wrote, by perhaps squealing or via a sharp intake of breath, but I could in fact accomplish neither feat because my lips and teeth were locked around the meat of a cactus’ denuded arm as I sucked the nectar from its innards. Collected in a perimeter around my suckling form I saw the shriveled remains of hundreds of similar cacti. The veil of the preceding months fell away: the railcar, the Doctor’s tale, the cartoon mice, the soft warm smell of my two daughters, the alcohol-fueled descent, the desperate arrival in Pittsville and the transformational experience of The Line—all of it shimmered before me like desert heat and then dissipated back into the pink atmosphere. I sucked at the longevity cactus and felt my teeth rattle like loose stones in the soft soil of my blackened gums. I tossed the remains of the plant into the sand and sat silent and stunned, watching the breeze reshape the runnels and striations that gave the sand dimensionality, the thrumming of the blood in my ears itself a strange miracle of mutual pressures. Then I felt a hand touch my shoulder.

“I had hoped you would come,” said my former traveling companion, Jacques wrote.

“I made an oath,” I replied.

“When we met on the train,” he said. “I was on my way here. I was coming to help you.”

I nodded and felt the truth sinking into my bones.

“I am afraid you already know what I have to say,” the Doctor continued. “There is nothing wrong with you that more life will cure.”

I stood, sore and stiff, and turned to face the Doctor, at whose back a door remained open, floating just above the desert sand, detached from the reality I belonged to or else a passageway back into a truer reality or else merely what it appeared, an open portal through which existed nothing but more sand, more desert. I saw that the Doctor held in his hand a black notebook not unlike those that so many of you hold open in your laps at this very moment, this particular make and model being as familiar to me as the crooked lines streaking across my own arid palms, a blank hard-backed artist’s sketchbook identical to the dozens of others that, prior to my flight into the desert, I had filled up with words and words, more words than any man has a right to in this lifetime, I had then thought, though now I understand that these words are the only thing I have ever truly possessed and my only genuine—if inadequate—protection against the Suffering Apparatus. The Doctor reached into the pocket of his slacks and produced a Uniball Microfine black roller pen, another of my private fetish-items, one that produced in me a sensation of violent freefall. Small but heavy beads of perspiration rolled like ball-bearings down the sun-seared and ruined parchment of my face. A voice, either the Doctor’s voice or my own, was not so much speaking as etching itself into the necrotic remains of my so-called mind: The longevity cactus has not saved you, it said. No one will be saved. Now practice the honest communion in pain that is your duty. The Doctor extended the notebook and pen with a look of great hope and, though I shook my head, I reluctantly accepted both from him. He smiled and turned and stepped gingerly through the door, vanishing back into the cruel and uncaring world that had spawned the need for his services. He is here with you today, Jacques wrote, hidden in plain sight. The door he stepped through is the same one through which I entered this auditorium, that gilded golden door at my back, the door through which I entered moments ago and from which I approached this podium. I recognize many of you from The Line, though I do not know which frame exists within which other frame. The problem of frames is deep and shimmery, Jacques wrote. Frames within frames, hierarchies in violent opposition, tugging at one another with enormous gravity. I feel anew, as I stand before you with sweat pouring from my brow and puddling here on the cheap veneer of this symbolic podium—the draw of the longevity cactus, its pull over me as I sought a way to extend my time on this earth beyond whatever threshold would enter me into a wisdom that rendered mortality acceptable—and I can right now feel that cactus glowing within a frame enveloped by a larger frame containing my dusty foreign traveling companion—the companion before he was replaced by all the metaphorical baggage that is Dr. Bakhtin—as he gestured in the air within our private car on that locomotive soaring across plains of heat and destitution, but then visible within the frame of that drunk and worried twosome another frame appears, this one containing the young Misty Bakhtin crouched on the floor of a crude and ramshackle domicile at the selvage of a green and febrile jungle within which ten-billion microdramas of predation and consumption and pain played out invisibly in a series of frames within frames within frames, and of course each of these frames, Jacques wrote, is encased within the largest and most recent frame, the one that is this address to you, my brothers and sisters in arms, and though of course while I was there at the Doctor’s door—a moment that has already receded as if to the bottom of the deepest sea—this address had yet to be imagined. I am sorry that I’m crying, Jacques wrote. I did not intend to cry. I once thought that our job was to heal, but no: Ours is simply to diagnose. To expose. To see and to report and, in so doing, to make of our pain a mirror. It is with great pleasure, my friends, Jacques wrote, that I may finally welcome you—here at the terminus of a road paved with the land mines of our doubt and denial—to this annual celebration of our shared pain. The doors are opening. Wander the big room. Stop at my table. I would be happy to tell you more about my work, Jacques wrote, still kneeling before the door that hovered above the darkening sands, his entire body glowing warmly with the embers of a meaninglessness that ran far deeper than any river, far wider than any jungle, ran beyond the edges of the rolled-up scroll of human sadness and stretched into and beyond the wider universe whose plentitude was born from nothing and would return to nothing and had nothing to teach. While in some other place, his elder daughter sat cross-legged on the warm sand of her local playground, folded beneath the skeletal shadows of slides and swingsets, wondering—as she did often—why Daddy had gotten so sick, why he had gone away, and whether or not he would ever hold her again the way he once did beside a silent and moonlit river, pulling her close and allaying all of her young and still-gestating fears with an oath whispered tenderly into the darkness between them: Daddy will always take care of you.