On Vanishing. Lynn Casteel Harper
of the body’s powerlessness and its power. As I prepared for Dorothy’s memorial service, I reflected on such corporeal conundrums. The body is unwieldy and dies. A source of perpetual conflict, the body is at once our home—there’s no escaping it—and our battleground, as we struggle to break free from its inevitable demise. We want the box to pop open to reveal our still-kicking legs; we want to shed impossible shackles.
I suspect those bodies in need of hands-on care by others are objects of cultural contempt, because they lay bare our collective fear of the body’s fragility and dependence. Perhaps those bodies most charged with the hands-on care of these bodies also bear the taint. The same malignant forces that marginalize the old and the cognitively impaired also marginalize their caregivers, who are often the most economically vulnerable and politically invisible people in American society.
The philosopher Eva Kittay notes that the particular demands of caregiving and the traditional relegation of this work to women or servants make care workers “more subject to exploitation than most.” According to a 2018 report released by the Paraprofessional Health Institute, nursing assistants who work in nursing homes—the majority of whom are women of color—suffer workplace injuries at nearly three and a half times the national average. Half of nursing assistants have no formal education beyond high school, and nearly 40 percent rely on some form of public assistance. Fifteen percent of nursing assistants live below the federal poverty line, compared to 7 percent of all U.S. workers.
Nursing assistants spend more time with residents than any other clinical staff, providing a median of 2.2 hours of hands-on care per resident per day. That this occupation, so central to resident care, is both hazardous and poorly compensated reflects the low cultural value placed upon those who perform it and, by extension, their clients. I can count on one hand the occasions I saw administrators on the Gardens’ dementia unit spending time with residents and staff. This absence reflected and reinforced the broader culture of invisibility. Perhaps it is little surprise that both the vulnerable staff (often black immigrant women) and their patients (often immobile, voiceless, dependent) were relegated to the same space. The curtain is drawn, hiding them from view—a vanishing act with no scheduled reappearance.
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Accompanying Dorothy’s obituary, many newspapers included a black-and-white photograph of her popping out of Houdini’s oversized radio—a prop that looked to me like nothing more than a coffin with dials affixed to it. Next to this box stood a tuxedo-clad, wild-eyed Houdini, his arms agape, holding a wand overhead as he presented his assistant, the “Radio Girl.”
The image made me think—perhaps irreverently—of the stories of Jesus’s empty tomb and the play of presence and absence that permeated early accounts surrounding his death. In Mark’s gospel, when women come to the tomb to anoint Jesus’s dead body, a young man dressed in a white robe—presumably an angel—appears to them and points to absence: to nothing but a heap of empty grave clothes. “Look, there is the place they laid him,” he says. The women look at where the body was. Offered only a brief explanation of the absence—“He has been raised; he is not here”—the women are granted no positive confirmation of Jesus’s whereabouts. They respond the way any God-fearing people would: they flee the scene, deathly afraid.
The scene has the right components of a magic show—an expectation of presence or absence (depending upon the setup) and a surprise reversal. I imagined Houdini at Jesus’s tomb wearing a white tuxedo and waving a magician’s wand overhead as he presented the empty space. The reversal, however, is askew, or it is, at least, incomplete. The dead body should be revealed as alive—not merely as missing. But the original ending of Mark, the earliest Gospel, includes no post-resurrection sightings of Jesus. The women at the tomb were to believe based on what was not there—a faith based on disappearance.
Uncomfortable with this silence and with the last image being one of women fleeing in fear—and perhaps intuiting the failed dramatic arc—Mark’s earliest editors added post-resurrection encounters with Jesus in the flesh, and not just with the clothes his flesh had once inhabited. The later Gospels chronicled rather detailed meetings between the risen Jesus and the disciples. Jesus shows them his feet, hands, and side; he walks through closed doors, breathes on them, and makes breakfast for them on the seashore. In John’s Gospel, Mary Magdalene mistakes the risen Jesus for a gardener, until he speaks her name. The disciples experience, with their senses, a newly constituted but still bodily Jesus—and thus gain what we moderns might call a sense of “closure” in the wake of Jesus’s traumatic death. When all seems lost, a magical, fleshly reappearance defies death’s despair.
Nevertheless, I am drawn to Mark’s original ending; it rings truer in light of the abundant absence that, to my mind, marks all earthly existence. The dead don’t often visit us again (imagine the silence at the yearly Houdini séance). The Population Reference Bureau estimates that 107 billion people have ever lived, which means that for every one person now alive, approximately fifteen people have died. There comes a tipping point in the timeline of our own lives when we know more of the dead than of the living. We all have forgotten much more than we remember. The proliferation of vanishing, more and more, is what we have to live with.
And yet disappearance does not necessarily mean obliteration. I hope that what remains might be enough, that beholding something as quotidian as a dead body’s dirty laundry might be enough to ignite and kindle undying devotion.
For all of his losses in old age, I have come to feel that my grandfather—Jack as Jack—did not vanish. He persisted, a complex conglomeration of the past and his new present. Jack would mock-sing into a saltshaker when good music came on in the nursing home dining room. What else but an affinity for life was behind the enjoyment of playing instruments, traveling the world, perfecting omelets, and singing into a saltshaker? Stooping over his wife’s coffin, deep in dementia, Jack said, “I don’t want to join you yet, babe!” What else but a will to survive was behind piloting a cargo plane across the treacherous Burmese Hump, scraping his way through medical school playing gigs in bars at night, and declaring at my grandmother’s graveside his desire to live? The essences behind his previous life endeavors seemed intact in Jack until the end—in subtle shades, often known only to those who spent time with him—while the activities that once embodied them had fallen away.
The mystics might say what is left is a truer, purer self. The dissolving of all doing, the stripping away of the via activa, makes straight the path for the naked, beloved self to emerge. The deconstruction of ego can facilitate a new freedom of being.
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The definition of “vanishing point” seems to integrate apparent opposites. The point at which parallel lines receding from an observer converge at the horizon is also the point at which the lines disappear. The vanishing point is both unification and dissolution, the point of convergence and cessation.
If I stand still and watch a person walk away from me, she grows smaller and smaller, until she reaches the vanishing point. She has not vanished from the planet or from herself—she has vanished only from my view. If I move toward her, she reaches her vanishing point more slowly; if I move away from her, she reaches it sooner.
Kitwood argued that as the degree of neurological impairment increases, the person’s need for psychosocial care increases. What traditionally happens is the exact opposite. As the degree of neurological impairment increases, the person becomes increasingly neglected and isolated, further increasing neurological impairment—a vicious circle. Malignant social psychology hastens the vanishing point. Person-centered care, which aims to affirm identity and promote well-being, tries to keep the vanishing point far off, to keep the person with dementia in view as a unified whole. The benefits of person-centered approaches, including the reduced usage of psychotropic medications among residents in long-term care settings, have been well documented. The Alzheimer’s Association 2018 Dementia Care Practice Recommendations, a comprehensive guide to evidence-based quality care practices, names person-centered care as its underlying philosophy, pointing to research showing that individualized care decreases depression, agitation, loneliness, boredom, and helplessness among people with dementia, and reduces staff stress and burnout.
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