19820513 Tom Bingham to Peter: "You can be a good Quaker doctor
or you can cure cancer." Peter asks whether his embrace of loyalty
to his family and interest in starting a family are not an extravagance
mirroring Tom's rejection of family life and particularly of
his own family's values. Professionalism and the family. 

19820514 Defiant worldliness. Depression, immunity, cancer, victim blaming
and magical thinking. "Success in one does not guarantee success
in the other...Work and Love: the [illegible] Balance" (Harmony
Books) (NYer ad) Are the notions of success and balance appropriate.
the advertisement shows a young man and woman - only. the work
is professional work, the success professional success. The love
is romantic love. Tom came to Dobbs Ferry for dinner last night,
Janet and Bob's 32d wedding anniversary. He was in a hurry to
eat, saying that in that case he would take a later train, tense
over a project which he must complete by today, anxious about
his performance. He explained to me, as we sat on the new wheelchair
ramp at the front door, that he has not, like the other "cub
scouts" in his firm, been allowed to specialize, but has been
given a series of discrete and disconnected assignments. "I have
to conclude that what I'm being graded on is my flexibility and
willingness to take on unfamiliar work." Flexibility, adaptation;
those are the issues. Tom has adapted to his environment - become
a Reagan Republican who disparages what he now sees as a pernicious
Quaker humility infecting the family. I, too, adapt too easily
to my professional environment, taking on the colors and values
of the hospital. The lawyer or businessman takes on greys, the
young physician, white. our values can be so much determined
by where we spend our time and whom with, by what they choose
to give us emotional rewards for, what they choose to - or are
capable of - supporting. Tom, Peter says, once advanced the notion
that frustrated ambition caused their father's brain tumor. "I
think you're a lot like Pa, and look where it got him." Thus
too civilized a life has stifled ambition, stifled something
natural, primal, and turned it inward. The family is represented
as limiting, stifling the natural man. And from this, Tom seems
to make the hop - it is no leap - to the notion that he can protect
himself from his father's fate by driving himself, by aiming
high and reaching his target. Doesn't making a virtue of ambition
invite frustration? is it to avoid frustration of it that one
should eschew ambition? Is not the basic reason because it is
idolatry? What is the emotional satisfaction for me in nursing
Uncle Robert? Am I not playing a game - playing at kindness?
Is it the satisfaction of intruding upon the survivors, of having
a relationship to them charged - in an almost erotic way - with
memories. These relationships are, no matter what benefit he
may derive from my attention and care, in some sense at his expense.
Fate makes him their occasion as in the teaching hospital patients
and their illness become occasions for displays of learning.
That is the problem with doing what I have done in offering to
come, coming,and arranging to come again: I am playing the role
of hero and rescuer. I am intruding. What i am doing is decent
only if one is touched by the tragedy more deeply than am I.
It is proper only in tears, and with great effort. 

I called Belmont this evening to find out whether Mommy and Daddy were 
coming to visit here tomorrow. I had spoken to them night before last,
when I described the situation here - Robert's deteriorating
state - to Daddy, and tried to explain my understanding of what
their visit might mean. Today, Daddy walked out of the house
when I called and did not come to the telephone. Mommy said that
he had been very depressed since talking to me. I found myself
less anxious than often. I am afraid that I feel somewhat self-righteous
about the situation, and that I am covertly glad not to be able
to rush back to his depression. As I think about this situation,
and about the crisis I precipitated with my plans to travel in
Europe, it seems to me that Daddy's situation resembles his parents':
in certain defined social situations, he is well-compensated
and productive, but others he cannot tolerate. his parents' world
is geographically limited and defined. He refuses to visit where
he does not have a place to work. He cannot, will not, sit with
people and enter aimlessly into their lives. I can understand
what happened this spring: twice, I put have him on the spot,
threatening to disrupt the world within which he functions, once
with the European trip, once with my visit here and my suggestion
that they come overnight. Janet, incidentally, seemed genuinely
sorry that they could not come. My excuse - my lie - was car
trouble, back trouble, and a sick patient. 

What is there be said about my putting him on the spot? Am I defining the 
limits of his capacities too clearly? And why are his capacities thus limited?
And is this limitation a necessary corollary of the passion of his work - 
which I fall far behind/ I have isolated myself, and now I must be independent,
for the one person whose support, approval and encouragement matters to me 
cannot give it - 

19820515 Why is it that Daddy finds the prospect of a twenty or thirty
hour trip and visit so upsetting? Does it date to Chappaqua and
the Flanders farm in Canaan? I doubt it, an explanation in terms
of the immigration is easy, and preserves the categories of socially
acceptable thought, for it 

======================== 

A book review in today's Times suggests that often love for an individual -
or what we think of thus - is really an addiction accompanied
by chronic depression. Breaking the addiction is said to mean
accepting anxiety. 

========================= 

posits the disruption by trauma of a conventional, universal pattern of 
feeling and relationships. What I have heard of his childhood in Germany
suggests to me that his way of feeling was different before the
emigration. I am reduced to an appeal to character. I wonder
if one can say much more specific without the benefits - and
costs - of an analysis. I can deal with these problems in two
ways. I can accept Daddy's behavior as a fact in my life, observe
and interpret my own response, and practice modification of my
own behavior. That is psychologically sophisticated and indeed
psychologically oriented self-discipline. I do not have much
hope of understanding myself in depth - I think such understanding
is probably necessarily the child of a social encounter. This
is the case if one understands interpretation not primarily as
truth but as the therapist's tool. If, however, one understands
it to be truth, then I should be able - perhaps?- to find it
myself. if it is poetry, I should be able to make it myself. The
other approach - and the two depend on each other - is to try
to understand Daddy. This is, on one level, important to allaying
my anxiety. What does "understand" mean? It can mean to acquire
or create a conceptual representation, it can mean a sense of
emotional affinity - sympathy or empathy - and it can mean simply
acceptance and the absence of anger. What are the verbs that
should accompany the word, concept, experience of anxiety? Understand?
Deal with? Hold, as the psychiatrists would say? Overcome or
master? Allay? Dispel? Sublimate? Escape from? 

It is evening, almost supper time, and I feel the compulsion to write again,
for as the sun goes down, melancholy comes over me. It is the
melancholy of being away from home. I remember experiencing it
in New Hampshire, when I visited at the Kilbournes' during college
summers. I wonder whether it is not - indeed I'm pretty sure that it is - 
a form of anxiety. 

19820516 The anticipation of calling Belmont evokes a sympathetic discharge. 
Is my fear of Daddy's anger or depression a turning on myself of anger 
I do not dare, from fear, do not allow myself, from pity and love
and conscience, to express? Would it be better to get angry, feel guilty - 
but I fear that guilt would be anxiety, unbearable, the expectation of the 
withdrawal of love and support - the requirement that I become independent.

19820518 Two thoughts came to me yesterday in an otherwise benumbed day 
1) that one must find a way of living fully, alertly, without social as 
well as without chemical stimulants. One must fight one's way through 
to a state in which one is always transcending the world. This is the 
only way to survive the world, and the best way to find peace to be 
active in it.


Klemens Meyer, MD
Mobile 617-549-5539