The Left Atrium · De l'Oreille Gauche

CMAJ 2000;163(1):69-72

• Challenges and choices
• What I could not return
• R is for writing
• Packaging Picasso

Tough choices: living and dying in the 21st century
Maureen A. McTeer
Irwin Law, Toronto; 1999
$24.95 (paper) 211 pp. ISBN 1-55221-040-5

Unfortunately, this goal has proved elusive. Tough Choices holds little appeal for the layperson (I can't speak for lawyers), and that is a shame. Although many of the issues McTeer tackles are important and interesting, she doesn't seem to have a knack for communicating them clearly. The writing is often awkward and confusing, the sections are frequently poorly organized and the index is almost completely useless.

McTeer is at her most convincing when she discusses genetic testing and the need to keep the results of such testing private. She argues that people can suffer discrimination by virtue of their genetic profiles and recommends that such information be treated differently from other personal medical information: "[W]e must be assured that, if we seek genetic testing, or if we or our newborns undergo this kind of testing, we will also maintain control over the resulting information. All provincial privacy legislation needs to be amended so that this principle is clear and enforceable."

Various passages on developments in reproductive technology and the legal status of human life before birth are also thought-provoking. McTeer notes that, in Canadian law, legal rights begin at birth: where there is an irreconcilable conflict between the interests of the fetus and the rights of the pregnant woman, our courts have chosen to protect the woman. She argues that, since there is no such conflict in the case of embryos created through in-vitro fertilization (IVF), these (unimplanted) embryos should be placed "within a zone of legal protection that spares them from abusive research, while simultaneously safeguarding women's reproductive rights in the context of contraception and abortion."

Generally, though, this book is an awkward hybrid of fact and opinion. Too often, just when an opportunity for thoughtful discussion appears, McTeer preempts the exploration of an issue with her own strongly held opinion. For example, early in her account of reproductive technology she insists that new laws "should guarantee that those suffering from medical infertility be provided access to those technologies through the public health care system." In other words, if the technology exists, people should be able to have "genetically linked children" without regard to ability to pay. This is a controversial view, given the potential burden on the health care system and general disagreement about just how "medically necessary" it is to treat infertility. Moreover, McTeer makes no attempt to reconcile her view on the "rights" of the infertile with her next, very brief section on the health risks associated with the multiple births that sometimes result from fertility treatments.

Occasionally, ideas are injected into the text without contextualization, as if the reader is completely familiar with the issue. At other times, McTeer makes recommendations without the support of a practical discussion. For example, she expounds on the risks of "reproductive incest," which she describes as a risk created by reproductive technologies that allow for the "deliberate creation of human beings while legally denying them the possibility of ever knowing the identity of their blood relatives." She suggests setting a "legally enforced" limit on the maximum number of live births allowed for one donor. The goal — to prevent the "potentially devastating health and human situations" that can result from the inadvertent pairing of close blood relatives — is laudable. But the mind boggles at how to legally limit sperm donation.

Extrapolating from what has been learned about the psychological needs of adopted children, McTeer believes that, at maturity, people conceived through IVF should have the option of meeting their biological parents. McTeer quickly moves on to another topic, but the reader is left imagining scenarios: 20 years later, the university student sperm donor meets his 64 children!

In her chapter on organ donation, McTeer lists as an option the long discredited idea that medical personnel be "legally mandated to ask all competent patients 'in their last illness'... to donate their organs and tissue for transplant. A fine or loss of funding to the hospital could be imposed for failure to do so." There is no indication that McTeer means to ridicule this suggestion. She appears to be genuinely blind to the conflict of interest involved.

"Compact and provocative" is how Senator Wilbert J. Keon, in his Foreword, describes Tough Choices. This is probably a fair assessment, as is his observation that this book tackles fascinating and complex issues. Unfortunately, while the book may be provocative it is not always satisfying, and the quality of the writing offers little to entice the reader. Instead, reading it feels like a chore.

Ann Silversides
Toronto, Ont.

[Contents]

I close my eyes and as if by remote control my mind flashes back 30 years. Click, and I am 8 years old again. I see the two of us riding rickety old bikes down gravel roads, a breeze sailing over our crew-cut heads. Wheat fields sway in the wind, as if waving me into this reverie. Blue prairie skies stretch before us into the future, many years of which I have already lived.

Sunshine. Gorgeous sunshine. It seemed our constant companion, as if it never rained, as if our lives consisted of endless summers untouched by gray skies or the crack of thunder.

And we were saints, our halos bright as the summer sky. Right. Boys, as they say, will be boys.

Bang, bang. (That was the cap-gun six-shooter.)

"Gotcha," I said.

"No, you missed," you said.

"No, I didn't. You're dead."

"No, I'm not. I'm the Lone Ranger and he can't die. Bang! Bang, bang. Now you're dead."

"No fair," I said. "You never die."

We fired our schemes like bullets against a bull's-eye of woodland and farm. We pretended to be Ronnie Lancaster, pitching rocks like touchdown passes through the windows of abandoned farmhouses. We skinny-dipped in the creek, clutching our privates, fearful of leeches and snapping turtles. We scoured the land, noting wild flowers, animals and birds. Sometimes we did more than observe.

I crept up to a red-winged blackbird chirping stupidly in the reeds of a slough.

BANG. (That was the BB rifle.)

"Ya got 'er," you said.

"Yep, pegged it right in the head," I said.

"Naw, you nailed it right in the chest. See?"

"Oh, right."

"Good shootin, anyways."

"Yuck," I said.

"What?"

"Look at its eyes. There's sort of a film over them."

"That ain't no film," you said. "It's dead. So its eyes are closed."

"Oh."

"What did you expect?"

I made no reply. I'm sure I never told you — that I didn't like shooting birds. Beautiful ones that sang. And I didn't much like what we did to gophers, either.

You remember about the gophers. It was our prairie right to kill them: they were vermin. We poured water down the hole and as the critter surfaced — either that, or drown — we whacked it on the head with a big stick until it was dead. Used to bother me, seeing that poor thing. A soaking wet gopher bursting for air is a pitiful sight. A child's natural instinct is to say, "Ah, poor gopher," and then giggle with delight as it steps out and shakes the water off itself like a dog. You know, a prairie dog. But a kid grows up quick on the prairie. There's no room for sissy talk. So you smash the gopher's head or shoot the dumb bird and feel sick about it, silently.

We grew older, and our thoughts shifted from the natural world around us to our changing physiques. We worried about the wisps of hair at our pubic bones and the new sensations our bodies offered up. How old were we when we first recognized our interest in girls? I see us now as we examined the advertisements in The Bay catalogue. The models in their undergarments summoned up shivery, naughty pleasures. We soon realized that the sight of Marion gave us the same goose-bumpy feeling. Ah Marion, the farmer's daughter, fair maiden!

"Call her up," you said.

"I don't really know her," I said.

"So what? How are you gonna get to know her if you don't talk to her?"

"Well, you call her up," I said. "She knows you, you're in the same class."

"Xac'ly why I'm not gonna phone her. Look, you're the motor mouth. You call."

And so I found myself, receiver in hand, nervously dialing the number. "Hello," I said (twitch, scratch, sweat). "Is Marion there?"

"Who's this?" she said.

"It's Doug, Tom's friend."

"Oh."

"So ... ," I said.

"So?" she said.

"How are you?"

"Okay, thanks. You?"

"Good, thanks," I said. "Ahh ..." Click. Dial tone. There I stood, boy–man, mute, cheeks burning, a wave of disorientation washing over me, until you broke the stunned silence.

"You hung up on her! Why'd ya do that? Great, that's just great. Now she'll think you're retarded."

Fast-forward to the painful memories of high school. We remained friends, yet — at school — were distant. You were a reluctant student, little interested in the finer points of Macbeth and immune to the logic of algebra. But your hands were magnificent. Mechanical objects were disassembled and reconstructed at your command, something I was completely incapable of.

Socially, you were aloof and withdrawn, a shadow in the background of teenage posturing. You lived for your time away from school, those days passed outdoors, camping on a riverbank, waking at dawn to practise the solitary art of fly-fishing or, in winter, snowshoeing a trapline you had set. When I accompanied you, tearing myself away from the teenage world you held in contempt, I saw a self-reliant youth, a friend at ease and alive. In turn, I felt relaxed and capable.

At school, I was unable to reciprocate, incapable of drawing you into a wider circle of friends. I couldn't demonstrate to you the attractiveness of words, the utility of talking to people, the beauty of typed words strung together in a novel. You read to learn something specific; fiction was a waste of time. Similarly, most teenage talk struck you as useless chatter. You avoided people who needed to talk, needed to impress, needed others. You seemed to need no one; I was one of your few friends.

"Geez, Doug. Why do you hang around that loser?" Susan said, dragging dramatically on a cigarette. It was after school; I'd been trying to summon the courage to ask her out.

"Look, Tom may be a hard guy to get to know, but he's no loser."

"Yeah, sure. Whatever you say. Like, go fish, eh." She laughed gracelessly.

"Tell you what. If I were ever lost in a snowstorm in the middle of nowhere, I'd rather be with Tom than practically anyone else. He'd figure out how to keep us alive."

"Like I'd ever be lost in the middle of nowhere anyway."

"Good point. You don't need to be in the middle of nowhere. You're lost most of the time already," I said, wondering why I had ever considered asking her out. Young people, I now understand, are afraid of nonconformists. So they find reasons to ridicule. But the outsider himself is still drawn to the opposite sex, even if he can't admit that to himself.

I am brought up short by a pungent odour. It is not the prairie smell of freshly turned earth or fragrant clover or of rain building in the distance, but the sickly perfume of hothouse flowers. I open my eyes; thirty years fall away in an instant.

Time. Time changes things. Memories fade. Emotions change colour, dry up and flutter to the ground.

I remember how we drifted apart. You stayed on the land that had revealed its character to you, honing the skill of your hands, learning a trade. I moved to the city to huddle over the printed word and to consider the cast-off thoughts of scholars. Our lives diverged.

And now I wonder if I really understand what happened to you. I think I do, but still I feel the need to invoke excuses. What's the buzzword? Closure. I seek closure.

I glance beside me and suddenly feel blessed to have my wife and children with me. How I wish now that you had found a partner, raised a few kids, maybe. Things might have turned out differently. Perhaps.

I look to the front of the chapel and can almost see you there, alone, a bottle of booze beside you: your friend, your crutch. And then I imagine you with a rifle to your head, sweat dripping down your forehead, your finger twitching, and I can nearly hear slurred words, your own voice, pleading, no, no, no.

But we are gathered today, Tom, to say farewell. And I am here to reflect on our time together as we ranged over rolling fields under open skies in the grand freedom of youth. We stand now to leave this place, the air redolent with mourning. I am filled with guilt that your life has ended, whereas mine seems, in its possibilities, to have just begun.

As I walk toward the door, the sun, the big radiant prairie sun, strikes my face.

I will always remember you. For all that I took. And for what I could not return.

Brian Deady
Emergency physician
New Westminster, BC

[Contents]

[Contents]

The billboards and shop windows of Montreal are filled with highbrow hoopla this summer promoting the current blockbuster at the Montreal Museum of Fine Arts: From Renoir to Picasso, 81 paintings from the esteemed Walter–Guillaume Collection of the Musée de l'Orangerie in Paris. Whatever else this exhibition may be, it is certainly a marketing success. The four-colour, 30-page guide handed out to visitors gratefully notes that, in view of the "significant economic spinoff" expected from the show, "both the private sector and the Quebec government have contributed generously to its presentation in Montreal." Statements like these make sense of the phrase "cultural industry." The business logic doesn't surprise me, but the gallery's willingness to be so frank about it does.

André Derain, Portrait of Mrs. Paul Guillaume in a Wide-Brimmed Hat, c. 1929. Oil on canvas, 92 cm × 73 cm. © André Derain / SODRAC (Montréal) 2000

Marketing savvy is a matter of survival for galleries and museums these days. But it's almost true to say that what impressed me most deeply about this exhibition was not any one of the paintings but the offerings of the gift shop conveniently set up at the end. After 10 rooms of Matisses, Modiglianis and Rousseaus one arrives breathlessly (and, in view of the crowds, airlessly) at the souvenir shop, where the experience is transmuted into consumable goods: Renoir aprons and placemats, crockery inspired by his Strawberries (are strawberries the quintessential Renoir?), replicas of the straw hat and silk scarf worn by Domenica, the wife of art collector Paul Guillaume, in her portrait by Derain. Art appreciation has become muddled up with consumerism and the house-proud craze for gardening, decoration and overeducated cuisine. Thus one may choose from books entitled À la table de Picasso, Le goût de la Provence de Paul Cézanne and Renoir's Table: the Art of Living and Dining with One of the World's Greatest Impressionist Painters. The bourgeois excess of it must have these once-iconoclasts spinning in their graves.

Amedeo Modigliani, The Young Apprentice, 1917. Oil on canvas, 100 cm × 65 cm.

The poster slogans for the show read along these lines: "The three sisters of Matisse are spending the summer in Montreal." Ditto for Renoir's son and Cézanne's wife — all references to subjects in their paintings. What is offered is not (merely) art but also an imaginary form of elbow-rubbing. But the fact is that these painters have entered our consciousness like few others, and their contribution to modern art is almost incalculable. The schools and styles that followed the Impressionist reinvention of vision — Postimpressionism, Fauvism, Cubism, Expressionism (not to mention sheer individualism) — are all familiar to us, and all have been assimilated into contemporary art and design. It is difficult to see, if not these particular paintings, then these particular painters, as if for the first time. On the other hand, the 11 artists represented include some (e.g., Derain, Soutine and Laurencin) who lack the mythic status of the title offerings, and their works help to demonstrate how complex the currents and countercurrents of early 20th-century French art were.

The challenge of the gallery goer is to leave an "important exhibition" like this one energized rather than drained. If you're in Montreal before the show closes on October 15 (it then moves on to the Kimbell Art Museum in Fort Worth, the only other North American venue), block out the hype and ignore the crowds. Looking at 81 paintings isn't like "doing" the Louvre in a day, but forget about absorbing them all. Stand stubbornly before whatever canvas moves or intrigues you. Spend an hour with Matisse or Cézanne or (if you don't suffer from vertigo) Soutine. Then skip the boutique and take time for coffee and conversation on the way home.

Anne Marie Todkill
CMAJ

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