The Problem With Meaning

David Brooks, writing about "meaning" today says "meaning has become the stand-in in concept for everything the soul yearns for and seeks."  He says, "In this way meaning is an uplifting state of consciousness. It's what you feel when you're serving things beyond self."

For me, meaning gained a very concrete status my second year of medical residency.
The meeting was mandatory, I was told, no excuses. I had been up thirty hours, but that was no excuse. Two other residents had been up just as long, but six of us had to rally for a meeting in the Department of Medicine office conference room. 

It was a very impressive room, with a long glistening conference table. Eight by ten photos of chief medical residents past  lined the walls, along with bookcases filled with medical journals and text books. We took our chairs and not a one was happy to be there. We were required to be there for the one hour of "psychiatry training" required of internists,  so we could sit for our board exams.  

Waiting for the shrink to arrive, I looked around and the three of  us who had been on call looked no better than I did: a day's growth of beard, dark circles under eyes, and white uniforms spattered with blood, urine, vomit,  all the stuff you acquired on call.

I fiddled with the rubber tourniquet looped through my belt and Jay, whom I had known since medical school, spun his reflex hammer on the polished table, eyelids drooping. David, flipped a sealed angiocath container up and down in his palm, as if he were throwing a knife.  We were, each in our own way, in a really foul mood.

Six hours earlier, I had been talking to a favorite patient, when his eyes went opaque in that peculiar, pathognomonic glaze unique to the eyes of the dead. We managed to get him back, briefly, with defibrillation and the code had gone smoothly, but then he flat lined and there was no getting him back. As many times as I saw patients die, there was still something about their eyes when they died that chilled me. FUBAR that night, no doubt.

 I had to call his wife in and take her to a conference room, and deliver the news, which has always been my absolute least favorite task as a doctor. 

What could this shrink tell me, or any of us, which would be of any use at all? He didn't have to do what I had just done. He never had to tell a wife her husband had died, or a son his mother had died, or worst of all, a mother, her child had died.  We had about as much use for this  shrink as skunk has for perfume.

The shrink walked in and sat down and looked around the table as we stared at its polished surface or met his eyes, each as we felt inclined to do. I actually felt a little sorry for him, but he was what was standing between me and my bed and four hours sleep before rounds.

He wore a nice Harris tweed jacket and his tie was flawlessly knotted, a silk rep striped tie, and he looked well rested and spotless, unlike his captives.

"What would it mean to you," he asked,  "To know you were going to die today, by the end of the day?"

Even in my resentful, sleep deprived state, that got my attention. But the real surprise was what followed. 

David and Jay, who were both married with kids, guys I thought I knew better than their own wives knew them, guys I stayed up with all night, guys who had watched people die with me, guys who confided in me secrets they would never have their wives know--how they lusted after the charge nurse who wore her skirts so short you could see her panties when she bent over a bed--these guys, my comrades in arms, both said, without hesitation: "It would mean I'd never get to see my kids grow up."

That came as a complete surprise to me. Of course, when I thought about it, it made sense. Being a father was something neither of them ever talked about. It was a part of their lives I never saw. I knew, in some abstract sense, they were married and had kids they never saw back at Payson House, in some apartment, with wives who only came out at parties, but there it was. The most important thing in the world to these two guys was not their world I shared, but that world I never saw.

I, of course, being unmarried, lived for a good sleep, the next day off, and whatever pleasure might be available at the Recovery Room or other pubs around the hospital.

It turned out "meaning" was bigger than I had guessed. Meaning for me meant I could live my life entirely for myself, for some discrete periods of time. My own family had been depleted by death and distance. I spoke to my father by phone every couple of weeks and to my brother and his wife a little more often, but mostly, I was on my own. I never saw childhood friends or neighbors--I was living in a city far away from my hometown.  I had friends, but it was like Army buddies: At some level, you knew you'd never see them again. You'd go on to "the real world," i.e. the world outside the hospital, where people dying was not a daily event.

The meaning of life was, for me, whatever was happening that day.

But not my two married friends. Meaning for them was invested in children I hardly knew existed. 

After that, I made it a point to go over to their apartments and play with their kids every now and then, to see what that sort of meaning meant.