Session Two: Time--Counting the Moments/
Making Moments Count
Editor's Note

In Session II, chaired by Gayle Greene, Professor of English at Scripps College, we turn to time: to "final moments," to evaluating and identifying the time of dying. As physician Guy Micco's comments suggest, identifying the moment of death becomes inextricably bound to the question, what is death? And central to this vexed area is the role of technology. In various ways the panelists confront the question of how technological innovation in medicine has changed our conceptions of the boundary between life and death.

Oncologist Debu Tripathy begins the session with a consideration of a paradox that haunts both physicians and their patients: new technologies may actually hold out promise for some patients but also create false hopes in a culture that craves certainty and sees technology as the means of attaining it. Such a paradox, Dr. Tripathy argues, suggests that medical practice should include talking with patients about the limits of medicine and, in some cases, the possibility of their dying of their cancer. In a sense, Dr. Tripathy is talking in a medical context about "preparation," a notion that literary scholar Michael Witmore explores further through its religious connotations in the literature of the early modern period that he studies. Particularly concerned with conceptions of accident, Witmore evaluates earlier generations' abhorrence of a sudden death that precludes preparation for the journey beyond. With reference to the ghost in Shakespeare's Hamlet, Professor Witmore emphasizes the significance of the voice that speaks from oblivion, from an "unknown country." He suggests that contemporary fascination with the "black box," the airplane voice recorder that is intended to help tell the story of the air accident in the event of a crash, is evidence that the "suddenness of death has retained its full measure of power."

Looking at time and death in another way, physician and bioethicist Larry Schneiderman argues for a realignment of time and nature. We go against "nature," Dr. Schneiderman argues, when we rely on technologies to prolong lives such as those in persistent vegetative state. It is, in his view, simply "hubris" not to recognize our "mortal limits." As both commentator and presenter, physician Guy Micco counters Lawrence Schneiderman's equation of "life" and "personhood" and then, through the anecdote of Mr. Reggie, explains the complexity of the question "when is dying?" Dr. Micco ends his comments with a clip from Fred Wiseman's classic documentary film of death in a hospital, leaving us with Wiseman's powerful image of the physician's ear turned to the body, listening for the heart's final beat.

The discussion that follows the presentations in Session II returns to issues in medical care, particularly the inadequate training of physicians in dealing with patients who are diagnosed with life-threatening illness. As in our other sessions, comments fall into two general camps: those who see death as a human passage and those who view it as a physiological event. Historian Tom Cole provides the final comment of the day, pointing out that we cannot find universal abstract answers to this dichotomy, that we must use "experiential terms that are moderated by metaphor and language." --CMG

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