Bill of Responsibilities

I’ve been working on a project recently where I am looking for the presence and/or absence of certain items.  This got me to thinking about the broader experience of presence and absence and how, as humans, we put stock in these experiences.  On the surface, presence or absence would seem a simple choice between the two.  Either something is there or it is not.  But on deeper reflection, it seems to me that it is much more nuanced.

Take physical pain for example.  This is one of the great challenges of aging.  I have more things that cause me physical pain as I get older.  Still, there are mornings I wake up virtually pain free!  Then I move.  Then pain is present.  Yet, if I move enough, the pain decreases (or at least goes out of my awareness) and then it is absent.  It may come and go, ebb and flow, or change in intensity.  But is it really absent?  Or is it lying in wait?

Then there is presence and absence of memories.  This, too, is one of the challenges of aging as so many of us experience shifts in our memory.  The greatest and most painful of these is, of course, Alzheimer’s.  This absence of memory raises questions of what truly defines us as “human”.  Are we human because we have the capacity to experience a past, present, and future?  If so, when that capacity diminishes or becomes non-existent, have we absented our “self”?  Do we value our past recollections more than being present in this moment?

Memory_LossLooking at Alzheimer’s in terms of presence and absence can be more helpful than looking at it only as a medical condition of decline.  There are moments, sweet moments, when the person with this condition is very present.  It may not last long, but it can be a gift.  One of my patients has a wife who is well into the disease, yet, on occasion, he tells me that he can sense her presence and in some way, he feels that she is able to be present with him as in the old days.

If you haven’t seen the video of Henry, a gentleman in a nursing home that appears to be absent until headphones are put on and the music he is listening to brings him into the present, click on this link . It is a wonderful example of how what we perceive as absent may be misleading when it comes to “self”.

Dark_light_colorAs humans, we are gifted with a remarkably complex system of detecting the absence and presence of changes in our bodies and our environment.  We have “apps” in our brain that can sense the absence or presence of salt, sweet, sour, and bitter in both tiny and overwhelming amounts.  We have an app that allows our eyes to adapt to the darkest night and the brightest day, and see all the colors of the rainbow.  We have apps that let us estimate the weight of things and program our muscles to pick up the lightest feather or the heaviest box.  We can hear the sounds of rain and rock and roll. We have an app that fills us with happiness and joy in the presence of someone we love and makes us weep or shut down when that person or pet dies.  When any of these remarkable capacities are impacted by disease or injury, we are aware of their absence.

Then there is presence and absence of loved ones.  We know that humans need connection to thrive.  When I am in the presence of others I can be inspired, offended, aroused or soothed.  When they are absent I can be depressed, relieved, afraid, or motivated.  These represent just a few of the experiences that absence or presence provokes.  How you or I engage with these energetic responses also changes as we age.  Loss becomes more frequent the older we get.  Loneliness and isolation also increase.  The presence of kindness, whether from family, pets, friends, or strangers often lingers with lasting benefit.

Diana2017I find during the holidays that I feel the presence and absence of loved ones more acutely.  My father died when I was 14.  When Christmas came around that year, what I found I missed most was his putting up the Christmas tree.  My mother and I didn’t have a clue how to put the tree in the stand, so we fumbled around and somehow we got it up. That’s one level of absence.  Both my parents are gone now, as is my husband.  Those absences no longer carry the charge of immediacy, but are still present with me.  This year, what I will miss most is my cat.  She occupied a special place beneath the Christmas tree, and her absence is hard to deny.

What remains present, however, is gratitude.  Gratitude brings me to a place where I am not hooked into a binary “either/or”.  Instead, I can be grateful for the presence of memories of loved ones, even while feeling their absence.  I can be grateful for what is in my life right now, which includes a sense of purpose, a feeling of accomplishment, and a joy in sharing my thoughts with you.  I can celebrate the presence of friendship, creativity, curiosity, and laughter that is abundant in my life.

My wish is that you are able to experience the “both/and” of presence and absence as this holiday season unfolds.


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