Physiology Lessons
Physiology Lessons

Physiology Lessons

How things work together.
March 1 st 2015
Appears in Spring 2015

I have been collecting images, lifting layers, switching between depths of field to catch glimpses of what's really going on here. How does work become more than what it is, and how do we become ourselves in the process? How do we find livelihood even as we are making it? How can an individual body of work contribute to a corporate body of work to participate in a universal, eternal, worldwithout- end body of work?

On my bookshelf sits a slim volume with a hard cover the colour of blood. This anatomy book belonged to my mother in her nursing school days. Tucked into the book's middle and flanked by pages heavy with text are pages of drawings created by a master medical illustrator using coloured pencils or paints. As a child, I made a beeline for these pages. Here, I could look at a heart with its valves and chambers or run my finger over the brain with its lobes. I could see how a baby curled up tight inside a woman's belly.

The surface view of grace isn't synonymous with the good life; history bears that out.

My favourite drawings were those of the headto- toe human body, one Mylar overlay on top of another and another so that by lifting one layer at a time you could go deeper and deeper inside and see what this body was made of. Lift the first layer, and you strip off the skin, revealing the pink criss-crossing striations of muscle wrapped over shoulders and around wrists alike. Lift another layer, and trace blood vessels, coloured red and blue, thin as string, that bleed in real life when cut. Lift another, and see the shiny liver and labyrinthine intestines. Lift one more, and uncover the bones, white and chalky.

I sometimes sat with my mother on her bed and asked her how it all worked, these parts of a whole and the whole together with its parts.

Sacrament comes from the Latin sacramentum, a translation of the Greek word for mystery. Augustine famously defined sacrament as a visible sign of an invisible grace. Years ago I copied out words from a Lenten book into my journal, "Pray to remember that upon you rest both the favour of God and the power of the Spirit." This is how I think of God's grace coming to us. And these words, "dedicate with faith your personal lifelong pilgrimage—regardless of how insignificant it may seem to you—as an important part of God's liberation of the world."

This is how I think of God's grace flowing through us. Even so, I easily forget about grace—coming to, flowing through—because it is invisible and even imagining it is hard work sometimes.

Please, Augustine, show me the signs.

I have felt bread on the tongue and water on flesh, but I crave signs of grace outside the cloister of the sanctuary and so am drawn to a teacher's recent suggestion to try living all of life as a sacrament, as a physical participation in the flow of grace from God to people and among people and back again. Who wouldn't sign up to live like that, in the flow of grace coming and going?

My life, your life, as visible signs of invisible grace.

Then I remember Christ's life and how it wasn't always something to smile along to, and I sober up. The surface view of grace isn't synonymous with the good life; history bears that out. Sometimes the favour and power of God, the share in God's liberation of the world looks like sweaty hard work, failed work even. I have to wonder about my willingness to live sacramentally, my willingness to have headaches and high blood pressure, frustration and exhaustion be visible signs of invisible grace as God works in me and through me while at my day job's medical writing desk.

My eye of understanding needs a face, and I think often of my friend Colette. She had wanted the labour that would birth her seventh child to be easy. If you asked anyone who knew her, they would have agreed that she deserved an easy labour. She planned to have an epidural to numb the nerves waist down to spare herself the pain, to free herself to enjoy the experience in a way that she had not in her previous five labours. When the time came, however, the midwife said no to the epidural. The baby was breech and up too far.

I asked her about the labour when I visited her afterward and got to hold Veronica, three weeks old and wrapped in a powder-pink blanket. Colette sat next to me on the couch holding the family dog, her brown hair pulled back in a ponytail, her brown eyes serene and joyful. She wore an orange short-sleeved knit shirt and khaki pants with a set-in zipper, impressive so soon after delivery.

"So how was it?"

"Painful and hard," she said then paused. "But sweet and peaceful."

Cradled in my arms, Veronica wore a longsleeved bodysuit of robins-egg blue knit adorned with lavender flowers that snapped along the front and down her legs. Her peachy complexion sparkled against the wardrobe pastels, like a gold coin in the sand glittering back to the sun.

The day of delivery had been a Thursday in Lent, three weeks before Holy Thursday, three weeks and one day before Good Friday. With each contraction, Colette recited part of a prayer said in her church starting at 3pm on Good Friday, the hour associated with Jesus' death, "For the sake of His sorrowful Passion, have mercy on us and on the whole world."

Thinking about it now, Colette's prayer and intention to journey beside Jesus, linking her contractions to his suffering, reminds me of a scene in Georges Bernanos's The Diary of a Country Priest. The Curé of Torcy, an elder, a mentor, is sharing a notion of his with the young priest, who has long been discouraged and sick. He imagines that in some sort of time warp that presents no problem to time's maker, each of us meets Jesus long before we are born somewhere on his road from Bethlehem to Golgotha. Our eyes and his lock, and that is the place of calling. For the elder priest, the place was Mount Olivet where Jesus asked Peter and the rest of the disciples, Why sleep ye?

Colette furrowed her brow for me as she finished saying the prayer. The space above her nose and between her eyes came together in small tight folds. "Whenever my forehead tightened like this my labour coach would rub it with her thumb to remind me to relax and pray," she said, demonstrating the rubbing and relaxing.

At the Sixth Station of the Cross, tradition has it that as Jesus carried his cross to Golgotha, it was Veronica who broke through the crowd and wiped his face after he fell, before he fell again. Veronica, risking physical censure by the Roman guards, lifted her hands to his tightened furrowed brow and brought her veil down upon his skin, absorbing the tears, blood, sweat, and spit.

Bernanos's troubled young priest dared not admit he was forever linked to the agony of Gethsemane. Others might conclude Jesus rested his eyes on them when he calmed the sea, or rubbed his spit in dirt to bring sight to a man's eyes, or gathered up the children, or taught on a mountaintop, or worked in his father's carpentry shop, or turned water into wine at a party.

"Lord have mercy" prayers have been streaming in my head like a subliminal tape, and I am being remodeled in the process. Lord have mercy: on the sender of that email, that work client, that colleague, or more times than I care to admit, on me.

My imagination often starves for the signs of grace to be unveiled in the realm of my work. I understand that by writing documents about treatment strategies and disease management, my place is on the healing team, but who are my patients and where exactly is healing transacted? From my desk, I never see the face of a person who is diagnosed, treated, or cured. I write the same disease statistics over and over again, but figures in the range of seven to nine digits don't quickly budge. I forget what is possible.

Massimo Camisasca wrote, "Every action, seen through God's eyes, has an infinite echo, it unleashes an atomic reaction that will never end, that brings the moment to eternity, to the infinite." Pick a letter, any letter, from this computer's keyboard. The path arcs upward with each tap. The world in a hazelnut; Christ in a key; love in a word. An eternal echo in a PowerPoint slide? Given that vision, how dare I not dip my fingers in holy water before doing the work for which I'll later collect my pay? Who knows what can happen.

There's an ancient story about Gideon that I like. Gideon found himself talking to an angel of the Lord. The angel sat with him and sent him to be a warrior. "Go in the strength you have," he told Gideon, the weakest family member in the weakest clan.

Gideon asked the angel to wait while he went to get an offering, and he returned with unleavened bread, a pot of broth, and a basket of meat. The tip of the angel's staff touched the bread and meat laid out on a rock. From the rock, fire flashed to set the offering ablaze.

Lord have mercy: on this project, the clinicians who will read it, the sick they will treat, the pharmacists who will dispense, the employers who will insure, the families who will support, the researchers, laboratory technologists, statisticians, trial nurses, phlebotomists. The have-mercies could go on forever once the path starts and the circle and webs and intersections present themselves.

After 40 days of Lent, the moment arrives on Easter Sunday when "Hallelujah" is spoken again for the first time:

The Lord is risen.
The Lord is risen indeed, Hallelujah.

"As loudly as you can," the minister encourages, and the congregation to which I belong responds as loudly as our Minnesota sensibility allows.

This church doesn't have an organ, but in other churches of which I've been a part, Easter Sunday closes with a pipe organ driving forward the "Hallelujah" chorus. The organist seals the service of resurrection with twelve pages of chords, each made up of nearly as many notes as fingers, played to a metronome pace of allegro: fast, lively. The neurobiology of music has theories to explain the tingle, the shiver, I feel whenever I hear this chorus, theories that involve nerve stimulation, changes in heart rate and blood flow, inhibition of some parts of the brain and activation of others. Frisson evoked by music has everything to do with expectation, says musicologist David Huron, and is not so different from that evoked by fear.

My mother had a tattered musical score of Handel's Messiah left over from years of singing in church choirs. I've practiced its music on the piano, first on the maple spinet in my parents' living room while I was in high school and still taking piano lessons, and later in my own house on an inherited upright. But Handel's music exceeds my reach. My fingers stumble across the keys.

The first movement, "Overture," with its single F-sharp offers the most success. Here is where I start each time I try again. With fingers warm and confidence boosted, I progress to the air for alto, "He Shall Feed His Flock Like A Shepherd," and then back to the chorus, "And The Glory of The Lord." The chords corresponding to that chorus' final drawn out words—"hath spoookeen iit"—jettison me toward the oratorio's climax: the "Hallelujah" chorus. On those pages, stumbling fingers meet frisson in a strange sensation of participating in something I know not what, in expectation of I know not what, but always with the hope that it would somehow include a miraculous transformation of my inadequate, but earnest, music making.

I am collecting images, lifting layers, switching between depths of field to catch glimpses of what's really going here, to understand how all things work together, and here is a show not to be missed. One December, I went to the Cathedral of St. Paul in St. Paul's Summit Hill neighbourhood to hear the Minnesota Orchestra and Minnesota Chorale perform Messiah, conducted by Eiji Oue, the Orchestra's music director at the time. My memory of this evening from years ago is tinted golden, like the Cathedral's low lighting reflecting off its gold-leafed dome. Perfume of gilded women and cologne of suited men blended with the incense of Sundays past to compose an aromatic combination as heady as any a master perfumer could create. The tuning notes of the oboes and flutes, clarinets and trumpets, violins and cellos accompanied the clatter and shuffle of high heels and leather soles on marble flooring as people found their seats.

Across the risers behind the orchestra, the chorale members filed in and took their places. The orchestra members straightened their backs and placed their instruments across their laps. Oue entered.

Applause! Applause!

He turned to face his singers, then lifted his baton and held it still. Now the nave was silent, like a bedroom in the moment before its sleeper awakens. The baton bobbed and with that, the story set to music hit its first note. The joined groups began at the same place as any stumbling piano player or church choir, with the "Overture." Except for one intermission, they continued straight through the oratorio to the final adagio "Amen," performing not only the sections related to Advent, the arias and choruses of the prophets and angels, but also the sections related to Lent and Easter, the laments of crucifixion and the celebration of resurrection.

When the moment came for the shout withheld, not for 40 days but 43 sections, the audience stood and the musicians did not disappoint. Ten times in unison the chorale exploded the pent up, "Hallelujah." Forward they went, pushing the crescendo upward. Oue nearly danced, body swaying and arms swinging left, right, diagonally, up, down.

Then, he stopped.

My memory is that it happened just after the sopranos hit the high A in the round of echoes, "and He shall reign for ever and ever." Oue lowered his arms, clasped his hands together behind his back, and lifted his face toward the singers.

He stood still.

I couldn't take my eyes off of him. Wasn't this his moment of glory, carrying his sopranos and tenors, his violinists and cellists, and his audience to the height of sublimity?

The painted dove in flight saw it all from above on the dome's inner surface, ringed below with paintings and stained glass. I read later about the Cathedral, that the paintings are images of the gifts of the Spirit—knowledge, counsel, understanding, piety, fear of the Lord, fortitude, and wisdom—and that the windows depict the Sacraments of Baptism, Reconciliation, Eucharist, Confirmation, Matrimony, Holy Orders, and Anointing of the Sick.

The voices soared, propelled by the strings, horns, woodwinds, and percussion. Upward to the dome. Careening around the marble curves. Bursting the bronze. Oue, however, remained still, his arms and hands restrained, his baton at rest. No assuring gesticulations to his performers, no cues aiming for perfection, no rhythmic pounding out of time. The show went on without him. At this climax of the climax, he revealed what had been concealed, like the magician who dares to show the trick the eye had been too slow to see.

The visible evidence of the invisible grace that powered the show ricocheted off the painted dove and crashes years later into my starved imagination. With the baton drawn down, the surface layer of effort, sweat, and skill removed, you get the hint that anything can happen. With grace flowing—in and through—who knows how high the voices will finally rise, how far the sound will carry, what beauty will shine? In the spirit of Ecclesiastes, there is a time to work and a time to let it go. When we say the word we're meant to say or do the deed we're meant to do, pray to God that it moves beyond the cloister of the workspace. Release it; by grace may it rise and carry and shine. Hope that it catches a current and rides to places unknown. Hope that even a leaf might move from a sigh sighed in ordinary time. By grace may it heal.

In my memory, Oue waits out the extended nine-beat final "Hallelujah," not bringing his work through to completion by his own sweat, not receiving the grateful and euphoric gaze of his singers and players in the flush of accomplishment. In my memory, his head, by then, is bowed; but in fact, it may be that the head bowed is my own.

Nancy Nordenson
Nancy Nordenson

Nancy Nordenson is the author of Finding Livelihood: A Progress of Work and Leisure (Kalos Press, 2015) and Just Think: Nourish Your Mind to Feed Your Soul (Baker Books, 2004). Her writing has appeared in Harvard Divinity Bulletin, Indiana Review, Comment, Under the Sun, Relief, and in other publications and anthologies, including The Spirit of Food: 34 Writers on Feasting and Fasting Toward God (Cascade), Becoming: What Makes a Woman (University of Nebraska Gender Studies), and Not Alone: A Literary and Spiritual Companion for Those Confronted with Infertility and Miscarriage (Kalos Press, 2015). Her work has earned multiple "notable" recognitions in the Best American Essays and Best Spiritual Writing anthologies and Pushcart Prize nominations.


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