Jack had one great passion in life: his farm. He had lived in the same farmhouse since birth, and, like many farmers, was deeply attached to the soil it stood on. Now, at 78, he could only watch his beloved orchard from afar, going back in time, and feeling deep pain that he could no longer be there, doing things.
A tree that died in Greenwich Park, London
To reach the main door, I had to struggle through a stiff gate and an overgrown hedge. In front of me was a large house where a thriving family must have once lived. Now, with falling roof tiles and peeling window paint, it looked as if the man of the house was either not there, or for some reason unable to take care of it. Somewhat incongruously, a couple of pots with episcopal purple ‘busy lizzies’ and bright blue and yellow pansies adorned the front wall. I rang the bell.
Jack’s wife Eileen opened the door. She looked worn out and resentful “I can’t take it any longer, doctor! He goes on and on about his farm, and the orchard, and the apples. Non-stop. Even if he says nothing, I know he’s thinking about it. I wish he could do something: help me in the house, sort out the bills, or take the dog out for a walk. Anything!” Eileen had health problems of her own; she needed steroids for her asthma, was in pain with arthritis, and couldn’t take over the additional responsibility of looking after Jack. She had done more than her fair share. After all, Jack was the man of the house, and he should remain so!
In a desperate attempt to have some time with Jack – away from nagging – quite uncharacteristically, I asked Eileen for a cup of tea. As she trotted off to the kitchen, I couldn’t help thinking that the vow “For better and for worse, until death do us part” sometimes didn’t stand the test of life. And sometimes there was a reason for it.
When we were left on our own, and after a brief silence, Jack confessed “I know she’s fed up with me. The thing is that I’m fed up with myself... You know what, I often wish I was no longer. I feel like a rabbit that wants to hide itself in a hole. A black hole, so that no one can see me. In fact, I feel like a black hole myself.” After a pause, he continued – “You see, they don’t look after the apples as I used to. I can see them scattered around and rotting under the trees. They say it’s no longer ‘economical’ to gather them after a certain time in the autumn, and that the labour is too expensive, that nobody wants to do it for what it’s worth. But apples shouldn’t be allowed to rot, should they?” He stopped, exhausted. Motionless, with a mask-like face, his thin figure looked like a withered away old tree. His deep set, dark eyes seemed fixed. He hardly blinked.
As I was looking at him in silence, a thought struck me like lightening: Jack has Parkinsonism* as well as depression! For some time, his GP had been treating him for depression, without much improvement, but Jack might need anti-Parkinsonian medication as well as an anti-depressant. I shared my discovery with the patient, and he exclaimed reassuringly: “Funny you should say that; I’ve thought of it too. My mother had Parkinson’s, but she had the shakes. Can it be without the shakes?” “It certainly can, and it’s then that the diagnosis is often missed.”
At this moment, Eileen appeared with the tea. I felt I was more than ready for it now and thanked her for it wholeheartedly. Before she would embark on a litany of Jack’s and her own problems, I rushed to present my new hypothesis, and that there might be another medication that could help Jack to be more active. I also suggested he came to the day hospital for one day every week. He greeted the offer with some apprehension, she with relief.
Before leaving, I asked Jack to show me his garden. Slowly, and with great pride, he took me on a tour and showed me his favourite trees and shrubs. The rays of the early autumnal sun seemed to be caressing the yellow, red and brown leaves, now falling one by one onto the grass. A tall chestnut tree in the corner of the garden caught my attention. It had no leaves at all and looked as if it were hollow.
“You’re absolutely right. This tree is dead and has been dead for many years!” Jack explained.
“And you haven’t removed it all this time?” I was rather surprised.
“No... because it’s a very special tree. I used to climb it almost every day when I was a boy. I could see the whole world from the top. Well... maybe... not absolutely the whole.” After a pause, he added, “One day, it was struck by lightening. But it was a brave and proud tree... it decided to continue standing. I had to respect its wish.”
“And that young apple tree next to it? Did you plant it afterwards?” I inquired.
“You’ve guessed it. You know, in nature nothing truly dies; everything comes back in a different form.”
“Perhaps it’s the same with human beings...”, I added, deeply in thought. I suddenly remembered a great Greek philosopher, Heraclitus, who famously said ‘Panta rhei’ – everything flows. He also believed the world and life to be in perpetual strife and change. “To the same river we step and do not step…” Of course, I kept these thoughts to myself; to share them with Jack at that moment would have been rather pompous. I looked again at his face. It was no longer mask-like; in fact, it seemed much younger.
When I saw him a month later at the day hospital, he was much improved. I wasn’t sure whether it was the anti-parkinsonian medication, a change in the anti-depressant, the day hospital, or all three. Or maybe something else altogether. He entered the consulting room rather briskly, with a smile on his face. He even wore a shirt and tie.
“Definitely, I’m feeling better. And I’ve brought you a couple of apples that I managed to rescue from decay! Good Worcester apples!”
When he sat down to tell me what he’d been up to since I saw him previously, I couldn’t help but to feel very pleased for him.
“Do you think you’re getting out of your black hole now?” I asked.
“Perhaps. At least I have hope now,” he said.
The image of a black hole had been with Jack a long while. Childhood memories on his parents’ farm were permeated by frequent and violent rows between them and the hardship of everyday life.
“I lived in fear that one day they would kill each other. There was an abandoned shed at the far end of the garden where I used to hide until their voices calmed down. My father was a very passionate, hotheaded man with many ideas, most of which ended in a fiasco. But at least he had them! My mother looked the most agreeable woman on Earth, but she was a specialist in pouring cold water over his head. He just couldn’t live without having new ideas, and she couldn’t live with them. As a result, they couldn’t live with each other. One morning, he was found dead in his bed. She told me he had had a heart attack, but my aunt later intimated that he might have killed himself with sleeping tablets. He was only 45 at the time.”
“And you, how old were you then?” I interjected.
“Nine,” he said, and after a little pause added “I missed him a lot. We used to do all sorts of things together. He would take me to the orchard and teach me about different kinds of trees, apples, pears… He was a kind man… After his death, the rows stopped, of course… but so did the laughter…” Jack went silent, his eyes watered. “You know, my black hole, I didn’t need to go and hide there any more. I, kind of, carried it in me, inside…”
It is always difficult to say anything consolatory in the face of deep sadness. Perhaps, it is also redundant.
Jack picked up in his mood and in his ability to do things. He also found his niche in the day hospital where he gave a couple of talks and demonstrations on how to run an orchard. These were followed by afternoon tea, with apple cake of course.
One day in spring, I received a message that Jack had died suddenly from a heart attack. His wife had found his body under the apple tree in their garden. The tree was in full blossom.
*Parkinsonism is a condition related to old age and the clogging of the arteries, whereas Parkinson’s disease is of idiopathic origin and starts much earlier in life. The same part of the brain is affected in both conditions, hence the symptoms are similar. The patient I’m describing here is a good example of how these epistemological boundaries can overlap.
I dedicate this story to Bill, my life-long friend who was an indirect inspiration for this story.
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