Methodist Journal

FEATURED GUEST EDITOR

ISSUE INTRO

The Scourge of Cardiogenic Shock

See More
RECOGNITIONS

Arvind Bhimaraj, MD, MPH, Guides Issue on Cardiogenic Shock

See More

REVIEW ARTICLES See More

Pathophysiology and Advanced Hemodynamic Assessment of Cardiogenic Shock

Cardiogenic Shock in the Setting of Acute Myocardial Infarction

Cardiogenic Shock in Patients with Advanced Chronic Heart Failure

Acute Mechanical Circulatory Support for Cardiogenic Shock

Management of Cardiogenic Shock in a Cardiac Intensive Care Unit

Physiological Concepts of Cardiogenic Shock Using Pressure-Volume Loop Simulations: A Case-Based Review

Systems of Care in Cardiogenic Shock

Cardiogenic Shock in Perioperative and Intraoperative Settings: A Team Approach

CASE REPORTS See More

COVID-19: A Potential Risk Factor for Acute Pulmonary Embolism

Repair of Extent III Thoracoabdominal Aneurysm in the Presence of Aortoiliac Occlusion

Williams-Beuren Syndrome: The Role of Cardiac CT in Diagnosis

A Rare Case of Pancreatitis-Induced Thrombosis of the Aorta and Superior Mesenteric Artery

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

A T2-Weighty Discovery: Aortitis on Cardiac MRI with Histopathologic Correlation

CLINICAL PERSPECTIVES See More

POINTS TO REMEMBER

Acute Kidney Injury in Cardiogenic Shock

EXCERPTA

Cardio-Oncology, Then and Now: An Interview with Barry Trachtenberg

POINTS TO REMEMBER

Onconephrology: An Evolving Field

POINTS TO REMEMBER

Herbal Nephropathy

EDITORIALS

Letter to the Editor in Response to “Cardiac Autonomic Neuropathy in Diabetes Mellitus”

Vol 16, Issue 1 (2020)

Article Full Text

POET'S PEN

East Coker

Jump to:
Article Citation:

Young JB. East Coker. Methodist DeBakey Cardiovasc J. 2019;15(3):231-2.



East Coker

I. (First Verse)

In my beginning is my end. In succession
Houses rise and fall, crumble, are extended,
Are removed, destroyed, restored, or in their place
Is an open field, or a factory, or a by-pass.
Old stone to new building, old timber to new fires,
Old fires to ashes, and ashes to the earth
Which is already flesh, fur and faeces,
Bone of man and beast, cornstalk and leaf.
Houses live and die: there is a time for building
And a time for the wind to break the loosened pane
And to shake the wainscot where the field-mouse trots
And to shake the tattered arras woven with a silent motto.

V. (Last Verse)

Home is where one starts from. As we grow older
The world becomes stranger, the pattern more complicated
Of dead and living. Not the intense moment
Isolated, with no before and after,
But a lifetime burning in every moment
And not the lifetime of one man only
But of old stones that cannot be deciphered.
There is a time for the evening under starlight,
A time for the evening under lamplight
(The evening with the photograph album).
Love is most nearly itself
When here and now cease to matter.
Old men ought to be explorers
Here and there does not matter.
We must be still and still moving
Into another intensity
For a further union, a deeper communion
Through the dark cold and the empty desolation,
The wave cry, the wind cry, the vast waters
Of Petrel and the porpoise. In my end is my beginning.

—T.S. Eliot

 

Excerpt from “East Coker” from THE COMPLETE POEMS AND PLAYS, 1909-1950 by T.S. Eliot. Copyright © 1950 by T.S. Eliot, renewed 1978 by Esme Valerie Eliot. Reprinted by permission of Houghton Mifflin Harcourt Publishing Company. All rights reserved.

 

In my beginning is my end. In my end is my beginning.

News of Notre-Dame de Paris burning spread around the world like an unchecked California wildfire. When I got the text from my youngest son, an inveterate news hound, my immediate thought was a photo of us in the cathedral’s plaza in front of the iconic twin towers. So many have one of those. I flicked on the live news feed and watched as the inflamed spire crumpled. It was disturbing—just as it was to watch the Camp Fire (aptly named) destruction of Paradise, California last November. One haunting photograph of the Paris fire showed the burning roof aflame like a roaring campfire, with the Eifel Tower shrouded in smoke, lurking ghost-like in the distance.

An estimated 13 million people visit Paris each year to view this magnificent Gothic structure, and the fire surely sparked memories of pilgrimages, sacred and otherwise, to this site. The immediate response committing massive amounts of cash to restore, rebuild, or fashion anew the 856-year-old landmark sparked its own firestorm of criticism: Why can’t that amount of capital be raised to fix the woes of the world? But my thoughts turned to the cycle of life. After all, spring blossoms were emerging, and for some Catholic faithful the fire seemed an ironic twist to the beginning of Easter weekend as fears of total destruction emerged. I then remembered a favorite poem of mine, “East Coker” from T.S. Eliot’s Four Quartets, published in 1943, a time of a different conflagration.

The wonder of poetry is that it allows us to personally interpret a poet’s words. Often, it turns out, the message is not what the poet was trying to say. No matter; words, when strung together, can have many meanings. The two stanzas extracted here are the first and last of the poem, with, arguably, the most important lines being the first and last. For me, as with Eliot some say, there was a spiritual theme to the poem, as the lines reflected the cycle of life. Beginning life meant that it would inevitably end. And so the cathedral surely had a beginning and it will surely have an end. But can a building, or village like East Coker, have a heart and soul and beginning and end? Perhaps that is where those 13 million annual visitors come into play. They make the cold stone and stunning artistry come alive.

“East Coker” also speaks of this…the rise and fall of an English countryside village. It makes me think of the rise and fall (and rise) of our rustbelt cities, including Cleveland, Detroit, and Pittsburgh as well as the Northern California gold country ghost towns, which rose and fell but generally did not rise again. Eliot’s writing to me often seems morose and brooding, as can be seen in many parts of “East Coker.” But it captures the cycle of life brilliantly. Cleveland, Detroit, and Pittsburgh have risen again, to some extent. And so will Notre-Dame de Paris.

Fascinating will be the debate of restoration, rebuilding, or recreating the edifice. Cities crumble the same way but can come back renewed with distinction. Though Cleveland, Detroit, and Pittsburgh collapsed in the same fashion, they did not rebuild in the same way. Nor will the cathedral. For everything about Notre-Dame de Paris to remain the same, everything about it must change. I believe that is at least one thing T.S. Eliot was trying tell us with “East Coker.” The cycle of life means that for everything to stay the same, everything must change. See what you think.

 

James B. Young, MD
Chief Academic Officer, Cleveland Clinic
Professor of Medicine and Vice-Dean for Cleveland Clinic Academic Affairs
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
Section Editor, Poet’s Pen, Methodist DeBakey Cardiovascular Journal

Add Comments

Please login to dialogue with author.

Comments