On Playing the Hand You Are Dealt

In this morning's New York Times, there was a marvellous piece by Gina Kolata on Alzheimer's disease. I won't link the article because it isn't what I want to write about. The question they were dealing with was whether people who have very early Alzheimer's or a high risk of developing it, should be told given that there is no treatment. It's an interesting dilemma. For the record, I'd like to be told.

Robert Stuart-Vail found that he had a gene variant (APOe4) that made the disease very likely for him and said, "You play the cards you are dealt." I've heard that a lot and I've never had any objections to it before, but today it seemed oddly constraining. The perspective required for "you play the hand you are dealt" seems to blow by a few things we ordinarily know about ourselves.

The first is that we deal ourselves quite a few of the cards we have. That's just a thing; it's not a good thing or a bad thing.

The second is that this is just one hand. There was a hand before this one and there will be a hand after this one. Why should I think of my present situation as just one hand?

The third is that "hand" in this metaphor is thought of as the resources for strategy, but it could also be thought of as the resources for resilience or even for graceful endurance.

Let me put the card metaphor in the most unattractive light I can contrive for it: "The cards I have came to randomly from some source outside myself and severely constrain my ability to follow the best strategy."

On the other hand, I like the new meanings metaphors can bring and I use them myself. I don't want to be put in the position of criticizing a metaphor Mr. Stuart-Vail found useful on the grounds that I didn't find it useful. I have had hard times myself, and I have taken comfort in pithy little sayings. I'll tell you about one and refer briefly to another, which will have meaning to fans of The West Wing and probably no one else.

The first comes from poet Edwin Markham, of Oregon City. At the time I needed it, the last two lines were all I had heard and I didn't like them right away. Here they are:

For all your days prepare,
And meet them ever alike:
When you are the anvil, bear-
When you are the hammer, strike.

They meant something to me because I was feeling like the anvil at the time. The meaning it had for me was that there are times when just "taking the hits" is the best you can do. A time to act will come and when it comes, you need to be ready, but this is not the time. I found real comfort in that.

The second comes from an episode in the second season of The West Wing (Noel) in which Josh is being treated by Dr. Stanley Keyworth for his inability to buffer himself from his memories of being shot at a Bartlet rally. "You need to be able to remember it without reliving it," Keyworth says. "You're reliving it." It turns out that it is music that cues Josh's panic attacks and when he hears that, he despairs. "So that's going to be my reaction every time I hear music?"

"No," says Keyworth.

"Why not." says Josh.

"Because," says Keyworth, "we get better."

Those last four syllables meant a lot to me. It wasn't just the idea. They were delivered with a calm assurance and a matter of factness that helped me remember that I would get better too; that there was a trend toward healing in me. I could count on it, but I needed to be patient.

So you see, I'm not in much of a position to criticize Stuart-Vail's choice of metaphors. I would like to be aware, however, of how many of the cards in my hand I have dealt myself and to be aware, also, that there will be another hand.