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Neurology Today:
doi: 10.1097/01.NT.0000312107.23219.86
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Finding Meaning in a Life with ALS

Gordon, Paul H. MD

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Paul H. Gordon, MD, is associate medical director of the ALS Research Center at Columbia University in New York, NY. He is also a visiting researcher at the Salpêtrière Hospital in Paris, France.

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Abstract

Returning to Earth. By Jim Harrison. 280 pages. Grove Press 2007

Having or knowing someone with the devastating and lethal amyotrophic lateral sclerosis (ALS) raises important personal questions about life, health, sickness, and death. In Returning to Earth, Jim Harrison, the author of eight novels, five novellas, and eight collections of poetry, tells the story of Donald, a spiritually-minded Chippewa-Finnish man who dies of ALS, and of his family's reaction to their loss. Harrison describes some of Donald's physical symptoms, but the novel focuses more on all that a terminal illness brings to the fore. It is about finding meaning in life and death, and it is also a love story.

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AN INTRIGUING PLOT

Set in Michigan's Upper Peninsula with a backdrop of lakes, forests, and wildlife, the novel is divided into four sections, each narrated by a different member of the family. In the first section, Donald recounts to his wife Cynthia what he knows of his family in order to preserve that history for his children. Donald begins in 1871 when his ancestors first came to Michigan, describing how they lived with nature, violence, and the unknown. Because he is half-Chippewa, he was considered a mixed blood in the region, and he alludes with occasional anger to the mistreatment that native people have received throughout history. He also describes some of his own personal weaknesses with perplexity and regret.

Donald, like many with ALS, was an athlete, and he lived a physically active life. He first met Cynthia while working with his father in the employ of her family, and they fell in love as adolescents and ran away to marry. Donald intersperses his personal history with matter-of-fact comments about his disease and references to his religion, rooted in traditional Chippewa customs. He is noble and spiritual, and, as he discusses his heritage, he offers insight into his love of nature and animals, as well as into humans' place in the world.

In the second section, K, who is a generation younger than Donald, and though unrelated, considers him a father figure, examines his own reasons for existence. He tries to find meaning in life and to interpret the randomness of life's events. K's account encompasses Donald's death and burial in Canada, on ground that Donald considers spiritual. It also describes how he himself finds love.

The third section, told by David, Cynthia's brother, begins after Donald has died and describes David's approach to mourning. David's and Cynthia's father was sexually perverse. Both parents were also alcoholics. David tries to separate himself from those practices, and in doing so, he becomes a more thoughtful man than his father; he forms lasting attachments in life.

Figure. Dr. Paul H. ...
Figure. Dr. Paul H. ...
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In the final section, Cynthia describes her pain as she endeavors to comprehend the loss of her husband. Fatigue and grief interrupt her plans for work, but as she slowly heals, she becomes aware of a growing need for intimacy, which confuses her. There seems to have been no uncertainty in the enduring love between Donald and Cynthia. While Cynthia is a realistic, strong person, she wonders whether she will ever fully heal.

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LIFE'S ESSENTIALS

Returning to Earth is grounded in Native American thinking and culture, and the pace of the writing as well as the importance given to small matters — taking walks, watching leaves fall on the sidewalk, reflecting on your dreams — lends a peaceful, thoughtful feel to the book. Some small inaccuracies about the physical symptoms of ALS and an occasional platitude are easy to overlook. Jim Harrison does well at reducing life to the essentials; his book is filled with wisdom and descriptions of the occasional hidden magic in life. As our society becomes ever larger and faster paced, this type of prioritization seems rare. Science works to make us healthier, but its lack of interest in the big picture cannot lead us to a happier existence. Jim Harrison grasps the pain and love in life, and it is refreshing to see these important elements in such clear focus.

©2008 American Academy of Neurology

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