Wednesday, March 15, 2017

New Hampshire Hospital ‘Stays Safe’ Through Violence-Reduction Program

Photo: Lisa Mistler, M.D., M.S., Diane Allen, M.N., R.N., Alexander de Nesnera, M.D., and Lt. Frank N. Harris.
Staff at New Hampshire Hospital say the effort to address violence and aggression among patients requires collaboration between the administrative, clinical, and nursing staff; police and security officers; and researchers. From left are Lisa Mistler, M.D., M.S., Diane Allen, M.N., R.N., Alexander de Nesnera, M.D., and Lt. Frank N. Harris.
Michael Carpenter, Envision Photography

It seemed to happen with a predictable regularity.
“Nora” was an inpatient diagnosed with a personality disorder at New Hampshire Hospital (NHH), a psychiatric hospital providing acute services for children and adults under the New Hampshire State Department of Health and Human Services. At a certain time of day, Nora began to decompensate, becoming restless, aggressive, and threatening to harm herself. Ultimately, she required seclusion or restraint.
“We called staff together for a case conference to look at the pattern of behavior that led to the decompensation and think about ways to get the patient motivated at that period of day and involved in certain activities, or to get her off the unit if that was necessary,” said Alexander de Nesnera, M.D., associate medical director at NHH and an associate professor of psychiatry at Dartmouth University’s Geisel School of Medicine.
“A decision was made to have two staff members accompany her away from the inpatient unit and to the hospital gym,” he said. “By intervening in this way, we could break the cycle of decompensation before it happened and protect the patient and the staff.”
  It’s an example of the effort de Nesnera and staff at NHH have made to address a problem that administrators, psychiatrists, and nursing staff on psychiatric inpatient units everywhere will recognize: the threat of violence and aggression on the part of patients that is directed at staff and associated with seclusion or restraint.
The initiative at NHH is comprehensive and involves administration, psychiatrists, nursing staff, law enforcement personnel, and community leaders. The effort also includes an ongoing research initiative designed to systematically gather data on aggression and violence, physical and verbal assaults and injuries, and variables associated with the occurrence of assaults.
In an interview with Psychiatric News, de Nesnera said the effort began in a formal way around 2008 and resulted from a “perfect storm” of factors also familiar to psychiatric administrators and staff: increasing demand and decreasing capacity for psychiatric care in the surrounding community, an influx of sicker, more complex patients frequently with substance use disorders in addition to mental illness, and forensic patients coming from secure psychiatric units in jails and prisons.
“Gradually we saw that we needed to address the issues associated with increasingly challenging patients with co-occurring disorders coming from a variety of settings,” he said. “We knew we needed to work comprehensively with staff and with community institutions and administrative entities before this challenge became a real crisis.”

“Nora” and patients like her who become agitated and potentially violent can be subdued with seclusion or restraint, but as de Nesnera says, “Seclusion or restraint is an emergency measure, not a treatment intervention.”
The Substance Abuse and Mental Health Services Administration (SAMHSA) has issued a number of “issue briefs” and other resources on reducing and eliminating seclusion and restraint. SAMHSA notes that these measures can result in psychological harm, physical injuries, and death to patients and to staff. Rates of injury to staff in mental health settings that use seclusion or restraint have been found to be higher than rates of injuries sustained by workers in high-risk industries.
“In the early 2000s, there was a national effort to reduce seclusion and restraint,” said Diane Allen, M.N., R.N., assistant director of nursing for acute psychiatric services at NHH. She told Psychiatric News it was after a SAMHSA training session on the subject that staff at NHH decided to track and record the episodes that resulted in seclusion or restraint (and very often in injuries to patients and/or staff). “We decided we were going to elevate these events, make them visible for higher levels of review—for supportive reasons, but also so we could learn more about the root causes.”
Allen and de Nesnera initiated regular meetings involving administrative leaders, psychiatrists, and nursing staff to discuss incidents of verbal or physical violence. “We emphasized that these meetings would not be about criticism or second guessing what people did—otherwise, no one was ever going to come,” she said. “Rather, our approach was, ‘Tell us what happened.’ ”
Out of these discussions emerged certain patterns associated with violence: inadequate treatment of patients’ symptoms of paranoia or hallucinations, patient frustration with hospital rules, inconsistencies in protocols between different units, or the receipt of bad news.
In particular, Allen said, troubling news was a trigger. Patients would learn, for example, that they had lost their job, their wife had left them, or there was no one to take care of their dog
Interactions with civil courts were also liable to be a trigger. “We learned that the highest number of episodes requiring seclusion or restraint fell on Tuesday—which is the day our patients appear in court,” Allen said. “One of the features of court hearings is that a judge may tell patients that they will hear some resolution of their case by the end of the day. Often that doesn’t happen, and patients become extremely angry and agitated. So we talked to judges and educated them about giving patients realistic expectations about when they may or may not hear a resolution to their case.”

Chart: Assault Injuries Fall Over Time

Police Regarded as Friendly Presence
From the findings that emerged out of case consultations, Allen and staff developed a strategy called “Staying Safe,” built around a model of staff and patient safety described by Robert Short, Ph.D., and colleagues in the 2008 Psychiatric Services article “Safety Guidelines for Injury-Free Management of Psychiatric Inpatients in Precrisis and Crisis Situations” (see chart on the left).
If “Staying Safe” was the on-the-ground strategy for reducing the threat of violence and injury to patients and hospital staff, there was a broader administrative strategy at NHH of reaching out to and working with institutions in the wider community to deal with systemic problems.
This included developing procedures for patients being “stepped down” from secure psychiatric units in jails or prisons (many of whom had been deemed not guilty of a crime by reason of insanity). Importantly, it also included working with hospital security police to create a “community policing” atmosphere on the unit, so that officers were regarded by patients as a familiar, benign presence—as opposed to a threatening and punitive one.
“Patients got to know the police officers in the friendly way that people in the community may get to know an officer who is regularly on the street,” de Nesnera said.
Additionally, de Nesnera and colleagues reached out to other state psychiatric hospital administrators in New England—including state hospitals in Maine and Vermont—to trade information and strategies for handling violent episodes. “We were able to share our experiences as to what it is like dealing with violent patients or with particular policies that were cumbersome,” de Nesnera said. “The ability to share our experiences and our expertise was really important and engendered a sense that we are all in this together.”
Tackling the problem of violence on inpatient psychiatric units requires hospital administrators to view the “big picture” while also being willing to work incrementally. You don’t have to reform the entire correctional system, de Nesnera suggested, but reaching out to educate one judge in the community—about mental illness, antisocial behavior, and hospital staff safety—can accomplish a lot.
“Administrators need to have a broad knowledge of the multiple systems working—sometimes together, sometimes not—on various aspects of mental health care for individuals,” he said. “But they should start with the ‘low hanging fruit’ to begin addressing systems issues that impede appropriate treatment of mentally ill patients. Once you do that, you can begin to work on the bigger problems.” ■

Tuesday, December 27, 2016

Manchester By the Sea: On the Lip of an Abyss

There is a central scene in Manchester By the Sea, when Randi (Michelle Williams) seeks to console her ex-husband Lee Chandler (Casey Affleck), assuring him he is not to blame for the personal holocaust that lay behind them, and hoping to make amends for the accusations she has hurled at him. It is an all but impossible task for both of them. Neither is quite able to look each other in the eye, but it took an astute young future filmmaker of my acquaintance to point out that one of the great feats of direction here is Lee’s inability to take his eyes off the infant in the carriage, a child of Randi’s remarriage.
Only infants and children are not guilty or accusing. No one else—none of the adults—in the story seems able to look anyone in the eye for long. Characters talk at each other, over each other, missing each other’s points. Incessantly, so that there is (at least for this aging viewer) an oppressive sense of perpetual conflict, of disjointedness verging on violence. These are redeemed—I mean that in the religious sense—by scenes of incandescent beauty: crystalline skies; a charming New England town encrusted in winter; seagulls pinwheeling in a grey mist over the water; crooked gravestones in snow; boats bobbing in the pier, heaving gently as if in slumber, or meditation; and always the sea. These are backed by a soundtrack of choral and string music—forgiving and benedictory.
Manchester By the Sea is a masterpiece of storytelling, a profound meditation on suffering, death and beauty. The horrific tragedy at the heart of this story (no spoilers here, go see the movie), singes everyone in this drama—with the exception, perhaps, of 16-year old Patrick, whose fate following his father’s death from congestive heart failure forms the plot of the film. But it has entirely consumed Lee, Patrick’s uncle. It has devoured him. He is a shattered soul, a walking ruin. Death, unadorned and unromanticized, is everywhere in this film. Lee is already walking dead, and his brother’s passage is only an occasion for dutifully tying up loose ends. “What’s he look like,” Patrick asks when Lee comes to his school to inform him of the death. “He looks dead,” Lee says. “Not bad. Just….dead.” Patrick’s father cannot be buried until spring so he rests in a frozen vault at the morgue.  “I don’t like him being in a freezer,” Patrick protests. “I don’t either,” Lee says. “But we can’t do anything about it. It’s the way it is.”
Lee’s brother has left behind a will making him Patrick’s guardian, but it’s a responsibility Lee—given the ruin he has become—cannot think about shouldering. Patrick (Lucas Hedges), handsome, impish and gentle, is the only one in the film free of the somber curse that hangs over the story. He is buoyantly alive, the source of the film’s best humor. As he boasts to his uncle who wants him to move to Boston, he has a life to live in Manchester: he’s on the hockey team, he has two girlfriends (one he has sex with and one with whom he is mainly doing “basement business,” as he explains to his uncle. “What’s that mean?” Lee asks. “It means I’m working on it”), and he plays in a rock band (an atrociously bad one). Scolding his uncle for being unable to make casual small talk with the mother of one of those girlfriends (the one he’s working on), Patrick has no problem at all speaking directly. “You can’t make boring adult conversation for a few minutes? Like `Hey, how ‘bout those fucking interest rates?’”

The resolution of this conflict (sorry, you won’t get that here, either) will not be the one we might find sentimentally satisfying; but it will be the one that works, in a human way.
In just that way does Manchester render its blessing on this story of human woe. They are trying, these characters, to work it out under a gunmetal sky, hemmed in by the sea, in the teeth of death. The guilt that consumes them, that renders them unable to look each other in the eye, may be the awareness that they haven’t deserved the beauty that surrounds them. Yet one of those redemptive scenes is a human one: gathering in the church for Patrick’s father’s funeral, family and friends and folks from the town do not hesitate to greet each other honestly—smiling, consoling, comforting, embracing. The art and craft of life is learning how to live on the lip of an abyss; mostly it’s a mess or a comedy show, and some of us fall off. But sometimes, in the right light, its beautiful.

Saturday, December 24, 2016

A Letter to the Religious Right

Nearly forty years ago Jerry Falwell Sr. emerged on the national stage, a happy warrior and leader of a movement that would become the Moral Majority. It was a movement that seemed at once to stand outside, over and above, what it considered to be a degenerating culture, demanding that it reform itself. At the same time, it was engaged, with its feet planted firmly on the ground and determined to win over not just the hearts and minds of the public, but seats in the House and the Senate.
   Even for those of us who couldn’t quite get on board with their agenda, Falwell’s movement was difficult to criticize. Here were Christians who took their faith seriously enough to take it, as it were, to the streets. I was 20 in 1980. I had been raised in a Methodist church and religious faith has always been important to me, something I have never quite relinquished even during slack periods when doubt and indifference overtake me. I was a “deacon” of the ecumenical church at my small liberal arts school. I thought briefly of going into the ministry (a bad idea Im very glad I never acted on) and thought more seriously about studying academic theology (something I wish to this day I had done).
   As a Methodist I absorbed the ethic of doing good works (“Do all the good that you can, wherever you can, whenever you can.”) As a college student I thrilled to my undergraduate dose of Dietrich Bonhoeffer. The Christianity I was attracted to was concerned with social justice. The historical Jesus I knew was the Jesus whose concern was always the poor, outcasts, the marginalized, including women (especially widows who had it very bad in his day). It continues to be baffling, in fact, how anyone can read the gospels and come away with any other portrait. It was a faith that claimed for Christ the whole of human experience, the repair of the world so that the community of man would mirror the Kingdom of God, nothing less. The faith of Falwell and the religious right, in contrast, seemed to takes its stand on a narrow beachhead of personal salvation and private behavior, still more narrowly circumscribed to the area of sexuality. It seemed, and seems to me now, an enormous retreat.
   But Falwell and his movement made its mark and it clearly resonated with millions who felt that the values that had built America were being shuffled off.  It captured the attention of Ronald Reagan, and was a vital component of the conservative Republican revival. In any social history of late 20th century America, the “religious right” had earned a chapter all to themselves.
   In time, there would be slips in the façade that seemed to confirm what some of us thought of the movement—as when Falwell suggested that the 9/11 attacks were America’s retribution for a culture of abortion and homosexuality. Now, in the aftermath of the ugliest political campaign in our history, a humiliation of international proportions in which you the public leaders of the “religious right” fell (with some notable exceptions) one by one into line with Donald Trump—today I and people like me, of every shade of faith and skepticism, wonder, quite literally, how you look yourselves in the mirror.
   Where does one begin? It ought to be entirely sufficient to mention simply that the candidate you backed has exhibited—not just during his campaign, but throughout his adult life and career in the public eye—every sort of behavior that decent parents admonish their children to avoid. A loudmouth, a braggart, a bully, a crybaby who is insulted easily, yet easily and breezily insults, a compulsive liar. And you know the laundry list of recent revelations—the jilting of contractors and employees, the claims against Trump University, the bankruptcies, the failed casinos and businesses—you know the list and you ignored it all. Of course, there is the famous Access Hollywood tape that captured your candidate’s distinctive style with women; that’s the one that caused Paul Ryan and other Republicans to be (briefly) shocked, shocked, and prompted Ralph “Family Values” Reed to pronounce Trump—using that conscienceless, value-free label so emblematic of baby-boomer moral neutrality—“inappropriate.”
   But honest to God, who is so sweetly naïve as to have been honestly surprised to learn that this man is a coarse, crude, vulgar reptilian? Boys will be boys—right?—and now the episode barely registers (a measure, itself, of political degeneracy). But some things do stand out and retain their capacity to take the breath away (at least for those of us capable of shock and shame). Trump’s mockery of a disabled reporter is one—perhaps because it was captured on video and replays itself in the mind like a traumatic memory. Maybe you take your lead from Ann (“Godless: The Church of Liberalism”) Coulter who rationalized that Trump was merely mimicking a “generic retard.”
   Is that how you explain this to your children?
   Or take Trump’s astonishingly, brazenly dishonest description of an altercation that took place, late in the campaign, during a rally at which President Obama was speaking. A veteran stood up and began heckling the president; predictably, some people in the crowd booed, attempting to silence him. But Obama lightly scolded the crowd and insisted the man, who served the country, had a right to have his say. The exchange was, of course, videotaped and can be viewed online.
   Later at his own rally—also, of course, videotaped and easily accessible--Trump described the exchange saying the President was “screaming” at the veteran, and called Obama’s behavior a “disgrace.” 
   Spend even just a minute or two to meditate on this: Trump made a patently false, publicly defamatory pronouncement about the President’s behavior during a rally that he knew (as all of us know now about virtually everything that doesn’t happen in the deepest warrens of our own homes) would be videotaped and widely available on the web. He made this statement (at a rally he also knew was being recorded) either not knowing what the President actually said or did; or he made it knowing exactly what the President said and did, and lied anyways. In either case--and this is really the important thing--he didn't care.   
   Do you care? Evidently not. Are you ashamed of not caring? I guess not. Does it matter to you what this behavior, when it is endorsed or overlooked by moralists such as you, does to the entire understanding of public truth? Evidently not.
   Spare me, spare all of us, your prevarications about Hillary Clinton. Drop it. There are countless ways you might have approached this travesty of a campaign without endorsing Mrs. Clinton and salvaged your integrity.

“We the public leaders of the contemporary Christian conservative political movement (the so-called `religious right’) urge Americans of faith to vote their conscience. However, we feel obligated to state that this entire campaign, and these candidates—both of them—are the rotten fruit of a political culture that is shot to pieces. This ruin has been a long-time in the making, with blame to go around on all sides (however much we as conservatives may feel that the great bulk of blame lay on the other side) and is ultimately rooted in a larger, broader culture degeneration which the founders of our political movement first began to point to nearly 40 years ago. Whatever the outcome of this election, Christians of all shades of belief must come together afterward to work to repair our democratic Republic.”

But no. Listen to William “Book of Virtues” Bennet on Fox News who said that Republicans who opposed Trump “suffer from a terrible case of moral superiority and put their own vanity and taste above the interest of the country.” How else to translate this except as follows: manners, civility, the norms of civilized discourse, are all an elitist affectation, unrelated to the substance of our politics, and irrelevant in judging the fitness of any candidate.
   On that note, by the way, would any of you dare to look anyone in the eye and say that your candidate would have been as gracious in defeat as Hillary Clinton was, and as Barack Obama, who endured eight years of nihilistic obstruction, continues to be? Right…Don’t even bother. Just move on and let that one go.  
   Mr. “Death of Outrage” Bennet was clearly cashing in on the current stock, lately risen so high, around the notion that “elitism”—which evidently includes commonplace and traditionally understood instincts toward civility and truth-saying—is what afflicts our politics. Yet nowhere among the conservative media outlets have I read anything remotely as sympathetic to Trump’s supporters as Larissa Macfarquhar’s article, “In Trump Country,” in The New Yorker—that citadel of the Manhattan literary and intellectual elite.  Read it--there is not a trace of that more-in-sorrow-than-in-anger condescension that sometimes characterizes liberal-left attitudes toward the underclass; it is an authentically sympathetic, even admiring, portrait of Trump supporters in rural West Virginia.
   By the way, I believe that your candidate should—as Mrs. Clinton suggested—be given a chance, despite my foreboding. He’s big on infrastructure (name a candidate who isn't) and everyone will smile if gets some bridges repaired. And, let us acknowledge: the man likes to build things. The nation needs a grand project (the interstate highway system, the Apollo space mission) to inspire it again.  So maybe your candidate will incite some clever entrepreneurs and engineers to throw a great string of gondolas across the West Virginia mountains, creating a monumental statewide park that will attract millions of tourists, hikers and campers to that beautiful state, employing tens of thousands of state residents and helping to rekindle a national awareness of Appalachian history and culture. And maybe he will couple this great national project with a massive infusion of public dollars for mental health and substance abuse treatment to battle the off-the-charts opioid epidemic there. 
   (I just made that up sitting at the laptop. You tell us what the New York City real estate mogul with the trophy wives intends to do for those people in Larissa Macfarquhar’s portrait.)
   Maybe he will be successful, or less disastrous than some of us fear. Perhaps inertia and the stuck forces everywhere (inertia plus stuck forces = “reality”) will rein in the man’s crazier impulses. Perhaps he won’t launch a nuclear war on a whim when he has a bad hair day and can’t find his I-phone. Perhaps someone sane will urge him to give the heave-ho to the unsanitary figures around him (Roger Stone, Steve Bannon). Maybe he will surprise us all, and all of the drama on Facebook and Broadway theaters will be shown to be so much foolishness.  Perhaps, who knows, your man will end up someday engraved on the side of Mt. Rushmore, his trousers down, seated on the crapper and studying his I-phone, his brow furrowed in mid-tweet—a final, enduring, case-closing rebuke to elites everywhere: This is who we are, get over it.
   Or not. Where will you hide your shame when it becomes clear that those tiny bones he tossed to the working class during the campaign will be all they will ever get, as your man stocks his cabinet with billionaire businessmen? Shamelessness. That’s the key to getting by for the next four years with your candidate who was forced to shell out millions to striving regular folks defrauded in his “University,” and as the revelations about his many conflicted interests emerge. Reach for the most shameless excuses as his curious crush on Vladimir Putin evolves, with ominous consequences for the NATO alliance and the Baltic states you would otherwise be howling at Democrats for having “lost.” Shamelessness is what will enable you to hold your head up when the peculiar childishness of this man’s temperament begins to unnerve the closed circle around him, and he careens from one drama to the next, punctuating the reality show with angry, semi-literate tweets composed at 3 am and aimed at whoever has not—in the Trump parlance strikingly reminiscent of a first-grader coming home from school in tears—been “nice” to him.
   Shamelessness, no need to hide anything. After all, you hold all the cards. The executive branch, both houses of Congress, a majority of governorships and state legislatures—all this along with your gerrymandered congressional districts, your multi-million-dollar megaphone at Fox News, the Koch Brothers, and legions of one-percenters determined keep employed those legislators in Congress whom Garrison Keillor called “Christian pirates with their hands on the tax levers.”
   Many of us—whose patriotism you would readily impugn if it was advantageous to do so—do indeed feel profoundly afraid for our country. Resentment toward our fellow citizens who voted for Donald Trump is not the way out, but for you, the leaders of a movement that has claimed for 40 years to champion the cause of character, integrity and values in our politics, there will be no forgetting and no forgiveness.
   There is a tremendous liberation that comes with finally seeing things as they are, at finally seeing you and your “movement” in all its naked shamelessness for what it is. Moreover, some of us will hold on to an assurance that, in fact, you are not the future. Now when the attendant of the man of God had risen early and gone out, behold, an army with horses and chariots was circling the city. And his servant said to him, "Alas, my master! What shall we do?" He answered, “Fear not, for there are more of us than there are of them.”
   There are more of us than there are of you. Here is the nub of what I have to say: you will never, ever again lecture Americans about the need for character and integrity in our leaders without being met by the rolling thunder of derisive laughter followed by the silence of contemptuous disregard. You have won another battle, congratulations. You have lost your war.

Friday, October 28, 2016

Road Trip: Hills, Voices, Mysticism, Candidates and Letting Go

“When I’m in California, I feel like something bad is going to happen, because there’s so much empty space. Here it’s cozy. If you believe the mountains are yours, like most West Virginians do, when you get back to these mountains you feel comfortable again. You feel at ease….When I see the mountains, it’s like they’re embracing me.”
I spent what felt like a lot of time driving through West Virginia this weekend on a 13-hour road trip from Washington, D.C. to Columbus, Ohio and back (six and a half hours each way), and found myself thinking about this comment. It’s from a lovely article by Larissa Macfarquhar in a recent New Yorker Magazine, a deeply sympathetic and informative portrait of Donald Trump supporters in a small town in southern West Virginia. It’s a highly descriptive statement; the hills in that country are so compressed together they do seem to make you feel enclosed. (During my first exposure to rural West Virginia on school trip when I was 12, I remember then being impressed by exactly this feature, and being rather scared of it; from suburban Washington, it was for me startling different and made me feel cut-off, entombed possibly in a vale of mist and shadows, and it exacerbated, perhaps, the lonely homesickness I was feeling on my first extended time away from home.) The crowded hills leave no space for the kind of expansiveness that one normally associates with a landscape, but create instead the characteristic hollows or ‘hollers.’ When fogs fills the hollers it becomes a world folded in on itself, shrouded, as it were, in its own distinctive self-history; it is out of this haunted landscape that the “high lonesome” sound of bluegrass was born. These impressions, and others I gathered 35 years ago when I took a bus trip across the country and then, a few years later, drove across the country, have caused me to think more than once about the effect of landscape on one’s perceptions of the world.

On this weekend I was driving between northern Virginia and Columbus, Ohio, and back the tops of the trees all over the hills were touched with the beginning of autumn.  Bright color, but still only dappled—one can imagine a careful child’s sponge painting, the reds and yellows and orange crenellated, and lots of greenery still carpeting the lower reaches of the ancient hills. In another two weeks it will be a riot.
Listening to the radio for six-and-a-half hours on a Sunday drive through the near-midwest and Appalachia is an interesting experience. A social historian, listening to a tape years later, might draw some interesting inferences about our country. Country music, “classic” rock stations, preachers of every stripe. Oddly, a large number of preachers with Scottish or Irish accents. Preachers relating (not explicitly, but still transparently) the meaning of being Christian to the importance of not voting for Hillary Clinton. Football games broadcast through static. A commercial in which an avid sounding 20-something fellow opens with, “I’d like to talk about an issue of grave social importance—condom use.” It was an advertisement for Trojan.

There is also a station I have lighted on many times driving through the East Coast mountain region—We Are One Body: WAUB, operated (according to the station’s website) by the diocese of Greensburg, Pennsylvania, out of Latrobe, Pennsylvania. There are no commercials, but the station does rely on contributions and there are occasional solicitations for donations.  It is otherwise a continuous reflection on Catholic Christianity hosted—most of the time I have ever tuned in—by the kindest sounding, most soft spoken, most brotherly young man, reflecting either on Scripture or very often on arcane doctrine of the Church. (I have heard him reflect—he doesn’t really “expound” the way preachers and pundits do—on the meaning of specific paragraphs and nuances of obscure Papal proclamations.) If there is a political or doctrinal inflection in one direction or another along the familiar cultural fault lines, I haven’t detected it. Certainly, the station would be appealing to the most orthodox Catholic; it is appealing to me, a non-Catholic skeptic. The website states that the station is “catechetical and contemplative” and “the programming is intended to present the life of the Church in a way that makes the Mystical Body of Christ more apparent.” (Catechetical and contemplative or not, the Brothers behind We Are One Body are living fully in the digital age. The website offers a downloadable App, and several venues for listening online at The reflections are interspersed with Gregorian chant, a musical form well suited to contemplation and especially resonant driving alone through those old, old hills, and with periods of silence. A radio station that promotes periods of silence. I think it’s a concept that should catch on.
Somewhere else on the radio dial, far away from We Are One Body, a devout, exasperated Catholic was asked what the Church could do about the fact that young people—“Millennials”—were drifting away from the Church. He grumbled about the intellectual vacuity of what he termed “the atheist idea” and seemed to believe that the way to get young people back in the pews was to argue them back. I would like to have told him he would do just as well to go outside and beat his head against a rock.

But it has occurred to me later that in fact the Catholic Church has an enormous gift that could draw in many of the disaffected—namely this rich, rich inheritance of contemplative mysticism, of which We Are One Body is a such a charming representative for motorists driving 65 miles an hour across the Interstate highways of the Appalachian mountain range. (Protestants, having no such inheritance, are left with offering to the un-churched these ubiquitous folk and “alternative” worship services with the rock band and the theatrical trappings.) If Catholic parishes began thinking about creative ways to offer the Church’s ancient treasure of contemplative mysticism to their communities I believe they would find young followers. Actually, I think young people might eat it up. 

It is not, after all, the life of the Spirit that young people (and others) are fleeing from in their flight from the Church (and from religion in general); it is rather from what I would broadly call—by way of shorthand—“clericalism,” the deification of little men in robes and vestments, the perfumed odor of pharisaical righteousness, the itchy, obsessive preoccupation (inherent, it seems, in every orthodox religion) with what everyone is doing with their poor, sad sexual organs, and the habit of most organized religions and many “religious” people to fabricate a God who conveniently just happens to look (and vote) as they do.

On the Sunday I was driving, the young Brother was reflecting on the Incarnation, the distinctiveness of the Christian belief that Jesus was God made flesh, and the need to meditate on this most paradoxical of all doctrines—that Jesus was fully man and yet also God.  
When I wasn’t listening to We Are One Body, or trolling the airwaves for music that wasn’t deeply depressing, I hung around the high upper 80s on the radio dial where, if you are close enough to a major city, you can pick up public radio. West Virginia public radio is quite good. There was a lengthy interview with J.D. Vance, author of “Hillbilly Elegy: A Memoir of a Family and Culture in Crisis.” Vance’s book sounds fascinating—he sounds like an interesting and likable man, with a rather tortured family history—and its garnered a lot of attention, in part, Vance acknowledges, because of the election, which has focused attention on poor working class whites. (In this, his book has been joined by the way, by “White Trash: The 400-year Old Untold History of Class in America.”)
But about this particular “meme”—Donald Trump and the white working class. Among the countless things that anger me about this election and Trump’s ascendancy, perhaps this is the most infuriating: while it is certainly true that white working class men are almost entirely voting (or saying they will vote, or showing up at rallies) for Donald Trump, there is absolutely no way in the world he could have come this far in an election on that demographic alone. (Leave aside the preposterous delusion—bewildering to all those who see Trump for what he transparently is—that the New York real estate tycoon is some kind of honest broker for poor white working class people, or that he could give a damn about the West Virginians depicted in Larissa Macfarquhar's New Yorker article.)

The Trump phenomenon, in fact, is fed by legions of invertebrate Republican "leaders" at all levels, the usual low-IQ loud mouths in conservative media , and many, many perfectly comfortable American men and women whose jobs are not endangered and have never been anything but elaborately privileged, even judging by American standards, let alone the standards of how most of the rest of the world lives.
When I reflect on this and this sad and miserable election, I think of a profoundly sorrowful statement by Garrison Keillor. “If we elect this man president we are not the country we think we are….The churches should close their doors.”

My trip took me through Ohio, West Virginia, Pennsylvania, West Virginia again and Western Maryland before coming into the mad traffic of the greater D.C. area.

The drive out from D.C. on Friday was miserable—it took at least two-and-a-half hours in northbound traffic to get as far as I might have gotten normally in one hour, and it rained the rest of the way. I had hoped to get to Columbus that night, but thought it better to stop for the night. I was visiting my daughter in college. We had a lovely time with her mother on Saturday, ignoring the Parents Weekend organized events and doing our own thing. But on Sunday I was impatient and crabby (I had a fuming fit standing in line at the Panera because a couple in front of us took too long placing their order) and eager—why? For what reason?—to get on the road.

I think my daughter was embarrassed for me at my immaturity. Or I was embarrassed for myself. Actually, she’s an adult and the necessary steps of separating she began as a teenager are all but completed. I doubt she gives me a lot of thought when she doesn’t absolutely have to. I haven’t quite let go of her—being her father has been the only aspect of my life in which I unquestionably knew what I was doing. All the rest of it, I have been making it up as I go along, a blind man groping along in the dark. I should let go of her, but I don’t know exactly what’s next.

It reminds me of a story I like a lot, “To Know a Woman,” by Amos Oz. The novel is a favorite of mine—I don’t read a lot of fiction—but I will admit it is a strange one. A lot of readers who love Amos Oz are stumped by it, understandably. Yoel Ravid is a middle aged Israeli, recently retired from the Mossad, the nation’s storied intelligence service. His wife has died in circumstances that are slightly mysterious, possibly involving a neighbor with whom she may have been having an affair. His teenage daughter seems to have some incompletely defined illness—which may or may not involve a certain amount of deliberate playacting on her part. Yoel’s relationship with her is scratchy, but not much more so than that of most fathers and teenage girls.  He is befriended by a middle-aged real estate agent, an odd fellow, a bit of a playboy whose admiration for Yoel is ever so vaguely erotic, something like a schoolboy crush.

The story is told in short, terse chapters in which not a lot happens. There is an atmosphere of tense uncertainty throughout, of frustrated action, of something being always uncannily “off,” not quite right—an ambience with which I somehow feel quite at home. Yoel’s is a keen intelligence, far seeing and penetrating, but hobbled by ambivalence—or rather, by a preternatural caution. He’s a cautious man by training (I am one by nature) and like me he wants to make the next step in his midlife a right one.
There is a pleasant, convalescent tenor to the resolution of the story, a relaxation—like a clenched fist slowly uncramping—of the low-grade anxiety that grips the story throughout, a sense of things out-of-balance suddenly righting themselves. Uncertainties are not so much resolved as let go of, as when Yoel (admonished by his daughter’s precocious boyfriend) agrees that he must let his daughter go and breathe on her own. For himself, Yoel is an observer, and he finds late in life a sudden pleasure in observing, only observing for its own sake and nothing more.  
Well, it’s a long drive back home from Columbus, not a fun one necessarily and I wasn’t wrong to be impatient, regardless of what my daughter thinks. On the other hand, I have always experienced driving to be somewhat meditative and as I found myself paying attention to those hills and valleys and the voices on the radio, and meditating on these observations as I wrote them over the following week since my return, I felt in a similar way that this too is who I am, an observer, whatever else may come as I grow old. Maybe that is all I will ever be.
It is not a bad fate. “Since he was capable of observing, Yoel grew fond of observing in silence. ... And if it was necessary to focus the gaze and remain on the lookout for hours and days, even for years, well there was no finer thing that this to do.”

Monday, May 23, 2016

Our Coming Clothespin Election: Hold Your Nose and Vote for Hillary

The writer Adam Gopnik has offered up some recent French history as an object lesson for how we might approach the coming election here in the United States. In 2002, the French far right National Front, headed by Jean-Marie Le Pen, managed—through luck, circumstance and lackluster opposition—to advance to a two-man contest for Prime Minister with the conservative reigning PM Jacque Chirac.

Le Pen is a not-so-closeted fascist whose opinions roughly mirror those of Donald Trump—foreigners out! Muslims out! France is for the French! It surprised exactly no one when Le Pen recently tweeted that if he were an American, he would vote for Trump.

But in that election year, French socialists and leftists united with sane conservatives to deny Le Pen. “Socialists who had spent their lives opposing Chirac, who thought him unprincipled, mediocre, and significantly corrupt, held their noses—some literally asked to take clothespins into the voting booths—and voted for him, and against Le Pen,” Gopnik writes. “…There are politicians we strongly disagree with, and then there are anti-constitutional crypto-fascist authoritarians.”

I think we are headed toward our own clothespin election, in which the probable candidates will be objectionable to many on both sides. I’ll not waste Observer readers’ valuable time on Donald Trump; but read Mr. Gopnik’s article in its entirety ( or David Brooks’ scorching commentary (, or this blistering article by Ezra Klein (

Ted Cruz, the republican alternative to Trump, is vastly more intelligent and certainly more authentic. But he is offering up the same brew of radical nationalism along with his own brand of angry, reactionary politics, and the weird and flatly inaccurate idea that America is a “Christian” nation.
Anyway, after the New York primary, it’s not been looking good for Cruz.

Gopnik aimed his article at conservatives whom he hoped would see that Trump is a disaster for their own cause, as well as for the nation, and expressed hope that perhaps the Bush family might, sometime in October, come out and endorse Hillary Clinton. “…[R]ational or far-sighted conservatives should be sighing with relief that the alternative to the monster they’ve created is a reasonable, experienced mainstream centrist whose chief fault in progressive eyes is that she is too close to the conservatives’ own ideology.”

Well, we’ll see. But it’s possible that many Democrats will need to bring their own clothespins to the voting booth this year. What can one say about Mrs. Clinton (and her husband) that has not already been said? Even discounting her most unhinged critics on the rabid right who think she is the Spawn of Satan (or Satan’s wife), the truth is that there is lot not to like about her.

But she is the presumptive nominee (and by the time this appears may have locked up the nomination). As for her tenacious Democratic opponent, I confess that, personally, I have never “felt the Bern.” Sanders’ signature issues are admirable—I’m a longtime advocate of a single-payer healthcare system, the only issue with which I identify as a “progressive”—but they are entirely aspirational and have no chance at all of coming to fruition when our Congress is populated by fellows like that guy who threw a snowball in the chamber of the House of Representatives to “prove” global warming is a myth. The model for Sanders’ vision are the Scandanavian social democracies, where a network of social insurance programs is founded on a broadly accepted cultural ethic of common provision, social solidarity and shared responsibility, including a very high tax rate (nobody is getting anything for “free”)—an ethic that doesn’t even remotely exist in this country, where even the commitment to an asset as integral to our national identity as public education has eroded.

Forget “free” public college tuition. Here is a prediction: The next big “crisis” that will have everyone wringing their hands and wondering how it happened and why we didn’t see it coming, is when a bridge somewhere collapses. And just you watch: that water and lead poisoning scandal in Flint is just the tip of a great big iceberg underneath our nation’s cities.  

Public taxpayer dollars subsidize a vast but largely invisible infrastructure supporting all that we take for granted as the comfort, convenience and reliability of the “American way of life”: safe roads and bridges, a safe food supply, clean water, and a public health system that can identify emerging diseases and respond before they become epidemics.

It’s setting the performance bar pretty low, but perhaps our political leaders could tend to these fundamentals. Perhaps conservatives (including the clown with the snowball) could be reminded that it was the Eisenhower administration that built the Interstate highway system.

In these fraught times, a “reasonable, experienced, mainstream centrist”—even one as compromised as Hillary—may be just what we need, and a more than tolerable option given the alternatives in the other party. If fair-minded conservatives can embrace her, as Mr. Gopnik hopes they will, then the rest of us—either progressive fans of Sanders or others, like me, who just wish the Clintons were, you know, better people—can also make a sacrifice for sanity.

Garrison Keillor wrote a clever and funny column about this election, urging a little less gloom from people like me. But he ended on a grave note. “The choices, at this point, are extremely limited. Some Bernie women wish Elizabeth Warren were running. She’s not. There is a disaster who is in the race, though, and he’s done well against divided opposition. Come summer, the pluribus will need to unite.”

So let’s unite. And if you need to, grab a clothespin, clamp it to your nostrils, and pull the lever for Hillary.

Tuesday, April 19, 2016

Clothed in innocence: My Experience as a Juror

This is a summons to appear for jury duty. I emerged from the rapid train at Tower City clutching the summons and supposing that I was heading to County Court, where I’d done four days of jury duty before (no trial, just waiting around until being dismissed, my duty served, on a Thursday afternoon). I hadn’t bothered to read the summons very closely (that’s how it is with pieces of mail you wish you could ignore) and it was only as I was hoofing it to the courthouse that I bothered to look at the address. My summons was for the federal Justice Center at 801 E. Superior Avenue.

I had been called for jury duty four or five times before in my life—a handful of times in the District of Columbia and suburban Maryland, where I lived as a younger adult, and once here in Cuyahoga County. I had never been seated on a jury to hear a case, so this time I had an uncannily strong presentiment that my number was up.
It was. A hundred or so of us were seated in the waiting room when our names were called off in numbered order (it would be interesting to know how that order was determined; I assume it was random). My number was 24. Thirty or forty of us were led up to the courtroom where the presiding Judge and attorneys for defense and prosecution were waiting for us. The first 12 potential jurors took seats in the jury box, the rest of us in the gallery seats. Then the defendant in the case was introduced and the charges were read aloud, providing the barest outline of what the case would be about.

Then began a process known as voir dire (it’s French, but derives from the Latin verum decire, meaning to “say what is true”) whereby the potential jurors are queried as to whether there is any reason to believe they could not impartially render a verdict in the trial. The Judge asked each of the 12 potential jurors in the jury box to say a bit about themselves. A few were dismissed. The lawyers for defense and prosecution were also allowed a certain number of “peremptory challenges,” whereby they could dismiss a potential juror without stating a cause (an exercise I interpret as an effort to allow each side some control over the randomness of random selection).

Throughout this winnowing process, dismissed jurors were replaced one-by-one by with those of us sitting in the gallery seats, until a final jury of 12 was seated in the jury box. But the court would also need four “alternates” to sit with the jury, hear the entire case, and potentially participate in deliberating a verdict if one of the original 12 should drop out. As the 24th in line after something like 10 dismissals (you do the math) my number was indeed up, and before I knew it, there I was, seated as an alternate on a jury hearing a criminal case in U.S. Federal Court.

As an alternate—in fact, I was the third alternate—I presume that the probability of my winding up in deliberations was always very slim. (In fact, I have no idea how often alternates wind up participating in a decision). This being the case you might think I was in a sweet position to sit back and watch an interesting drama without having the responsibility of deciding the matter.

Undoubtedly, a different kind of personality might have looked at it that way. I could not. For one thing, I found the facts of the case immensely engrossing. I also found them unsettling. In any case, the judge instructed us alternates to pay attention to the case as if we might be making the deliberation, so that’s what I did. For the next ten days, the myriad facts of the case overtook my mind, waking and sleeping, like an occupying army, sealing the borders and subjugating my thought life to a kind of Marshall Law, imposed by The Case. I woke at odd hours of the night and early morning with the details of the case tumbling over and over and over in my mind like so much laundry, yet to come clean.

The trial included moments of very high drama. And there appeared on the witness stand a handful of extremely vivid characters who might have walked off of a movie set. (In this particular case, it would have to be film noir.)

I would not promise that every juror’s experience will include such color and shade. In many other respects the proceedings were deflating to those of us used to watching television courtroom dramas where the narrative is tightly compressed for dramatic effect and experienced actors make eloquent pronouncements written by highly paid script writers. There were periods of exquisite tedium. And a fair amount of lawyerly maneuvering (all those objections, overruled and sustained!) are bound to be opaque to jurors who are, as I am, jurisprudentially naïve.

About that naiveté. One of my strongest feelings throughout the trial was that of my utter inadequacy to be deciding the matter at hand (even to be in a position to potentially decide)—a matter which was, after all, no small thing, pitting the rule of law versus the fate of a fellow human being in the docket. Speaking personally, I experienced it as an awesome and terrible thing to be sitting in judgment on another individual. I suspect my feelings are not uncommon. But in fact justice does not require that you bring any kind of “expertise” to jury duty, only that you bring the simple wisdom, accessible to most of us, to see a fact for a fact, and to see evidence or the lack of it for what it is, and what it is not. And your fellow-feeling for the fellow in the docket is precisely what is implied in the phrase “a jury of one’s peers.” (Somewhere in the halls of the Justice Center there is a photograph on a poster designed to encourage jury duty that always brought a smile to my face when I looked at it. It depicts a cat, with a stricken look on its face, surrounded by a 12-member jury of dogs.)

Some of the language of law is intimidating and might compel a normal individual to flee in the opposite direction as from a swarm of bees. But there are some phrases and images of startling beauty. One of those is the phrase, “clothed in innocence.” “There sits the defendant clothed in innocence,” the judge told us, pointing to the defendant at the beginning of the trial.
I had never heard the phrase, although I gather it is a standard injunction. As the trial wore on, perhaps it stood out for me amid the dispiriting facts of the case, as a bit of graceful human wisdom.

It’s a compelling image—clothed in innocence. It suggests, first, the totality of the innocence in which the defendant is presumed to stand before the court of law—innocent, as it were, from head to foot. But it also suggests something else—for if innocence, for the purposes of the trial, is only a garment, then it can be torn asunder, and the defendant can be exposed, disrobed, made naked before his or her peers. Which just about precisely conveys the vulnerability of a defendant at trial.

Of course, a “presumption” of innocence is not a certainty, and all of us are invested in seeing that guilty parties are exposed at trial and given a just punishment for their crimes (otherwise as a society we are lost). This tension—between the rule of law, which no one is above, and the rights of the defendant—is the tension that animates a jury member’s responsibility in rendering a decision, and it is the foundation for the drama that unfolds in a trial.

But the “real truth” about what transpires in human affairs (always untidy and frequently tragic) can never be known in any ultimate sense by those on the outside; that truth—about who did what to whom and when in any particular human drama—can only be known by the protagonists themselves. Barring a dramatic confession in the courtroom, the two contending sides in a trial will stick to their conflicting versions of the “truth” down to the wire.

This side of death we do, as the apostle said, see through a glass darkly. The 18th century rationalists who conceived a jury system and our constitutional arrangements accepted our compromised state with regard to “ultimate truth,” and created instead a system admirably arranged—rationally arranged—to arrive at workable truths, livable solutions (would that our politicians would keep this in mind—workable truths, livable solutions). What the jury can do is arrive at such truth as can be discerned by the light of the rules of evidence and the law as it applies to that evidence (which is explained by the judge before the jury goes into deliberation).

The trial had lasted five-and-a-half days. The jury of 12 deliberated for approximately 15 hours over two-and-a-half days. (During the period of deliberation, we alternates were still required to be present in the justice center, and whiled away the time chatting, reading, and fidgeting with our smart phones. A bit anticlimactic, to be sure. We did not discuss the case amongst ourselves—the judge admonished all jurors during the trial not to discuss the case during breaks—and during the deliberative period when we all assembled in the morning, the alternates were kept segregated from the deliberative jury.)

Temperamentally, I am inclined to believe the last reasonable thing a reasonably sincere sounding person tells me. I don’t know whether that makes me a good juror, or the worst kind of juror imaginable.  What I can say is that nothing about the case I heard seemed “open and shut” for either side. Defense and prosecution both told a narrative that was compelling and, on different points and in varying degrees, convincing. But on the night before what turned out to be the day when the jury of 12 would conclude its deliberations, I arrived (more or less easily) at a conclusion—the same conclusion, in fact, that the jury of 12 would deliver the next day.

I and my fellow alternate jurors would not know that verdict any sooner than anyone else in the courtroom, until the judge himself was handed the jury verdict and read it aloud. All 16 of us filed into the courtroom together. The entire court rose as we walked in. I dared not to look at the defendant or at the prosecutors or at the assembled men and women in the gallery, packed on both sides. The jury foreman handed an envelope to the bailiff, who handed it to the judge.
“Not guilty,” the judge said. There was no dramatic response anywhere, at least not while we jurors were still in the court. (Before leaving, I stole a look at the prosecutors table; the lawyers appeared to be models of composure and rectitude.) In the jury waiting room where we retreated after the verdict the sense of relief was palpable, as if all twelve jurors had been holding their breath for ten days and were finally allowed to breath. 

My experience as a juror was the education of a lifetime, in many respects. It was also chastening; for the other thing I will take away from the experience was how palpably fateful, how vividly earnest were the proceedings. Our other civic duties—voting and paying taxes—are most certainly consequential, but they are filtered through a prism of mass effects. In a jury, the voice of a single juror can decide a case, and the guilt or innocence of the defendant has real world implications that ripple out beyond the immediate. Very little I ever do (outside of the raising of my child) will ever be as consequential, as pregnant with implications in the “real world,” as the decision rendered by my colleagues on the jury. It is remarkable thing—sobering and affecting—when 12 men and women bring nothing more elaborate than their humanity to bear on the judgment of a defendant who remains, until disrobed by a force of facts sufficient to overcome reasonable doubt, clothed in the raiment of innocence.
(Image: DNYC59/

Saturday, January 23, 2016

The Movies: Reviews of Four Oscar Nominees

Spotlight tells the story of the Boston Globe’s explosive expose of child abuse in the Boston diocese, which later detonated throughout the Catholic world. The trailer, seen in theater previews and on YouTube, depicts reporter Michael Rezendez (played by Mark Ruffalo) demanding to know when the newspaper will go public with what it has learned. It’s an authentic emotional flashpoint, but it’s also unrepresentative of what makes this movie so powerful; for this is a film that studiedly avoids emotional grandstanding.

The background of the story, the Church’s systematic protection of repeat sexual predators, is so emotionally charged that the film doesn’t need to grandstand. It is fundamentally a movie about journalism—work-a-day, multi-sourced, investigative journalism of the kind that is threatened by the demand for digital speed and brevity. The victims, now in their adulthood, are heartbreaking, but quietly so. The one accused priest who makes a brief appearance is depicted not as a monster, but as pathetic and emotionally stunted. The journalists are not firebrands, just very competent professionals (and there are none of the shopworn motifs about reporters; they even dress reasonably well, or at least not like total slobs). All of the actors are exceptional—Ruffalo as Rezendez (a likeable regular guy and old school reporter), Michael Keaton as Spotlight team leader Robby Robinson (careful, smart, treading the waters with Church higher-ups who would like the story to go away), and Liev Schreiber as editor Marty Baron (a deeply self-contained character whose recessive nature draws you to him and drives the reporters). This is a brilliant movie.


Brooklyn, based on the novel by Colm Toibin, is proof in this wised-up age that a compelling movie can still be made from a simple love story, some fine acting, and some pretty camera work. Set in 1952, a young Irish girl named Eilis (pronounced AY-lish), leaves her mother and sister behind when she emigrates to America, landing in Brooklyn where she falls in love with a local. Complications arise when she is called back to the old country upon the death of her sister, and Eilis must make a choice between her birth home and her life in the New World.

The primary romantic love story and triangle is a sentimental one, perhaps a bit too impossibly sweet for wised-up types. And the movie trades unashamedly on a couple of charms that for American audiences will never, ever die: period images of the immigrant experience, and the special magic that adheres to anything involving an accent or a brogue from the British Isles.

So much for wised-up cynicism. The really compelling love story here is the love of a place called home and the heartache and contradictions that always attend having to leave. Saoirse Ronan is a contender for best actress in a leading role. Certainly, if there were a category for “Most Expressive Face” she would walk away with it.

The Big Short (based on the non-fiction book by Michael Lewis) depicts the true story of some sharp Wall Street types who foresaw the colossal fraudulence of the mortgage industry and its sensational collapse in 2008. It’s an entertaining education if not exactly a comfortable movie-going experience. The humor—it does actually manage to be funny—is very bitter, and the joke, I’m afraid, is on the American public (that’s all of us), whose distracted cultural self-absorption and consumerism is depicted as fodder for a vast corruption founded, from top to bottom, on make-believe. There is a wicked cleverness in the movie’s use of popular celebrities to explain the esoteric “instruments” designed by hedge fund managers at the top. (Selena Gomez, at a roulette wheel in Vegas, explains “collateralized debt obligations.”) At the bottom end, a pair of Florida real estate guttersnipes make a special practice of selling over-leveraged mansions with adjustable rate mortgages to poll-dancing strippers who have a lot of ready cash and a tendency to be acquisitive.

It all really happened. The protagonists are not villains, just guys who saw what was coming and—with varying degrees of cynicism or anguish—cashed in. Steve Carell plays the anguished one, who prophetically announces as the house of cards is collapsing that no one will be held accountable and the resulting catastrophe will be blamed on immigrants and poor people.


“Out in the world, things happen and happen and happen, and it never stops.” That’s just one of the Zen-like observations of a five-year old boy named Jack who emerges from a room in which he has spent all his young life with his mother, in Room, the most decidedly un-Hollywood movie of the seven nominees for Best Picture. And ponder this (the quote isn’t exact): “Out in the world there is so much space that time gets spread very thin like butter all over the roads and houses and playgrounds and stores, so there's only a little smear of time on each place, then everyone has to hurry on to the next bit.”

For the first approximately 20 minutes, viewers have no explicitly clear idea why Jack and his mother are in the room, but are immersed in the world they have fashioned of out of the small space. Just as well, because the backstory to why they are there is not what the film is about. (Cleveland audiences may be unavoidably reminded of a certain sensational local episode; my advice is to forget about it.) What the film is about is Jack’s awakening to an unconfined universe he didn’t know existed, a meditation on the vastness of human freedom in a world without walls, without boundaries—a freedom that it is all but impossible not to waste. His esoteric but believably childlike observations are grounded in the unglamorous reality of his surroundings, and the complications associated with the aftermath of his and his mother’s ordeal. (Some of that aftermath seems wayward and disjointed or just nonsensical—a distraction from the movie’s purpose.) The film didn’t quite come together (for this viewer) until the last powerful scene when Jack and his mother return to look at the room, now gutted and empty. Anyone who has ever revisited a landmark of one’s most trying period, from which it was thought there was no release, will recognize the emotions—not least of which is a sympathy for the person you once were. And a very peculiar longing for the comfortable familiarity of our sundry confinements—predicaments, routines, obsessions and addictions. There is just the merest, but unmistakable, wistfulness in Jack’s voice when he tells his mother, “A room isn’t a room when there isn’t a door,” before the two of them leave it behind them forever.