The Imposition of Meaning: Lessons From J.M. Coetzee About the Humanity of Others
Dr. Ben Martin on the Real Life and Times of “Mr. S.”
In J.M. Coetzee’s novel Life & Times of Michael K, an unnamed military medical officer broods over his patient, the eponymous Michael K:
You are like a stick insect, Michaels [sic], whose sole defence against a universe of predators is its bizarre shape. You are like a stick insect that has landed, God knows how, in the middle of a great wide flat bare concrete plain. You raise your slow fragile stick-legs one at a time, you inch about looking for something to merge with, and there is nothing.
The officer, a pharmacist by training, has been deployed as a bedside clinician in a makeshift hospital for political prisoners. He works for the tyrannical government carrying out the forced migration and imprisonment of seemingly all non-white people in the novel’s quasi-fictional South Africa destabilized by civil conflict. The officer’s simile is one of many attempts to make sense of the man he is charged with treating.
Life & Times of Michael K is primarily a story of the protagonist’s survival. On his journey as a hunted person of color, Michael K squats on an abandoned farm, hides in the mountains from roving police, escapes a labor gang and a prison camp, and subsists on pumpkins he grows from seed. Michael travels great distances by foot. The omniscient narrator writes: “Sometimes the only sound he could hear was that of his trouser-legs whipping together. From horizon to horizon the landscape was empty.” It is near the end of the novel when soldiers apprehend Michael, malnourished and stuporous, and relinquish him to the medical officer.
Michael is one of the great characters of modern literature who knows solitude, and solitude has been on my mind. I recently re-opened the book hoping to learn something about one of my own patients who seemed impossibly alone. Last March, as COVID-19 spread, I assumed care of a man I will call Mr. S., a 64-year-old who first presented to the Emergency Department with confusion and recurrent falls. At that time, months before I met him, he had been treated for acute alcohol withdrawal. His electrolytes returned to normal, his bumps and bruises healed, cultures of his blood and urine grew nothing, but his confusion did not improve. He saw rats running across the floor. He heard whispered voices about the end of the world. He seemed to have no reliable short-term memory. Each time someone asked him what he did yesterday, he offered a different response: shopping for a jacket, clearing out brush from the woods, working on the frame of a house. When asked if he knew where he was, he responded: “Keyboard.”
Brain imaging didn’t turn up an explanation. The neurology and psychiatry consultants agreed that Mr. S.’s presentation was consistent with permanent memory loss and psychosis due to chronic alcohol use and vitamin B1 deficiency. Korsakoff syndrome, a condition known for its feature of confabulation. If you ask someone with Korsakoff syndrome what they did last night, they can’t remember, so their brain involuntarily offers up a fabricated event. The region of Mr. S.’s brain that regulates emotion and memory had been irreparably damaged.
Mr. S. ate his meals and exercised with physical therapists. His hallucinations improved with daily quetiapine. But he couldn’t retain the names of his pills, couldn’t remember when to take them. He continued to have difficulty getting dressed by himself. He was better, but was he ready to leave the hospital? He had no spouse or living relatives. He had some old friends who were reluctant to help and eventually stopped answering the phone. He had nowhere to go.
One rainy afternoon, he vanished. It took hours for police to track him down on the median strip of a highway, hair matted, desperately searching for a pair of boots that didn’t exist. Without protest, he let the officers return him to the hospital, and the matter of his discharge was settled. Mr. S. needed a so-called memory unit, a facility where patients with cognitive disease and unpredictable behavior receive care under strict supervision. Beds on these units are hard to come by. Weeks added up on the timeline.
When I met Mr. S., he had been in the hospital for months, but there was little for me to do as his doctor. We spent our time exchanging pleasantries. “How do you feel?” I asked him each day. “I’m healing,” he would tell me, eyeing my stethoscope. When I asked if he had shortness of breath or chest pain, there was some variety in his responses, a mild display of confabulation, but the spirit was the same: “the bronchitis is getting better” or “the pneumonia is all gone.” He passed afternoons stretched out in bed or sitting in a chair by the window, a sportcoat on, a Bible in his lap. One day, I found him writing scripture on the wall’s whiteboard. He made no mention of my face mask and goggles, now mandatory protective equipment when examining any patient. A pandemic had made its way across the globe, but for Mr. S., nothing had changed in his inner reality, or at least nothing I could detect.
What was his life like before he came to us? In a decade-old note, in the virtual bottom of his electronic file, I found a passing reference to a year he spent in sobriety at the Faith and Healing Farmstead. Nowhere else in the chart was this part of his life mentioned. It is easy for me to fill in the gaps, imagine him performing the activities his mind now offers as confabulation. Chopping wood, knocking fences together, rolling cigarettes. But the stories of his chart do not reveal the answers to my real questions: Where do you belong? What do your stories and their gaps mean?
As with Mr. S., Michael K comes under medical care in an advanced state of malnutrition, his inner world cordoned off. Michael either ignores the medical officer’s questions or offers evasive responses. His inscrutability frustrates the officer, who continues to call him Michaels even after Michael corrects him. The officer doesn’t trust Michael to know his own name.
“You are like a stick insect,” the officer tells him. It is one of many attempts to assign meaning to Michael with animal imagery. The officer compares Michael to a pet duckling, the runt of a cat’s litter, and a fledgling expelled from the nest. He is like a “bunny-rabbit sewn up in the carcase of an ox.” In the degrading, imperialist spirit of Dutch settlers in Cape Colony who described Indigenous people “clucking like turkey-cocks,” the medical officer speculates that providing Michael with physical rehabilitation would be “like trying to teach a rat or a mouse or (dare I say it?) a lizard to bark and beg and catch a ball.”
Via the omniscient narrator, the reader learns that Michael, too, attempts to understand himself through animal metaphor: “When he tried to explain himself to himself, there remained a gap, a hole, a darkness before which his understanding baulked.” At the limits of self-knowledge, Michael casts himself as a snail without its shell, an earthworm, a mole. He does not consider soaring kites or stalking panthers. The animals with which he identifies are small or subterranean, the kind that seek the vital protection their physical form cannot supply. At one point, lying on the ground after escaping from a work camp, he thinks, “I am like an ant that does not know where its hole is.” Solitude in its loneliest form.
The reader is drawn into a patchwork of animal imagery as an instrument of explication, but neither Michael nor the officer seem convinced by their effort. “Forgive me Michaels,” the officer imagines himself telling his patient. “I only want to tell you what you mean to me, then I will be through.” It is a plea originating from self-interest: once he can explicate Michael, the officer will be one step closer to understanding his own role in a tragic history, one step closer to making sense of the chaos unspooling around him.
How did the novel’s racist hellscape come to pass? The reader is never given an origin story. The armed agents of the government carry out their duty with indifferent cruelty. A guard at a work camp tells Michael: “You climb the fence and I’ll shoot you dead, mister. No hard feelings.” Stopping Michael at a checkpoint, a motorcyclist warns: “You want to stop on the expressway, you pull fifty metres off the roadside. That’s the regulation… Anything nearer, you can get shot, no warning, no questions asked.” The phrase no questions asked seems to summarize the spirit of the militarized state. In exchange, Michael adopts a rejoinder: no answers offered.
So: Michael’s solitude is a shield. He has no reason to trust the officer. He forgoes durable friendships with other prisoners, observing them from afar to avoid their ire. He manages to be solitary even when crammed into a train car. But his shield is an imperfect defense against the ubiquitous machinery of state violence, and his prolonged starvation underscores the limits of his autonomy. Nowhere to buy seeds. No fresh water in sight. At times, the only decision to make is whether to walk through a spell of dizziness or lie down.
If I can explicate Michael where the officer comes up short, I have less luck with Mr. S. During my seven days as his doctor, my other patients changed course. My patient with pneumonia went home with an oxygen tank. My patient with kidney injury went home with hospice care. Mr. S. continued to sleep in, sometimes until early afternoon. He drank coffee and flipped through the Bible. When there was time, his nurses would take 20 minutes to sit by his side, talk about whatever came to mind. He spent most of his day alone.
On the morning he deviated from our normal pleasant exchange, Mr. S. looked me up and down. “This is a wicked town,” he told me.
“Anything bothering you physically?” I asked.
“I’d be better if I was left the hell alone,” he said.
“Fair enough,” I said, backing away. “I can come by later.”
“Fair enough,” he repeated. “That’s right.”
“No papers, no money,” the medical officer muses on Michael. “No family, no friends, no sense of who you are. The obscurest of the obscure.” Michael K, Mr. S., both alone, both obscure—is this why I feel compelled to draw a link between them? If Mr. S. is like Michael, am I like the medical officer? By all measurements, he is my fictional shade. Like him, I view my patient with a gaze distorted by the desire for meaning. Like him, I foist symbolism on a person who never asked to be symbolized.
Instead of filling in the gaps in Mr. S.’s chart, I should follow Michael’s example and try to explain myself to myself. What kind of animal am I? Am I like a wandering ant? Are my goggles like the compound eyes of a fly? Does my prowling in the hallways, leaving and returning to my patients’ rooms, mimic the path traced by something more sinister, like a wolf?
If Mr. S. is both like and unlike Michael K, if I am both like and unlike the medical officer, what about our respective environments? As COVID spread through the US last spring, studies revealed disproportionately high rates of morbidity and mortality in people of color. At the same time, nationwide protests filled the streets in response to a string of racist murders at the hands of police. In May, the NAACP called for the United Nations to classify US police violence against Black Americans as a human rights violation. Some cities condemned the violence; others issued curfews enforced by police. In the headlines: lootings, beatings, gas canisters arcing into unarmed crowds. A friend sent me a photo of a burning car taken from a window in the COVID unit of his hospital. In the footage of George Floyd’s murder, the crime is partially hidden by a police car, but the killer’s face occasionally emerges into view, a crease in his brow, eyebrows raised almost quizzically, as if to say: “No hard feelings.”
At the end of Life & Times, Michael manages to climb a fence and flee the hospital. He walks the landscape and imagines quenching his thirst by tying a teaspoon to a string and lowering it into a well. An image of hope. A pitiful image. One can drink from a teaspoon, maybe, but a cup is not too much to ask for.
Over half a year from the night of his admission, months after we parted ways, Mr. S. also left the hospital, at last discharged to a memory facility. In a different kind of story, in a different environment, a long-lost friend might track him down, pay him a visit from time to time. But if his solitude changes character, I will never know about it. Probably for the best. Best not to think of Mr. S. like one thing or as something else. Best to resist the temptation to wring out meaning from unyielding sources. Instead, I cling to my understanding of Michael like a fist around a spoon.