On Wanting to be Where the Wild Things Are Jun 4, 2012

by Rick Rader, MD

Recently I was attending a conference for a national medical organization and, during one of the breaks, I was delighted to find a chair at an empty table in one of the break areas. Sitting with a latte courtesy of The Intergalactic Pharmaceutical Company, I was looking forward to some much needed solitude. It didn't last long (the solitude that is). A young guy wearing a name tag that identified him as an emergency medicine physician from Seattle asked if he could join me. I smiled and nodded and he placed a 12 pound plastic bag filled with drug company exhibit "take aways" (announcing that this was a new experience for him) on the table.

We started to chat and in a ceremony that is most reminiscent of college mixers ("So what's your major?") we exchanged the preliminaries. We exchanged names, cities, medical specialties and how good it felt to sit down.
He went first. He was a third year-emergency medicine resident in a busy university affiliated hospital. The lingo was familiar to me. Knife and gun club, mayhem, repeaters, inappropriate primary care, long hours, in and out, come and go, off days spent sleeping, grueling shifts, huge school loan debts, trauma, undecided if he loved it or hated it. I listened and said, "Sounds intense." He nodded.

I went next: intellectual and developmental disabilities. Community based non-profit agency. Teaching, research, creating programs, developing policies, advocating, addressing disparities, transition planning and kicking down doors. I think I saw him starting to peer into his bag of brochures; nothing sounded familiar or probably intriguing. Then I hit him with "people with common or rare genetic syndromes, mostly non-specific funk, usually accompanied with seizures, non-communicative, non-ambulatory, neuro-motor disorders, stuff like spinal muscular atrophy, dual diagnosis, organ transposition, osteoporosis, spasticity, altered sensorium and sensory processing impairments, challenging behaviors, vulnerable, compromised and marginalized." He looked up at "seizures" and was riveted at "behaviors," but I was still laying out the landscape of what awaits us every day. He swallowed, shook his head and offered, "Wild." I smiled.

He was right of course. "Wild" says it all. Not wild in the sense of savage, mad or feral. Not in the sense of bungee jumping, or zip line runs or class five white water rafting. But "wild" in the sense of "living in a state of nature," "not cultivated," and "not tamed." Wild as in "uninhabited." Wild in the sense of a place where, if you have a zest for life, you need to be. Wild in the most "organic" sense. Wild in the sense that you better not just be standing still. Wild in the sense of you need to be doing more than looking. Wild in a way best described by David Herbert Lawrence, "I never saw a wild thing sorry for itself."

I immediately thought of the book, "Where the Wild Things Are" by Maurice Sendak. First published in 1963, it has remained a classic and has been adapted as an animated short, an opera, a live action film and a piano musical. When it first appeared, the grotesque illustrations caused some controversy with parents who thought the fanged characters would disturb children. They were wrong. Children embraced them and loved them! Turns out that Sendak, who both wrote and illustrated the book, originally thought that the story would take place in the "land of wild horses." Shortly after embarking on the story Sendak realized that he didn't know how to draw horses and they morphed into "monsters." "Wild things" as referred to in the title, was inspired by the Yiddish expression "Vilde chaya," meaning boisterous children. The story has some affinity for those who have gravitated to working with individuals with special needs, a field that, indeed, appeals to those with an affinity for "wild things."

The book tells the story of Max who, one evening, plays around his home making "mischief" in a wolf costume. As punishment, his mother sends him to bed without supper. In his room, a mysterious, wild forest and sea grows out of his imagination, and Max sails to the land of the Wild Things. The Wild Things are fearsome-looking monsters, but Max proves to be the fiercest, conquering them by "staring into all their yellow eyes without blinking once," and he is made "the king of all wild things," dancing with the monsters in a "wild rumpus." However, he soon finds himself lonely and homesick and returns home to his bedroom where he finds his supper waiting for him, still hot.

I am not suggesting that any of the above is a metaphor for our work, or symbols of our challenges, or that any of us are "fierce," or "conquer" anything. One thing is for sure, however. We are never homesick. Indeed every day is a day we are where we want and need to be—at home with the "wild things."

He was fond of saying, "Things come to you without you necessarily knowing what they mean!"

Maurice Sendak died May 8, 2012, at age 83.

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