Dragons - Chapter 65 (DRAFT)

It took me forty-eight minutes to complete the assessment. According to Pamela Thornsby, who had sat silent and unmoving across the table from me the entire time and who, when I finished, took my completed scoresheet and test booklet from me with all the reverence of holy scripture -- according to Pamela forty-eight minutes was very respectable, very respectable, indeed.

I wasn’t so sure. If I can be honest for a minute, I really can’t stand standardized tests like the one they made me take. None of them are worth the paper they’re printed on. To this day, I have never heard nor seen what my results from that day were, but I’m sure they paint a picture that looks nothing like me. They never do. They can’t. There are too many layers to the whole thing.

What do I mean? Well, let’s take that one statement I remember. I suppose some people may consider me to be a bit of an intellectual. Now, how was I supposed to answer that? Do I agree or disagree with that statement? Well, given all the nested layers in that statement it’s hard for me to know if I agree or disagree with it because it’s not clear to me what I’m agreeing or disagreeing with -- or more precisely what the damn test is going to assume I’m agreeing or disagreeing with.

Let’s just pretend I agree with that statement. Now, what does the test think I just agreed with? Does it think that I agree that I am an intellectual? Or that I am a bit of an intellectual? Or that some people consider me a bit of an intellectual? Or that some people may consider me to be a bit of an intellectual? Or that I suppose that some people may consider me to be a bit of an intellectual? Because those are five different things that I may agree or disagree with. Maybe I agree that I am an intellectual, but I disagree that some people consider me one. Maybe I keep my intellectualism private and don’t talk about it in front of people, least of all a bunch of losers at work who aren’t going to trust me if they think I think I’m better than them.

So how am I supposed to respond to this statement? Do I read it at its absolute face value? Do I agree or disagree with this statement: I suppose … some people … may consider me … to be a bit … of an intellectual. Well, guess what? I disagree with that statement. I don’t suppose that some people may consider me to be a bit of an intellectual. But had you asked, and I suspect what you are really asking, if I thought of myself as a bit of an intellectual, then I would have agreed with that statement. I do. I do think of myself as a bit of an intellectual. But I don’t suppose that most people think of me that way.

But wait, I’m not done. Because then there’s the whole nonsense of just agreeing with something or strongly agreeing with something. Don’t forget about that. What is that supposed to mean and what am I supposed to read into that? Truth be told, there isn’t much that I strongly agree or disagree with, least of all the kinds of things that show up on these idiotic personality assessments. Like maybe if they said I like torturing helpless animals I could safely say that I strongly disagree with that statement. But the kind of equivocating crap that they load these assessments up with, I personally don’t see how anyone can have strong feelings about any of it, one way or the other.

But they clearly want you to have strong feelings about these things -- at least about some of them. If not, the choices wouldn’t even be there. They clearly think it’s important to know what you strongly agree with compared to what you just agree with, for what reason it’s not clear to me. What difference does it make if I agree or strongly agree that people think I’m an intellectual? Does strongly agreeing with that statement mean it is more likely to be true, or just that I think it is more likely to be true, or that I think being thought of as an intellectual is a very important thing?

And what about the number of strongly agrees or disagrees that show up on my scorecard? How is the test going to interpret that? Is it good or bad to have strong feelings about a lot of things? In my book, that’s not necessarily a good thing, as people who feel too strongly about too many things often swing too far and too quickly in whatever direction those strong feelings take them. Is that how I’m supposed to calibrate my responses? Pick some things to feel strongly about, but not too many?

Hey, I just realized. Maybe you can help answer these questions for me. You must use these stupid assessments in your line of work. Do you know how they work?

What? Oh, I see. State secrets, huh? Don’t let the test subject know how the grading system works. It stops being a valid test then. I get it.

What? Oh, you’re curious, aren’t you. Well, I did what I always do when someone puts me in their Skinner Box. I assume, probably without justification, that the scientist knows exactly what they are doing and that every word has been carefully chosen and calibrated to elicit exactly the response they’re looking for, so I play along. I stick rigidly to the absolute meaning of the words on the page in front of me, and I determine my level of agreement or disagreement as honestly as I can.

I suppose some people may consider me to be a bit of an intellectual. You know what? I agree. I suppose some people may consider me to be a bit of an intellectual. But I don’t feel strongly about it.

So that’s what took me forty-eight respectable minutes to do. Pamela then shook my hand, told me they would reach out again once my results were scrutinized, and sent me on my way. There was still several hours before my flight. I went back to the hotel where I had stored my bag, and had lunch in their lobby restaurant before picking it up.

“What can I get you?” the waitress asked me. She was an elderly woman, at least as old as my grandmother with her silver hair tightly permed and her eyebrows shaved off and inked in with grease pencil.

I didn’t even look at the menu. I told her to bring me the BLT, with a slice of avocado, if they had it, and a cup of the French onion soup. To drink? Unsweetened iced tea, with a slide of lemon.

I remember sitting there in a kind of blissful silence, willfully instructing my brain to quiet itself, to quit reading so much into everything I saw, and when the food came I ate it mechanically, slurping the soup and letting its warmth coat the back of my throat, and then chewing the sandwich, carefully isolating the taste of each ingredient on my tongue before swallowing and taking another bite.

When I was finished I picked up my bag from the bell desk and then caught a cab to the airport. In the cab I tried to call home, ready now, I felt, to have a conversation with Jenny and to tell her everything that had happened, but the phone just rang and rang, no one, not even the answering machine, bothering to pick it up.

At the airport I stood in the requisite lines and did the requisite things, picking up a bottle of water and a candy bar after clearing security and before settling down on one of the uncomfortable chairs in my designated gate area. There was still a good two hours before departure.

When my phone buzzed in my pocket I thought for sure it was Jenny calling back, but the number on the screen was unfamiliar to me.

“Hello?”

“Hello, Alan?”

“Yes?”

“Alan, this is Steve Anderson calling. How are you?”

Steve Anderson. It actually took me a few seconds to place the name. He was the chairman of the organization I had just interviewed with.

“I’m fine. How are you, Steve?”

Why the fuck was he calling me? Did I leave something behind? Did I accidentally set the building on fire as I left?

“Great. Say, are you in Logan airport right now?”

I stood up, suddenly intensely paranoid that I was being watched, that this was some kind of elaborate trick. “Yes. Yes, I sure am, Steve. Just waiting for my flight home.”

“Great. Say, Frank Zeidler is here with me, and we’re both in the Emerald Club. We were wondering if you would have time to come talk with us.”

“The Emerald Club?” I was still wildly scanning the area around me, desperately looking for the uniforms or the men in black who had come to detain me. “Sure. I mean, I guess so.”

“What time is your flight?”

I told him and Steve reassured me that they would have me back at my gate in plenty of time, and then he told me where I could find the Emerald Club and that they had left my name with the attendant at the front desk, and then he said he would see me in a few minutes, and then he said goodbye, and then he hung up.

I didn’t move for at least three minutes. Both my heart and my mind were racing, each trying to stay ahead of the other one and win a race that would end in either a stroke or a heart attack. Eventually realizing there was nothing else for me to do, and that I had already kept them waiting minutes longer than I should have, I began moving in the direction Steve had indicated. After six steps I had to go back for my carry-on and briefcase, and then I started moving again.

When I arrived at the Emerald Club it was just as Steve had promised. I had never been in one of the executive lounges at an airport -- such things were unavailable to anyone but Mary or Don in the company -- and I had no real idea what to expect when the frosted glass doors whooshed apart for me. Inside it was something like a hotel lobby, with a central teak wood table supporting an enormous floral arrangement dominated in whites and purples. Behind it stood a lattice like screen, apparently of the same teak, separating the lobby from the inner sanctum of the lounge itself. To the left and right were polished wooden counters in the same general stain, and behind each stood an airline employee, one man and one woman, each smiling happily and uniformed in something between crew and flight attendant.

“May I help you, sir?” the woman asked me, and I approached and gave her my name.

“Oh, yes,” she said, moving out from behind the counter. “Let me store those bags for you and I’ll show you to your meeting room.”

I stood like a coat rack as she took my carry-on from my hand and my briefcase from my shoulder, attaching a tag to each and then pressing the stub into my hand, giving me a look like it was her hotel room key.

“Won’t you please follow me?”

I did as instructed, catching a mischievous smile from her male colleague as we passed and entered the lounge itself. A broad set of windows looked out on the tarmac, a few planes moving slowly between gates under a cloudy sky, and inside a scattered collection of desks, chairs, and sofas, many of them occupied by men and women in business suits and with phones pressed against their ears. We seemed to skirt the edge of this common area and soon came to a row of private offices and conference rooms. One had its door standing ajar, and my guide instructed me to enter it with a graceful wave of her arm.

Inside I caught Steve Anderson and Frank Zeidler talking to each other. They were each seated in a pair of comfortable chairs -- the pair, a sofa, and a coffee table seemingly the only furnishings in the small room -- but upon seeing me, their conversation abruptly ended and Steve leapt to his feet.

“Alan!” he said. “Welcome! We’re so glad you could join us on such short notice. Can I get you something to drink?”

I looked and saw a clear-glass refrigerator under a built-in counter with a collection of alcoholic and non-alcoholic drinks inside. “Sure,” I said, forcing myself to adopt a jovial tone. “What are you guys having?”

“We’re drinking Amstel Lights,” Frank said. As before, his voice was like a tire deflating. “It’s about the best thing they have.”

But not too jovial. “That would be delightful,” I said.

Steve retrieved a third Amstel Light from the fridge, opened it with a bottle opener conveniently placed on a small banquet tray also holding a small ice bucket and a few glasses. Handing me the bottle, he motioned for me to take a seat and I did on the edge of the small sofa closest to them.

“Cheers,” he said, “holding up his own bottle and tipping it slightly in my direction.

Frank joined in on the toast and the three of us took a sip of beer out of each of our bottles. Despite having been in the fridge, mine was on the warm side and tickled my nose as the bubbles went down my throat.

“So, Alan,” Steve began. “You’re probably wondering what the kabuki show back in the office was all about.”

He paused, probably waiting for me to take the bait, but I didn’t. Something told me to just keep my mouth shut. I put my beer down on the coffee table. I smiled. I nodded.

“It’s Thompson,” Frank cut in sharply. “Much of what happened today was for his benefit. He’s been with the organization a long time and it’s important that he feels he has an active hand in the transition.”

Now that was something I should bite at. “Feels?”

“Touche,” Steve said, acknowledging their subterfuge. “We won’t hire anyone he hasn’t blessed, but the hiring decision is ours, not his. We respect his service, but Thompson long stopped looking forward and now only seems capable of looking backwards. We need something very different for the future.”

And with that, with the ice thus broken, Steve and Frank talked for the next ten minutes, each in turn almost as if reading from a prepared script, talking to me about their vision for the organization, how it needed to change, and the kind of person they were looking for to help make that change happen. My mind was strangely quiet, locked firmly in absorption mode, trying to soak up every word they were saying and keeping its wheels from spinning too quickly. Listen, some small inner voice was telling me. Listen carefully, but just listen. Don’t speak until they ask you to.

That time came quickly enough.

“Look, Alan, I’ll be honest with you,” Steve said, the tone of his voice enough to let me know he was summing up. “We’ve talked with several candidates, and we like the potential we see in you. It has been extremely helpful meeting you in person, but we’re not ready to move forward just yet. We’d like you to spend some time thinking about the things we’ve said today, and then we’d like to schedule a call with you. We want to hear your ideas. What you can bring to the table. What you can do to help us get to the place we want to be.”

“Do you think you can do that?” Frank said.

“Absolutely,” I said, easily, more easily, I hoped, than I felt inside. “I would welcome the opportunity.”

“Grand,” Steve said, as he and Frank stood in unison, forcing me to join them. He shook my hand. “We’ll be in touch. Sometime next week, my assistant Julie will reach out and get something on our calendars. From here on out, you’ll be working directly with just Frank and me.”

“Great,” I said, not knowing whether that was great or not.

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“Dragons” is a work of fiction. Names, characters, businesses, places, events, locales, and incidents are either the products of the author's imagination or used in a fictitious manner. Any resemblance to actual persons, living or dead, or actual events is purely coincidental. For more information, go here.

This post first appeared on Eric Lanke's blog, an association executive and author. You can follow him on Twitter @ericlanke or contact him at eric.lanke@gmail.com.

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The Emperor of All Maladies by Siddhartha Mukherjee

In some ways this book is a massive achievement -- a self-styled “biography of cancer,” in which the author lucidly and engrossingly takes us through several millennia of cancer understanding, diagnosis, and therapy.

But in other ways this book is a massive disappointment -- because it leaves the reader with the sense that not much has changed in those several thousand years. Then, as now, we treat the symptoms of cancer, but against its ultimate cause, we are seemingly as helpless as the ancients.

Therapy

Here’s a nice summary of the therapeutic side of the equation.

Recall Atossa, the Persian queen who likely had breast cancer in 500 BC. Imagine her traveling through time -- appearing and reappearing in one age after the next. She is cancer’s Dorian Gray: as she moves through the arc of history, her tumor, frozen in its stage and behavior, remains the same. Atossa’s case allows us to recapitulate past advances in cancer therapy and to consider its future. How has her treatment and prognosis shifted in the last four thousand years, and what happens to Atossa later in the new millennium?

First, pitch Atossa backward in time to Imhotep’s clinic in Egypt in 2500 BC. Imhotep has a name for her illness, a hieroglyph that we cannot pronounce. He provides a diagnosis, but “there is no treatment,” he says humbly, closing the case.

In 500 BC, in her own court, Atossa self-prescribes the most primitive form of a mastectomy, which is performed by her Greek slave. Two hundred years later, in Thrace, Hippocrates identifies her tumor as a karkinos, thus giving her illness a name that will ring through its future. Claudius Galen, in AD 168, hypothesizes a universal cause: a systemic overdose of black bile -- trapped melancholia boiling out as a tumor.

A thousand years flash by; Atossa’s entrapped black bile is purged from her body, yet the tumor keeps growing, relapsing, invading, and metastasizing. Medieval surgeons understand little about Atossa’s disease, but they chisel away at her cancer with knives and scalpels. Some offer frog’s blood, lead plates, goat dung, holy water, crab paste, and caustic chemicals as treatments. In 1778, in John Hunter’s clinic in London, her cancer is assigned a stage -- early, localized breast cancer or late, advanced, invasive cancer. For the former, Hunter recommends a local operation; for the latter, “remote sympathy.”

When Atossa reemerges in the nineteenth century, she encounters a new world of surgery. In Halsted’s Baltimore clinic in 1890, Atossa’s breast cancer is treated with the boldest and most definitive therapy thus far -- radical mastectomy with a large excision of the tumor and removal of the deep chest muscles and lymph nodes under the armpit and the collarbone. In the early twentieth century, radiation oncologists try to obliterate the tumor locally using X-rays. By the 1950s, yet another generation of surgeons learns to combine the two strategies, although tempered by moderation. Atossa’s cancer is treated locally with a simple mastectomy, or a lumpectomy followed by radiation.

In the 1970s, new therapeutic strategies emerge. Atossa’s surgery is followed by adjuvant combination chemotherapy to diminish the chance of a relapse. Her tumor tests positive for the estrogen receptor. Tamoxifen, the antiestrogen, is also added to prevent a relapse. In 1986, her tumor is further discovered to be Her-2 amplified. In addition to surgery, radiation, adjuvant chemotherapy, and tamoxifen, she is treated with targeted therapy using Herceptin.

Much of this sounds strikingly similar to me. Herceptin may be more efficacious than goat dung, but they’re both intended to treat the cancer instead of the patient. But Mukherjee assures us that significant progress has been made.

It is impossible to enumerate the precise impact of these interventions on Atossa’s survival. The shifting landscape of trials does not allow a direct comparison between Atossa’s fate in 500 BC and her fate in 1989. But surgery, chemotherapy, radiation, hormonal therapy, and targeted therapy have likely added anywhere between seventeen and thirty years to her survival. Diagnosed at forty, say, Atossa can reasonably be expected to celebrate her sixtieth birthday.

And there is more to come -- although note Mukerjee’s use of the word “management.”

In the mid-1990s, the management of Atossa’s breast cancer takes another turn. Her diagnosis at an early age and her Achaemenid ancestry raise the question of whether she carries a mutation in BRCA-1 or BRCA-2. Atossa’s genome is sequenced, and indeed, a mutation is found. She enters an intensive screening program to detect the appearance of a tumor in her unaffected breast. Her two daughters are also tested. Found positive for BRCA-1, they are offered either intensive screening, prophylactic bilateral mastectomy, or tamoxifen to prevent the development of invasive breast cancer. For Atossa’s daughters, the impacts of screening and prophylaxis are dramatic. A breast MRI identifies a small lump in one daughter. It is found to be breast cancer and surgically removed in its early, preinvasive stage. The other daughter chooses to undergo a prophylactic bilateral mastectomy. Having excised her breasts preemptively, she will live out her life free of breast cancer.

Indeed, these are all “management” techniques. Ways to mitigate the impact of the disease, not ways to prevent it from happening, or to stop it from having its deadly effects. And when Mukerjee takes Atossa into the future, not much will change.

Move Atossa into the future now. In 2050, Atossa will arrive at her breast oncologist’s clinic with a thumb-size flash drive containing the entire sequence of her cancer’s genome, identifying every mutation in every gene. The mutations will be organized into key pathways. An algorithm might identify the pathways that are contributing to the growth and survival of her cancer. Therapies will be targeted against these pathways to prevent a relapse of the tumor after surgery. She will begin with one combination of targeted drugs, expect to switch to a second cocktail when her cancer mutates, and switch again when the cancer mutates again. She will likely take some form of medicine, whether to prevent, cure, or palliate her illness, for the rest of her life.

I’ll forgive Mukherjee’s use of the word “cure” in that last sentence -- coming in at the end like some kind of Hail Mary pass -- because the larger question is much more compelling. Why? Why is the future so much like the past, and why does that word “cure” seem so out of place?

Mukherjee is not oblivious to this painful reality. He concludes this summary with the following thoughts:

This, indubitably, is progress. But before we become too dazzled by Atossa’s survival, it is worthwhile putting it into perspective. Give Atossa metastatic pancreatic cancer in 500 BC and her prognosis is unlikely to change by more than a few months over twenty-five hundred years. If Atossa developed gallbladder cancer that is not amenable to surgery, her survival changes only marginally over centuries. Even breast cancer shows a marked heterogeneity in outcome. If Atossa’s tumor has metastasized, or is estrogen-receptor negative, Her-2 negative, and unresponsive to standard chemotherapy, then her chances of survival will have barely changed since the time of Hunter’s clinic. Give Atossa CML or Hodgkin’s disease, in contrast, and her life span may have increased by thirty or forty years.

Part of the unpredictability about the trajectory of cancer in the future is that we do not know the biological basis for this heterogeneity. We cannot yet fathom, for instance, what makes pancreatic cancer or gallbladder cancer so markedly different from CML or Atossa’s breast cancer. What is certain, however, is that even the knowledge of cancer’s biology is unlikely to eradicate cancer fully from our lives. As Doll suggests, and as Atossa epitomizes, we might as well focus on prolonging life rather than eliminating death. This War on Cancer may best be “won” by redefining victory.

It’s a fair point -- but one that became increasingly frustrating for me while I read this book. Mukherjee says we still do not understand the biological basis of cancer. To me, that means that, after several millennia, we still do not understand why cancer happens. We increasingly know what to do when we see it, and in some cases prevent it from appearing, but when it does appear, no one in Mukherjee’s long history, from Atossa to Doll, can definitively tell us why.

Etiology

The book will get us pretty close. When it gets down into the molecular and genetic nitty-gritty of what’s going on in an organism, one feels like we are getting tantalizingly close. But that final leap, from cause to effect, remains obscure.

By the early 1990s, cancer biologists could begin to model the genesis of cancer in terms of molecular changes in genes. To understand that model, let us begin with a normal cell, say a lung cell that resides in the left lung of a forty-year-old fire-safety-equipment installer. One morning in 1968, a minute sliver of asbestos from his equipment wafts through the air and lodges in the vicinity of that cell. His body reacts to the sliver with an inflammation. The cells around the sliver begin to divide furiously, like a miniscule wound trying to heal, and a small clump of cells derived from the original cell arises at the site.

There. That was it. Did you miss it? His body reacts to the sliver with an inflammation. That’s an example of how close cause will come to effect in this book, but it still doesn’t tell us what we really want to know. Why? Why does the body react to the sliver with an inflammation? Does the sliver cause the inflammation to occur? And if so, how? What does it actually do to make the inflammation occur?

We don’t know. But I’m going to relay the rest of Mukherjee’s story about this fire-safety-equipment installer -- one of Mukherjee’s actual patients -- not because it tells us any more whys or hows, but because it tells us a lot about the process that gives rise to cancer, and reveals how that process is surprisingly difficult and achingly random.

In one cell in that clump an accidental mutation occurs in the ras gene. The mutation creates an activated version of ras. The cell containing the mutant gene is driven to grow more swiftly than its neighbors and creates a clump within the original clump of cells. It is not yet a cancer cell, but a cell in which uncontrolled cell division has partly been unleashed -- cancer’s primordial ancestor.

A decade passes. The small collection of ras-mutant cells continues to proliferate, unnoticed, in the far periphery of the lung. The man smokes cigarettes, and a carcinogenic chemical in tar reaches the periphery of the lung and collides with the clump of ras-mutated cells. A cell in this clump acquires a second mutation in its genes, activating a second oncogene.

There. There it is again. A cell in this clump acquires a second mutation. From what? From its “collision” with a “carcinogenic chemical.” What does that mean? And how does that cause a cell to mutate?

Another decade passes. Yet another cell in that secondary mass of cells is caught in the path of an errant X-ray and acquires yet another mutation, this time inactivating a tumor suppressing gene. This mutation has little effect since the cell possesses a second copy of that gene. But in the next year, another mutation inactivates the second copy of the tumor suppressor gene, creating a cell that possesses two activated oncogenes and an inactive tumor suppressor gene.

Now a fatal march is on; an unraveling begins. The cells, now with four mutations, begin to outgrow their brethren. As the cells grow, they acquire additional mutations and they activate pathways, resulting in cells even further adapted for growth and survival. One mutation in the tumor allows it to incite blood vessels to grow; another mutation within this blood-nourished tumor allows the tumor to survive even in areas of the body with low oxygen.

Are you following this? We’re twenty-plus years in with six genetic mutations - each, evidently, an unlikely and random occurrence. And the man, now sixty-something, is still oblivious as to what is going on.

Mutant cells beget cells beget cells. A gene that increases the mobility of the cells is activated in a cell. This cell, having acquired motility, can migrate through the lung tissue and enter the bloodstream. A descendent of this mobile cancer cell acquires the capacity to survive in the bone. This cell, having migrated through the blood, reaches the outer edge of the pelvis, where it begins yet another cycle of survival, selection, and colonization. It represents the first metastasis of a tumor that originated in the lung.

The man is occasionally short of breath. He feels a tingle of pain in the periphery of his lung. Occasionally, he senses something moving under his rib cage when he walks. Another year passes, and the sensations accelerate. The man visits a physician and a CT scan is performed, revealing a rindlike mass wrapped around a bronchus in the lung. A biopsy reveals lung cancer. A surgeon examines the man and the CT scan of the chest and deems the cancer inoperable. Three weeks after that visit, the man returns to the medical clinic complaining of pain in his ribs and his hips. A bone scan revealed metastasis to the pelvis and the ribs.

You know what comes next. Time to treat those nasty symptoms.

Intravenous chemotherapy is initiated. The cells in the lung tumor respond. The man soldiers through a punishing regimen of multiple cell-killing drugs. But during the treatment, one cell in the tumor acquires yet another mutation that makes it resistant to the drug used to treat the cancer. Seven months after his initial diagnosis, the tumor relapses all over the body -- in the lungs, the bones, the liver. On the morning of October 17, 2004, deeply narcotized on opiates in a hospital bed in Boston and surrounded by his wife and his children, the man dies of metastatic lung cancer, a sliver of asbestos still lodged in the periphery of his lung. He is seventy-six years old.

Treat them, that is, until the patient dies. For many forms of cancer, that seems to be all that medicine can currently do.

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This post first appeared on Eric Lanke's blog, an association executive and author. You can follow him on Twitter @ericlanke or contact him at eric.lanke@gmail.com.

Dragons - Chapter 64 (DRAFT)

Pamela was strangely silent as she escorted me back to my conference room, exuding the exact opposite of the chipper confidence she had after my meeting with Mister Thompson. I fell into step half a pace behind her, feeling exactly like I had screwed something up but not knowing exactly what it was. Looking out over the sea of work cubes, I saw far more heads up over the sight line, far more faces turned towards me, each bearing a blank and uncertain expression.

At the door to my conference room, Pamela stepped aside so I could enter and, when I had, simply told me to “wait here,” and then closed the door with me on the inside and her on the other.

I let out a deep breath. I had admittedly not interviewed for a job in more than a decade, but this so far had been about the strangest interview I had ever been through. It barely felt like an interview at all. Looking at my watch I saw that I had been there for just over two hours, and I estimated that I had only spent about ten minutes answering the kind of questions that could have reasonably been considered part of an actual interview. Everything and everyone else had felt more like an obstacle course -- one that no one had shown me in advance and in which I had no idea what time I was trying to beat as I raced through it.

Not knowing how long I was going to be there and not having anything else to do, I decided to go over and closely examine the framed black and white photo I had only glimpsed before. I was not surprised to see that it was similar to all of those that Thompson had shown me in his office, but it was somewhat larger than any of those. And it was old. Maybe the oldest of all the ones I had seen. It was a wide shot of a hotel ballroom, taken from a balcony, with forty or more figures seated around a series of banquet tables, each and every one of them looking up at the photographer. They were all men, and they were all dressed in formal wear, the deep black of their tuxedo jackets contrasting starkly against the lighter shades of the tablecloths and their shirt fronts. A set of white block letters, standing in the bottom corner, and written apparently by a slanting hand with a fine brush, proclaimed quietly:

FIRST ANNUAL MEETING, 1953
EMPIRE BALLROOM
WALDORF-ASTORIA, NEW YORK

I forced my eyes to move slowly from face to face. They were people from another era, but in their facial features and expressions they seemed as normal as any group of similar men that you could assemble today. Some heavy, some thin. Some dark-haired, some light. Some smiling, some deadly serious.

I felt my phone buzzing in my pocket and I brought it out to see my home number on its little screen.

“Hello?”

“Hello, Alan?” Jenny’s voice said in my ear as I continued to study the photo. “Can you talk? Is the interview over?”

“I don’t know,” I said, completing my tour of faces and finding myself surprised to discover that none of them resembled what a fresh-faced young Mister Richard Thompson would have looked like at the time.

“What do you mean, ‘you don’t know’? Is it over or not?”

“I don’t know,” I said again, pulling my eyes away from the past and trying to explain to her what had happened so far that morning.

“So you’re just supposed to wait there?”

“Apparently.”

“Mommy!” I heard Jacob’s shrill voice shout in the background.

“For how long?” Jenny asked.

“They haven’t told me.”

“How do you think it’s going?”

“Mommy!” Jacob wailed again, this time much closer and with extra anguish.

“Jacob, honey, Mommy’s on the phone with Daddy right now.”

I began to answer Jenny’s question, but stopped when Jacob began shouting and crying again, this time not even bothering to form words.

“Jacob, get down!” Jenny shouted, and then the phone must have slipped out of her grasp because I heard it clunk and clatter on our hardwood floor. “Jacob! Goddammit!”

I stood patiently, feeling some unfocused anger growing within me, but taking some deep breaths and telling myself to calm down. In a moment, Jenny was back on the line, but it was only to tell me to hang on, hang on just a minute, and then the phone clunked again as if being set down on a table. There was rustling, then footsteps, and both shouting and crying, all of it quickly fading off into the distance.

I turned back to the Empire Ballroom, and tried to imagine myself sitting there among those tuxedoed titans. One guy, I noticed, had a fat cigar captured between two thick fingers, and I put myself at his table, between him and another guy that looked more like a university professor, his bow-tied shirt collar hanging loosely in front of his scrawny neck. What, I wondered, had they been talking about before and after the photographer clicked this photo? What was happening in the stock market? How much they did or didn’t like the way Ike was running the country? Their summer cottages in upstate New York? Everything that came into my mind seemed like a cliche, something a stranger would graft thoughtlessly upon another stranger. Surely, like me, these forgotten men had had inner lives that were important to them. They must have had thoughts of esoteric value and worth, and they must have had relationships that both expressed and fell short of those ideals.

“Alan?” Jenny’s voice was again in my ear. “Alan, are you still there?”

“Yes, Jenny. I’m still here.”

“Sorry about that. Jacob needed me.”

“Uh huh. Look, I should go. I don’t know when they’re going to come back for me.”

“Okay. But how do you think it’s going?”

“Jenny, I have no idea. This is about the strangest experience I’ve ever been through.”

“Okay,” she said. “Well, call me when you’re done.”

“Sure will.”

“Bye.”

“Bye.”

After putting the phone back in my pocket I stood there in silence for perhaps two minutes. I even closed my eyes and strained my ears to pick up any sounds that might be happening in the office on the other side of my conference room door. There was nothing -- at least nothing that I could detect.

Eventually, I took a seat in one of the conference room chairs. Clearing my mind, I opened my padfolio and looked down at the extra copies of my resume that I had brought with me. No one had asked for them, so there they still sat, paper-clipped together in a tight little packet, my name boldly printed across the top of each of them. Setting them aside I revealed the legal pad beneath, on which I had written several questions that I had intended to ask.

What’s the biggest challenge facing this organization?

How would you describe the culture of the Board?

What three things must the new CEO accomplish in the first year in order to be successful?

I had put a lot of thought into those questions, and they still seemed like good ones to me, but I hadn’t had the chance to ask any of them yet. I suddenly wondered if I ever would.

I flipped to a fresh page on the legal pad and picked up the pen. I didn’t know what else to do so I started writing down whatever came into my mind.

No circumstances
Could have prepared me for this
Hope I’m doing fine

I was busy counting the syllables, making sure it was actually a haiku, when the conference room door suddenly opened and Pamela came bursting back into the room.

“Not kept waiting too long, I hope,” she said, her tone back to co-conspirator mode, and quickly took a seat opposite me.

I closed the padfolio on my awful poetry. “No, not at all.”

“Well, well,” Pamela said, “it seems you made quite an impression on them. I knew you would, I knew you would.”

I nodded my head and smiled. “Are they done already?”

“Yes, of course, of course. They are completely done and have made an important decision.” She brought a manilla folder she must have walked in with up from her side and placed it on the table between us.

I looked at my watch, noting that it couldn’t have been more than twelve minutes since I left the Executive Committee. “They are? Did they even bother talking to the third candidate?”

“Excuse me?”

“The third candidate. Weren’t they going to interview someone else after me?”

Pamela’s face actually went pale. “Yes, yes, well, let’s not worry about that. The Executive Committee is, ummm, is meeting with that person as we speak, but they have still already made an important decision. You are moving on to the next step of the process.”

“I am?”

“You are, you are. Here,” Pamela said, sliding the folder across the table to me, “inside this folder you will find a short assessment tool. It’s important for you to complete it as quickly and as honestly as you can.”

I opened the folder. Inside was a paper booklet, printed on something close to newsprint and stapled bound on the left margin, and a single sheet of thicker paper, bearing several hundred small pale red circles and obviously designed for use in an optical recognition scanner.

“Do you need to use the restroom, or do you need a glass of water? Once you begin, we must ask that you work straight through until you finish. I will sit here quietly while you work in order to ensure there is no funny business -- but, of course, there won’t be! My apologies, protocol requires me to say that, but it is a mere formality in your case, I am sure. Just let me know when you are ready to start and I will begin the timer. You will have 60 minutes to complete the assessment, no more, no less -- but, again, I’m sure that such a time limit will be unnecessary for someone of your experience. Do you have a pencil?”

While Pamela spoke I had begun flipping through the booklet, and quickly released that I was facing one of those standardized tests -- some kind of personality assessment, the kind that was intended to trick people into revealing the anti-social tendencies that actually lay under their phony attestations of teamwork and growth that otherwise comprised their interview talk. There were several dozen such assessments on the market, some more well known than others. I had never heard of this one before, but the questions were all too familiar both in their structure and their vagueness. My eye picked one out at random.

I suppose some people may consider me to be a bit of an intellectual.

I was supposed to strongly disagree, disagree, agree, or strongly agree with that statement. Flipping further through the booklet, I saw that there were more than 200 other such statements I would need to respond to.

“Alan?”

“Yes?” I said, looking up at Pamela.

“Do you have a pencil? You will need a number two pencil in order to complete the response sheet.”

“No,” I said. “I don’t have a pencil.”

“I’ll get you one,” Pamela said smiling, patting my hand reassuringly, before rising from her chair. “I’ll be right back.”

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“Dragons” is a work of fiction. Names, characters, businesses, places, events, locales, and incidents are either the products of the author's imagination or used in a fictitious manner. Any resemblance to actual persons, living or dead, or actual events is purely coincidental. For more information, go here.

This post first appeared on Eric Lanke's blog, an association executive and author. You can follow him on Twitter @ericlanke or contact him at eric.lanke@gmail.com.

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A Distant Mirror by Barbara W. Tuchman

I had a really hard time getting into this one. Which is a bit of a disappointment, since I fondly remember reading two of Tuchman’s other works -- The Guns of August and The March of Folly.

A Distant Mirror is subtitled “The Calamitous 14th Century,” and it tries to be a history of that century, but I think it fails in three very crucial ways. And all three of these issues are things Tuchman confesses to in her Foreword.

First, right out of the gate, A Distant Mirror is not the book she wanted it to be.

The genesis of this book was a desire to find out what were the effects on society of the most lethal disaster of recorded history -- that is to say, of the Black Death of 1348-50, which killed an estimated one third of the population living between India and Iceland. Given the possibilities of our own time [Tuchman is writing in 1978], the reason for my interest is obvious. The answer proved elusive because the 14th century suffered so many “strange and great perils and adversities” (in the words of a contemporary) that its disorders cannot be traced to any one cause; they were the hoofprints of more than the four horsemen of St. John’s vision, which had now become seven -- plague, war, taxes, brigandage, bad government, insurrection, and schism in the Church. All but plague itself arose from conditions that existed prior to the Black Death and continued after the period of the plague was over.

Although my initial question has escaped an answer, the interest of the period itself -- a violent, tormented, bewildered, suffering and disintegrating age, a time, as many thought, of Satan triumphant -- was compelling and, as it seemed to me, consoling in a period of similar disarray. If our last decade or two of collapsing assumptions has been a period of unusual discomfort, it is reassuring to know that the human species has lived through worse before.

So, in other words, Tuchman wants me to know that what I’m about to read is a story she learned along way as she vainly pursued a much more interesting story. Great. Buckle in for something long and rambly.

Which, to Tuchman’s credit, she tries to head off at the pass by focusing the story around a single protagonist -- someone who, through his eyes, we can try to make better sense of all the disarray she’s about to describe.

To narrow the focus to a manageable area, I have chosen a particular person’s life as the vehicle of my narrative. Apart from human interest, this has the advantage of enforced obedience to reality. I am required to follow the circumstances and the sequence of an actual medieval life, lead where they will, and they lead, I think, to a truer version of the period than if I had imposed my own plan.

But there is a problem -- the second problem in our list. We don’t make the acquaintance of Tuchman’s chosen protagonist -- Enguerrand de Coucy VII -- until Chapter 7, and even then, he never really strikes me as more than a single star in a vast constellation of other French and English knights, noblemen, popes, and kings. The cast of characters is a little like that in Game of Thrones, where everyone goes by the same four or five last names. Now, which Coucy is this guy again?

And the third difficulty is that the characters are extremely difficult for modern readers to relate to, since they, and the age they live in, are so different from us and the one we live in. Here, Tuchman herself makes this point.

Difficulty of empathy, of genuinely entering into the mental and emotional values of the Middle Ages, is the final obstacle. The main barrier is, I believe, the Christian religion as it then was: the matrix and law of medieval life, omnipresent, indeed compulsory. Its insistent principle that the life of the spirit and of the afterworld was superior to the here and now, to material life on earth, is one that the modern world does not share, no matter how devout some present-day Christians may be. The rupture of this principle and its replacement by belief in the worth of the individual and of an active life not necessarily focused on God is, in fact, what created the modern world and ended the Middle Ages.

So what are we left with? A second-hand tale, cobbled together from pieces that never cohered as intended, framed around an elusive protagonist who, when he does manifest, acts is ways difficult for us to understand or sympathize with. How’s that sound? It’s what you’ll get if you decide to pick up A Distant Mirror.

The Lure of Earthly Things

All that said, there are some interesting tidbits that can be drawn out of the text. As more fully described in The March of Folly, there is the catastrophic excesses of the medieval Catholic Church which, of course, leads to the Protestant Reformation.

The conflict between the reach for the divine and the lure of earthly things was to be the central problem of the Middle Ages. The claim of the Church to spiritual leadership could never be made wholly credible to all its communicants when it was founded in material wealth. The more riches the Church amassed, the more visible and disturbing became the flaw; nor could it ever be resolved, but continued to renew doubt and dissent in every century.

One formative lesson for me came in the reading of a biography of Theodore Roosevelt who, like many “conservatives” of his day, grew concerned about the increasing wealth disparity of his age, fearing that it would lead to revolution and anarchy.

Oppression of the peasant by the landowner troubled the conscience of the time and evoked warnings. “Ye nobles are like ravening wolves,” wrote Jacques de Vitry, a 13th century author of sermons and moral tales. “Therefore shall ye howl in hell … who despoil your subjects and live on the blood and sweat of the poor.” Whatever the peasant amasses in a year, “the knight, the noble devours in an hour.” He imposes illicit taxes and heavy exactions. De Vitry warned the great not to scorn the humble or inspire their hate for “if they can aid us, they can also do us harm. You know that many serfs have killed their masters or have burned their houses.”

This juxtaposition, I think, is why Tuchman chose her title. In this and many other ways, the 14th century appears like a distant mirror to the early 20th -- and perhaps even today.

The ubiquitous and oppressive Christianity of the age led to a lot of strange circumstances. Here’s a brief footnote that surprised me, but perhaps shouldn’t have.

[Jews] maintained a place in society because as moneylenders they performed a role essential to the kings’ continuous need of money. Excluded by the guilds from crafts and trades, they had been pushed into petty commerce and moneylending although theoretically barred from dealing with Christians. Theory, however, bends to convenience, and Jews provided Christians with a way around their self-imposed ban on using money to make money.

Since they were damned anyway, they were permitted to lend at interest rates of 20 percent and more, of which the royal treasury took the major share. The increment to the crown was in fact a form of indirect taxation; as its instruments, the Jews absorbed an added measure of popular hate. They lived entirely dependent upon the king’s protection, subject to confiscations and expulsions and the hazards of royal favor. Nobles and prelates followed the royal example, entrusting money to the Jews for lending and taking most of the profits, while deflecting popular resentment upon the agent. To the common man the Jews were not only Christ-killers but capricious, merciless monsters, symbols of the new force of money that was changing old ways and dissolving old ties.

Yes, you read all of that right. Christians -- including Christian kings -- banned by their religion from usury, worked in close partnership with Jews to finance their exploits, all the while damning the Jews for their moneylending practices and for their legendary hostility to Christ and his followers. If one holds that distant mirror up to our modern society, one might cite the way some U.S. administrations financed political wars in foreign countries through the production and selling of illegal drugs, only to wage their own rhetorical war against the scourge that those drugs brought to their society.

A Strange Personification of Death

But the most fascinating parts of Tuchman’s narrative have to be those that deal with the cultural effect that the Black Death had on the people of Europe.

A strange personification of Death emerged from the plague years on the painted walls of the Camposanto in Pisa. The figure is not the conventional skeleton, but a black-cloaked old woman with streaming hair and wild eyes, carrying a broad-bladed murderous scythe. Her feet end in claws instead of toes. Depicting the Triumph of Death, the fresco was painted in or about 1350 by Francesco Traini as part of a series that included his scenes of the Last Judgement and the Tortures of Hell. The same subject, painted at the same time by Traini’s master, Andrea Orcagna, in the church of Santa Croce in Florence, has since been lost except for a fragment. Together the frescoes marked the start of a pervasive presence of Death in art, not yet the cult it was to become by the end of the century, but its beginning.

This is significant.

Usually Death was personified as a skeleton with hourglass and scythe, in a white shroud or bare-boned, grinning at the irony of man’s fate reflected in his image: that all men, from beggar to emperor, from harlot to queen, from ragged clerk to Pope, must come to this. No matter what their poverty or power in life, all is vanity, equalized by death. The temporal is nothing; what matters is the after-life of the soul.

This is the view that dominated the age, and it was reflected as such in the art that came before the plague. But now, in the Traini fresco and in many other works to come, the brutal facts of this allegory will become stamped with a crusted and gruesome reality.

In Traini’s fresco, Death swoops through the air toward a group of carefree, young, and beautiful noblemen and ladies who, like models for Boccaccio’s storytellers, converse and flirt and entertain each other with books and music in a fragrant grove of orange trees. A scroll warns that “no shield of wisdom or riches, nobility or prowess” can protect them from the blows of the Approaching One. “They have taken more pleasure in the world than in things of God.” In a heap of corpses nearby lie crowned rulers, a Pope in tiara, a knight, tumbled together with the bodies of the poor, while angels and devils in the sky contend for the miniature naked figures that represent their souls. A wretched group of lepers, cripples, and beggars (duplicated in the surviving fragment of Orcagna), one with nose eaten away, others legless or blind or holding out a cloth-covered stump instead of a hand, implore Death for deliverance. Above on a mountain, hermits leading a religious contemplative life await death peaceably.

Below in a scene of extraordinary verve a hunting party of princes and elegant ladies on horseback comes with sudden horror upon three open coffins containing corpses in different stages of decomposition, one still clothed, one half-rotted, one a skeleton. Vipers crawl over their bones. The scene illustrates “The Three Living and Three Dead,” a 13th century legend which tells of a meeting between three young nobles and three decomposing corpses who tell them, “What you are, we were. What we are, you will be.” In Traini’s fresco, a horse catching the stench of death stiffens in fright with outstretched neck and flaring nostrils; his rider clutches a handkerchief to his nose. The hunting dogs recoil, growling in repulsion. In their silks and curls and fashionable hats, the party of vital handsome men and women stare appalled at what they will become.

Death, no longer the abstract equalizer held at bay for decades of distraction and comfort, now flies among us, striking us down with all the ambivalence long foretold.

Violence Official As Well As Individual

Tuchman makes the point that the ubiquity of death from plague changed the art of the day, but it is a lot less clear whether it had other effects on the surrounding culture. One would like to attribute the horrific violence of the time with the increasing uncertainty of life, but in more ways than not, it seems like violence predated the scourge of the Black Death.

In England coroners’ rolls showed manslaughter far ahead of accident as cause of death, and more often than not the offender escaped punishment by obtaining benefit of clergy through bribes or the right connections. If life was filled with bodily harm, literature reflected it. One of La Tour Landry’s cautionary tales for his daughters tells of a lady who ran off with a monk and, upon being found in bed with him by her brothers, they “took a knife and cut away the monk’s stones and threw them in the lady’s face and made her eat them and afterwards tied both monk and lady in a sack with heavy rocks and cast them into a river and drowned them.” Another tale is of a husband who fetched his wife back from her parents’ house, where she had fled after a marital quarrel. While lodged overnight in a town on the way home, the lady was attacked by a “great number of young people wild and infect with lechery” who “ravished her villainously,” causing her to die of shame and sorrow. The husband cut her body into twelve pieces, each of which he sent with a letter to certain of her friends that they might be made ashamed of her running away from her husband and also be moved to take vengeance on her ravishers. The friends at once assembled with all their retainers and descended upon the town where the rape had occurred and slew all its inhabitants.

I’m a little surprised that Tuchman didn’t reference the Bible story in Judges 19 on which this latter tale is obviously based, but I guess that’s not relevant to the larger point she is trying to make: that the literature reflected the violence of the time. And frankly, if she only cited stories such as this, I’m not sure I would’ve believed that the 14th century was any more violent than our own (I mean, have you ever seen a Marvel movie?). But she goes on to make the case that the violence of the time was something far beyond just popular entertainment.

Violence was official as well as individual. Torture was authorized by the Church and regularly used to uncover heresy by the Inquisition. The tortures and punishments of civil justice customarily cut off hands and ears, racked, burned, flayed, and pulled apart people’s bodies. In everyday life passersby saw some criminal flogged with a knotted rope or chained upright in an iron collar. They passed corpses hanging on the gibbet and decapitated heads and quartered bodies impaled on stakes on the city walls. In every church they saw pictures of saints undergoing varieties of atrocious martyrdom -- by arrows, spears, fire, cut-off breasts -- usually dripping blood. The Crucifixion with its nails, spears, thorns, whips, and more dripping blood was inescapable. Blood and cruelty were ubiquitous in Christian art, indeed essential to it, for Christ became Redeemer, and the saints sanctified, only through suffering violence at the hands of their fellow man.

In village games, players with hands tied behind them competed to kill a cat nailed to a post by battering it to death with their heads, at the risk of cheeks ripped open or eyes scratched out by the frantic animal’s claws. Trumpets enhanced the excitement. Or a pig enclosed in a wide pen was chased by men with clubs to the laughter of spectators as he ran squealing from the blows until beaten lifeless. Accustomed in their own lives to physical hardship and injury, medieval men and women were not necessarily repelled by the spectacle of pain, but rather enjoyed it. The citizens of Mons bought a condemned criminal from a neighboring town so that they should have the pleasure of seeing him quartered. It may be that the untender medieval infancy produced adults who valued others no more than they had been valued in their own formative years.

This is something else entirely. Less a distant mirror, and more a looking glass into a strange and brutal Wonderland.

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This post first appeared on Eric Lanke's blog, an association executive and author. You can follow him on Twitter @ericlanke or contact him at eric.lanke@gmail.com.