The Left Atrium

presence in the patient’s final days, and In their introduction, the authors dying,” A Few Months to Live offers a that personal relationships remain a ask, “What individual and collective re- moving, provocative and frank response primary source of care for people who sponsibility do we have toward people to these questions. are terminally ill. The narratives of who are dying, family members, family members, close friends and in- friends, neighbours? What value is Patricia Boston formal caregivers reflect strength, wis- there in the last phase of life? Can there Associate Director, Education dom, empathy and active listening, as be any value in the process of dying?” McGill Programs in Integrated well as loving support and care. This is In striving to provide narrative accounts Whole Person Care a welcome balance against our tendency that extend “beyond the usual cate- Department of Oncology to professionalize human problems. gories of facts and figures of death and McGill , Montreal

Lifeworks “If the soul is nourished …”

s a child of a warrior serve and restore the country’s heritage Aand an adult media junkie I arrived (except churches of course, the most in Moscow with a burden of precon- magnificent of which, Christ the Re- ceptions. I anticipated a grey city where deemer, was literally blown apart). Com- most residents lived in poverty, beset by munist celebrated the existing Wild West–style crime and great un- culture that fit its ideals and fostered its certainty. Unfortunately for Mus- own brand of art. Artists, at least those covites, I found this was more or less with the right politics, were revered and true, but I also discovered something were given the choicest apartments and quite extraordinary: the residents’ pas- other perks. Of course, art often served sion for the arts, education and culture. the “greater purpose” by glorifying From candy-bar wrappers adorned with Communist ideals. Thus, peasants, fac- replicas of Russian classics, to metro tory workers and heroes of the Revolu- stations that look like palaces, to statues tion were commonly depicted in works of literary greats seemingly dominating of art. Not that state- or church-spon- every corner, residents enjoy a daily sored art is anything new; indeed, dose of a rich cultural heritage. for 600 years (until the 17th century) This cultural richness stems, at least Russian art was predominately ecclesias- Barb Sibbald Pushkin gazes at a Martini advertise- in part, from Lenin’s law to cherish, pre- tical. And, one could argue, in times ment in Tverskaya Square of widespread poverty this sort of sponsorship is the only thing that allows art This cultural legacy of Communism to exist. But in Communist endures. A decade after the USSR was Russia, art was also creat- dissolved, this sprawling low-rise city of ed for sheer aesthetic plea- 10 million still features more than 40 sure. The Diamond Fund, a museums and galleries, documenting repository of the former history, art, the metro, architecture, lit- ’s biggest and erary heroes and even vandalism. most remarkable gems, for Moscow also has seven large classical example, contains a three- music concert halls, plus the world-

Barb Sibbald metre long section of Sov- famous Bolshoi Theatre, and more than Detail from a depiction of Stalin’s in iet-era jewellery that 50 big theatrical companies, including Moscow’s Graveyard of the Fallen Monuments. includes an exquisitely the 60-year-old Gypsy Theatre. This “graveyard” contains some of the sculptures wrought fireworks-shaped The Muscovites I got to know are removed from around Moscow at the end of the brooch. These pieces have extremely proud of this cultural rich- Soviet era — mostly because they were being van- never been worn; they were ness. “When we were growing up [in dalized — and provides an outdoor atelier for pre- created to perpetuate the the 1960s and 70s], we were told that sent-day sculptors. Ironically, this work is placed jeweller’s craft for the en- your personal success wasn’t important, behind a giant, slightly damaged statue of Stalin. joyment of all. your personal development was,” says

CMAJ • FEB. 5, 2002; 166 (3) 357 De l’oreille gauche

Larissa Mahotkina, a travel agent who the failure of the political experiment, Arts offers Egyptian treasures, a half- emigrated to Canada in the mid 1990s. but also because of the severe loss of fi- dozen Rembrandts, and Impressionist Conversation, art, culture, reading and nancial security during the past decade, masterpieces. In June the museum held education were prized. “We might have particularly in the early 1990s an Andy Warhol retrospec- only a loaf of bread, but we’d invite peo- when some 50 million Rus- tive. Across the Moskva ple for dinner and talk until morning.” sians lost their savings in pyra- River, the State Tretyakov “We were much more dissident mid schemes. Gallery houses the world’s thinkers than you may know,” added But Pavluk hopes this re- foremost collection of Marina Pavluk, our multilingual tour spect for art and culture, Russian art, 100 000 works guide who has been working in tourism which predates Communism, ranging from 12th-century since 1974. will endure under capitalism. icons, such as the famous They were also well educated. Half “There is a Russian belief that Trinity by Andrei Rublev, the population has a diploma or art is immortal and a reflection to Alexander Ivanov’s 19th- university degree, according to 1989 gov- of what is going on.” That is, century masterpiece, The ernment statistics. Education was free art helps people make sense of Appearance of Christ to the and highly valued. These women talk their world, past and present. People, which took him 20 Barb Sibbald about events during their 850-year his- Preserving this respect will An elegant choco- years to complete, to the tory, such as the debate over why Ivan be a challenge. Moscow’s cul- late bar Russian Avant-Garde of the Terrible murdered his son, as though ture is rapidly being under- the 1910s with works by it happened last week. Every mined on the fast track to de- Marc Chagall and Wassily 1, National Knowledge Day, all students mocratic capitalism. Support of the arts Kandinsky. But accessibility is being go to school to celebrate the start of and sciences has been reduced, and the threatened. A third of the tickets to the classes — or so claimed the 15-year-old country’s best composers, mathemati- Bolshoi used to be held for students and daughter of a Mus- cians, physicists, musi- pensioners; now many of these are covite friend. During cians and scientists are scalped. One would be lucky to get a our tour of the Pushkin leaving in an unprece- ticket for US$30, far beyond the reach of Museum of Fine Arts, dented — but largely many people in a city where the average she espoused at length undocumented — income is about US$100 a month. Cin- about the innovative brain drain. Advertise- ema is popular, but where documentaries artist Mikhail Vrubel ments (unheard of and art films were once shown, today (1856–1910), whose three years ago) now 80% of the films are American and, as work was influenced by blight the urban land- Pavluk puts it, “not the best.” State- the Russian Symbolist scape. Magnificent art approved television has given way to un- poets. I couldn’t bring deco buildings are ru- regulated broadcasting and the influx of myself to admit I’d ined by an excess of dozens of channels from all over Europe. never heard of the guy. promotions for Coca Who wants to be a millionaire? is the most As for the difficul- Cola and McDonald’s; popular show. Books, until recently the ties of living under an imposing statue of entertainment, are still incredibly cheap, Communism, Pavluk’s Pushkin gazes into a but, for the first time in 70 years, illiter- comments are wry and billboard for Martini. acy is an emerging problem, says Pavluk. oblique. “People were (Whatever would he Perhaps there will be a revival of cultured and well-edu- Vincent Pietropalo think?) The Mus- support for the arts, education and cul- Our Moscow correspondent cated,” she says, “but with one of the many Lenin covites I encountered ture, but with 36% of the people living miserable.” She quotes look-alikes who, for a fee, pose — albeit a handful and at the subsistence level of US$1 a day, a former minister of for photographs such as this. hardly a scientific sam- Russia has more pressing concerns. For natural resources who, pling — were dis- the first time, the country plans to after the failure of a mayed, to say the least, spend more on social services than on business scheme in the 1980s, famously by this visual assault. Museums and gal- the military. But that announcement said, “We did our best but it turned out leries are still inexpensive — free to stu- was made before the events of Septem- as usual.” dents and seniors — and impressively ber 11 preoccupied the world. Despite the hardships wrought by crowded even in the middle of the week “If the soul is nourished… .” Ma- Communist dictatorship, what appears (perhaps with the unemployed, also a hotkina leaves the sentence incomplete, to weigh on her mind are the psycho- new phenomenon). The house muse- hinting at dreams unfulfilled. logical effects of the collapse of the So- ums, where Tolstoy, Chekhov and Dos- viet Union. There is a feeling of humil- toevsky once lived, are crowded with Barbara Sibbald iation, she remarks, not only because of Russians. The Pushkin Museum of Fine CMAJ

358 JAMC • 5 FÉVR. 2002; 166 (3)