life support 101

I practiced medicine for over thirty years before I retired a few years back. I saw thousands of patients during my career. How is it, then, that the distant memory of one of them popped into my mind for no particular reason this week? After nearly fifty years.

"A memory is what is left

when something happens and does not 

completely unhappen."

~Edward de Bono~

The patient (I still remember her name) was admitted to my service with a classical case of bacterial endocarditis--an infection of one of her heart valves that resulted from a congenital defect. She was in her forties. Unfortunately, she experienced one of the dreaded complications of the condition when she suffered a stroke that left her unable to speak or move one side of her body. The stroke caused intractable seizures, so we ended up pumping her full of antibiotics for the infection, and antiseizure meds as she lapsed into coma. After a couple of weeks in ICU, the time arrived to make a decision regarding whether to continue life support...or not. Given her dismal propsects for recovery, the decision was made to start withdrawing treatment, little by little, to see what we ended up with. The first meds to go were the antiepileptic drugs. I can still remember the look on the nurse's face when the sedative effect of the antiseizure drugs wore off, and the patient opened her eyes for the first time. Long story, short...once the patient was awake, she made slow but steady progress until she eventually walked out of the hospital on her own. Taking her off life support brought her back to life. Her recovery was so remarkable, it has stayed with me all these years, and it just pops up every so often because it taught me a lesson.

"Somewhere, something incredible

is waiting to be known."

~Carl Sagan~

This is the thing: No one knows how memories are made, or where they're stored, or what they're made of. No one knows why some persist while others fade, or how they arise unbidden, complete with authentic emotion (sadness, anger, joy), and physical reification (shaking, nausea, sweating).

"Embodiment means we no longer say, 

I had this experience;

we say, I am this experience."

~Sue Monk Kidd~

We can, however, codify the context of memory-making and retrieval this way. Memories will be created and stored most effectively:

1. when the experience is associated with:

• fear
• pain
• anger
• sorrow
• joy 
• gratitude
• love

2. when the experience challenges us, or teaches us something new 

3. when the experience changes the course of our life, or our attitude toward it

4. when we are moved by beauty, or kindness, or a sense of calm

5. when the experience causes us to wonder, to question, or to seek an elusive answer or truth

The list goes on.

Memories foster and animate storytelling. They preserve experience, embody emotion, and teach us so we can teach others. Every so often, they re-emerge from no-one-knows-where to surprise us, to remind us where we've been, who we are, and where we're going.

"We are the universe 

experiencing itself."

~Carl Sagan~

jan