Monday, May 31, 2021

an outpouring of stories



If you want to hear an outpouring of stories about medicine, start a conversation about childbirth with a gathering of women, or ask about sports injuries among men. Ask a group of doctors about their most difficult cases. Listen to any cancer survivor describe her diagnosis and treatment. Ask a child about the band aid on his knee. You’ll find a story there.

Photo by Dmitri Maruta on DepositPhotos

These stories serve us in several ways:
  •  By narrating our experience, we organize our thoughts about it. No longer are we plagued with a vague sense of fear, or dread, or uncertainty. We come to understand what our fear is based upon. The pregnant woman confesses, “I thought I did something wrong to cause the bleeding.” The basketball player says, “I thought I’d never play again.” The doctor admits, “I had no idea what to do next." 
  • Storytelling is an attempt to understand the cause and timing of an illness. Why me? Why this? Why now? What did I do, or fail to do, to bring this on?
  • It enables us to understand the role illness plays in our lives. How it affects our family and friends, our team, our job, our finances. Our future. It all comes out.
  •  It forces us to ask some difficult questions. What could I have done differently? How much pain can I bear? Who will take care of me? How long do I have to live? 

Image result for confused person
www.emaze.com

This is a big deal. Illness disrupts our lives at the same time it grounds us. It forces us take a good hard look at what we value. Shared stories of recovery and healing dispel fear, and give us hope. Stories of loss deepen empathy, and help us confront denial. Stories of courage and faith strengthen us for our own battles.

"Telling our story
does not merely document who we are.
It helps make us who we are."
~Rita Charon~

The importance of storytelling in medicine cannot be overestimated. Most of us are bursting with stories, about to explode with the untold narratives we stuff inside because no one invites us to tell them. Or we don't know where to start. Or we trivialize their importance.
 
"One of the most valuable
things we can do to heal
one another is to listen to
each other's stories."
~Rebecca Falls~

How, then, will we heal?
 jan
 

Sunday, May 23, 2021

why writing is good medicine

 

They're baaaack!

Numerous studies document the positive effect of writing--aka. storytelling--on both psychological and physical healing. Studies that look at the physiological correlates of writing demonstrate improvement in parameters such as blood pressure, heart rate, sleep patterns, and the levels of stress hormones such as cortisol in patients who are encouraged to write deeply about their thoughts and feelings. Surveys of subjective measures including quality of life assessments, cognitive functioning, and relaxation also emphasize the benefits of writing as a healing practice.

"Writing is medicine.
It is an appropriate antidote
to injury."
~Julia Cameron~

Several studies actually demonstrate that writing promotes physical healing, such as wound closure. In one such study, half of the participants were assigned to write daily about a deeply traumatizing event in their lives including their thoughts and feelings about it. The other half was assigned to write about their plans for the next, day but not their thoughts or feelings about them. Then, small biopsies of the skin were taken, leaving a tiny open wound. The group who wrote deeply about a traumatizing event healed more quickly than the group that wrote about a neutral topic.

"As the number of studies increased,
it became clear that writing was
a far more powerful tool for healing
than anyone had ever imagined."
~James W. Pennebaker~ 

Imagine a new drug or procedure that could make that same claim. Clinicians would jump at the opportunity to offer it to their patients.
 
So...why not storytelling?
 
"While you're working on your book,
your book is working on you."
~Nancy Erickson~
jan


Monday, May 17, 2021

illness and aging as a spiritual practice



Has this ever happened to you? You run into someone you haven't seen for awhile, and you know at a glance that something isn't right. Their color isn't good, or their gate is slow and hesitating. They appear slightly stooped. They seem to have aged rapidly.

Do you comment on it? Do you express your concern, hoping they won't take offense at it? You wonder if, perhaps, they have cancer, or their heart is giving out. Are they depressed, or just worn out? You want to know their story.

"We age not by years,
but by stories."
~unknown~

This happened to me just last week. I met up with a friend I haven't seen for months, thanks to Covid-19, and I was surprised to see the toll time had taken on him. So I asked about it. How was his health? No answer. Had he seen a doctor? No. Had he undergone any testing? No. The story was not forthcoming. 

It is a person's prerogative, of course, to defend his privacy. It is his right to decline evaluation and treatment. It may be his choice to suffer in silence...

"Be good to yourself.
If you don't take care of your body,
where will you live?"
~Kobi Yamada~ 

...even though this path can leave concerned family members and friends feeling helpless. It can be frustrating, indeed maddening, not to be trusted with the truth. Not to be allowed to help, even if all we can do is listen.

We all encounter people we cannot help. In healthcare, it is sometimes a patient whose treatment has failed, when we have nothing else to offer. Some people refuse help out of a sense of heroic stoicism, or fierce independence. Some of us are ashamed, or afraid, or unable to face the truth when we age, or our health fails, or we sometimes want to give up. So we don't say anything.

"There is no greater agony
than bearing an untold story inside you."
~Maya Angelou~

Caring and concerned friends are then left with nothing to do but watch, and worry. Or pray, when we don't know what we're praying for. Or simply to let life unfold as it is meant to be.

"Old age spiritualizes us naturally."
~Ram Dass~
jan

 

Monday, May 10, 2021

the difference between the story you can't tell, and the story you won't tell



There's quite a difference between withholding a story because you won't tell it, and harboring a story because you can't tell it.

There are just a few circumstances that make it imposssible to tell your story. If you're sedated in the ICU with a tube down your throat, you can't tell your story, or if you've suffered one of those strokes that knocks out your speech center, or if your voice has beeen silenced because of throat cancer or head & neck trauma, you can't tell your story. That's understandable. 

"It's your reaction to adversity,
not adversity itself
that determines how your life's story 
will develop."
~Dieter F. Uchtdorf~

But then, there are all the excuses we dream up for refusing to tell our stories.

We convince ourselves we're not good at storytelling, or we don't know where to begin, so we never get started. Maybe it's a voice from the past that discourages us...a teacher who took her red pen to every assignment we turned in, or a kid down the block who ridiculed us for the poetry we wrote, or a submission that didn't make the cut. 

"This is how you do it:
you sit down at the keyboard and
you put one word after another
until it's done."
~Neil Gaiman~

Perhaps we just finished reading something like it, and feel as though we have nothing more to say on the subject. We doubt our worth, or our ability, or our talent, so we never tell our story. 

Maybe you're ashamed of what happened to you, or how you handled it. Perhaps you're afraid you'll offend someone if you tell the truth. Maybe the story still brings you to tears, or scares you, or mystifies you, so you won't tell us what happened, or how it changed you, or what you learned from it.

Storytelling is an act of courage. A transcendent portal to healing. It is a gift that connects us across time and space with the rest of humanity. Why would we withhold it?

I have been nudging several friends to tell their stories for years, but fear and shame have silenced them. Even though the tubes are out of their throats, and their wounds have healed, they are still hesitant to start, and afraid to fail. They can do it, but they won't. It's a shame because:

"The healing that can grow
out of the simple act of telling our stories 
is often quite remarkable."
~Susan Wittig Albert~

jan









Wednesday, May 5, 2021

why we do what we do








In my last post, I talked about three people close to my heart who were fighting for life...theirs or for someone they loved. One was facing difficult and risky surgery in an effort to defeat an oppositional defiant cancer. One was in ICU with Covid pneumonia, who ended up on ECMO (extracorporeal membrane oxygenation) in a last ditch effort to save his life. Another friend's husband passed away while they were on vacation out West.

This week I want to update you on their progress so far.

My friend's surgery went well. Meaning, not only is he recuperating, but so is his wife, his sister and brother, and his children and grandchildren, all of them feeling better because he has done better than expected.

"You gain strength, courage, and confidence
by every experience in which
you really stop to look
fear in the face."
~Eleanor Roosevelt~

The young man with Covid came off  ECMO today, stood up, and spoke for the first time in three weeks. His recovery so far is considered something of a miracle, if you believe in that sort of thing. Meaning his mother, father, brother, sister, wife, and two young children now believe in them without any question...as if they hadn't been praying for a miracle this whole time.

"Good doctors replace the fear of illness
with trust in recovery."
~unknown~

My friend made it home from somewhere in Texas where her husband passed, and laid him to rest this week. She'll be charting a new path forward now, with the help of all of us who love her.

"Patients don't care how much you know,
until they know how much you care."
~www.geekletters.com~

The point is this:

This is why healthcare providers including doctors, nurses, and therapists in every field do what they do. Because when you help one person heal, you help everyone around them heal. You get to see relief and gratitude on all their faces. And you get to feel it, yourself. This is why you go without food or sleep. This is what compels you to devote your time and attention to strangers when your own children and loved ones ache for your presence. This is how you wrestle fear, and uncertainty, and exhaustion to the ground, and hold it down for the count. How you rise again, and how you help your patients move on from there.

This is our narrative in medicine, the story of our lives. 

"Wherever the art of medicine is loved,
there is also a love of humanity."
~Hippocrates~

jan