a tribute to anyone who has ever been hospitalized

Lately it seems like an uncanny number of my friends have been hospitalized for one reason or another. One because she was in diabetic ketoacidosis. One to manage the side effects of chemotherapy. This week another one started up the mountain...from X-ray, to biopsy, to surgery, to God-knows-what.

This post, then, is a tribute to anyone who has ever been hospitalized. It's a snippet from my novel, "The Bandaged Place." In it, my protagonist, Kate Tilton, shares her thoughts about her first day post-op:

"Even when surgery goes well, it wrings you out dry. I can attest to this because yesterday, as soon as anesthesia wore off, I felt like, well, road kill. I looked like it, too. And it just keeps getting worse because today they had the nerve to let visitors loose in my room to gawk at me when I am in no mood to entertain.

The pain isn't the problem. I'm getting morphine for that. In fact, the morphine is the problem. I just feel so giddy. I can't see straight, and I'm prettty sure my speech is slurred. The last time I was awake enough to speak, Shirley, my nurse this shift, asked me about the pain. I think I said "five" when I meant to say "fine." To a med-surg nurse, "five" means the worst pain possible, so she gave me another squirt of the magic potion...which is why, now that I'm awake again, I'm in love with everybody in the whole wide world. I just haven't figured out why they can't be here in bed with me right now.

And it doesn't bother me in the least when, for the umpteenth time in eight hours, Shirley hits the switch, and I am blinded by the overhead lights while she rechecks my vital signs--blood pressure, pulse, respiratory rate, and temperature--signs that I have survived. This has been going on all night long.

Shirley has been a nurse here for twenty-some years, night shift. After she finishes checking wounds, adjusting IV's, and passing meds for the night, she fortifies herself with Oreos and Coke. Despite her weight, she is the kind of woman who seems to walk on air--easy, silent, and graceful. Her touch is gentle, and her hands are warm. She is genuinely kindhearted, so even though she has interrupted my sleep countless times all night, I don't resent her for it at all.

"Sorry to disturb you again, darlin'," she says. "I'll just be a minute here."

I roll toward her and extend my arm. I like it when people apologize even though they haven't done anything wrong. You can forgive them in an instant, and then you're endeared to one another for life. "It's not your fault. I was a cake anyway," I mumble. I'm pretty sure that doesn't come out right, but it's the best I can do right now.

She laughs as though she thinks I'm the sweetest patient she has ever cared for, and then she reassures me, "First night's always the hardest." She takes my temperature, wraps the blood pressure cuff around my arm, and feels for the pulse in my wrist.

That's the last thing I remember until six o'clock sharp when someone arrives to draw my blood for the tenth time to check my blood count, sugar, and potassium. But I'm not diabetic, I didn't hemorrhage, and there's potassium running in my IV, so why even bother?

Right on schedule, a breakfast tray is delivered to my bedside and deposited on a little table that is just out of reach. So even if I were hungry or thirsty--which I am not--I'd have to settle for the smell of food, and that turns my stomach.

Not fifteen minutes later, the lady from dietary is back. "Not hungry yet?" She smiles as though she understands completely. It's much too soon after surgery to have worked up an appetite. So she clears away the untouched tray without so much as a word of encouragement like, "Here, let me bring this a little closer. So you can reach it. You should try to eat a little something." Not that I could get a fork up to my mouth if I tried.

I could cry, but I won't, so help me God, not even when Shirley insists I get out of bed and shuffle all the way over to the bathroom and back, pulling my IV stand along behind me like a two-year old, "Come along, now. It's time to go potty." Whoa--not so fast, I'm thinking. As I roll over and sit up, ten thousand poison arrows pierce my chest. The moment I get my feet down, it feels like the floor falls away. My knees quiver. The room spins. Thankfully, Shirley has the strength to steady me.

"Take your time, now. Take it slow. We don't want you to take a tumble now, do we?"

No, we do not, I'm thinking. So can't you just bring me a bedpan or something?

Oh, my God! Did I just ask for a bedpan? Somebody please hand me a gun!"

*

If you're a healthcare provider...or if you've ever been a patient...and you're hesitant to tell your own story because you don't think anyone wants to hear it, or you don't think you write well enough, or you're having a  hard time putting it into words...

tell somebody else's story.

"There is nothing worse than thinking

you are well enough...

Don't turn your head.

Keep looking at the bandaged place."

~Rumi~

Famke

jan

when storytelling is an obstacle to healing

The goal of training in narrative medicine is to provide the health care provider with tools to help him uncover otherwise unspoken details that might impact diagnostic accuracy and successful treatment. 

"You'd be surprised what lengths

people will go to not to face

what is real and painful inside them."

~Various Attributions~

This is especially important given what we now know about childhood trauma and its remote influence on adult health and well-being. Most patients don't make the connection between their experiences as a child and the headaches, hypertension, IBS, anxiety, depression, and addictions that plague them as adults. 

The enduring effects of childhood trauma in its many guises--verbal/physical/sexual abuse or neglect, injury or illness, a significant loss, the stress conferred by poverty, racism, and even bullying--can be hard for patients to put into words. This is especially true if the trauma they experienced occurred pre-verbally, if it was a secret they kept, something they couldn't tell anyone about...and still can't, or if it was so severe they dissociated from it. They may have suppressed the memory of it, or lack the language to express it. 

"You can spend a lifetime

trying to forget a few minutes 

of your childhood."

~From HealthyPlace.com~

But make no mistake...they still feel it in their bodies. 

Working with these patients can be a challenge because just the process of narrating the experience can be traumatizing to them. When they are encouraged to re-tell the story, they can re-experience the trauma, and regress or shut down. In this case, exploring the patient's narrative can pose an obstacle to healing. 

You may sense this when the patient's body language shifts. His posture may change. His facial expression and the tone of his voice may change. He may start fidgeting, stiffen, or slump. Instead of asking him what he is thinking about, it may help to ask him where in his body he is feeling it. Does his neck ache? Is he aware of his heart beat? Is he shaking? Does he feel nauseated? Lightheaded? Once he understands that he is safe despite these somatic manifestations, he may be able to connect them with his traumatizing experience, and eventually with his ability to heal.

"Trauma comes back as a reaction,

not a memory."

~Bessel Van Der Kolk~

Somatic psychotherapy helps patients integrate the physical manifestations of illness with the fear, anger, grief, shame, confusion, and denial they cannot express. Suppressed memories may emerge.

When the patient understands that he is safe despite the fact that his chest aches, or his energy is drained, or his mind goes blank, the mind-body connection is strengthened, and a pathway to healing is revealed. 

Six Steps to Strengthen

Mind-Body Connection:

1. Close your eyes and

    take a deep breath

2. Scan the body

3. Be aware of any sensations,

     pleasant or unpleasant

4. Notice where the sensations

are coming from

5. Let your awareness travel

around your body

6. Follow these sensations

     until they disappear

~From Quotemaster~

*

jan

how civilizations heal

~Ukraine Flag~

by Setsiri Silapapsuwanchai

If, like me, you are deeply affected by the war in Ukraine, you may find it difficult to put your thoughts and feelings into words. Thankfully, others have taken a stab at it for us. They have shared inspiration and consolation with us, both with and without words:

~Tower of Mothers~

A 1937 sculpture by German artist Käthe Kollwitz that

depicts women standing in a circle to protect their children from the horrors of war.

*

The Peace of Wild Things

~Wendell Berry~

When despair for the world grows in me

and I wake in the night at the least sound

in fear of what my life and my children's lives may be,

I go and lie down where the wood drake rests

in his beauty on the water, and the great heron feeds.

I come into the peace of wild things

who do not tax their lives with forethought

of grief. I come into the presence of still water

and I feel above me the day-blind stars

waiting with their light. For a time

I rest in the grace of the world, and am free.

*

Hope springs eternal.

*

Cultivate EQUANIMITY:

mental calmness, composure, and evenness of temper,

especially in a difficult situation.

*

~I've got peace like a river~

*

Mahatma Gandhi, on nonviolence:

First they ignore you,

then they laugh at you, 

then they fight you,

then you win.

What inspires you? Where do you turn for comfort? For solace? For peace? 

How do you make sense of life as it unfolds?

"There is no time for despair,

no place for self-pity,

no need for silence,

no room for fear.

We speak, we write,

we do language. 

That is how civilizations heal."

~Toni Morrison~

How will you help?

jan