everything you need to know about life

 

Four books are stacked on my desk within an arm's reach when I sit down to write...which is every day. These are the books that taught me how to write, and why I should stick with it. They inspire me. They motivate me. They fill me with desire and longing. With envy. They are always at my side.

A couple of years ago a friend of mine pried my clenched fist open and pressed a copy of Elizabeth Berg's book, "Talk Before Sleep", into my hand.

She insisted I read it. She begged me to give it a chance. But back then, I didn't read fiction. Ever. Who had time? I read about medicine. I studied medicine, I lived it, I dreamt it. Still, she assured me that this would be a quick read, and because I love her, I did it for her. I took it to the beach with me that summer, and I read it.

Well, let me tell you...I loved this book so much I wanted to crawl inside of it and stay there forever...while at the same time, I grew to despise this woman, Berg. I was that JEALOUS of her. I couldn't imagine how she'd come to write so beautifully. And because I thought it was impossible for me, I abandoned my own dream of writing out of pure, unadulterated despair.

And then, my muse stepped in.

"Fool,'' said my muse to me.

"Look in thy heart and write."

~Philip Sidney~

Now, you have to know my muse. She possesses a pretty mean oppositional-defiant streak. In fact, she can be an absolute nag. So...of course, she put her foot down and started feeding me little snippets of character, scene, and dialogue at the oddest times...when I was walking the dogs, or daydreaming in church, or fetching the mail...serving up tidbits of inspiration like manna in the desert.

As if that weren't enough, the "boys in the basement" got into the act, too. They started sending up some pretty darn decent plot points. And they kept fanning the ashes until a lone smoldering cinder of desire reignited my passion for writing.

"We don't choose

what's going to wake us up."

~Dani Shapiro~

So...I guess you could say that the book that nearly extinguished my desire to write was the same book that ultimately inspired me to try. Which is why I keep it close.

"Broken Open", by Omega Institute co-founder Elizabeth Lesser is an absolutely lyrical book about how to navigate difficulties in life, and how they can help us grow. It is simply a pleasure to read her beautifully written words, so I keep her nearby, too.

"Memoir as Medicine" by Nancy Slonim Aronie is there, too. I have been fortunate to have studied with her at numerous workshops over the years, absorbing nothing but positive energy when she teaches. Encouragement. Support. Affirmation. Something we all need every day.

But...this is THE BOOK:

If you are a writer, or you yearn to write but don't think you have it in you, or you simply appreciate good writing when you read, you should run right out and get this book. If you want to know what it's like to live the life of a writer...if you wonder how all those books get onto the shelves, and who does all that writing, and what it takes to stick with it, you should get this book. If you appreciate honesty, seek truth, and love metaphor...this book delivers it all. To me, it felt as though the author and I must have met over a cup of coffee or a glass of wine in some previous life and shared everything we knew about the life of a writer...the pleasure and the pain, the victories and defeats, the humor and the gravity of it all. It was as though she somehow captured every unspoken thought of mine and translated each one into words on the page. 

Which writer inspires and motivates you? What books do you keep close at hand? 

When will you write yours?

"Everything you need to know about life

can be learned from a genuine and ongoing

attempt to write."

~Dani Shapiro~

jan

revisit, revise, and recover

 

"I write because

I don't know what I think

until I read what I say."

~Flannery O'Connor~

This observation by author Flannery O’Connor rings true to anyone who harbors a vague feeling of anxiety for no identifiable reason. 

Even though they are living in a comfortable rut—let’s say, they are financially secure, their health is good, their family is intact—they can’t deny the knot in their gut or the dull ache in their chest that suggests something is wrong. Or, maybe they wake up every day with a sense of dread, exhaustion, sadness, or isolation that screams “depression”, even though, as people like to remind them, they have nothing to be depressed about. After all, they have a steady job and a nice home, their children are doing well, and their bills are paid. They should be happy. Still, the feeling is always there…uncertainty, fear, emptiness, hopelessness. They just don’t know why.

"Worrying is like walking around
with an umbrella
waiting for it to rain."
~Wiz Kalifa~

This is where storytelling comes in. Writing enables us to seek out and sort through memories, and to locate them in time and space. It encourages us to name the gremlins that stalk us, to label our fears, acknowledge our wounds, and reimagine our lives. We are no longer the victims of some obscure fear or unacknowledged sorrow. We can claim it and conquer it.

"The act of putting pen to paper
encourages pause for thought.
This, in turn, makes us think
more deeply about life…"
~Norbet Platt~

Physicians do this for every illness—from diabetes to heart disease to cancer. We ask about symptoms. We search for causes and encourage our patients to do what they can to avoid or eliminate them. We name the disease and suggest a course of treatment. If we have done our work well, we alter the course of the illness. We take control of it. We change the patient’s narrative.

"Revision is the heart of writing."
~Patricia Reilly Giff~

This is storytelling at its finest. It is also the goal in both clinical practice and in narrative medicine. When we write about illness, we revisit the initial injury. Perhaps it was a childhood rape, or a tragic accident, or the loss of a friend or family member we couldn’t face. By naming it, we confront it. The road to recovery leads us to a new perspective or understanding of it. Then, when we read what we’ve written, we finally know what we think.

Storytelling is the very process by which we revisit, revise, and recover.

~Revisit. Revise. Recover.~

jan

 

 



you really should watch this

 

Last weekend, I was speaking to a friend of mine who is thinking about retiring from medical practice, not because he can no longer keep up with the demands of patient care or the new technology. Not because of ill-health, or exhaustion, or forgetfulness. The problem is a health care system that subscribes...indeed, surrenders...to the demand for power, speed, and profit at the expense of excellence, compassion, and human connection.

"America's health care system

is neither healthy, caring, nor a system."

~Walter Cronkite~

Back when I started out in medicine, in the early 1970s, the problem was oppressive paperwork. Now-a-days it's an oppositional defiant electronic medical record. A baffling coding and reimbursement system. The ever-present threat of litigation. A pharmaceutical industry that invests as heavily in marketing as it does in service. A health insurance industry whose number one priority is corporate profit, not compassionate care. 

My friend feels he has no choice but to retire.

"You can quit your job,

but you can't quit your calling."

~Lissa Rankin~

Reflecting on his predicament, I put a series of rhetorical questions to him:

• What happened to the drive for excellence in patient care?
• What does that excellence embody?
• When did our priorities as providers shift in favor of speed, power, and profit?
• Is it possible to restore the sanctity of the doctor-patient relationship?
• Is there any time or space for compassion, communication, and connection in patient care?

He met my gaze with a blank stare.

Then I remembered a TED Talk by Abraham Verghese, titled "A Doctor's Touch." You can view it here:

https://www.ted.com/talks/abraham_verghese_a_doctor_s_touch

 Don't get me started...

In this video, he discusses the laying on of hands by the physician...the importance of touch in patient care. He reminds us that modern medicine is in danger of losing this powerful diagnostic and therapeutic tool because, in today's health care system, patients have been reduced to mere data points. He calls for a return to the traditional one-on-one physical exam. This belies the glorification of the 10 minute office visit, the game of "Beat the Clock" doctors have to play in order to meet productivity quotients. In order to generate income.

These trends in the practice of "modern" medicine, among others, are what led me to bow out of medical practice when I did. I retired out of fear of the inevitable: that someday a patient of mine would suffer or die because there simply wasn't time for me to do my job well. It has happened. 

It happened to the patient who was admitted through the emergency room with a diagnosis of acute appendicitis when the ER doc, in his haste, missed the pulsating mass in her right lower quadrant that would have clued him in to the dissecting aortic aneurysm that brought her in that night.

It happened to the eighteen year-old who died of complications of sub-bacterial endocarditis that was missed because it can be hard to palpate an enlarged spleen or to hear a soft heart murmur when you're in a hurry.

It almost happened to the woman in the ER who claimed to have sustained a injury to her right eye when she tripped and fell against the corner of her nightstand...when in truth, a blow from her muscle-bound boyfriend's clenched fist had caused a fracture of the orbit that required urgent surgical intervention. Try teasing that out of an EMR. It also meant we had to notify law enforcement, and social services to secure safe shelter for her when she recovered...if she recovered. None of which could be rushed.

These are all true stories. 

Thankfully, there are physicians like Abraham Verghese who are willing to speak up while the rest of us struggle to collect our thoughts. How did this happen? Who is in charge here? Is there any hope for us? We are defeated by our failure to act on what we know to be true. Discouraged from exercising our deepest intuition and hard-earned wisdom. Defeated by a system that is on the wrong trajectory and doesn't grasp the problem.

"We touch heaven when we lay our hands

on a human body."

~Novalis~

Next, we need to tackle the absence of eye contact with our patients.

jan

the final common pathway

Toni Morrison probably said it best:

 "If there's a book you really want to read,

but it hasn't been written yet,

then you must write it."

~Toni Morrison~

So, this is the book I really want to read, or to write. It would be titled: "The Final Common Pathway." It would reference the hundreds, if not thousands, of practices and techniques that are employed all over the world to help people heal--physically, psychologically, emotionally, and spiritually--all of them intended to promote a more peaceful, mindful, and joyful way of life. These practices range from hypnosis to meditation to yoga, from EMDR to Emotional Freedom Techniques (EFT) such as tapping, to chanting, to qigong and tai chi. From shamanic rituals to diet and exercise. To psychedelics. All of them proven to be effective for some, but not for all. 

For example, back in the seventies, when "alternative" medicine was regarded with the same disdain as snake oil, I breezed through a surgical procedure under self-hypnosis. I believed in it because I'd seen it work. I studied it, and I practiced it until I was ready to use it. Hypnosis is one of those techniques you have to want to practice in order for it to work. If you don't believe in it or trust it, you won't be able to surrender to trance. So, it works for some people but not for everyone.

"Allow yourself to see

what you don't allow yourself to see."

~Milton Erickson~

From hypnosis, I went on to study and practice meditation and yoga. Just practicing breath control (pranayama) helped me navigate a difficult time in my life without surrendering to anger, or bitterness, or regret. It got me through three lonely pandemic years with unexpected peace and happiness. 

Now I'm exploring Qigong as a way to access and channel energy in the body. It resonates with what I already know about therapeutic touch and the flow of energy within, around, and between us. It connects consciousness and movement with neuroplasticity and human physiology. It makes sense to me.

"Qigong is the art and science

of refining and cultivating internal energy."

~Ken Cohen~

If you're curious about how these techniques work, and whether or not they could help you, you may have to try several practices before you find the one you trust to be authentic and effective. One that you are willing to practice with patience and perseverance. One that works as well for you as hypnosis did for me in the OR...

...which is why I can't help but wonder if all of these practices don't simply work through some final common pathway. If, no matter which practice you choose, the same circuit is activated, or the same switch is flipped, and that sets change in motion. After all, they all seem to embody:

INTENTION

BELIEF

PRACTICE

In other words, they all seem to work a lot like hypnosis.

They all empower us to live a more mindful, peaceful, and happy existence.

"Attached to nothing. Connected to everything."

~author unknown~

jan