scary first encounters

 

Window art~Jack Frost's finest.

If you are a healthcare provider...a doctor, nurse, physician's assistant or nurse practitioner, EMT, or other first responder...you had to navigate some pretty rigorous training to prepare you for your job. Scary stuff. Scary enough that you might still recall the feeling your autonomic nervous system registered for easy reference later on in your career. The knot in your stomach whenever you approach a spinal tap. The ache in your chest whenever you charge up the paddles. The way your heart races before you make that first incision. The vagal nerve wants to remind you what it felt like the first time you tried. 

"Do the thing you fear to do,

and keep on doing it."

~Dale Carnegie~

This is exactly what we are called to do in practice. Which explains the vague sense of anxiety some of us feel every day. We don't don't know what the next patient will need from us. It worries us a little even when things are going well.

Here is a list of my top contenders for:

Scary First Encounters

• Performing my first spinal tap (lumbar puncture) and, for that matter, every one since then...because it requires you to aim a big, long needle into a fluid filled space you can neither see nor feel that is millimeters away from the spinal cord. What could possibly go wrong?
• Taking charge of a Code Red (CPR) by myself, calling out orders, processing changes in the patient's cardiovascular, respiratory, and metabolic status. And knowing when to call it off.
• Inserting my first subclavian line...aiming for an artery that is hidden from sight and is impossible to palpate because it courses behind the collar bone. Meaning, it's a blind stab.
• Delivering my first baby...performing the episiotomy, easing new life into fresh air, hoping nothing gets stuck on the way out. Listening for that first lovely wail...because sometimes it doesn't happen.
• Intubating a patient, because you can blow out a lung or damage his vocal cords if you don't get it just right.
• Performing arterial punctures because they're just so painful, especially when you're forced to go in after the femoral artery.
• Performing pericardial/thoracic/abdominal paracentesis to draw off fluid or blood from a potential space surrounded by critical organs you can't see.
• Performing any procedure that causes pain to an infant or child, like drawing blood from a scalp vein in a newborn, for example, or performing a suprapubic bladder aspiration on a baby. Do they still do that?

We are trained in these procedures so we'll be prepared to perform them when we are out on our own. Still, as many times as we are called upon to perform them, that vague sense of dread, fear, and insecurity can follow us through life, wiring our autonomic nervous systems to betray us even when all is otherwise perfectly calm. 

"The greatest mistake we make

is living in constant fear 

that we will make one."

~John C. Maxwell~

What makes you anxious about patient care? What do you fear encountering in the office, or at the scene of the accident, or in the operating room? What procedure scared you most when you did it for the first time?

"You must find the place inside yourself

where nothing is impossible."

~Deepak Chopra~

jan

writing what we wonder about

 

It isn't unusual for me to have two or three books open at the same time. Right now, I'm switching between these three books:

This book delves into the physiological correlates of emotional and psychological states as orchestrated by the autonomic nervous system. This is especially important when we treat victims of childhood trauma whose symptoms follow them into adulthood. For health care providers, the concepts are not especially difficult, but because the author is the academic researcher who first described the polyvagal theory, his language is fairly lofty and dense, so it is a little hard to follow. At least, it is for me...which is why I took a break from it and treated myself to this book by Julia Cameron, author of The Artist's Way among many other books...all of which I have read at one time or another over the years.

This is light reading. It's inspiring. Encouraging. I keep it at my bedside for a little comfort before I nod off at night.

And then, there's this one:

I was invited to a friend's home for dinner a couple of weeks ago when a total stranger suggested this book to me. Don't ask how dinner conversation got around to human perception and the illusive nature of reality, but it did. The author of this book is a theoretical physicist and one of the founders of the loop quantum gravity theory, about which I know nothing. Yet. He invites the reader to imagine a vast, mysterious, and still largely undiscovered universe and to contemplate its essential nature. Which is beyond awe-inspiring. Beyond belief. Beyond the imagination.

The point is this:

"If you want to be a writer,

you must do two things above all others:

read a lot and write a lot."

~Stephen King~

Read for enjoyment. Read to learn. Read for inspiration. Read to raise new questions. Keep reading until you find the answers...because:

"The more you know,

the more you know you don't know."

~Aristotle~

Reading is the sure path to knowledge. To wonder, awe, and amazement. To laughter. To tears. What you read can raise your ire or allay your deepest fears. It can challenge your beliefs or validate them. 

"Reading gives you the ability

to think in as many dimensions as you want."

~Nitin Namdeo~

The scary thing is the fact that the topics or genres you enjoy reading about may ultimately be what you write about. If you don't write about it, your narrative will be lost to the rest of us. What have you learned? What enchants you? What scares you? How do you experience the world we share? 

If you don't like to read, chances are you simply haven't found the right book yet. If you can't find time for reading, chances are you won't find time to write. What a shame! It will all be lost.

"We don't write what we know.

We write what we wonder about."

~Richard Peck~

jan

the four healing salves

If you have a story to tell, but the idea of writing it down stops you in your tracks, take heart. There are other ways of sharing your narrative. We're not all wired to write book after book about our lives like, say, Mary Karr who authored, "The Liar's Club," and "Lit," and then topped them off with a book about how to write memoir ("The Art of Memoir").

 

"A dysfunctional family is any

family with more than one person in it."

~Mary Karr~

 

Your story might not lend itself to cold, hard words. If so, you might want to try what Kathryn Craft did. She took an experience that was too painful for her to put into her own words (her husband's suicide) and instead, gave them over to characters in a novel that captured her thoughts ("The Far End of Happy").

 

"There is such beauty in the fight to live.

We must all find the courage to go on."

~Kathryn Craft~



You might prefer to put your thoughts down in poetry, like Nick Flynn does in "Some Ether":

 

"Lately I study rain,

each drop shaped like a comet,

ten million of them, as if a galaxy

had exploded above us."

~Nick Flynn~



Or, maybe song works better for you, like Tom Rush in "Child's Song":

https://www.youtube.com/watch?v=8Dx6Zdx2AJ4



Or, dance.

~from Beverly Merz-

Executive Editor at Harvard Women's Health Watch~ 
 

You can put your thoughts down on canvas, or weave them into a quilt, or sculpt them in clay. You can whittle them out of wood or chisel them into stone in total silence.

 
The point is that no matter how you choose to do it, sharing your story will help you heal, and it will help someone else.

 

"Dancing, singing, storytelling, and silence

are the four healing salves."

~Gabrielle Roth~

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your healing presence

 

True story:

 

When the nursing home called, my mother was already on her way to the emergency room. She’d been experiencing a deep cough and increasing shortness of breath for two days. When her oxygen levels fell to dangerously low levels, her doctor ordered her off to the hospital.

 

I left as soon as I got the call, hoping to get there ahead of her because, by this point in her decline, my mother had lost the ability to speak. She didn’t suffer from dementia. Rather, her inability to communicate was the cumulative result of multiple small strokes. I knew she would be scared and confused, and ultimately frustrated by her inability to express herself. As sick as she was, she would be unable to give her medical history or answer questions. 

Nevertheless, I had no doubt she would receive excellent care—the ER staff would start an IV, administer oxygen, get a chest X-ray (and a scan if needed), draw her blood, and monitor her vital signs. She would receive antibiotics, or medications for her heart, or anticoagulants depending on the test results (pneumonia vs heart failure vs pulmonary embolism). If worse came to worse, she would be intubated. The doctors and nurses would do everything they could for her automatically and efficiently, without giving it a second thought. 

Without knowing a thing about her.

"You treat a disease: you win, you lose.

You treat a person: I guarantee you win."

~Patch Adams~

When I got to the emergency room, my mother was sucking down oxygen via IPPB. She was weak and pale, but alert. The minute I pulled the curtain back and stepped to her bedside, she relaxed. A faint smile of recognition and relief appeared. She closed her eyes and squeezed my hand as if to say healing could now begin.

"A kind gesture can reach a wound

that only compassion can heal."

~Steve Mariboli~

I kept an eye on the monitors that surrounded her bed while I sat with her and explained what was happening and why. I requested an extra blanket for her. I answered the nurses’ questions. I ached to know the results of the tests the doctors had run, what her diagnosis was, what was in store for her. Through it all, I kept a smile on my face while all the worst-case scenarios played out in my imagination.

"Isn't it fascinating

how long a few minutes can seem

when you are completely alone 

with not a familiar face in sight?"

~Kirby Larson~

 

Imagine the relief I felt when the ER physician returned to check on her…when he drew the curtain aside and I recognized a trusted colleague, a man I knew to be compassionate, gentle, and wise. Like my mother did when she saw me, I relaxed as soon as I saw him. I smiled with a deep sense of relief and gratitude. I could talk to this man and I knew he would listen. He would treat my mother like his own, and me, like a sister. As if we were family. I felt as though healing had already begun.

This story is intended to convey the healing power of the personal relationship between the physician, the patient, and the patient's family…the sense of relief a familiar face can bring when everything else is foreign and frightening to the patient. It speaks to the importance of trust and confidence in the healer’s character and expertise. It should remind us to regard every patient with compassion, and to treat every patient with the same respect, kindness, and care we would extend to our best friend and to members of our own family.

None of us can change this reality, but we can always offer a gentle touch and a kind word, and by doing so, we can serve as a healing presence to all.

"I've learned that people will forget

what you said.

People will forget what you did,

but they will never forget

how you made them feel."

~Maya Angelou~ 

jan

who do you want to be today?

Do you, like most people I know, begin each new year by making a list of resolutions…goals, actually, or intentions, or yearnings? Do you intend to lose weight? To exercise daily? To simplify your life? If so, I wish you success. Unrelenting self-discipline. Fierce determination. Whatever it takes.

Perhaps your goals are somewhat loftier this year. To find happiness. To embrace equanimity. To cultivate inner peace and extend it to others. To heal the wounds that cause so much suffering. Which, I believe is what we are called to do with this one transcendent life of ours. To help others heal.

The bad news is that these are difficult goals to achieve. Right up there with dieting and exercising.

The good news is that help is on the way. Wisdom abounds. Why, just this past week, the following brilliant nuggets popped up among my emails:

·       How to make the best of life

·       How to master a life transition

·       How to be perfect

·       How to reprogram your subconscious mind

·       How to access superhuman abilities

·       And my personal favorite: “The Secret to Finishing Your Book”

It’s all there. Words of advice and encouragement for whatever you hope to achieve…from people who claim to know it all. Except that no one knows it all. Which reminds me of Buddha’s advice:

"Believe nothing,

no matter where you read it

or who has said it,

not even if I have said it,

unless it agrees with your own reason

and your own common sense."

~Buddha~

 Or, as Einstein put it:

"The important thing is to

never stop questioning."

~Albert Einstein~

…to which I would add, when you think you have everything figured out, think again. Question yourself.

Some people consider the new year to be a time of reinventing or recreating the Self. A time of correction, redirection, and redemption, when it may, in fact, be an opportunity for rediscovery. For restoration. For reconnection. A time to remember what feels true, and worthy, and right about ourselves.

Which is why this piece by artist Emily McDowell, from “Em & Friends” resonates so authentically with what I feel is true:

“‘Finding yourself’ is not really how it works…You are not lost. Your true self is right there, buried under cultural conditioning, other people’s opinions, and inaccurate conclusions you drew as a kid that became your beliefs about who you are. ‘Finding Yourself’ is actually returning to yourself. An unlearning, an excavation, a remembering who you were before the world got its hands on you.”

Those inaccurate conclusions about who we are include a litany of disempowering, disheartening, and discouraging misconceptions we embraced as children that continue to cast a long shadow over us as adults. No matter where we go. No matter what we accomplish. The never-good-enough, never-thin-enough, never-smart-enough, never-funny-enough, never-worthy-of-anything judgements that bury us alive.

 As you look forward to the year ahead, spend a little time exploring who you were before the world got its hands on you. 

When you wake up in the morning, instead of asking yourself what you need to do that day, consider asking this question:

Who do I want to BE today?

jan