the bridges we cross vs the bridges we burn

 

My current WIP is, roughly speaking, about breaking away from learned and/or conditioned beliefs and behaviors that no longer ring true to us...and why we should. 

Given today's political climate, this is relevant as we encounter people whose deeply entrenched convictions offend our beliefs about justice, lawfulness, and compassion. We wonder if there is anything we can say or do to change the minds and the behaviors of MAGA supporters who discriminate against whole classes of human beings, who have withdrawn support from the neediest among us, and who put our health at risk. What would it take to convince them otherwise? Is it possible to change their world view?

"Sometimes you change your mind.

Sometimes your mind changes you."

~Binyomin Scheiman~

When we learn something new or are exposed to a different way of thinking or responding to life's twists and turns, it can lead to a shift in perspective so that we see the world differently. This comports with the principles of Transformational Learning Theory, introduced by Jack Mezirow, a sociologist and Emeritus Professor of Adult and Continuing Education at Columbia University, in the 1970s.

Transformational learning considers how people make sense of life. It refers to the ways we adjust our thinking based on the acquisition of new information...how we make sense of what happens to us and around us. It is based on the contradictions between newly acquired knowledge and previous knowledge, and how this alters our way of thinking about an idea or situation. These changes can arise from sudden moments of insight, or they can unfold gradually as the learner reflects upon what they have learned, or observed, or experienced, and how that affects their beliefs. Their world view.

Mezirow taught that in childhood, learning is formative, meaning it is derived from formal sources of authority such as parents and teachers, and from socialization including adherence to cultural norms and expectations.

In adulthood, on the other hand, learning can become transformative, as adults acquire the ability to discern distortions in their own beliefs, feelings, and attitudes. This opens the door to change.

How does this happen? Mezirow believed that the change occurs when we face what he labelled "a disorienting dilemma", an experience that does not fit our expectations or make sense to us without a substantial change in our world view, our conditioned assumptions, our previously held beliefs, or our tightly held convictions. It forces us to reconsider our beliefs in a way that brings us into alignment with what we have learned.

"Sometimes the hardest thing in life

is to know which bridge to cross and 

which bridge to burn."

~Daniel Russell~

Transformational learning refers to the ways we develop and use critical self-reflection to adjust our thinking based on the acquisition of new information. There’s nothing surprising about that. We do it all the time. For example, we might quit our job when we learn that our boss is employing unethical or illegal business practices. The thing that sets transformative learning apart from, say, what we learn from reading a book or taking a class is the fact that transformative learning always involves a "disorienting dilemma".  It can be painful. What we learn, or witness, or experience leaves us stunned. Confused. Unsure. It forces us to ask several questions:

• What have I been thinking all this time? Why?
• What is important to me?         
• What am I really committed to?
• What is preventing me from accomplishing what I am committed to?
• What path will I take going forward?

Let's consider a specific example...something that directly affects us as health care providers: the theoretical case of a diehard MAGA supporter who loses his unvaccinated child or grandchild to a totally preventable disease, such as measles or RSV. He was convinced that RFK was right about the dangers of vaccination, until he was forced to confront the truth.

 
Mezirow describes ten phases in the process of transformational learning:

1.     Encountering a disorienting dilemma...in this case, the totally preventable death of a child

2.     Self-examination accompanied by feelings of guilt or shame, in this situation, for having rejected the science behind vaccination

3.     Critical assessment of the epistemic, sociocultural, or psychic assumptions that guided one's choices

4.     Recognition that one’s discontent and the process of transformation are shared…that others have successfully navigated a similar change, that others have changed their minds about the risks and benefits of vaccination

5.     Exploration of options for new roles, relationships, or actions...such as transforming from an antivaxer to an advocate for vaccination

6.     Planning a course of action

7.     Acquisition of knowledge and skills for implementing one’s plans

8.     Provisional experimentation with new roles, such as encouraging others to reconsider the issue

9.     Building competence and self-confidence in new roles and relationships

10.  A reintegration into one’s life based on the conditions dictated by one’s new perspective
 
While Mezirow's theory was intended to reference learning in adult education, it is applicable across a broad spectrum of behavior, thought, and experience. It is at work our relationships, in our careers, in our faith, and now, in our politics.

I wouldn't wish a "disorienting dilemma" on anyone except that it might lead to the kind of transformation we can, otherwise, only hope for.

 "When the wind of change blows, 

some people build walls.

Others build windmills."

~Chinese Proverb~

jan

 

 
 

let nature heal you

 

My hike in the woods this week was more about meditation than getting exercise. It was silent, and still, and peaceful out there. It slowed me down. I paused to meditate for a few minutes every so often, until finally, I just sat down and let everything else go.

"Sometimes you find yourself

in the middle of nowhere,

and sometimes in the middle of nowhere 

you find yourself."

~A Living Rock~

~Circe Sola~

I've been studying and practicing one form of meditation or another for over fifty years. As far as I know, none of my friends or colleagues practices it, although I do know several women who practice various other forms of energy healing, including accupuncture, therapeutic touch, neurofeedback, hypnosis, and Reiki. Most traditional Western providers shun these techniques out of ignorance, or disdain, or denial, but I've seen them work for others, and they have worked for me, so I have an intuitive attraction to them. 

While there are many other forms of meditation, these are some I practice:  

• Insight meditation involves focusing the attention to let go of the cascade of thoughts that pass constantly through the mind. A basic training involves simply observing one's breath in order to achieve a state of calm, clarity, and detachment, letting go of thoughts as they arise.
• Mindfulness meditation teaches us to maintain moment-by-moment awareness of our thoughts and feelings without judgement, in order to see things as they are in the present moment rather than rehashing the past or projecting into the future. 
• Loving-kindness meditation is the practice of sending loving intention to yourself, to the people you love, to people you recognize but don't really know, and finally, to people who have offended you. It usually involves an invocation. Mine goes like this:

May you be happy

May you be healthy.

May you be safe.

May you dwell in peace and loving kindness.

My practice goes on to include all people, especially the suffering, to all animals including pets, to farm animals who die painful deaths so we can eat meat, to animals in the wild, to sea creatures, and from there to the environment. It takes about an hour depending upon how detailed I get.

• Tonglen involves the mental process of taking on the suffering of another person with the in-breath, and sending them peace, comfort, and love on the out-breath, starting with people you love, moving to people who are neutral in your life, and ending with those who are hard for you to love.
• Mindfulness based stress reduction (MBSR) integrates yoga and mindfulness with science and Western medicine to reduce stress, anxiety, illness, and chronic pain.

"If meditation were a drug,

failure to prescribe it would

constitute medical malpractice."

~Robert Delozier, MD~

• ECO meditation ("energy ecology meditation") uses methods that retrain the brain to avoid defaulting to conditioned or learned patterns of reactivity that reinforce negative emotions such as anger, hatred, and fear. Instead, we learn to reframe our emotional reactions and behaviors to acceptance/tolerance, compassion, and loving-kindness. It utilizes Emotional Freedom Techniques (EFT) such as tapping accupressure endpoints.
•  Guided imagery is another technique that can lead the meditator to a peaceful, loving emotional state.

"Of all the paths you take in life,

make sure a few of them are dirt."

~John Muir~

Meditation is a restorative practice, and mindfulness is its foundation. Among its numerous health benefits are stress reduction and the accompanying decrease in blood pressure and cortisol levels, reduction in measurements of systemic inflammation, and therefore, improvement in the immune system, alleviation of chronic pain, and management of PTSD.

If you are a health care provider, you should explore every option, every path to healing for your patients. If you are in need of healing, in addition to the surgery you need, or the chemotherapy or antidepressant you are taking, consider this:

"Go home to nature

and let nature heal you."

~Thich Nhat Hanh~

jan

the origins of cruelty and indifference

 

Burlington Harbor

I practice meditation regularly, daily if I can. My favorite is loving-kindness meditation when I first bring to mind my family and friends, and then I move on to connect one by one with groups of people who are suffering. This includes the sick, injured, and dying, children who are neglected, abandoned, and abused, people affected by poverty, hunger, and natural disasters, and those in refugee camps and war zones, among others. It takes a while...because then I extend loving kindness to people who challenge me. And to animals who, likewise, may be abused, neglected, injured, lost, and suffering. Next come the sea creatures. The natural world. The planet as a whole...that it will survive.

It goes something like this:

May you be happy.

May you be healthy.

May you be safe.

May you dwell in peace and loving kindness...

...or (depending upon the situation)

may you be embraced by peace and loving kindness,

or may you come to understand peace and loving kindness,

or may you spread peace and loving kindness.

Today when I sat down and closed my eyes, it occurred to me to focus on something else...on the kind of people who are least likely to extend peace and kindness, and least likely to be offered it. People who need it the most. You know who I'm talking about: the President and his inner circle, including Vance, Hegseth, Rubio, RFK, Bondi, and Leavitt among others...

...because I don't know about you, but I am struggling to understand the conduct of our President, and I am flabbergasted that so many MAGA republicans support him. They support policies that are fundamentally unjust, illegal, and unconstitutional...but also cruel and uncaring. Some are frankly delusional, as for example, something about "medbeds" and accusations of chaos and violence on the peaceful streets of Portland, Oregon. Our leadership is obviously out of touch with reality and reason.

I found myself asking, "How does this happen among men and women who are clearly intelligent?" These are people who have risen to the top ranks of government, business, and law. How do they surrender to the deceit, lies, and delusional thinking that are clearly untrue, or unjust, or untenable? The answer may lie here:

"What happens to us as children

shapes who we become as adults."

~Alice Miller~

A while back, I wrote about childhood trauma and its lingering effects on our beliefs, behaviors, and even our health as adults. We're not just talking about physical and sexual abuse or physical neglect, but the less obvious connection between emotional pain in childhood and the inability to process it as adults. The child avoids it by shutting down, by dissociating from it. By avoiding it, they may never acquire the ability to process emotional issues. This is referred to as "emotional dysregulation." It can manifest in adulthood as denial, lack of empathy, and even outright cruelty...which is what we are observing among our legislators, now.

As a matter of fact, this connection has been investigated and confirmed in several independent studies. If you're interested, check out:

pmc.ncbi.nlm.nih.gov

Of course, the problems associated with childhood trauma are multifaceted and sometimes difficult to uncover. Still, I am willing to wager that most adults who are cruel, uncaring, and indifferent to the suffering of others are all victims of childhood trauma in some way. When they were most vulnerable, they did not receive love or care from the people they depended upon to help them process the fear, confusion, or the sadness that pervaded their emotional world. They sought relief in other ways. Escape. Distraction. Withdrawal. Retribution. And so, here we are. 

"Childhood trauma is the greatest

unaddressed health threat facing our nation."

~Robert Block, MD~

The treatment for problems that arise from childhood trauma, including dissociative and attachment disorders, anxiety and depression, and absence of empathy and compassion is complicated and difficult. Unless a person recognizes these issues for what they are and is genuinely dedicated to working through them, they are stuck. And so are we. 

According to Peter A. Levine, PhD., author of "Healing Trauma" and "Trauma Through a Child's Eyes":

"Trauma is perhaps the most

avoided, ignored, belittled, denied,

misunderstood, and untreated cause

of human suffering."

...which is why it is so hard to comprehend its lingering after-effects--the cruelty and indifference we observe in some adults. Victims of childhood trauma need the loving kindness they reject, but they don't understand it, so they can't embrace it. And they can't extend it to others.

The rest of us can, though. Remember:

Be kind,

for everyone is fighting a battle

you know nothing about."

~Wendy Mass~

Scatter loving-kindness to whomever you can, wherever they are, whenever you can.

No matter what...

jan

 

we all deserve a little "down" time

We all deserve a little "down" time now and then, don't you think? Time away from work. Time away from the news. Time to daydream. Even Mother Nature can't be at the top of her game every day of every week of every season. Which is why we're headed into October, and this week, the weather is beach worthy, hot and humid. At this rate, the pumpkins we put out will rot before Halloween. Perhaps Mother Nature just needs a little time to muster the energy it takes to move into Fall.

"I prefer winter and fall,

when you feel the bone structure

of the landscape.

Something waits beneath it.

The whole story doesn't show."

~Andrew Wyeth~

Although, to her credit, Mother Nature did share a moment of inspiration with us last week when she let loose with a few days of glorious cool, crisp autumn-like weather. Now it's back to the same old thing--the heat and humidity--just when things were looking up. It makes you wonder. Will Fall ever come to stay? Will winter ever get here? Does Mother Nature just need a little "down time"?

 

This comes to mind because that's how my writing has been going lately. I've been slogging back and forth through the last three chapters of my WIP for weeks, not making much progress. Except for a rare moment of inspiration, I have been stuck. I sometimes wonder if I'll ever move ahead. If I'll ever get to the end of it. 

 

Like Mother Nature, I think we all occasionally need a little "down time" in our writing, because, in Brenda Ueland's words:

 

"Inspiration comes very slowly and quietly...

The imagination needs moodling--long, inefficient,

happy idling, dawdling and puttering."

~Brenda Ueland~

 

Patience. Optimism. Nurturing. You can no more rush a thought into being than you can hurry the seasons along.

 

Eventually, autumn will get here. Sooner or later the story will finish itself.

 

Do you ever experience "down" time? Do you let it discourage or energize you? Are you open to what will follow?

"...it is the way you are to feel when you are writing--

happy, truthful, and free,

with that wonderful, contented absorption

of a child stringing beads.

With complete self-trust."

~Brenda Ueland~

jan



 

off topic, but worthy of reflection

"Alpabzug" or Alpine Descent in Switzerland

I met up with a friend at our favorite restaurant the other night. It's something of a joke between us because I can order her meal from memory. Steak. And she can predict what I will have. Seafood. It's as predictable as the tide. It never changes. There's a story behind it, though.

Perhaps you have already noticed this. There are certain books that leave a lasting impression on you. Others, you can't even remember having read. I picked up a copy of "The Mind Illuminated" by John Yates, PhD this week. It has been collecting dust on my bookshelf for a while now. It's a guide to meditation based on Buddhist wisdom and modern neuroscience. It sounded interesting. Imagine my surprise when I opened it up and discovered I had already read it, complete with underlining, notations, and dog ears. Obviously, though, I'd forgotten about it.

On the other hand, I read "The Jungle" by Upton Sinclair when I was in high school. The book is an expose of the greed, cruelty, and indifference Sinclair uncovered in the meat packing industry. It changed me, but I didn't respond to the horrors and cruelty he exposed right away. After all, I was still expected to eat what my mother put in front of me...meat and potatoes. Still, the images of cruel and abusive breeding and butchering of animals stuck with me until I made the transition to vegetarianism, actually pescatarianism (veggies and occasionally seafood) in my later years. Almost fifty years later.

"All animals just want to be loved."

~Anthony Douglas Williams~

I won't bore you with arguments for or against vegetarianism except to suggest you give it some thought. Or read "The Jungle" yourself, or read something by Jane Goodall, or check in with Joar Berge online at https://moustache-farmer.de/en 

'Nuff said. Pictures speak louder than words:

~Joar Berge
 @moustache_farmer~

~@thegentlebarn~

~Arik Vasquez~

~estherthewonderpig.com~

~Tatyana_tomsickova~

Consider this:

"The greatness of a nation

and its moral progress can be judged

by the way its animals are treated."

~Mahatma Gandhi~

...and not just its pets, I would add. Also, according to Darwin:

"The love for all living creatures is

the most noble attribute of man."

~Charles Darwin~

No offense intended, but if you love animals, you could consider not eating them. If you can't resist a good steak or chop once in a while, you should offer deepest reverence and gratitude to the being that offered it up for you. Or, in deference to hunters:

"Don't eat anything

you aren't willing to kill yourself."

~Lorene Lavora~

jan

 

questions we should be asking ourselves

 

If you have dedicated your life to work in the field of health care, chances are it was more than the prospect of a secure income that motivated you to spend so many additional years studying and preparing when your friends were already out in the world. Earning money. Cultivating a social life. Even starting a family. Perhaps you come from a long line of nurses or doctors and felt the pressure of expectation to continue the tradition. Maybe you were attracted by the prospect of authority and prestige. Perhaps you pursued medicine or nursing out of a heartfelt desire to do good in the world. To help people heal. Or because you felt called to this line of work.

"The two most important days in your life

are the day you are born

and the day you find out why."

~Mark Twain~

If medicine is your calling in life and you know it, good for you! But if your purpose in life is not yet clear to you, if you're not sure what you were put on Earth to do, or who to be, or why it makes any difference, you might want to start thinking about it. Otherwise, you may find yourself wandering through life without a clear path forward. Chasing after someone else's expectations for you. Investing time and effort in something that offends your sense of right and wrong. Surrendering to something that is meaningless to you or harmful to others. 

If you have been contemplating your calling in life but still feel lost, or you've been avoiding the issue because you don't know where to start, I highly recommend Stephen Cope's book, "The Dharma in Difficult Times".

In it, he illustrates the teachings of the great Hindu text, the Bhagavad Gita, through the lives of dedicated visionaries including Gandhi, Thoreau, Sojourner Truth, and Marion Anderson, among others, all of them committed to non-violent resistance/activism. How did they discern their sacred calling? What were they willing to sacrifice to achieve their goal? How did they apply the principles of non-violence to their efforts? What was the outcome?

These are questions we should all be asking ourselves at this time of political divisiveness and retribution.

Why is it important? Because we all have a sacred calling, a duty to ourselves, to others, and to the planet, whether we care to embrace it or not. Sooner or later each of us will be confronted with a dilemma that will require us to discern right from wrong, truth from untruth, whether to follow the crowd or to stand up for what we believe and value. Each of us needs to decide if this is a challenge we are willing to accept. A goal worth pursuing. A battle worth fighting. 

"Tell me,

what is it you plan to do

with your one wild and precious life."

~Mary Oliver~

I believed medicine was my sacred calling in life. I ignored the naysayers who insisted women weren't meant for it. That I would regret my decision. That I would fail at it. Instead, I made the sacrifices that were necessary to do the work I chose. Diligently and without fanfare. For over thirty years.

What about you? Where are you on your journey? To what cause do you feel a sacred duty? Cope states: 

"Sacred duty is the thing that

 if you do not do it,

you will feel a profound sense of self-betrayal."

~Stephen Cope~

 

Is it health care? Climate change? Racism? World hunger? Cruelty to animals?

All of the above?

How will you make a difference?

"Be the change you wish to see

in the world."

~Mahatma Gandhi~

jan

your untold story

 

Those of us who support the narrative medicine/narrative healing movement would like you to believe that the simple (or not so simple) act of telling your story and knowing it has been heard can bring about healing. How does that happen?

"I will soothe you and heal you.

I will bring you roses.

I, too, have been covered with thorns."

~Rumi~

Perhaps something like this has happened to you:

You wake up and it's a beautiful day. The sun is shining. Your bills are paid. The laundry is done. You pick up a good book and head out to the porch to read. But you can't concentrate. You sense a heaviness in your chest, and you can't stop sighing. You're tired, even though you haven't done much all day. You feel a certain sadness, but you don't have anything to be sad about. Your neighbor sees you and comes over to say hello. She immediately senses something is wrong. You shrug her off, and then it hits you. This is where you were sitting when you heard the screeching tires that you knew meant trouble. This is the same kind of beautiful September day you lost your dog on the street in front of your house. Seventeen years ago. 

"If you never heal from what hurt you,

you'll bleed on people who did not cut you."

~Karen Salmonsohn~

Or you go out for the mail and in it is an invitation to your friend's baby shower. You burst into tears. Because you never got to have a baby shower. You lost the baby before anyone knew you were pregnant, so you never told anyone. Or maybe you were never able to get pregnant in the first place. And your arms feel so empty.

Or maybe your story plays out like this. You didn't mean to put a dent in the fender the first time you took the car out alone when you were sixteen. Your father told you to be careful when he handed you the keys, and you promised you would. Then, a ball rolled out into the street and to avoid it, you swerved and grazed a tree in somebody's yard. You knew you'd be in trouble when you got home, but you didn't expect a beating for it. I mean, you were being careful, and it wasn't your fault. But your dad had been drinking that day, and when he saw what had happened, he hauled off and bloodied your nose and gave you a swollen black eye. In school the next day, you told the teacher you'd slipped and fallen down the basement stairs. And that was the end of it, but not really. Now your heart races and your head throbs and you break out in a sweat every time your own son takes the car out. And you don't know why.

"The scars you can't see

are the hardest to heal."

~Unknown~

If you sometimes react to situations in ways that don't make sense, or you can't explain why you feel sad, or tired, or anxious, or people often ask you what's wrong, your untold story may be hiding in the shadows, playing tricks on you. Because until you call it by name you may not know it's lurking there.

When you give your story a title, and describe how it unfolded, you may begin to understand why it still disturbs your peace after all these years. If someone you trust is listening, you may come away with an entirely fresh perspective on it. You may be able to forgive yourself, or the person who hurt you. You may be able to cast aside some of the things you've always imagined were wrong with you but never were. Your energy may improve, your headaches may lessen, your heart may open. 

If your story has been under lock and key for years, or you've forgotten where you left it, or you can't imagine finding the words to express it, you should consider getting back to work on it. Somebody else may need to hear it.

"Just because no one can heal you 

or do your inner work for you

doesn't mean you can, or should, or need to

do it alone."

~Lisa Olivera~

jan

l

  

 

Janet Cincotta, MD

2254 Old Hollow Road

Mechanicsburg, PA 17055

drmomjfc@gmail.com

(717) 574-7357

 

Governor Gavin Newsom

1021 O Street, Suite 9000

Sacramento, CA 95814

 

Dear Governor Newsom,

 

I am writing to express my relief and gratitude for the leadership you have shown on behalf of your fellow Californians as well as Democrats across the country for the past several weeks. The current political climate is driven by greed, injustice, deceit, and fear. You have demonstrated great courage, integrity, and clarity in your efforts to counteract this blight on our democracy. I hope you have your sights set on a presidential campaign in 2028.

 

To be brief, however, I would like to suggest that you consider tempering the humor you have employed to mock and even mimic our current president’s rhetoric and buffoonery. While your satire and mockery are clever and engaging (please don’t stop), the issues at stake are grave. As such, I believe they deserve to be presented with utmost dignity and sincerity. You do not have to stoop to the inferior standards of conduct employed by your Republican colleagues to make this point. A little parody goes a long way. This is serious stuff.

 

As an aside, speaking as a physician, if you have not already done so, I would suggest you have your vocal cords checked. You sound a bit hoarse which could be caused by a polyp, which is an easy fix. I’m concerned because America needs to hear what you have to say in a clear, loud voice.

 

Thank you for your attention. Again, you have my deepest respect and hopeful anticipation for our country’s future as a democracy.

 

Yours truly,

 

 

Janet Cincotta, MD

 

how does life go on

This past week was a tough one for me. Not for me personally, but for people I know and love, for people I don't know but whose stories I've heard, and for millions of others around the world who, we all know, suffer every day.

It reminds me that my week passed quite peacefully. The sun came out, but it stayed relatively cool thanks to an arctic front that pushed through, a perfect week to get yardwork done and to get some walking in. I went to the grocery store and picked up whatever I wanted to fill my cupboards. I slept in a safe, soft bed. I got a little writing in. It was a quiet and pleasant week for me, but unfortunately, much of the rest of humanity didn't fare so well, and that disturbed me.

It started with images of skeletal children dying of starvation in Gaza, their mothers watching in horror. It continued with pictures of people shuffling through the debris in war-torn Ukraine. It reminded me of people fleeing their homes ahead of the wildfires out West and in Canada, and of those who were reinforcing sand dunes along the East coast head of a monster hurricane. I heard about an otherwise healthy teenager who presented to the Emergency Room with shortness of breath and fever suggestive of pneumonia whose chest x-ray and subsequent CT scan revealed a 15 cm. (that's almost seven inches across) mediastinal mass with lymph node involvement...and I learned about a father who found his daughter hanging close to death in her bedroom when he got home from work. 

How will life go on for them? This is their reality, now. How will the rest of us process it?

"Be kind,

for everyone you meet is fighting

a battle you know nothing about."

~Wendy Mass~

Part of the problem is the sheer magnitude of suffering in the world. Part of it is the utter sense of futility that greets us in our efforts to reach out to others. We do what we can, but it amounts to little more than a dewdrop in the ocean. With a couple of clicks on my keyboard, I donate regularly to a couple of organizations that provide food and assistance to victims of war, poverty, injustice, and natural disasters although I have no clear idea what happens to my donations. I don't know if they help anyone at all. You may do the same, or you may volunteer to pitch in when disaster strikes, or you may simply rely on the power of prayer to relieve the world's suffering, but pain and sorrow still hang heavy around us...

...as does guilt. The gratitude we feel for all we have...food, shelter, good health, and community...can amplify the heartache we harbor for those who are not so lucky. We feel guilty even though we have done nothing to deserve it. We feel guilty because we are so helpless.

"Guilt is not a weakness.

It's a reminder of our capacity to care."

~DESIQuotes.com~

Do you share my sense of futility? Of frustration? Of discouragement?

Where do you turn for solace? For Peace? For joy? How do you sustain a sound spirit of equanimity? Is it even possible?

"EQUANIMITY:

(n.) mental calmness, composure, and

evenness of temper, especially 

in a difficult situation."

~various attributions~

If this week is difficult for you, try this: Take a deep breath in and let it out slowly. Feel the pulse beating in your own wrist. Ask yourself how the universe we know to be cold, dark, and dangerous drapes itself around us in baby blue. 

Wendell Berry may have said it best:

"It may be that when 

we no longer know what to do,

we have come to our real work,

and when we no longer know which way to go,

we have begun our real journey."

~Wendell Berry~  

jan

the consequence of fear and ignorance

 

I was going to try to avoid writing about anything political this week, but I couldn't help myself. This blog is about the role storytelling plays in the practice of medicine, including the stories that describe our patients' experiences and the stories we recount as health care providers. I'm afraid the narrative is about to change, though, as we witness efforts to discontinue public health programs and dismantle medical research initiatives. Meaning that people...children...will die.

"The two public health interventions

that have had the greatest impact

on the world's health are 

clean water and vaccines."

~World Health Organization~

I've been around long enough to have celebrated the triumph of vaccination against polio, make that "paralytic polio", a disease you do not want to see, treat, or God forbid, suffer. We are already witnessing an uptick in cases globally, not because the vaccine is unavailable (yet...), but because RFK is spearheading efforts to withdraw funding from Gavi (the Vaccine Alliance, or Global Alliance for Vaccines and Immunization) whose purpose it is to fund immunization programs in underserved populations around the world. Trouble is brewing.

Closer to home, disinformation has bred skepticism and fear. Parents are hesitant to provide their children with even routine vaccines that have been proven safe and effective for many years. We have already seen an upsurge of measles cases among the unvaccinated that have claimed the lives of three otherwise healthy children.

Count yourself fortunate if you have never watched a young polio victim struggle to use crutches, much less fight to breathe in an iron lung. We thought those days were behind us. Now, we can't be sure.

The stories we have enjoyed for years may be changing. We may be going backwards.

"Universal vaccination may well be

the greatest success story

 in medical history."

~Michael Specter~

I can tell you the story of an otherwise healthy child who came home from school one day with a headache and a slight fever...and died the next day of meningococcal meningitis. That fast. Back in the days before we had a vaccine that would have prevented it.

I can tell you what it was like to treat a child with measles encephalitis and watch them die of a totally preventable disease or suffer its consequences for the rest of their lives.

I can tell you how hard it is to intubate an infant who is struggling to breathe with whooping cough or a toddler with epiglottitis, diseases we never see in vaccinated children anymore. 

Without a doubt, the stories we tell and those our patients tell will change given the present leadership of the Department of HHS. From triumph to heartbreak. From hope to despair. From success to defeat.

Trust me: you do not want your child, or grandchild...or ANY CHILD...to suffer or die from a preventable disease. You don't want ANYONE to die of a preventable disease because of skepticism, fear, or ignorance. If you agree with me, please make your thoughts known at:

Contact Us | HHS.gov

The US Department of Health and Human Services

Hubert H. Humphrey Building

200 Independence Ave., SW

Washington, DC 20201

1-877-696-6775

"To fear what you do not understand

is to mistake ignorance for safety."

~Ginn Hale~

jan

survival 101

This may not sound like a political rant, but it is. It's about surviving the news that greets us every day...coming from a man who is totally out of touch with reality, but nevertheless, has been entrusted with our nuclear codes. Scary thought. 

This is about loss of environmental protections, the eradication of public health initiatives and medical research (just when we are on the path to treatment of cancer with mRNA vaccines...), and the elimination of programs to protect the safety and purity of the water and food we have always taken for granted. It opposes gun violence. It is a call to alarm as the economy crashes, the military marches into our own cities, and human rights are dismissed with a shrug of someone's shoulders. It is a reminder that cruelty, arrogance, and greed are alive and well on Planet Earth.

"Deliberate cruelty is not forgivable.

It is the one unforgivable thing,

in my opinion."

~Tennessee Williams~

How are you coping with it? Are you worried? Scared? Disgusted? Angry? Depressed?

You could be experiencing all of those feelings...but still, you don't have to be consumed by negativity. I would recommend you try what I like to call "fierce mindfulness." It has been especially helpful to me this past week. If you already practice mindfulness meditation, you are ahead of the game. If not, this is a good time to start. You'll wish you had as the situation worsens...

For me, fierce mindfulness is an act of countercultural resistance, a refusal to succumb to the threats to our safety, well-being, and peace that are imposed on us by people who claim to be in power. Billionaires. Politicians. Liars and cheaters. You know who I mean.

I focused on mindfulness many times this past week. When the president announced his plans for a new White House ballroom. When RFK dismantled research into mRNA vaccines. When the military was deployed to the streets of Washington, DC. I could go on...

Here's how I did it. While other people fretted, or ranted, or chose to ignore the news and carry on as if nothing were wrong, I simply turned my attention to my very own senses, right where I was, in the moment. I focused on what I was seeing in the moment. What I was hearing. How the air around me felt. Which added up to something like this, most days: The sky was clear blue and cloudless. The air, warm. The breeze, gentle. I asked myself, "What more could I want? What could be better than this?" The chaos, the cruelty and injustice, the suffering of the entire world did not cause a ripple in my reality at the moment. In most of my mindful moments, in fact.

"You are the sky.

Everything else is just the weather."

~Pema Chodron~

When we surrender to worry, dread, anger, and fear we give them power over us. We bow to the enemy...but we don't have to. We can turn our attention inward. We can focus on all the ways the universe supports us. With intention, we can always find something to feel grateful for. Something that embraces beauty and peace. Something that heals us. Just a few minutes of respite from the craziness reminds us that there is hope.

"Resistance is feasible even for those 

who are not heroes by nature,

and it is an obligation, I believe,

for those who fear the consequences

and detest the reality of the attempt

to impose American hegemony."

~Noam Chomsky~

jan