the greatest mystery

If you work in health care as a doctor, or a nurse, or a therapist in any field, it's probably safe to assume you understand how the human body functions. How the heart maintains its steady beat without any effort or awareness on your part. How the lungs manage to deliver just the right percentage of oxygen to your tissues, and how they eliminate the carbon dioxide you exhale. How an open wound closes, or a broken bone heals.

"Your body's ability to heal is greater 

than anyone has permitted you to believe."

~Roger Ford~

If the way the heart and lungs operate is something that amazes you, the way the brain works should mystify you. How it oversees and regulates every bodily function. The way it controls movement, maintains our sense of balance, orchestrates vision and hearing, enables our senses of taste, touch, and smell, and modulates the neuroendocrine system. And on and on...

If you're in health care, you studied human anatomy and physiology for years. You learned about the anatomy, physiology, biochemistry, microbiology, and cellular biology that life, as we know it, depends upon, and illness disrupts. You are familiar with the functions and processes that make healing possible. Except one.

"Your body hears everything 

your mind says."

~Naomi Judd~ 

The one thing we don't study, or dissect, or measure in preparation for patient care, which is our calling, is the nature and essence of thought. We don't examine memory under the microscope, or trace the course of creativity and imagination. We don't fully grasp the location or power of human consciousness, and we don't come close to understanding the function of the unconscious. Because no one understands it.

The hardest thing we can do is to think about our own thoughts.

"Consciousness poses the most baffling problems 

in the science of the mind.

There is nothing that we know more intimately

than conscious experience,

but there is nothing that is harder to explain."

~David Chalmers~

Interestingly, it is not so much the biologists, physiologists, pathologists, or psychiatrists who are making headway in the quest to understand consciousness, but the quantum physicists, contemporary incarnations of the likes of Einstein, Bohr, Planck, Bohm, Heisenberg, John Wheeler, and Paul Levy who are compelled to define reality without any proof of it. To understand consciousness without any image of it.

If, like me, you are in awe of the complexity, precision, and perfect timing that mark the biology and physiology of the human body, you can't help but be mystified by the brain. Sooner or later you will be led to contemplate the role of consciousness in health and disease. The benefits of meditation. The influence of mood and emotion on wellbeing, all of which should amaze you. Humble you. And naturally spiritualize you.

"Attempting to understand consciousness

with your mind

is like trying to illuminate the sun

with a candle."

~Mooji~

I just finished a book about quantum theory. It opened with an introduction, foreword, and preface, and it ended with 896 footnotes. It suggests that there is a precise, elegant, and exact parallel, down to the most minute detail, between the laws of subatomic physics and the workings of the human mind. That would be hard enough to comprehend if we understood the mathematics that proves it. The problem is we don't have a language to express it yet. And, until we do, the nature of consciousness will remain a mystery, and an untapped resource for patients and healers alike.

"If you think you understand

quantum mechanics,

you don't understand quantum mechanics."

~Dr. Richard Feynman~

jan

the difference between permanent scars and invisible scars

 

1. the gash in my right eyebrow

2. the sprained ankle

3. the incident with the pitchfork

These are a few of the inconsequential injuries I survived as a child, the kind of bumps and bruises, scratches and scrapes, sprains and strains we all experience at one time or another. None is a big deal, until you know the stories behind them.

"Injuries are our best teachers."

~Scott Jurek~

I was four years old when I sustained the gash in my right eyebrow that took five stitches to close, and left me with a scar that is still visible today. But that's not the story. The story belongs to my brother who was recuperating from a near-fatal case of rheumatic fever at the time. When he came home from the hospital, he was ordered to bed for a year to rest his weakened heart. We moved his bed into the living room where he could be with the rest of the family even though he was bed-ridden. I took on the task of making him smile, not an easy thing to do. On the day in question, I was spinning around, making myself dizzy so I couldn't walk a straight line. Which he found hilarious...until I lost my balance, and fell against the corner of the coffee table. Bam! A permanent scar.

The sprained ankle happened when I was skiing in Vermont and took a tumble that caused my skiis to fly off while I slid to the end of a very steep slope on my back. My friend followed me down and managed to pick up my hat, poles, and gloves en route. Rather than make a visit to the first aid shed for an ACE and crutches, I simply tightened my ski boots...which kept the swelling down, acted as a perfect splint, and lent a whole new meaning to the word "stubborn."

The pitchfork incident occurred during an attempt to be helpful at home by digging a weed out of one of my mother's flower beds...except that the weed I was after turned out to be her most prized plant. No problem. The pitchfork slipped and impaled my foot before I could do any damage. Voila! Another enduring scar. And another reprimand...

"The pain of recovery
is sometimes worse than
the pain of the injury."

~Christine Caine~

None of these incidents was unusual, dramatic, or serious, but each of them supports a story. Yours will be different. Perhaps it was the time you had a black eye, and you lied to your teacher when she asked about it. You told her you slipped and fell in the backyard when, in truth, your father hit you in a fit of rage.

Or maybe you tell people that you always wear a tee shirt at the beach because you're prone to sunburn when you're really trying to conceal the scar that runs the full length of your chest...from the heart surgery you required to close the congenital defect that was missed at birth.

Maybe it doesn't show anymore, but your heart still races, your chest aches, and your hands shake whenever you have to cross a bridge because your best friend fell off the train trestle you were crossing when you were both just ten years old. And he didn't make it. And you had been warned to stay away from the railroad tracks...

The field of narrative medicine/healing embraces more than the technical side of illness and injury. It explores more than the biochemical, electrophysiological, and neuroendocrinological aspects of disease and trauma. It serves as a vehicle for understanding the context and meaning of illness and injury, which has everything to do with healing and recovery.

"The most important part of a story

is the piece of it you don't know."

~Barbara Kingsolver~

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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? 

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

 

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

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

 

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

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