the wound that still needs to heal

 

You don't have to be a healthcare provider to share a medical narrative with the world. If you have ever been sick or injured, or if you have cared for someone who was ill or injured, you have a story to tell. Why should you? Because people everywhere are experiencing some iteration of the same ordeal...pain, fear, shame, anger...and no one knows how to navigate it. They need to know how you made it through. Where you found the strength and courage to heal. How you overcame obstacles to recovery. How many tears you shed...and how you learned to smile again. 

"Healing yourself is connected with

healing others."

~Yoko Ono~

Perhaps you recall the time you had to remove the splinter from your child's foot. It seemed like a trivial enough incident...until you are reminded of her pain, her fear, and what you did to ease her through it. Or maybe it was the day you learned your newborn needed open heart surgery...when your fear and your dread outweighed his. Perhaps your narrative started with nothing more than the bruise you tried to ignore, until it morphed into leukemia. Maybe it began when the doctor missed the diagnosis, or botched the operation. Oh! You have a story to tell, all right. Emotions to explore. Sorrow to express. Anger to release. These things happen every day, and people never stop struggling with them. They need your help. What will you tell them?

"The final stage of healing is using 

what happened to you to help other people.

That is healing in itself."

~Gloria Steinem~

If, on the other hand, you are a healthcare provider--a physician, nurse, EMT, or therapist in any field--your narrative may have different layers, each emerging from your unique perspective as a healer and/or caretaker. When and why did you decide to enter your chosen field? What was the hardest thing about your training? About your practice? Is it what you had hoped it would be? Your story embraces your victories and defeats, successes and failures, your motivation and your frustrations, your determination and your insecurities, your joys and your sorrows. If you have ever been seriously ill or injured, you can also write from the perspective of the patient, in light of your special insight and expertise. What will you reveal? What still needs to heal?

"The healing that can grow out of

the simple act of telling our stories 

is often quite remarkable."

~Susan Wittig Albert~

Oh! It's in there, all right. We all have a story to tell because we all embody a wound that needs to heal. Won't you tell us about yours?

"Write hard and clear 

about what hurts."

~Ernest Hemingway~

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the hardest thing

Healthcare providers are, by nature, driven by the desire to serve as helpers and caretakers, healers and comforters, empaths and sympathizers. Both on the job and off...

...which is why last week was so hard. There was a death in our family, a call to be present. An appeal for connection and support. An invitation that tested both spirit and belief.

Hundreds of people--family, friends, coworkers, and acquaintances--dropped everything in an effort to gather to "celebrate" (actually, to mourn) the life that had passed. They took time off from work, and made arrangements for childcare, travel, and accomodations. They ordered flowers, and delivered food. They knelt in prayer, or sat in meditation. They embraced one another and wept openly, or they mourned silently. They did all they could.

"Look for the helpers.

You will always find people

who are helping."

~Mr. Rogers~

Navigating grief is difficult, but it isn't the hardest thing we are called to do. When we arrive at the graveside, we are asked to check everything else at the gate...our expectations, our fears, our anger, all the sorrows we hold in our hearts. Disappointment. Shame. Guilt. Blame. We are asked to come with open arms and caring hearts.  

"Give me your past.

All your pain. All your anger. All your guilt.

Release it to me, and I will be a safe harbor

for the life you need to leave behind."

~Jewel E. Ann~

This may be hard...pretty much impossible for some of us...but it's not the hardest thing. You could be left out...as a friend, as an anchor, as a wellspring of comfort and consolation. Perhaps you couldn't get time off from work, or your flight was cancelled, or bad weather kept you away. You wanted to be there, but you couldn't.

Still, it could be even worse...

...if you simply cannot leave your own burdens behind. If you arrive weighed down with old resentments, disappointments, and misunderstandings. When you don't have the strength or desire to reach out. You arrive without flowers or food. You cannot manage a song or a prayer. 

When you are needed the most, you are helpless, and that is the hardest thing. 

"Grief does not change you...

It reveals you."

~John Green~

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what to expect when you recover... if you recover

 

At a writing workshop I attended recently, we were asked to respond to specific prompts. We wrote for 15 minutes or so, and then read what came up for us to the group. One of the prompts was to write about a time someone lied to us. I wasted a good five minutes trying to recall a story-worthy episode to write about. This is it:

True story:

Telling a lie can have life-threatening consequences.

My shift in the Emergency Room was almost over, and I was already counting the minutes until I could head home to my tail-wagging, cheek-licking puppy and my own warm bed.

Just one more patient to see.

I pulled the curtain aside to find a young woman with a tear-stained face, pressing an ice pack against her right eye, her boyfriend holding a bloodied towel.

"We were just having fun jumping on the bed," she explained, "but I lost my balance and hit my eye on the corner of the nightstand. Right, Kevin?"

"One thing more shocking than the truth 

are the lies people tell 

to cover it up."

~Author Unknown~

It occurred to me that they were rather old to be jumping on a bed for fun. And he looked like a bodybuilder, suggesting the bed must have been made out of reinforced steel and concrete.

"Let's take a look," I said...thinking it would just take a few quick stitches and I'd be done for the day.

But under the ice pack, her eye was bruised and swollen shut. Blood oozed from a cut above her eyebrow, and her nose looked a little crooked, too.

The technical term for her injury is a blowout fracture of the orbit, or eye socket, and it represents a medical emergency. It's like a skull fracture, and it can result in blindness. You hardly ever see this kind of injury except in a car crash, or an industrial accident, or a major league baseball game. It takes a lot of force to cause a blowout fracture.

I got to work. I ordered Xrays and summoned the surgical team while they prepped the OR. I started an IV, drew her blood, and convinced her to sign the consent form.

One of the nurses escorted her boyfriend out of the room as chaos erupted. When he was safely out of earshot, I tried again.

"Linda," I said. "Tell me what really happened."

"Trust your instincts.

Intuition doesn't lie."

~Oprah Winfrey~

A direct blow to the eye by a fist is a terrible injury, and it adds layer upon layer of extra work. You have to summon the police and file a report. You may have to obtain a protection from abuse (PFA) order. You have to consult someone in Social Services to secure a safe place for her to shelter when she recovers. 

If she recovers. 

Because, in medicine, telling a lie can cost you your life.

"In the long run,

the most unpleasant truth

is a safer companion than a pleasant 

falsehood."

~Theodore Roosevelt~

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variations on a theme

 

Let's say you have three patients who are battling cancer.

One is devastated by the diagnosis. She is overwhelmed by fear and dread. Convinced her situation is hopeless, she resists starting chemo. She just wants to die. Her doctor suggests an anti-depressant.

"Once you choose hope,

anything is possible."

~Christopher Reeve~~

One is a man of deep faith. He is convinced that God has the power to cure him even though his prognosis is unfavorable. He devotes himself to prayer and sacrifice because he believes that will earn him God’s mercy. Even when his cancer spreads, he clings to his faith. It gives him hope and a sense of optimism right up until he is forced to surrender to the disease. His doctor tries to be respectful of his faith, but he can’t shake off his own doubts about it.

"Cancer didn't bring me

to my knees.

It brought me to my feet."

~Michael Douglas~

The other patient is f***ing pissed off about it. She is not about to lose this battle. After all, she has a husband and three children at home. It isn’t fair to them. She agrees to an aggressive plan of treatment that includes surgery, radiation, and chemotherapy. She begins a program of exercise, diet, and meditation, and she adopts a practice of loving self-care. She is determined to beat this thing. Her doctor encourages her even though he doesn't indulge in self-care, himself.

"You never know how strong you are

until being strong is

the only choice you have."

~Bob Marley~

Three different patients with the same disease, and three different stories. What difference does it make? There is an abundance of literature concerning the factors that affect a patient’s quality of life during treatment for cancer and how this correlates with his likelihood of recovery. Some factors are immutable: age, gender, and family history, for example. Others are modifiable: emotional and attitudinal factors, dietary factors, level of fitness, faith, and social support.

Given their stories, the physician will approach each of these patients differently, even though each of them has the same fundamental needs: education, encouragement, and support.

When is the last time you had to convince a patient to enter treatment? When is the last time you offered to pray for--or with--a patient?

When is the last time you practiced self-care?

"Self-care is a 

divine responsibility."

~Danielle La Porte~

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a grand tectonic shift

I spent last week at a writing workshop at Omega Institute for Holistic Studies in Rhinebeck, NY. Usually, when I go to Omega, I spend an inordinate amount of time in the bookstore, and I come home with a small fortune in books I can't wait to read. But something changed this time. I walked away empty-handed again and again. It dawned on me that I had read what I wanted to about Buddhist psychology, meditation, healing, and consciousness. Of course, what I know is barely the tip of the iceberg, just a smattering of the literature, the teachings, and the practice. But leaving the bookstore with nothing, it struck me: It's time for me to start writing my book. 

"If there's a book

you really want to read,

but it hasn't been written yet,

then you must write it."

~Toni Morrison~

I felt a twinge of panic. This is going to be hard.

"Write about disturbs you,

what you fear,

what you have not been willing to speak about.

Be willing to be split open."

~Natalie Gildberg~

What will I write about? This is about those tectonic shifts that dismantle the foundation our lives. That make us question what we have always believed, or been taught is true, or have tried to live by, and where we go from there. Sometimes it concerns physical healing...when cancer strikes, or the heart gives out, or a disabling injury occurs. Sometimes it requires emotional, psychological, or spiritual healing...from trauma, or abuse, or shame, or guilt.

"If you never heal

from what hurt you,

you'll bleed on people who

didn't cut you."

~various attributions~

When did it happen to you? How did it change you? How will you heal? When will you begin writing about it?

"We write out of revenge against reality,

to dream and to enter

the lives of others."

~Francine du Plessix Gray~

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a change of mind, a change of heart

 

 Anyone who knows me, or reads this blog, knows that I am fascinated with the human mind. How little we understand about how it works. How thought is generated. How memories are retrieved. So it's no wonder I am intrigued by the concept of neuroplasticity--the property of the brain that allows it to change structure and function in response to changes in the environment, our personal experience, and our intentions. It accounts for how the brain changes over time, and specifically, how we can consciously generate those changes. In other words, it allows us to rewire our brains. We can change our minds.

"Nature has given us a brain

that survives in a changing world

by changing itself."

~Norman Doidge~

This came into focus for me in light of the Covid-19 pandemic. While most of us are compliant with the simple mitigation practices that have been shown to contain the spread of the virus, and are eager to get vaccinated, not everyone agrees. Some people are skeptical of the science behind Covid research, and the physicians who are trying so hard to explain it to them. There is an oppositional-defiant edge to their attitude and behavior. They cannot, or will not, change their minds despite the proven efficacy and safety of such simple measures as masking and social distancing. They refuse the vaccine. Their defiance puts their lives at risk, and it threatens the rest of us.

"The highest form of ignorance is

 when you reject something

you don't know anything about."

~Wayne Dyer~ 

As a physician, this frustrates and angers me. There is a tiny voice in the back of my head that keeps telling me that people like this deserve to get sick. To suffer. To die. To watch their children get sick and die. It was the choice they made, and nothing we have said or done so far has had any effect on them. They don't care about us, so why should we care about them? And on and on...

This little voice is not one I welcome. This is not me speaking. It is social media exerting its pull. It is political commentary pushing back. It is, in fact, human nature going down its well worn path. But it is not what I know in my heart to be true, so I'm making an effort to change my conditioned and deluded mind about it...

"It is not the strongest 

of the species that survives,

nor the most intelligent that survives.

It is the one that is most adaptable to change."

~Charles Darwin~

...because I hate to see anyone suffer. Certainly, not a child on a ventilator. Not his mother in tears at his bedside. Not even a turtle stuck on its back, or a robin with a broken wing. I wouldn't wish Covid-19 on anyone. No one "deserves" to suffer, and if the decisions they make cause them pain, my intention for them is comfort, solace, and healing. If I could speak with them, I would tell them that they'd made a mistake. That people lied to them. That there's a lot of misinformation out there.That they didn't understand how viruses are spread, how they replicate, and mutate. How vaccines work. 

Then I'd teach them about neuroplasticity. I mean, if I can learn to change my mind, maybe they can learn to change theirs.

"Sometimes you change your mind...

sometimes your mind changes you."

~Binyomin Scheiman~

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the moose in the mud

 

"The clearest way into the universe is through a forest path." 

~John Muir~

I was lucky enough to have been invited to spend last week in a cabin in the Maine woods. My "bucket list" item for the trip was to spot a moose, and I did. But not in the way I had hoped.

My daughter and I set out one evening for a bog that was known by the locals as a good place to watch for moose. We pulled off the road and waited...and waited...and waited. We thought we were seeing a bird flapping its wings every so often, until we realized we were seeing the ears and tail of a moose twitching as she lay in the mud. 

We pulled up closer, and sure enough...there she was, lying in the mud, barely visible. It occurred to us that she might be sick or injured, but she wasn't struggling, or calling out. So we concluded that, like all good mamas, she just needed a little time to herself, and what better place for a moose on a hot day than in a nice cool mud bath. Still, we didn't think it was too much to ask for her to stand up and take a few steps for us, so we whistled at her, clapped our hands, called out to her, and honked at her. We pleaded with her and cajoled her...all to no avail. We gave up as darkness closed in...

"Until one has loved an animal,

a part of one's soul remains unawakened."

~Anatole France~

...but the next morning we were on the road at 5 AM to see if she was still there. Again, it was hard to make her out, but there she was! We stayed with her for an hour, but except for those twitching ears, she didn't move. 

So, we went back that evening, and we were actually relieved to see that she had moved on...that she was OK...until we pulled off the road to turn around. That's when we found her. Dead, in a clearing, with two broken legs. How she managed to get out of the mud and through the underbrush to the clearing I will never understand. The pain. The suffering. We were stunned. Heartbroken. And so, so sad for her.

"May all that have life

be delivered from suffering."

~Buddha~

Why am I sharing this story on a narrative healing blog?

I can't get her off my mind. Perhaps telling her story will help me accept it. Maybe it will serve to caution inattentive or careless drivers. Maybe it will honor her suffering, in some way. 

It makes me wonder how I will bear my own  pain when the time comes. What if I go into heart failure? Or I develop cancer? Or I fall and I can't get up? Will I bear it quietly? Courageously? Patiently? How will I prepare my family for it? 

~Ilan Shamir~

As health care providers, we all witness pain and suffering. We are trained to do whatever we can to relieve it. We all witness death. In some cases, we have time to prepare our patients for it. We are sometimes called to break the news to their families. I held my mother's hand during her last hours, and stayed with her until she took her last breath. She didn't die alone, in pain, to be discovered too late by some passerby.

It makes me wonder how, in that vast wilderness, a solitary moose and a rare passing vehicle happened upon each other that day. Why? What are we meant to learn from this disasterous stroke of synchrony?

It reminds us that we don't always know when someone is suffering. Like the moose in the mud, they may not let it show. 

We are reminded to seek them out. To be patient with them. To be kind and gentle always.

To hold space for them in our hearts when there is nothing we can do to help.

I'm pretty sure the moose just became my spirit animal.

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