defending our right to write

 

There is no question that women's reproductive rights are under assault, again. Whether you choose to defend the rights of the unborn or to support the freedom of women to choose, the battle lines have been drawn. There will be no surrender. 

If, like me, you harbor strong beliefs about the impending overturn of Roe v. Wade, you may feel helpless to be heard. Political debate hasn't changed anything. Demonstrations haven't changed anyone's mind. Social media has only inflamed the issue. What are we to do?

"The emphasis must be

not on the right to abortion,

but on the right to privacy and

reproductive control."

~Ruth Bader Ginsberg~ 

I don't know what you will do, but I chose to write.

This is a copy of the letter I mailed to every Republican senator this week:

The Honorable…

United States Senate

Washington, DC 20510

 

May 8, 2022

 

Dear Senator …,

I am writing to you regarding my concerns should the Senate move to undermine the reproductive rights of women by overturning the 1973 United States Supreme Court decision on Roe v. Wade.

I am a physician with over thirty years of experience in Family Medicine so I am familiar with the issues that impact the accessibility, efficacy, and safety of women’s health care. I am also the mother of three adult children, and a grandmother to three youngsters, so I know a lot about the sanctity of a woman’s body and her reproductive rights.

As a physician, it is my duty and privilege to assist my patients with the difficult decisions they have to navigate when it comes to health care. Whether or not it is safe to vaccinate their children. Whether or not to sign the Do Not Resuscitate order. Whether to carry an unintended pregnancy to term, especially in the case of rape/incest, or contraceptive failure. I don’t make these decisions for my patients. I educate them. I guide them through a maze of questions and concerns, some of which they might not otherwise have considered. Together we look at the pros and cons, the advantages and disadvantages, and the risk of unfavorable outcomes when we explore their treatment options. I don’t coerce them, or manipulate them, or mislead them to satisfy my personal, political, or religious agenda. I listen to the stories they share with me, and I respect the decisions they make for themselves.

It's not that I don't hold strong beliefs about a woman's reproductive freedom. I do. I am not declaring my support for, or my opposition to abortion. It is not my role, my duty, or my intention to impose my beliefs on anyone. Nor should you.

At the heart of Roe v. Wade is a woman’s right to decide for herself about elective abortion. Most of us will never have to confront this decision, but our daughters may, and our granddaughters may. The next time you give you daughter a hug, the next time you sweep your granddaughter into your arms, imagine her as a victim of rape. If you vote to overturn Roe v. Wade, be absolutely certain you are willing to watch her suffer. To make her suffer. Ask yourself if you will embrace her child of rape with the unconditional love you feel for your own children.

Because this is my fear. I fear for the infants born to these women. That they will be neglected, rejected, and abused because the color of their skin, or the texture of their hair, or their facial features mark them as different. As undesirable. As unlovable. I worry that they will end up in our emergency departments, abandoned on our streets, or cast off into the trash. How will we care for the ones who survive? Who will care for them? You cannot claim to support the right to life of the unborn unless you have a plan in place to protect and care for them after birth. 

I worry, too, that women will, once again, be forced into back alleys and basements in a desperate and dangerous effort to terminate these pregnancies. That we will see a resurgence of the septic abortions and mutilations that compelled us to support women’s safety and well-being by passing Roe v. Wade in the first place. I am afraid the next generation will manifest a whole new class of traumatized, angry, and abandoned women and children.

But that’s not the only problem I anticipate. The decision to revoke the protections and human rights of women will set a new legislative precedent. It will confer authority to outliers and men in power to unilaterally eliminate the protections we have put in place to support immigrants and asylum seekers. To prevent gun violence. To feed the hungry and shelter the homeless. To access affordable health care, and to protect our privacy.

If Roe v. Wade falls, it will bring our constitutional democracy to its knees, a democracy that has flourished not in spite of, but because of, its diversity, inclusivity, and vision for over 200 years. Indeed, we have already witnessed the violation of basic human rights, the corruption of justice, and a surge in violence and fear among our most vulnerable citizens in the name of political power, self-proclaimed entitlement, and hatred.

This is not the America you and I grew up in. It is not the same country that bestowed upon us a path to success, security, and freedom. How can we deny it to others?

As a United States Senator, you are in a position to change the course of history as it is being written. Will you allow yourself to surrender to men who are hungry for power and control over the reproductive freedoms of women they don’t even know? Why are you afraid to stand up to them? Has your heart hardened against the humanity you are part of? What scares you about defending the rights of women? What prevents you from acting out of dignity, purpose, and principle?

When did you fold?

For the sake of all women and children, out of compassion for all who suffer, and in the name of human rights, I implore you to reconsider your support of the Republican leadership on this important issue. Vote to uphold Roe v. Wade. Do what is honorable, compassionate, and just, or explain to us why you refuse.

Thank you for your attention and consideration.

Yours,

Janet F. Cincotta, M.D.

*

I chose to write not because I believe my words will actually make any difference, or change anyone's mind. I don't. It isn't important to me that anyone is impressed by what I have to say. Nor do I judge or condemn anyone whose convictions contradict mine. I wrote because it is the one thing I can do, and I strongly believe each of us should do something--whatever we can--to preserve social justice, defend democratic principles, and sustain the balance of power in this country. 

"The measure of a man

is what he does with power."

~Plato~

jan

how storytelling reopens the wound

If you are reading this blog, you probably have some familiarity with, or curiosity about, the concept of storytelling as a healing practice. If you are a health care provider, a therapist in any field, a caregiver—or if you have ever been sick yourself—you may have an untold story wreaking havoc in the back of your mind. Perhaps it reflects a painful, sad, or frightening episode in your past…something you’d rather not resurrect. Maybe there was a time of such joy or relief or healing you can’t imagine putting it into words so you haven’t even given it a try.

"A writer is someone

for whom writing is more difficult

than it is for most people."

~Thomas Mann~

Or…perhaps you’ve started the story again and again and gotten nowhere with it. It turns into a rambling description of places, persons, and events that fails to capture the emotions that made the experience meaningful to you.

This is where a good writing prompt can be helpful. That and a supportive reader who knows how hard this is for you and heaps praise upon you just for trying.

If you need a little nudge to get you started, here a of couple of writing prompts for health care providers that might help:

·         Write about “expectations” you’ve embraced (or rejected).

·         Tell us what it feels like to work without sleep, on an empty stomach, when you have to pee, in the middle of the night.

·         What goes through your mind on the way to work in the morning…or on your way home at the end of the day.

If you are the one who was sick, or you cared for someone who was ill, try these:

·         Write about "waiting."

·         Tell us what you fear the most.

·         Tell us what you do to care for yourself.

When you begin, don’t worry about grammar, spelling, or punctuation. That’s the easy part, and it can wait until later. Instead, write about the first thing that comes to mind.

"When in doubt, tell the truth."

~Mark Twain~

Give yourself 15 minutes or so, then rest. Wait a couple of days and try again. Write until you come up against the piece that is hardest to write…a time when you were so sad or scared or angry you still hesitate to commit it to paper…or so comical or comforting or inspiring it leaves you groping for words.

"The most important things are

the hardest to say

because words diminish them."

~Stephen King~

When you write, include details even if they seem insignificant. The missing tile on the ER wall. The overflowing trash can in the visitors’ lounge. The ladybug that made its way into the OR. These familiar images connect the reader to your story. Use the senses to bring the scene to life. The sight of blood pumping out of a tiny artery after the other bleeders were all tied off. The taste of cold, black coffee in the middle of the night…and why you sometimes need it. The smell of stale urine.

"To create something exceptional,

your mindset must be relentlessly focused

on the smallest detail."

~Giorgio Armani~

An untold story can leave us with a vague sense of frustration, anxiety, or confusion that we don’t understand, and can’t dispel until we put it into words...until we set the scene, name the players, and face the feelings that have festered out of sight for so long.

Storytelling unmasks the wound so healing can begin.

"Nobody cares how much you know,

until they know how much you care."

~Theodore Roosevelt~

jan





have you had your nap today?

 

Have You Had Your Nap Today?

 

Back in the days when my priorities were somewhat skewed, writing was on the bottom of my list of the ten most important things I needed to accomplish every day. Ahead of writing…dreaming up characters, fabricating dialogue, and searching for just the right word…were:

--caring for my patients

--getting the kids out of bed, dressed, fed, and off to school

--keeping the house in reasonable order

--getting meals on the table

--staying ahead of the laundry

--managing the yardwork

--running to the bank, grocery store, post-office, dry cleaner, etc., etc.

--preventing dirty dishes from accumulating in the sink

--getting a little exercise

--staying in touch with family and friends

...all of which are honorable and necessary expressions of a civilized life, but really? How much can one person do in one day? And notice that embellishments such as enjoying a manicure or massage, meeting with friends over a cup of coffee or a glass of wine, and slowing down long enough for an afternoon nap are nowhere on the list, a sure sign that something needs to change.

"Good things happen

when you set your priorities straight."

~Scott Caan~

Now I know better. I have learned that many of the little self-imposed tasks and obligations that we stake our lives on can be organized and dispatched in a heartbeat. I know now that before we tend to them, we must first of all write…or paint or compose or sing or dance…in order to sustain momentum, to nourish and energize ourselves, to satisfy and fulfill our longings. In other words, to be creative and connected and happy. And instead of barreling through the day at warp speed in order to earn ourselves a few free minutes to write before we collapse into bed at night, we must learn to celebrate the virtues of idleness, day-dreaming, playfulness, solitude, silence, and rest. As the mind wanders, so does the imagination. And out of the imagination, who knows what might emerge? 

                                "Let's start by take 

                     a smallish nap or two."

                                            ~Winnie the Pooh~

Have you had your nap today?

jan

there's a wound out there in the shape of your words

 

I spend a lot of time encouraging people I know to tell the stories they hold tight in their hearts. To write them down, or get them onto a canvas, or put them into movement or song. As a physician, I do this because I know that storytelling is a healing practice. Why is this important? In the words of poet Sean Thomas Dougherty:

"Because right now

there is someone out there 

with a wound in the exact shape of your words."

~Sean Thomas Dougherty~

People need to know they're not alone. They need to know how you survived. That there is hope. That their story is important, too.

We hesitate to begin out of fear. We tell ourselves we don't write well enough. We don't know where or how to get started. We are sure no one could possibly be interested in what happened to us, so we make up excuses. I don't have time to write. My grammar and spelling stink. People will never believe me.

Sometimes, shame silences us. We have been conditioned to keep secrets. We blame ourselves for what happened to us. Or perhaps we're still struggling with the issue. It's too painful, or sad, or maddening to put into words.

If you're having trouble getting started with your story, if you have no confidence in your ability to tell it, or you have no time or energy to devote to one more thing...welcome to the club! This is where we all started.

The good news is that help is available. 

"When the student is ready,

the teacher will appear."

~Various Attributions~

This week, I finished "Memoir as Medicine" by Nancy Slonim Aronie. As soon as I hit the last page, I started again at the beginning. If you need just a tiny jolt of reassurance, inspiration, and encouragement to pep you up, stop whatever you're doing right this minute, and order this book. Or run out and purchase it. Do it! We'll wait. While you're at it, pick up a new notebook or journal so you can take notes. Prepare to laugh, and perhaps, to cry. Prepare to begin writing. Get ready to heal.

"Writing is medicine.

It is an appropriate antidote to injury.

It is an appropriate companion for

any difficult change."

~Julia Cameron~

Now go to the author's website at https://chilmarkwritingworkshop.com/ to learn more.

jan

a tribute to anyone who has ever been hospitalized

Lately it seems like an uncanny number of my friends have been hospitalized for one reason or another. One because she was in diabetic ketoacidosis. One to manage the side effects of chemotherapy. This week another one started up the mountain...from X-ray, to biopsy, to surgery, to God-knows-what.

This post, then, is a tribute to anyone who has ever been hospitalized. It's a snippet from my novel, "The Bandaged Place." In it, my protagonist, Kate Tilton, shares her thoughts about her first day post-op:

"Even when surgery goes well, it wrings you out dry. I can attest to this because yesterday, as soon as anesthesia wore off, I felt like, well, road kill. I looked like it, too. And it just keeps getting worse because today they had the nerve to let visitors loose in my room to gawk at me when I am in no mood to entertain.

The pain isn't the problem. I'm getting morphine for that. In fact, the morphine is the problem. I just feel so giddy. I can't see straight, and I'm prettty sure my speech is slurred. The last time I was awake enough to speak, Shirley, my nurse this shift, asked me about the pain. I think I said "five" when I meant to say "fine." To a med-surg nurse, "five" means the worst pain possible, so she gave me another squirt of the magic potion...which is why, now that I'm awake again, I'm in love with everybody in the whole wide world. I just haven't figured out why they can't be here in bed with me right now.

And it doesn't bother me in the least when, for the umpteenth time in eight hours, Shirley hits the switch, and I am blinded by the overhead lights while she rechecks my vital signs--blood pressure, pulse, respiratory rate, and temperature--signs that I have survived. This has been going on all night long.

Shirley has been a nurse here for twenty-some years, night shift. After she finishes checking wounds, adjusting IV's, and passing meds for the night, she fortifies herself with Oreos and Coke. Despite her weight, she is the kind of woman who seems to walk on air--easy, silent, and graceful. Her touch is gentle, and her hands are warm. She is genuinely kindhearted, so even though she has interrupted my sleep countless times all night, I don't resent her for it at all.

"Sorry to disturb you again, darlin'," she says. "I'll just be a minute here."

I roll toward her and extend my arm. I like it when people apologize even though they haven't done anything wrong. You can forgive them in an instant, and then you're endeared to one another for life. "It's not your fault. I was a cake anyway," I mumble. I'm pretty sure that doesn't come out right, but it's the best I can do right now.

She laughs as though she thinks I'm the sweetest patient she has ever cared for, and then she reassures me, "First night's always the hardest." She takes my temperature, wraps the blood pressure cuff around my arm, and feels for the pulse in my wrist.

That's the last thing I remember until six o'clock sharp when someone arrives to draw my blood for the tenth time to check my blood count, sugar, and potassium. But I'm not diabetic, I didn't hemorrhage, and there's potassium running in my IV, so why even bother?

Right on schedule, a breakfast tray is delivered to my bedside and deposited on a little table that is just out of reach. So even if I were hungry or thirsty--which I am not--I'd have to settle for the smell of food, and that turns my stomach.

Not fifteen minutes later, the lady from dietary is back. "Not hungry yet?" She smiles as though she understands completely. It's much too soon after surgery to have worked up an appetite. So she clears away the untouched tray without so much as a word of encouragement like, "Here, let me bring this a little closer. So you can reach it. You should try to eat a little something." Not that I could get a fork up to my mouth if I tried.

I could cry, but I won't, so help me God, not even when Shirley insists I get out of bed and shuffle all the way over to the bathroom and back, pulling my IV stand along behind me like a two-year old, "Come along, now. It's time to go potty." Whoa--not so fast, I'm thinking. As I roll over and sit up, ten thousand poison arrows pierce my chest. The moment I get my feet down, it feels like the floor falls away. My knees quiver. The room spins. Thankfully, Shirley has the strength to steady me.

"Take your time, now. Take it slow. We don't want you to take a tumble now, do we?"

No, we do not, I'm thinking. So can't you just bring me a bedpan or something?

Oh, my God! Did I just ask for a bedpan? Somebody please hand me a gun!"

*

If you're a healthcare provider...or if you've ever been a patient...and you're hesitant to tell your own story because you don't think anyone wants to hear it, or you don't think you write well enough, or you're having a  hard time putting it into words...

tell somebody else's story.

"There is nothing worse than thinking

you are well enough...

Don't turn your head.

Keep looking at the bandaged place."

~Rumi~

Famke

jan

when storytelling is an obstacle to healing

The goal of training in narrative medicine is to provide the health care provider with tools to help him uncover otherwise unspoken details that might impact diagnostic accuracy and successful treatment. 

"You'd be surprised what lengths

people will go to not to face

what is real and painful inside them."

~Various Attributions~

This is especially important given what we now know about childhood trauma and its remote influence on adult health and well-being. Most patients don't make the connection between their experiences as a child and the headaches, hypertension, IBS, anxiety, depression, and addictions that plague them as adults. 

The enduring effects of childhood trauma in its many guises--verbal/physical/sexual abuse or neglect, injury or illness, a significant loss, the stress conferred by poverty, racism, and even bullying--can be hard for patients to put into words. This is especially true if the trauma they experienced occurred pre-verbally, if it was a secret they kept, something they couldn't tell anyone about...and still can't, or if it was so severe they dissociated from it. They may have suppressed the memory of it, or lack the language to express it. 

"You can spend a lifetime

trying to forget a few minutes 

of your childhood."

~From HealthyPlace.com~

But make no mistake...they still feel it in their bodies. 

Working with these patients can be a challenge because just the process of narrating the experience can be traumatizing to them. When they are encouraged to re-tell the story, they can re-experience the trauma, and regress or shut down. In this case, exploring the patient's narrative can pose an obstacle to healing. 

You may sense this when the patient's body language shifts. His posture may change. His facial expression and the tone of his voice may change. He may start fidgeting, stiffen, or slump. Instead of asking him what he is thinking about, it may help to ask him where in his body he is feeling it. Does his neck ache? Is he aware of his heart beat? Is he shaking? Does he feel nauseated? Lightheaded? Once he understands that he is safe despite these somatic manifestations, he may be able to connect them with his traumatizing experience, and eventually with his ability to heal.

"Trauma comes back as a reaction,

not a memory."

~Bessel Van Der Kolk~

Somatic psychotherapy helps patients integrate the physical manifestations of illness with the fear, anger, grief, shame, confusion, and denial they cannot express. Suppressed memories may emerge.

When the patient understands that he is safe despite the fact that his chest aches, or his energy is drained, or his mind goes blank, the mind-body connection is strengthened, and a pathway to healing is revealed. 

Six Steps to Strengthen

Mind-Body Connection:

1. Close your eyes and

    take a deep breath

2. Scan the body

3. Be aware of any sensations,

     pleasant or unpleasant

4. Notice where the sensations

are coming from

5. Let your awareness travel

around your body

6. Follow these sensations

     until they disappear

~From Quotemaster~

*

jan

how civilizations heal

~Ukraine Flag~

by Setsiri Silapapsuwanchai

If, like me, you are deeply affected by the war in Ukraine, you may find it difficult to put your thoughts and feelings into words. Thankfully, others have taken a stab at it for us. They have shared inspiration and consolation with us, both with and without words:

~Tower of Mothers~

A 1937 sculpture by German artist Käthe Kollwitz that

depicts women standing in a circle to protect their children from the horrors of war.

*

The Peace of Wild Things

~Wendell Berry~

When despair for the world grows in me

and I wake in the night at the least sound

in fear of what my life and my children's lives may be,

I go and lie down where the wood drake rests

in his beauty on the water, and the great heron feeds.

I come into the peace of wild things

who do not tax their lives with forethought

of grief. I come into the presence of still water

and I feel above me the day-blind stars

waiting with their light. For a time

I rest in the grace of the world, and am free.

*

Hope springs eternal.

*

Cultivate EQUANIMITY:

mental calmness, composure, and evenness of temper,

especially in a difficult situation.

*

~I've got peace like a river~

*

Mahatma Gandhi, on nonviolence:

First they ignore you,

then they laugh at you, 

then they fight you,

then you win.

What inspires you? Where do you turn for comfort? For solace? For peace? 

How do you make sense of life as it unfolds?

"There is no time for despair,

no place for self-pity,

no need for silence,

no room for fear.

We speak, we write,

we do language. 

That is how civilizations heal."

~Toni Morrison~

How will you help?

jan