unspoken forces at work

  

Hippocrates is the one who advised physicians, "First, do no harm." Cicero proclaimed, "The safety of the people shall be the highest law"...lofty principles that, to this day, both challenge and inspire health care professionals.

It was Paraclesus, though, who declared, "The physician should speak of what is invisible...He becomes a physician only when he knows that which is unnamed, invisible, and immaterial, yet has its effects." He was speaking, of course, about the impact of the patient's thoughts, feelings, and emotions on his experience of injury and illness. These include his fears, expectations, and hopes...all invisible, all immaterial. 

"O, what an untold world

 there is in one human heart."

~Harriet Beecher Stowe~

In his book, "The Wise Heart," Jack Kornfield reminds us that the key to healing has to do with the patient's understanding of his illness. What is he fearful about? Why? What does he think will happen to him? How will he support his family? Who will take care of her children? It turns out making the diagnosis is sometimes the easy part. Uncovering the patient's hidden fears can be harder.

"You'd be surprised

what lengths people will go to

not to face what is real and painful 

inside them."

~Ian Kester~

For example, let's say a patient presents with breast cancer. She is forty-four years old, the same age her mother was when she was diagnosed. But her mother died following surgery and a full course of radiation and chemotherapy. This is what scares her. She jumps to the conclusion that this is her fate as well, despite the fact that her mother's cancer was far more advanced when it was detected. Despite the fact that treatment has improved in the twenty years since her mother's diagnosis. The patient's initial reaction to her diagnosis may be to give up right then and there...her unnamed, invisible, and immaterial thoughts, feelings, and emotions left unchecked.

"Your body hears everything

your mind says."

~Naomi Judd~

Or let's say the patient is a middle-aged man who schedules a ten-minute appointment with you so he can get something for his heartburn. But he isn't simply experiencing indigestion. He describes symptoms that suggest he is having angina, and it's getting worse. He has convinced himself that it's just his stomach because the thought of a heart attack scares him. His brother had one last year and ended up with a defibrillator. His ten-minute appointment includes an EKG and blood work, and it stretches into a forty-five minute dialogue about unstable angina and the need for hospitalization. He tries to laugh it off, but beneath his cavalier manner, he fears for his life. His family. His business. All of it unspoken, invisible, immaterial.

"A physician is obligated to consider

more than a diseased organ,

more than even the whole man.

He must view the man in his world."

~Harvey Cushing~

Clues to the unspoken forces at work in the patient's life include refusal of, or noncompliance with treatment. Denial, anger, impatience, or resistance. Reticence. Despair. 

As providers, we should handle these patients with special care. We should ask about their fears, expectations, and perceptions. We should confront whatever misinformation they may have picked up on-line. 

We have to explore what we intuit to be unnamed, invisible, and immaterial before healing can begin.

"Anything will give up its secrets

if you love it enough."

~George Washington Carver~

jan

a vision for healing

The Northern Lights in Reine, Norway

It has been said, 

"We touch heaven when we lay

our hand on a human body."

~Novalis~

As healthcare providers, this reminds us there is something sacred about the study and practice of medicine. Something that has been sacrificed in favor of speed, power, and profit among our corporate taskmasters. After all, we invoked all the gods and goddesses as witnesses when we took the oath that sealed our commitment to healing:

THE HIPPOCRATIC OATH

We pledged:

"I will comport myself

and use my knowledge in a godly manner."

The ethical, moral, and humane practice of medicine is our sacred duty. As Stephen Cope puts it:

"Sacred duty is the thing that,

if you don't do it,

you will feel a profound sense

of self-betrayal."

~Stephen Cope~

I was reflecting on this recently in view of the unrelenting onslaught of cruelty, injustice, hatred, and suffering that are all around us. War. Gun violence. Racism. Human rights violations. Climate change. Sexual misconduct. The anger and sorrow we bear. How hopeless things appear. How helpless we sometimes feel...at work, at home, in our communities, and in the world at large.

And then the answer appeared. A vision for healing.

If you do not read anything else in your lifetime, hop online right this minute, and order this book:

You don't have to read the whole book, unless, of course, you're interested in somatic psychotherapies, grounding vs. transcendence, and the nature and practice of embodiment. But if you're interested in how to survive in this world, just read the last chapter, "Call to Action!":

"Your sacred purpose maybe be subtle and calm...

or it may be the fiery path of the activist."

"We need you to endeavor to make

our medical system more heartfelt and wholistic."

"We need awakening men to rise up defiantly

and stand down those men still locked inside patriarchal 

and sexist ways of being."

"Don't be fooled by the shopping mall, 

the suburban malaise,

or the numbing addiction 

to our phones, screens, and virtual realities."

"It's one thing to pray, meditate, dream, and visualize

the sacred possibilities for our planet;

it's quite another to ground our expansive intentions

in lived action."

"It should not be women's work, alone,

to shift patriarchal paradigms--

men must boldly rally for their female counterparts."

As healthcare providers--doctors, nurses, nurse practitioners and physician assistants, EMTs and first responders, and therapists in every field--we are called to live out our sacred calling every day. Indeed, as human beings we are all compelled to seek the truth, and to defend our right to live according to what we learn. In this book, Jeff Brown encourages us to confront our sacred purpose consciously. He teaches us to overcome the obstacles that prevent us from discerning our unique calling in life and to live according to our own deep truth.

He suggests we ask ourselves:

What am I here to learn?

What am I here to overcome?

What am I here to offer?

What does my authentic face look like?

Who am I beyond the inner static of inauthentic voices?

jan

 

an existential crisis

Moskenesoya, Norway

Something shifted this week. After a month or so of stubbornly cold, gloomy weather we awoke to clear blue skies and temperatures that soared into the eighties. Suddenly everything turned green. The air was thick with the fragrance of honeysuckle and lilacs. I had just received a message from my daughter with a video of my granddaughter receiving an award at school (she's in kindergarten) citing her for being mindful, hard-working, kind, helpful, and inclusive. I was sitting on my deck watching a couple of deer in the woods out back, enjoying the sound of birdsong and the acrobatic antics of the squirrels, thinking to myself, "This is a perfect day." Then I received a second message from my daughter. 

She is a Child Life Specialist which means she supports children and their families when they come into the hospital where she works. Using age-appropriate language, she educates them about what they can expect to happen, and she uses calming and distraction techniques to help them through it.

This message described a child she was seeing who had been admitted with RSV a few weeks earlier but didn't seem to recover completely, so her parents brought her back to the ED. She was displaying some behavioral changes which led them to perform an MRI of her brain, and there it was: a massive midline tumor with hydrocephalus and metastatic spread all the way down to her lumbar spine. BAM!

She is six years old. My award-winning granddaughter is six years old.

How does anyone process this? One child happy and healthy, the other doomed to pain, fear, and suffering that herald an early death. In a few months. On an otherwise normal day.

How can we hold space in our hearts for both of these children? For their parents and siblings? 

How would you? 

"Hope is the last thing ever lost."

~Italian Proverb~

I ended up on a path through the woods. This is my "go to" refuge when I need to think things through, when I need peace, or strength, or insight. A walk in the woods serves as the perfect metaphor for the duality that sometimes throws us for a loop. One minute it's warm and sunny, the next it's cloudy and cold. One minute the path is straight and smooth, the next it's stoney and steep. One minute the air is quiet and calm, the next it's windy and wild. One minute you know the way; the next minute, you're lost.

Like life.

"Of all the paths you take in life,

make sure some of them are dirt."

~John Muir~

The child my daughter supported during her MRI will be transferred to a medical center that is better equipped to treat her. My daughter will never see her again. Nor will she ever forget her. 

Nor will I.

"At the end of the day

people won't remember what you said or did.

They will remember how you made them feel."

~Maya Angelou~

jan

no mud, no lotus

 

Gimsoya, Norway

If you are a healthcare provider in any field, or the caretaker for someone you love, you are well aware of the duality that permeates every aspect of reality...the coexistence and contradiction between joy and sorrow, between kindness and cruelty, between life and death. We feel this deeply every day in our work, but never more acutely than with the care of our patients. 

If you are writing about your experience, you may feel the push and pull of duality in your narrative.

First there's the story you have pictured in your mind...and then, there's the process of translating it into words on a page. It can take you from soaring with enthusiasm to slogging through the muck. You may find yourself stuck.

"No mud, no lotus."

~Thich Nhat Hanh~



Inspiration wanes, fatigue sets in, and the story line languishes. Self-doubt creeps in. And even though the end is in sight, like a desert mirage, it fades away the closer you get to it.

"What makes the desert beautiful

is that somewhere it hides a well."

~Antoine De Saint-Exupery~



This is a lonely place for writers. Your memoir or manuscript isn't polished yet so no one else has seen it or commented on it. Therefore, you don't get to enjoy the inspiration that comes with an exchange of ideas, weighing in on suggestions from writing partners. You need a fresh infusion of incentive, like the energy that emerges when composing a query letter or submitting to an editor or agent. But you're not there yet. This is just hard, lonely work, day after day.



How do you cope with it? 

Sometimes I'll take a little time out to dash off a piece of flash fiction, a short essay, or, like today, a blog post. It's like indulging in a little snack when you can't wait for supper.

 

Sometimes I have to tear myself away from the keyboard and polish off a few necessary chores before I can concentrate again. For example, when there's no food in the house, or I run out of clean underwear. I mean, priorities do change. Writing sometimes has to wait, especially at this time of the year. There is spring cleaning to think about and yardwork to do. Storytelling may have to take a back seat for a while.

What can you do in the meantime?



When I'm stuck for an idea or unsure how to put one into words, I'll pick a random passage to edit and revise, backtracking a bit until I'm sure I'm on the right path again.

"Real writing begins with rewriting."

~James A. Michener~



It also helps to read something by another author on a similar topic. A couple of my go-to favorites are:

"Memoir as Medicine" by Nancy Slonim Aronie

and

"Still Writing" by Dani Shapiro

Right now, I'm reading "Good Writing--36 Ways to Improve Your Sentences," by Neal Allen and Anne Lamott. Next will be "Dharma Dog," by Stephen Cope when it comes out later this year.

Just the process of reading beautiful writing invites the mind to get in on the action. 

Do you ever get bogged down in the middle of a project? What do you do to recharge? To move ahead? How do you get it all done?

"Many of life's failures

 are people who did not realize

how close they were to success

when they gave up."

~Thomas A Edison~

jan

the aftermath of childhood illness

 

Reine, Norway

I post a lot about the importance of telling your story...the one that needs to be told, the one that won't go away, the story others need to hear. But have I mentioned how hard this can be to do? Have I told you how hard it is to get started? How long it can take? How confusing it can be?

 

"If I'm gonna tell a real story,

I'm gonna start with my name."

~Kendrick Lamar~

 

The story I need to write has been nagging at me for over 70 years...since I was three years old. That's when my brother and I both went into the same hospital with the same illness at the same time. The story explores the divergent paths we took through life in the aftermath of our shared experience. And how long it took to share our separate truths.

 

It begins:

          "The aftermath of childhood illness can linger for a lifetime. You think you’re over it when, out of nowhere, you remember the way the nurse rolled you onto your side and bared your little buttocks. First came the jab, then the dull ache that lasted until the next shot was due. One moment you’re a fully functioning adult. The next, you’re a sobbing three-year old.
          Like a stain that won’t come out, like a fog that never lifts, it stays with you. It can send you down a path you never intended to follow. It has the power to transform you into someone you never wanted to be. The memory of it catapults you back to a time you'd rather forget."

I started working on this project in earnest six years ago. This is as far as I've gotten. The details are vivid in my mind, the story arc is clear, and I already know how it ends. What, then, is so difficult about telling it?

 

I think the hardest part is convincing yourself that your story is worth telling. And after that, engaging the reader. Convincing him that your story is also his. Compelling him to read on in order to make sense of his experience in light of yours. Finding meaning not so much in the recitation of events, but in their cause and effect, in your process and outcomes, in the truth you summoned the courage to share.



"When you stand and share your story...

your story will heal you

and your story will heal somebody else."

~Iyanla Vanzant~ 

 

For reasons that will take a full-length book to explore, my brother spent most his adult life battling the anxiety, fear, shame, and insecurity that followed his hospitalization, as well as the addictions that helped him cope. His story is an epic quest for healing.

 

I went on to study medicine.

 

If you are mystified by the way your life unfolded as it did, if you have spent sleepless nights reflecting on the people, places, and circumstances that shaped you as a human being, if you have ever wished things had been different, you have an important story to tell.

 

"Other people are going to find

healing in your wounds.

Your greatest life messages

and your most effective ministry

will come out of your deepest hurts."

~Rick Warren~

 

If you are discouraged about telling your story because you don't know where to begin, start by writing something. Anything. Start with your name.

jan

 

 

do the right thing

 

Guess where I've been all week. Here are a few hints. Imagine:

~charming fishing villages~

 

~sheer mountain cliffs~

~endless fjords~

~reindeer~

~and, yes, awe-inspiring views of the Aurora~

...not to mention kind and smiling people (especially the ones who gladly went out of their way to track down and recover a couple of misplaced carry-ons of ours), and delicious food...all of which we enjoyed despite a few days of dense fog, freezing rain, sleet, snow, and gale force winds! 

"There is no such thing as bad weather, 

only bad clothes."

~Norwegian Folk Saying~

If you guessed Norway, you would be correct. Norway...where we were treated to a sampling of life lived with intention above the Arctic Circle, complete with unimaginable beauty in a sometimes harsh and uninviting environment. Where the indigenous Sami people have protected herds of reindeer for generations out of reverence for their shared space. Where solitude is cherished, and community is celebrated.

This is where we spent almost ten days. We went from exclamations of "Wow! Wow! Oh, wow!" on the first day...directly to (pardon our French) "HOLY F--K!" the very next day! Because, you know, the Northern Lights. The pod of orcas we spotted. The bright blue-green water and how painfully cold it was. H.F. We fed the reindeer. We went snowmobiling in a blizzard. We jumped straight out of our hot tub into a snowbank. We ate reindeer stew. When in Norway...do as the Norwegians do.

And then it was time to leave, no small challenge when our flight home was cancelled. I won't bore you with the details, except to say this. When we arrived at JFK, we still had a two-hour drive home...along roads that were disappointingly, disgustingly littered with garbage, notably so because there was no such thing in Norway. Not a cigarette butt, or a gum wrapper, or a beer can anywhere. I mean, we knew we were returning to political mayhem, to cruelty, deception, and greed. To war. But to so much litter? To the trashing of our homeland?

This is the thing. People in Norway believe it is honorable and sacred "to do the right thing." To lend a helping hand without expecting so much as a "thank you." To care for one another and for their wildlife because they all benefit from it. To keep the land and water clean and beautiful.

Americans? Not so much. 

That said, my new mantra is: 

"DO THE RIGHT THING"

...whether you're tossing out a gum wrapper, or reaching out to someone in need, or going to the polls. Do the right thing!

jan 

relief may be just a small kindness away

As healthcare providers, we choose to devote our lives to caregiving. This trend continues for many of us after we retire from our careers as nurses, doctors, first responders, and therapists in every field. Many of my former colleagues continue to work in food banks and soup kitchens, to teach, and to volunteer to help those in need.

I do not. The pandemic forced me into isolation, and I discovered that I rather enjoyed it. It afforded me uninterrupted time for reading, writing, walking, and meditation. For silence. For reflection. I prefer to call it solitude...and I have continued to cultivate it in my life.

Still, I do help out here and there. With family and friends, their dogs, and especially the grandchildren. The goal is to make life just a little easier for them whenever I can. This week it involved a trip to Pittsburgh to deep clean a house for my son as he prepares to move in...a task he did not have the time for. Luckily, a friend offered to help me, someone who (for reasons I do not comprehend) actually likes to clean! And clean, we did...even though we all know that:

😉

But this is the thing. We were rewarded with his deep and sincere gratitude. His mood shifted. A burden lifted. It marked a new start for him. It was a joy to see.

And it also worked for me.

The gloom that blankets the world because of the steadily deteriorating state of the news, day after day witnessing cruelty, dishonesty, greed, and now war...also lifted for me. I felt a quiet sense of joy. Of accomplishment. Of connection. 

Of course, we all extend kindness to others. We help out when and where we can. We don't always expect or enjoy an outpouring of appreciation or any compensation. We do it out of the generosity of our hearts whether or not we are thanked or even acknowledged for it. Still, our intentions, our efforts, and the sacrifices we make are rewarded when what we do brings relief, gratitude, and even a faint ray of optimism to someone else. When their spirits lift. When they can relax and breathe a sigh of relief. When they can smile again...which is what we all need right now.

"No act of kindness,

no matter how small,

is ever wasted."

~Aesop~

If things are getting you down right now--your finances are suffering, you're in poor health, a relationship has gone sour, you've experienced a major loss, you feel frustrated by the state of the planet and its people, war scares you...whatever--remember there is hope. If you want to feel better, extend a small act of kindness.

"The world is full of kind people.

If you can't find one, be one."

~attribution unknown~

 

If you can't muster the strength or motivation to reach out and you need help yourself, do as Mr. Rogers suggests:

"Look for the helpers.

You will always find people

who are helping."

~Mr. Rogers~

jan