If you are a healthcare provider, you should be scared. If you are a healthcare consumer or a patient, you should be terrified. If you require prescription medication, or physical, occupational, or speech therapy, or you require mental health services, if you are raising children or caring for an aging parent, you should be afraid.
"The degree to which you can tell your story is the degree to which you can heal."~S. Eldredge
Sunday, March 16, 2025
the scariest thing
Sunday, March 9, 2025
writing to heal
Some time ago, I talked about the ACE (Adverse Childhood Experiences) Score and how childhood trauma can cause epigenetic changes in the young brain that trigger an overactive inflammatory response. This has been shown to lead to disease states in adults, such as autoimmune conditions like lupus and rheumatoid arthritis, heart disease, diabetes, stroke, depression, and PTSD-like anxiety and reactivity. Luckily, epigenetic changes can be reversed. Healing is possible.
Among the practices that have been shown to promote epigenetic healing is writing to heal. Researchers at Carnegie Mellon found that the simple act of writing and reporting on an emotional state had a significant effect on the body's physical state. It improved measures of immune function even in patients battling life-threatening diseases. It reduced markers of the stress response by lowering the heart rate and blood pressure. It lowered rates of depression, addiction, anxiety, and PTSD. The damaging effects of ACEs can last a lifetime, but they don't have to.
- Find a time and a place to write without distraction or interruption.
- Try different modalities, such as writing long hand in a journal, tapping it into your laptop or phone, or dictating and transcribing your story.
- As you write your first draft, do not worry about or let yourself be sidetracked by correcting grammar, spelling, or usage.
- Forget what you imagine others will say about your writing.
- If what you are writing about makes you increasingly anxious, set it aside. Focus, instead, on self-care. Take a walk outside. Take a nap. Have something good to eat. Call a friend. Return to writing when you are ready.
Tuesday, March 4, 2025
five succinct bullets
Last week, Elon Musk directed all federal workers to submit a list of five things they had accomplished at work in order to justify keeping their jobs...or risk being fired. A few days later, they were advised to ignore the order. Then, without explanation, they were redirected to comply with it. Needless to say, this resulted in total chaos. In fear, anger, and confusion.
I'm retired, so obviously, this doesn't apply to me. Still, I thought it might be fun to try it (tongue in cheek...). So, here it is:
1. When my plans for the weekend fell through at the last minute, I decided, instead, to drive to Pittsburgh to surprise my son who was celebrating the first year anniversary of his very own craft brewery, CoStar Brewing. Check it out at https://www.costarbrewing.com/. I think it pleased him when I showed up unannounced.3. I read. I'm reading "Coming to Our Senses" by Jon Kabat-Zinn in preparation for a meditation retreat with him later this year. It's a big book! It'll take a while for me to get through it.
4. I woke up early to enjoy the sunrise.
5. I fed the birds, squirrels, and the deer out back with the "good" (meaning "expensive") birdseed every day.
Thursday, February 20, 2025
make me care
The art of storytelling is as old as the spoken word. It entertains, informs, and connects mankind across culture, race, and creed. It has the power to heal, and in medicine, it can be a life-saving skill.
Most people enjoy reading or listening to stories at their leisure. The health care provider, on the other hand, listens to stories all day long because it's part of his job. This is how he obtains the "history of the present illness," perhaps better described as the "story of the present illness." It forms the basis of all that follows: performing the physical examination, tracking down the diagnosis, and formulating a treatment plan.
The clinical encounter begins when the health care provider takes the patient's history. He listens for specific details that lead him to the diagnosis. If the problem is pain, the provider wants to know where it's located, and whether it's sharp or dull, steady or throbbing, constant or intermittent. He wants to know how long the patient has had the pain--for a day? For a month? For years? What makes it better? What makes it worse? These details guide him through a maze of possibilities.
The problem is that patients don't know what the provider needs to hear. They don't arrive at the office prepared to rattle off a list of relevant signs and symptoms. It's the provider's job to ask about them, but he only has so much time to get to the bottom of the patient's problem. Nowadays, the written or dictated clinical note has been largely replaced by the electronic medical record (EMR), so rather than listen to the patient's history, the provider navigates his medical record with a series of clicks that pull up an array of bulleted lists, complicated charts, and sketchy details. This is intended to expedite what has been ruthlessly abridged to a ten-minute office visit.
Because time is limited, doctors often redirect the patient who appears to be getting off track or is slow coming up with answers. In fact, one frequently quoted study found that physicians interrupt and redirect the patient when they are as few as 18 seconds into the interview. Frequent redirection leads the patient to believe that what he wants to say isn't important or relevant, so details go missing.
This is a problem. Healing, or failing to heal, occurs in the context of a person's relationships with his family and friends, his surroundings, expectations, and perceptions, as well as his emotional, psychological, and spiritual life. If the patient is denied the opportunity to tell his whole story, part of him may never heal.
Let's say, for example, that the patient presents with abdominal pain. He answers all of his doctor's questions. The pain has been present for four days. He describes it as constant. It started in his upper abdomen, but now it radiates into his back. Eating makes it worse. In fact, the patient says he hasn't been able to keep anything down for the past twenty-four hours. After a focused physical exam and a few tests, the physician correctly diagnoses the problem as acute pancreatitis. But that doesn't explain why the patient develops a headache, has trouble keeping his balance, and becomes confused the day after he is admitted to the hospital.
What the doctor doesn't know is that the patient has been drinking heavily because his wife walked out on him recently. In fact, he blacked out a couple of days ago and woke up on the floor next to his bed. He didn't mention it because he was busy answering the doctor's questions about his abdominal pain. So, the doctor missed the small subdural bleed his patient sustained in the fall until days later when he had his first seizure.
This scenario highlights an important problem. Obtaining an accurate and thorough medical history takes time. Given the imperative to see more patients faster, the provider may have little time to explore the details of the medical history with every patient. Perhaps he's running behind schedule, or an emergency interrupts him. In some cases, the patient can't bear to disclose the sorrow, or fear, or shame that underlies his symptoms, so he doesn't mention it. It takes time to invite, enable, and encourage some patients to share the story that brings them to the office in the first place.
When the patient is constantly redirected in order to satisfy the provider's agenda, important parts of the story may be overlooked. This reinforces the importance of hearing the patient's full narrative. When we reach into their cholesterol laden hearts to understand why they are poisoning themselves with food, we need to know more than what they are putting into their mouths. When a patient is noncompliant, we need to consider what he is afraid of, or angry about, or grieving over. When we allow the patient to speak, we may discover that the reason for this one's fatigue, or that one's intractable headache is end-stage disappointment, or anger, or shame that has festered for years.
Only then can we help them heal.
Sunday, February 16, 2025
bipolar tendencies
If you weren't downright bipolar before the November election, you might be tending in that direction now, torn, as we are, between fear, dread, and uncertainty...and the bravery it takes just to make it through the day. Between periods of chaos, and moments of peace. Between utter despair, and a faint glimmer of hope. Between anger and gratitude. Sorrow and surrender.
Tuesday, February 11, 2025
why you should take up writing
Sunday, February 2, 2025
close encounters of the hardest kind
to diagnose someone's disease,
but it takes a friend
to recognize someone's suffering."
~www. WishesMessages.com~
is the moment you rewrite the chemistry
of your body."
~Bruce Lipton, Ph.D.~
when patients tell of symptoms
or even fears of illness--
first to themselves, then to loved ones,
and finally, to health professionals."
~Rita Charon, M.D., Ph.D.~
“The shortest distance between
truth and a human being
is a story.”
~Anthony de Mello~
jan
Wednesday, January 29, 2025
acquiring a knack for discernment
The decision to depart from my chosen path in life and to start all over again as a wannabe writer both broke my heart and healed it.
Tuesday, January 21, 2025
the downside of doctoring
Tuesday, January 14, 2025
what you can do when things get to be too much
"The greatness of a nation and its moral progress can be judged by the way its animals are treated."~Mahatma Gandhi |
This week was especially challenging for those of us who identify as empaths.
According to Chivonna Childs, PhD of the Cleveland Clinic, an empath is a person who feels what others feel. They are known to take on the emotional responses of others and to process them on a deeper level. When others suffer, they suffer.
This week's news was hard on empaths. It featured the devastating loss of life and property in the California's wildfires. The continuing challenge of frigid temperatures, wind, and drifting snow that have had a paralyzing grip on the mid-Atlantic states and on New England for weeks. The fact that residents of North Carolina are still struggling to recover from Hurricane Helene. Not to mention the political chaos our country is facing. Not to mention the unavoidable static of illness, grief, and despair that blankets so many.
On the other hand, some things barely made the news at all this week. The wars in Ukraine and Gaza. A massive earthquake in Tibet. The all but forgotten refugee camps in Sudan.
On a more personal note, I have been fretting about the deer, the little squirrels and chipmunks, and the birds outdoors with nothing but a little fur or a few feathers to keep them warm. My heart aches for all the pets who snuck out the door and wandered off when no one was watching and are now lost out in the cold, without shelter or food...which is why I doubled the amount of birdseed I put out. Even the deer are eating it.
People suffering. Animals suffering. Empaths suffering.
How do you process it? Where do you begin?
Well, you can try to ignore it. You can turn off the news. Distract yourself with mindless entertainment, go shopping for things you don't need (...be honest), or attend to some of those mundane chores you've been putting off. You can pretend it isn't your problem, even though, in a way, it is.
Here are a few things that helped get me through the week:
- I was finally able to get outside and walk, which is a contemplative practice for me. It may not have helped anyone else, but it gave me time to reflect on my place in the world with gratitude and compassion.
- I watched the squirrels scamper around and the deer bound out of the woods the minute I put the birdseed out...the good kind with whole seeds, real nuts, and dried fruit in it. Happy to oblige.
- Night after night I watched the sun set in brilliant shades of pink and orange and purple.
- I watched the "wolf" moon rise.
- I learned something new from Neil deGrasse Tyson about the tides. You can visit him here: https://www.youtube.com/watch?v=dBwNadry-TU
- I took note that snow still glitters in the sunshine.
Monday, January 6, 2025
a pathway to healing
I came up against this situation several times recently, and I wasn't exactly sure how I could help. In each case, the circumstances were different but the issue was the same.
In one case, a gentleman had fallen and injured his hand, but he didn't seek care for it at the time. Weeks later, he was still complaining about the pain...and still refusing to have it evaluated and treated.
Another person had multiple medical problems including diabetes and a heart condition, but he neglected to see his doctor for follow-up. He constantly complained about disabling shortness of breath, fatigue, swelling in his legs, and back pain, but refused to have his symptoms evaluated and treated.
A third person had a persistent cough and wheezing that she blamed on the "flu", even though she was a smoker. She knew it could be something serious, but she refused to have it checked.