why me? why this? why now?

I had one of those "Why me? Why this? Why now?" moments this week when I passed a dog who apparently took offense as I walked by and decided to teach me a lesson. The bite wasn't bad, but it meant limping home to clean things up, a trip to the drugstore to get a tetanus booster, and a ten-day course of antibiotics. Meaning I couldn't take care of the yardwork as I had planned this weekend. And my leg may still look a little funky when we leave for vacation next week. 

"I am not what happened to me."

~Carl Jung~

We have probably all had these moments. I'm sure my brother did when he suffered the stroke that landed him in a long-term care facility. For the rest of his life. 

I'm sure my best friend wanted answers when her daughter succumbed after a long battle against ALS a few weeks ago. 

"Little by little, we let go of loss...

but never love."

~Attribution Unknown~

Anyone who has been affected by the recent onslaught of severe storms, wildfires, and earthquakes must be wondering the same thing. Anyone who has unexpectedly lost their job or their home. The injured and the sick. Victims of war. Not to mention the thousands of legal immigrants who will lose their Temporary Protected Status today and face the imminent threat of deportation at the whim of our so-called leaders. I could go on.

Why me? Why this? Why now?

Making sense of suffering is one of the great existential challenges we face. How to relieve suffering is another. How to bear it ourselves is probably the greatest task of all.

"When we are no longer able

to change a situation,

we are challenged to change ourselves."

~Viktor Frankl~

Conventional, albeit uninspired, wisdom suggests we reframe the questions we ask:

Why not me?

Why not this? 

If not now, when?

This, though, oversimplifies the issue and denies its deep emotional origins and effects. It makes it sound as if we should know better.

People who don't understand the depth of pain suggest that we simply let it go...our anger, grief, shame, despair...since we can't do anything to change what happened to us. This, of course, is impossible, so that's no help.

Whether what happens to us or around us arises coincidentally, or synchronously, or paradoxically, or it simply strikes us as bad luck, our goal should be to stay grounded. To acknowledge and embrace reality as it unfolds, and to explore our emotional and psychological response to the truth.

I don't think I did anything to provoke the dog that snapped at me. My brother didn't do anything to cause the stroke that changed the course of his life forever. There was nothing my friend could have done to slow or stop the inevitable course of the disease that claimed her daughter's life. We are stuck with reality.

As Ralph Waldo Emerson put it:

"The purpose of life is not to be happy.

It is to be useful,

to be honorable,

to be compassionate,

to have it make some difference

that you have lived and lived well."

...because we are sometimes rewarded for it. When something good comes our way--let's say we find a better paying job, or the scan comes back normal, or we win the lottery, for crying out loud!--remember to ask yourself:

Why me? Why this? Why now?

jan

 

taking the plunge

 

I took the plunge this week and registered for a weekend conference at Columbia University in October titled "Embodiment and Attention: Narrative Medicine Fundamentals." It builds on the program that was conceived, developed, and implemented at Columbia under the leadership of Rita Charon, M.D., PhD. It teaches health care providers to reflect upon and to write about illness as it affects their patients.

 



This goes beyond traditional training which is satisfied with arriving at an accurate diagnosis and effective treatment plan. It involves much more than clicking the bullets on an EMR. Exploring the patient's narrative provides insight into the ways illness/injury changes every aspect and every relationship in a patient's life. Their sense of self. Their ability/inability to fulfill their perceived role in the family and in society as a whole. Their fears and sorrows. Where they find strength. What gives them hope. This process enables doctors to see their patients as more than interesting or challenging cases. It empowers them to tend to the whole person--body, mind, and spirit.

 

"Stories are not material to be analyzed;

they are relationships to be entered."

~A.W. Frank~

 

This practice improves the physician's sense of engagement with his patients. It deepens empathy. It has been shown to improve physician satisfaction and to lessen the likelihood of burn-out.

 

"Writing improves clinicians' stores of

empathy, reflection, and courage."

~Rita Charon, MD, PhD~

 

But narrative medicine isn't just for doctors.

 

Everyone who works in a health care system carries untold stories with them. Nurses and aides, EMTs and first responders, and therapists in every field have important stories to tell. Even staffers like receptionists, orderlies, and maintenance and food service workers all have stories they could share with us.

 

"While medicine creates material

for writing, perhaps even more important

is that it also creates

a psychological and emotional

need to write."

~Daniel Mason~

 

But narrative medicine isn't just for them, either.

 

The book on narrative medicine begins with the patient's story...a story almost everyone can tell. If you have ever visited a doctor's office or an emergency room, or been admitted to the hospital, or been a caretaker for a friend or family member, reflecting on the experience can help you organize your thoughts about it. It encourages you to sort out and name your feelings about it. It clears away confusion, and that eases fear. When you tell your story and someone hears it, you both learn from it. When you write your story and someone reads it, you leave part of your burden on the page.

 

Storytelling applied to the practice of medicine is more than helpful. It is a healing process.

 

"Writing is medicine.

It is an appropriate antidote to injury.

It is an appropriate companion

for any difficult change."

~Julia Cameron~

 

I'm looking forward to Dr. Charon's opening address in October. I am interested to know if anything has changed in a healthcare system that neither allows the time, provides the tools, nor recognizes the importance of storytelling in medicine. A system that denies its role in healing.

jan