Recently, I heard a fantastic story on the radio about how one of the leading medical schools in the country is allowing a growing percentage of humanities majors into medical school. My first reaction was one of gratitude that a training facility for medical and health care professionals sees the potential of well rounded human beings being even better health care practitioners. My second reaction was self-reflection.
I didn't go to medical school. I always wanted to be a psychologist. For 17 years now, I've been living out my dream of doing just that, but in the setting of cancer care. I've probably seen many thousands of people, treated hundreds of family members for grief. I didn't set out to do this.
And I learned very little of how to do it in my formal graduate education.
As an undergraduate, I had the incredible luck of attending one of the most eccentric colleges in the country, the University of California at Santa Cruz. Set high above the Pacific Ocean on the edge of a redwood forest, it was an idyllic locale for inner and outer exploration. I planned on being a psychology major. Unfortunately, it seemed at least half the student body had the same idea. The pre-requisite classes were just too crowded. I couldn't get in. It seemed that if I wanted to do the psychology major route, it would probably require an extra year.
Back then, I was allowed to do an independent major. So I put together my own curriculum and syllabus and major requirements over the course of an angst filled weekend during my sophomore year. I recruited three of some of my favorite faculty members to serve on the committee. The major-- I called it Psychology of Self-- was a mix of explorations into transcultural identity, mysticism and hermeneutics. Most of my classes were one-on-one, a professor, assigned study text and me meeting weekly. One particular highlight was a meticulous study of Exodus 3:1 using Martin Buber's I and Thou as a sort of decoder ring.
Every week for 9 weeks, my professor and I studied the scriptural text word by word using the transcending flow of I and Thou to understand the interaction and interplay of human and divine. We travelled through a spiritual landscape populated by personal experience and individualized quest for meaning. Weeks were spent contemplating "Moses, take off thy sandals from thy feet, for the ground upon which you stand is holy ground." Where did the voice come from? Was it referring to only that spot on the mountain? What is holy? What is holy ground?
I can't convey all that went on in those conversations. The point of it was that each of us has to answer those questions for ourselves.
As I sit with a patient who is newly diagnosed with a curable disease, or told they only have a short time to live, or with a family member whose only companion now is the absence of a loved one, I realize so much of what I do is still in that tiny room, sipping mint tea with a scholar of the Hebrew holy books, contemplating the mysteries of the spiritual and the mundane.
Neither of us knew in those conversations that it would lead to comfort for the sick and dying in a most literal sense 25 years later. None of this was done with foresight. Yet without the freedom to let my mind and spirit wander in that misty forest campus, I don't think I could do much of what I do today half as well as I hope I am doing.
I realize that in order to provide compassionate care to those who need a companion to be present as the mysteries of suffering, illness, pain and death unfold, the companion needs to travel some of this territory on their own. This isn't taught in graduate training programs nor in medical schools. It's the realm of the humanities. Supposedly unpopular and unlucrative majors like English literature, philosophy, religious studies may offer keys to unlocking our health care system. They offer the path forward towards breathing humanity into the health care system, of restoring medical care into a healing art and allowing healers to have genuine, intimate contact with patients.
And a way for healers to heal themselves from the burdens of care delivery.
Clearly, there is no substitute for competent, evidence-based care. But there is also no substitute for a curious, compassionate person providing that care who has spent as much of their lives living as well as studying.
Showing posts with label #eolcare. Show all posts
Showing posts with label #eolcare. Show all posts
Wednesday, May 27, 2015
Tuesday, December 10, 2013
Seven Tips from the Edge
For the past 15 years, several hours of each work day for me involves seeing the world from the perspective of someone who is dying. I don't know exactly how it is or what it is in me that chose to do this for a living, but I feel very strongly it's a big part of what I was put on this planet to do with the life I have.
It's not for everyone to do, and I don't think it makes me all that special. I can assure you that when my car makes a funny noise, I'm clueless as to what to do about it and glad that there's a mechanic who is doing what he or she was put on this planet to do, and fix my car. I can't do that. That makes the mechanic way more special to me. I need my car.
I've written elsewhere that recently for an 18 month stretch, I knew a steady stream of 2 or 3 people who died every week. I knew some of these people for days, others for years. That streak got interrupted for a few weeks, but seems to have returned in its brutal predictability.
Being in such close and regular contact with death, of having people gravely ill, dying, frozen in fear or radiating peace, them and their loved ones asking me what this whole gig we call existence is about... Roshi Joan Halifax refers to this space as an "edge state", way out on the horizon where the known and the unknown meet. I believe this horizon is what the existentialists refer to as "absurdity", the quest for relevance and meaning in an otherwise indifferent world that cares little for our individual existence.
Out on this edge of absurdity, I've had these flashes of insight lately as I go about my day that the whole gig is a giant inkblot. We see patterns where there maybe are none, we see images where they may be only empty space, we impose rules where chaos reigns, we see connection when we are really flying alone by the seat of our pants. And it's probably okay to do that.
Our intelligence and capacity for insight gives us choices in what patterns we see, what decisions we make, which rules of the game we choose to abide by. For many of us, religion saves us time and effort, offering us a template of guidance. For many of us, we find our own way.
For all of us, I think the most important facts to keep in mind are these:
1) None of us are fully in control of anything, no matter how much power, wealth, fame or status we accumulate. Pink Floyd sang it best years ago, "all the iron turns to rust, all the proud men turn to dust."
2) The whole inkblot nature of reality does not make violent or mean behavior acceptable. On the contrary, we should treat each other, and all life, lovingly, as we would lost and scared children that showed up at our door. That's really what we all are-- lost animals trying to find our way into the comfort of each other.
3) We waste a lot of energy doing stupid things to keep the crushing absurdity of being alive out of sight. Rather than focus on self-destructive vices like gambling and drugs to indulge our insatiable appetites for fleeting pleasures, we should bear mindful witness to fleeting moments of awe that surround us every day that go un-noticed. We're often too lost in our internal chatter to notice awe, to the point where we often can't dwell in awe.
4) Respect the body. See #3. Our choices should nurture our meat suits, not destroy them. We don't have our body for as long as we would like. It begins to age and fall apart just when you're getting used to it. Don't grease the wheels towards achiness.
5) Find what soothes you that is healthy, and what soothes those around you that is healthy. Create opportunities for soothing regularly. We're all lost children, we want security blankets. There's nothing wrong with that.
6) Structure the ambiguity of our absurd existence with self-disciplined progress towards goals. Exercise, meditation, healthy eating and sleep hygiene form a powerhouse of security and inner resources to ride through waves of suffering and anxiety. I've written about this extensively in my books. You actually have to do these things, though, not just read about them.
7) Live a life that others would want to grieve. This sounds strange to our pleasure driven society, but grief is often a sign that you got close to people, that people got close to you. Grief is healthy, and it's essential. Live a life that people would want to celebrate after you leave. You might not know how to do it now, but if you embrace absurdity with love, you're probably going to find out how.
It's not for everyone to do, and I don't think it makes me all that special. I can assure you that when my car makes a funny noise, I'm clueless as to what to do about it and glad that there's a mechanic who is doing what he or she was put on this planet to do, and fix my car. I can't do that. That makes the mechanic way more special to me. I need my car.
I've written elsewhere that recently for an 18 month stretch, I knew a steady stream of 2 or 3 people who died every week. I knew some of these people for days, others for years. That streak got interrupted for a few weeks, but seems to have returned in its brutal predictability.
Being in such close and regular contact with death, of having people gravely ill, dying, frozen in fear or radiating peace, them and their loved ones asking me what this whole gig we call existence is about... Roshi Joan Halifax refers to this space as an "edge state", way out on the horizon where the known and the unknown meet. I believe this horizon is what the existentialists refer to as "absurdity", the quest for relevance and meaning in an otherwise indifferent world that cares little for our individual existence.
Out on this edge of absurdity, I've had these flashes of insight lately as I go about my day that the whole gig is a giant inkblot. We see patterns where there maybe are none, we see images where they may be only empty space, we impose rules where chaos reigns, we see connection when we are really flying alone by the seat of our pants. And it's probably okay to do that.
Our intelligence and capacity for insight gives us choices in what patterns we see, what decisions we make, which rules of the game we choose to abide by. For many of us, religion saves us time and effort, offering us a template of guidance. For many of us, we find our own way.
For all of us, I think the most important facts to keep in mind are these:
1) None of us are fully in control of anything, no matter how much power, wealth, fame or status we accumulate. Pink Floyd sang it best years ago, "all the iron turns to rust, all the proud men turn to dust."
2) The whole inkblot nature of reality does not make violent or mean behavior acceptable. On the contrary, we should treat each other, and all life, lovingly, as we would lost and scared children that showed up at our door. That's really what we all are-- lost animals trying to find our way into the comfort of each other.
3) We waste a lot of energy doing stupid things to keep the crushing absurdity of being alive out of sight. Rather than focus on self-destructive vices like gambling and drugs to indulge our insatiable appetites for fleeting pleasures, we should bear mindful witness to fleeting moments of awe that surround us every day that go un-noticed. We're often too lost in our internal chatter to notice awe, to the point where we often can't dwell in awe.
4) Respect the body. See #3. Our choices should nurture our meat suits, not destroy them. We don't have our body for as long as we would like. It begins to age and fall apart just when you're getting used to it. Don't grease the wheels towards achiness.
5) Find what soothes you that is healthy, and what soothes those around you that is healthy. Create opportunities for soothing regularly. We're all lost children, we want security blankets. There's nothing wrong with that.
6) Structure the ambiguity of our absurd existence with self-disciplined progress towards goals. Exercise, meditation, healthy eating and sleep hygiene form a powerhouse of security and inner resources to ride through waves of suffering and anxiety. I've written about this extensively in my books. You actually have to do these things, though, not just read about them.
7) Live a life that others would want to grieve. This sounds strange to our pleasure driven society, but grief is often a sign that you got close to people, that people got close to you. Grief is healthy, and it's essential. Live a life that people would want to celebrate after you leave. You might not know how to do it now, but if you embrace absurdity with love, you're probably going to find out how.
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