Patient patient

As an English teacher, I loved leading students through the rules and nuances of grammar.  I still love words and those times when a single word needs context to create meaning.

Take the word “patient”. It could mean the noun “patient”, someone who is ill or injured and needs or is receiving medical care. Or it could mean the adjective “patient”, suggesting that someone is or needs to be prepared that something might take some time, even more time than one might want. Here’s my recent story of being a patient patient!

Five weeks ago, on a Tuesday morning around 8 AM, my foot slipped while trying to get into a very high truck without helpful runner boards. The force and angle of the three foot drop was enough to seriously twist my ankle. I heard an internal ‘pop’ and felt intense pain. Given that I was away from home and had to fly about 6 hours the following day, I decided to head to Emergency to be checked out. I chose to become a patient.

And here are some of the things I learned in the Emergency Department that morning:

Early is always better than late.

If you have to go to Emergency and you have any choice, going early on a weekday morning is better than waiting to go later in the day. There were four of us in the waiting room at 9 AM but by 10 AM, the waiting room was getting crowded.

Everyone who shows up in an Emergency waiting room is worried.

They're worried about the reason that made them come in the first place, about not knowing how long they will have to wait, about being fearful about potential outcomes. That morning, my waiting companions included a young father with an inconsolable crying toddler; a mother with her school-aged son, having been told by a walk-in clinic to go to Emergency right away without fully knowing why; a middle-aged woman who, post back surgery, was experiencing significant pain and didn’t know what else to do but come to Emergency because her doctor was away. They were all worried.

Being a patient patient is difficult when it appears that no one is being called and no one is explaining why nothing is happening.

There are usually valid reasons for delays. For example, as I was leaving the x-ray area, my porter came to an abrupt halt—before our eyes, we witnessed a “Code White”, a call for security back-up; a patient in a cubicle had started to attack the person looking after him. The response was impressive—quick and effective, resulting in a calmed patient. But people in the waiting room didn’t see the refocused energy and extra personnel required when that patient became violent. If only someone could touch base with people waiting to let them know what is going on behind the doors they can’t see through.

I eventually learned that I had broken my ankle, fortunately not badly enough to need surgery.  My leg and foot was placed in a walking-boot type of cast and sent on my way, back to the meeting I had been trying to get to at eight o’clock that morning in the first place.

Now I am home being a patient patient as my ankle bone heals. It’s quite a change for me to not be able to drive, to not be able to go for long walks when the sun comes out, to not fill up the bird feeders myself, to not being able to just go to the grocery store when I think I need more grapefruits. Someone asked me what I thought the ‘message’ was for me in this…and I replied, “I’m more interested in thinking about the ‘opportunities’!” And there have been many.

I’ve slowed down. I happily watch robins find worms on my lawn. I’ve learned to ask for help and have enjoyed the car rides and conversations with friends who have willingly ferried me from A to B and back again. I had time to think about what two poems I would take to my book club for a poetry night and was delighted to discover that the two I chose (Ulysses by Alfred Lord Tennyson and the lyrics to The Impossible Dream from the play The Man of La Mancha) were two of twenty poems I selected for a poetry project, done back in 1970, and kept these many years.

I have also read more books than I’ve read in quite a while. One of them was a delightful and thoughtful memoir by Anne Berube titled Be. Feel. Think. Do. The author shares how she learned to prioritize being and feeling over thinking and doing in order to experience her life more richly, fully, and true to her deepest callings and dreams. She makes the point over and over again that we can choose our attitudes and can adjust our perspectives. 

Berube recalls that Viktor Frankl, commenting on the horrors of the concentration camps, explained that prisoners who were able to help others and imagine a positive future fared better than those caught up in despair. And she recounts a Buddhist fable in which an aging master, who had grown tired of his apprentice’s complaints, asked the apprentice to put a handful of salt in a glass of water and then drink it and then take that same handful of salt and throw it in a lake and then drink that water. The apprentice comments that the water in the glass is bitter but the water in the lake is fresh. The master quietly says: “The pain of life is pure salt; no more, no less.  The amount of pain in life remains exactly the same. However the amount of bitterness we taste depends on the container we put the pain in. So when you are in pain, the only thing you can do is to enlarge your sense of things. Stop being a glass. Become a lake.”

No question about it—I am a lake. Yes I broke my ankle but I’ve been grateful for so much during this time of being a patient patient… grateful for friends; grateful for my attentive daughters and grandchildren; grateful for where I live; grateful for the signs of nature as spring unfolds; grateful for the care I received in that emergency department; grateful that my bone is healing; grateful for books; grateful for the opportunity to slow down and have time for reflection. Being a patient patient has its blessings!

Crossings

For a week last November, Iowa City held me in its thrall. I was there for a conference at the University of Iowa titled “The Examined Life”. I had wanted to go to this conference for years; finally both the timing seemed right and the conference planners accepted my proposal for a workshop called “Healing Words: Writing Your Way to Compassion and Health”. The conference turned out to be everything I hoped for… a coming together of people engaged with in both writing and health care, many of whom wanted to be better communicators with their patients, to tell their own stories and to heal from the burdens they carried.

In addition to the rich emotional and intellectual fuel of the conference, I also enjoyed several sessions which were part of the simultaneously scheduled Iowa City Book Festival. This annual festival is just one of the reasons Iowa City was named the third UNESCO City of Literature in November, 2008, following on the heels of Edinburgh, Scotland and Melbourne, Australia. Another reason for UNESCO’s choice was that, since 1936, Iowa City has been known as the home of the Iowa Writers’ Workshop which has produced many of America’s outstanding writers, including 17 winners of the Pulitzer Prize.

I attended an author reading was given by Jon Kerstetter, whose book, Crossings: A Doctor-Soldier Story, had recently been published. The book jacket says that Jon Kerstetter’s life “has been marked by a crossing from one world into another: from civilian to doctor to soldier; between healing and waging war; and between compassion and hatred of the enemy”. I had purchased the book earlier in the week thinking that this man’s story sounded incredible and I wanted to know more.

Jon Kerstetter grew up in poverty on the Oneida Reservation in Wisconsin but his curiosity and determination led him to become an emergency physician and then a soldier, serving in Rwanda, Kosovo, Bosnia and Iraq. The first half of the book is full of descriptions of bravery and adventure and adrenalin and accomplishments. But then Jon’s life took a surprising turn and he faced a new ‘crossing’—from healer to one who needed to be healed, from one who helped ease other’s burdens to one whose own burden seemed impossible to carry.

At the reading, I observed a tall man, standing, speaking clearly, engaging with his audience, recounting various chapters of his life… poverty to college education, First Nations reservation to army barracks, emergency rooms to helicopter evacuations. If you just walked into the room, knowing nothing of this man, you would never know that his just being able to stand there and speak belied the greatest challenge of his life.

When Jon returned from Iraq, he had a debilitating stroke. Everything changed—Jon went from a decorated doctor-soldier to having to learn how to do everything from scratch. The stroke left him with profound cognitive and physical disabilities, excruciating pain, all complicated by PTSD.

Jon finally had to admit that he could never be a doctor or a soldier again; he knew he had to make another “crossing”. One of his doctors helped Jon realize that his love of books was grounded in a thirst for knowledge. Building on this, the doctor suggested that Jon enroll in a writing MFA program. Jon had already experienced some ‘writing as therapy’ having done some therapeutic journaling and had felt its benefits.

However, his internal critics identified any number of reasons why he shouldn’t do this—he was too old (59); his reading level, post stroke, was only grade 5.3 level; he was still in rehab; he couldn’t “keep up a fast pace with a slow brain”. Fortunately his internal cheerleaders spoke up and reminded him that he had pushed against boundaries his whole life; that he had gained more, post stroke, than many had thought possible; and that it was worth at least applying… and he was accepted. He remarked “I didn’t learn quickly, but I did learn… Speed was not my forte; persistence was.”

Jon Kerstetter, just as he had imagined becoming a doctor when he was boy living on a reservation, now was imagining become a writer while living in a body and mind complicated by disability and trauma. He says, near the end of his book, that through writing “Details and emotions come to life; I see a page, and the page is me. That extra dimension helps me see that I am healing and not dying; it helps me understand how I am testing the edges of my recovery.  And so, I sit and write.”

“Healing” has been a years-long process for Jon and is still ongoing. He says he still stumbles and forgets words. All the more amazing, then, that he chose to write this incredible book and could stand and tell us about it!

And so I end where I began—I attended a conference on “The Examined Life” in Iowa City and gave a workshop about “Healing Words” to health care providers who wanted to explore the potential of writing to tell their stories and to lighten their burdens. And then I witnessed a powerful example of what I had been teaching… Jon Kerstetter is lightening his burdens and healing himself through words. It was a remarkable privilege to hear him speak and then savour his writing.

Resilience

Photos from Sheryl Sandberg and Adam Grant's Option B

This is my first blog post and I will use this space to share reflections on words that matter and thoughts about what is touching me in my life. This post will be about a book.

I recently finished reading Option B by Sheryl Sandberg and Adam Grant. I heard Sheryl being interviewed on CBC radio a few weeks ago and was drawn to her poignant story, relevant insights and tender wisdom. In short, Option B is about the sudden and untimely death of Sheryl’s husband, Dave Goldberg, at age 47, while the two of them were on Mexican vacation, far away from their two young children. Sheryl, noting that Dave had been gone for longer than anticipated, went to find him and discovered him at the resort’s gym where he had collapsed and died...and that’s when events unfolded at both warp speed and in slow motion. The book captures and retells some of those early, awful moments of discovery, of the trip home, of telling her children their father had died, of the early days and weeks. But in addition to this basic story, the book exploreswhat Sheryl’s friend said: “Option A is not available. So let’s just kick the shit out of Option B.”

Easy to say, but how does one do that? The book explores the concept of resilience, and how to develop it so that one can move from a trauma to experience “post-traumatic growth”. The book’s chapters trace Sheryl’s steps along this journey and what helped and what hindered progress. She explores such things as the impact of words, of friends’ actions, of work relationships, and of honouring and recreating family traditions.

I know I was drawn to this book because of two of my own experiences—first, I discovered my mother, dead in her bed, when I was fifteen years old and, years later, discovered a colleague near death at the gym (I talk about these experiences in Transforming Memories); and second, I also experienced the death of my husband, albeit knowing it was coming and that he was not 47 but just over 70. While I know that every trauma is different and unique for the people touched by the trauma, I also have come to deeply understand some of the core elements of the path to resilience Sheryl describes and which I have mirrored:

• How important it is to acknowledge trauma and talk about it
• To not hide from pain but to honour it, to embrace it
• To maintain traditions that feel important and also develop new ones

My mother died over 50 years ago and my husband died over three years ago.  I feel both experiences have led me to ‘post-traumatic growth’. I’m OK and Sheryl Sandberg is on the path to OK. Resilience is possible for all of us. Life gives us reasons to develop ‘resilience skills’ but we don’t have to wait for trauma—we can learn the skills for self-compassion and self-confidence any time. I recommend Option B as a primer and Transforming Memories as a catalyst!

Please note: If you check out the blog category On My Bookshelf, you will discover annotations about books I have found to be important, inspiring and insightful... each group of four books, changing monthly, is from a list I’ve compiled over recent years. I love books and I hope you will share titles of books which have been important to you.