Last night we had a discussion about "light" in medicine. Not just the feeling of enlightenment, or going toward the light, or light shining in a particular way on the subject at hand, but the way one is light on one's feet, the way Milan Kundera called "the unbearable lightness of being". Which to me is not unbearable, but actually the most desired way to move in the world; that is to be fitting in to the molecules of the situation in such a way that one is both coherent and graceful, and can do what is needed with the least friction, the "lightest" touch.
I haven't read the book by Milan Kundera in a long time, but I think I remember that the most important thing is that he cannot sleep unless he is holding her hand-- he begins to know love in that fact. He wants to stay connected, to touch, to be held by this particular woman. He who went through women like water before, suddenly finds a particular woman necessary-- and it is because he cannot sleep without holding her hand.
When we are going to surgery, I hold the patient's hand. I know that there is a primal fear, that the person is conscious of the reason the surgery is needed; but that they are frightened, as a child looking over the edge of an abyss is frightened. Holding the hand of someone trying to go to sleep without terror is a very important thing. Surgeons need to do it, sharing that moment with the patient in our care. It is a wordless reminder that we will be "attending" them through this experience, and that we have their life in our attention and care, and yes, love.
Another thing we talked about is the shared feeling of meaning. One of the great young women docs in our group, Neha, told us that she asks 5 questions when a person is in the hospital. The patient in the hospital always feels the terror of the child looking into the abyss. I call it "walking through the valley of the shadow of death". She feels that in between the daily rounds, there is a lot of time for the patient to find answers to these questions.
Her 5 questions:
"What is the meaning of the part of you that is ill? Why this part of your body?"
"What else needs to be healed?"
"Why now, in your life?"
"What else might you have missed?"
"What would you say if you could speak from your heart?"
I find this profound and helpful. It helps the patients find meaning and context for the illness, and for the way their life has been wending. It usually helps people come to terms with whatever other issues may need to be addressed, besides the illness. For most people, the logjam is in the relationships around them, and these questions help them to find the way to open up and deal with the dilemmas. The wonderful fact is that we are all having these dilemmas, and none of us is only a "patient". Our own "cloud of unknowning" is part of trying to work with our patients in helping to find coherence, in befriending their lives. We work toward our own coherence, as we confront these questions together, and find the answers.
One of our wonderful docs, Bruce, has become a chaplain. He spoke about the personal way we have been given some time. From the first breath to the last, we have a "complete" circle. He spoke of the way that each day, each breath, in whatever time we have-- another hour or another decade, is precious. We recognize the gift of it-- even when we are most profoundly affected by the loss of loved ones. This too, is a great gift. It lightens our suffering, to see "completeness"-- even when a life seems broken-off.
Energy is very like light. Vivekan Flint was a wonderful soul who helped Rachel Remen MD set up the program at Commonweal, and ISHI. He wrote poems. Abby read a poem of his, which speaks of a meteor. At the end, it turned into a streak of light. Light is a complex of mass and energy.
I wrote a poem called "Prayer for the Blue bird"-- it is in the first book of poems, called "My throat is full of Songbirds". It ends this way:
"Even death cannot stop
The true singing,
The real joy.
The air will fill with light,
The joy will be like light,
When light is speeding and blending with mass,
Becoming the bluebird singing."