August 29, 2013


It is easy to keep your equanimity in heaven; can you keep it in hell?

–Zen saying

August 25, 2013

search for meaning

     Victor Frankl, if you have not heard of him, is a rather famous author and physician, most notably for his book Man's Search for Meaning.  He developed a form of psychoanalysis dubbed logotherapy, which arises from the Greek word logos meaning an account or reason.  In his particular context it meant therapy to help find meaning in life.  Once one knows the meaning of their life, everything else becomes secondary, in his mind.  And this book is no dry tome laden heavy with medical terms.  It is his thoughts and conclusions from having survived WWII as a Jew in a concentration camp.  If anyone should know suffering, this man should.  It sounded perfect for my next round of bibliotherapy after Hamlet.
     While not a technically difficult read, it is emotionally difficult, at least for me.  My first impression was, "this man suffered far, far worse than I have and yet did better than me.  Crap, I'm weak."  It's a valid evaluation as this man went on to live a long and fruitful life without becoming horribly bitter or resentful.  He suffered his torments well but as to the how, he merely states:
If someone now asked of us the truth of Dostoevski's statement that flatly defines man as a being who can get used to anything, we would reply, "Yes, a man can get used to anything, but do not ask us how."
     I can relate.  When I've told others of my experiences in med school, they often ask how did I survive that?  I'd shrug my shoulders and say, "I have no idea but I never want to go through that again."  But the again part is here, yet again.  So do I trust that I will make it through yet one more time and at the end, shrug my shoulders and say, "I have no idea how I survived"?

August 22, 2013

dark night of the soul

"Letting go of our images of God can be terrifying. It is often the result of an experience of suffering in our lives, when our previous understanding is no longer adequate to give meaning to what has happened to us. When my mother died suddenly in my early thirties, I was thrust into the desert. All of my certainties about God and life were stripped away and I was left raw and frightened. Many people offered trite words and shallow comfort in my grief, they were not willing to sit with me in the darkness, but only hoped to rush me through to a place of light.

This is the mystical experience of the “dark night of the soul,” when old convictions and conformities dissolve into nothingness and we are called to stand naked to the terror of the unknown. We must let the process move through us—one which is much greater than we can comprehend. We can never force our way back to the light. It is only in this place of absolute surrender that the new possibility can emerge. We don’t just have one dark night in our lives, but again and again, as we are called to continue releasing the images we cling to so tightly."

-          Christine Valters Paintner

August 18, 2013

what DOES come out the other side?

I've been away from writing for too long.  It's a cathartic process for me, but remains quite difficult under the current circumstances.  Emotions come at me faster than I can process them.  Besides, I'm more than a bit slow emotionally.  Ask me for a diagnosis and I can that spit out quickly.  Ask me what I'm feeling and I take on the appearance of sloth.  You might as well ask a 6 year old to solve a derivative equation.  I may be slow, but I'm not stupid.  So I looked to the past as to what I felt when my brother was diagnosed, when my dad was diagnosed and all the events that followed.  Do any of those feelings still apply?  Some rules have changed when it's your own kid.  Others still apply.  Like this post.  It's hard to believe I wrote this over two years ago.  It was true then.  But today looking back, it's even more true now, if that makes any sense, especially the last couple of sentences.  My bearings are so lost, I have even less of an idea of what comes out the other side.  And at this point, is there even an other side to the tunnel?

January 15, 2011
what comes out the other side?
    I'm enrolled in an extracurricular class entitled "The Healer's Art".  It's a six-part seminar whereby they train a more human and humane physician.  The second seminar was dubbed "Honoring Loss".  We were instructed to close our eyes, center ourselves and in our mind's eye go to a time where we dealt with disappointment, loss, grief.  No trouble there.  After some exercises, we broke into smaller groups to explore the role that loss plays in healing.  Personal stories were told and after recounting a much abbrievated tale of dealing my with my brother's illness as both brother and physician, I was asked, "did you find things out about yourself that you didn't know?"
    My reply, "in situations such as this, you never really know what you'll do until you're confronted with the situation."  A week has passed from that session and now I'm yet again confronted with more slings and arrows.  My dad went in for a physical and came back with a descriptive condition by the name of pancytopenia.  In a nutshell, his red blood cells (and corresponding hemoglobin), platelets and neutrophils are all way too low.  Family doc thinks, "maybe it's a fluke or instrument problem."  Retest.  Same answer comes back except his hemoglobin drops from 10.0 to 8.6 in just 7-days (normal for a male is >14 depending on the lab, anything less than 8.0 becomes critical anemia).  Conversations between my dad and I flow back and forth.  He thinks that it's due to a bleeding ulcer as he has a history of that.  Nothing terribly serious, in his estimation.  I can tell that he wants to believe that.  If only.  My gut tells me differently.  This is something potentially very serious.  And I'm angry because once again I'm thrust into the position of convincing a loved one that something very dangerous is going on.  This takes priority over everything else, period.  Where the hell is the doctor in all this?  Why does this keep happening?  After reflection, I accept that nobody wants any of these cards but this is the hand we're dealt.  My brother didn't want cancer.  My dad didn't want something from a deep dark road I don't even want to think about, but can't help (leukemia, lymphoma, aplastic anemia, etc).  A sense of naivete still hopes for something less ominous.  We'll have to wait for more testing. 
    The anger is still there.  If anything, it's intensified with the reflection and dealing with my brother going through a rough patch.  I start to wonder if I am capable of doing this.  But no, I can at least now put one foot in front of the other and accompany yet another family member to an oncologist to start the path of naming the demon we're confronted with.  This week, it's my dad.  Next week, it's my brother for a clinical trial.  Somewhere after that I supposedly have some exams, too.  In the midst of all this, I can tell that family members are beginning to become concerned about me.  It's a valid concern, I guess.  In looking ahead, I can't see a damned thing.  I used to think about what kind of doctor or person would come out the other side of medical training with a sense of curiosity.  Now, I have no idea.  How can I?  What kind of life comes out the other side of this?

August 3, 2013

all the world's indeed a stage

Like most, I first read it in high school.  And probably like most other people, that was the only time I read it.  Too old.  Too many strange words.  Too many long, drawn out speeches.  Completely unable to relate to the modern world.  Lacking the life experience then, I never thought much of the highly acclaimed play Hamlet.  Until now.  I just reread it.  As my dad said, "interesting choice of leisure reading."  I am blown away by Ol' Will's ability to string words together.  Granted, I had to look a lot of them up as I'm no scholar in old English but as I moved towards to what is arguably in my mind some of the finest writing ever in the Western World, I had tears brought to my eyes as I read Hamlet's soliloquy debating whether life is worth living.  For most people, it's a no brainer.  But having been run through time after time after time......I. Grasp. Every. Single. Word. Of Hamlet's dilemma. Not on an intellectual level as something to be studied and dissected, but on an experiential level.  How many times must, or even can, a man endure "The slings and arrows of outrageous fortune" before we question whether or not "to end the heartache and the thousand natural shocks that flesh is heir to?" and answer it thusly, "Tis a consummation devoutly to be wished."  This man not only commands language like few in history are capable of, but he knows the depth and darkness of what it means to be wounded and the associated weariness of tolerating further wounds upon the very soul.  I could go on but I do it no justice.  Just watch Mel Gibson's performance below.  You may have to watch it more than once.  You may need to have the words if you're not familiar with it.  They can be found here.