imtalkinghere

Can you see health from your place?

Over at Lance Mannion's shop, he's musing on the many weirdnesses in the voting last night for the imperfect House health reform bill. Imperfect, indeed. Anyone who thought it could be otherwise is a magical thinker of the first order. The fact is our approach to health and medicine - two waaay different things, by the way; genuine health may be further from what most people call medicine than Russia is from Sarah Palin's porch - is a mess almost beyond measure. Some kind of government health reform is a necessary step; but without a shift in consciousness it's just an insufficient finger in the dike. Some examples:

Today's Sunday Times Magazine features Dr. Brent James and "The Theory of Evidence-Based Care", a completely rational approach to bringing down health care costs:

PROBLEM :  For any given diagnosis, a doctor can consider a number of ways to treat a patient. But how does a doctor know which treatment to use?

SOLUTION:  Committees of doctors and others track treatments and their outcomes by medical specialty, developing treatment protocols based on the data.

RESULT:  A doctor may choose to ignore the protocol. But patient care should improve as  doctors see evidence for the most successful treatments.

Yay-Rah for Dr. James. Thanks for helping, and it's not enough.

In part, because there is this block quote in the Times article:

"It is possible to rely too heavily on numbers and patterns when treating patients but the BIGGER RISK - the one we are now taking - is relying too heavily on intuition."

May I just step in here to mention that I would prefer to have a physician WITH intuition? Not just some intuition, but I want a doc with major, mind-boggling intuition! The problem is not so much that we are "relying too heavily on intuition", it is that we are relying on faulty intuitions, because our current medical education is designed to thump the intuition out of these people, when it should be actively nurturing just the opposite.

I'm remembering a conversation I once had with a family physician who had been practicing  for about ten years. He told me that he'd recently heard at a seminar that, while examining a patient,  it would be good to place his free hand on said patient in such a way as to establish  more human connection, and that he had found this to be true. To quote SNL, "REALLY?!" Here was a guy supposedly "called to healing" who couldn't figure this out on his own in ten years of practice... with kids, mothers... "REALLY??" - I asked him how he'd come to medicine. Answer: "Well, I could have gone into law or engineering or medicine and it just happened to go this way." In other words, income was the call. I'm okay with income being the call to to law or engineering. With medicine, I'd like a little something more. But I can tell you from having attended a top pre-med school, income is primarily the call. So when people fret that government health reform will lower doctor salaries and drive people away from medicine, I smile and say, "Bring it on. Alter the damn universe. Up the proportion of actual healers in the ranks. It can only improve the system in the long run."

* * *

If the physician attending me cannot be an intuitive genius, then I want him or her to at least have some deeper awareness of subtle energies. In Chopra's latest book, he tells the story of a patient with a pulled muscle that grew more and more painful.

"I knew from doing this kind of thing before that it was tendinitis... I was given the name of a really good acupuncturist and made an appointment... he stuck needles in a few places. not just in the afflicted muscle. When the treatment was over and I was about to leave, (he) surprised me by asking if I was depressed. My mother had died the year before, and I told him that I had been feeling down, though I didn't think I was still grieving. He told me that he had detected weak energy around me. That was how he recognized that I was depressed, and he suggested that I let him do a few things...he pressed a few points along my spine, very gently... The whole thing took no more than ten minutes, and he didn't charge me... As I was walking back to my car...I felt very good. I was buoyant, my footsteps lighter. Only then, when the gray cloud over me had lifted, did I realize I had been feeling down for quite a while. The next day I was still in a good mood, almost elated...The visit stands out for receiving a healing I never expected."

How many doctors today spend enough time with each patient to make or cure such discoveries, or for that matter know you as a human being?

Findings have estimated that on average, patients can expect to spend no more than 10 to 16 minutes with their doctor, depending on the negotiations that doctor has made with that patient's insurance company.

Sixteen minutes once or twice a year.... Now, there's a meaningful relationship. With pressures to move 'em through as quickly as possible, physicians need to become extraordinarily perceptive and sensitive. How many do you know like that? Name one required med school course that addresses this need.

* * *

Another example of "off" thinking: The Placebo Effect. As Dr. Andrew Weil points out every time he speaks at medical schools, the placebo effect is the most interesting thing in drug  studies, it's the place of power and potential: How exactly did those patients heal without drugs?  That's what we should be looking into - not to the exclusion of all else, but certainly we should be giving it more respect than it gets.

Meanwhile, we're all drowning in TV pharmaceutical ads... Ugh. Or should I say glug?

* * *

For some people, the decision to not buy health insurance is based on a desire to commit to prevention: "I can either spend $600/month on coverage, and have nothing left over for personal maintenance or I can use that $600 to buy better food and have regular acupuncture, massage, Ayurveda, etc. to keep my body in the best possible shape." Some people might call them irresponsible. Really? At least they are consciously applying themselves to health.  How many health plans make room for that? It will be interesting when those people have to - by law - put that  $600 into insurance. We should all hope that they - who know whereof they speak -  will start demanding a health care system that allows for a much more flexible and intuitive approach  to prevention. 

* * *

In short, yada-yada-yada - reform the system, change the system. Yes, do what you can and as soon as possible. But until we fundamentally transform the works through a shift in consciousness, the current beat will go on and on and...

Well, aren't I "special" ?

"I read an article recently in the New York Times Magazine about anxiety – it was a big cover article… about 'Is this the culture of anxiety, the age of anxiety?' It  was one of those articles where I had this light bulb go off in my head. This guy, Jerome  Kagan,  did this twenty year research study starting with babies all the way up until they were in their…early twenties because he was of the belief that anxiety is learned, that it is behavioral ...it’s a nurture versus nature thing. And then after 20 years of observing babies that … had, he called it, a 'high reactive nature' when they were born, went on to be anxious people. Now, if I can read from the article, 'Clinical anxiety disorder of which there are several forms – panic, social anxiety, phobia, obsessive-compulsive, post-traumatic stress, and a catch-all called generalized anxiety order, taken together,  make anxiety the most common mental illness in America,  affecting an estimated 40 million adults' and I’m looking at that list and I’m like, 'Those are all my hobbies! This is my day-to-day life!' I don’t know where the hell people have time to watch TV, to take in movies, to Tivo shit, to look at YouTube videos… I mean,  I am old school with my entertainment options. For me it’s dread, panic and revenge fantasies. That’s where my imagination goes, that’s how I find satisfaction. And now I find that I’m among forty million people that have this disorder. On some level it’s a relief to me, to know that when I’m going what the fuck, why the fuck, who the fuck, where the fuck – that that is a common experience that forty million people have."

    Mark Maron, WTF Podcast, 10.23.2009

I used to go to a massage therapist weekly. I would drag myself up the steps feeling like the most pathetic, barely functional bucket of stress and then, somewhere during the massage, she would comment, "Oh, that's really good. See how your muscles just let go there? I have so many clients who are just like steel there. Nothing ever lets go."

And I would mumble from my head hole, "Really? How do they manage to walk around?"

Or I would be talking to a friend over lunch and the friend would say, "But you're different, you forgive people. You just don't hang onto that stuff. Most people aren't like you."

And I would ask,"Really? How do they manage to walk around?"

This was not a joke question. It was sincere. How. Do. They. Walk. Around? - How is it possible to be in a worse state than I am and still remain upright and mobile?

"Oh. You're just especially sensitive. That's only like 15% - 20% of the population, you know. You feel everything more than other people."

If so, of course, I can't really know what it is like to feel things less, because I don't. Except it would explain a whole heck of a lot that has flabbergasted me over the years.

I've mentioned here before that my husband has a habit of responding to things I say by pointing at me and announcing loudly to the sky, "Not Normal!" He's not being mean. He's just trying to explain that I shouldn't count on a lot of understanding or agreement.

Or there was that first class reunion where I was standing in a circle of the "girls" I'd known in high school - they were all married now, some already had children, and living back in town - and one of them said to me, "Well, we always knew you weren't going to come back here and settle down with a husband and kids like us," and then they all nodded vigorously in  agreement, and I sort of left my body for a second or two. It was the all nodding that blew me out the top of my head. Really? You all knew that? How? I don't remember ever talking about this with you. What was I doing that made you think this?

A "boy" from my class announced that same night, "You always struck me as a mystic. There was always something metaphysical about you."

Really? What?!  I was not, after all, some freak. I didn't dress strangely. I was wearing Villager, for crying out loud.  I was not a trouble-maker, I wrote thank-you notes, I picked up litter.  I didn't do drugs or drink. If anything, I was more mature and responsible than most of my co-horts.

Sid Wise, one of my undergrad professors, wrote me a note one Christmas two decades after college saying, "I never could quite figure you out. You didn't fit any patterns I knew."

I could go on. You get the drift on this throughline of my life.

So imagine the extraordinary comfort, even joy, I found this past week in reading William Zinsser's Inventing The Truth: The Art and Craft of Memoir and Writing About Your Life: A Journey into the Past, as one chapter after another put me in shared company that I recognized as my own.

It turns out that the disconnected chunks of writing I have in my files are exactly how other people write about their lives.

It turns out that guilt about writing personal stories is the most common stumbling block in the world. Everybody feels that way. Even better, there was this completely delicious sentence: "Guilt is a form of narcissism." Wheeeeeee! I love that. I can work with that.

It turns out that the things I worried about and fought hard to provide when I ran a speaker series are, according to Zinsser's extensive shared conversations with other folks on the circuit, exactly what speakers worry about and want provided - and too rarely get.  In other words, I was just naturally in sync with a certain tribe.

And so on with Zinsser, who reflects at one point on how many people have come up to him over the years and said, "You altered my life."

"It comes down to permission. I'm struck by how scarce the commodity is. I go around America giving people permission to be who they want to be, and I think: Why me? How did I get stuck with the job? Isn't that what our schools are supposed to be doing? ... When I mention 'permission' the word detonates like a bomb...America has more than enough people willing to go through life being someone else's precise fit. What we need are men and women who will break the mold of conventional thinking, who won't buy the phrase, 'We've always done it this way. This way is good enough.'"  (Writing About Your Life - pp. 215-216)

I think Zinsser's real power is somewhat different. He comes across as a remarkably authentic man, and he writes with a clarity that allows a resonance in his readers - through his words, but mainly out of his very being, which infuses those words -  whereby the readers  feel what is authentic in themselves, and it is that recognition that opens a doorway to their own internal "permission", which is the only one that counts. While it is useful to acknowledge one's differences, it is far more empowering and beautiful to feel how  one connects to tribe. There's always a tribe. Maybe highly select, but a tribe - and owning connection is freeing... clarifying - not to "be like the rest",  but just to feel the communal aspect of self, the bigger energy at work, and know that you are never all by yourself.