Joy of Healing

Celebration at UNC School of Medicine Graduation

“…may I long experience the joy of healing those who seek my help.”

Hippocratic Oath

It is rare to find others who have traveled and share a similar vocational journey.  I found that person and journey in the book, The Finest Traditions of My Calling One Physician’s Search for the Renewal of Medicine, by Abraham Nussbaum, MD.   He has been on a big quest as his memoir recounts.

The book is full of big ideas and not the least of these is the “joy of healing” found in the last sentence of the Hippocratic oath.  This joy seems hard to find in the reality of current western medical practice.  As the photo demonstrates, there are exceptions even in the face of the reality.  

Will there be “joy” after 10 years of practice or at the end of their professional career?  There are certainly no guarantees, but I suggest that a positive response hinges on being able, like Abraham Nussbaum, to remember your calling and oaths.   These are the foundation for the “joy of healing”.

Marvin

References:

1. Screen shot from the UNC School of Medicine graduation on May 7, 2016

2. Nussbaum, Abraham M. (2016-03-22). The Finest Traditions of My Calling: One Physicians Search for the Renewal of Medicine. Yale University Press. Kindle Edition. 

3. Hage, M. L. (2014). Joy http://healingagents.blogspot.com/2013/06/joy.html

A Healing Curriculum

What if you were given the opportunity to design an educational curriculum that had as its purpose the teaching and learning of healing?  What would you emphasize?  How would you do it?  Are there examples?  Does the healing goal exist under another name?

What I have found is this healing curriculum is identified by a variety of titles but only rarely is the word “healing” used.  The reasons are complicated particularly in our Western culture.  For me the opportunity to see and live this curriculum has been in Africa.   Here is what I can recommend from what I have found:

1. We need to use the word healing.    
2. We need to name healing when we see it happen in our patients.
3. We need to name healing when we are the recipients as physicians, nurses and therapists
4. We need to teach healing in our relationship with students and patients.

The best part of being in healthcare has been being a part of the larger story of healing.  It is a sustainable prescription to a suffering world.

Marvin

References

Boudreau JD;  Cassell EJ;  Fuks A. A healing curriculum.  Medical Education.  41(12):1193-201, 2007 Dec.

Previous blog references:

Hage, M. L. (2009). Healing at Tenwek.

http://mhage1941.blogspot.com/2009/01/healing-at-tenwek.html

Hage, M. L. (2010). Christian Surgical Mentoring.

http://mhage1943.blogspot.com/2010/11/chrisitian-surgical-mentoring.html

Hage, M. L. (2012). Educational Partnerships.

http://tenwek2012.blogspot.com/2012/01/educational-partnerships.html

Hage, M.L. (2012) Burnout and “Path Report”

http://healingagents.blogspot.com/2012/08/burnout-and-path-report.html

Another Kind of Healing

Julius, the carpenter, and the custom chair for a child with cerebral palsy

Tenwek Hospital, Kenya

He left there and returned to his hometown. His disciples came along. On the Sabbath, he gave a lecture in the meeting place. He made a real hit, impressing everyone. “We had no idea he was this good!” they said. “How did he get so wise all of a sudden, get such ability?”  But in the next breath they were cutting him down: 

“He’s just a carpenter—Mary’s boy. 

We’ve known him since he was a kid."    

Mark 6:1-3a (MSG)

I just finished a book by Kate Bowler, Blessed, A History of American Prosperity Gospel, that provided a deeper and wider look at healing as seen and understood in American religious culture.  It is a comprehensive history.

I have professionally and personally avoided this history.  Kate Bowler helped me understand two important issues: (1) Healing has been an important part of American culture and (2) religious healing has been seen mostly as rapid “cures”.  This book helped me to appreciate the importance of a bigger definition of healing that is not limited to a culture or cure.  

I read this book after spending a month in Kenya (Tenwek Hospital) where healing is embraced as central to their mission.  It’s meaning there is not about performance or a method of aggrandizement. It is God at work through the hands and feet of very dedicated and committed physicians, nurses, therapists and missionaries.  It is the body of Christ.  It even happens with healing hands of a carpenter!

Marvin

Bowler, K. (2013). Blessed: A History of the American Prosperity Gospel (1 ed.). Oxford University Press. 

Shuman, J., & Volck, B. M. D. (2006). Reclaiming the Body: Christians and the Faithful Use of Modern Medicine (The Christian Practice of Everyday Life) (1 ed.). Brazos Press.

Healing Leprosy

Over 200,000 Cases of Leprosy in 2012

Anyone with such a defiling disease must wear torn clothes, let their hair be unkempt, cover the lower part of their face and cry out, ‘Unclean! Unclean!’.  As long as they have the disease they remain unclean. They must live alone; they must live outside the camp.

Leviticus 13: 45-46 (NIV)

While he was in one of the cities, there came a man full of leprosy; and when he saw Jesus, he fell on his face and besought him, “Lord, if you will, you can make me clean.”  And he stretched out his hand, and touched him, saying, “I will; be clean.” And immediately the leprosy left him.  And he charged him to tell no one; but “go and show yourself to the priest, and make an offering for your cleansing, as Moses commanded, for a proof to the people.”  But so much the more the report went abroad concerning him; and great multitudes gathered to hear and to be healed of their infirmities. But he withdrew to the wilderness and prayed.

Luke 5: 12-16 (NIV)

The Bible has descriptions of and laws related to leprosy and healing.  Did you notice that women are not identified in any of the leprosy accounts?  This probably represents the social isolation and stigma that accompanies this disease.  They probably did not survive the isolation.

I have not seen leprosy during pregnancy.  The challenge is how to treat and the effects of the treatment on the fetus and baby after delivery.  Let me briefly tell you of a patient that I recently saw:  

The patient was a 26 year old admitted with bacterial meningitis and pregnant around 24 weeks.  Her mother has been with her and provided the history.  She was treated with antibiotics and showed improvement.  What was more remarkable was her face with large painless nodules that have been there for the last six years.  I will not post a picture of the patient, but I will never forget her face.  It looks like the pictures of known cases with leprosy.  We still have to confirm the diagnosis with biopsy of the lesions and begin treatment. 

This case will probably not be resolved for a long time and will require multiple providers and resources that will be difficult to find.  A comprehensive treatment program is required that is more than just the medications.

What I learned again from seeing this patient is that God’s love continues to reach out to the poor, the outcast and the isolated.  Thanks be to God for his healing gifts!

Marvin

References

http://hopeforhansens.org

Duncan, M E. An historical and clinical review of the interaction of leprosy and pregnancy: a cycle to be broken.  Social Science & Medicine.  37(4):457-72, 1993 Aug.

 Morrison, A. A woman with leprosy is in double jeopardy.  Leprosy Review.  71(2):128-43, 2000 Jun

Invited

“Go forth as a new doctor, conscious that everybody is to be revered, reverenced as created in God's image whether inner-city and rural areas go forth to demonstrate your Ubuntu, to care for them, to heal them especially those who are despised, marginalized. Go forth to make the world a better place for you can make a difference. The task is daunting of course, but it is our necessary struggle.”

Desmond Tutu, 

handwritten address delivered at 

Morehouse Medical School Commencement,

May 15, 1993.

For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.

Matthew 25:35-36 (NIV)

I have been reading about the challenges to communities.  We are all members of multiple communities.  What holds us together?  What breaks us apart?  Who is “in” and “out”?  We would like to believe that in healthcare we could articulate clear answers to these “why” questions.

In college, I was assigned the novel, L’étranger by Albert Camus.  It was a difficult read with profound questions about the meaning of our lives and our disconnectedness. Camus’s stranger was profoundly separated from his community.  It may well be that this character is found in all of us during our most lonely times.  

The contrast to our isolation can be found in the big idea of ubuntu.  It is a great idea!  I even got a Christmas gift of a T shirt that clearly displays the message.  This belief is found in the words of Matthew as well as Bishop Tutu.

The “why” and purpose of community is a paradox as described in Matthew.  We are called, by invitation to inclusion.  Hospitality is the key to and for healing communities.  We have the wonderful opportunity, even as strangers, to be invited into the lives of those we serve and with that invitation; “we are”!

Marvin

References:

Michael Battle. Ubuntu: I in You and You in Me (Kindle Locations 518-520). Kindle Edition.

Block, Peter (2009-09-01). Community: The Structure of Belonging . Berrett-Koehler Publishers. Kindle Edition. 

Camus, A. (1971). L’étranger (Collection Folio, no. 2) (French Edition) (New edition ed.). Gallimard

Healing Conversations

“Reclaiming conversation is a step toward reclaiming 

our most fundamental human values”

Sherry Turkle

Let your conversation be always full of grace, 

seasoned with salt, so that you may know how to answer everyone.

Colossians 4:6 (NIV)

I just finished Reclaiming Conversation, a provocative book that exams our digital culture and the loss of conversation.  It was a challenge to a goal of this blog, “Promoting healing conversations”.  Here are my take aways:

1. This blog is the wrong tool…blogs are not real conversation.
2. People are loosing the emotional tools of conversation.
3. Conversations are critical to healthcare and our culture.

Sherry Turkle believes that by understanding these realities we can compensate and reclaim this critical cultural ingredient.

It is reassuring finding a voice that reflects your concerns.  That connection is the beginning of a conversation!  What is concerning is that our digital tools are changing us in ways that need healing. 

The prescription, I believe, is more than just conversation.  The proposals of this blog are based on how your story and life engage a larger faith story.  

Marvin

References: 

Photo retrieved from http://www.chicagotribune.com/lifestyles/books/ct-prj-reclaiming-conversation-sherry-turkle-20151008-story.html

Turkle, Sherry (2015-10-06). Reclaiming Conversation: The Power of Talk in a Digital Age (p. 7). Penguin Publishing Group. Kindle Edition.

Previous Posts;

http://healingagents.blogspot.com/2015/09/healing-work.html

http://healingagents.blogspot.com/2015/07/presence.html

http://healingagents.blogspot.com/2015/01/confrontation-conversation-and-healing.html

http://healingagents.blogspot.com/2011/07/minds-bodies-machines-and-souls.html

A healing conversation;

http://www.tutufoundationuk.org/what-we-do/conversations-for-change/

Rx - Be a Blessing

“It is not doing the thing we like to do, 

but liking the thing we have to do, that makes life blessed.”

Johann Wolfgang von Goethe

Blessed be the Lord,

    who daily bears us up;

    God is our salvation. Selah

Psalm 68:19 (NRSV)

Patient engagement is a “hot topic” for health care planners.   It is part of the “meaningful use” prerequisite for electronic data management and access to information technology.  Underlying these ideas are how physicians, nurses, allied health connect with patients.  Here is my understanding and experience of that connection.

I would regularly meet a woman on entering the hospital who would respond to “Good morning, how are you?” with a smile and a consistent response, “Blessed”.  It immediately started my day with another vision of my work.  Recently, I read a tribute/eulogy to a teacher and mentor where the author discovers the source of his relationship with patients…”You are a blessing”.  

These two observations remind me of the opportunity we have been given when we are at our best as physicians.  We have that wonderful privilege of being with and standing by patients and their families at critical times in their lives.  

We have duties that we have sworn to uphold, but there is a larger dimension of what we should be and prescribe, “Be a Blessing”.  It means that even in the midst of a difficult illness or procedure, our patients should leave with the belief that you and your team have provided comfort and have been a blessing.

Students will see if this virtue is a reality in the life of the physician/teacher when it happens at the bedside and in the consultation room.   So besides the physician, those who are members of the teams of caring will also be blessed and leave thankful for the opportunity to be a recipient of a blessing.  Sometimes the new communication tools will make that happen.

Marvin

References

http://content.healthaffairs.org/content/32/2/223.abstract

Carbone L. You are a blessing. Annals of Internal Medicine.  150(4):276, 2009 Feb 17.

Verghese A;  Brady E;  Kapur CC;  Horwitz RI.  The bedside evaluation: ritual and reason.  Annals of Internal Medicine.  155(8):550-3, 2011 Oct 18.

Hage, M. L. (2012). Rx Ubuntu. Retrieved from http://healingagents.blogspot.com/2012/04/rx-ubuntu.html

Hage, M. L. (2013). Selah. Retrieved from http://healingagents.blogspot.com/2013/04/selah.html