a blessing for caregivers

 

Blessed are we
for whom the call to loving action is still strong,
whose every urge is to keep going, keep working,
and not to count the cost.

And yet blessed are we,
beginning to notice that we are slowing down, inexplicably,
or just pausing, staring for no reason,
or starting something,
but then quickly turning to another demand.

Blessed are we,
realizing that we are beginning to lose the thread.

Blessed are we who say
I really can’t keep going like this,
at this pace, under this weight,
and also, the momentum is so strong, I can’t stop.

God, come and be the hands that sit me down
and keep me there long enough
for me to really feel what I feel,
and know what I know.

Come and be the wisdom
to find the support system that is broad enough,
kind enough, effective enough to meet the needs that are here
– both mine and theirs.

Come and be the peace that frees me
to let my hands lie gently open awhile,
the grace to just receive.

Seek the rest you need, and a little bit more.
it is a sacred space.

Kate Bowler: https://katebowler.com/blessings/a-blessing-for-caregivers/

 

Medical education and training, especially as it relates to the clinical activities of history, physical exam, and diagnosis, spends a lot of time and energy on understanding patients’ identification, naming, and description of their symptoms. A primary assumption underlies this and underscores the importance of the clinician discerning the veracity and salience of the symptoms described. The belief that patients know their bodies, can identify among the vastness of sensory experiences in the body which ones are related to their presentation, and possess the language to articulate accurately and understandably their symptoms becomes central to the clinician’s work in the clinical encounter.

 

But how reliably do patients, or for that matter any of us know our physical symptoms? And how dependably can a patient, or for that matter any of us describe them accurately? And perhaps even more significant, how important is our body-awareness and ability to describe it given the power of our technology to look at and into the human body at levels ranging from the gross to the molecular? Are we in a time in human development and in medicine that through a Star Trek-like wave of a handheld device like Dr. McCoy’s we have all that we need to make diagnostic and treatment decisions?

 

I recently listened to the podcast On Being in which the host Krista Tippett interviewed Kate Bowler, a Canadian academic and writer from Winnipeg, Manitoba, currently an associate professor of the history of Christianity in North America at Duke Divinity School, and author of a number of books including No Cure for Being Human: And Other Truths I Need to Hear, and who was diagnosed  eight years ago at age 35 with stage IV colon cancer. She describes many moments before her diagnosis, during, and since when the medical professionals’ responses to her describing her embodied experience were mostly cerebral. Kate describes a profound shift in her healing when she connected with her professional caregivers at the level of their shared humanity which usually manifested in the recognition of their common embodiment.

In mindfulness training including the pedagogy employed in the Mindful Practice in Medicine Program, a lot of time and energy is spent on cultivating what is referred to as the first foundation or first establishment of mindfulness, stated simply by the late teacher Thich Nhat Hanh as mindfulness of the body in the body. Body awareness through mindful attention with the development of increasing levels of embodiment comes about through building awareness of the body through our senses as well as through awareness of our emotional relationship to the body and our cognitive constructions about the body (these levels of mindful awareness in turn integrate the 2nd and 3rd foundations within the cultivation of the first, as they are not truly separate). We could argue that somatic awareness taught in this way could be a reassuring foundation across formal and informal educational experiences for all of us. For the patient to be able to recognize, describe, and accurately express physical symptoms and for the clinician to be able to trust and understand those descriptions in part through their own personal somatic awareness achieved through cultivation of the first foundation of mindfulness would add tremendously to the success of the medical encounter, the cultivation of empathy, and the diagnostic and therapeutic processes.

 

Equally, or perhaps more importantly (and one reason why the Star Trek approach falls far short), as Kate Bowler describes so beautifully, healing is much more than getting the right diagnosis and the right treatment. There remains the lived experience of illness and suffering and loss that is in part, perhaps in large part, an embodied one. And it requires a meeting of embodied human beings to care for and, in Jon Kabat Zinn’s characterization about what healing is, to come to terms with things as they are. How does the health professional begin to enact healing in this way?  I offer following as an attempt to render this creative, uncertain, and vital endeavor:

 

Here I am.

Here you are.

How can I help?

What hurts?

Where?

How?

I understand that a bit because I have a body too.

I have some knowledge that may help.

I will try.

I will do my best.

It hurts to see you suffer.

It feels good to help relieve it.

I won’t abandon you.

You are not alone.

 

Our mindfulness practices, however, we understand them, however we practice them, and however we return to them, reliably and consistently build the being part of our humanity that connects us on human- physical, emotional, and cognitive levels with another. We can trust in what we discover as we practice our embodiment in the classrooms of life- for the curriculum can be found in everything and everywhere that we work, dwell, and have this human experience.