Transitions

Yesterday I saw my chiropractor and asked if she could recommend a new PCP. She immediately gave me a list of names of doctors her own patients love. One of the people she recommended very highly is a Nurse Practitioner who works with an MD who's also trained in medical acupuncture. I'd already heard good things about him and had been considering checking him out -- here's his bio, which I find both honest and compelling (I especially like his definition of illness as "the human experience of disease," which is a precise and helpful distinction) -- so that was an easy sell, especially since he's on my insurance! I've had good results from acupuncture for my sinusitis, although I'm skeptical about a lot of "energy work," especially Reiki.

When I got home yesterday I called and got an appointment with the NP for 10:30 this morning. How convenient is that? As a plus, she's considerably closer to my house than my old PCP (although the office park where she's located is an absolute maze, and I kept getting lost).

I think she's great: warm, personable, empathetic, a great listener. She looked at me instead of at her computer, although like everyone else these days, the practice uses electronic medical records. She had, for a wonder, heard of Narrative Medicine! She shares my skepticism about the energy stuff and says she's had a hard time wrapping her head around acupuncture, but she keeps seeing patients respond really well to it, so that's convinced her. She adores the doctor. When I said, "I've decided that allopathic medicine is great for acute illness and life-threatening stuff like cancer and heart disease, but holistic medicine is better at treating chronic problems," she nodded vigorously and said, "That's so well put. I'm going to use that."

She recommended a new orthopedist, a knee specialist who's doing her own knee replacement next week. (Ouch!)

She talked about the fact that normal lab values -- while they can reassure you that you don't have cancer or whatever -- aren't a reason to dismiss complaints that people aren't feeling well. (My old doc's response tends to be, "You're fine. Your bloodwork's splendid.") She said, "You don't need more lab work or pharmaceuticals. You need to be treated as a whole person. We need to monitor your depression to make sure it doesn't become a problem, and we need to help you work through your grief." She asked if I was currently in therapy; I said I've stopped getting good results from talk therapy, although I process a lot through the blog, and that led us into a discussion of writing and healing. She hadn't known about James Pennebaker's research -- here's his writing and health homepage -- and was fascinated.

So her recommendation is that I see the doctor for a consultation; I have an appointment with him for June 9. When I left, she both shook my hand and hugged me. My old doctor's fallen into a pattern of walking away without a backward glance, not even responding to "thank you" or "good bye."

So I'm feeling vastly relieved and cautiously optimistic. A small voice in my head is saying, "You know these folks will burn out in five years, just like everybody else you've seen," but I'm trying to ignore it. And even if it's true, five years is better than nothing. So thank you to all of you who urged me not to settle for a doctor with whom I'd become uncomfortable!

In other news, today's my last fiddle lesson with Charlene. Her husband has a job in Madison, Wisconsin, which of course is one of the coolest places on earth, and has a much better music scene than Reno does. They're moving later this month.

I'm hoping, at some point today, to finish the extraordinarily rough first draft of Mending the Moon, and then to start revising like a maniac. I'd love to have it done by Mythcon, although that may be overly optimistic.

Tolkien and Trauma

So I said (or implied) in my last post that I probably wouldn't be blogging for a bit, but something really neat happened today, and I wanted to write about it.

Background: I've been having some trouble with job satisfaction lately. Partly this is because I've been through a lot these last few years and am simply tired. (That sabbatical can't come soon enough!) Part of it comes with the territory: all teachers have spells when they can't see if anything they're doing is making any difference to a soul. And part of it -- a lot of it -- is because of the hideous state budget situation, especially in terms of education. Our "no new taxes" governor is talking about cutting higher education by twenty-four percent, after a series of cuts that's already been disastrous.

I've long argued that our society claims to care about kids and education, but clearly doesn't, based on spending priorities. The current leadership of Nevada couldn't say any more clearly that it doesn't care about education. If you're a teacher, that's bound to make you feel, well, a little . . . undervalued? I think my job is safe -- lots of students major in English, and we're responsible for several courses all students need to graduate, and we're so understaffed right now that we're actually being allowed to make some new hires -- but let's just say that university morale in general isn't terrific at the moment. My personal fatigue, against that community background of despair and paranoia, has been a fairly toxic brew.

Fortunately, I'm teaching my Tolkien course this semester, which is always one of my favorites. (Tolkien's a great antidote to despair and paranoia!) Today my students read, among other things, part of the Foreward of Tom Shippey's J.R.R. Tolkien: Author of the Century. Shippey begins by claiming that the fantastic is the dominant literary mode of the twentieth century, and goes on to observe that many fantasists are survivors of combat or other traumas, a fact he calls "strange." Talking to the class, I said that I don't find it strange at all; I gave them a brief overview of my theories about fantasy and trauma (basically, that the "strangeness" of fantasy allows writers to represent the strangeness of trauma more realistically than realism can). I mentioned that there's well-established research about writing and trauma, which I could talk about more later were anyone interested.

I'd thought there wouldn't be time to talk about that material, but it was one of those days when discussion never took off. I wound up with about ten extra minutes at the end of the class. All teachers know that this happens, but it can also make you wonder what you're doing wrong. Today, a bit desperate, I said, "So, is anybody interested in hearing more about writing and trauma?" (All teachers also know that we tend to keep material in reserve for just such moments.) To my relief, a few people nodded.

So I gave them the condensed version of my speech about why writing is the opposite of trauma, even though it wasn't strictly on topic. Most of them looked interested. One student actually seemed teary-eyed, but I assumed that was allergies or a speck in the eye or something.

After class, though, that student came up to me -- openly weeping -- and thanked me for the trauma lecture. This is someone who plans to go into healthcare. "My friends have been asking why in the world I'm taking this Tolkien class, because it has nothing to do with my field, but now I can say, 'Hey, she has some really interesting ideas about trauma!' Now I know that I'm supposed to be here." The student has experienced personal trauma, which made the lecture especially applicable (to use a favorite phrase of Tolkien's!).

During my office hours, another student showed up and thanked me for the trauma lecture. "That was really moving." This student, too, has a personal history with trauma, and has dealt with it partly through writing.

So, hey. Just when you think you aren't getting through and have nothing to contribute, it turns out you're saying something other people need to hear. It's a good feeling, I have to say.

Funerals

We know now that there will be a viewing for Ken in Phoenix on Thursday evening, followed by a graveside service in Flagstaff on Friday. Liz, Gary and I are flying into Phoenix on Wednesday and leaving Saturday. We're going to share a rental car and hotel room to cut costs.

Meanwhile, a friend from my parish also died last week. He'd had brain cancer for three years, and faced it with tremendous humor, aplomb, and intellectual zest. Tim was a dear man who made a point of attending all of my literary readings, something that meant a great deal to me. I'll miss him, and I grieve for his wife and children.

His funeral's on Saturday. I can't be there because I'll be flying back from Ken's funeral.

Meanwhile, today I got the Coast Guard certificate about Dad's burial at sea on July 17.

Are we sensing a theme here?

I called Carol today. She'd just secured a burial plot and firmed up the schedule, but didn't have anyone to do the service yet. She asked very tactfully if I could do such a service, and if I'd be willing to. Our side of the family's pretty solidly atheist (except for yours truly), but her folks are Methodist and Baptist and need Christian comfort, and another cousin's wife and their children are Jewish and need comfort that isn't overtly Christian.

Mindful of the lesson I learned from trying to do Dad's memorial myself, I told her that this was probably too close for me to handle, and that I'm not clergy anyway -- which might be important to her Methodists and Baptists -- but that I'd be happy to make phone calls to try to find someone. One of Ken's brothers had suggested that she talk to me about this; I've evidently become the go-to person for funeral arrangements in the family.

She said she'd like that, so I got on the horn to Flagstaff and, after leaving messages at a hospital pastoral-care department and an Episcopal Church, called a funeral home where the director -- who laughed pretty hard when I said we needed somebody who could do a service that would suit atheists, Baptists, Methodists, Jews, an Episcopalian, a lapsed Quaker and a lapsed Unitarian -- gave me four names. The first person I called, who'd been at the top of the funeral director's list, laughed at the hodge-podge of traditions too, but said that since he's a hospital chaplain, he's used to dealing with situations like this. (He's Lutheran.)

Go, hospital chaplains!

This process brought me right back to making calls to find someone to do Mom's service. Hard to believe that was only a few months ago.

So he's going to call Carol. His time on Friday is a bit limited, but he's available in the early afternoon, which sounded plausible to me. I'll call Carol in an hour or two to see if the two of them connected, or if I need to keep making calls. In the meantime, I've been trying to figure out what I can do for her and for Tim's wife here in Reno. The best thing anyone did for me after Dad died was to buy me a massage, so I've decided to do that for both of them. Tim's wife and I go go the same health club, so that will be easy. I Googled massage places in Phoenix, but I don't know which ones are a) good and b) anywhere near Carol's house, so I'll wait until I get down there and talk to one of her friends about it.

I also ordered some books for Carol: Joan Didion's memoir of her husband's sudden death, Louise De Salvo's book about writing and healing, a blank journal, and a pen. I'm sure she has pens, but I wanted to send a complete set. The items will arrive via Amazon, albeit in three or four shipments. I told Carol that I know she may be not be able to look at any of the stuff for a year or two, if ever, but that I wanted her to have it.

This all feels like trying to light birthday candles in a hurricane, but it's better than nothing.

Oh, and speaking of journals -- and given the frequency of funerals lately -- today I started a new blessings journal, in which each day I'll write down a list of good stuff that's happened. This sounds simplistic, but it's a quick and handy way to maintain perspective. I kept a daily list of blessings for almost ten years before stopping in 2006 or so, and this seems like an excellent time to resume that discipline.

Score One for Narrative Medicine!

I recently got some nice news from my friend Marin Gillis, who's the Director of Medical Ethics and Humanities at our medical school, and who's been a steadfast champion both of narrative medicine and of my work with it. She was the person who asked me to teach a class on narrative medicine as part of the third-year Clinical Reasoning in Medicine course.

Some of the medical students are more than a little skeptical about this, for obvious reasons. They have gobs of hard science to learn, and they aren't getting enough sleep, and many of them are scientists by inclination as well as training. In this setting, narrative medicine, and other work in the humanities, often feels fluffy and extraneous. Although the students have always been polite to me and done the work I asked of them -- often very well -- there's also been some unspoken resistance. I could often sense the "this is bs" current in the room, although no one ever said it aloud. (I should add that this mindset isn't limited to medical students, and is often much stronger in freshman comp classes, where students can be much less polite about it!) But as a med school faculty member told me, "They'll get in five years, you know? When they're in actual practice, something's going to happen in a patient interaction, and they'll look back and say, 'Ooooh! That's why she wanted us to learn this!'"

For at least one student, it didn't take five years.

When I saw Marin last week, she told me that one of the medical students who'd been in the CRIM class told her a story about another student in the class, who'd been very resistant to the material. I'd given them a published case about a fourteen year old boy dying of cancer; I had the students write a letter from one of the people described in the case (the boy, one of his parents, one of his doctors, his beloved neighbor, the beloved neighbor's beloved dog, the girl in his class he wanted to kiss) to someone else on the list of characters. The students paired up and swapped letters; each then wrote a response to the other's letter. So if one student wrote from the boy to his doctor, the second wrote from the doctor to the boy.

This one student, evidently, thought the whole exercise was complete and utter hooey. Why were they spending time on this garbage? How was this ever going to be useful?

Two weeks later, he told his friend, something happened at the hospital, and he suddenly understood why it was important. He had the aha moment. "Ooooh! That's why she wanted us to learn this!"

I don't know what happened, although I'd love to know. Marin's trying to get the student to write me a note about it, but apparently he's too embarrassed. (Dear med student: If you're reading this, you don't need to be embarrassed. Believe me, I know the material can seem irrelevant at first! I'm just glad it didn't take you five years to change your mind.)

In any event, this is an invaluable affirmation of the work I've been doing. Marin and other med school faculty have been very positive all along, but the opinions that matter the most are those of the students.

In other medical-humanities news, we'll be starting up the Literature & Medicine program in August, and Marin recently met with the staff of a care facility where there's strong interest in a writing and healing group. So I may be doing that work sooner than I expected. And we also have our first student in a narrative-medicine elective, and she may be able to get me invited to teach a narrative medicine or reflective writing session at the HEART elective in Santa Cruz next April.

I'm excited!