Category: mental illness

Open for Business

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photo by Josh Scholten
photo by Josh Scholten

Astonishing material and revelation appear in our lives all the time. Let it be. Unto us, so much is given. We just have to be open for business.
~Anne Lamott from Help Thanks Wow: Three Essential Prayers

I have the privilege to work in a profession where astonishment and revelation awaits me behind each exam room door.

In a typical clinic day, I open that door 36 times, close it behind me and settle in for the ten or fifteen minutes I’m allocated per patient.  I need to peel through the layers of a person quickly to find the core of truth about who they are and why they’ve come to me.

Sometimes what I’m looking for is right on the surface: in their tears, in their pain, in their fear.  Most of the time, it is buried deep and I need to wade through the rashes and sore throats and coughs and headaches to find it.

Once in awhile, I can actually do something tangible to help right then and there — sew up a cut, lance a boil, splint a fracture, restore hearing by removing a plug of wax from an ear canal.

Often I find myself giving permission to a patient to be sick — to take time to renew, rest and trust their bodies to know what is best for a time.

Sometimes, I am the coach pushing them to stop living sick — to stop hiding from life’s challenges, to stretch even when it hurts, to get out of bed even when not rested, to quit giving in to symptoms that can be overcome rather than overwhelming.

Always I’m looking for an opening to say something a patient may think about after they leave my clinic — how they can make better choices, how they can be bolder and braver in their self care, how they can intervene in their own lives to prevent illness, how every day is a thread in the larger tapestry of their lifespan.

Each morning I rise early to get work done before I actually arrive at work,  trying to avoid feeling unprepared and inadequate to the volume of tasks heaped upon the day.   I know I may be stretched beyond my capacity, challenged by the unfamiliar and stressed by obstacles thrown in my way.  It is always tempting to go back to bed and hide.

Instead, I go to work as those doors need to be opened and the layers peeled away.  I understand the worry, the fear and the pain because I have lived it too.   I am learning how to let it be, even if it feels miserable.  It is a gift perhaps I can share.

No matter what waits behind the exam room door,  it will be astonishing to me.

I’m grateful to be open for business.  The Doctor is In.

photo by Josh Scholten
photo by Josh Scholten

Now and Now

barnstormingblog5 Comments
photo by Josh Scholten
photo by Josh Scholten

And so you have a life that you are living only now, now and now and now, gone before you can speak of it, and you must be thankful for living day by day, moment by moment … a life in the breath and pulse and living light of the present…
~Wendell Berry

My days are filled with anxious people, one after another after another.  They sit at the edge of their seat, eyes brimming, fingers gripping the arms of the chair.  Each moment, each breath, each rapid heart beat overwhelmed by fear-filled questions:  will there be another breath?  must there be another breath?   Must this life go on like this in panic of what the next moment will bring?

The only thing more frightening than the unknown is the known that the next moment will be just like the last.  There is a deficit of thankfulness, no recognition of a moment just passed that can never be retrieved and relived.   There is only fear of the next and the next so that the now and now is lost forever.

Their worry and angst is contagious as the flu.
I mask up and wash my hands of it throughout the day.
I wish a vaccination could protect us all from unnamed fears.

I want to say to them and myself:
Stop.  Stop this.  Stop this moment in time.
Stop expecting some one, some thing or some drug must fix this feeling.
Stop being blind and deaf to the gift of each breath.
Just stop.
And simply be.

I want to say:
this moment is ours,
this moment of weeping and sharing
and breath and pulse and light.
Shout for joy in it.
Celebrate it.
Be thankful for tears that can flow over grateful lips.

Stop me before I write,
because of my own anxiety,
yet another prescription
you don’t really need.

Just be–
and be blessed–
in the now and now.

Realm of Briar

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photo by Josh Scholten

Far from Love the Heavenly Father 
Leads the Chosen Child, 
Oftener through Realm of Briar 
Than the Meadow mild.

~Emily Dickinson

I know folks being dragged through the realm of briar right now.  They are dealing with life-threatening disease, disintegration of relationships, significant mental health challenges or the results of random tragedy.  The cruelty of so much earthly suffering cannot be easily explained nor dismissed.  It feels “far from love” to be chosen to walk through a place that rips and tears away at one’s very flesh and spirit.  Yet many of us are chosen to experience such trials rather than allowed to live life in the mild meadow.

The only consolation is that we are not alone on this path of pain.  The Chosen Child, sent to walk alongside us through the realm of briar,  bleeds with us, bleeds because of us, bleeds for us, bleeds when we have nothing left, ultimately bleeds so we no longer have to.

To be everlastingly filled, we must first be emptied.

To find our forever home, we must admit we have lost our way and need rescue.

Accompanied through the realm of briar, we suffer wounds that only Love can heal.

Heart Ache

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photo by Josh Scholten

…be comforted in the fact that the ache in your heart and the confusion in your soul means that you are still alive, still human, and still open to the beauty of the world, even though you have done nothing to deserve it.
Paul Harding in Tinkers

There is plenty of aching confusion this week about the nature of criminal intent, premeditated planning and the role of mental illness in excusing responsibility.  Seeing the blank confused eyes of the Colorado mass murderer during his first court appearance (was he faking it?  was he sedated? was he simply mentally “checked out”?) brings up the question of his competency and capacity to discern right from wrong.   He was certainly very competent and highly organized at setting up and executing a diabolical and intricate plan for killing as large a number of people as possible.    Incompetent people usually can’t plan breakfast much less mass murder.

So how do we know evil when we see it?  We don’t have to look very far.  It is hidden deep enough in each of us that we don’t usually confront it daily, but it is there.  For some it is their daily bread, feeding them as it is fed and growing.   It can be all-consuming, finally taking over the heart and the soul completely, leaving nothing recognizable behind.

Not recognizable, however though completely undeserving, redeemable.

May there be mercy for the aching, clarity for the confused and a new heart to replace the lost.

 

 

Mingled with Grief

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“The world is indeed full of peril and in it there are many dark places.
But still there is much that is fair. And though in all lands, love is now
mingled with grief, it still grows, perhaps, the greater.”
— J. R. R. Tolkien

What happened last night in Aurora, Colorado is not fair.  There could not have been a darker place than a theater where a masked gunman gassed, then shot and killed escaping movie goers at a midnight showing of the new Batman movie.  I’m not a fan of the genre of troubled superheroes but my children and their friends and many of my patients are.  They like to attend first movie showings at midnight in big batches, celebrating an anticipated release together.  The young people who were killed and injured are just like them.  It is so unfair, just like so many violent tragedies instigated by a desperate person wanting to prove a point through random killings, then make the news in a “suicide by police” gesture.

The media has just released information that the young shooter is a neuroscience graduate student withdrawing from his program–someone whose motives are still unknown but whose struggles were undoubtedly apparent to his family and mentors.  He must be a bright and talented individual to have made it into a PhD program so this somehow compounds the tragedy.   One of the stark realities of our time is that before a shooter is identified by the media, there are dozens, maybe hundreds,  of people who wonder if and fear their family member (or patient) could be the one.   There are so many struggling with dark impulses and those around them often have a clue and have tried to help.   I’ve seen students in my practice with such thoughts and it is a heavy burden for them and for me to sort out how best to reduce the risk of them acting out their impulses.  There have been times when hospitalization isn’t possible, when meds aren’t effective or not taken, when counselors are ignored, when families are non-existent support.   That is when I can only pray on my own for light in my patient’s darkness, that he will not become the next headline, the next suicide, the next mass shooting.

There must be unfathomable grief today on the part of the families of the killed and injured, and on the part of the family of the shooter, and the recent University administrators and others who may have tried to help him.   There is no response possible except to love these hurting people as deeply as possible, surrounding them with hope and prayer.   They will never be the same.  The shooter has made certain of that.

The shooter didn’t extinguish the light nor has he extinguished himself, no matter how hard he hoped to.  We need to make sure he failed in his goal.  The media needs to draw a curtain around this tragedy and limit exposure.   To dwell on it only encourages this and the next mass murderer in their quest for infamy.

Our grief mingled with love grows the light brighter than ever;  prayers for mercy can effectively flood and extinguish the darkest of places.

Perhaps the last thing James Holmes might expect is that there are people who will pray for him as well.

It is only fair.