Tag / Healthcare

by Michael

Trauma, Disparities, & the Exercise of Needed Distrust

I’m thinking about Dr. Susan Moore, a Black physician who recently died after battling for her own quality medical care and against Covid 19. And I’m thinking about a mother named Mary from a long time ago who was unmarried and who spoke sonnets about her experience of getting impregnated and carrying a baby whose existence was misunderstood from mystical beginnings.

Trauma, a word coming out of an early surgical model for discussing injury, has come to encompass a full set of pains. Trauma is an injury, a bewildering injury or set of injuries.

A trauma can occur to a person or a people. A lot of people from many disciplines are talking about trauma these days, how it happens, what it means to be trauma-informed, etc. From anthropologists to neuro-scientists, chaplains and therapists, and social workers and teachers, lots of folk are discussing and working to respond to traumas in people.

There is language in these discourses about how a trauma is a discrete event in many cases. It happens; it ends. There is a healthy discussion on when and if that’s always true. Some traumas do end. Some are protracted and are, in a real sense, unending. I won’t get so much into that but I want to write a little about the way trauma can return.

After occurring and “ending,” it/they can revisit persons in seen and unseen ways, through known and recognized forms, as well as through insidious and unacknowledged means. Sometimes we see the re-visitation coming. We anticipate it. When we do, we can prepare and draw upon resources to help through the revisited pains. When we don’t see them coming, we are likely more reactive, doing anything in response to the unexpected-but-somehow-still-known.

Disparities in healthcare and medical treatment can be a means of trauma recurrence. Unfairness and mistreatment become a mechanism whereby trauma returns. Now, you’d have to accept a cultural transmission of trauma to appreciate this reality where earlier experiences are translated and handed over to subsequent persons related to those who have experienced trauma. In other words, what happened in prior times affects these times. There is another post somewhere in this direction that combines cultural trauma (at least that type of trauma) with attachment theory to explain this transmission and the patterns and connections making this possible.

Still, interacting with a disparity in the emotional neighborhood of a prior trauma is an uneasy psychological experience. I’m thinking about healthcare but this is true in other places. Whenever a person meets the reminders of prior pain, the body recalls and sends all its resources to preserve life. Emotional life. Spiritual life. Physical life. You don’t want to be hurt. You never do. So if you’ve been hurt, if your people have been hurt, you consciously or unconsciously respond to the disparity, the trauma, at least because of deep memory.

This is evidence of what, in The Inward Journey, Howard Thurman called a “strange quality of renewal.” The response to the disparity is to, in some way, resist it as a means of death. Resistance is a sign, a strange one perhaps, of life. Thurman says, “this is the way of life.” When you’ve experienced traumas and bruising pains, and when those are revisited among you, your reactions are little signs that life is present.

The exercise of distrust by Black people, then, is a needed one. It is needed because that distrust is evidentiary of a different trust, a trust in life. I call it everlasting life. Black distrust of the traumatic opens the world to the actual agitating presence of the God of life, the Source of life. Distrust of one system illuminates abiding trust in another. Distrust of medical science or research practices, say, points toward the life bonds elsewhere. Isn’t the question, “how do I find the life here?” Or “What does trust look like then?”

Take it from there. Look for the next sign of life. But name that life force. Relish the presence of Spirit. Moving against the brokenness and the flagrant disregard of life is a spiritual resistance that itself is being visited in the world through your own act of resistance.

Listen to the Spirit. Act with the Spirit to preserve life, to vanquish non-life. Do what will counter the forces of death and what will make right – or righter – what was wrong the first place.

by Michael

My Blog: Rested

I was reading KevinMD, a physician’s newsletter, that comes to my inbox. It’s a regular list of interesting articles discussing the ways physicians and care providers practice.

Among the recent posts was one about sleep deprivation and how necessary a culture shift is for doctors, those in training and those teaching. It made the point that working up to 100-hour weeks is unhealthy. Sleep is a medical necessity.

This is something I’ve wondered about with the healthcare professionals I’ve served as a pastor. Further, they and the blog have me thinking about what’s necessary for me to get rest, what’s necessary to my feeling rested, and what by virtue of my choices exhausts me.

Perhaps good posts like those on KevinMD’s blog will get us to thinking about how to support our care providers and how to live healthy lives.

by Michael

When Suicide Happens

by FreestocksI’ve read of the suicides of many people in the past, and no such story is a good story. Whether it’s a person who’s in the public eye or a person who was hardly noticed, we lose a person. A mother devastated by her toddler’s death. An actor who suffered in bruising isolation. A seminarian whose struggle was largely unseen. A doctor who couldn’t continue under mental anguish. A pastor who was overwhelmed by everything.

The loss is aggravated by the circumstances surrounding the death. Those left to respond  rotate a series of questions, all of them in big-deal categories. We question life, ours and theirs. We wonder about God and faith. We query our social relationships and relatives. We turn to the tragic circumstances that form around an individual and try to see them.

Here are a few things I think are worth doing–commitments worth making–when someone commits suicide, in no particular order. They sound too general because I’ve written them about “a person” and I fully intend for that be come across as a person who comes to mind, a particular person, a designated individual or individuals who you love:

  1. We commit to being and not only doing, to tunneling into the beautiful wonder that is the self and to emerging from that wonder with a stubbornness for searching for the same in others.
  2. We commit to grieving, feeling as fully as possible, the deep fissures in us when someone kills herself or himself.
  3. We commit to becoming more human by relating to individuals differently and based upon their uniqueness all the time.
  4. We commit to the hard work of paying attention to what turns a person, lifts up a person, spoils a person, hurts a person.
  5. We commit to loving as much as possible in the present moment.
  6. We commit to getting mental and emotional support for ourselves and our communities in the forms of clergy who are permanently slanted in the direction of full liberation; therapists who are helpful in pursing with us our own deep change in the face of psychologically rough worlds; spiritual directors who can listen us into freedom as we journey into the company of God together; family members who embrace us unconditionally and love us lavishly; and friends who are just like family and who stay in place when family diminishes, drops, or dies.
  7. We commit to asking better questions, even when the question is “How are you?” and staying around for the response.
  8. We commit to telling another person how they impacted us, how we felt because of something they did or said, and how we are changed specifically because they matter.
  9. We commit to standing close when a person feels abandoned, reminding them by our physical presence when our unheard words ring hollow that we are with them.
  10. We commit to responding after any death with a voracious invitation to our own special life, to cultivating healthier relationships, to dealing with the destructive dynamics in our own lives, to being different and better people, and to advocating for everybody’s healthcare and self-care.

Also, if you’re in Chicago, consider attending the National Day of Solidarity to Prevent Physician Suicide.

by Michael

Complications, Surgeons, Care, & “Undeniable Power”

Thanks to Leeroy and Life of Pix.

Thanks to Leeroy and Life of Pix.

This is an intriguing report about patient choice, public information about doctor’s records, and surgeons teaming up to prevent complications and errors even though they’re paid less for it. Here’s a quote that made me hopeful–and there were a few:

There was undeniable power in putting the information out there, where everyone could see it.

“When you get that grade, if you don’t like that grade or think you can do better,” Kaplan said, “you either study harder or go to the teacher and ask, ‘What can I do better?’”

Being a unit chaplain for surgical floors and a medical intensive care makes me particularly interested in this report which you can read here. Of course, your disagreements, your considerations, the comments after the report, and so forth are just as helpful in learning about all these things. And I’m grateful that Marian Wang shared this.