Sunday, July 20, 2014

Can we Change the Course of Cancer by treating our Patients with Love?

I recently had a heart expanding moment.  In that moment, I felt a deep and wide sensation of energy radiating from the center of my chest.  I would call this a “vertical moment” one that feels powerful in its quantum nature.  Its memory has lingered and inspired me to reflect on the power that love can have on the course of an illness. As a physician, it made me wonder, “what if we engaged our love when we delivered a diagnosis?  What if we offered hope rather than fear? What if we loved our patients more?  What if we engaged wonder and mystery rather than statistical predictions?”
We were at a small café in Madison, WI for Saturday breakfast.  The middle aged couple at the table next to us was leaving as we arrived.  The wife clearly had cancer.  She had a makeshift turban over her bald head and her skin looked pale and flat, like the skin of many patients undergoing chemotherapy.

I watched their interactions as she fumbled to stand up after her meal.  Her husband’s kindness was palpable.  He offered her support with his strong arms and loving words. He knew she was too weak to stand up by herself.  His voice was filled with love and resounded like a melody through my heart.   It was one of those numinous moments where my heart melted and I wanted to laugh and cry at the same time.  I was reminded of the depth of loving kindness that people are capable of showing each other.  I surmised many theories about their life during this sacred moment – “he was in it with her for the long haul; he loved her unconditionally; she had learned to receive his love and support; she was weakened by her treatment; she was working extra hard to stay positive.”

Many people going through a cancer journey share similar challenges.  Traditional medicine fails them in its chosen ignorance of process.  Loved one’s who care for family members with cancer go unnoticed and unacknowledged by many in health care, especially physicians.  A cancer diagnosis also affects a patient’s larger community.  This is their lifeline that carries the task of empowering and caregiving over the long haul.  They are presented with the monumental task of transcending the fear that is mindlessly handed to the patient during the delivery of the cancer diagnosis.  This fear is the shadow companion that consumes vital energy during the cancer journey.

Fear is the often handed to the patient alongside a diagnosis of cancer. Is the “fear” part of the hand out really necessary? Or has our society just normalized it?  Why haven’t we normalized love, hope, reclamation, possibility or even opportunity?  I feel that it is finally time to reframe our perceptions of cancer or any illness, so those affected can be seen as the shamans that they are, bearers of deep and sacred wisdom.  They have faced the possibility of death and chosen to live.  They are powerful alchemists.  We must be open to learning from them as we also honor their process.

Of all diseases, cancer is one that can suddenly call us to transform.  It can be seen as a sudden wake up call, one that contains “awful grace”. It can force us to reevaluate our perceptions of the world, what we eat, how we behave, how we express feelings, and how we practice self-care.  I would call these reevaluations, a kind of “medicine” that cancer carries in its powerful and tight grip.  This medicine must be uncovered and released in order for one to truly achieve wholeness.  The causes of cancer are often hidden and only present at unconscious and unseen levels.  Wouldn’t it be meaningful to explore these levels, to make them conscious for clarity and healing, so we can be guided into becoming larger versions of ourselves than before the cancer occurred?

One would think this could and should be the normalized approach in cancer, from the moment of diagnosis through recovery.  If we only view cancer as the monster we need to attack, how can we learn what it is here to teach us?  How can we reclaim our life from what we feel may be its many causes?  These are the nuggets of learning that carry the capacity for us all to free ourselves from its threat and restore wholeness during our journey. How can we awaken the alchemist within us and transform every atom in our cells into luminosity and light?  As we seek its elusive and often hidden “medicine”, we may even learn to live in a way that makes us “bad hosts” for it, to prevent it from resurfacing.  This is the framework that must accompany the diagnosis of cancer to offer patients the best outcome.

When fear is handed to patients in the exam room, a cascade of events occurs.  First, they dissociate to enable them to actually “take in” the diagnosis.  A part of them becomes paralyzed as their limbic system engages for survival.  This is the part of the brain that is activated for fight-or-flight.  Trauma enters the emotional body, disrupting their electrical system, creating an unsettled, chaotic feeling of shock that remains present for months and sometimes years.  Many describe this as a feeling of “static in their field”.  Patients have a hard time feeling settled and empowered.  They find it difficult to engage their imagination where they can access solutions and become seekers.  This is where they can also gain access to their inner wisdom, instinct and insight and the healing power of Sophia, the Divine Feminine, whose power and capacity lays dormant, waiting for connection.  Cancer or any disease carries the potential for activating this.  The fear handed out subverts their connection with this intrinsic power which regulates their inner pharmacy, capable of more healing we can imagine, more than even the medical system can understand.  It subverts their access to the ‘stuff of soul’ where quantum healing awaits.

The physiology of the stress response and the impact of chronic stress on the body/mind is well known throughout the scientific literature.  Its impact on the endocrine system is erosive and thwarts the regenerative power of cells.  Cell to cell communication is impaired and growth hormone in the pituitary gland is suppressed.  Insulin receptors malfunction and the adrenals wear out.  The entire delicate web of hormonal and endocrine communication is harmed.  Under stress, the tapestry of these delicately woven systems unravels and its threads begin to fray and tear.  Under stress, the very molecules of the body degenerate denying access to the luminous.  We become uncreative and unimaginative.  We lose faith in possibility and our lens of perception turns negative.  We risk feeling like ‘victims, waiting to be rescued’.

Cancer has been normalized by society as a terminal disease, one that leaves little hope for recovery.  Recovery is termed ‘survivorship’ and the adopted identity of ‘cancer survivor’ becomes a badge that defines the end of the battle.  Meanwhile, the energy of cancer alongside fear hangs in the rafters, waiting.  Fear is intricately linked with ‘survivorship’.  It lies huddled in the background, surfacing with the slightest symptom.  Fear ultimately causes chronic stress.  The immune system feels its cold claws, as they scrape even lightly upon the psyche and imagination.

Creating a new framework to support patients with cancer has the potential to change its face and its course.  The negative thought forms where fear and death are kept at bay, can be transmuted into opportunities for seeking the growth and healing this diagnosis evokes.  Such an approach has the potential to change its course and significantly improve its outcomes. I believe this is truly possible but will take an effort on all our parts to reframe what we accept.  Our greatest effort will be to embody the awareness that is required to shift the traction from fear that has been normalized that ultimately predicts and defines the course of cancer or any illness.

Medicine is at a crossroads, a gateway, where it needs to transform into a system that offers more love, and hope, and where exploration and education are honored as core values.  As a practicing physician, I have carried this framework alongside my expertise and have learned to love deeply and widely along the way. I have felt my heart expand and my wisdom grow, but most of all, I have grown to honor the sacred contract with my patients and their loved ones, who have chosen me as their companion, and walk with them through sickness into health and often into a transformed life.  For this, I am profoundly humbled and deeply grateful.

And regarding the couple in the café, in that moment of witnessing their love, my heart leapt towards them with a loving and supportive embrace as they left to continue their courageous journey through the hills and valleys ahead.   Their very presence was a gift and an inspiration to me as a physician and a person who feels deeply. Even though they may never read this article or know how deeply they touched my heart, somewhere in the tapestry of the Universe that weaves us all together, I hope they do.  I want them to know that their love, kindness, and courage was witnessed, and deepened many around them in more ways than they could have imagined.

Wednesday, July 9, 2014

An EPIC Degree of Soul Loss

The practice of medicine has undergone yet another change. Over the past several years, it has gone electronic. Those of you who have experienced electronically recorded medicine have had to adapt to the profound change that this brought to the physician visit. Physicians, already stressed from adapting to the corporatization of medicine, now have to adapt to data entry during their time with their patients. I, for one, resisted this as long as I was able.  I intuitively knew what this would do to the sacred essence of the physician-patient encounter.  Last year, I was forced to succumb.  I was not really given a choice. Implementing the electronic medical record (EMR) in my practice was not only extremely expensive for a primary care physician in private practice, it was extremely stressful for one who practices “patient centered” medicine. For a physician who relishes spending time with my patients, listening for clues in their stories to help them problem solve and heal, this was deeply intrusive.

When I used paper charts to record patient encounters, I was able to look at my patients, be in their presence and receive their stories while using my technical and intuitive skills. Most importantly, I could hold sacred space for every patient who I promised to help and heal.

After the electronic medical record became a part of my practice, I grieved the presence of a machine in my exam room that interfered with this connection. Surprisingly, I found myself in constant heart ache struggling through the day to try and capture the sacred essence of my beloved patient encounter. I realized the “mill” medicine had now become was a data collecting one that no longer valued humanistic listening and caring.  I had to learn how to enter patient data quickly and efficiently in order to maintain connection with my patients, so vital for their healing.

Given the level of my grief, I was curious if other physicians felt like I did. I explored internet conversations and blogs about how others felt since this implementation. One physician accounted that the stress of implementing EMR caused him to suffer a heart attack.  Could this be symbolic of his heart break from not being able to engage with his patients like he used to, combined with the stress of learning this heartless system of data entry?  It is certainly a cause for wonder.

Our current corporate system of medicine has been in crisis for nearly two decades. Patients and physicians are disillusioned by what today’s health care system has become. It is obvious that it suffers from a great degree of “soul-loss.” Rather than finding ways to fix and heal it to improve patient care, I believe the implementation of the EMR has furthered its dis-ease.

We were told that this method of documentation would make health care seamless, more collaborative and save paper and time. It has done the opposite. Different health care systems are not able to access the records of shared patients; it has created more paper waste and has taken up more physician time. Physicians who are unable to balance the EMR with patient contact opt to complete their charting after work into the late hours of the night. This compromises their work-life balance, adding to their stress and rendering them vulnerable to mental and physical illness.  We have all heard of numerous

physicians who opted to retire before their intended time when EMR was implemented. They were unwilling to compromise the art of healing for data entry.

Many patients do not realize that physicians had no say in this decision to implement EMR. They were merely required to adapt to this mandate.

As a patient, when you visit your private practitioner who is now electronically linked, please have patience. And physicians, please know you are not alone in your frustration with yet another intrusion in the exam room, our sacred sanctum. We will have to adapt in a way that preserves the sanctity of our vocation, despite the stress this has created for us.

Our precious field of medicine cannot continue to lose its soul in the many ways it already has. At some point it will have to transform and reclaim its true purpose and restore the sacred contract between physician and patient.

Till then, as physicians, we must carry the flame of healing in our hearts for our patients with continued love for our craft, and patients must carry patience in their hearts for their beloved physicians who struggle to remain connected with their heart and feelings while trying to adjust to the presence of the EMR.