Wednesday, April 22, 2009

Mind Games

One of the small perks of my blogging -- mainly related to Surgeonsblog -- has been the occasional request to review a book, sent in hopes that I'd mention it on my blog. I'm reading one of those now, and one chapter struck a chord.

For now, and maybe forever, I'm not going to mention the name of the book, because at the moment I'm not sure I'd give it a favorable review. It's written by a surgeon, and its theme is spirituality in surgery; but to me much of what he sees as evidence of a higher power is unconvincing -- even more so in that he states clearly at the outset that he's burdened with OCD, a characteristic of which, by my reckoning, is believing in causal connections where none exist. Still, I liked this story:

In brief, the author had had a young patient die of cancer, and in the final days, he (the surgeon) had canceled a family vacation to be with the young man -- that feeling of indispensability that many of us surgeons have had, only to find out how wrong we were... It seems the author also had a bad back, often wearing a brace while operating (me, too!) Some time after the death, the surgeon had a particularly sudden and incapacitating episode of back pain. By coincidence (?), a friend of his, a Native American (Navajo, as I recall without picking up the book to look), happened by his house as he lay immobile on the floor. The friend took a look and left, saying he'd be back with help.

The help, it turns out, was a medicine man, who insisted on gathering the surgeon's entire family in the living room to share in a ritual (small kids, past bedtime.) Lighting a fire in the fireplace, chanting, doing stuff with the smoke and feathers, he announced that there was a young man whose spirit was angry at the doctor for refusing to let him go, to let him get to the spirit world. It struck the surgeon hard, and he knew immediately who it was; he began to sweat and to sob, freaking out his kids, during which time he eventually began to notice his pain was ebbing...

I've made it pretty clear: I'm not much on religion. But I think the need for spirituality is universal, and stories like this appeal to me greatly. I can go only so far to "explain." Maybe the friend knew of the doc's sadness over the loss of the patient, and mentioned it to the medicine man. Without doubt, many kinds of pain syndromes are affected by psychic stress...

When I was in Vietnam, concerned mostly about the world that was within three feet or so, a friend sent me a book, "Remember, Be Here Now," by Ram Dass. I could go on at length: at the time it affected me greatly. Suffice it to say that only about one third of the book is comprehensible, and much of that is devoted to Ram Dass' (formerly Richard Alpert, colleague at Harvard of Timothy Leary) experiences with his guru-to-be, Baba Ji, in India. Heady stuff. If the events are true (one might well question the memories of a life-tripper; but a friend from college, who seems a pretty earth-bound sort, tells me he read the same book and was so impressed he went to India to study with Baba Ji, and witnessed similar things) it speaks of mental powers way beyond the norm. Mind reading, would be a mild way to put it. Great stories. In Vietnam, where life was often nasty and scary, viewed through the other end of the telescope, opening the book was like entering a cool room on a hot day. A reminder -- a hope, at least -- that there was something more out there; maybe, eventually, available to us all.

A favorite phrase around our house is "How was the cookie?" Too long a story to tell you why.


SeaSpray said...

Well if this isn't an ironic twist in reactions!

"A reminder -- a hope, at least -- that there was something more out there; maybe, eventually, available to us all."

While I don't know of these spiritual things you speak of...what your post did for me was remind me of my faith and how my perceptions have changed greatly recently... understandably so.

And yes...there is a strong connection between mind and body...which is why..i know I need to get a grip.

My mother died of an intestinal GI bleed in the ED Friday night.

I have been taking it extremely hard..I think because of our complicated history and knowing, feeling I should've done more...particularly these last few years. even these last 6 months in the nursing home. but we bonded more and we did love each other.

I have been beating myself up with the should've would've could'ves.

I know sometimes our best isn't other people's best or even our best... but maybe it is our best at the time. Sucks though...when you could've done more.

maybe it was denial..thinking I have more time. The whole thing was a huge adjustment.

I was beating myself up for not going the last 5 days she lived. I had planned thurs/Fri but didn't because I wasn't feeling good. Friday nurse called to say her stomach was distended because she couldv't urinate but foley cath helped and she said it was a relief. Thing is, prior to that call...i was going in to see her... but I asked nurse how she was and she stated that she was fine and talking and so I decided..alright..I will go see her tomorrow.

Apparently... she wasn't "fine" and If I had gone maybe I would've seen something was wrong and alerted them.

They called me Tuesday to inform me she had a sm sore they were treating.

I have since found out through various staff that they were wondering why she was so lethargic Thurs/Fri. She had very high coumadin levels wed and doc said stop coumadin for a couple of days.

She didn't want even her favorite foods for dinner Thursday night and Friday she refused to eat anything and only wanted to sleep.

If only I knew about the lethargy and not wanting to eat!

I have to forgive myself and I am trying.

And this is haunting me and I wonder if I should've tried harder.

For at least a couple of months...she would complain of abdominal pain. Not use that word but say oh it hurts and grab that area. It seemed rhythmic at times and so I wondered about bowel. I reported it to the nurse who didn't seem concerned. Without getting too descriptive..sometimes her bowels moved normally and other times not and I think they thought it was the meds.

the problem is that she had dementia and so sometimes they came in and she seemed fine or she would say it was her head or foot.

I told her neurologist about her usually grabbing abdomen and to me..pain seemed to be their intermittently... but how can you tell when pain is real in dementia pt? She said you can't.

She wasn't out of it though and you could talk to mom. but she did greatly mix things up.

Even on Easter..she was fine, eating and interacting somewhat and then suddenly she was saying oooh she was in pain. I said.. I wasn't in the rest of the week when she was apparently declining.

they called Friday evening to say she was bleeding heavily and by time she was at hospital she had lost so much blood, was still bleeding, her coumadin was a 10 and she was in renal failure.. and I watched her fade away from us over the next few hours. the Bp numbers did a steady decline. She was intubated at the nursing home and they couldn't give her pain meds because of the low bp, but she wasn't agitated... thankfully.

My only solace in this is that we were all there in the room until she passed.

I guess I am sharing this.. because I haven't even talked in my SS blog yet... because this post of yours reminds me that there is so much more and I have been navel gazing and conjuring up every wrong thing I have ever done and taking on all this guilt.. for past and present. I lost my perspective about all that is out there beyond what we know and can experience through our senses.

And she is NOT suffering now.

Still... I do wonder about the pain and if it was connected to the bleeding... and could I have made a difference?

I thought I had a turn around moment today..and I did... but I know I have to go through the process too and I know...i am going to have to fight the negativity that at times is looming over me larger than life. grief with guilt..i think is a deadly mixture and I am trying to overcome it and rise above.

The irony is that I seemed to have lost sight of my faith and the bigger picture I always talk about... and you who's views are usually the antithesis of my belief system... are the one who is indirectly allowing for faith possibilities.

And so you have also inspired me through this post to not lose sight of my faith... which does provide the peace that surpasses all understanding..when we let it.

Thank you Dr S. that post where you told me to take a were right..I was fired up about that and had actually almost finished a comment to post in response but then I got the call. But.. none of it matters now.

And I always meant to say thank you to Sam but didn't come back right away. Awhile back he stated that he had written a different response to one of my comments but that when he saw my gentle tone..he changed his comment to me.

Thank you Sam.

Anonymous said...

It's humbling that you should think of me just now. I am glad if I provided you with some small solace, perverse though it might have been.

Despite the fact that I am not religious, this passage has helped me regain perspective in trying times:

"When God made man, he made him straightforward, but man invents endless subtleties of his own."

Kindest Regards,
Sam Spade

Sid Schwab said...

Seaspray: having both witnessed it many times and gone through it myself I know the loss of a parent seems always to leave a person with feelings of guilt, among the many others. From what you've said in other posts and comments, it seems clear that you devoted a great deal of care and love in her declining times. Can it ever be enough? Most people, I'd guess, never think so.

I'm sorry for your loss and pain. I hope that as time passes you can take comfort from the times you were there, and not dwell on the times you were not. To me it sounds like your mom was lucky in the love she received from you.

SeaSpray said...

Thank u Sam. :)

Dr S -I apologize for writing all that here. Having major blogger's remorse over it and if you feel it is inappropriate I won't be offended if you delete it and this.

I haven't been responding in anyone's comments, but when I read this... I had an epiphany moment in realizing I was grieving so and filling up with regret that I couldn't see beyond it...even though I know better.

It's funny how the least expected things will trigger profound reactions sometimes.

SeaSpray said...

Thank you Dr S. :)

No... I guess it is never enough. Of course... I really could've done some things better.

My m-i-l treated her mother and sister better than I have ever seen anyone treat their relatives and even she has expressed concerns about decisions, etc.

I just wish that we had these insights we are bound to have when faced with the loss of a loved one...while they are still with us.

But I guess..that is just life and sometimes it's complicated and we do what we can do at the time. In other words ... we think we are doing what we can do..or we think we WILL still do what we KNOW to do... thinking..there's more time...I'll do it tomorrow, next week, etc. *sigh*

I think we also forget that they weren't perfect either and made their mistakes too...but somehow...after the person dies..we only see what we perceive as mistakes/omissions, etc.

Thank you again for your kind words.

Anonymous said...


It was much the same with my mother-in-law; on a Thursday the nurses reported her as being stable, talking, good vital signs, the very next day, Friday, we received an early morning call telling us to get to the hospital quickly because she was dying.

We had delayed visiting until the weekend because of the hundred mile drive to the hospital.

She died while we were stuck, in commuter traffic, exchanging text messages with her family.

We experienced the same sort of feelings you spoke of - wishing we had been able to be there, but the reality is that no one can know when death will come, we can only hold the loved one in our hearts when the hour comes.

I am sorry for your loss, but know, that in time, the mother that lives on, in you, will be there again; one day you will feel her there beside you, and she will never leave you again.

When you see the beautiful and wonderful, you may think "I wish mom could see this" Don't let grief send her away, let her be there to share with you.

The saddest, truest words I ever heard about loss are these:

"Parting is all we know of heaven, and all we need to know of hell."

Peace and Love be with you.


SeaSpray said...

Eugene..thank you so much for your kind words too.

I am sorry that happened with your m-i-l. I can imagine how difficult being stuck in traffic was at that time and your frustration/disappointment.

Thank you for sharing your story.

And thank you for those beautiful thoughts.

One of my favorite types of books to read are about heaven and have found them so fascinating. Also tapes.

We are not going to be bored..just floating around on some cloud.

We will be known as we were known here. We bring with us... our experiences, personality but over there become even more perfected. And education continues, faith grows, activities, skills all continues.

Although..if there is no more sickness.. I'm not sure what doctors will do. ? ;) But I am guessing that there is so much that we don't know..perhaps their skills will be of use in places we don't know of yet or they will advance all the more in a certain direction because of their knowledge/skills/experience.

We are going to be eating (I assume calories don't count ;)in our perfected bodies.

I know..this might seem out there to some of you. Just some stuff I've read, etc.

But so interesting. :)

One day our pastor was discussing the scripture where Jesus said, "In my father's house are many mansions and I go to prepare a place for you and so pastor said.."You KNOW i'm going THERE! He's been working on them for 2 THOUSAND years!" I told this to one of the Jewish docs I worked with and he very seriously said, "Are there any condos up there?" Hilarious the way he said it with his dry sense of humor.

Anyway..I know it is a healing process... but you all brought some peace and even a smile to my spirit. Thank you again. :)

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