The Healing Journey

Abstract

The following are excerpts of a speech made during the combined graduation ceremony of the 3 Memphis area Family Medicine residency programs on June 30, 1997. At that time, the author was preparing to leave his faculty position at the University of Tennessee and accept one at the University of Connecticut. During the convocation, he shared his ideas and personal experiences in an address entitled “The Healing Journey.”

For many of us here this evening, we will soon be saying good-bye to Memphis and the department that has instilled in us a very deep sense of what Family Medicine is all about. For many months, I had been contemplating how I might say my good-byes—especially to my chairman and mentor who I will always consider my friend, my colleagues whose fortitude and commitment I respect and admire, the residents from whom I have learned perhaps even more than I have taught, to the medical students who have taught me the art of teaching, and to our dedicated staff that every day teaches us the true meaning of caring.

A few months ago, I was asked to give the invocation at tonight's ceremony. I happened to be reading the Celestine Prophecy¹ at the time, which is one man's fictionalized account of insights into life's hidden meanings. It is a book I highly recommend. The first insight in the book is powerful: “Things don't happen without a reason. … There are no coincidences in life … nothing happens in God's world without a reason.” It was around this time that my secretary came into my office and told me that the graduation committee requested that I give the invocation at tonight's ceremony. Then the thought occurred to me—I now see it as no mere coincidence—the opportunity to speak here tonight would give me a chance to say my good-byes.

What I'd like to share with you tonight is something immensely different than I have ever talked about before. It's not about my familiar territory in chest x-rays, EKGs, vasectomies, or exercise treadmill testing. … What I'd like to share instead are several intensely personal chapters from my life. Remember that it was only 7 short years ago for me that I sat right where many of you are now. So I mined my journal and my memories for important lessons that you have all helped me learn, for things that would help the graduating resident and fellow. So let me say my good-byes with a few short stories, and 5 lessons that I have learned along the way of my healing journey. I say the word journey with great enthusiasm, because it was only after I concluded residency that my life became more of a journey, rather than a destination….

Lesson 1 came suddenly during the first month out of residency training. Oh, how glorious was the day when I left residency. So full of knowledge, ready to apply it and teach. I remember how I was on hospital rounds pontificating to the residents, as many of you are well aware I often do, when the chief resident was frantically paged to the hospital. An obstetrical patient we had recently delivered was having seizures. All eyes were on me for a direction on what to do, and then came the sobering thought: What do I know about postpartum eclampsia? To a guy who prided himself on his fund of knowledge, this was very disconcerting, and it quickly shattered my illusion that I somehow was fully prepared for what was ahead of me as a doctor and a teacher. It was frightening. So I tell all of you who are embarking upon your healing journeys, be ready to confront the unknown. Embrace it rather than resist it.

Without the pressures of exams or every third night call in the critical care unit, postresidency I finally had the time, as you soon will, not only to read more but to explore my thoughts and feelings, in essence, to learn more about myself. For many of us, this is a journey into our own psychopathology. As I embarked upon my journey inward, I discovered something about myself that I have in common with many other physicians: a trait called codependency, which is an unhealthy way of building our self-esteem by relying on the opinions and impressions of others to feel good about ourselves. I feel that I am not alone in this regard; I have observed the authoritative yet inflexible physician who is at times arrogant and intolerant. I know this person well—this is the physician I used to be. I now believe that arrogance is often nothing more than thinly veiled lack of self-esteem. The lesson here is that the insight and intellect each physician possesses is a gift not to be squandered or spent on self-adoration, but one that needs to be directed fearlessly inward to explore one's inner psyche. But it isn't about being perfect. The message here is that as we lose our “my way or the highway” philosophy of life that is so common among physicians, we learn to think and to feel in more flexible ways, and life becomes better. And we, in turn, become better physicians.

Lesson 2: I used to pride myself on the profound thinkers I associated with in college. In medical school, it was the esteemed physicians who commanded great respect because of their diagnostic acumen. I think we have all observed great physicians and have listened in awe to brilliant clinicians who fascinate us with their depth of knowledge and insight. Somehow, we think we must emulate them to achieve success and wisdom as a physician.

And then along comes the nonphysician, the person whose profound message into life's meaning eclipses the wisdom of our esteemed professors and colleagues. Now that my eyes and ears are open, it happens all the time. It happened most recently on an airplane trip. I really didn't want to talk to the person next to me. My wife and I had our young twin daughters with us; each one of us had one child on our lap. Anyone who has ever traveled with small children on an airplane knows that there really is only one major thought going through a parent's mind as a child squirms on your lap: survival. But this stranger needed to talk to me. She kept looking at my daughter trying to wriggle out from my lap. Then she unselfishly befriended my daughter and me by capturing my daughter's interest by playing with her toy. And she told me about her desire but inability to have children—the tragic story of how her husband contracted chronic active hepatitis from a blood transfusion, how they were in Memphis contemplating a liver transplant, and how scared they were. Her fear was palpable and real, but so was her faith. Her faith, she freely admitted, was carrying her through this difficult time. In sharing her story with me, she unselfishly gave me new insight into my own condition, and it dawned on me once again. This woman reminded me how extraordinary the ordinary human life is. As physicians, we must strive to be open and more receptive. Given the intensity of our medical training, we truly are a sheltered lot, and we must struggle to extend our circles beyond those of medicine. After all, you never really know where your next message is coming from.

Lesson 3 was one of the most profound for me and has changed the way I take care of patients. It came from a book on my nightstand. My wife knows me as the master of starting but never finishing many books. Fortunately, I got far enough into this one to be stunned by its meaning. In his book Iron John, Robert Bly notes that “Where a man's wound is, that is where his genius will be. Wherever the wound appears in our psyches … whether it stems from isolation, disability, or disease, that is precisely the place for which we will give our major gift to the community.”2(p42) He didn't mean that we engage in masochism to derive meaning from life, but how life is richly full of meaning, even the darkest of tragedies—a paradoxical paradigm, if you will. His profound message helped me in connecting the dots in my life. Something that I have shared with only a few people in my life is the dark secret that I suffered a terrible bout of major depression during medical school. It was a tragic time for me. I suffered relentless insomnia, and the second year medical school courses just kept coming at me. I could hardly remain alert in class, and I was gripped by fears of losing my mind. I couldn't quite figure out why such an illness would befall me. I cried out, “God, where are you?” I felt abandoned. I wondered what good could possibly come from this suffering. I was losing my will to live, and I had lost my desire to become a physician.

As you are witness to today, I miraculously survived, received excellent treatment, and completed medical school on schedule. But I became embarrassed to face many of my classmates, since many knew something had gone terribly wrong with me. As I got better, I wanted to run as fast as I could and distance myself from what was the most painful chapter of my life. Only in the past few years have I been able to still my soul, look back on this painful time, and examine what this “wound” was all about. Rather than run, I have chosen to face the roar. In doing so, I have received a great gift of insight into who I am and why I am. I have had a spiritual awakening as many others experience after a major life crisis. I can now dramatically help those patients I see with similar crises. You know the saying, “There's nothing like having a baby to know what having a baby is like.” On second thought, I'm rather happy that I can't have a baby. But you get the idea. God means for us to translate our wounds into powerful, healing gifts.

Lesson 4 is not original, but well worth heeding: Practice random acts of kindness. In my conference for medical residents on financial planning, this kind of giving wasn't part of the equation. I focused on how to count your pennies and missed one very important point: the concept of giving, the biblical principle of tithing. For instance, I could never understand why anyone would donate a large sum of money to a charity and do so anonymously. Yet I believe this is precisely the kind of giving that is intended for us. One can only know what I mean when one gives freely in this manner. I thought I was a pretty generous guy—giving to church, donating to my college, and volunteering as a physician in a poor neighborhood clinic—but it is not really giving if you expect something in return.

Recently, I remember reading about the tragic shooting death of an armored car guard who was brutally shot in the head. After the shooting, an innocent bystander came along, saw what had happened, and rather than run for her life, knelt beside the dying man, and cradled his head as he lay dying. She later said the most remarkable thing, that “For a moment, I loved this man, for his family and wife that he would be leaving.” She was helping to ease his suffering, selflessly, and without any reason other than it felt like the right thing to do. Her actions deeply affected me and I'm certain countless others. It has forced me to examine my motives for giving. I believe the message is to give freely of your time and money to the service of others. Don't waste time counting pennies; you can't take it with you. When you really get down to it, it's God's money after all.

Lesson 5 has to do with the spiritual dimension of healing. I used to think this was the “when all else fails measure.” You know, the “only invoke God in front of patients in desperation” maneuver. It was the ace up my sleeve. In essence, my definition of God was a God of convenience, but this is the same unfortunate thinking that many physicians suffer from. As intellectuals, physicians often think we are the source of our own power; in doing so, we are either supremely egotistical or stubbornly ignorant. For some, it is easier to believe that atoms could organize into molecules and ultimately that from randomness could come order and that matter would spontaneously defy entropy and form self-replicating matter known as DNA. I say to such physicians, if there is no purposefulness to be found anywhere in the universe, do you actually believe it was the result of a colossal accident? As biologist turned creationist Edwin Conklin said, “The probability of life originating from accident is comparable to the probability of the unabridged dictionary resulting from an explosion in a print shop.”3(p87) Isn't it much simpler to accept on faith that there is a power much greater than us at work in our healing?

At the National Day of Prayer in Washington this past year, an evangelistic minister exclaimed that America has a great hole in its heart that can't be fixed by 500-channel TV sets, luxury cars, or faster computer chips. There is a prevailing notion in our country that to seek God is to be weak. Ironically, he goes on to point out that America's survival and revival has always come when America has been brought to its knees in crisis and has sought God through prayer. Great presidents have always invoked God when the nation was at a crossroads, Washington, Jefferson, Lincoln, and Kennedy, to name a few. And God has never let this country down. I don't believe God lets us down if we are seeking his will in our lives. Pablo Casals once said, “In music, in the sea, in a flower, in a leaf, in an act of kindness, … I see what people call God in all these things.”⁴ When I stare into the eyes of my beautiful twin daughters, I see God. I ask you to try to see God at work in your patients when you stare into their eyes. If we decide to be open and receptive, we begin to find God in all the little details of our lives. Spiritual awakening is a wonderful daily occurrence.

Let me conclude by sharing what I believe is the solution to a happy, healthy, and prosperous career. The solution, I have discovered, has been quite simple. It can be summarized in 3 words: God, family, and work. In that order. It bears repeating: God, family, work. It is interesting that my life only seems chaotic and unmanageable when I get these priorities confused. And as many of you are aware, these are the priorities that are taking my family back to our roots in New England.

The healing journey that awaits our graduates is a great paradox. The journey begins with healing one's own wounds. For many of us, it was our pathology that got us here; it is our gift of insight that allows us to survive and ultimately flourish in our role as healers. After all, what we do in medicine isn't a job, it's a calling.

What an honor it has been to serve you. May God bless our graduates and their families as each of you embarks upon your healing journeys.