Witnessing the unexplainable: Remen excerpt #11

For the last ten years of his life, Tim’s father had Alzheimer’s disease. Despite the devoted care of Tim’s mother, he had slowly deteriorated until he had become a sort of walking vegetable. He was unable to speak and was fed, clothed, and cared for as if he were a very young child. As Tim and his brother grew older, they would stay with their father for brief periods of time while their mother took care of the needs of the household. 

One Sunday, while she was out doing the shopping, the boys, then fifteen and seventeen, watched football as their father sat nearby in a chair. Suddenly, he slumped forward and fell to the floor. Both sons realized immediately that something was terribly wrong. His color was gray and his breath uneven and rasping. Frightened, Tim’s older brother told him to call 911. Before he could respond, a voice he had not heard in ten year, a voice he could barely remember, interrupted, ‘Don’t call 911, son. Tell your mother that I love her. Tell her that I am all right.’ And Tim’s father died.

Tim, a cardiologist, looked around the room at the group of doctors mesmerized by this story. ‘Because he died unexpectedly at home, the law required that we have an autopsy,’ he told us quietly. ‘My father’s brain was almost entirely destroyed by this disease. For many years, I have asked myself, ‘Who spoke?’ I have never found even the slightest help from any medical textbook. I am no close to knowing this now than I was then but carrying this question with me reminds me of something important, something I do not want to forget. Much of life can never be explained but only witnessed.”

Rachel Naomi Remen, M.D., Kitchen Table Wisdom: Stories That Heal (Riverhead books, 1996), pages 300-301.

Life is filled with mystery: Remen excerpt #10

Rachel Naomi Remen writes: I am not much of a meditator. No matter. I have come to suspect that life itself may be a spiritual practice. The process of daily living seems able to refine the quality of our humanity over time. There are many people whose awakening to larger realities comes through the experiences of ordinary life, through parenting, through work, through friendship, through illness, or just in some elevator somewhere.

The recognition that the world is sacred is one of the most empowering of the many realizations that may occur to people with life-threatening illness and those close to them, their friends, family or even their health professionals. It is one of the ways that such people heal the community around them. And should they die, it is often the legacy they leave behind.

After years of trading mystery for mastery, it was hard and even frightening to stop offering myself reasonable explanations for some of the things that I observed and that others told me, and simply take them as they are. ‘I don’t know’ had long been a statement of shame, or personal and professional failing. In all of my training I do not recall hearing it said aloud even once.

But as I listened to more and more people with life-threatening illness tell their stories, not knowing simply became a matter of integrity. Things happened. And the explanations I offered myself became increasingly hollow, like a child whistling in the dark. The truth was that very often I didn’t know and couldn’t explain, and finally, weighed down by the many, many instances of the mysterious which are such an integral part of illness and healing, I surrendered. It was a moment of awakening.

For the first time, I became curious about the things I had been unwilling to see before, more sensitive to inconsistencies I had glibly explained or successfully ignored, more willing to ask people questions and draw them out about stories I would have otherwise dismissed. What I have found in the end was that the life I had defended as a doctor as precious was also Holy.

I no longer feel that life is ordinary. Everyday life is filled with mystery. The things we know are only a small part of the things we cannot know but can only glimpse. Yet even the smallest of glimpses can sustain us.

Mystery seems to have the power to comfort, to offer hope, and to lend meaning in times of loss and pain. In surprising ways, it is the mysterious that strengthens us at such times. I used to try to offer people certainty in times which were not at all certain and could not be made certain. I now just offer my companionship and share my sense of mystery, of the possible, of wonder. After twenty years of working with people with cancer, I find it possible to neither doubt nor accept the unproveable but simply to remain open and wait.

I accept that I may never know where truth lies in such matters. The most important questions don’t seem to have ready answers. But the questions themselves have a healing power when they are shared. An answer is an invitation to stop thinking about something, to stop wondering. Life has no such stopping places; life is a process whose every event is connected to the moment that just went by. And unanswered question is a fine traveling companion. It sharpens your eye for the road.

 

Rachel Naomi Remen, M.D., Kitchen Table Wisdom: Stories That Heal (Riverhead books, 1996), pages 288, 292-293.

Pray to serve a holy purpose: Remen excerpt #9

Rachel Naomi Remen writes: A patient of mine who is very ill was recently told by his oncologist that there was nothing more that could be done for him. The physician then said, ‘I think you’d better start praying.’ For this doctor, prayer has become a kind of last resort, something to offer his patients when he runs out of ways to help them personally, where there are no more effective treatments. God has become his final referral.

But prayer is not a way to get what we want to happen, like the remote control that comes with the television set. I think that prayer may be less about asking for the things we are attached to than it is about relinquishing our attachments in some way. It can take us beyond fear, which is an attachment, and beyond hope, which is another form of attachment. It can help us remember the nature of the world and the nature of life, not on an intellectual level but in a deep and experiential way. When we pray, we don’t change the world, we change ourselves. We change our consciousness. We move from an individual, isolated making-things-happen kind of consciousness to a connection on the deepest level with the largest possible reality. And then the question ‘How did you become well?’ becomes more a question about mystery than about efficacy. A very different kind of question.

At its deepest, prayer is a statement about causality. Turning toward prayer is a release from the arrogance and vulnerability of an isolated and individual causality. When we pray, we stop trying to control life and remember that we belong to life. It is an opportunity to experience humility and recognize grace.

Sometimes the most powerful prayers are also the most simple. Once, when I was lying on an operating table waiting for anesthesia, one of my surgeons took my hand and asked if I would join him and his operating team in a prayer. Startled, I nodded. He gathered the team around the operating table for a moment of silence, after which he quietly said, ‘May we be helped to do here whatever is most right.’

This traditional American Indian prayer seems such a simple of relinquishing ultimate causality. By means of it, in operating room equipped with the latest technology, we were not alone in the house. The comfort my surgeon offered me was very genuine. I felt my fears about outcome slip away and went under anesthesia holding on to those few words with the deepest sense of peace. Like all genuine prayers, this prayer is a powerful way of embracing life, finding a home in any outcome, and remembering that there may be reasons beyond reason.

Prayer is a movement from mastery to mystery. I used to pray for my patients. These days I pray for myself, too. Sometimes I pray for compassion, but often I pray for harmlessness, the great spiritual quality embodied in the Hippocratic oath. As a human being, I know I can never hope to have the depth and breadth of perspective to know whether any of my actions will ultimately harm or heal. Yet it is my hope I may be used to serve a holy purpose without ever knowing. So sometimes, before I see a patient, I offer up a little wordless prayer: Understanding the suffering is beyond me. Understanding the healing is, too. But in this moment, I am here. Use me. 

 

Rachel Naomi Remen, M.D., Kitchen Table Wisdom: Stories That Heal (Riverhead books, 1996), pages 270-272. 

Discovering grace within: Remen excerpt #8

Rachel Naomi Remen writes: The shamans attribute illness to soul loss, a loss of a sense of awareness of the sacred in us and around us. Sacred experience is subjective and even intuitive experience. Growing up in this culture, many people have developed and cultivated a harder-edged notion of what is real. Few of us can easily talk about those things we cannot touch or express in numbers, no matter how commonplace the experience. And the experience of God is commonplace. God is in the ordinary, the minute particulars. When you come right down to it, all life is holy. What is most real may be those very things which cannot be expressed at all but only known.

The experience of immeasurable realities is far more important than we might imagine. The things we cannot measure may be the things that ultimately sustain our lives. Much recent medical research suggest that isolation makes us vulnerable to illness and that relationship furthers survival. Medical science has demonstrated that our simple caring for each other sustains us and enables us to better survive even such physical challenges as metastatic breast cancer. Community heals. Yet when it comes to healing relationship, who’s to say that communion isn’t as important as community.

A diagnosis of life-threatening illness casts us headlong into the subjective world. People who have sought healing everywhere else are often afraid to look within, afraid to find, at depth, someone insignificant or even unworthy. Yet this is rarely the case. The soul is our birthright. At depth, everyone is beautiful. Often it is the discovery of the ‘spot of grace’ that heralds the beginning of our deepest healing.

 

Rachel Naomi Remen, M.D., Kitchen Table Wisdom: Stories That Heal (Riverhead books, 1996), pages 261-62.

Trusting has great power: Remen excerpt #7

Dr Remen writes: ‘Human being’ is more a verb than a noun. Each of us is unfinished, a work in progress. Perhaps it would be most accurate to add the word ’yet’ to all our assessments of ourselves and each other. 

If life is a process, all judgments are provisional. We can’t judge something until it is finished. No one has won or lost until the race is over.

‘Broken’ may be only a stage in a process. A bud is not a broken rose. Only lifeless things are broken. Perhaps the unique process which is a human being is never over.

In our instinctive attachments, our fear of change, and our wish for certainty and permanence, we may undercut the impermanence, which is our greatest strength, our most fundamental identity. Without impermanence, there is no process. The nature of life is change. All hope is based on process.

Naming a disease has limited usefulness. It does not capture life or even reflect it accurately. Illness, on the other hand, is a process, like life is.

Seeing the life force in human beings brings medicine closer to gardening than to carpentry. I don’t fix a rosebush. A rosebush is a living process, and as a student of that process, I can learn to prune, to nurture and cooperate with it in ways that allow it best to ‘happen,’ to maximize the life force in it even in the presence of disease.

Simply trusting process has a great power. The trust of process that comes from personal knowledge and experience is really the foundation of helping and comforting one another. Without it all of our actions are driven by fear. Fear is the friction in all transitions.

Holding and conveying a sense of possibility does not mean making demands or having expectations. It may mean having no expectations, but simply being open to whatever promise the situation may hold and remembering the inability of anyone to know the future. Thoreau said that we must awaken and stay awake not by mechanical means, but by a constant expectation of the dawn. 

There’s no need to demand the dawn, the dawn is simply a matter of time. And patience. And the dawn may look quite different from the story we tell ourselves about it. My experience has shown me the wisdom of remaining open to the possibility of growth in any and all circumstances, without ever knowing what shape that growth may take.

Rachel Naomi Remen, M.D., Kitchen Table Wisdom: Stories That Heal (Riverhead books, 1996), pages 223-225, 231.

We may all be healers: Remen excerpt #6

Rachel Naomi Remen writes: In the past few years a great deal of attention has been paid to angels and many people have become more aware of the possibility that insight and guidance may be offered at surprising times and in surprising ways. Books have been written about meetings with such celestial messengers and the help and healing they have offered. What is not so commonly recognized is that it is not only angels that carry divine messages of healing and guidance; any one of us may be used in this same way. We are messengers for each other. The difference between us and the folks with the wings is that we often carry these messages without knowing it. Like the holy Shadow.

It has been my experience and the experience of many other therapists that when I am facing a difficult personal issue or a painful decision or am struggling with some recalcitrant and stubborn part of my self, a very peculiar thing will happen. Many of my clients will spontaneously bring in the same issue. Completely unaware of the personal importance of the issue to me, they will work on some aspect of it as it pertains to them, all the while offering me, through their own work, guidance and perspective on the issue for my healing. Sometimes they work on the very issue or sometimes in the process of working on something else they will offer a single sentence or thought that cuts through my confusion and free me.

I have many examples of this, but one stands out in my mind. It was a time when I discovered that a friend had incorporated some of my ideas and exercises into her bestselling book without acknowledging where she had learned them. I felt hurt and betrayed by this until my third client of the day sat down and pleasantly remarked, ‘You know, you can get a lot of good done in this world if you don’t care who gets the credit.’ Astonished, I asked her what had made think of this ‘Oh,’ she said, ‘it was on the bumper sticker of the car that just pulled out of my parking spot.’

Perhaps the world is one big healing community and we are all healers of each other. Perhaps we are all angels. And we do not know.

 

Rachel Naomi Remen, M.D., Kitchen Table Wisdom: Stories That Heal (Riverhead books, 1996), pages 247-48. 

Listening can be healing: Remen excerpt #5

I have come to suspect that the subjective world is probably a hologram and the pattern of our most fundamental beliefs is reflected in the smallest of our behaviors. If this is so, breaking up that pattern at any one point may eventually free us from it. The way in which we go to the grocery store may tell us everything about the way in which we live a life. The way we tend the life force in a plant may be the way we tend our own life force. We are exquisitely coherent. Healing requires a certain willingness to hear and respond to life’s needs.

We all can influence the life force. The tools and strategies of healing are so innate, so much a part of a common human birthright, that we believers in technology pay very little attention to them. But they have lost none of their power.

People have been healing each other since the beginning. Long before there were surgeons, psychologists, oncologists, and internists, we were there for each other. The healing of our present woundedness may lie in recognizing and reclaiming the capacity we all have to heal each other, the enormous power in the simplest of human relationships: the strength of a touch, the blessing of forgiveness, the grace of someone else taking you just as you are and finding in you an unsuspected goodness.

Everyone alive has suffered. It is the wisdom gained from our wounds and from our own experiences of suffering that makes us able to heal. Becoming expert has turned out to be less important than remembering and trusting the wholeness in myself and everyone else. Expertise cures, but wounded people can best be healed by other wounded people. Only other wounded people can understand what is needed, for the healing of suffering is compassion, not expertise.

Listening is the oldest and perhaps the most powerful tool of healing. It is often through the quality of our listening and not the wisdom of our words that we are able to effect the most profound changes in the people around us. When we listen, we offer with our attention an opportunity for wholeness. Our listening creates sanctuary for the homeless parts within the other person. That which has been denied, unloved, devalued by themselves and by others. That which is hidden.

Listening creates a holy silence. When you listen generously to people, they can hear truth in themselves, often for the first time. And in the silence of listening, you can know yourself in everyone. Eventually you may be able to hear, in everyone and beyond everyone, the unseen singing softly to itself and to you.

Rachel Naomi Remen, M.D., Kitchen Table Wisdom: Stories That Heal (Riverhead books, 1996), pages 214, 217, 219-220.