Dr. Richard Selzer is a surgeon and a favorite author of mine. He writes the most beautiful and compassionate descriptions of his patients and the human dramas they confront. In his book Letters to a Young Doctor, he said that most young people seem to be protected for a time by an imaginary membrane that shields them from horror. They walk in it every day but are hardly aware of its presence. As the immune system protects the human body from the unseen threat of harmful bacteria, so this mythical membrane guards them from life-threatening situations. Not every young person has this protection, of course, because children do die of cancer, congenital heart problems, and other disorders. But most of them are shielded—and don’t realize it. Then, as years roll by, one day it happens. Without warning, the membrane tears, and horror seeps into a person’s life or into the life of a loved one. It is at this moment that an unexpected theological crisis presents itself.
Everything stinks: creosote, bleach, disinfectant, soil, blood, gangrene.The military authorities say uniforms must be preserved at all costs, but that means manhandling patients who are in agony. Cut them off, says Sister Byrd, and she's the voice of authority here, in the Salle d'Attente, not some gold-braid-encrusted crustacean miles away from blood and pain, so cut they do, snip, snip, snip, snip, as close to the skin as they dare.On either side of Paul as he cuts are two long rows of feet: yellow, strong, calloused, scarred where blisters have formed and burst repeatedly. Since August they've done a lot of marching, these feet, and all their marching has brought them to this one place.
We're not hunter-gatherers anymore. We're all living like patients in the intensive care unit of a hospital. What keeps us alive isn't bravery, or athleticism, or any of those other skills that were valuable in a caveman society. It's our ability to master complex technological skills. It is our ability to be nerds. We need to breed nerds.
Who gets to be the judge of reality? If it was deeply felt, believed, spoken about often or altered your life course, then it was real enough. Faith doesn't get the luxury of all those things one hundred percent of the time, but we call that normal behavior based on a gut feeling.” I said. I looked at his wife and she busted out laughing. Her husband was trying to catch invisible butterflies above his head—dementia. My patients teach me the most sobering of truths: Why wreck his smile. If I could see them, I would want to catch them too.
It was a lesson she was still learning. When she had first started nursing, she had taken every death personally, like she was losing her father all over again. Every patient lost under her care was a little piece of death she would carry around with her until the end of her own life. But the alternative seemed so unfeeling. Tina and the other nurses could crack jokes and banter back and forth about contestants on American Idol before the body of a deceased patient was even cold. It was a coping mechanism, she knew, but not necessarily one she thought she would ever adopt. There had to be something in between. Olive had been called a bleeding heart before, but her heart no longer had the same plasticity and tenderness—it was scarred and worn beyond repair
I don’t understand hospital chaplains that try to rob my patients of their anger. Sometimes anger is a key motivator that gets people to take action. Anger can push a cancer patient to jump out of his hospital bed, walk down to the nurses station and scream, “I am getting the hell out of here!”. There is a misconception that God is simply sweet and passive. Actually, God can be quite cunning, manipulative and relentless with his children. What we consider as negative traits are actually helpful in molding us. He will use a negative emotion if needed to push people to do things that will change them for the better. He will allow people or situations to derail us if there is a chance that those interactions will push us forward. Personally, I don’t want a God that is going to send some church member to my deathbed with a plate of cookies and tell me to have faith. Actually, I rather have a God that screams, “Get the hell off your ass, stop feeling sorry for yourself. Walk down the hall with that Physical Therapist so you can get on with your life!" A little anger in a person can push them to do amazing things.
I think timing is better left up to God to decide then religious leaders. I once met a man that brought his wife flowers in the hospital. They held hands, kissed and were as affectionate as any cute couple could be. They were both in their eighties. I asked them how long they were married. I expected them to tell me fifty years or longer. To my surprise, they said only five years. He then began to explain to me that he was married thirty years to someone that didn’t love him, and then he remarried a second time only to have his second wife die of cancer, two years later. I looked at my patient (his wife) sitting in the wheelchair next to him smiling. She added that she had been widowed two times. Both of her marriages lasted fifteen years. I was curious, so I asked them why they would even bother pursuing love again at their age. He looked at me with astonishment and said, “Do you really think that you stop looking for a soulmate at our age? Do you honestly believe that God would stop caring about how much I needed it still, just because I am nearing the end of my life? No, he left the best for last. I have lived through hell, but if I only get five years of happiness with this woman then it was worth the years of struggle I have been through.
You don’t have to spend much time with the elderly or those with terminal illness to see how often medicine fails the people it is supposed to help. The waning days of our lives are given over to treatments that addle our brains and sap our bodies for a sliver’s chance of benefit. They are spent in institutions—nursing homes and intensive care units—where regimented, anonymous routines cut us off from all the things that matter to us in life. Our reluctance to honestly examine the experience of aging and dying has increased the harm we inflict on people and denied them the basic comforts they most need.
In the absence of any therapy, the mentally ill of the 20th century were chained, shackled, straitjacketed, kept nude, electrocuted, half-frozen, parboiled, violently hosed, wrapped in wet canvas, confined to “mummy bags”, subjected to insulin-induced hypoglycemic comas, forced into seizures with massive doses of the stimulant Metrazol, injected with camphor, drugged into three-week comas with barbiturates and tranquilizers, involuntarily sterilized, and surgically mutilated. Rape by hospital staff was common, as was humiliation and verbal abuse. One reporter noted that a state hospital patient had been restrained for so long that his skin was beginning to grow around the leather straps.
In the Awakenings movie I found it very interesting that the most profound awakenings in the catatonic patients occurred in 1969, the year that the Aurora Borealis was seen from N.Y. to Louisiana. It seems the patients were getting environmental radiation stimulation in addition to their L-Dopa drug that year. L-Dopa plus radiation therapy may eventually be proven to be a very potent brain stimulant.
When ill, the patient assumes what Parsons called "the sick-role". Accordingly, the sick person is, on the one hand, excused his or her social responsabilites, but, on the other hand, is expected to desire a return to health and to comply unquestioningly with the directives of medical experts in order to achieve this goal