Category: health humanities

Medical Maze: Part One

IMG_2595.jpgA sigh of relief for me this past week that our crazy mess of a so-called health care system is not made crazier and more mean-spirited. A break from politics here to share my story of getting lost in the medical maze. Part one of a three part (triptych). This was published last year by Columbia University’s The Intima: A Journal of Narrative Medicine. The photos are of the stranger than fiction building where I work.

*****

MEDICAL MAZE

Wayfinding

I work in the world’s largest university building: the Warren G. Magnuson Health Sciences Building at the University of Washington (UW) in Seattle. The building, which includes the 450-bed UW Medical Center hospital, has close to 6,000,000 square feet of space, the equivalent of more than thirty Walmart Supercenters under one roof. The building is comprised of over twenty wings, whose hallways are connected, but in an Escherian, disorienting way. Besides the hospital and its associated specialty clinics and administrative offices, the medical complex is home to five health science schools—medicine, nursing, dentistry, pharmacy, and public health. Ten thousand people work or are hospital patients in this building; many spend at least some time lost in the medical maze.

The UW medical complex is sandwiched between two busy streets and one busy ship canal. The building’s courtyards are covered in concrete, with a few scraggly rhododendrons in containers. There are numerous entrances and exits to the building. Inside, the hallways have exposed guts—tangles of wires and pipes—and metal carts filled with glass test tubes, flasks, boxes of fruit flies, and cages of rats. The air is uniformly cold, with an acrid-medicinal, disinfectant smell. The bathrooms are tiled—floors and walls all the way to the ceiling—and are painted a jaundiced yellow. Some of the oldest rooms retain remnants of the original pale “hospital green” so popular in the twentieth century.

“Spinach green” is what Harry Sherman, a surgeon in a San Francisco hospital in 1914 named his invention. Using color theory, he distilled this green to counterbalance the hemoglobin red he encountered in his operating room. He claimed that this particular tone of green helped him discern anatomical details, resulting in better surgical outcomes. At around the same time, a leading American hospital architect, William Ludlow, advocated the use of color therapy: “…the convalescent needs the positive colors that nature has spread so lavishly for her children…soft greens, pale blues…but above all, the glorious golden yellow of the sunshine.” (p. 511). Perhaps the pale yellow tiles and paint in the UW medical complex bathrooms started off the shade of sunshine, but they have not aged well.

Color-coding of medical center hallways and units helps people navigate the complex physical structure of the modern hospital and clinic. It is a form of wayfinding, which is a dynamic relationship to space, a continuous problem-solving process: knowing where you are and where you are headed, knowing and following the best route to get from here to there, and knowing when you have arrived at your destination. Large hospitals are a modern urban common space like no other. The closest are probably busy airport terminals. But in hospitals, the business is not simply travel; the business of hospitals is life, illness, and death. Susan Sontag points out that we all hold dual citizenship, “in the kingdom of the well and in the kingdom of the sick.” (p. 3).  In hospitals, she states, patients are “emigrating to the kingdom of the ill.” (p. 3).

The first time I entered the UW medical complex was in February 1994. I was visiting Seattle from Baltimore, where I was finishing my doctorate in global health. As a single mother of a seven-year-old son, I needed a stable, well paying job—something global health did not offer. On a whim, I contacted the UW School of Nursing about a tenure-track academic position they had advertised. Teaching nursing was far down my list of desirable careers. I have long viewed nursing as old, stale, and a hindrance to my ambitions—yet when I am feeling more humble, I can’t imagine a higher calling than being a nurse. I was, and still am, a nurse. Despite what I term my nursing ambivalence, I was curious about this job possibility. It helped that Seattle was as exotic as a foreign country to me.

“There’s a courtyard on your right. You’ll see a sculpture of people hanging on the outside wall of a brick building—go past that and enter the doors to your right.”

These were the directions given to me by the professor with whom I’d set up an informational interview. I found her office, had a series of interviews, was offered and accepted the job. So in December of that same year, after moving across the country to start my new job and new life in a new city, I went to my first official day of work. I parked in the cavernous underground S1 parking lot behind the medical complex. I followed the cute little tooth signs out of the parking lot, through a tunnel, and into the Dental School entrance. Knowing the general direction I needed to go in order to get to my new office, I took the stairs up one floor, and then decided to take a shortcut through a small internal courtyard. I suddenly found myself locked inside a 10’x10’ barren cement courtyard that was surrounded on all sides by six stories of brick walls. I stood there for several minutes, gazing up at the walls, contemplating possible escape scenarios, contemplating the possible deeper meaning of this space, awed by its quiet peacefulness, before a woman passed by and opened the door. I have never been able to find that courtyard again—it doesn’t exist on any map.

Today, I am a tenured Associate Professor in the Department of Psychosocial and Community Health in the UW School of Nursing. No one knows what ‘psychosocial’ really means, including me, so I tell people I work in the Department of Community Health. As of December 2014, I have officially worked here for twenty years. My office is in the ugliest wing of the medical complex. The wing’s hallways are painted the same sick yellow as the bathrooms. There is a 6-inch wide grey rubber seam that bisects my office. It runs up one wall, across the ceiling, down the other wall, and across the floor. This rubber seam is the building’s earthquake shock absorber. I often wonder what it would be like to stand on the rubber fault line during an earthquake. Would I be safer there rather than under my fake-wood desk or trying to find my way out of the building?

The particular part of the Health Sciences building I work in, the T-wing, was built in the late 1960s and is a prime example of Brutalism. It is also a prime example of why Brutalism is not an architectural style suited either for Seattle weather or for being attached to a hospital. Brutalism was an architectural movement that espoused the use of exposed concrete and other functional elements. It focused on the ideals of a better future through the use of technology.

Outside and inside the T-Wing, the building appears to be made of crumbling, damp and moldy concrete. In one staircase I use frequently, there are arm-sized stalactites on the ceiling, with liquid perpetually oozing from their pointed ends down into a black and green puddle on a stair landing. It has a bizarre beauty. Every few years, someone from the maintenance crew removes the stalactites and paints the ceiling. I watch as the stalactites slowly return.

The land that the UW medical complex is built on had been salmon fishing ground for the Lakes Duwamish people before white settlers claimed it as pastureland for cows. As the town of Seattle grew, and the UW moved from its original downtown location, north to its current location, the 40-acre parcel of land became a nine-hole golf course, then the 1909 Alaska-Yukon-Pacific Exposition’s Pay Streak section with carnival rides, then briefly the site of a WWI Navy training camp, and finally it became the site of the expanding Health Sciences and University Hospital. On October 9, 1949, Governor Arthur B. Langley laid a ceremonial cornerstone for the official opening of the Health Sciences Building. Inside the cornerstone was a lead box containing a stethoscope, a set of false teeth, a nurse’s cap, and a mortar and pestle: artifacts representing the Schools of Medicine, Dentistry, Nursing, and Pharmacy, which were housed in the new building. The box with the artifacts is still there, buried in the side of the building.

Cornerstone, foundation stone, quoin-stone: the first stone set for a new building. The stone that all others are placed in reference to. The stone that determines the strength and future stability of the building. The stone that holds the genius loci, the guardian spirit, of the place.

IMG_4471.jpg

The Role of Trauma-informed Care

IMG_1055Time to revisit and review trauma. Trauma-informed care is health care provided within the framework of an understanding of the various neurocognitive, psychological, physiological, and social effects of trauma on individuals. People who are homeless have particularly high rates of trauma—both before and during their experience of homelessness. And, of course, homelessness itself is a type of trauma, a type of deep illness, as sociologist Arthur Frank refers to an illness that casts a shadow over your life.

Trauma is an event that is life threatening or “self” threatening. Serious accidents and medical mishaps. Drug and alcohol addictions. Natural and manmade disasters. Wars. Rape. Intimate partner violence. Childhood neglect, physical, and sexual abuse. Complex trauma is trauma that occurs within key caretaker relationships and that is pervasive and enduring. Complex trauma is, well, more complex to live with and to treat.

We use the phrase scared speechless to describe fear that overwhelms and suppresses the speech and language area of our brain while we’re in the midst of a traumatic event. As Bessel Van Der Kolk, a physician and expert on trauma puts it, “All trauma is preverbal.” (p 43) Trauma bypasses these higher order areas of the brain and goes straight to the more primitive fight and flight fear area—the amygdala, two almond-shaped areas deep inside our brains in the primitive limbic system. Trauma is not stored as a storied memory with a clear-cut beginning, middle, and end, but rather as fragments of experience, images, smells, sounds, and other bodily sensations. That is why people who have survived a significant traumatic event—even years and decades after the trauma is over—struggle to tell the story of what happened. Yet their bodies bear witness to the event through terrors, flashbacks, numbing, and stress-mediated physical problems like migraines and auto-immune diseases—diseases in which the body turns on itself, as if in slow suicide. If the trauma happened to the person as a child before the firm development of a sense of self, that person’s memories of the event can remain visceral and largely inaccessible to verbal processing.

Van der Kolk states, “Almost every brain-imaging study of trauma patients finds abnormal activation of the insula. This part of the brain integrates and interprets the input from the internal organs—including our muscles, joints, and balance (proprioceptive) system—to generate the sense of being embodied.” (p 249) He points out that the flood of activating neurochemicals from the fight or flight response to trauma effectively cuts people off from the real origin of their bodily sensations; the fight or flight flood numbs people, and is the reason for dissociation and out-of-body experiences many trauma patients deal with. Van der Kolk goes on to declare, “In other words trauma makes people feel like some body else, or like no body. In order to overcome trauma, you need help to get back in touch with your body and your Self.” (p 249)

Art, music, and dance are often used as treatments for trauma patients because these expressive modalities do not depend on language. They do not depend on—indeed, they are better off without—the use of our rational minds both to create and to experience. As psychiatrist Laurence J. Kirmayer writes, “And if the text stands for a hard-won rational order, imposed on thought through the careful composition of writing, the body provides a structure to thought that is, in part, extra-rational and disorderly. This extra-rational dimension to thought carries important information about emotional, aesthetic, and moral value.” (pp. 324-325)

In the late 1990s, in a Seattle area community health clinic where I worked as a nurse practitioner, many of my patients were Bosnian and Ukrainian refugees. One of my more heart-wrenching patients was a 4-year old Bosnian girl whose teeth were rotted to the gum line because her mother had given her a sugar-soaked rag to suck to keep her silent as they tried to escape the civil war. The language interpreter told me that the child’s older brother had ben killed, and that her mother had been raped. I referred the child to our children’s hospital where they surgically removed all her baby teeth and then fitted her with child dentures until her adult teeth appeared. I was hoping to refer the mother for talk therapy to deal with her traumas, but soon realized it was best to refer her for massage therapy with a trauma-informed female therapist. I worked with our clinic social worker to petition the patient’s health insurance (which happened to be the state Medicaid office) to pay for this—what we typically consider slightly frivolous and self-indulgent treatment. Medicaid paid for the massage therapy and it seemed to lighten her depression. This wasn’t art, music, or dance therapy, but it was body-based therapy.

The body remembers. Maddy Coy, a UK-based researcher who works with survivors of prostitution, maintains that especially for women who experienced childhood sexual abuse (a startlingly high percentage of prostitutes worldwide), the use of appropriate body work such as yoga and massage is oftentimes crucial for recovery. Body work helps traumatized people reestablish a focus on what the body can do instead of what is done to the body.

Early in my career as a nurse I worked for a year in a safe house emergency shelter for women who were escaping intimate partner violence. Before my work there I did not understand the concept of trauma mastery and how this played out in the lives of women caught up in the cycle of abuse. I sided with the common misperception that the reason so many women return to their abusive partners is because they are psychologically damaged and weak. There is the not insignificant role of addiction to the thrill of trauma and danger—to the effects of the activating yet numbing fight or flight neurochemicals—which can bring at least temporary relief to the bouts of fatiguing depression that often accompany trauma. Then there is the unconscious attempt to return to the site of previous trauma to get it right this time, to do what we wish we could have done the first time, to master our trauma.

As social worker Laura van Dernoot Lipsky points out, these unconscious attempts to master our traumas often backfire and simply reinforce our old traumas. Lipsky goes on to say that many of us in health care and other helping professions often are using our work as a type of trauma mastery, and that by doing so we may set expectations for ourselves and others that are “untenable and destructive.” She advocates ongoing efforts aimed at self-discovery and self-empathy, and points to the many positive examples of “people who have been effective in repairing the world while still in the process of repairing their own hearts.“ (p 159) Eve Ensler and her personal, combined with world repair, work that she describes in her powerful book In the Body of the World, is one of my personal favorite role models for this sort of balanced approach.

University Student Mental Health

Version 2In these uncertain and anxiety-provoking times, our universities have an increased responsibility to support student mental health and wellbeing. This is not about the issues of “spoiled and coddled” Gen Xers, helicopter parents, and the endless debates over the use of trigger warnings in higher education. This is about having a positive impact on not only our future workforce, but also our future leaders and change agents.

William Pang, a second-year student at McGill University in Montreal, wrote a moving NYT op-ed piece “The Season to Be Stressful” (December 19, 2016). He discusses his experience of learning to deal more effectively with overwhelming anxiety exacerbated by the highly competitive atmosphere of his university. He states, “I don’t think we should demonize an entire generation as reliant and narcissistic. We should instead celebrate a generation that is coming to realize the importance of initiating conversations about our mental health.” It is dismaying to read through the NYT comments to Pang’s op-ed piece with so many people basically telling him to buck up and become an adult.

The photo above is of me with the amazing UK nurse and PhD student Josephine NwaAmaka Bardi  with her social media campaign, “Raise Awareness of Mental Health in Higher Education” (#RAMHHE)  I met NwaAmaka Bardi this past September in Seville at the 5th Annual International Health Humanities Conference: Arts and Humanities for Improving Social Inclusion, Education and Health. She also works in the area of mental health cafes as an effective alternative community mental health service. London’s Dragon Cafe is a good example of a creative, welcoming, and supportive community cafe with a focus on mental health and wellbeing. It would be great to have a similar community cafe open to university students.

Universities UK is developing a mental health framework for universities to embed mental health and wellbeing across all university activities with the goals to decrease stigma and increase access to a variety of mental health and wellbeing services. (See: “New Programme to Address Mental Health and Wellbeing in Universities” December 2, 2017.) They point to the need of “getting universities to think about mental health and wellbeing across all their activities, from students and teaching, through to academics and support staff.” It doesn’t end with the provision of mental health and support services for students but needs to permeate the entire campus.

Doris Iarovici, M.D., a psychiatrist at Duke University Counseling and Psychological Services has written a book titled Mental Health Issues and the University Student (Baltimore: Johns Hopkins University Press, 2014). Although geared towards college mental health professionals, it includes useful information on the variety of mental health issues that our students face in universities—from anxiety, drug and alcohol problems, sexual assault, eating disorders, and relationship problems, to depression, suicide, and schizophrenia. She concludes by stating, “If we provide a range of services, including individual, group, and community programs, we will be in step with the goals of health care reform to focus on both prevention and optimizing outcomes.” p. 219

Home Is…

p1020046What is the meaning of home to you? What is the one essential ingredient of home? These are questions I pose to people in my workshops and talks on homelessness. I’ve adapted “The Meaning of Home” values clarification exercise that I learned from the (sadly, now defunct) Bay Area Homelessness Program, which was a dynamic collaborative of Bay Area universities and homeless-serving agencies. As they put it, the goal of this exercise is “to help participants understand the connection between home and humanity. It builds empathy for homeless people, shows the range of reasons why a person can become homeless, and shows the interconnectedness of human needs.” (Source: my copy of the exercise directions, dated September 1998).

Part of my adaptation of “The Meaning of Home” exercise is to give participants strips of colored paper (the size of a large bookmark), crayons, colored markers and pencils, and I ask them to write or draw (or both) their most essential ingredient—or essence—of home. And, if participants agree, I add their responses to a growing public art project I’ve named The Blue Tarp Tapestry. This is part of my ongoing digital humanities transmedia project, Soul Stories: Voices from the Margins, funded, in part by the National Endowment for the Humanities, the University of Washington Simpson Center for the Humanities, Jack Straw Productions, and 4Culture. (A special thanks to all of these.)

I highlight some of the participant responses here and today because they are especially pertinent to the season, the climate of our country, and the sort of community that people in Seattle seem to desire: safe, diverse, compassionate. Their responses also highlight the fact that, unfortunately for too many people, home is not a safe and cozy place. The photo above is a weaving I made out of responses to “The Meaning of Home” exercise. The photos in the slideshow below are some of the responses from recent workshops.

This slideshow requires JavaScript.

 

Listen, Carefully

johann_heinrich_fu%cc%88ssli_-_silence_-_wga08336
“Silence” by Johann Heinrich Fussli, 1799-1801

My essay, “Listen, Carefully,” was published today by Electric Literature/Okey-Panky. I love the Okey-Panky tagline, “Literary oddments for busy people.” They state that my essay (or is it really a prose poem?) is a 4-minute read. It includes a link to my 7-minute digital storytelling video of my reading of the piece, accompanied by my photographs.

“Listen, Carefully” is part of my book and digital humanities project, Soul Stories: Voices from the Margins. In “Listen, Carefully” I parse out some of my criticisms of the practice of narrative medicine, as well as the rhetoric of listening—and of silence.

Continue to BE Uncomfortable

meay1756
The Hansberry Project’s Panel of Black Women Playwrights. University of Washington.

In returning from a year-long academic sabbatical, one of the lessons I learned that I want to carry forward is the importance of being uncomfortable—of reaching outside my comfort zone to allow myself to be exposed to different people, ideas, and experiences. As a teacher, as a nurse, as a person, these are the sorts of things that help me to keep learning and growing.

I was reminded of this yesterday as I listened to an amazing panel of Black women playwrights discuss their work and lives at the Black Woman Wisdom Summit at the University of Washington. They spoke about their experiences with institutional racism, of having their plays labeled “not Black enough” or “too Black” by (mainly) white male critics. Of what we as White allies can do to fight against racism, to overcome the self-indulgent paralysis of White Guilt. As I listened to their stories, as well as the stories of young Black actresses and authors from the audience, I was simultaneously inspired, awed, and uncomfortable. These are uncomfortable conversations to have. These are uncomfortable times that require all of us to be willing to step out of our comfort zones, to be willing to listen to people whose lives are different from our own.

Here are my top ten lessons learned from my sabbatical (and yes, I do fully recognize my own privilege in having a sabbatical—thank you University of Washington):

  1. Continue to read widely and deeply.
  2. Commit to dedicated time each morning for writing (as I am doing now…)
  3. Contain email! Check email once in the morning and once at the end of the day.
  4. Disconnect from school/university politics: It Doesn’t Matter!
  5. More puppy time (note: by puppy I mean my geriatric sweet sweet corgi)
  6. Continue doing at least one week per year of solo retreat time on Orcas Island (note: we’re talking in a ramshackle cottage)
  7. Continue spending daily “fireside time” (a fake electric fireplace), or “hammock time” or Virginia Woolf’s “Wool-gathering time” daydreaming without any electronic devices in sight or hearing.
  8. Spend more time (daily) in nature.
  9. Spend more art/creative/ “way out” time.
  10. Engage in more outside the box thinking, reading, learning, such as in the Health Humanities (which I adore).

And here, below, I include my original post “BE Uncomfortable” from this time last year, pre-sabbatical. Pepe’s words ring so so true!

“BE uncomfortable. That’s how you learn!” was one of the final exhortations to our students by Pepe Sapolu Reweti at the conclusion of our”Empowering Healthy Communities”study abroad in New Zealand program this past summer. She was describing the fact that there are many Pakehas (‘white’/European descent New Zealanders) who do not personally know any Maori people, much less ever been on a Maori marae (‘meeting place’ similar to our U.S. Indian ‘reservation’ except that it is the ancestral home of the Maori iwi, or tribes), much much less ever have been in a Maori home. She pointed out that our students had all been on a marae (several, in fact) and had been inside a Maori community meeting house, and had shared ‘kai’ (a meal–several, in fact). That’s an honor and a privilege and something for us to learn from, to take back home–to apply in our own country, in our own daily lives. If the students learned nothing else from this study abroad experience, I hope they learned this.

I was reminded of Pepe’s words this past week as I listened to Ta-Nehisi Coates talk about his latest book Between the World and Me, written in the form of a letter to his son about being a black man in the deeply scarred and racist modern day America. His talk was in the sold-out 2,900 seat McCaw Hall at the Seattle Center, as part of the Seattle Arts and Lectures literary series. The interviewer asked Coates about his article “The Case for Reparations” in the June 2014 edition of The Atlantic, and why he thought it had ‘gone viral’ and been so popular among white people. He replied that he thinks people like the fact he doesn’t sugar-coat things, that “It’s a sign of respect the way I talk directly about things.” And he added, “Reality is uncomfortable. Period.”

Looking around the packed auditorium in one of the whitest cities in America, I wondered how many of us white audience members were now wallowing in white guilt: white guilt which is itself a white self-indulgent privilege. How many of us white Seattleite audience members are willing to push past white guilt to do anything constructive to confront racism in our country, in our city, in our neighborhood, in our own homes? And what are we as health care educators doing to ‘teach meaningfully to’ the effects of personally-mediated and institutionalized racism?

“…as Americans we are so heavily invested in shame, avoidance, and denial that most of us have never experienced authentic, face-to-face dialogue about race at all.” (“To Whom It May Concern” by Jess Row in The Racial Imaginary: Writers on Race in the Life of the Mind edited by Claudia Rankine, Beth Loffreda, and Maxine King Cap, Fence Books 2015, p. 63.) In this same essay, Row states she once saw a book on classroom management for college teachers with the title When Race Breaks Out. “As if it’s like strep throat, as if it has to be medicated, managed, healed.” (p62.)

We need to allow ourselves–and our students–to be uncomfortable, to confront uncomfortable truths in order to learn any lessons that are worth learning.

On (Not) Letting Go

imageHaving read, and liked, Jonathan Kozol’s previous books Rachel and Her Children and Amazing Grace, I looked forward to reading his recent medical memoir The Theft of Memory: Losing My Father One Day at a Time (New York: Broadway Books, 2015).

While there were parts of the book that I appreciated, including Kozol’s candidness about the relative loneliness of his life and his reasons for wanting to extend his father’s life as long as possible even after Alzheimer’s disease had ravaged his father’s mind and body, overall the book was frustrating to read. It felt as if it had been written in a hurry and not edited carefully. For instance, there were frequent awkward and overly long (as in six to seven lines in length) sentences that detracted from the story. And I really did not care at all about the long sections of the book pertaining to Eugene O’Neill and his family and personal dramas. It felt more than unethical for Kozol to have mined his psychiatrist father’s notes pertaining to his patients, including O’Neill.

Kozol comes across in this book as an overly-privileged and entitled man who blames all of his father’s doctors for under and mis-treatment of his father’s health conditions. He does on occasion show some self-insight, as in this passage: “At some level, I think I was aware that selfish motivations of my own might very likely be at stake in the decisions I was making. …As nonresponsive as he often was, and physically enfeebled as he had becomes, I could not escape the crazy thought that I still needed him.” p. 151. That part of the book, a look inside the decision-making process for a family member such as Kozol who defies medical advice and staunchly fights for his father’s life to be medically extended as long as possible, made it a worthwhile read. That is a mindset that I do not understand, both as a medical provider and as a family member. Having read this book, I do have greater insight and compassion for people who hang on to their loved one’s lives far past what would appear to be prudent.

Past Forgiveness: Part 1

DSC02140The following is an excerpt from my book manuscript titled Soul Stories: Voices from the Margins (under review). I’m sharing it here—and now—because I know of at least one young woman out there in the world who probably needs to hear these words. I’ll post a a “Part II” soon.

_________________________

In Regarding the Pain of Others Susan Sontag writes of the meaning of images depicting tragedies and traumas. Towards the end of the book she contends, “There is simply too much injustice in the world. And too much remembering (of ancient grievances: Serbs, Irish) embitters. To make peace is to forget. To reconcile, it is necessary that memory be faulty and limited.”

But I wonder if reconciling, if forgiving, is always predicated on forgetting. And, is forgiving always a good thing?

As I began writing this essay, a young white supremacist shot and killed nine black people during a prayer service in a historic black church in Charleston, South Carolina. The day after this hate crime atrocity, the relatives of those murdered came together and gave a public declaration in which they called on the shooter to confess his crime and repent. He was not admitting to any wrongdoing or crime, yet they forgave him for murdering their loved ones. They said that they called on their deeply held Christian convictions to guide them in this matter.

Was their quick and very public forgiveness a form of Christian witnessing, a rebuke to the Devil, to evil in the world? Or was it something else? I realize I am treading on difficult ground here, that being within my white privilege I can never know what the family members of those victims experienced. Of course, there is something admirable and noble in turning anger and vengeance into love and forgiveness. But then that becomes the standard and what if there are relatives of victims who can’t or do not want to forgive the white supremacist murderer?

Forgiveness is a peculiarly Christian thing to do.  Having been raised within an exclusively Christian worldview—with its turn the other cheek, forgive a person seventy times seven, forgive us our debts as we forgive our debtors—I hadn’t realized that other major world religions like Judaism have different views on forgiveness. In Judaism, forgiveness can only be granted by the aggrieved person, and only after the perpetrator has asked for forgiveness and has made both atonement and restitution.

Forgiveness is also a peculiarly female thing to do; it is emphasized in traditional gender roles in Eastern and Western societies. Women are conditioned to be the family and community peacemakers, and forgiving is viewed as an essential part of that role. People who forgive are supposed to “soften their hearts,” release their anger and sense of revenge in nonviolent, nonliteral ways.

Robert Enright, a Catholic psychologist at the University of Wisconsin—Madison, has developed a 60-item Forgiveness Inventory to measure forgiveness, and an 8-step program leading to forgiveness. He has been dubbed “Dr. Forgiveness.” Through his research, he contends that people who forgive lead healthier and longer lives than those who “stay stuck” or “hold on to” resentment and a lack of forgiveness. He advocates the use of the “two chair technique” in counseling someone to forgive. The person sits in one chair facing an empty chair representing the person who wronged them. They tell that person—that chair—how they feel. Then they sit in the second chair, try to see things from the other person’s perspective, and talk things through with the imaginary person until they achieve forgiveness.

There is even an International Forgiveness Day, the first Sunday of August, established by the World Wide Forgiveness Alliance. (It has been changed to October 7th for 2016 for some reason.) The 2015 Forgiveness Day was on August 2nd, and at 2pm on that day people were called “to take two minutes to forgive someone and join over 2 million people in the Wave of Forgiveness.” On their website, they featured photographs and testimonials of the 2015 Heroes and Champions of Forgiveness. Most were women and it seems that most were women of color, a fact I find ironic given the power dynamics inherent in forgiveness.  I took the online 33-item Forgiveness Quiz with questions such as “Forgiveness is a sign of weakness,” and “I believe that revenge is devilish and forgiveness is saintly”—an echo of Alexander Pope’s famous line of poetry “To err is human; to forgive, divine.”

Most of my answers to the quiz questions using their Likert scale were neutral because my real answers to these questions were “it depends.” Nevertheless, my composite score told me I tend towards being a more forgiving person. Even though I think it is a rather silly and oversimplified test—and I question our society’s insistence on forgiveness, especially gendered forgiveness—I find my test result to be comforting. I also find that comfort disquieting.

Summer Reading Challenge 2016

IMG_7812Reading through the recent NYT article “12 New Books We’re Reading this Summer (and 6 Not So New),” with the list of summer reading by their book critics and staff, I was reminded that it is time to come up with my own summer reading challenge book list with a health humanities and social justice slant. Also, I was reminded to come up with a more diverse reading list than the one offered by the NYT. I did  similar list last summer (see previous blog post, Summer Reading Challenge with a Health Humanities/Social Justice slant ( June 2, 2015), with subsequent posts on my reading progress and reviews of the books.

My Summer 2016 Reading Challenge list of fifteen books is mainly composed of books I’ve acquired over the past few months during my cross-country travels, as well as from both the Association of Writers and Writers Programs (AWP) Conference in Los Angeles and the Health Humanities Consortium meeting in Cleveland. Four of the books on my list are truly ‘new’ books and the rest are new-to-me books. Here they are, listed from the bottom up as shown in the photo above:

Happy and thoughtful and humanistic summer reading everyone!

The Health Humanities Consortium

logo-1This relatively new group has provided a breath of fresh air in my life, as they manage to blend a not-overly-stuffy academic grounding with all the passion, creativity, and ‘meaning of life’ that the humanities has to offer. I’ve recently returned from their second annual conference and these both have easily been among the best conferences I’ve ever attended (and being an academic-type, I have been to numerous conferences). Great people doing great and important work to try and humanize health care and health professions education.

From their fresh-off-the press website:

“About: The Health Humanities Consortium is a community of scholars and institutions who work in the humanities and arts to promote, reflect on, and advocate health and health care in the world.”

Source: About