Form and Function

By Stefanie M Smith

As I’m moving forward in my healing journey, I am increasingly grateful for the transformative and explorative nature of words.
One area that I have needed to do a lot of personal work on is the difficult relationship with my mother, we had various ups and downs up until her death in January 2008, thankfully we had made our peace in the months leading up to her passing.
In December 2007 I needed to arrange for her to be admitted to the Medical Admissions ward at the hospital where I worked, and due to the staffing levels I actually ended up completing the admission paperwork myself. As you can probably imagine, this was an incredibly stressful time, and not something I was able to process fully until much later; the following is a piece I wrote which helped with that tremendously:

“Just words written on pieces of paper:
Name: Mum
It was a Thursday night, I think two days before Christmas, and I had just left the hospital after a late afternoon shift; my mobile started to ring and because of the state of play I pulled over to take the call. It was my step-dad; my mum had taken a turn for the worse, she was really struggling with her breathing. Instead of finishing my route home, I diverted to their house and went in. She was propped up on the settee, which was a makeshift bed, barely conscious and her breathing was very raspy indeed.
Address:
Immediately I switched mode. I took out my phone and rang the hospital, asking to speak to the bed manager; then as soon as connected, ‘June,’ I asked, ‘have we still got any beds?’
‘Two,’ she replied, ‘Why?’
‘It’s mum,’ I said simply, everyone knew she was terminal, ‘she needs to come in for a few days.’
Date of Birth:
With June agreeing to hold a bed for a short while, I set the wheels in motion. It was difficult as we all knew mum didn’t want to die in hospital the way my father had all those years ago, but she needed to be made comfortable if nothing else. I telephoned out of hours and managed to negotiate an admission for mum, then popped home to change while they waited for the ambulance to collect her.
Marital Status:Married
My step-dad gave us three bells when it arrived so I could set off and meet them at the ward. My ward. Medical Emergency Admissions. The ward I had left perhaps two hours ago. Not expecting to be back so soon. We sat either side of the bed, my step-dad and I, watching the nurses, my colleagues, go about their business. It was so busy, I was glad I’d thought to call June to save a bed.
Nationality:
After sitting there twitchily for forty-five minutes or so, with no-one having any time to come and complete the paperwork, I popped up to one of my colleagues, ‘Mary,’ I said quietly, ‘I know it’s not protocol, but you are run off your feet, and mum really needs to be seen. Would it help if I completed the admissions forms?’
‘By all means,’ she agreed, ‘just don’t sign them. I’ll do that.’
So here we were nearly midnight now. Sitting by my mother’s bedside, completing the paperwork as part of her admission. Form and function. Keeping my brain in check and focussed, not wanting to reveal any weakness, the slightest wobble would I know open the floodgates and that must not happen.
Registered GP:
Religion – I started to write ‘None’.’Methodist,’ said my step-dad. Really? Since when? I thought. But I wrote it none the less. I was sure that since her diagnosis, less than two months ago, they must have had a lot of discussions around these kind of subjects.
Next of Kin:
The clock keeps ticking. The on-call consultant comes and goes. My step-dad can hardly talk, so I do my best. My mother is moved from admissions to a side-room, put on a drip and made comfortable. Once settled, I give her a kiss, and hug my step-dad.
Medical condition: Hmm, yes the biggie – Cancer. Cancer that had taken my father when I was ten; cancer that will now take my mother. But, it’s alright. Now at this moment, I’m not the daughter, I’m the nurse. It’s nothing personal, it’s just words. Words on paper. Words I know off by heart, I can write them standing on my head.
‘I really need to go home and get some sleep,’ I say emptily, ‘I’m back on in the morning. I’ll pop in and see her before I start, and let you know how she is.’ I know that being in a side-room, they will let him stay as long as he needs. Mum was going nowhere that night, but I knew neither was he.
And then I leave, and I can sit in the car and cry.”

Writing in this way allowed me to take a step away from the situation itself, to write without all of the intrinsic emotions it would have stirred up. Whilst emotions can often be useful in processing difficult situations, they can also get in the way, and I am gradually learning through my writing practice when I need to create a little distance to allow the real healing to come out.


Editor’s note: This is Stefanie’s second blog post in fulfillment of her Transformational Language Certificate.

stefanieStefanie M Smith, is a 47 year old former nurse and qualified hypnotherapist who has lived in Lincolnshire, UK, since childhood. Unfortunately in 2009 her health took a nosedive, and she now deals with fibromyalgia, depression and other chronic health conditions on a daily basis. During this enforced rest period, Stefanie has been able to re-ignite her love of the written word, especially poetry and will shortly having a selection of her poems published in an anthology. Having noticed a marked benefit to her health through her own writing practice, Stefanie is now re-training in the therapeutic and transformational uses of language with the aim of sharing this phenomenal tool with others.

A Tool as Powerful as Drugs or Surgery in Addressing Illness

by Diane Glass

In the last five years, I have presented to Des Moines University medical students on the topic of doctor/patient communication. They have enrolled in an elective course called “Death and Dying” to learn how to communicate with individuals facing serious, sometimes life-threatening illness.

Although still in school, they are not unlike the doctors I have encountered over the years. In interviewing patients, doctors choose to stick to the script, asking questions about symptoms, offering possible diagnoses, and recommending tests and treatment options. Computerized medical forms encourage this approach; insurance companies need the information doctors collect to authorize payment.

What doctors often don’t often ask are the simplest of questions: “What is this like for you?” “How is this affecting your life?” “What do YOU think would make a difference?”

When I suggest these questions to students, they express reservations. “There’s not time for this kind of conversation.” “I won’t know what to say if they start talking about their lives; I’m not a therapist.” “Patients just expect answers from me.” Their reluctance underscores a basic misconception about the purpose of this communication. It is not simply to produce a medical outcome (a test, a diagnosis, a prescription), but also to create the kind of relationship between doctor and patient that will lead to quality care over time.

This relationship provides care and comfort to patients with terminal diagnoses. At this stage, patients seek not only treatment that will ease suffering, but also the opportunity to talk about life joys, disappointments, and desires. A caring relationship in which patients feel free to share their feelings and experiences also serves individuals with complex chronic illness and pain. In these situations, doctors find simple solutions illusory. Patients face needed lifestyle changes. The illness impacts all areas of patients’ lives. When I hear a doctor say to me, “There’s nothing more I can do,” I know that he or she underestimates the power of caring and commitment. There is always more that can be done.

So to the medical students I talk with, I offer this kind of advice in response to their reservations about open-ended conversations with patients:

Reservation: There’s not time for this kind of conversation.

Response: Take charge of your schedule. Without your initiative, you will be scheduled every 20 minutes (or so) for a new patient. You can change that. Reserve multiple blocks of time, especially in meeting with new patients. Arrange regular appointments with patients with more complex issues; don’t wait for them to request appointments. Yes, fill out the forms, but make that a secondary and separate part of the conversation.

Reservation: I won’t know what to say if they start talking about their lives; I’m not a therapist.

Response: Your job is to listen with care, not to provide answers. You are not expected to be a therapist or psychologist. Listen for underlying themes that may explain your patients’ symptoms. Often stories provide metaphors for what the body is experiencing. Notice gestures and postures. Be comfortable with silence. Your patient may be about ready to share something important when you speak too quickly. Say, “Tell me more” and repeat key phrases and words so your patient will know you are listening.

Objection: Patients expect answers from me.

Response: It’s true: many patients place the bulk of the responsibility on the doctor for their own health. Communicate (and believe) that you and your patient are partners with shared responsibilities. Build that partnership by involving the patient in every aspect of identifying problems and working out treatment plans. Focus your resources on those patients who are interested in this approach.
Patients tend to keep their stories under wraps, fearing their doctors will consider them irrelevant or distracting. Yet in open-ended conversation, they may discover factors affecting their health they had not thought about.

Most aspiring doctors get into their fields because they want to help people. Listening with respect, compassion and sensitivity equals medical knowledge as a tool for doing that.


Editor’s note: This is Diane’s fifth blog post in fulfillment of her Transformational Language Certificate.

dianeDiane Glass teaches classes in storytelling as a tool for spiritual growth. She offers workshops in the spiritual dimensions of chronic illness and pain and in the body as home to the soul. Her memoir, “This Need to Dance” (Amazon), relates her own experience growing up with spina bifida, being diagnosed with breast cancer, and finding meaning in her pursuit of health

Suheir Hammad: Poems of war, peace, women, power

Suheir Hammad is the author of Breaking Poems, recipient of a 2009 American Book Award and the Arab American Book award for Poetry 2009. Her other books are ZaatarDivaBorn Palestinian, Born Black; and Drops of This Story. Her work has been widely anthologized and also adapted for theater.

Her produced plays include Blood Trinity and breaking letter(s), and she wrote the libretto for the multimedia performance Re-Orientalism. An original writer and performer in the Tony-winning Russell Simmons Presents Def Poetry Jam on Broadway, Suheir appears in the 2008 Cannes Film Festival Official Selection Salt of This Sea. She is the Artist in Residency at the NYU’s APA Institute for 2010.

Discovering TLA

by Melissa Rose

When I was studying Art Therapy as an undergrad, I knew I wanted to use creativity to help and connect others, and while I loved the visual mediums of painting, sculpting, collage and drawing, my own personal passion was for writing and performing, which was not included in my college coursework. It was then that I discovered TLA Network and from the moment I learned about the organization, I knew that it was the closest description to my own desire to build stronger communities and people through the spoken word.

Since becoming involved with the organization, I have experienced several of the online classes which have enriched my own personal and professional development, as well as connected with other individuals who also share the vision of transforming others through the written, spoken and sung word.

The Network has focuses on three areas for particular advancement and development:

  • Growth of the Field and Profession of TLA: In coming together to amplify TLA, we can both grow the field of study that is TLA and the profession of making a living from TLA. Such growth also helps those who have been doing TLA without a way to name their work in a larger context.
  • Connection and Networking: Through providing opportunities for individuals and groups to meet, share resources, teach and learn from each other, and help enhance one another’s work, we bridge many fields and traditions, groups and institutions. Such a network allows all involved to make informed decisions about the direction of their TLA work, and provides opportunities for alliances, joint projects, education, and inspiration.
  • Right Livelihood through TLA: Right Livelihood, a Buddhist term connoting the work we do in the world to serve our communities and make the most of our gifts, when applied to TLA encompasses the art of facilitation, ethics, engaging diversity, the business of TLA, and self-care.

I believe in the power of words and that through telling our stories and expressing ourselves and experiences, we not only deepen our own self awareness, but form stronger bonds with others in the communities we serve. Through sharing our words and experiences as TLA practitioners, we grow our strengths as members of a larger collective to learn from.

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