Saturday, October 08, 2005

On Being a Witness to Suffering

What does it mean to be a witness to suffering? What impact does it have on one's psyche and soul to bear the very human burden of sharing others' pain? Is there a cumulative effect? Does one become immune or hardened against the pain of others? Is there a point where one just has to quit altogether? These are ostensibly rhetorical questions which I frequently ask myself in the midst of my work, especially during periods of exceptional stress and intensity.

What does one say to a patient who has an enormous unidentified growth in her upper chest for which very little may be done? How does one console the middle-aged man addicted to crack cocaine and destroying his life? What tactic of therapeutic counseling is best when dealing with a 50-year-old woman with addiction to migraine medications? How to assuage the fears of a lovely woman with progressive multiple sclerosis who can no longer cook or do laundry, let alone go shopping for clothes with her teenage daughter who hates her mother for being chronically ill? How can one offer hope to the gentleman with throat cancer, a tracheotomy, a feeding tube, and chronic pain? Is it possible to salvage a life which is apparently imploding before one's very eyes? These are examples of not-so-rhetorical questions which figure largely during my interactions with patients on a painfully frequent basis.

There are many answers, but each answer also raises further questions, rhetorical or not. And with each patient who leaves my orbit---either through death or another less dramatic form of programmatic attrition---another takes their place, individuals whose stories will also become threads in the fabric of my Monday-to-Friday life, seeping into my weekend consciousness all too frequently as well (an occupational hazard, apparently).

I sometimes ask myself why I choose such work, electing to continue to serve those in pain, those suffering, those whose lives are unorganized, chaotic, riddled with disease and dysfunction. There's not always an easy answer to such ruminations, and on days when I witness people making incredibly poor life choices and propelling themselves into further illness and dysfunction, I cringe at my dedication and wonder if my limit will soon be found, the emotional levees breached, the city of my mind flooded beyond its capacity to continue to witness such self-destruction and pain. Until that time, I imagine, it is the golden moments---such as the recent death of my sweet patient and the gratitude of his caregiver---which propel me forward and reinvigorate my desire to serve.

Please understand that, among my eighty-ish patients, there are a good number (15 to 20, perhaps?) who care well for themselves, make excellent choices, practice flawless self-care, and respond to their environment and circumstances logically and sanely, even under duress. Serving these individuals is a pleasure, and I will bend over backwards to assist those who are willing to meet me half-way, those who give 100% of themselves to their own care and survival.

But it is the others---a majority---whose care is burdened by the sense that one is working against psychic and cultural forces upon which one can have little influence. There are some patients who seem to completely lack all powers of personal insight, who lash out at the world, flailing in desparate loss of control and the inability to step outside of themselves and objectively examine their own behavior and place in the world. Yes, socioeconomic barriers, racism, and cultural dynamics are also at play here, but that does little to assuage one's feelings of hopelessness, frustration, and yes, anger, when banging one's head against a wall day after day appears increasingly futile and counter-productive.

Nonetheless, it is the human spirit which powers our lives and our choices, connects us to one another, and energizes our will to give to others. Yes, I have also suffered--most profoundly the unjust killing of my dear friend Woody, but yet my suffering seems small when compared to the trauma which others have witnessed, often first-hand. Drug addiction, physical violence, untreated mental illness, poverty, malnutrition, institutionalized racism, economic violence---I am free of such dramatic experiences, and thus I am afforded opportunities which others have never been blessed to know.

Sitting in my comfortable home, surrounded by my relative luxury, I rest from the week's travails, and revel in the fact that I have this glorious time and comfortable physical space in which to take in my many blessings---blessings which I can so very easily take for granted if I am not conscious of their transitory nature. No matter how difficult my path may seem at times, it is a path of priviledge---priviledge unknown by so many. Paradoxically, it is this very priviledge that allows me to recharge my batteries and return to the fray each week. Burnout is not an option but is an ever-threatening reality. The weekends offer time to wash the stress from my body, release the cortisol from my tissues, and ready myself for the days to come, the cycle of life and work, of service and giving, of the turning of the page. Thankfully, today's page was a gentle read, and I am grateful for the ease with which it unfolded.

As for suffering, it is still my karma to work to lessen the suffering of others, and to that end I'll continue my work for now with as much humility and patience as I can muster.

May all beings be free from suffering.
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