Where Were The Doctors?

Last week, I attended an all-day conference on mind-body medicine here in Santa Fe. At the beginning of the day, the speaker obviously wanted to know the professional make-up of her audience, so she called out various professions and had us raise our hands in response. Of course, nurses made up the majority of the approximately 225 people in the crowded room, and psychologists, counselors and social workers were also very well-represented. And when she asked about doctors, only one person raised his hand. A murmur rippled through the crowd, and there was much ironic laughter. So, where were the doctors?

Nurses Need Support

The more nurses I talk to, whether in my clinical nursing work or as a coach for nurses, it's increasingly obvious to me that nurses simply need support. While "Nurses Day" and the accompanying flowers, buttons and pens may be nice gestures, Nurses Day and other such celebrations would mean a whole lot more if meaningful support---not platitudes---were offered to nurses who so desperately need it.

Gender, Healthcare and Communication

Last night on RN.FM Radio during a discussion with Beth Boynton, the nurse author of "Confident Voices: The Nurses' Guide to Improving Communication and Creating Positive Workplaces", we touched on the subject of gender and its effects on communication. Countless books on communication between the sexes have been written---the ones most readily coming to mind being those by Deborah Tannen, including "You Just Don't Understand" and "That's Not What I Meant"---and I am keen to point out that there is currently no book on the market of which I am aware that specifically discusses the gender aspects of communication within healthcare.

A Type of Suicide

The other day, I had the opportunity to meet a very kind gentleman in his mid-forties, not one year younger than me. And like most people in our forties, we eventually got around to talking about our health.

During our chat, he pulled out a pack of miniature cigars and began puffing quite vehemently on one of them. I was surprised, and asked him why he smoked at his age.

"Well, I've been smoking two packs of these cigars every day for about 15 years and don't want to quit. I have a chronic cough that just won't stop, and I bust a rib every few weeks because I cough so hard."

I asked him if the coughing bothered him, and this was his reply.

"You see, I'm diabetic, so I'm not gonna live that long anyway. So why give up smoking now?"

I was shocked, and our conversation continued from there.

"Just a few minutes ago, you showed me some photos of your grandchildren," I told him.

"Yeah, that's right."

"Don't you want to live to see them graduate from high school? Don't you want to be there for them?"

"Hell," he said. "I don't control my sugars that good, anyway, so whether I smoke or not, I'm still gonna die. So what's the difference? I won't make it to their high school graduation no matter what I do."

Stunned into silence, I went about the business at hand, and I ruminated on what he had said. Basically, this man chooses to not focus on controlling his sugars, and he adds insult to injury by inhaling at least 10 of those cigars every day. Slightly overweight and sedentary, his ratio of body fat is also not doing him any favors. He is a walking time-bomb, and as he ages, his risk of blindness, amputations, kidney disease, and serious respiratory illness increases exponentially.

There are millions of Americans like this gentleman, millions of people who simply don't understand how (or why) to take care of themselves. Apparently ignorant of the proactive choices that they could make in order to halt (or even reverse) the forward march of their respective chronic illnesses, these individuals are destined for disability and/or institutionalization, costing taxpayers billions of dollars in health care costs that could have been altogether preventable had they willingly engaged in their own self care.

Nursing homes and hospitals are crawling with people who oftentimes make lifestyle choices that fly in the face of logic, poisoning their bodies with cigarettes, nutritionally unsound foods, excessive amounts of alcohol, and a sedentary lifestyle that certainly contributes to their eventual demise.

We are all footing the bill for people like my new acquaintance who simply choose to eschew their own well-being by pursuing a lifestyle that contributes to personal ill health as well as a society-wide health care crisis. When such a critical mass of people are drugged into oblivion by cigarettes, alcohol, TV, bad food and the mushrooming effects of ill health, it is a recipe for a nationwide disaster as well as a personal form of suicide.

Ben Franklin was prescient in saying that "an ounce of prevention is worth a pound of cure", but his admonition regarding the importance of prevention has apparently lost it's impact through the subsequent centuries. Most Americans seem to simply want a pill that will help them to eat less, quit smoking or lose weight, and that reliance on an outside source for the answer to one's personal health concerns is misguided and serves as a poison in the veins of the society.

Our health care system is in crisis, and our population is aging and growing more obese and ill with each passing year. As costs rise and quality of care decreases, a small few profit from the mess as most of us suffer the collective consequences.

The smoking diabetic described above is one of millions of Americans who choose to take the path of least resistance when it comes to their health, and if I explained to him that his choices are actually driving up the cost of health care around the country, he probably would have looked at me as if I had two heads.

Americans may be obsessed with health on one hand, but on a very deep level we seem to have basically given up the ghost. My diabetic acquaintance certainly sees no reason to change any of his habits, and as he slowly commits suicide, his care will consistently tax the system, adding to the sorry statistics that paint a picture of American health care that is anything but rosy. His premonition that he won't live to see his grandchildren's high school graduation is probably accurate, and when his grandsons wonder why Grandpa couldn't be there to watch them accept their diplomas, will anyone use his story as a cautionary tale? Most likely not, and the cycle will probably repeat itself in the next generation in a form of suicide that is, for all intents and purposes, more common than any of us would like to believe.

The Nurse as Coach

Life coaching has become big business, and now health and wellness coaching is hot on its heels as the next big wave of wellness for the masses. So, why would a nurse make a good coach? What would give a nurse an edge when it comes to coaching willing clients through the process of getting well, maintaining wellness, or increasing one's aptitude for health, wellness and well-being?

Nurses are trained to examine patients/clients in a holistic manner, taking into consideration myriad aspects of an individual's "biopsychosocial" self. From the beginning, nurses are trained to look for areas of both strength and weakness, and nurses are then taught to assist patients in learning new skills which will allow them the maximum amount of independence and quality of life possible.

Coaching and nursing seem to be a match made in Heaven. Coaching is all about helping people to maximize their health and well-being, create a wellness plan, be held accountable for their actions, and produce concrete results in their lives.

As a case manager and a visiting nurse, I have worked with the sickest of the sick, those with multiple life-altering illnesses, and underserved inner-city populations struggling with cycles of poverty, poor health, chronic illness, substance abuse, and institutionalized racism. On a personal level, having removed myself from that front-line world for more than year, I am now ready to work with the well, with those who are motivated and anxious to improve their health, those strongly desiring to take their level of wellness and personal well-being to the next level. Coaching seems to be one of the ways to do such work, and it feels like the right fit at the right time.

Nurses are coaches, for all intents and purposes, and grafting professional coach training onto a nurse's education seems to be a fail-proof avenue to create a new way to make a meaningful living in the world while serving others. If there are any readers out there who have had a positive (or negative) experience with a health and wellness coach, I would love to hear about it. And if there is anyone who would like to experience coaching with me for a very low introductory rate, I am very willing to work with any person committed to their health and open to engaging my services as I power up a new and exciting vocation.

Surviving Stress

These days, it seems that stress is the #1 factor impacting my health and the health of many others that I know. From financial worries to chronic health conditions to the multifaceted and fast-paced aspects of modern life, many of us are suffering from stress on some level or another, and I submit that stress universally impacts the health of millions, both as a cause of disease, as a symptom, and as a 21st century illness or syndrome in and of itself.

Many subsume their stress with alcohol, sugar, caffeine, unnecessary spending, and various forms of addiction and emotional sublimation. We all feel the effects, and we all react in our idiosyncratic way to the vicissitudes of life.

On a personal level, I have lately turned to acupuncture, herbs, supplements, meditation, exercise, and dietary and nutritional changes to assuage the effects of stress. Further challenging myself to pursue optimal health and wellness, I have engaged the counsel of a wellness coach who helps to keep me on track as I navigate some challenging personal times.

All of these changes and approaches have indeed decreased the severity of my Multiple Chemical Sensitivity, improved several aspects of my health, and pointed me further down the road towards optimal wellness. Still, certain chronic conditions continue to rear their heads, and I struggle to make more headway in those areas.

The pace of life frequently seems largely untenable, and we manage our lives as best we can amidst the tumult. We eat well, keep hydrated, exercise, seek leisure and fun, connect with family and friends, pursue creative projects and spiritual renewal---all in the name of balance and wellness.

It's a bumpy road, and all too often we lose sight of our own self care as we focus like a laser beam on our latest to-do list and the unending tasks before us.

Personally, I need to take an enormous breath, sit back, and reassess what's really most important in my life. Failing to do so would simply be an invitation for the stress monster to sink it's teeth deeper. In my commitment to wellness and optimal health, it's ultimately a commitment to creating the healthiest, most satisfying and productive life possible.

Dangerous Messages

Standing in line at the pharmacy the other day, I was struck by the headlines I saw on several magazines on display near the register. The headlines screamed, and I paraphrase: "Young Starlets Reveal How They Lose Weight Fast!" and "Tired of Winter Fat? Lose 20 Pounds in One Week!"

Living in a college town, I wondered how many young impressionable female college, high school, junior high (and elementary!) students stood in line at this and other stores, reading those headlines, fervently ruing the few pounds they may have gained over the holidays. How do they compare themselves to those starlets and models? What messages are sinking in, especially into the brains of those school-age girls? What are we doing to girls and women in this culture?

As the media proclaim the dangers of obesity (some calling it an epidemic), we also run the risk of running too far in the other direction, sending our young girls (and some boys) into crazed tailspins of body image dysmorphia. As someone who was a chubby youngster, I myself was frequently on the receiving end of jokes and innuendos about my weight from relatives, family, and strangers alike. The resultant misguided self-talk about my body still reverberates in my mind to this day, and I still suffer the psychic consequences of the frequently cruel statements which so often came my way.

In this media-saturated world where there simply seems to be no escape---especially for the young---it is the responsibility of the society at large to monitor its language and the messages which it feeds to its most vulnerable members. From my point of view, we are failing miserably, and the resulting eating disorders and unrealistic body image suffered by young women across this country are the natural result of our stark collective failure. How can we right this wrong?

Our collective failure is, of course, our collective responsibility to rectify. But how can we do so when the powers of the media---and the very culture itself---thwart us at every turn? God help young women as they face this constant onslaught to which they can never measure up, and if we can't stem the tide, we will have no one to blame but ourselves.

Late-Night Thoughts

Many are the wonders of having a physical body. The scent of flowers, the feeling of grass on the soles of one's feet, the taste of a favorite food, a glass of wine, the gaze of one's lover, the feast of looking at art, the crunch of a cucumber. Physical existence offers such breadth of experience, such sensual delight, such a plethora of feelings and sensations building one upon another in a crescendo of stimulation and experience.

And there are the disadvantages, the ways in which the physical becomes burdensome, even painful. A cyst grows on a nerve root in my lower spine, causing incessant contraction of muscles that are like ropes under the physical therapist's fingers. A malfunction in the junction of my esophagus and stomach allows gastric secretions to bubble up and cause me discomfort. My step-dad's pancreas harbors an uncontrollably growing mass. My dog's kidneys failed, and twenty-eight days ago we eased his spirit from his tired old body and placed that beloved furry body in a hole in the earth. The ache which I feel from his absence is like a physical pain, although I know that it is not.

Life offers such contrast, such dichotomy of feeling and experience. Most of us would agree that it is better to have loved and lost then never to have loved, yet in that moment of loss it seems the pain will last forever. In the joyousness of health we leap through life and take our bodies' wholeness for granted. And when illness strikes, we long for the carefree days before we felt betrayed by that collection of cells we call our own. But is it truly a betrayal, or simply just another way of being in that body, of embodying our own existence?

Of course, we in the health and medical fields see optimal health---physical, mental, spiritual---as the goal of our work, and the desire of all. But there are those who seem to suffer---often from birth---from afflictions and illnesses over which they have no control. And even those individuals find meaning and purpose in life, often in spite of, or perhaps because of, their suffering.

At birth, our parents hope to see ten toes and fingers, an even number of limbs, hear a healthy cry, and observe us engaging the world with that first magical breath that transforms us from an aquatic cosmonaut to a terrestrial creature with feet on the ground and head in the sky. This long process called life offers such opportunity, such room for growth and transformation, and as parents we hold a vision of life without pain and suffering for our offspring.

But this business of having a body brings with it great risks as well. Illness, suffering, pain, loss, malfunction, death---they are all here with us on our journeys around the sun.

Working as I do with the chronically ill, I see some of the worst things that can happen to a body, the afflictions and struggles which can beset a human on his or her trajectory through this earthly existence. I can only conclude that there is great beauty in life---even in death---and that suffering, in its myriad forms, offers its own stark beauty, its own language of learning and growth. Still, I mourn for those who suffer needlessly, who experience torture, rape, brutality, and other unspeakable indignities, and I hope that even those who suffer so, when released from that suffering, know a peace beyond that which is imaginable for us remaining here on this three-dimensional side of the veil. My hope would be that it is so.

I will take the years offered to me and try to use them well. Pain and suffering be damned, there is nothing else to do but take this life in my own two hands and shape it with the force of my will. On this third ball of dust from the star we call The Sun, our lives unfold as so many stories of bodies and minds and hearts in motion. In pleasure or pain, life is what it is, and we simply take each day and live it as our truth, since no truth can be clearer than the one confonting us in the mirror each morning. And when you look in that mirror tomorrow, what, pray tell, will you say?