On Suffering: Pathways to Healing and Health

Preface

preface The impetus for writing this book comes from my early experiences as a physiotherapist treating two young, injured military men in a veteran’s hospital. (The stories of these two young men, Dan and Roger, like other stories in this book, are imaginative conglomerations of events inspired by my many experiences as a clinical physiotherapist. These stories are not real-life reports.) The first patient , “Dan,” was a soldier who, on a particularly hot summer day, dived into a lake to cool off and broke his neck. (I use the term patient here because it is specific to those who are receiving medical care.) Prior to his injury, Dan was a vigorous, fun-loving, intelligent family man who enjoyed a beer or two with his pals. After the accident, he was physically helpless and in a constant rage, lashing out at everyone. Dan and I worked together several times a day for over seven months in the rehabilitation hospital. Ours was the typical physiotherapist–patient relationship . I pushed him as hard as I could to achieve everything that was humanly possible, and he tried with all his heart and soul to help himself. Sometimes he called me “Bubbles” and sometimes I was the battleaxe from hell. But we worked hard together. Dan made some improvements, but it soon became apparent that he would never become the person he once was. Eventually Dan was discharged to a long-term care facility. Three months after his discharge, I heard that Dan had committed suicide. I cried. “Roger,” the second patient, was a young airman whose plane crashed on an icy mountaintop. Roger was paralyzed from the waist down, and both his arms had to be amputated because of frostbite. My first encounter with Roger occurred on the day his mother died. Roger and I started the long and difficult process of rehabilitation, and once again I was sometimes “Bubbles” and most of the time I was the “devil’s handmaiden.” Roger and I worked, argued, talked, laughed, and worked some more, day after day. After several months Roger was discharged from the hospital. For a long time, I never knew what had happened to him. One day, I had a phone call from a friend of mine who was a nurse working in the United States. She told me about a patient of hers by the name of Roger who had asked her to give me a message. She said Roger was an outpatient at her hospital. She said he seemed happy, was involved with a wheelchair sports team, was living independently, and self-managing minor health problems. He asked her to say “hi” to Bubbles and tell her “I’m doing okay.” Those two patients and countless others troubled me throughout my professional life. Why did one person survive suffering while another did not? The psychologically pat answers of medicine only xii Preface explained medicine’s need to fight disease and death. I could not dishonor my patients by giving such explanations. I pursued my clinical career, assumed the responsibilities of academic life, and continued to explore the question of suffering in medicine. This book is the result of twenty-five years of treating those who suffer and another twenty years of scientifically exploring the issue of suffering and health. This book argues that suffering is a life experience that is separate from, and only sometimes caused by, pain. Individuals suffer when there is a perception of threat to the idea of self and how this self should act in the face of adversity. Failure to incorporate suffering into clinical treatment plans results in a loss of human potential and an escalation of health care costs. ...