Meaning in Suffering: Caring Practices in the Health Professions

Introduction

Introduction nancy e. johnston and alwilda scholler-jaquish Suffering does not happen to us; we happen to suffer. Suffering is what we choose to do with pain. Younger, 1995, 55 When we suffer personally, and when we encounter the suffering of another person, we are confronted with many questions. A taken-forgranted and apparently robust future now jeopardized leaves in its place a hollow of uncertainty and fragility. Painfully unsettling, suffering seems to call forth a natural human proclivity to distance oneself from the specter of vulnerability. Understandably there is a tendency for healthcare professionals to protect ourselves from the ravages of suffering encountered in the lives of the persons we care for. We do this by relating from a distance even though this is incongruent with our commitment to remain engaged and to care compassionately. This volume calls us to strengthen our capacity to remain fully present to individuals and their families during times of profound loss and also reveals ways in which new possibilities both arrive and are closed down during suffering. In the opening chapter Kathryn H. Kavanagh uses narrative ethnography to offer an intimate portrait of one woman’s journey with a chronic illness. She deepens our understanding of the essential facts of suffering, illuminates how meaning and purpose come to be challenged in a time of suffering, and reveals how the self comes to be redefined. Laying the foundation for her interpretive inquiry by developing the metaphor of quilt, Kavanagh asks how we explore and understand such interrupted 3 4 introduction lives. She explores this question by writing that we understand by listening , and further suggests that listening involves “attending to both the dominant and the muted meanings . . . [and] searching for the pain and stories that lie outside expectable discussion.” Ingrid Harris then offers a compelling philosophical approach to suffering . Suggesting that suffering can be a gift, Harris creates awareness of the opportunities that come to sufferer and healer alike. Drawing on the thought of Calvin Schrag, she writes that the way the gift becomes present is through the interaction of the sufferer and the healer. Harris reminds us that meaning is double edged since it is all too often that negative rather than positive meanings are taken up. These negative, destructive meanings close down our ways of being in the world, prevent healing, and distort attempts to regain wholeness. Expanding further on how health professionals can respond “fittingly” in ways that help with the reconstruction of positive meanings, Harris encourages us to consider the infinite number of possible ways our imagination allows us to interpret any event. Nancy Johnston takes the position that enabling healthcare professionals to come to grips with suffering in a way that helps them to overcome the tendency to care “at a distance” requires a new discourse. This discourse must not only enable us to understand the threats to meaning and purpose that people experience during a time of adversity but it must also generate knowledge about how meaning comes to be restored in the face of great trial and hardship. She also shows how her interpretive phenomenological study contributes such knowledge by illuminating how people reconstruct meaning in situations of adversity and by shedding light on human and healthcare practices that both help and hinder the restoration of positive meanings. Craig Klugman uses a narrative phenomenological study to reveal how the practice of inviting bereaved people to tell stories of loved ones who are deceased assists individuals to accomplish important grief work. Noting that tellers are often searching for new hope, new interpretations , and new outcomes, Klugman affirms that it is during a “breakdown ” that people have the opportunity to grasp new meaning about their lives. Revealing the power of storytelling as a caring health practice, Klugman shows how it enables catharsis, heals wounds, constructs new meanings, restores connections to community, and fosters openness to new experiences. Bonnie Ewing explores the meaning to dying children of a wellintended social practice—the granting of special wishes to children with a life-threatening illness by the Make-A-Wish Foundation. Addressing the special challenges of gaining access to children’s perspectives uncontaminated by adult preconceptions and expectations, Ewing describes a hermeneutical phenomenological study in which children were invited to express their experiences through artwork. Explicating the embedded meanings that were manifested in symbols and images in the children’s drawings, she uncovers the shared meanings of...