Category Archives: Medical Decisions

Review: Being Mortal: Medicine and What Matters in the End, by Atul Gawande

Author Atul Gawande is an American surgeon, writer and public health researcher; he practices general and endocrine surgery at Brigham and Women’s Hospital in Boston, Massachusetts. His personal experience regarding the subject of aging and mortality includes a grandfather who lived to be 110, his father who experienced cancer, and his mother-in-law’s aging and dying process. Professionally, he was often called upon to perform last chance surgeries on patients in a medical system that doesn’t like to admit defeat.

Many of these surgical procedures didn’t provide clear benefits, but in today’s medical world, a lack of action is equated with giving up. Gawande learned the hard way that though medicine could offer endless treatments to prolong life, in most cases, additional treatment did not serve the patient’s deeper wishes, and often made matters worse. These “heroic measures” also greatly interfered with a peaceful and connected exit; it’s hard to talk when you’re intubated.

Gawande unflinchingly explores the nursing home and assisted living options today. Once again, it’s clear our country and health care system have “issues”. Being Mortal addresses these areas as it elegantly and intelligently explores (the book’s subtitle) “medicine and what matters in the end”.

You’ll hear an amazingly informative history of how our current nursing homes came to be. Have you ever heard the term poorhouses? My great aunts would use this term in a joking matter, such as, “Oh no, then you’ll wind up in the poorhouse”. This was clearly something to avoid. Continue reading

Grief Emotions – A Self-Healing Mechanism

This month I attended a Trauma Competency conference for two days. Grief was one of the topics. I heard a statement that impressed me, and that might be helpful if you’re dealing with grief.

Just like so many painful things, it’s natural to want to avoid grief. I have been known, for example, to stay busy, to play computer games or other mindless activities, to watch movies or read pulp mysteries, just to name a few options. These passive activities (it’s called “passive coping”) can provide some soothing, some comforting, it’s true. But more often than not for me, I finish that book and feel like I’ve been wasting time. Especially if I’m in avoidance.

So in the avoidance of grief, you may try to hold back tears, and think you have to hold yourself together for the world. Sometimes that is true – not only would a breakdown be inconvenient at Walmart, it would also not be the most supportive environment to let grief flow. That makes sense.

Yet when you go on for a long time successfully avoiding feelings of grief, you can get numb. This will shut down or curtail your life energy, your life force. It will inhibit your presence, your ability to respond to the moment. You might lose interest or motivation to do things you enjoy. Yes, there is a lot of emotional fall out to avoiding grief. Besides the fact that you’re usually stuck in place – which is again, natural for some time, but not if it lingers for years.

So here is the statement I heard last week, paraphrased: The emotions of grief work like a self-healing mechanism. So tears, anger, devastation, guilt – and particularly the physical emotions that come up – are part of your self-healing time. You just have to make room for it. And, what’s harder, relax with it.

When you are healing trauma, one of the main methods is to stay relaxed in the body while facing a memory or past pain. This is similar with working with grief. Whenever the emotional stress arises, there are a few things you can do to stay relaxed. These instant moves help switch you from fight or flight mode to more calmness. If you can stay with the calmness, you are moving through grief versus clenching against it – clenching will tend to keep it stuck.

How to switch out of fight or flight mode? For the ongoing help to cultivate your calm side in the face of a crazy world, it helps to have a regular meditation/relaxation practice. In a moment of grief, you can also try these quickies to stay somewhat calmer:

a) Put your hands behind your head and breathe (it goes to the belly zone, a signal to the body to calm down)
b) Switch your visual focus to peripheral vision (similar thing here)
c) Relax the muscles in your pelvis, specifically between your sitz bones and your front pelvic bones (It’s said  you can’t stay in fight or flight with a relaxed pelvis)

Note: The sitz bones are the bones you feel on the bottom of your butt against a chair when you are sitting.

It takes practice to be with strong emotions. These 3 instant stances can help you stay with the waves of emotion so they can express themselves. Yes, sometimes you’ll need to hold that deluge back. That’s normal. And when you want to support yourself in your grief, when you want to have some healing time, you can set it up in your schedule, by having some time with nothing at all scheduled. And there, you can play with these ways to not clench your body and mind, and let the self-healing mechanism of grief flow.

You can also try these three methods with any challenges that cause stress or kick in your fight or flight / clenching mode. You tend to make better decisions, and have awareness of more options, when you help your brain and body calm that fight or flight instinct.

I was able to test these instant stress busters on a plane ride. The pilot announced we’d need our seat belts for the turbulence ahead for the next twenty minutes. Yikes! I felt myself start to get a bit panicky as the bumpy ride and drop-outs began. Then I relaxed my pelvic muscles. I felt the stress drop – instant relief! And it stopped escalating. I was able to go back to my book.

Let me know how it goes if you try this, okay? Blessings.

Denise Barnes, MA, LPC
Sanity and Santuary for Grief, Medical Decisions and End of Life Prep
Consults: text 303.501.7402