“Holistic Decision-Making – It’s Not Just for Doctors”

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Check out the very nice article that Shelly Francis put together about my book on the Courage & Renewal Blog. She excerpted Chapter 10 on “Holistic Decision-Making.”

Here is the quote from my book that the article starts off with:

Decision-making is something that you can do with either your limited mind and ego, or by letting the choices percolate through your body, emotions, mind, heart, creative self-expression, intuition, spirituality, as well as through the dimensions of context and time – until a decision becomes clear with input from your total Self. Decisions made this way may ‘freak out’ your ego, but they can be truly transformative.”

I am very happy to see the book appealing to a larger, non-health care audience. Re-humanizing Medicine advocates for a personal growth framework for the physician to become a whole person, but this model applies equally to anyone.

Please visit the above link to see the article, you can also look at their programs, I attended their “Integrity in Health Care: The Courage to Lead in Changing Times,” and I wrote a guest blog called Recovering Hope, Poetry and Connection in Health Care that you can also visit, this was published May 9, 2013.

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De-humanization in Medicine A Review of Doctored: The Disillusionment of an American Physician by Sandeep Jauhar.

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I read this book quite quickly. It is a gripping, emotionally honest memoir and critique of contemporary medicine. Dr. Sandeep Jauhar is a cardiologist and author. His first book was called, Intern, about the first year of residency training, and he writes for the New York Times. With great emotional honesty, Dr. Jauhar charts his journey from finishing his cardiology fellowship and into the world of medicine on Long Island and into the underworld of private practice.

The book starts with a quote from Jung on the mid-life transition:

“Wholly unprepared…we take the step into the afternoon of life; worse still, we take this step with the false assumption that our truths and ideals will serve as before. But we cannot live the afternoon of life according to the program of life’s morning – for what was great in the morning will be little at evening, and what in the morning was true will at the evening have become a lie.”

As Jauhar, documents his own “mid-life crisis” (struggling financially, trying to balance the expectations of his Indian family and golden boy brother, dealing with problems conceiving children, then with the difficulties of being a single income family with small children) he, interestingly, portrays American medicine as being in a mid-life crisis of its own. I think this is a useful way of looking at our health care system today, particularly in light of Jung’s advice about the afternoon of life, that the truths of the morning no longer serve and that we require new truths to prevent crisis from becoming breakdown. There are thus three stories that Jauhar weaves together: the story of his own life, the local realities of cardiology practice in New York, and the larger story of the culture of medicine in the US and how we have gotten to this place. He tells a compelling tale on all levels.

The first story, of the life of Sandeep Jauhar, traces a first generation Indian immigrant to the US, who struggles to balance the “old world” expectations of his family with the “new world” expectations of someone who has spent his formative years in the US. Jauhar captures these cross-cultural struggles and these are just one of the many ways that he is trapped between different people, systems, cultures and expectations. (More on Indian-American immigration and cross-generational issues can be found in the great book by Indian American author, Jhumpa Lahiri, Interpreter of Maladies). Another place that Jauhar is trapped between is between the American dream of having his kids in good schools, providing for his family and his inner morality of not wanting to engage in unethical billing practices (which ties in with the next level of the story of local practice). This story of Sandeep Jauhar at midlife is told with brutal honesty, and the reader can feel the sense of being trapped between multiple forces with no clear way out. He tries ignoring his conscience and doing what everyone else is doing, but that doesn’t work for him. Jauhar points out that every day, one American physician kills him or herself as he weaves the story from the personal, to the local, to the national culture. He tries going to his wife’s family’s guru, but that doesn’t work for him either. The only helpful advice he gets there is slipped to him by another participant at the audience, “Once you know and accept that you are going to die, the future will not haunt you.”

The second story is utterly depressing and is like a never-ending nightmare. Dr. Jauhar, looking to increase his income to support his family in their one bedroom apartment and to pay off medical school loans for himself and his wife, peddles himself all over town, trying to take on more work. The cardiology private practice culture (and it seems he is mostly exploring a sub-culture of Indian and Pakistani immigrant physicians) is rife with over-billing and almost indentured servitude in which the boss brings in young doctors to do the busy work and takes the lion’s share of the profit. Sandeep Jauhar is just not cut out for this kind of work. He comes across as the kind of man you would want as your doctor, thoughtful, not arrogant, not putting himself forward, not focused on the money, but on “doing the right thing” for the patient. However, he portrays the painful clash of his personality and ethics with the ugly realities of private practice cardiology on Long Island. He explains the local history and the vectors of force acting in medicine today.

The third story traces the larger history of American medicine, to the point that Jauhar identifies as its “mid-life” crisis. Medicine today is in a crisis, for sure, and everyone in it is often unhappy, the doctors, the nurses, the staff, and the patients. Dr. Jauhar explains how we have gotten to this point and provides an intelligent critique. He moves from the personal to the cultural as he summarizes research on physician suicide and burnout. He writes,

“Most of us went into medicine for intellectual stimulation or the desire to develop relationships with patients, not to maximize income. There is a palpable sense of grieving. The job for many has become just that – a job. Something fundamental is lost when physicians start thinking of medicine as a business,” (171).

I cover similar ground to that of Dr. Jauhar in my book, Re-humanizing Medicine: A Holistic Framework for Transforming Your Self, Your Practice and the Culture of Medicine. In addition to the critique of the economics of medicine, I also look at the effect of an over-emphasis on science and numbers to the detriment of the human aspects of medicine.

The solutions that Dr. Jauhar suggests are largely systemic, such as shifting the way medicine is reimbursed from fee-for-service to accountable care organizations, bundled payment, or paying doctors as employees rather than based on how much they can bill. He is realistic and sees how difficult it is to reform medicine, but he also points out that one in every six dollars spent in the US goes to health care. However, this still places the responsibility for change with the government, with hospital and clinic administration, with insurance and tort reform. Jauhar does point out that, “Doctors never seem to acknowledge that the widespread burnout in our profession is in part due to the behavior of doctors themselves,” (171). This is an excellent point, we can’t wait for reform and change to come from outside. I quote in my book from physician Peter Salgo’s New York Times piece where he says “we as doctors have felt powerless to change this,” and he puts out a call to patients to demand change. I take this statement to task a bit. We as physicians are the point of contact of medical care within the US. While there are many competing demands, vectors of force, and forces of dehumanization within the institutions of medicine (which both I and Jauhar document), we cannot relinquish our responsibility and the considerable influence we have as the providers of the actual care. However, it does mean that we have to look at our own behavior and challenge ourselves to change, even if it means going upstream and working, at what seems like cross-purpose to the system, by providing humane and compassionate care, in caring for ourselves first of all, and then our clients and colleagues.

Here is where I do take Jauhar to task. He has documented the problems in contemporary medicine. He has shown the painful struggles of physicians within our current system. He has portrayed the moral crisis and the mid-life crisis in medicine today. But, in the narrative of the book, it looks like the way that Dr. Jauhar solves these problems is to move to the suburbs and to reduce his expenses. Is this the best we can hope for in medicine today, a small personal reprieve? I like Sandeep Jauhar, I feel like I know him from how well he writes and how well he captures the existential dilemmas of contemporary medicine. I think in bearing witness and documenting the disillusionment of an American physician, he has done a wonderful service. I think we need to look at what he says, though, that burnout in our profession is in part due to the behavior of doctors themselves. This means that we can address this problem by changing our behavior and this is something that we can do now, we do not need to wait for political or institutional reform. I encourage Dr. Jauhar to read Parker Palmer’s article “A New Professional: The Aims of Education Revisited.” Palmer has written that “institutions are us,” and he outlines the way that professionals can take responsibility for the ethical direction of institutions. We need to move beyond critique and into change and transformation.

I found myself thinking as I read Sandeep Jauhar’s book, would my book work in his situation? Would it help at all? He documents dehumanization in himself and in the profession. I aim to re-humanize medicine through empowering individual professionals and encouraging them to develop themselves as whole people in order to provide whole person care to their clients. I encourage a counter-curriculum, which individuals have personal responsibility to create and maintain in order to preserve their precious humanity that is so needed in medicine today. I call for a compassion revolution in medicine. And I am not alone in this, Parker Palmer, Robin Youngson and Tony Schwartz, just to name a few, are out there trying to change the way that we think of ourselves as human beings in our work places. But as I read Jauhar’s book, I found myself wondering, is this enough? Is my approach practical or even feasible? Maybe it only works in psychiatry? How would if fare in the underworld of private practice cardiology in distant Long Island? I feel that my framework is generalizable, as I have developed while working in many different practice settings in two different countries. There are days when I despair about the systems we work in and all the ways that our institutions seem designed for the opposite of compassionate care of the whole person. But, I think my book can help. We have to do something. We can do something. Dr. Jauhar, if you are out there, I’d like to send you a copy of my book. Thank you for your emotional honesty and your excellent critique of the mid-life crisis of American medicine. I think we can do something more to nourish our humanity as well as that of our clients and colleagues.

Re-humanizing Hector

A Review of Hector and the Search for Happiness

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Hector is a psychiatrist, whose life seems perfect, ordered and predictable. The only problem is that he gradually realizes that although his private practice patients have so much, they are perpetually unhappy. Eventually he comes to realize, too, that he is unhappy. It is a classic midlife crisis, he is successful in the world, but the interior meaning and vitality of life elude him.

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Swiss psychiatrist, Carl Jung wrote that for men, the midlife period marks a time of moving from an external, materialistic orientation to a more inner, spiritual orientation. “Midlife is the time to let go of an overdominant ego and to contemplate the deeper significance of human existence.”

This is exactly what Hector sets off to do. His overdominant ego has controlled and limited his experiences in life, he feels compelled to break his routine and to go off on an adventure. The movie starts with a dream sequence, Hector is flying a biplane, his trusty childhood dog in the co-pilot seat. He loses his dog and instead an assassin attacks him from behind, the plane is running on empty and goes into a dive – and he awakes to another day of the same breakfast, the same patients with the same problems and a very pleasant, but measured life. His childhood dreams were of being a pilot, flying, exploring the world (he has Tintin memorabilia in his office), yet he lives his life in complete safety and isolation in his office. One of his most endearing clients is a clairvoyant who has lost her ability to tell the future and feels like she is inauthentic. She also gives Hector prescient advice.

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At first Hector thinks he needs to go on a journey to do research so he can better help his clients learn what true happiness is, but he eventually realizes that he himself is too controlled to know true happiness and that his quest is, in reality, for self, to live and experience happiness.

He travels to China, meets a businessman and sees all of what money can buy, but it is not happiness. He goes to Tibet and feels a brief glimmer of happiness, but he loses it. He goes to South Africa where his friend from university practices in a free health clinic. Here he sees his friend living a dream of service to humanity, and of being loved for who he is. But this is also a very dangerous place, as Hector soon finds out. He bumbles along, his kindness to others making him friends and people are changed in subtle ways around him (for instance he sorts out a drug lord’s wife’s psychiatric medication and this has a small humanizing effect on the man). Hector next travels to LA, where he seeks out his childhood sweetheart, who is now married, with two kids and pregnant with a third. She teaches him that happiness does not lie in the past. On the flight to LA, he is called upon as a doctor to take care of a woman with terminal brain cancer traveling to see her sister for one last time. He dismisses his kindness and work with the woman as nothing, but she teaches Hector that, “Listening is loving.”

The last lesson he learns is from a psychologist studying happiness through brain imaging. Hector reviews the wide variety of emotional experiences he has undergone, but is still holding back. At one point, something breaks through, and he learns that happiness is feeling everything all at once, fully and deeply. Happiness is a by-product of being capable of feeling everything. This fits with my experience working with clients and from my own self-observation. It is possible to stop “negative” emotions, but it is at the cost of dampening “positive” emotions as well. The way I think of it, they flow through the same channel, so to speak, and the only choice is to feel it all, or to try to dampen and repress emotions.

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All through the movie, Hector has a small journal that he doodles in and writes down his maxims of happiness. While he learns that lists and aphorisms do not make happiness, it is still worth sharing this list. The movie is based on the successful series of books by the French psychiatrist and author, François Lelord.

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Here is the list from the book:

  1. Making comparisons can spoil your happiness
  2. Happiness often comes when least expected
  3. Many people only see happiness in their future
  4. Many people think happiness comes from having more power or more money
  5. Sometimes happiness is not knowing the whole story
  6. Happiness is a long walk in beautiful, unfamiliar mountains
  7. It’s a mistake to think that happiness is the goal
  8. Happiness is being with the people you love; unhappiness is being separated from the people you love
  9. Happiness is knowing that your family lacks for nothing
  10. Happiness is doing a job you love
  11. Happiness is having a home and a garden of your own
  12. It’s harder to be happy in a country run by bad people
  13. Happiness is feeling useful to others
  14. Happiness is to be loved for exactly who you are (People are kinder to a child who smiles)
  15. Happiness comes when you feel truly alive
  16. Happiness is knowing how to celebrate
  17. Happiness is caring about the happiness of those you love
  18. Happiness is not attaching too much importance to what other people think
  19. The sun and the sea make everybody happy
  20. Happiness is a certain way of seeing things
  21. Rivalry poisons happiness
  22. Women care more than men about making others happy
  23. Happiness means making sure that those around you are happy

This movie is really lovely, funny, heart-warming, profound, and thought-provoking. It portrays a man becoming who he truly is, overcoming his fears and defenses, becoming engaged in the world and being fully human. Simon Pegg is great as Hector. Rosamund Pike does a wonderful job as Hector’s somewhat neurotic girlfriend, who creates medication names for a pharmaceutical company. All the actors are well cast and the movie flows well, despite moving through so many settings and characters. It was directed by Peter Chelsom, who also directed the 2001 film, Serendipity, amongst others.

I just read the recently released book, Doctored: The Disillusionment of an American Physician, by Sandeep Jauhar. I will write a review of this book soon, as the theme of this book, as well as the theme of Hector are relevant to my book, Re-humanizing Medicine: A Holistic Framework for Transforming Your Self, Your Practice, and the Culture of Medicine. The joyless practice of medicine that Dr. Jauhar describes in painfully honest detail aptly captures the dehumanizing elements of medicine. Hector, while a bit of a feel-good romantic comedy, offers a portrayal of one doctor’s attempts at re-humanizing himself, his practice and the larger culture. He creates a counter-curriculum of life experience and he not only writes the book on happiness, he lives it, too. I give it 5 stars for being fully human. (The soundtrack was great, too, but not available yet).

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Review of Mira Bai, by Saritha Gnanananda

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(2010 Kindle e-book)

 

“Sri Krishna alone is my lover. I have gone mad with grief.”

“I will have no peace of mind unless Sri Krishna comes to me.”

These quotes open Gnanananda’s book on Mira Bai, described as having “dedicated her entire life to God and endured all the difficulties of life. Awake or asleep, all the time she thought only of Sri Krishna.” Princess, widow, mystic, poet, musician and Hindu Saint, Mira Bai (alternatively Mirabai or Meera Bai) lived in the 1500s (1498-1546) in Rajasthan (the Northwest of modern India). She is known as a “the most renowned woman poet-saint of India,” (Daniel Landinsky, Love Poems From God). Gnanananda describes Mira as “the very embodiment of Bhakti (or devotion to God).” Wikipedia describes Bhakti as “closely related to Islamic Sufism, which appeared around the same time: both advocated that a personal expression of devotion to God is the way to become at one with him.” Gnanananda expresses this bhakti devotion with loving care of the subject of Mira Bai.

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This Kindle e-book gives a biography of Mira’s life, starting with her birth in a noble family. As a small girl she saw a wedding procession and asked what the bridegroom was and then asked to have one to play with. Her grandfather gave her an idol of Krishna and said “Take good care of him.” Another story tells of her wanting the Krishna idol of a holy hermit. The hermit was visited by Krishna in a dream and was told to give his idol to the young girl. When she was older, Mira Bai was married to a man whose family disapproved of her constant devotion to Lord Krishna. At this point, Gnanananda admits,

“It may seem strange that one should regard God as the husband and behave accordingly. But it is not a new thing in the Bhakti cult. There are several types of Bhakti (devotion). They are classified according to the relation that exists between God and the devotee.”

Vatsalya Bhava: God as Parent

Dasya Bhava: God as Master

Sakhya Bhava: God as Intimate Friend

Madhurya Bhava: God as Husband

Gnanananda states that Madhurya Bhava is the highest form of devotion for it includes all other forms of relationship.

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This type of devotional love of God has roots in Christianity, as well, for instance in the writing of St. John of the Cross, author of Dark Night of the Soul  (who lived during a similar time, 1542-1591) and John of Ruysbroeck  (1293-1381) in his book, The Adornment of the Spiritual Marriage; or even the earlier Old Testament book, The Song of Songs in which bodily love and spiritual love are intertwined. A very nice book of poetry exploring the writing of poets from many religious traditions in regard to different forms of the divine love is Daniel Ladinsky’s Love Poems From God (2002). The Poet Seers website is also a nice place to visit for poems and short biographies of poets.

Mira was thought to be mad by her in-laws, and they attempted to sequester her, poison her, and tarnish her name. However, “she was known among the people as ‘a great saint,’” (Gnanananda). Her fame was such that the Moghul Emperor, Akbar the Great, (who was an integrator of religions) visited Mira in disguise and laid a diamond necklace at her feet. Although she refused the gift, Akbar (in disguise) said “I cannot take back what I have brought for Sri Krishna. Please do not refuse,” (Gnanananda). Thus, she was not able to turn away Akbar’s gift.

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However this gift made her in-laws even more angry with her and she survived several attempts to kill her. She sought refuge at a holy place, however the leading man at the site refused her entrance as she was a woman. She rejoined, saying, “I thought the only man in Brindavan is Sri Krishna. Now I see there is a rival.” Thus she outwitted the holy man as, “In the Bhakti cult the love of the wife for her husband is said to be the best form of devotion. According to this all are women in this world. God is the only Man,” (Gnanananda). This short book ends with a discussion of the disappearance of Mira, offering different possible ends of her life, for instance, that she was finally merged bodily with Sri Krishna, such was her devotion. This mirrors the story of the Virgin Mary’s Assumption bodily into heaven.

Mira Bai was a strong woman, poet, singer, mystic and Hindu saint. As a mystic, she argues for a direct communion with God and this was threatening to the male hierarchy, both religious and political. She is a champion for women’s (and all humans) rights to worship God directly and her devotional poems blend a physical sensuality and subversive, revolutionary, single-minded love of God which takes precedence over all other laws and hierarchies.

It is fitting to end with a couple of poems of Mira Bai, translated by Daniel Ladinsky.

A Hundred Objects Close By

I know a cure for sadness:

Let your hands touch something that

makes your eyes smile.

I bet there are a hundred objects close by

that can do that.

Look at

beauty’s gift to us–

her power is so great she enlivens

the earth, the sky, our

soul.

 

A Great Yogi

In my travels I spent time with a great yogi.

Once he said to me,

“Become so still you hear the blood flowing

through your veins.”

One night as I sat in quiet,

I seemed on the verge of entering a world inside so vast

I know it is the source of

all of

us.

 

Mira Knows Why

The earth looked at Him and began to dance.

Mira knows why, for her soul too

is in love.

If you cannot picture God

in a way that always

strengthens

you,

You need to read

more of my

poems.

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Radio Free Albemuth (the movie)

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This movie has been a long time coming. Filming started in 2007, it was shown at Sedona in 2010 and I have been waiting for it to be released, which didn’t happen until June 27, 2014, which I completely missed and just saw it on demand and watched it last night.

The movie is the first of the four novels of Philip K. Dick’s VALIS “trilogy” to be adapted to film. While it is often said that PKD’s books are great and the movies never live up to them (and perhaps that could be said of this movie as well), this is an important movie for several reasons.

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Firstly, as mentioned, it is the first of PKD’s late books to be adapted to film (Blade Runner, Minority Report, The Adjustment Bureau, as well as many others being adaptations of PKD’s earlier work). In February of 1974, Phil had his first vision/hallucination. He continued to have these experiences over the next months and his late career revolves around his attempt to understand these experiences. He picked up and set down many different explanations for his visions: God; extraterrestrials so advanced that they may as well be God; mental illness; Russian mind control experiments; beams of energy from a satellite; attempts by extraterrestrials to intervene to save the earth; an over-lap in parallel universes, as well as many other theories. In 2011 PKD’s 976 page Exegesis was published posthumously, containing many pages of his attempts to understand his experiences, as well as ideas for his late novels. It should be mentioned that Radio Free Albemuth was written in 1976 as a draft of what later was published in 1981 as VALIS. RFA was published posthumously in 1985. The two novels are similar only in the fact that they have a character named “Philip K. Dick” who is a science fiction writer. In both novels, PKD is a kind of foil, a straight man to either Horselover Fat (VALIS) or Nicholas Brady (RFA). Phil creates a split having one character experience the visions and the pink phosphene beam and receive communications from VALIS, while the “Philip K. Dick” character is initially skeptical, but gets pulled into the metaphysical action.

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Secondly, the movie is important because of its political themes. In this universe, the United States is ruled by four-term President Fremont, who has declared war on the subversive organization Aramchek, which may or may not be a real organization. The characters in the movie are visited by FAP (Friends of the American People) who are young, Hitler Youth types with unquestioning patriotism. At one point, Nick and his wife, Rachel, have to complete tests after watching President Fremont’s speech. The question is: “If the American people have to give up liberties in order to fight Aramchek, are they gaining or losing ground?”

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The movie features

Nick goes through a series of visions, which are very close to the visions that PKD described having in real life. At one point he becomes convinced that current reality is an overlay of Rome in AD 70, the time of persecution of Christians by Nero, “The Empire never ended,” which means that PKD/Nick believes that the US government at the time was equated with the Roman empire, and President Nixon can be seen as a kind of Roman emperor.

The movie stays close to PKD’s novel and has all of the many twists and turns of the plot, including visions of messages from an alternate reality from someone in the Portuguese States of America – while this entity can give advice, it cannot answer the question, “Who are you?” It presents PKD’s spiritual beliefs, which are a mixture of science fiction, Gnosticism, Christianity, and Neoplatonism. The movie has lines, like “No one ever truly dies” and “Our minds are being invaded by an alien life form, for our benefit.” (PKD particularly developed the concept of the Paraclete as an alien life form that cross-bonded with the early Christians who accepted it in. Phil often spoke of “Firebright,” which is what he called the light he sometimes communicated with.

The question of what exactly happened to the real PKD is an interesting one and he spent the last 8 years of his life trying to decipher this, considering all possibilities. I have started work on this question as well, looking at PKD’s experiences and personal journal (The Exegesis) and Carl Jung’s visionary experiences and personal journal (The Red Book). I have a draft for a book length project called Every Thought Leads to Infinity, which is a line from The Exegesis. The link leads to the abstract from my 2012 presentation of that name.

The movie seems to have all the right ingredients, other than a big special effects budget. The actors are believable in a PKD world. Knowing the back story as I do, it is difficult to say how well the movie stands on its own, apart from PKD’s stories and life. (The movie has just had limited release and has only made $8,493 at the box office). It could serve as an introduction to his later works and it also has a theme that is relevant in today’s society of a decade of war against terror. Before Nicholas Brady is executed without a trial, the last thing he says is, “I am an American citizen, I have rights!”

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The tagline on the official movie website reads, “A message of hope from the stars.” In the end, PKD was always hopeful that the little guy, who takes the morally right stance against totalitarian political regimes and institutions of thought control, would come out on top. He also made arguments that are consistent with the Recovery Movement in mental health, a kind of human rights movement. I have summarized PKD’s views of humane mental health treatment in a presentation, “What Does it Mean to Be Human?” Philip K Dick believed that there was reason to hope, and in his worlds that hope often was supported by metaphysical/science fiction intervention from God or VALIS (Vast Active Living Intelligence System).

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[A quick mention about the music featured in the film. Much of it is by Robyn Hitchcock, and has a few old songs by his earlier band, The Soft Boys. However, I can't find the soundtrack and it looks like Hitchcock wrote a song, "To Be Human" for the film that is not available elsewhere at this point. Neither does Alanis Morissette's song, "Professional Torturer" appear to be available.]

[John Alan Simon, the director and co-producer of Radio Free Albemuth, also obtained the rights to VALIS. In an interview in Bleeding Cool, Simon talks about VALIS, and also about his own long-standing interest in visionary experience, having studied and written on Yeats and Blake's visionary experiences. I have always thought that VALIS would make a great movie. It has more of a sense of humor, as well as darkness, it has the movie within a movie theme, as well as it just seems like the best PKD novel containing a little bit of everything from his life's work].

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Re-humanizing Medicine is available for pre-order on Amazon!

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It is very strange to see something I have been working on for so long posted on Amazon. You can even look inside the book. The publication date is still set for November 28, 2014, but you can now pre-order the book.

It is difficult to say when this journey began, particularly as I distill my professional life’s work in the book. I think it was probably around 2006 where the book started to take shape as Creating A Holistic Medical Practice. I had written a draft of a book I was calling Being Your Self, but it was kind of diffuse and unfocused, gradually I realized I wanted to write about my views on holistic medicine and my work in creating a holistic medical practice. My earliest memory of working on this book was when I was at the American Holistic Medicine Association conference in 2006 in St. Paul, Minnesota. I remember sitting at a café and distilling some of my thoughts about how the structure of a holistic practice differed from a conventional practice. I had started my private practice in 2005, so I had been spending a lot of time thinking about and creating systems that supported genuine human connection in a psychiatric setting. I had set out some time in my private practice for writing, but clinical and then teaching demands intervened and the book languished. I wrote material for the classes I taught, Finding Your Self and Being Fully Human.

I moved to New Zealand as part of the culmination of a long-term dream and compulsion. I became busy there at my first job, realized I was partly living my dream, but that I needed dedicated time for my book, so when I took my second job there, at Buchanan Rehabilitation Centre, I went down to 4 days a week, so that I had Tuesdays set aside for what was most important to me. It was then that things really started happening! The book really started to take shape. I started looking into agents and publishers, eventually landed a contract with Ayni Books through John Hunt Publishing. In the process of getting book endorsements, Vincent Di Stefano mentioned the phrase “re-humanizing medicine” and that really clicked. That is where my passion was, not just in a book on creating a practice, but on challenging the dehumanization in contemporary medicine and setting out a program of re-humanization. Phrases like “counter-curriculum” and “compassion revolution” came together and the book took on its current shape, after an extensive re-write. Also, I figured out how to bring myself into the book, or the book out of me. Instead of giving facts and information, I felt the book was a part of me and I of it. At this stage, the writing of the book served an integrative process for myself, bringing together the first research project I worked on with Deb Klamen (who wrote the foreword to the book) as well as the many side projects I worked on along the way.

Eight years later, the book is now going public and I am shifting into a new phase with it. It is very exciting and I hope that the book resonates with an unmet need for physicians and clinicians and helps re-chart an inner direction that leads to outer transformation and reform. What will happen next?

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click here to go to Amazon to pre-order the book

Text from Back Cover of Book:

What starts as personal dissatisfaction in the workplace can become personal transformation that changes clinical practice and ultimately changes the culture of medicine.

Physicians and professionals train extensively to relieve suffering. Yet the systems they train and practice in create suffering for both themselves and their clients through the neglect of basic human needs. True healthcare reform requires addressing dehumanization in medicine by caring for the whole person of the professional and the patient.

Re-humanizing Medicine provides a holistic framework to support human connection and the expression of full human being of doctors, professionals and patients. A clinician needs to be a whole person to treat a whole person, thus the work of transformation begins with clinicians. As professionals work to transform themselves, this will in turn transform their clinical practices and healthcare institutions

“Modern medicine is engaged in a struggle to find its heart, soul, and spirit. This task must begin with physicians themselves. Dr. David Kopacz’s Re-Humanizing Medicine is an excellent guide in how this urgent undertaking can unfold.”

Larry Dossey, M.D., author of One Mind, Reinventing Medicine and Healing Words; executive editor of Explore: The Journal of Science and Healing.

“Dr. David Kopacz bears exquisite witness to medical dehumanization and puts his heart and soul into a thoughtful, reflective, yet practical guide for countering its contemporary ills. This book can change lives, careers, and systems.”

Stevan M. Weine, M.D., author of When History is a Nightmare and Testimony after Trauma; director, International Center on Responses to Catastrophes, University of Illinois at Chicago.

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A Review of At Ganapati’s Feet: Daily Life with the Elephant-Headed Deity, by Janyananda Saraswati (David Dillard Wright)

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David Dillard-Wright is an Assistant Professor in Philosophy at University of South Carolina, Aiken. He has a broad range of interests in the philosophy of the mind, bioethics, meditation (authored the book, 5-Minute Mindfulness and others), and in his latest book, he describes his experience and interest in Hindu ritual and meditation. At Ganapati’s Feet is a short, quick read at 99 pages. It starts off autobiographically, with Dr. Dillard-Wright’s story of seeing a friend’s statue of the Hindu god, Ganesha, and being drawn to the statue. He sought out his own statue and installed it on his writing desk as he worked on his dissertation (published as The Ark of the Possible: The Animal World in Merleau-Ponty) and began offering prayers as he worked to Ganesha. He eventually made a promise that if his dissertation were completed and published, he would write a book on Ganesha (Ganapati being one of Ganesha’s 108 names).

I, too, have a statue of Ganesha on my writing desk (a small return gift for loaning a friend a copy of Gandhi’s autobiography). Ganesha is a liminal deity, a threshold god, the first to be acknowledged on entering a Hindu temple Ganesha is often thought of as the remover of obstacles, and also a patron god of writers as well – having made a promise to complete a writing, and when he ran out of writing instruments, broke off his own tusk to use as a quill (which is why he is shown having one broken tusk). I had picked up a few elephant statues over the past few years and was very interested in the symbolism of removing and moving through obstacles. I came to think of my leadership style at times as an embodiment of this elephant energy when I hit an obstacle – not to overpower it by force, but to refuse to budge or be forced backward on any issue I considered crucial to gradually make advances on toward a clinical or administrative goal. This was kind of between putting something on the back-burner (essentially putting off until later) and having something on the forefront of one’s focus. I developed an ability to have continual awareness on an issue and whenever the smallest opening appeared, to take a step or two forward and then hold, until the next step was possible. This was a kind of medium to long-term planning, and in the meantime I would go about the daily issues and concerns.

One of the interesting facets of this short book is Dillard-Wright’s background of passing through the Christian seminary. His spiritual practice appears to have seamlessly incorporated Christian and Hindu belief and ritual. In fact, he writes that his Hindu practice has helped to bridge the Christian gap between the spiritual and the earthly, Ganapati, himself embodies the union of animal head and human body. His two wives, Riddhi (prosperity) and Siddhi (spiritual attainment) also bridge the common tension between material wealth and spiritual wealth. The book examines an integration of Hindu and Christian theology to arrive at an embrace of both the material and spiritual worlds. Even the split between human and divine is repaired as Dillard-Wright describes that the Hindu “gods represent the latent powers within ourselves; aspects of our true nature,” (10).

Rather than claiming to have found “enlightenment,” Dillard-Wright describes having “found tools to lighten the load,” through “seeing the negatives themselves as part of the journey toward liberation…to push oneself ever closer to the divine nature as it unfolds in this world. Eventually we come to regard ourselves not as separate beings, but as aspects of Ganesha’s nature. We come to be the removers of obstacles for others,” (14). He further writes that the “path forward for humanity, the only way that does not lead to destruction, lies in mutual service and submission,” (14-15). He thus finds in the heart of Hinduism the heart of Christianity. He presents Hinduism as being more accepting of other religions, as it is a polytheism. While most Christians do not consider the study of Hinduism part of the path to God, Dillard-Wright states that almost “every major Hindu saint has at some time read and appreciated the teachings of Jesus, and many authors have seen Jesus as a great yogi,” (16). This concept of religious tolerance, while a founding principle of the United States, is currently a topic of great concern – as intolerance, in general, appears to be growing in the Land of the Free.

After a discussion of harmonizing contrasts between Hinduism and Christianity, Dillard-Wright moves to an exegesis of the symbolism of Ganesha. His comments about the broken tusk, in particular, are of interest. While we often think of elephants as slow and ponderous, Ganesha represents the lighting flash of the creative mind, using his four hands to write four times as fast as someone using a single hand. His one remaining tusk represents “single-pointed devotion and oneness with his father,” (Siva) (31). Turning the broken tusk to his advantage, this “symbolism means that Ganesha takes defects and quickly makes them into tools, thereby overcoming them. The quickness with which he fights his adversaries and composes poetry he also pours into his devotee’s lives, making them quick and nimble as well,” (31).

The next section of the book explores mantras and spiritual aphorisms of Ganesha, such as “Regard everything as holy,” (63) and “When trouble comes, retreat into meditation,” (65). The remainder of the book focuses on the steps of a ritual practice of puja, detailing the prayers and sequence of devotions and movements in the ritual worship of Ganesha, including the recitation of Ganesha’s 108 names.

This is an interesting little book, about a big subject, Ganesha the elephant-headed deity. It details the adoption of daily Hindu practice by a man who describes himself as a Christian, and is also a professor of philosophy. His handling of the topic is open, honest, straight-forward and thoughtful. It is well worth the short time it takes to read and raises many interesting topics in integrative religion and spirituality.

Publication Date for Re-humanizing Medicine: November 28, 2014!

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Here is the front cover of the book, exciting to see it start to take form after so many years working on it…

Here is the link to the publisher page for the book.

I have to start moving into a new phase now, done with writing and on to marketing and promoting the book. Totally new territory. I am going to start looking into conferences and bookstores for public appearances.

The timing of the book is excellent with my work at the VA. There is a national Office of Patient Centered Care and Cultural Transformation and my book is really consistent with their message. I was just down in Atlanta for the Whole Health: Change the Conversation conference and it was really energizing and helped me to get excited about the work of the book. It will be really interesting to see how the book does once it is out in the world.

In the meantime, I continue my day to day work at the VA. I have started the pilot run of The Hero’s Journey Class, based on the work of Joseph Campbell. It uses mythology and narrative as ways of assisting Veterans in their Return Home. Here is a photo of me at work on this project.

Hero's Journey Reflection

Otherwise, I have a few interesting possible projects on Patient Centered Care and staff wellness in the works. I will be presenting a poster next month at the annual meeting of the American Holistic Medical Association – Connection & Collaboration: Innovations in Patient-Centered Care. The poster is on Collaborative Poetry Writing as a way of engaging patients with psychosis and trauma histories.

I will post more details on the book publication as they are available.

Update

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So, what else???

I haven’t really blogged too much about the settling in this side in Seattle…

It has been busy buying a new house, moving in, settling in to work and putting the finishing touches on the book. I have finished the index and sent in the final proofs on the book. I have seen the draft of the cover, which is a stethoscope that forms the outline of a human head, a nice representation of having to look past the technology to the person. I am not sure how long this next process will take, but I believe the next step is publication!

I have been doing a little painting. I have large, well-lit work space in the basement and the above photo is a detail of the first painting.

I have been learning about the national VA Office of Patient Centered Care and Cultural Transformation, and I am going to a training put on by the office next month in Atlanta. There is a lot of overlap with my book, Re-humanizing Medicine: A Holistic Framework for Transforming Your Self, Your Practice, and the Culture of Medicine. There are potentially some great opportunities on the horizon!

As soon as I know more about when the book will be coming out, I will definitely post it here.

I have also been working on a draft of what could be an interesting book. I’ll be running a pilot of a class for Veterans using Joseph Campbell’s framework of the Hero’s Journey next month. I have been writing a draft of an outline for each session with various myths, movies, stories, and ideas. I’m really enthusiastic about it as it is bringing a lot of things together in a format that is different from a traditional therapy group.

That’s all for now…in honor of the blog earlier today on the review of the union of inner/outer wilderness, here is a photo of me and a tree…(the tangled branches represent my tangled thoughts, and the teleology of branches represent my seeking the truth, which appears to be mostly off to one side of my head).

Oh, yes! I also saw Rebecca Solnit speak a couple weeks ago. I should really do a blog on that soon…

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