Becoming Medicine Now Available for Pre-Order at Itasca Books & Amazon!

Becoming Medicine: Pathways of Initation into a Living Spirituality is now available for pre-order!

By David R. Kopacz, MD & Joseph Rael (Beautiful Painted Arrow), with a foreword by Lewis Mehl-Madrona.

From Itasca Books: full color Art Medicine Edition and Standard Edition in black & white.

From Amazon: full color Art Medicine Edition and Standard Edition in black & white.

The Gift of Burnout: Initiation into Becoming a Healer

This is the title of a poster presentation that my good friend, Gary Orr, and I presented at the Australasian Doctors’ Health Conference in Perth, Australia, November 22nd, 2019. This conference takes place every two years, rotating through the Australian states and New Zealand. Here is a screen shot of the whole poster, it is a bit difficult to read in this format, so I’ll break down the elements and type them in below the poster…

THE GIFT OF BURNOUT: INITIATION INTO BECOMING A HEALER

David R. Kopacz, MD, ABPN, ABIHM, ABoIM, Puget Sound VA, University of Washington

Gary Orr, MB BS MSC DIC MRCPsych (UK) Dip Interior Design (Au)

HYPOTHESIS

Burnout could be a predictable rite of passage that occurs several times throughout the education and practice of being a doctor. It is part of the initiation into becoming a healer.

We should not aim to prevent burnout, but rather to expect it and plan for how to create healing inner and outer environments to support doctors through the burnout phase of initiation into becoming a healer. Currently there is a failure of moral leadership in health care institutions, resulting in moral injury (1,2) and burnout with rates upward of 50% of physicians.

This poster provides a new view of burnout, re-examining it as a process of transformational learning and initiation into the archetype of the wounded healer. We will examine the process of finding strength and compassion in our wounds and discuss how we can develop a system of mentorship that guides and supports those going through the initiatory wounding of burnout. Gary will show how the path of a healer sometimes leads out of clinical care and into larger challenges of reinventing one’s self and the effects of design on health.

Introduction:

The World Health Organization has recently defined burnout as an “occupational phenomenon.” (3)

• feelings of energy depletion or exhaustion;

• increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job;

• and reduced professional efficacy

Symptoms of burnout have been reported in over 50% of physicians (4,5). Much of the literature on burnout, implicitly or explicitly, focuses on deficits, deficiencies, or negligence of self-care of the clinician. Individual suffering is marginalized and responsibility for addressing burnout is placed upon the individual. Yet there is a growing realization that burnout is a consequence of a mismatch between the professional values and ideals of physicians and institutional demands that require physicians to compromise their values and ideals – some have begun to call this moral injury. An initiation perspective depends on the availability of elders to communalise and contextualise suffering and yet our institutions marginalize the human and silences the elders.

Burnout as Initiation

We can view burnout as a necessary step for us to grow as healers rather than a pathology to be avoided. The problem then shifts from the individual experiencing burnout to the professional community whose job it is to guide and support the burnt out clinician to become comfortable in suffering rather than to eliminate or minimize discomfort and suffering. Initiation is a form of transformational learning, which does not seek to restore a previous state, but rather the transformation of the individual, leading to a new and expanded identity.

Rather than blame the victim or search for deficits — shift to narratives of transformation and healing.

  • Intentional Suffering – approaching suffering rather than avoiding (6)
  • Initiation (6,7)
  • Hero’s Journey – Joseph Campbell (6)
  • Wounded Healer
  • Soul Loss
  • Feelings of being fragmented, apathy, lack of joy in life; the inability to make decisions; the inability to feel love for others or receive love from another, often resulting in the sense of being emotionally flat-lined. despair, suicidal ideation, addictions, and depression (8)
  • Transformational Learning & Education – Jack Mezirow,(9) Richard Katz (10)

Burnout as moral injury

Outer Environments of Burnout / Healing:

  • Contributing Factors
  • Poor physical environments
  • High levels of clinical demand
  • High staff turnover
  • High staff sickness and absence
  • High levels of violence
  • Poor personal control over day to day scheduling of calender
  • Poor clinical leadership and evidence of bullying, undermining of the professionalism of the practitioner
  • Discrimination which was dismissed by leadership

While we can view burnout as a necessary step in the growth as healers, the problem then shifts from the individual experiencing burnout to the elders of institutions and professional communities whose job it is to guide and support the wounded clinician through the initiation process. We know how to use suffering for growth, Indigenous communities have been doing this for millennia, the question is: Can our institutions and professional organizations create the ritual space for elders and sufferers to do the work of transformation, or will there continue to be failure of moral leadership?

If there is a failure of moral leadership, moral injury will be the result – where physicians are put in institutional situations in which there is cognitive dissonance between professional values and institutional priorities. If we look at recommendations on treatment for moral injury, we see the importance of community, interpersonal connection, reconnecting to meaning and purpose and reconnecting to positive aspects of identity. (11)

Lived Experience of Burn Out and Personal Reflections

Personal Reflections on Moral Injury

Finding oneself constrained in a system that is not able to reflect on its failings can lead to stagnation of the system. Then, when the incoming senior comprehends the moral failings of the system’s leadership, and then calls the leadership to account, but the leadership fails to stand to account. The incoming

senior individual becomes scapegoated, victimized, marginalised, and ostracised. If there is a lack of Elders within the service and subsequent of the Silencing of the Elders, many of whom had a personal over-identification with the service. This failure of moral leadership leads to a lack of elders within the system, and those that are there, are silenced. There are then consequences for the institution

Science – Evidence-based Reductionism

All too often, an evidence-based reductionism can lead to dehumanisation of the process of intellectually comprehending the psychodynamic underpinings of such human behaviour. This can lead to the process of devaluing an individual’s unique experience and expertise, and the individual becomes scapegoated, victimized, marginlised, and ostracised.

Institutional vs. Individual Values

Burn-out takes place when the individual is not able to reconcile the conflict between their own value system and that of the institution.

Economic vs. Individual Values

The trend of chasing multiple KPI’s as proxy measures of care, removes the process of individual’s being treated as individuals, resulting in increased stress in the work place. For example: the KPI of time to transfer from ED, can lead to rushed decision making in order to meet the KPI, rather than allowing a sensible treatment approach to take place, and safer discharge planning processes to be put in place. Increased time to be able to clearly create an effective discharge plan, can lead to an improved out for patient and staff – can there can be cost savings for the service.

Design

Healthcare environments outside of well resourced centres are often characterized by poor standards of the physical environment. Working in a poorly maintained environment has an impact on both staff and patients. There are multiple Issues of OH&S; impacting staff and patients contibuting to increase violence and aggression in the healthcare space, leading to high staff turn over and increased risk of burn out. People are less likely to respect a poorly maintained environment.

Review Procedures

These can be a helpful mechanism of independent external review and recommendations, but the impact can be limited depending on invested interests and potential issues of Elders having been silenced by higher failings of moral leadership. Grass Roots activism and lived experience groups can be a helpful alternative source of raising issues within a service.

Leave your job

Leave medicine – this was the choice that Gary made

Institutions need to Change:

Institutions need to expect burnout, and create workforce and job planning that takes account of such.

There is an opportunity for institutions to create working practices that encourage doctors to create portfolios that include variety in both clinical, leadership, academic and teaching opportunities. Create healing & supportive circles/communities of elders to support working through burnout.

There is a requirement to shift from prevention to developmental career guidance, and institutions need to take moral responsibility for contributing to burnout.

It is possible that institutions and professional organizations are incapable of morality and compassion, because those are human traits—the responsibility of the institution is to organize humans and create space and support for humans to provide moral guidance and the human wisdom of elders.

Discussion:

The fact that we cannot heal the wounded healers is an indictment of our current health care institutions and professional organizations and calls for a refounding and reorganization of the way we do medicine.

We recognize that a crisis of the individual healer is a crisis of the system.

We have allowed institutional economics and protocolised flow charts to replace human caring and moral leadership.

Our institutions have lost focus on the care in health care—no longer caring for their staff or creating

institutional spaces for the care of the patient.

Questions and Reflections:

Is this conference (ADHC) capable of caring for the souls of those who are caring for the souls of others?

Is the ADHC an organization that inspires hope, helps us find meaning & purpose, and cares for those who burnout?

Is a doctor merely a human form engaging in an AI process?

Do we have caring elders in medicine capable of guiding the younger generations through burnout and through initiation into becoming a healer?

Does Health Care still care about Caring?

What is the Economic toll of Burnout – for the individual; for institutions?

Are $’s more important than people?

Does the desire to care predispose one to burnout?

Are concepts about machines & economics good models for caring for the soul?

Are health care workers expendable equipment?

How does an institution take moral responsibility for the wounds and suffering of its workers?

How does an institution undertake reflection?

How does an institution undergo refounding?

Can we create healing circles of elders to guide physicians from wounded to wounded healer?

Remedies & Remediations

  • Recognizing burnout as the disorienting first step of transformation
  • Finding Your Soul (soul retrieval)
  • Re-envisioning Your Calling (reconnecting to your healing vision)
  • Finding Your Self (the counter-curriculum of re-humanization) (12)
  • Finding Your Tribe (mentors and guiding elders)
  • Finding Your Bliss (what brings you joy?)
  • Starting a Revolution (compassion revolution resources) (12)
  • Becoming a Medical Activist

REFERENCES:

1. ZDoggMD, “It’s Not Burnout, It’s Moral Injury,” https://zdoggmd.com/moral-injury/

2. Talbot, SG & W Dean, “Physicians aren’t ‘burning out.’ They’re suffering from moral injury. STAT, 7/26/18.

3. World Health Organization, https://www.who.int/mental_health/evidence/burn-out/en/.

4. Dzau, VJ, DG Kirch, and TJ. Nasca, M.D. “To Care Is Human — Collectively Confronting the Clinician-Burnout Crisis,” New Engl J Med, 378(4), January 25, 2018.

5. Shanafelt, TD, Hasan O, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc 2015; 90: 1600-13.

6. Kopacz, David and Joseph Rael. Walking the Medicine Wheel: Healing Trauma & PTSD. Tulsa: Pointer Oak & Millichap Books, 2016.

7. Moore, Robert L. The Archetype of Initiation: Sacred Space, Ritual Process, and Personal Transformation. Xlibris, 2001.

8. Shared Wisdom website, Hank Wesselman and Jill Kuykendall, http://www.sharedwisdom.com/page/soul-loss

9. Mezirow, Jack. “Transformational Learning Theory,” in Jack Mezirow, Edward Taylor, and Associates (eds.), Transformative Learning in Practice. San Francisco: Jossey-Bass, 2009.

10. Katz, Richard. “Education as Transformation: Becoming a Healer Among the !Kung and the Fijians.” Harvard Educational Review, Vol. 51, No. 1, February 1981.

11. Griffin, B, N Purcell, K Burkman & S Maguen. “Can trauma cause a moral injury?” ISTSS Stresspoints, (01/01/2019) https://www.istss.org/education-research/traumatic-stresspoints/2019-januarycan-trauma-cause-moral-injury_aspx

12. Kopacz, David. Re-humanizing Medicine: A Holistic Framework for Transforming Your Self, Your Practice, and the Culture of Medicine. Washington DC: Ayni Books, 2014.

This presentation was submitted as a workshop using the suffering of burnout as a process of initiation into becoming a healer however, it was accepted as a poster significantly limiting experiential and healing components. This highlights the challenge of working positively with burnout – institutional limitations interfere with the proper functioning of human beings

Transformative Language Arts Network Power of Words Conference, Scottsdale, AZ, Sept, 2019

Labyrinth at the Franciscan Renewal Center, Scottsdale, AZ

I attended the Transformative Language Arts Network’s annual Power of Words conference for the first time last week and it was amazing! Caryn Mirriam-Goldberg, former Kansas Poet Laureate, started a MA program through Goddard College in 2000, founded the Power of Words conference in 2003 and the Transformative Language Arts Network was officially founded in 2005.

The 2019 Power of Words conference was a small, intimate group of around 60 people. I found the discussions with fascinating and interesting people outside of the conference as inspiring as the actual conference offerings – which were incredible! I was able to have a nice chat with Caryn and we exchanged books, and I now have her Landed and Following the Curve to continue the conference with now that I am home. I met the new managing director, Hanne Weedon. Actually, I ended up chatting with most of the council at some point during the conference: Liz Burke-Cravens, Caleb Winebrenner, and Chip Cummings.

Right from the start of the conference, I sat down to dinner with author Gregg Levoy (Callings, Vital Signs) and Pediatric Neurologist, Peter Bingham (whose book in progress idea sounds great and I hope to read some day). Gregg Levoy did a few presentations, starting with his pre-conference workshop, Courage & Clarity with Your Right Calling – a great session in which he asked the audience a series of questions leading deeper into passion and calling and then looking through our answers to “search for concentrations of energy” in our answers and common themes. He also gave the keynote that night. Gregg was gracious enough to attend my workshop Heroic & Healing Journeys for Contemporary Times (which I’ll discuss in a future post), and he referenced Camus’ The Rebel, that “to be human is to rebel against tyranny.” It is quite a synchronicity that I had brought along that very book with me to the conference!

Gregg Levoy

The first pre-conference workshop I attended was Noa Baum’s “Stories Old & New: A Path to Healing & Resilience,” a storytelling workshop. This was a very helpful workshop and made me think about how “transformation is contagious,” to tell a personal story of transformation can become a universal story of transformation, and vice versa. Noa also gave a spell-binding performance of her “A Land Twice Promised.” I was speechless for a while after it. Noa is a Jewish woman from Israel and it is the story of her years of friendship with a Palestinian mother, recalling the struggles of growing up in the Middle East, whilst their children played together in the United States. The performance follows the story of their friendship, as well as the stories of their mothers. The name of her performance is the same title as her book, A Land Twice Promised: An Israeli Woman’s Quest for Peace. In speaking of the distinction between the performance and the book, Noa told me, “the show is the story of our friendship and the stories of our mothers. The book is a bit different – it is a memoir telling the story behind the show and how it all came to be. It is also the story of how I discovered the transformative healing power of storytelling and how I use it for peacebuilding.”

Noa Baum

The third pre-conference workshop was given by the wonderful poet, Usha Akella, “Fetch the Fire: Writing the Ghazal.” This was a great history and introduction to the form of the ghazal and we all muddled through writing one ourselves. The generous poet, Steffen Horstmann had donated signed copies of his book, Jalsaghar – thanks for this Steffen! We studied his ghazal, “[Clouds roil as Shango drum echoes in the Nile delta],” with the great line: “Charms rattle in a shaman’s fist as wind along the shore / Thrashes trees (rousing panthers from shadows) in the Nile delta.” Usha’s keynote the next day, “Matwaala: The Birth of a Festival,” described how she worked to found Matwaala, the South Asian Diaspora Poets Collective. This was a riveting presentation that focused not only on poetry, but politics, spirituality, immigration, and on bringing all voices together. It concluded with Usha reading her own poem, “Enough!” which Usha told the TLA Network they could share. This poem is a call and a challenge for “the people” to take care of the children of this Earth. Usha’s newest book of poetry is entitled, The Waiting. The book starts with the Prologue: “The hidden hand gently opens, reveals / the secret script so concealed from us, / And as the hope-less night moves to morning, / The heart’s compass from distrust to trust.” The Waiting is published in India, but you can get a copy directly from Usha by emailing her at: Reachmatwaala@gmail.com. Her other books are worth looking for: A Face That Does Not Bear the Footprints of the World, …Kali Dances. So Do I…, Ek: An English Musical on the Life of Shirdi Sai Baba, and her travel journal and poems, The Rosary of Latitudes. You can find links to Usha Akella’s poems through the Matwaala website and also a few of her poems from The Waiting are available on the Muse Indian website.

Usha Akella

I thoroughly enjoyed several long talks with Peter Bingham of Vermont Children’s Hospital and Suzanne Richmond, who developed the Health Arts & Sciences program at Goddard College. Suzanne introduced me to Dr. Celia Hildebrand, an acupuncturist, who then invited me to drive out to meet Gladys Taylor McGarey, one of the founders of the American Holistic Medical Association. I had a nice chat with Celia and Gladys and we all spoke of our callings and journeys into becoming healers. Gladys is quite impressive, at 98 years old she is still working on developing a Living Medicine program in the community and she shared with us some of her notes for her upcoming talk at the Academy of Integrative Health & Medicine conference later this month.

Dr. Gladys McGarey

The conference was set at the beautiful Franciscan Renewal Center with a desert healing garden that I started every morning in, drinking coffee, journaling, and watching and listening to all the desert birds and animals waking up for the day.

Such great community, inspiring company, and visionary creativity at the Transformative Language Arts Network Power of Words Conference! Check out their website and their work! Photos below of (Middle Right) David Kopacz, Usha Akella, and Chip Cummings and (Lower Left) Peter Bingham, David Kopacz, poet Cindy Rinne, Suzanne Richmond, and Usha Akella.

New Article in The Badger: Words Create Worlds, Part 2 Rebecca Solnit and Calling Things by their True Names

My next article in this series on words creating worlds, fascism, and spirituality is out in The Badger online magazine! It can be found on pages 52 – 60.

This article focuses on Rebecca Solnit’s latest book, Call Them by Their True Names (2019). Here are a few excerpts from the article and accompanying photos from the Olympic Peninsula.

“Words create worlds,” said Rabbi Abraham Joshua Heschel.[i]

What we call things creates not just discourse, but reality. The words that we use and the words that we do not use lead us in certain directions and have different effects. Words are not just words, they are tools that shape, and give expression to, reality.

Words create our reality and our current reality is in crisis.

Across the world, in many different countries, politicians are rising to power using words of separation rather than words of union. This political crisis is a spiritual crisis because using words to create reality is a spiritual act.

One of the Crises of the Moment is Linguistic

Rebecca Solnit’s Call Them by Their True Names (2018) examines the uses and abuses of language in politics, stating that “one of the crises of this moment is linguistic.” The linguistic crisis confuses us about what is real, what is true, about who we are, and about our relationships with each other and the natural world. “Calling things by their true names,” Solnit writes, “cuts through the lies that excuse, buffer, muddle, disguise, avoid, or encourage inaction, indifference, obliviousness. It’s not all there is to changing the world, but it’s a key step.” “Once we call it by name, we can start having a real conversation about our priorities and values. Because the revolt against brutality begins with a revolt against the language that hides brutality.”[ii]


Sun through the Rain Forest, near Sol Duc River, Olympic Peninsula (D. Kopacz, 2019)

The Deregulation of Meaning

"If you begin by denying social and ecological systems, then you end by denying the reality of facts, which are, after all, part of a network of systematic relationships among language, physical reality, and the record, regulated by the rules of evidence, truth, grammar, word meaning, and so forth. You deny the relationship between cause and effect, evidence and conclusion; or, rather, you imagine both as products on the free market that one can produce and consume according to one’s preferences. You deregulate meaning. . . . And this is how the ideology of isolation becomes nihilism, trying to kill the planet and most living things on it with a confidence born of total destruction."[iii] 

A Storytelling Work that Matters

"This work is always, first and last, a storytelling work, or what some of my friends call ‘the battle of the story.’ . . .  To sustain it, people have to believe that the myriad small, incremental actions matter. . . . To believe it matters—well, we can’t see the future, but we have the past. Which gives us patterns, models, parallels, principles, and resources; stories of heroism, brilliance, and persistence; and the deep joy to be found in doing the work that matters. With those in hand, we can seize the possibilities and begin to make hopes into actualities."[iv]

Doing “the work that matters,” this is what we are called to do. Joseph Rael reminds us that “work is worship,” so this work of activism, this work of story, this work of loving our neighbors, is a sacred work that we are called to do and that we are called to put into words so that we can create, instead of a world of hate, separation, and war, we can create a world of love and peace.

Sun through the Trees, Mt. Muller, Olympic Peninsula

Next issue: Rob Riemen’s To Fight Against This Age: On Fascism and Humanism

Throughout 2019, I will continue to write about some of these topics of how our “words create worlds.” In working with Joseph Rael, writing our next book, Becoming Medicine: Pathways of Initiation into a Living Spirituality, I felt compelled to write about the responsibility of mystical, visionary, and shamanic experience—that we must work toward “Spiritual Democracy.” At its deepest point, mystical experience leads to an awareness that we are all one and this comes with a responsibility to challenge words of separation which ultimately lead to fascism. Mystical experience is a pathway that leads us to question who we are and gives us a responsibility to use our words wisely to create worlds where we are becoming the medicine that our world needs. As Rumi says, “We are pain and what cures the pain.”[v]


[i] Life Between the Trees blog, https://lifebetweenthetrees.com/2012/08/06/words-create-worlds-monday-morning-parable/. I first came across a shorter instance of this quote in the Omid Safi reference below.

[ii] Rebecca Solnit, Call Them by Their True Names, 4, 1, 4.

[iii] Ibid., 50.

[iv] Solnit, 184-185.

[v] Rumi, “We are the mirror as well as the face in it,” The Essential Rumi, trans. Coleman Barks, (106).

Circle Medicine Series on CLOSLER

Thanks CLOSLER for publishing a series of 5 short articles on Circle Medicine!

Out of One, Many – David Kopacz, 2018

I have been working on this concept of Circle Medicine since I had the realization that a number of different holistic models I was working with all included circles: the Hero’s Journey, the Medicine Wheel, the Circle of Re-humanizing Medicine, the Circle of Health, and Circle Medicine: the circle of circles.

In our forthcoming book, Becoming Medicine: Pathways of Initiation into A Living Spirituality, we have a table comparing Circle Medicine with Linear Medicine. Linear medicine is the predominant, biomedical approach in contemporary medical practice, however it misses crucial aspects of human being that are only found in holistic, circular models of medicine.

Linear Medicine Circular Medicine
Pathological Process Natural Process
Treatment          Transformation
Elimination of symptoms Acceptance of symptoms
Restoring old state    Achieving new state
Disease-based Health-based
Biomedical Model Holistic Model
Evidence-Based Medicine Human-Based Medicine
Hierarchical        Collaborative
Can Foster Dependency     Empowering

Here are links to each of the short articles:

CIRCLE MEDICINE: A HOLISTIC APPROACH TO HEALTH FOR CLINICIANS AND PATIENTS

THE HEALING CIRCLE AS A HOLISTIC FRAMEWORK

THE CIRCLE OF RE-HUMANIZING MEDICINE

THE CIRCLE OF WHOLE HEALTH

CIRCLE MEDICINE

Rainbow Medicine Wheel, David Kopacz, 2017

Happy National Book Lovers Day!

August 9th is National Book Lovers Day in the United States. I’ve been wanting to write a piece on books – specifically buying too many books, but then I came across an idea that maybe too many is not too many. Here are some ideas to make you feel better about having stacks of unread or partially read books – or maybe it will just be an excuse to buy more books!

My home office desk

A 2018 article in Big Think entitled, “The value of owning more books than you can read,” by Kevin Dickinson, has some interesting ideas around unread books. Dickinson summarizes a view by statistician Nassim Nicholas Taleb, of unread books as an “antilibrary.” Taleb wrote about the anti-library in his book, The Black Swan: The Impact of the Highly Improbable. Taleb discusses author Umberto Eco’s library of over 30,000 books. Dickinson writes,

“Eco’s library wasn’t voluminous because he had read so much; it was voluminous because he desired to read so much more.”

One of my bookshelves in my office

This idea of the benefit of the “anti-library” and unread books shows us something about the benefit not of knowing, but of wanting to know. A small, tidy library may be a sign of an ordered mind and tidy life, or it may be a sign of a lack of curiosity about the world and the world of ideas. Dickinson quotes Taleb:

“Read books are far less valuable than unread ones. [Your] library should contain as much of what you do not know as your financial means, mortgage rates, and the currently tight real-estate market allows you to put there. You will accumulate more knowledge and more books as you grow older, and the growing number of unread books on the shelves will look at you menacingly. Indeed, the more you know, the larger the rows of unread books. Let us call this collection of unread books an antilibrary.”

Another book shelf, with my assistant, Corbin, finishing a snack

Dickinson quotes Taleb, “We tend to treat our knowledge as personal property to be protected and defended.” And further, “It is an ornament that allows us to rise in the pecking order. So this tendency to offend Eco’s library sensibility by focusing on the known is a human bias that extends to our mental operations.” Dickinson cites Jessica Stillman’s concept of “intellectual humility,” as focusing on how much we do not know, instead of how much we do know.

My other assistant, Sofia

Dickinson then writes about the Japanese word and concept, tsundoku, referring to stacks of unread books. He says its etymology comes from “tsunde-oku (letting things pile up) and dukosho(reading books).”

Dickinson’s article, “The value of owning more books than you can read,” is a good read with a number of interesting ideas around the value of books beyond knowing the actual knowledge found in the books. I have not summarized the whole article, I’ll leave you to it if you are interested, or perhaps you would rather just go out and buy Taleb’s book and maybe read it or maybe not!

My writing desk and another book shelf

 I thought today, National Book Lovers Day was a good day to write about this thought-provoking concept of the anti-library of unread books which teaches us about the value of having things we have not mastered, always having the next book (or three, or forty) you want to read, and it says something about the value of focusing on what you desire more than on what you have acquired.

Oh, and one last thing, I must have done this subconsciously, but I just realized I’m wearing the appropriate shirt today for National Book Lovers Day!

The Circle of Re-humanizing Medicine – new guest post at CLOSLER

Thanks again to the folks at CLOSLER for the next in a series of guest post on various forms of Circle Medicine & Circle Healing. This week’s post is titled, “The Circle of Re-humanizing Medicine.”

Here is the Takeaway summary:

We need human-based medicine in conjunction with evidence-based medicine. If we only identify as scientists and not as healers, we risk dehumanizing our patients and ourselves.

They also included the Circle of Caring for Self & Others that my sister, Karen Kopacz, designed for use with the workbook of that same name that I have been developing with Laura Merritt. It is based on my 2014 book, Re-humanizing Medicine: A Holistic Framework for Transforming Your Self, Your Practice, and the Culture of Medicine.

Caring for Self & Other Circle

Next week is the last in my series of guest posts at CLOSLER, please check it out. It is on the VA Circle of Health, another holistic model of Circle Medicine.

A Full Circle Re-Treat

30 years ago, July 1989, I bought a Greyhound bus ticket and a backpack and rode 50 hours Chicago to Seattle. I was going to be starting medical school at the end of the summer. I felt a need to make some kind of quest, some kind of initiation into becoming a healer. I needed to get myself into a certain state of mind and a certain state of being in order to start medical school.

The trip was formative in many ways. Looking back it does feel like where I became an adult, a man, and a medical student. I met people from all across the United States and from all over the world as they traveled. I stayed with friends and family for a bit in Seattle and Port Townsend, then I set off for a 2 week solo backpacking trip in the Olympic National Park. I spent days without encountering another human being, but I had many companions along – my portable library.

David Kopacz after backpacking up ridge, south of Mink Lake, in Olympic National Park, 1989

I faced my racing thoughts, which for the first few days went berserk without having anything more to focus on than when to walk and when to rest. I faced my fears of death sleeping alone in the woods with no one around for miles. I put in at Sol Duc Falls, hiked up to Mink Lake and then up to the ridge that led to Hyak and the North Fork of the Bogachiel River. I remember waking up one morning and hearing what sounded like a Native American funeral procession by the Bogachiel River, when I was staying at the Flapjack campsite. I left the national park and hiked to Undie Road. After the beauty of the National Park, I then walked through the World War I trench war aftermath landscape of newly clear cut National Forest. I then hot-footed it up 101 while logging trucks raced alongside me. I reached Forks, but had blisters from walking quickly on the roadside. I limped along 110 as best I could toward the coast, where I was planning to spend a few days. The agony was too much with each step, so I reluctantly stuck out my thumb to hitchhike, because I knew I was not going to make it. The second or third car pulled over and I got in with an old fellow who said, “I’m not really doing anything, if I can help someone else out, I consider it a good day.” He told me how he had lived there his whole life and had helped to build the bridge over the river as he drove me to Rialto Beach. I then spent a few nights on the coast after limping up through the sand to a camp site.

My wife and I almost moved back from Seattle to the Midwest this past year. We where pretty far along in the process when we hit some snags and it fell through. We re-oriented and decided that we’ll stay in Seattle for the foreseeable future. I had blocked out a week of my clinic schedule which was going to be my last week at work and then I was going to drive our second car across the country. I kept the time off and wasn’t sure what I was going to do, until I realized it was the 30 year anniversary of my trip in the Olympics. Then I realized it was 30 years to the month and I knew I had to go and retrace my steps and go on a bit of a retreat, a re-treat, covering again some of the same ground. So I loaded up the car, brought along Henry Corbin, our fun-loving papillon and we set off to retrace our steps.

Dave & Corbin at the ferry

I rented a cabin and it turned out to be on the Sol Duc River, just as I had started 30 years ago at Sol Duc.

Camp at Sol Duc River

Since I had Corbin along, we couldn’t go into the National Park, except for some of the coastal beaches. We went to Bogachiel State Park, so that we could put our feet in both the Sol Duc at our cabin and in the Bogachiel River.

Tree near Sol Duc River

We spent some time out on the coast at Rialto Beach, Ruby Beach and Beach #3.

Then we took a hike up toward Mt Muller in the Olympic National Forest.

Then we drove up north, through the Makah Reservation, up to Cape Flattery, the Northwesternmost point of the continental United States.

I feel I should share some sort of insight or conclusion from this trip – I felt some pressure initially to do so, but once I realized that I was ending up at Sol Duc and Bogachiel, and that there seemed to be a hidden coherence in the trip, I decided to just see what happened. At one point I remember what I told my friends after the first trip, 30 years ago: I had reached a deeper and more meaningful level of confusion!

I did write something that seemed to summarize the trip:

Looking back, I realize now that I live in the place that was the place of my adventure 30 years ago – in other words, I am living my adventure. Who I am now and the amazing things and fascinating things I am doing in my life and work are just what I would have dreamed of for my future life, even more so!

Healing Trauma with the Help of Ceremony from Lukas Budimir

Thanks to Lukas Budimir for this wonderful piece from the Seeds of Peace Newsletter, Issue 12, February 2019, reprinted with his permission and the permission of the editors of Seeds of Peace. For information about the newsletter or to subscribe, please email Marina Budimir at mayarinabudimir61@gmail.com

Healing Trauma with the Help of Ceremony from Lukas Budimir

There are so many ways in which beautiful painted arrows have influenced my life and the way I do what I do that it’s difficult to start writing about it.

Basically everything changes; not so much what I do, but how I do it, because we are all connected with everything and everything comes back in circles. And changes on the inside show on the outside.

You can only access the past and the future in the eternal now – that is why ‘work is worship’ and the effort you put into things needs to be balanced through the connection to your heart so that the seeds of peace can grow out of the soil and bear fruit.

I am not special, I am like everybody else, with all the tasks we have in our lives, because the tasks are there for me to learn and become aware, to place myself in relations and to find a new beginning all the time so I can come back to my childlike innocence. Perhaps I’m just as special as everyone else.

Let’s look at an experience from my life: After caring for and working with people who have experienced severe brain damage for ten years, I decided to move from Denmark back to my native Germany and look for a new job. I thought, perhaps I could work with veterans, so I ordered the book Walking the Medicine Wheel: Healing trauma and PTSD by David Kopacz and Joseph Rael.

What I did find was a job at an institute that claimed to offer homes to youngsters that can’t live with their parents. What I found was that I was working with traumatized youngsters with behavioral problems. My primary goal was to build a relationship of confidence with them. In doing so, I realized they had been hurt on different levels and didn’t, or couldn’t, react appropriately to normal situations.

One example of this is:

A young refugee from Afghanistan comes down the stairs with a boom box on full blast. I tell him to turn it down. After telling him the same twice, I touch him on the shoulder and say it a third time. He turns around in combat mode with his eyes wide open, as if he wants to show me something. And then he grabs me by the throat. Our eyes are very close, and I look right into them. In a split of a second, I can see all the pain that he and his people have experienced.

Reading the above-mentioned book, I finally get to page 161 and read about healing the soldier’s heart.

Here Joseph explains that in every person there is a held back place in the heart where goodness is stored. No matter what we do or experience. He describes how to blow light into the heart, suck out what is in the way, and then, so that the hole does not stay open, seal the heart with your hands. David then explains that there are multiple ways of understanding Joseph´s exercise and how he uses it in his practice. I use it with the 17-year old and he starts to change, becoming more and more what he really is. It becomes one of my favorite ways to help people connect to the goodness that they always have within.

So thank you Grandfather and thank you David for doing what you do and being who you are. And a thank you to Life for its perfect timing, for always giving us a solution just when we need it.

Lukas Budimir, Germany: Soundchambereurope@gmail.com