The Only Good Doctor is a Compassionate Doctor

It seems my last post made it clear how I've been suffering with my bipolar disorder, compounded by the death of a friend and a funeral that did me - and another friend - more harm than good.  I heard from several compassionate readers.  (I want to include here a painting I did Sunday night that vividly illustrates the high and low, but technology is defeating me.  Maybe tomorrow.)

The background:  the last time I saw my trusted psychiatrist he told me he couldn't do squat for me.  (You can read the post I wrote then here.)  Nothing.  He suggested meditation, which showed me that he hasn't heard a thing I said, or if he did, didn't write it down, or if he did, didn't take time to look at my file.  I told him I've been meditating since I had cancer in 1997.  That's not the kind of thing they think matters.  I was wrong to like him as much as I did.  I'm sure you should never trust a doctor who always runs on time.  We don't need clockwork doctors.

The whole problem with a teaching/research hospital is that the doctors who survive there are the kind who want to do research and pontificate in classrooms.  These jobs use areas in the brain (and ego) that have little to do, I am sorry to say, with humanity or compassion.  OSU is infamous around here for its unfriendliness, but we experienced similar contempt when we visited the Cleveland Clinic a couple of years ago.  I suspect teaching hospitals are like this unless a considerable effort has been made to be friendly.

The whole idea of doctors doing research and teaching hospitals nests in the whole idea of Western Medicine, which I am beginning to call a Parliament of Clowns (or choose your obscenity).  Here is a neat illustration that I pulled off the internet comparing Western Mechanical-Man medicine to traditional Chinese medicine, which views the body as a garden:

(It's fun to blow this up, print it, and color it.)  It is very Western to think with the left-brain, to respect advances in technology, to believe that enough money and knowledge will cure you - and that's how all the big hospitals advertise, too.  They are cutting-edge, they save kids with weird cancers.

The brand of Western Medicine I have been unfortunate enough to live through, which misdiagnosed me for three years (I almost died of suicide), then ruined my kidneys with lithium, then charged me $200,000 for a transplant, and then didn't  give a damn what happened to me after that - is actually American medicine.  I hear things are better in European countries.  American medicine is profoundly influenced by the American Dream, the get-rich get-status gunplay frontier attitude on which this country was founded by a bunch of  fortune-hunters and misfits (and a few good men).

At present we have a medical profession run by rich old white guys and the occasional Queen Bee, too many of whom went into it for money and status.  Too few went into it out of compassion, out of a desire to relieve suffering and heal the world.  (And I do know those doctors exist.)  People who want to help others often go toward the helping professions, ministry, nursing, teaching, massage, alternative healing modes.  Who can afford med school, anyway, but the sons (and, recently, daughters of the rich?  And who can endure the brutal frat-boy hazing system of internship and residency, which is not nearly as much fun as Grey's Anatomy makes it look.

What do you do when a system is broken at its very foundation?  Anyone can tell you it's going to be a long long uphill climb of the Sisyphus kind.  Nevertheless, we should try.  Here are my suggestions:

1.  Medical schools should begin screening with psychological tests all applicants who look smart and diligent enough to be admitted.  Test for this:  compassion.  Test for what we call people skills.  That shouldn't be too hard.  Further, interview selected candidates.
2.  We patients should begin interviewing and evaluating our doctors.  What is their spiritual practice?  Why did they go into medicine, why this field?  What do they do when they don't know what to do for a patient?  (Throw her out in the snow?)
3.  We should all begin asking ourselves what each of us can do to bring attention to this awful mess, how we could suggest corrective measures.  (Don't overlook the ability now to rate doctors on internet sites.)
4.  You should print out this post and send it to your doctor.  Or former doctor.

I myself intend to write that doctor a letter, striving for compassionate communication, explaining to him how this has affected me.  Try to show him that it was appalling to dump me - a known suicide risk - out here without any help in coping with this dangerous mental illness.  I want to suggest he consider going into administration full-time.  He's already rising in that department and told me he likes it.  He likes being busy. 

I may also write to Les Wexner, a local rich man who has given OSU so much money that his name is now part of the name of the OSU Medical Center.  I don't need to mention the bad doctor's name; the point is not to punish an individual who thinks he means well.  The point is to examine the very premise of the place.  If anyone is in a position to set a few balls rolling and shake things up, it's Les.  As I think about it, such a letter sounds to me like skillful means, one of those Buddhist concepts.

I won't have time to do this today.  I highly doubt I will be able to do it tomorrow.  It's been day UP/day down since I went off Seroquel, and that would make tomorrow a down day.  Those days it's a real struggle to get dressed, to drink my water take my pills on time and eat halfway right.  To somehow distract and amuse myself during the endless blank painful hours of a day like that.  To fall asleep.  But maybe the day after that.  After all, I have taken the Bodhissatva vow, to save all beings.  You have to keep working at it from wherever you are.

I Vow to Save All Tomatoes

Vertiginous path with nodding onion

Yes, it's Jeanne back today, Tashi being closed out of the room, because she eats the blind cords. She hates to be closed out.  I hate to think what she may write about that next time she gets access.

As it happens, already this morning my e-mail has brought me two posts from people who feel over-whelmed. As I told both, I understand. At this moment this morning I feel okay, fine, even.  Last Friday was a different story. An hour from now could be a different story.  You can always analyze why this happens to you, and you hope you can learn from it and avoid it in the future, though sometimes it is all unavoidable.  And all you have to work with is now - what to do now?

As for unavoidable, one of my friends has the Attack of the Killer Tomatoes coming on in her garden.  (That's an actual movie, by the way.)  Of course this year, crops doing so badly with all this weather, you have to love a decent tomato. But in the past, in mid-America, one was always deluged with the damn things, not only in your garden, but in everyone else's too, so people would give them to you, and other people would refuse to take them. There they all were, a flash mob on your kitchen counter-tops and table and the dining room table, too, crying out, Save me.  It was a sort of ugly version of what happens when you take the Bodhissatva Vow to save all beings, and you look up and realize, wow, there they are.  A sea of people drowning in their suffering.  Only it's a sea of good food that will die unfulfilled unless you do something with it.

I wonder if it would be helpful to think back on what was going on with me at that time in my life when I was deluged with tomatoes.  This was about ten years ago, when we lived in the Cape Cod in which I had creatively, haplessly, installed thirteen gardens. One of which was heirloom tomatoes from the seeds of last year's heirloom tomatoes.

At this time I had gotten myself overwhelmed with too many projects and responsibilities outside the tomato realm, all of which I took very seriously.  Now, there was the problem, right there, beyond my difficulties with time/impulse management. I believed - I had been conditioned in my upbringing to believe - that it was very important to always do what you said you were going to do.  I had not learned that it was no big deal to call someone and say you have to cancel.

Add to that, it was important to do it perfectly.  Not just okay, not just show up, but give it your very best, excel.  Looking back I see this belief contributed to my father's insanity, and thus to that of everyone in the family.  I don't want to spend time remembering what it was like, my childhood.  Anyway, I think that way under these ideas was a terrible sense of insecurity, of trying hard to be good enough. But look at it another way and you can see that an idea like that will make you feel inadequate.

Now, in practice, you can bag up the tomatoes and take them to the food pantry.  You can leave a box of them at the door of the church Sunday morning, and people will probably take them home.  You can just say the magic words, "I can't."  I can't.  This is a kind of surrender.  Looking back I can't believe how hard it was for me to do.  I just can't.  It seemed like caving in, giving up.
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Next day: Yesterday I had so much more to say on this, oh my.  Then I had a too-busy day yesterday, too much stimulation for sure in going to a 3D movie, that cave thing.  3D is not like reality at all, and scrambles your brains.  I didn't care much for the movie, either, though it did make me feel like getting out my charcoals and seeing how they would do ensos.  (Hello, Genju.)  It amused me to imagine someone asking me my opinion afterward, which would have enabled me to say, "I haven't seen 3D in fifty years."  Thus.

Peter Singer is still battering my heart (see yesterday's post) to such an extent that I wanted to look up John Donne's sonnet of that title. Yet, I cannot stop reading, am eager to finish the book so that I know how much money he thinks I should be able to give away. I am nervous about this. We live on pensions, most of which is taken up with living expenses. But it is feeling imperative to keep reading this and thinking about how I live, eating beef as I please, driving a second car.

Singer is one of those natural teachers, cutting through to clarity about a situation with a Zen-like blade. He describes many people who work to end extreme poverty. Just now I am reading about a doctor, Paul Farmer, cofounder of Partners in Health, who has devoted his life to serving the poor in Haiti for many years before the earthquake.

And just yesterday I also got the first letter of this year's pledge campaign from my church. They want a stunning 5% of my gross income. I will pledge, but I am thinking about how my church enhances lives in many ways, including my life, but does not do much to save them. In fact, I think my specific church has not contributed to the national church and its social justice programs for a several years.

Here is where I stopped reading to look up Partners in Health and write this post:

Flying from the peasant huts and their malnourished babies in Haiti to Miami, just 700 miles away, with its well-dressed people talking about their efforts to lose weight, Farmer gets angry over the contrast between developing countries and the developed world.

He seems to have taken the bodhissatva vow to heart.

What counts

Buddhists talk about taking the Bodhissatva vow. It is a vow to stay on this earth through many lifetimes (and not go to nirvana) until all beings are saved. If you don’t believe in reincarnation, it makes sense to interpret it as a metaphor: a vow to stay in what Kierkegaard called “the finite,” the everyday world, and not relax in a bliss that is far removed from the world of creatures. The Zen metaphor for staying in a removed place of purity and calm is sitting on “the hundred-foot pole,” like a religious hermit, looking down on the marketplace from far away, not involved.

I remember exactly when I began to get that koan, “How do you get down from a hundred-foot pole?” I was at church, having coffee in Fellowship Hall and talking with a member of the Zen group I sometimes sat with at the time. He talked about a problem the group was having - I’ve forgotten now what it was. Suddenly I realized, I shouldn’t be talking about this - I should be in there helping. Then I thought, That’s what they mean about getting down off the hundred foot pole.

The pole is the state we bring back from a good retreat, the calm, removed state we mistake for “enlightenment” or “being saved.” I remember once telling another Teacher in great frustration, “I was enlightened, I had it, I know, but I keep losing it.”

He said with rare abruptness, “Enlightenment is not something you hold on to.” I suppose he explained it further in his talk that night. It was years before I got it, though, and that was from reading another teacher, Lama Surya Das - “There is no such thing as enlightenment - there is only enlightened activity.” Clearly, that activity must take place in this created world, our every-day every-moment life.

And further, it is action that counts - not mood or a state of being. Good intentions? The jury seems to be out on that. But when you look at it case by case it becomes clear that how we act is, after all, what counts. What happens in Vegas, whether it's adultery or losing the farm, doesn't really stay there, but makes its way out into the world, sometimes with sad consequences.

I always thought the idea in the song attached here (interpreted by Elvis with effortless beauty) was questionable. It made me think the songwriter cheated on his wife and neglected her - well, a singer on the road, you know, all the temptation - and what he did wasn't supposed to count because . . . well, because he maintains he was always thinking of her when he did it. As pretty as the song is, I kind of doubt that. In fact, I don't even like the idea. My reply, when I was a Christian, would have been, "Faith without works is dead." Another case where the religions seem to come into agreement.