Arts-in-Medicine I, Spring 2006
Response Paper # 3
Rossi Burns,  4/20/06

Pain, Energy, and the Heart
            My Rule of Bedtime Reading for the Heart while in graduate school is to have short pieces lined up that I can read and finish within about 20-30 minutes.  I choose pleasant pieces – I’m going for: hearty, heartening, heartfelt, heart-warming, perhaps a heart-to-heart with another person, or something hearty-har-har humorous.  (forgive the spelling allowance!)  This is a time when I reach to my bookshelf and pull out slim volumes of poetry, photography or nature books, quirky and silly stories, or inspirational books.  I sleep with a happier heart, usually, if I follow my rule. 
A book that I returned to recently was All Things Bright and Beautiful, by James Herriot.  This book is written superbly with wisdom, humor, optimism - with great heart.  I find I am able to read one chapter, and lay the book quietly down with gratitude, knowing that one man serving as a veterinarian in the Yorkshire dales of England could find poetry and meaning in an artful practice of working with his animal patients, his very human clients, and enjoying the beauty of nature.  A passage from the book caught my eye after we had the lecture on “pain.”  James had been helping a ewe through a difficult birth process in a barn when he noticed another ewe who had been left alone to die in a dark corner.  The farmer gruffly told him she was dying from a difficult lambing and was past help – to ignore her and help with ewe he’d been called out to help with.  This second ewe was in terrible pain, panting, lying in her own excrement and discharge.  James couldn’t stand to know the suffering of this poor ewe, and when the farmer was out of the barn, he darted over quickly to the second ewe, and gave her a lethal dose of Nembutal to put her out of her misery  and let her die more peacefully.  Her breathing slowed and became more regular, and her eyes closed.  James was called back out to the same farm a few days later.  The farmer pointed to a ewe, and indicated that was the ewe that had been dying on his previous visit.  The farmer said that she went to sleep, and stayed sleeping for two days.  Then on the third morning she woke up, stood up, and ate a hearty meal.  She recovered fully by the fourth day.  James wrote that her life “had not been saved by medicinal therapy but simply by stopping her pain and allowing nature to do its job of healing.  It was a lesson I have never forgotten: that animals confronted with severe continuous pain and the terror and shock that goes with it will often retreat even into death, and if you can remove that pain amazing things can happen.  It is difficult to explain rationally but I know that it is so."  What I loved was that here was a man who was not pouring through evidence-based articles and citing sources.  Here was a man who allowed himself to be observant and open to a simple truth that I think holds true for sentient beings.   As Andra Davis quoted in her presentation, suffering is “The state of severe distress associated with events that threaten the intactness of the person.”  (or ewe, in this case!)  The distress needs to be relieved in order to help the healing process, so the being does not retreat even into death to escape.  Or, the pain relief may not be able to aid actual physical healing, but may simply help regain more quality of life during the illness or the dying process.
Pain can be related to our next subject of energy.  It seems to me that when someone is in such tremendous pain, all of their energy is concentrated in the pain.  In “Practical Nondrug Approaches to Pain” it states that a patient “needs a pain relief measure that allows him to rest” and I believe this addresses the issue of where this person's energy is focused. If healing is enabled through rest and relaxation, allowing the body's resources to be used in renewal, then pain and distress get in the way of healing.  Energy was defined as “the capacity to do work, usually expressed as the integral of power and the time over which that power is applied” in Definitions and Standards in Healing Research.  But in the case of pain and healing, we are more often talking about bioenergy, which is believed to “flow through and off living systems.”  When Andra Davis mentioned distraction and cognitive refocusing, she said that these ideas came out of the “limited capacity to focus” model.  I believe that is speaking to a limited capacity to focus one's energy – a limited ability to focus on anything but the pain.  And this is where we may depart from the idea of using just pain relieving medications to enable rest and healing, as in the case of James's ewe.  At this point we don't truly understand the perception of animals, so I can only address what we know of human perception.  Leslie Tuchmann related that in the book Tales from the Night Rainbow, it says that changing a person's perception can change everything.  This speaks to the biology of belief.  On a very basic level, I have felt this happen within myself.  If late at night I hear a noise that I perceive to be threatening - perhaps an intruder- my heart and respiration rates increase, and my muscles tighten up for a possible flight or fight response.  If I then perceive that it must be the sound of one of my sons coming in for the evening, my heart and respiration rates decrease, and my muscles relax.  The stimulus of the noise was the same; there was just a difference in my perception of the meaning of that stimulus.  A notecard I keep strategically placed above my computer as I do school work says, “Where is my energy?"  If I am worried, anxious when studying for a test, concerned I'm not writing my response paper adequately, then the energy available for my writing or thinking is being diverted.  So, this is a question that I ask myself, to ground myself in the moment, in the process.  It speaks to my intention, and my consciousness as I work.
Addressing the idea of my intention can also address the deeper issue of my heart.  For, where my heart is, my intention lies.  When I am most deeply present, most intimately “in the moment” my heart and my intention are congruent.  I think it is so fitting that we are ending this wonderful semester of the Arts in Medicine course with the subject of the heart.  This semester ends the academic portion of my occupational therapy program.  The program has opened my eyes and my awareness to the importance of affirming the value of the various occupations which are meaningful to all of us in our daily lives.  We have learned a great deal in the occupational therapy program about body systems, cognitive, developmental, neuro and motor processes - all of which will be extremely valuable to us as therapists.  But I have always been a person very interested in getting to “the heart of the matter” - and believe without a doubt that healing can be enabled through the wonderful gifts of humor, insight, joy, gratitude, love, and acceptance.  I hope that in my profession I will be able to maintain congruency within my intention and my heart when working with clients, and hopefully be able to help them direct their energy in a way that can help them feel more whole.  Allowing them to take advantage of opportunities to express themselves through music, art, movement, and writing might enable them to gain a new perspective on their changing lives, to free their energy toward healing or insight, and to distract them from their pain or allow them to reframe their experience of pain. 
It is rare to take a class that moves the students to be more “wholehearted,” more congruent with their intention, and their source of energy.  I am grateful to you, Patrice, for offering a class in art, medicine, curiosity, possibilities, and the heart.  And for giving me more wonderful possibilities for my Rule of Bedtime Reading for the Heart.
           

 

Bibliography

Davis, Andra.  Guest lecturer.
Herriot, J. (1973). .All Things Bright and Beautiful . St. Martin’s Press:  New York.
Jonas, W.B., & Chez, R.A. ( 2004). Recommendations regarding definitions and standards in healing research.  The Journal of Alternative and Complementary Medicine, 10, 171-181.
McCaffery, M., Pasero, C. (1999).  Distractions for pain management: Benefits and limitations.  Clinical manual.  Mosby, Inc.
Park, Susan.  Guest lecturer.
Tuchman, Leslie.  Guest lecturer.
Viscaya, Jenna.  Guest lecturer.