Why Don’t Doctors Give More Hugs?

need a hugA few weeks ago, I went through a thorough brain evaluation at a place called the Amen Clinics (I really hate that name as it sounds like some hokey pray-it-away sort of religious place. It’s not, but so far they have ignored my comment card suggesting a new name), and part of the work-up involved sitting down with one of their therapists to go through my entire history with mental health problems. When I sat down on her couch, I saw here Wake Forest diploma on the wall and we initially connected over having both gone there. Over the course of the interview, it came out that we had also gone to the same high school, were both the 4th of 5 children, and had dealt with nearly the exact same sort of behaviors and coping mechanisms throughout our lives. It was both eerie and extremely comforting to meet someone who is so much like me.



After the meeting was over, I stood to leave and felt that rising awkwardness of uncertainty as to the appropriate physical gesture in this situation. Under any normal circumstances, it would’ve been one of those long, I-just-met-you-but-we’re-already-life-long-friends sort of hugs. But these were “professional” circumstances, and the normal gesture would be a handshake, even though that felt remarkably formal and awkward, too, given the conversation we’d just had with our own dopplegangers. In true OCD/anxiety fashion, I gave her an awkward hug and then proceeded to second guess myself for the next week about it.

This encounter reminded me of the time 5 years ago when “the cheese fell off the cracker” (as a friend puts it), ultimately leading me into a 3-day-stay in the mental hospital. As said cheese was falling, I was desperately grasping at any help I could get from a medical professional. As such, I visited my primary care doctor for a second opinion after my psychiatrist (not my current one) told me I was “just depressed.” Well, duh.

As usual, the doctor’s visit was preceded by the nurse who took my blood pressure, etc. When I told her how I was feeling, I started to sob – something I did more of in those few days than the rest of my adult life combined. She did something very, very weird and extremely “unprofessional”: She hugged me. And I mean it was not just a pat on the back hug; it was a long, let-it-all-out-now-Tim sort of hug (just in case a few certain friends who shall remain nameless, who can turn buying deodorant into a sexual joke, are reading this, I feel the need to clarify: this nurse wasn’t one of the sort that Matt or Kevin (oops, I outed them) are probably imagining. She was a grandmotherly sort of nurse. Sorry guys!). Ironically, the doctor himself couldn’t have been more opposite in his reaction. He acted almost offended that I was seeking a second opinion from him and said in no uncertain terms that anti-depressants CANNOT cause depression despite the black box warning on all of their labels (I was convinced that my depression had to do with a new anti-depressant I had tried). He literally said this to me: “Anti-depressants probably make suicidal people feel just enough better to act on their impulses.” Ohhhhhh, that makes sense, mister doctor! Someone who can’t even get out of bed finally feels well enough to do so and his/her first thought is, “Finally I have the energy to load my gun and off myself. Thank God! Actually, I’m feeling so much better I might just draft a doozy of a suicide note, too!”

In reflecting on these two encounters which took place in the same examination room 5 minutes apart, I came to 2 conclusions. First, just because someone is “book smart” enough to become a doctor does not make them emotionally intelligent or even good at their job. As one of my friends who actually is a doctor once said, “Doctors are essentially highly trained mechanics.” My translation: Doctors may know the human body, but they may not be very familiar with the human condition. Second, doctors of all sorts should give more hugs.

I know, I know…they’d get sued. But I can say from a lot of experience with all sorts of doctors (my brain isn’t my only problem. Soon I’ll be starting blogs about back pain, digestion issues, sinus problems, and heart palpitations) that doctors are some of the least qualified people to care for the suffering of humankind. I’ve encountered so much more in the way of common human decency from teachers, counselors, ministers, etc. than from the sum total of doctors I’ve seen. When I wrote my book and expressed my dissent from the traditional Christian view(s) of hell, I worried that everyone I knew would tell me I was wrong and attack me. But that only happened with 2 people: a Southern Baptist and, you guessed it, a doctor. Everyone else who read it expressed what you’d hope – compassion, understanding, and care for me and my internal struggles. I find it interesting that a doctor was one of the ones who was more concerned with being right than with expressing human decency. As for the Southern Baptist, well, you can’t squeeze blood out of a turnip now, can you?

In my doctoral dissertation, I essentially made the same argument about teaching that I’m making here about doctors: Both professions involve a fundamentally human encounter. In the English classroom, we encounter the human experience in the form of literature about the human condition. In the doctor’s office, we (doctor and patient) encounter the reality of our human frailty. In the doctor’s office, we come face to face with the fact that we are sick; we’re actually in the process of dying, and nowhere is this more obviously true than in a doctor’s office. But in both the classroom and the doctor’s office, too many professionals prefer to “keep their distance” and to BE “professional.”

But I ask this to every professional who comes face to face with the human condition: Would you rather keep your distance and miss the chance to help hold someone who’s suffering up for a brief moment or take the chance of being misunderstood once in awhile while acknowledging our shared humanity with the people we work with and for? Either way there’s a risk involved. In my opinion, the risk of ignoring people’s suffering and simple humanity is fraught with far greater potential danger than the dangers involved with a gesture of compassion like a hug or shared tears or a personal email/note acknowledging the common ground we all share. Sadly, when I make this argument, I always feel the need to add the caveat that I’m not suggesting candlelit dinners with your smoking hot clients so as to affirm their humanity. I’m not suggesting free back rubs for your patients, students, or clients. Yes, these things will get you fired rather quickly (or divorced, or imprisoned). But why do I even need to say that? Of course those things are improper. But when a patient is sobbing in a doctor’s office, what’s so wrong about hugging that person? Or when a client turns out to share your exact same background in nearly every way, why can’t the meeting end with a hug that acknowledges our need to connect with others, to be understood?

So, though I am not a medical doctor, here is my prescription for everyone: Give more hugs. And while you’re at it, be honest enough with people about your own humanity that you might get a hug or two as well. We’d all be a lot better off with more decency, more compassion, more honesty…

And more hugs.



PS. As I’ve been doing lately, I’d like to encourage you to think of someone who might need a hug or a pat on the back or to read this post and reach out to them. The purpose of this blog is for you to know you’re not alone in your struggles. If this has done that for you, please share the love and let someone who might be suffering in any way, shape, or form know that they are not alone. How you express it doesn’t really matter…just do it. (Sorry, Nike!)

And one final plea for your help: If you find this blog helpful, you’d be doing me a big favor if you’d “follow” it by entering your email address either at the bottom of this page or on the home page (right-hand side) rather than relying on Facebook or Twitter to get these updates. I’m trying to develop this blog into something that broadens beyond my immediate circle of friends, and the more people who follow the blog, the more likely that is to happen via search engines, etc. You’ll get an email when I post…otherwise, nothing will change. And I certainly won’t ever do anything with your email like sell it to cats.com so you can get cute cat quotes and pix (though, who wouldn’t want that?!). But really, it would help me out if you’re so inclined. Thanks!

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Mindfulness and Your Favorite Color

Buddy gifYesterday at my psychiatrist’s office, I knew I was in bad shape when she seemed baffled and disheartened by my current state. She started throwing out words like “treatment-resistant depression,” “ECT” (electric shock therapy), and “alternative methods.” Eesh. What to do? Every therapist or doctor I’ve ever seen ends up saying to me, “Yours is a complex/difficult case, Tim.”

I suppose this is because there are no clearly-drawn lines inside my head. Between bad brain chemistry and a complex personality, I’m apparently somewhat of an anomaly when it comes to my psychological well-being. As a very tangible example, I submit this: The two strongest drives within me are for a) authenticity and b) people-pleasing. Ponder the paradox of those impulses for a moment, and you see a bit of what leads therapists to tell me my case is a tough one. On the one hand, I simply cannot stand fakeness in any form, within myself or others. I am compulsively honest about who I am (thus this blog!). Yet I am also petrified of disappointing people, and even the slightest hint of disapproval from those I love leads me to intense anxiety. Argh.

Another of my “complexities” is my inability to let go of the “big questions” in life. I ponder them incessantly. Just this moment, as I sit at Einstein’s Bagels, one of those cute, sweet little old men is talking to whoever will listen about what an answer to prayer it is that so many Republicans won the elections yesterday. One of the people he’s managed to engage seems to agree with him, but another is annoyed by how many incumbents kept their seats. And I’m sitting here thinking, “Do you honestly think that God answered your prayers by letting Republicans get elected? Do you realize that there are countless Christian Democrats and/or Independents who were praying for the opposite result? And if God is willing to answer your prayers, what does that say about those whose prayers aren’t answered, like my friend Riley’s prayers for relief from his brain that were never answered, leading to his untimely death? Or the 6 billion other examples every day of valid, urgent prayers that fall on deaf ears? How can a reasonably intelligent person possibly believe that ‘God answered his prayers’ with Republican victories?!'”



At this point, you’re probably, and rightly, thinking, “Geez, Tim, let it go. It’s just a little old man looking for someone to talk to.” Ohhhhhh how I wish I were able to do just that, but you see I have this “beautiful brain” (that’s what my doctor calls it; I call it a piece of shit.) that refuses to be still or quiet or peaceful. Ever. Even when sweetlittleoldman expresses his silly views, I’m wandering down the road of who-is-God and how-does-this-all-work and how-can-well-meaning-people-come-to-such-different-conclusions?

I’ve thought about these big philosophical questions for so long and from so many different angles that I’ve come to the conclusion that, for me at least, these fundamental questions simply do not have satisfying answers. Why do children get kidnapped and sold into sex slavery? I have no idea. Why do people like Hitler slowly rise to power while God does nothing about the situation until 6 million of “his chosen people” are dead? No clue. Why do I often hurt the people I care most about through my own foibles and demons when all I want is to do what’s right for them? Don’t know. If a god exists, s/he has never felt the need to explain things to us in any satisfying way. Every religion will tell you that theirs is a truly satisfying answer, but I beg to differ based on the simple fact that there are sincere seekers of God in all religions who have come to fundamentally different conclusions. At the very least, this makes God a not-so-stellar communicator.

All this, of course, leads me to this question: What’s your favorite color?

Here’s what I mean: You probably have a favorite color, but if I were to ask you why it’s your favorite color, you’d probably laugh and say, “It just is” or “I just like it.” There’s no answer to why you like it. You just do. And maybe that’s the same for the big theological and philosophical questions. There are no answers. Or at best, the answer is the cliche: “It is what it is.” Could anyone really explain why green appeals to them more than red?

It is what it is.

Maybe it’s the same with all of the big questions, too. It just is what it is. Don’t bother trying to understand why 9/11 was allowed to happen or why the Kardashians seem to be rewarded for being shallow and selfish (that one’s intended as a bit of levity in a heavy (so far, but be patient with me) post…I don’t actually equate 9/11 and the Kardashians’ fame). Some things have no discernible explanation.

Lately, I’m working on “mindfulness” – a practice born out of Buddhism that seems like one of those “duh!” concepts not worthy of giving a lot of thought to as it’s so simple. I have long believed in the idea behind it, but I have never pursued it or made it a daily practice until recently.

Here’s the basic idea: Whatever you’re dealing with right in this very moment is the hand you’ve been dealt for right now. Rather than trying to wriggle free of the negative aspects of your current experience, accept it, AND give yourself grace both for experiencing it and for the difficulty you may have accepting it. Put more succinctly, mindfulness is the practice of being fully present in the current moment with a non-judgmental attitude.

Lately it’s my depression that lays on every cell of my being like one of those lead blankets you get when having X-rays taken. As I feel the weight settling in on me, I tend to think, “Not again!” or “Dammit, this medication isn’t doing its job,” or “I want out of this brain/life!” After practicing mindfulness for a few weeks, I have developed the hint of a new attitude toward my depression. Instead of the normal thoughts, I been trying to say this to my pal depression: “Ok, depression, I will just allow you to exist today. Instead of running from you, I will actually sit here and allow your presence without judging what it means or asking ‘why me?’. Since this is the hand I’ve been dealt in this moment, I might as well be fully present with these feelings, and I might as well forgive myself for feeling this way as I can’t force it away.”

I’ve spent my life looking for ANSWERS that will solve my inner turmoil once and for all. Usually, these supposed answers are religious in nature. How many times I have thought, “Aha, now I know why God has given me this struggle!” But those religious answers have all been drained of substance and meaning for me. At the end of the day, French philosopher Albert Camus is right: No philosophy or theology has solved the age-old philosophical quandary about God: S/he is either not entirely good or not entirely powerful. But Camus, believe it or not, has an optimistic conclusion very similar to the philosophy of mindfulness. Camus uses the ancient Greek character Sisyphus to make his point that any existence can have meaning and purpose, even in the absence of Cosmic Direction. You might remember that Sisyphus’s eternal fate (damnation) is to roll a giant boulder up a hill for eternity without ever reaching the top. Camus concludes that any fate, even rolling a rock up a hill or battling depression or facing a tragedy or simple daily boredom…can be assigned meaning. In fact, it is when we say that one fate or existence is inherently better than another that we get in trouble. For now, the rock I must roll up a hill is called depression, and the hill feels unclimbable. So what do I do? Camus says I have two options: 1. Kill myself (He really does say this; I’m not being dramatic). Or 2. Quit expecting a divine answer/explanation and roll my rock up the hill, not in order to get to the top, but because any and all fates can be imbued with meaning through our own freedom to choose to opt IN to each moment rather than OUT of the moments we consider unpleasant.

Camus called his philosophy Absurdism, by which he meant this: If there is a Big Meaning to all of our questions, we as human beings have never and will never have access to it. It is, therefore, “absurd” to continue beating our heads against the wall of “Why?!” Just like countless religious mystics, Camus concludes that this moment is all we have access to, so we’d better get busy “making meaning” in this very moment, whatever it hands us. To put it in more supernatural terms, this moment IS eternity. NOW will never quit existing, but if you wish NOW away, you have chosen to “kill” this moment and/or yourself. The choice is yours, every single moment.

One final thing: I’m a seasoned veteran in new-ideas-that-will-supposedly-fix-me, so I’m not remotely offering this as The Answer or The Solution. But I will say that this particular practice has led to one very tangible benefit for me…I’ve quit picking at my fingers until they are raw and bleeding, something I’ve done for my entire life. The practice of “being present with my breath,” as mindfulness teaches, along with the practice of accepting what each moment brings, good or bad, has alleviated a lot of my nervous energy. For the first time ever, there are no scabs on my fingers. So, whatever else may come of this new practice, at the very least, my fingers have appreciated the reprieve offered by mindfulness.

Since I grew up in Southern Baptist churches, you’ll forgive me for having a 2nd final thought: If you’re interested in doing some of these “mindful meditations,” there are lots of apps and lots of stuff on YouTube that will get you started. Plenty of the instructors are ridiculously annoying – like they’re trying to sound mystical and magical. But there’s so much out there that if you don’t like one person, just move on to someone else. I highly recommend the app called Headspace. It walks you through 10 minutes of mindfulness for 10 days. It’s a British guy, and he talks in a completely normal tone so as not to annoy easily annoyed people like yours truly (you can check out Headspace here). Whatever “instructor” you choose, I’d love to hear if this helps you make some tangible progress. Give it a couple of weeks and, if you’re so inclined, let me know.

 

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Antidepressant Side Effects: Weight Gain and Hurt Feelings
This isn't actually me, but I do like the t-shirt.

Antidepressant Side Effects: Weight Gain and Hurt Feelings

I stand an imposing 5’9″ with an average build, so I should probably weight 160 to 170-ish. But ever since starting bi-polar medication (Seroquel to be exact) I can’t lose weight. I spent all of last summer exercising diligently 4 times a week for 45 minutes at a time…and doing the “fat burn” session to boot…only to lose exactly 0.0 pounds. Nothing, zip, nada. Still feel like the guy in the picture below after all that hard work!

In reality, I only weigh 196.6, so I think it’s fair to say that I’m still pretty normal insofar as Americans go, but sometimes I feel like I should go on Biggest Loser. Other times, it feels nice to have some heft – a sort of way to mark my territory in the world around me. But unless I want to go off of Seroquel, it’s probably there to stay, joining whatever future pounds find their way to my mid-section.

This past Sunday my wife and I were packing to return from a trip to visit extended family. I pulled out the electric scale from the bathroom in order to weigh our duffel bags so as not to exceed the 50 pound airline limit. The relative in question, who shall remain anonymous, stood looking over my shoulder at the scale, apparently unaware that most people’s weight is a matter of some sensitivity.

There it was: 196.6 lbs.

Not only did said relative stand there staring at the scale as I weighed in, s/he was also kind enough to comment: “Woah, 196, geeeeeeez!” s/he said with genuine shock at the number (I guess I carry my extreme fat well, right?!).

Time for Biggest Loser, I guess.

Perhaps I’m just looking for an excuse, but anti-psychotics like Seroquel are notorious for making the battle of the bulge quite difficult. I suspect it is at least somewhat to blame for my inability to lose weight. Even if it’s not, I was annoyed the the general oblivion this person was demonstrating toward other people’s struggles. Maybe I seem like someone who can take it, but the truth is, I’m not. I’m one of those terrible sorts, unfortunately, who can dish it out but can’t take it. I suck at taking it!

Here’s another example: At a recent dinner, some other anonymous relatives noticed my bleeding fingers – thank you incessant anxiety that prohibits me from sitting still. After allowing them to examine them more closely, one of them asked if my fingers hurt. “Hell yes they hurt,” I said. The response: “So why don’t you stop?”

There it was after 38 years of picking at myself…THE SOLUTION! Just stop. I immediately took the advice, quit being anxious, quit picking my fingers, and I’ve never been anxious again.

Actually, I shot this person an internal bird and went on picking my fingers…and went on wishing that these people who genuinely love me and care about me would do their part to be sensitive to the battles that rage inside of me.

To be entirely honest, I’m probably more guilty of these sorts of insensitive comments to others than either of the offenders above. As a teacher, it’s rare that I make it through a day without regretting some jab or joke I make in class (I’m well known for my filter-less mouth). Nevertheless, both of these episodes really pissed me off, and if I could have a do-over, here’s what I’d like to say in response to my recently hurt feelings:

“Listen, I’m doing my best here! Every day is a roller coaster of my own bad brain chemistry mixed with the medication side effects that I HATE but that are better than the alternative. Cut me some slack! If you’ve known me for more than a week, you should know that I’m not playing with an ordinary deck of cards. I know my charm and brilliance mask my inordinately screwed-up brain chemistry, but news flash: I’m messed waaaaaaay up! So back off and let me pick my fingers and struggle with my weight in my own way.”

Did I say any of that? Nope. As usual, I sunk inside my head, thinking about how no one understands and how lonely I feel and started telling myself that maybe I’m just making a bunch of excuses for my problems when really I could easily fix them all. Maybe what I call antidepressant side effects are cleverly masked crutches meant to prove that I really have a problem when I actually don’t.

But seriously, people, I do.

anorexia

 

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