Haven't we all experienced a client, family member or colleague, who has survived a trauma or unspeakable war damage, or a gloomy medical prognosis, against the odds? We ask ourselves, why, and how? Having explored trauma and survival in previous columns1-2 I posed these questions to an array of colleagues, with curiosity of their thoughts and experiences.
Hospital Insights?
Irish born transplant surgeon Jacqueline Lappin MD says survival is prompted, in her experience, by the (Hebrew) Chai - life force - some would call it the "divine spark,"she says. Dr Lappin adds, "it's beyond my control – but I can, as a physician and human being, be supportive and nurturing of its presence."
Rochester, New York based acupuncturist and documentary film maker Laurie Kash experienced a youthful "power of the will" as a twelve year old determined to survive the paralyzing effect of Guillain-Barre syndrome, to be able to return home before Passover. "I really had to live because I felt so responsible for my sisters, brother and mother. I knew my death would devastate them."
Kash writes eloquently of her love- hate relationship with her ventilator. When it facilitated her breathing, it prompted a "tango dance" with her voice. She would shout a word. The machine would beep. Kash remembers this vividly, years later. She felt sad when it was finally wheeled away, as though she had to let go of her best friend's hand. The survival experience spurred her choice of a career in Chinese medicine.
PCOM (NYC) assistant professor Yuxia Qiu, who practices both acupuncture and medical Qigong, sums up survival as a reflection of "inner life force" and a desire to complete unfinished things, and to be with people they care about. This is especially true of parents willing themselves to survive for the sake of their kids. Certainly, Elle's editor-in-chief Jean-Dominique Bauby achieved the impossible after his paralyzing stroke, when he was able to dictate his life story just via eye signals to an observant speech therapist. Resulting in the remarkable book, "The Diving Bell and the Butterfly" published a few days before his death in Paris.3
Survival vs. Status
Austin based acupuncturist and psychologist Janet Lee Cook adds a political observation. "Don't underestimate the incredibly strong Qi/will an individual from an oppressed group can have. Often, from what I have seen, that energy is used for the group rather than for oneself." She adds, "the question of what activates survival of the body requires examination through the lenses of various forms of oppression, e.g. class, race, gender, or immigrant status, to name a few." Economic class is an equally potent reason when "frequently, poor people of color have to work two full-time jobs to support a family." Often prompting the health decline of those without access to nutritious foods in local stores, and a choice between rent or paying for medications, which can end up in homelessness.
The Power of Resilience
Austin based psychotherapist Debbie Lyons observed, "some people have more resilient personalities – many examples can be found among kids who seem to have no parenting, no adult support systems, and no social power, but manage to find people to attach themselves to throughout their development, gradually piecing together a life that is radically different from their own. Survivors of child abuse often contain such examples." Also, adds Dr, Lyons, " if survivors of trauma can talk immediately to others who have experienced the same trauma, this can reduce physical and psychological damage and improve healing."
Those of us who work with trauma survivors well know this is a key factor to prevent the compounding impact of trauma if a survivor isn't believed or heard, is dismissed by family members, or has no support network at all. During our acupuncture and shiatsu volunteer work in Austin at a resource center for survivors of Hurricane Harvey, we found our individual therapies were enhanced when folks felt they could share their experiences, their anxieties, their plans. They needed time with us. We gave it to them. But we also honored those folks who just wanted complete silence and peace during the session away from the bustle outside.
A Buddhist insight?
Swiss trained pediatrician and AOMA graduate Isabelle Chen-Angliker, adds another perspective – "the yearning of some to survive as long as they can, in order to, in a Buddhist sense, accumulate favorable karma for future lives and ultimately liberation from rebirth." Ever practical, Angliker adds, "It's not survival so much as surviving, and if the person has the ability to survive (resources, support structures, family, material buffers). She also quotes the example of one of her cancer clients. "She values life quality over mere survival. Her drive for life is living out her creativity, and experiencing/savoring happy moments."
Surviving War?
Palestinian RN Karimah Tarazi – who experienced wars as a child in the Middle East, volunteered at Ground Zero after 9/11. To be able to work in a situation of such heightened trauma for days, she says she goes into "auto pilot" when her instincts and scientific education take over and she places emotions on hold. Once the event is over, she studies, and analyses the experience in order to maintain mental health. This can take minutes to years "to be able to process and move on."
Croatian Darija Klaic survived the Yugoslav war, along with those who "found comfort in collective suffering, knowing you are not alone, and with the strong emotional support of family and friends." She believes this is the reason her cousin – a pianist - survived - after his body was riddled with shrapnel and he lost half his right hand. She also stressed the importance of "normalizing" a catastrophic situation by going on with life as usual with adjustments.
I can relate to that, remembering the moments of reassurance seeing bakers out in the streets selling fresh pita and taxis plying to and fro during the Jordanian civil war I experienced as a former journalist years ago. In fact observing the endless ways in which families survive catastrophic events prepared me well for a future career in Asian medicine.
References
Ferguson PE. Insights From a Cancer Survivor. Acupuncture Today, Nov 2012.
Ferguson PE. Exploring the Link between Pain and Trauma. Acupuncture Today, July 2011.
Bauby JD. The Diving Bell and the Butterfly. New York: Vintage International, July 1997.
As modern medical standardization continues, the field of traditional Chinese medicine has the advantage of comprehensive personalization. For rare or complex cases, deeper consideration of constitution is invaluable. Proper constitutional assessment, especially with first-time clients, can guide desirable and predictable outcomes. This leads to a higher rate of return, and greater trust between you and your patient.
Though the creation of a financially sustainable, health-promoting model feels far away today, we are casting a vision for a full return on health, believing that this compels us to keep one foot firmly rooted in caring for the sick and the other foot firmly founded in maintaining health. Shifting from a fee-for-service model to value-based care using a phased approach is paramount.
Traditional Chinese medicine and the Vedic traditions both offer rich frameworks for understanding human health, emphasizing the balance of physical, mental, and spiritual aspects. The concept of "souls" or spiritual components in TCM, namely Hun, Po, Shen, Yi, and Zhi, bears significant similarities to the yogic concept of koshas. Their similarities and differences provide insights into how these systems contribute to holistic health practices.
