What I Did On My Summer Vacation: I Accidentally Conducted a Personal Study of Integrative Care

Abstract

As a physician, I am a regular witness to transformative experience and its aftermath. The source of the experience doesn’t seem to matter—a grave diagnosis, a trek up Mount Everest, a devastating loss. The need to question, to look at essential values, assumptions, and priorities is urgent and compelling. The answers galvanize intention, injecting it with potency. Patients realize they are living in a habitual way and their responses have some universality. They describe a new clarity and sense of self. They’re emboldened. They are more connected to life and to people who love them. Often they have a new sense of meaning and purpose to being alive. In August, I had my own transformative experience. What I did not expect was that my experience would validate for me the integrative approach from the inside out. From my heart.

As a physician, I am a regular witness to transformative experience and its aftermath. The source of the experience doesn’t seem to matter—a grave diagnosis, a trek up Mount Everest, a devastating loss. The need to question, to look at essential values, assumptions, and priorities is urgent and compelling. The answers galvanize intention, injecting it with potency.

Patients realize they are living in a habitual way and their responses have some universality. They describe a new clarity and sense of self. They’re emboldened. They are more connected to life and to people who love them. Often they have a new sense of meaning and purpose to being alive.

In August, I had my own transformative experience. A deeply disruptive condition, though not life threatening, led me to a frightening depth of suffering and the revelation that life as I knew it, myself, as I knew me, could not continue as before. As I might have expected, the experience changed my relationship with myself, my priorities, and the calculus of choice in my work and private life.

What I did not expect was that my experience would validate for me the integrative approach from the inside out. From my heart.

As a practitioner, I am versed in the literature supporting integrative care as well as the evidence for a mind body spirit holistic approach. I am satisfied that it is an affirming body of scholarship. But I was drawn to this way of working instinctually. I had faith that offering comfort and support, along with scientific and technical consideration, makes better care. I knew that metrics for quantifying this belief are elusive, that the power of the integrative approach can be difficult to measure.

As a patient, I accidently discovered a deeply persuasive way of assessing integrative care. My unintentional research was personal, painful, and, yes, subjective. But it revealed the power of relationship and the interdependency of healing in integrative care. I have been reminded that it works—without reviewing any data.

Sleep No More

My own transformative experience followed a 48-hour ordeal with a kidney stone and was greatly influenced by the fear that I would need surgery to remove it (I didn’t). The crisis passed (pun intended), and I became unable to fall asleep. I took the first several nights in stride. Medical training, medical practice, and, above all, parenthood had acclimated me to periods of inadequate sleep. But this time, when deprivation made me ready for sleep, my awake state did not yield. I couldn’t turn off. I lay awake for hours. I read. Watched TV. Nothing.

As an integrative physician, I love getting to know a patient in order to provide care that is tailored to their individuality. We actively explore their preferences, beliefs, attitudes, and experiences—anything that will guide us in developing approach. I try to see through their eyes, to identify where their curiosity might lead us as we explore how to address their expressed needs. At its core, it is learning about self.

The first steps I took with myself were narrower. I didn’t look deeply. I didn’t take stock of my situation or ask myself to discern what was needed to understand my situation. I simply hoped I would find a quick fix. I tried herbal teas, baths tinged with essential oil. I tried needling myself, exercise, meditation, and chanting. I juggled potatoes standing on one foot. I tried sleeping in my wife’s red flannel cat pajamas (I was desperate.) At best, I would fall off for some dozing before morning. Many nights, I had no recognizable sleep at all.

Reality hit as my condition worsened. I began to anticipate the evening: Would I sleep? If not, would I manage? How long could this go on, and if it did, what would happen to me, to my family? I grew more anxious and began to have panic attacks. During the day I was lightheaded and dizzy. My heart would speed up noticeably with only modest walking. As my fatigue increased, I struggled to get through the end of the workday, needing to lie down between patients. My anxiety amplified.

I finally realized that this was going to require the same process of discovery that I offer patients. I needed to make some space, to create a chance to focus without managing competing demands for my attention. I decided to take a leave of absence and get some help.

After 2 weeks of leave, I figured out how to get some sleep every night. It took a combination of a structured schedule, medications, and some supplements. I began regular daytime exercise, ate balanced and scheduled meals. I journaled as a process of self-reflection and self-organizing, and I followed a plan in the evening to prepare for sleep—quieting activities, including meditation and breath work; a variety of somatic relaxation techniques, a bath, timed nutraceuticals and medications. It was a dedicated production in sharp contrast to the chaos that was my previous organizing principle.

Ten weeks later, I still needed medicine to sleep but less. I relaxed the strict schedule of the evenings but stayed true to the spirit of supporting the transition from the day to the night, of giving myself time to reflect and be quiet. I became devoted to the practice of Metta meditation.

I also began to understand how an integrative approach influences the transformative experience and the healing that follows, how patient-directed curiosity and exploration can enhance the depth and intimacy of the transformation. I felt ready to go back to work.

The Love You Take

In conventional medical settings, team work is often a technical construct involving clear roles and objectives, efficient use of resources, and outcome driven by metrics. In integrative medicine, the definition of team work is collaborative care planned by a group that includes the patient. Delivery of care, attending to patients, clinical discussion and coordination are all managed in an environment of relationships, of fellow human beings working together. We see it as an opportunity to promote and nurture, to cultivate connection and caring. From this culture, we believe, healing grows.

I knew my workplace to be a healing and supportive environment. As important as it was for me to take time off, it was also hard to be away. I didn’t know if I was ready to come back to work; but I wanted to be surrounded by coworkers and colleagues who are a part of my true family. I also wanted to be with patients, the fellow humans who tolerated my bad jokes with remarkable resiliency.

My instincts were right. In the circle of my team, I was checked in with frequently, asked if I needed a hand, asked if I’m sure that I’m not taking on too much. I saw more vividly the warm gaze of those who care about me, the deep listening to my story, the caring smiles as I walked the hallway, the playfulness and teasing I received as I was assisted in countless ways.

When I began seeing patients again, I was not prepared for their reaction to my return. I was met with tears of welcome, hugs held robustly, prolonged moments of presence without words or awkwardness, refusals to give me updates before I gave mine. Many shared with me concern that I give myself time. Was it too soon? I was urged not to push it, they would wait awhile before coming back. Some brought fruits and treats, cards, letters, and poems, all expressing their deep felt concerns. Still others just dropped by for a hug, to express, in person, their concern and to tell me that they’d wait for me. So many said they were glad I took time for myself.

I have always been attentive to the relational aspect of my work with patients. It is a foundational part of integrative practice, and coincidentally, it has been my nature to think and feel like a fellow traveler, a companion who has some technical and experiential knowledge to share but is also just another human being. But I did not understand the degree to which my patients have been just as attentive to fellowship, empathy, and care in our partnerships.

My experience upon return to practice exposed something new to me, something which is now so much clearer though, I struggle to communicate it. It’s a feeling of reciprocity in these relationships at a conscious and visceral level. I am receiving in a new way—actively absorbing the feeling of being cared about and taken care of by patients. It’s a mutual caring, a respecting and honoring of each other. There’s compassion and empathy and, not infrequently, love. How else to say it? These are holy moments in this sacred space.

I have found it hard to describe what I have received in the wake of my transformative shift. Overwhelmed is part of it. Comforted is a bigger part. Healed also sounds right. Like others in the wake of these experiences, my gratitude for its collateral enrichment has overshadowed the trauma of the ordeal. The dimensions of my experience are seemingly richer and vibrant. I am infused with a collective life force. It feels good to hold each other in this work we do together—in our shared lives. It feels more than good. It feels necessary.

Supplemental Material

Supplemental material for What I Did On My Summer Vacation: I Accidentally Conducted a Personal Study of Integrative Care

Supplemental Material for What I Did On My Summer Vacation: I Accidentally Conducted a Personal Study of Integrative Care by Draisin Jeffrey MD in Global Advances in Health and Medicine