Healing for healers

Tomorrow I have the profound honor and gift of holding space for family medicine physicians-in-training.

This holds deeply personal meaning for me–a person of medicine, trained as a family medicine physician, having practiced as a primary care physician in my community for fifteen years. I was at the point in training they are now–having completed that intense first year, going into the second of three–nearly twenty years ago.

As I prepare for this retreat I consider what has changed about the healthcare system, the practice, the technology, the business side of medicine. The pressures, the endless bureaucracy, the soul-crushing impossibilities of managing the fifteen minute office visit while endeavoring to perform (at least) thirty minutes worth of high stakes decision making, offer deeply personal existential guidance, or even establishing trust-facilitating rapport. I am considering the beautiful, sacred nature of the archetype of healer, of the response to a call to service as old as our human family. To help someone to heal. The opportunity to walk our own path of healing in the process.

There are sacred questions that may serve wayfinding for those walking this path of becoming a physician these days. How does one hold fast to  integrity, to sense of self, to purpose? How do we keep a vision of possibility alive within a system that, while affording us the great gift of being a practicing physician, is also commodifying what many of us hold as sacred work? How do we hold this lightly enough to traverse the depths, holding the light within, connecting with our fellow physician-healers on this winding path? What sustains us? How do we replete our energy so that our light does not dim, that we do not become jaded, demoralized, harmed by the system, burned out or worse?

I think back to my time in residency at UCSF Family and Community Medicine, at San Francisco General Hospital. We were a class of thirteen incredible women. As I began residency, I was being initiated in the school of life–leaving my home state, my familiar natural ecology, navigating the discombobulating heartbreak of divorce, landing in a circle of women who were each on their own journey of self-discovery while in the crucible of internship. Four years of intensely formative learning in medical school under our belts, jelling now in this place of committed service – to those “underserved”, marginalized, disenfranchised. Elders, families, pregnant women, infants and children. Each with their own precious story, health crises, need for supportive counsel and, at times, life-saving or supporting interventions. In that city of great beauty, still, at that time, affordable on the modest salary we earned, where everyone was covered by health insurance. This city of dedicated heart, that opened its arms to those who were not embraced, perhaps, elsewhere. That hospital of grit and love, whose units had born witness to the AIDS epidemic of the 80’s, where our inpatient service principally cared for those who lived in places like SROs in the Tenderloin, or were unhoused, or had fled civil wars and death squads and gang violence in Central America. Where you could feel, palpably, the way everyone showed up to care for those who had the least in our society. San Francisco General, before renovation and renaming. I loved every moment of it.

We processed what was hard, what was beautiful, the gorgeous poignance and devastating losses. We had space held for us, and had a culture of support. At the bedside, there was time to sit down, to explain what was going on to the patients under our care, as we too developed our understanding in this most extraordinary of learning experiences. The need was great, the challenge was formative. We graduated as family medicine physicians, well-prepared to guide, to counsel, to offer treatment plans and coordinate care, to prescribe when necessary. To hold space for healing on this precious human journey.

I look back on what sustained me then. In addition to the support of friends, in the touching of mystery and meaning, I cultivated a practice of regularly going to nature, especially Mount Tamalpais, with intention. I would hike special trails to tucked away places for contemplative time in reflection. Sometimes I’d rise early, timing entrance to the park so that I could take in the sunrise, experiencing the renewal that comes with the dawn. Or I’d hike to a tree I knew, her limbs outstretched toward the seemingly infinite western horizon, stretching my mind into a similarly expansive energetic when I was in her field. I’d bring a blanket and a journal to the bay tree growing out of the south-facing rocky outcropping where once, years later, my daughters and I encountered a beautiful rattlesnake basking in the sun. Or once, navigating crossroads by intuition, guided by unseen forces on the little traversed north side of the mountain, where maps at the time failed to describe the territory, yet inner knowing brought me to where I needed to be. Feeling the support, the connection with the natural world, the elements, the healing energies available to all there.

This is what sustains me now, too, and has served in orienteering. The map, as they say, is not the territory. The trail mapped out for us by the architects of these systems will not necessarily guide us to where our heart tells us we must go. The art of medicine is deeply beautiful, and invites one to make space to be fully present with it. While dedication to keeping abreast with the science and intellectual aspect of the practice is essential, there is much can only be learned through humble attunement, so that we may be a clear channel intuiting and responding to the needs of another fellow traveler in this life. Through developing, with practice, the wisdom to listen for what is ours to do, without ego, trusting the grace of guidance that comes when we are orienting to our unique purpose in this one precious life. The path that rises to meet us is revealed through this attunement.

As I write this, I am returning from a vacation to my homeland, where I was with my sister and her family. My brother-in-law asked me the question–”would you recommend medicine to someone considering it?” I see so much of who I was at fifteen in my neice, his daughter, and consider my response with her in my heart. I did, after all, just leave my primary care practice after fifteen years just a few months ago, as I re-oriented myself on my path of service. 

“Absolutely.” Though with these caveats–that one must know that this is what they are meant to do and be ready to lean into that which is incredibly challenging. That one resources oneself in ways that allow regular contact with purpose, with Spirit, with guidance, with soul nourishment. That one holds fast to the promise of possibility to walk one’s own path, with the trust that structures can evolve, that we can advocate for our patients AND ourselves. That one be able to lean into the learning, the training, and the practice with appreciation for that which we are becoming, aligning ourselves with, embodying. Along with a prayer that the healthcare system will soon evolve to be more considerate of the needs of the healer working within it.

Tomorrow I will hold space with this in my heart, for these family medicine residents, as I have held space for myself over these twenty years. I deeply understand the pressures of training and practicing within our patchwork, commodified healthcare system, of trying to piece together care and service within a fraying safety net and threadbare societal support. And the essential work of supporting those who are dedicating themselves to this path of service, so that they may trust that even when it gets really shadowy, they may know the way forward.

This is ground truth for me, that I feel in the core of my being: the sacred work of being a person of medicine, the intensely beautiful energy of this archetype at work in the world, is a potent force that is seriously needed right now, as it always has been and always will be. That this energetic is more powerful than vested corporate interests. That it will find its way, like water, flowing around obstacles. That we can become clear channels to allow this healing energy to move through us, with good energy and in a way that is healing for us, as well.