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Close to the Bone
Life-Threatening Illness as a Soul Journey
By JEAN SHINODA BOLEN
Red Wheel/Weiser, LLCCopyright © 2007 Jean Shinoda Bolen
All rights reserved.
CLOSE TO THE BONE: ILLNESS AND THE SOUL
In noisy wards and crowded waiting rooms of county hospitals and clinics, in quiet private rooms in medical-center pavilions or in well-appointed waiting rooms, examining rooms, or offices, wherever there are patients, there are long moments of silence, pauses sometimes preceded by a sigh, a transient stillness when the air feels heavier. When the eyes of the patient or others who are there turn inward. When someone retreats inside as others chatter, or seems to be somewhere else even as the doctor is explaining something important. Sometimes I have glimpsed that same look with its attendant quiet on the face of a doctor or nurse. Occasionally, a room suddenly, collectively, goes silent in this same deep way. When this happened in ancient Greece, people would observe: "Hermes has entered."
Hermes was the messenger god and the guide of souls to the underworld; dreams and divination came under his auspices. Today, when that hush happens, someone might break the silence with, "An angel has come." A subtle perceptible shift in the air unaccountably occurs that people from ancient times to the present have attributed to the presence of invisible winged messengers from the eternal world. In these moments, the persona or face we wear for the ordinary world to see drops away and the mind is empty of its preoccupations and responsibilities and we are with soul.
Illness and the Soul
The reality and possibility of serious illness evokes soul from the first moment it registers. It might be after hearing a report that something serious was found on the X-ray or more sophisticated scans or in the specimen sent to the lab, or after an illness announced itself with the sudden onset of acute pain, loss of consciousness, or bleeding, or after the discovery of a suspicious lump or discolored area, or after surviving a suicide attempt or a disabling injury. Whenever or however that line from health to illness is crossed, we enter this realm of soul. Illness is both soul shaking and soul evoking for the patient and for all others to whom the patient matters. We lose an innocence, we know vulnerability, we are no longer who we were before this event, and we will never be the same. We are in uncharted terrain, and there is no turning back. Illness is a profound soul event, and yet this is virtually ignored and unaddressed. Instead, everything seems to be focused on the part of the body that is sick, damaged, failing, or out of control.
A hospital has much in common with an auto-body repair shop. It is there with its staff of specialists to diagnose, fix, or replace what it can of the physical body to get it running again. The patient and those accompanying the patient through this crisis are considered to behave well if they do not get in the way of whatever the doctors want to do with the ailing body. Troublesome patients (or their troublesome significant others) ask questions, want to understand what is wrong and why a particular treatment and not something else has been selected, bother doctors with requests, or don't respond properly. The medical setting is one in which there is a definite line of authority with the doctor in charge and others responsible for carrying out orders. A good patient like a good soldier is one who cooperates or obeys orders. Especially when cancer is the diagnosis but in many other conditions as well, the doctor's perspective is often similar to a general at war: the disease is the enemy to be fought, with the body of the patient the battleground.
Threshold Between Life and Death
When something is wrong with our bodies, we want whatever is wrong to be fixed. When something destructive is going on in our bodies, we want the disease to be stopped. We go to doctors and to hospitals with the expectation that they will take care of our bodies. That the soul might also be engaged is not our expectation. Yet, a life-threatening illness calls to the soul, taps into spiritual resources, and can be an initiation into the soul realm for the patient and for anyone else who is touched by the mystery that accompanies the possibility of death. When life is lived at the edge—in the border realm between life and death—it is a liminal time and place. Liminal comes from the Latin word for "threshold." It is not an everyday word; it is one whose meaning I want to evoke out of the remembered experience of the reader and the collective memory of the human race, which we all have access to. Whenever we participate in something that will change us, and change how others relate to us—as when we marry, are inducted into the armed forces, or are ordained, become a doctor, or survive an ordeal— that experience is a liminal one. Whenever we are initiated into knowing something we did not know before on a body level—for example, through sexual intercourse or pregnancy—we cross a threshold. Here the mystical, spiritual, or psychic awareness of what is happening, however, determines its significance as a soul experience. So it is with a life-threatening illness, which similarly happens in and to the body and yet can profoundly affect the soul.
Illness, especially when death is a possibility, makes us acutely aware of how precious life is and how precious a particular life is. Priorities shift. We may see the truth of what matters, who matters, and what we have been doing with our lives and have to decide what to do—now that we know. Significant relationships are tested and either come through strengthened or fail. Pain and fear bring us to our knees in prayer. Our spiritual and religious convictions or the lack of them are called into question. Illness is an ordeal for both body and soul and a time when healing of either or both can result.
Once upon a time, or so it seemed, potentially fatal illnesses were unexpected tragic events that happened to young children, and terminal illnesses were mostly chronic conditions that afflicted the elderly. Diagnostic tests and biopsies have made it possible to diagnose life-threatening illnesses earlier and treat them aggressively; so much so that invasive treatments can be health and life endangering themselves. Midlife now presents the possibility of death and disability for far too many people. Not just cancer, but also diseases that affect the health of body and mind strike people in their prime adult years. There are times when midlife can feel like a medical war zone, with people dropping around us; for those of us in the health professions the impact of numbers is even greater. Life-threatening and life-changing illnesses are striking close to home. One may be threatening your spouse, your lover, your son or your daughter, your parent, your friend, or you.
To be a passive, obedient patient or, the terrain on which a battle is fought by the medical profession, goes against the grain of people who question authority, see value in alternative viewpoints, and understand that body and psyche are related. Whether as patient or as a person with love and responsibility for the patient, there are life-and-death consequences to the choices we make or allow others to make. To act out of fear or out of trust, to go with intuition or against it, to do what we know is right for us when it upsets someone else—issues that are life issues are made all the more crucial when death or recovery may depend upon what we decide. Moreover, if the battle for a medical cure is lost, doctors often abandon the field, all but avoiding the patient, who is now a reminder of defeat.
Illness as a Psychological Ordeal
The travails of being a patient and the physical illness together are an ordeal that can have a transformative effect on the soul. Psychological stress is a major part of the ordeal through which the soul must pass. When the possibility of a serious illness unexpectedly arises on a routine examination, or there is an onset of symptoms, or there is a need to be hospitalized, we may be assailed by fears and vulnerabilities. We fear—with or without justification—that we may never be our former healthy selves ever again. Those close to the patient may also be having these or similar concerns, or be having them when the patient is not.
Thoughts are shaped by how we perceive what is happening to us or to someone near and dear every bit as much and sometimes even more so than by objective information. Depending upon our psychological makeup, under such circumstances we tend to live in the present or in the future as we foresee it. If a serious illness is a potential that will only be known after the biopsy or after the workup, a person who lives in the present can often put dire possibilities easily out of mind: an attitude of "why borrow trouble?" comes naturally. A future-oriented person, on the other hand, especially one who worries or is aware of the likelihood and magnitude of the situation, may have the patient practically dead and buried before the results are in. Stress may be virtually absent for one, and off the chart for the other. When someone is in the throes of pain, limitation, weakness, or nausea, the awfulness of the moment may not only be all there is, but all there ever will be for that person, while another person faced with the same symptoms may experience this as part of a difficult time that will pass. When pain is not relieved, or obsessive negative thoughts crowd the mind, they leave little room to attend to the concerns of the soul.
For soul to be heard, the mind must be still. Then thoughts and feelings can arise as if from a deep well within us. Often these thoughts and feelings are not shared. When they are, the soul looks outward for a moment, and we hope that we can truly share the depth into which illness is taking us. We wonder if we should die, will our lives have been worthwhile? What do we regret doing or not having done? What do we still want time for? Do we matter? Do the people in our lives really matter to us? Is there a God? An afterlife? What unfinished business gnaws at us? What long-buried thoughts and memories are coming back to us now? What are our dreams saying?
When we voice concerns and content such as these, we are baring our soul. At such moments, we are as if naked, and all too often when we speak of such matters, the impulse of others is to hurriedly cover up our words with a thin layer of reassurance—to which we respond by withdrawing. Revealing matters of the soul makes those who dwell in shallower waters uncomfortable. Soul-searching questions are those that people who are addicted to work or to alcohol or to superficial activities are warding off by their addictions. They do not want to be exposed to their own deep questions, as voiced by us.
Sometimes, we are caught looking inward, feeling something move in our own depths—a thought, a memory, emotion, an intuition, wisdom—and someone says, "A penny for your thoughts?" And we retreat self-consciously. Or this time we speak our concerns aloud, and there is joy at finding a soul friend. A soul-level friend is a sanctuary, a person to whom we can tell the truth of what we feel or know or perceive. When something is expressed at a soul level, it is not something for the other to fix or minimize or deny or take personally; what is said and felt needs to be received, heard, accepted, held—as in a womb space, where the insights into ourselves and what matters to us can incubate, grow, and develop fully into consciousness.
Those moments of stillness when the eyes seem to turn inward are pregnant silences, times when we are communing with our deeper thoughts or perceptions or holding a feeling or an image that can be all too fleeting; the mood shifts and what for a moment we had a grasp on can be gone like a dream fragment.
The premise of this book is that illness can be soul evoking and that the soul realm is one akin to dream or reverie, a source of personal meaning and wisdom that can transform life and heal us. This is not to say that illness is ever welcomed. It can only be retrospectively appreciated by those for whom it was a soul experience, but having a perspective such as this makes the potential of it being so more likely.
Recovery of soul and recovery of the health of the body may occur together or not; healing may occur, and the body may not survive. Life is a terminal condition, after all. It is a matter of when and how we die, not whether we will. Illness takes us out of our ordinary lives and concerns and confronts us with big questions and the opportunity of tapping into soul knowledge that can transform us and the situation. Prayers that are said and rituals that are done help by focusing us and by tapping into spiritual energies.
At a soul level, we can see clearly what matters and recognize the truth of our personal situation. We know that we are spiritual beings on a human path rather than human beings who may be on a spiritual path. At the soul level we recognize what is sacred and eternal. At the soul level, an illness, even a terminal one, is a potential beginning, a liminal time when we are between the ordinary world and the invisible one.
I believe that in any particular illness as in every individual life, the soul questions are the same: What did we come to do? What did we come to learn? What did we come to heal? What and who did we come to love? What are we here for? Questions to do with the essence of who we are. I believe that illness can be a call to consciousness, a wake-up call some would say, and that illness involves a descent into the depths and an exposure to what we fear. I have seen how illness can unearth love and reveal strength of character, and I know that it is truly an opportunity for soul growth. Or not. I believe that stories and myths, dreams and mystical experiences can become more vivid during illnesses, and that integrating soul knowledge from these sources into ordinary life makes life as well as death meaningful.
Close to the Bone
The first time I knew that illness was both a soul and body experience was when I was in my late twenties. I had just begun my psychiatric residency and took a six-month leave to be with my parents when my father came home to die. My father had lost a long, heroic struggle to overcome the cancer that had defeated his body, and even after medicine could offer no further even ameliorating procedures, his will to live kept him going for many more months. Yet as he died, I saw his eyes open wide, and his face light up with joy. I am convinced that he saw something I could not see, and I trust my perception and deeply appreciate the gift of seeing this. One moment, he was there, the next instant he was gone. Only an empty body remained; his soul had left. His body was warm, and some cells were probably still functioning seconds later, but he— his soul—wasn't there anymore. His suffering was over, and the body he left behind was like discarded clothes that were worn and threadbare, familiar and of no further use to the person who once wore them. His face told me that there was something beautiful to look forward to at death, and the period beforehand, in which he took a long time to die, left me with the belief that this period too was important. With an airway, talking was difficult, and in his last months, the inner world seemed to absorb him. Quite possibly, he died after staying as long as he needed to remain, to do whatever it was he had to do at the threshold between this world and the next. Dying people spend their days like newborns do, sleeping and dreaming and having their basic needs taken care of by others; the dreaming, the reverie, and the moments of clarity and conversation may not only ease the transition but be soul-healing time. In the intervening years since then, my son, my mother, and my closest friends have gone through medical or surgical crises. I found that when a child is going through major surgery, a mother feels the child's and her own vulnerability, perhaps more so than in any other relationship. It also was for a son on the edge of adulthood, an ordeal that had the elements of an initiation into manhood, and it clearly was a soul journey. The perspective I gave him may have made a difference in how he experienced what he went through.
When my eighty-five-year-old mother became too ill to go on, it seemed like the beginning of the end, which is what she and I thought until she made a full recovery and returned to her independent personal and professional life for three more years. I think that what I did and said tilted the scales and made a difference, though it was she—at a soul level—who made a decision to live, and her body was able to recover.
The medical and surgical crises that my closest friends have gone through affected me in a way that only contemporaries we love can; they bring home to us knowledge of how fleeting our own lives might be.
Everyone who comes to me for analysis or consultation brings me their close-to-the-bone concerns. Drawing on the depth and breadth of this experience convinces me that it is impossible in a lifetime not to be directly or indirectly affected by potentially disabling or potentially fatal illnesses: they can or will happen to us and to others around us. Whether we are the patient or a witness, when illness enters our circle of people, it touches us deeply. Life-threatening illness takes the patients, those who love them, and those who treat them into the realm of soul.
Excerpted from Close to the Bone by JEAN SHINODA BOLEN. Copyright © 2007 Jean Shinoda Bolen. Excerpted by permission of Red Wheel/Weiser, LLC.
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