Darren Littlejohn, Author of The 12-Step Buddhist

May 29, 2009 | Leave a Comment

Dr. Kent: Welcome to Sound Authors! It’s Friday again today, and this is Dr. Kent. I’m excited to have three authors on the show and one musician, as always. Some great books on the show today. I’m going to speak later on in the show to Steve Knopper. He’s the author of Appetite for Self Destruction, that’s a great book about the crash of the record industry these days. Later on in the show, At Face Value, by Terry Healey, an incredible memoir. At the end of this show is a group called Likeness to Lily, and Susan Oetgen from that group. We’re going to listen some of the music and chat with her. Without further ado, at the beginning of this show I’ve got a fellow on named Darren Littlejohn, and he’s written a book called The 12-Step Buddhist: Enhance Recovery from Any Addition. Welcome to the show, Darren.

Darren Littlejohn: Hi. Thanks very much for having me, pleasure to be here today.

Dr. Kent: So give us all a nutshell of this book.

Darren Littlejohn: This book is about deepening recovery for anyone who is either involved in a 12-step program, or wouldn’t be involved in a 12-step program because they’re afraid of the Judeo-Christian religiosity. It’s for anybody who knows an addict, anybody who treats addicts, anybody who’s suffering from any kind of attachment related (inaudible), and it’s applicable to what Buddha said, “All beings who suffer.” So we’ve combined the 12-steps, which are about attachment gone wild, and Buddhist terminology attachment is one of the root causes of our suffering, but in the addict it’s way out of control. So we try to get sober and get free of our attachment in the extreme form with the 12-steps. This really illuminates the Buddhist path because this is, after all, what the Buddha taught. This is hard to see if you’re, it’s easier to see, I should say, if you’re an addict already. So the two paths have a way of really complimenting each other and illuminating the nooks and crannies where it might otherwise be a little difficult to see.

Dr. Kent: Tell me a little bit about, to the non 12-step person, and to the non-Buddhist, give us some introductions into those two different worlds.

Darren Littlejohn: For the non-addict, everybody, of course we go from the Buddhist perspective. So everybody, according to the Buddhist teachings, suffers from not getting what we want and thinking that whatever it is that’s going to make us happy is really what we call I Buddhism the inherent cause of happiness. So in other words, one of my teachers always uses the reference of chocolate cake. And if chocolate cake were the cause of happiness, I would simply back up a truckload to my front porch, have an unlimited supply of chocolate cake, and obviously we know that that’s ridiculous. After your second piece you’re sick. So chocolate causes a temporary happiness. But then if we have too much of it, it becomes the cause of suffering. So for the non-addict, even if you’re not a food addict, we can look at these examples in our own life. Anything that we think is going to make us happy: more money, better job, better house, (inaudible), things along those lines. We start to examine this and see that, hey wait a minute, what I thought was going to make me happy is not really the source of true happiness, any way you look at it. And for the non-Buddhist, those terms are what work best, just looking at the three types of common known Buddhism, which are attachment, aversion, which is, when we don’t get what we’re attached to, we simply turn that around into something we don’t want and have an aversion towards entering. In 12-step terms we get a big resentment over it. So you don’t have to be a Buddhist to really understand attachment, and the fact that what we think we want is not in the long run every enough to make us permanently happy. As a matter of fact, most people don’t even believe that total, absolute happiness is possible. Most people don’t believe that ending suffering is possible. So all beings suffer according to Buddha. That’s the first simple truth. Life is suffering, it’s not a negative, it’s an observation. What it means is basically what I’ve just described. What we think makes us happy in the long run really doesn’t, so there’s something more, maybe something on a spiritual plane. That’s basically what the chapter’s about.

Dr. Kent: And describe for us also, many of us know the 12-step program. I have many family members who have gone through it, but it is deeply Christian most of the time. Talk about what inspired you to, clearly it’s coming from something personal in you. But what inspired you to do the 12-Step Buddhist? It makes a lot of sense, and I know that, for example, Native Americans use some of the 12-step processes with their own religion. Where did you get this idea?

Darren Littlejohn: I started in the 12-steps in 1984, and I had a sobriety period of ten years. During that period I moved through the various (inaudible), and metaphysical Christianity, the science of mind, all of these types of positive thinking, and could really very much have Judeo-Christian Creator God monarcheistic based philosophies, which were really well suited to 12-step recovery. Then I got into mediation pretty seriously, after a few years in recovery. I found myself in a spot, after a few years of sitting, staring at a blank wall, I was practicing Zen Buddhism, I found myself in a spot where what I saw really wasn’t improving. What I was looking at, as I followed that path and noticed my body, labeled my thoughts, after years and years of that with therapy and 12-step recovery, and education and psychology and so forth. I found myself in a really dark, depressed place, and I didn’t want to look anymore, it wasn’t looking too good. I couldn’t really get past that block. The concept of praying to something that was going to fix me, or putting responsibility for my life outside of myself. Even though I was willing to surrender and willing to follow the steps and principles, I never really felt that that task really amounted to much, I terms of un-enduring happiness. So after all this week, after ten years of sobriety, all kinds of zen mediataion therapy and everything else, I found myself in a place that was dark enough for me, that I made the choice to go back and try the various substances of my addiction again. So when I came back, because that doesn’t work, because the disease is incurable, the disease doesn’t go away with abstinence It actually continues and sort of deepens. So when I came back in 1997 I had to re-examine everything that I’d ever thought about before, and I got very much a good vibe again in 12-step recovery and zen Buddhism, and psychotherapy, but it wasn’t I found the teachings in Tibetan Buddhim. Which really explained a lot, and it went into a lot of detail of various types of methods and visualizations and practices that went hand in hand with the 12-steps. So that inspired me to continue my spiritual path and to really stay involved in both the 12-steps and in Buddhism. But I found that the problem I had is that in the 12-step program most people settle for just as much spirituality as is necessary to get sober through the day. Most people aren’t capable of a real, super deep seekers are looking with a real spiritual (inaudible). Some are, maybe not to a degree, but the people who are super into it are few and far between. And those are the people who really stand out and become sort of legendary in the 12-step treatment community. In the Buddhist community I found that I was sort of an addict… when an addict speaks, particularly from the disclosure that we use in 12-step rooms, we basically tell anybody anything, we air those feelings, whether or not its appropriate, until you learn better. But we really learn how to kind of be raw and truthful, and after many years of that, it’s pretty hard to tone down. So, finding myself being in the Buddhist groups, sharing, or having relationships or communications with teachers and so forth, it’s really kind of awkward. Then I thought it was a bit odd that I would be so honest. “Wow, that’s such a wise thing.” I’d say, “Oh, that’s not wise, I heard it in a meeting.” So I really had to learn instead of doing one or the other, instead of graduating from the 12-steps and finding a better, spiritual path, which leads to more disease and relapse, at least it did in my case, and in the case of many others. Instead of choosing this or that, I had to learn how to do both and find the similarities. What we talk about in 12-step meetings is (inaudible) the difference is. I found so many profound similarities between the 12-steps and Buddhism that I started blogging about it and eventually got a lot of feedback, people really enjoyed the writing. I decided to put those thoughts together, and came up with a lot of methods for the book after I started working on it. I found that there is actually a lot more than I even, I really think I just scratched the surface in the book, to be honest with you. Even though there’s a ton of chapters, and most people are finding it to be pretty dense work to get through it. I feel like there’s actually a lot more to be said on the topic.

Dr. Ken: Well, it’s so fascinating. Let’s talk about the issue of Buddhism. It’s a very accepting religion. I had a fellow on the show about a year ago who wrote one of the Dummies guides on Buddhism, and he sort of explained a lot of it. It’s a fascinating and very accepting religion, whereas Christianity isn’t necessarily all that much. Talk to that a bit.

Darren Littlejohn: I have kind of a saying I made up here, don’t throw the Buddha out with the bathwater. You can look into the deep teachings of Jesus through the Sermon on the Mount, for example, and you can see, for example, teachings on karma if you just take the principle of we reap what we sow. If you really take that principle and you look at karma and you look at Buddhism you can see that we’re talking about the same thing. However, people hear what they want to hear, people take the message and turn it into whatever they want. So I don’t discount the teachings of Christ on any level. As a matter of fact, many Buddhists feel that Jesus was a Bodisapha, or a very highly developed practitioner, maybe a Buddha, the completely awakened one. So there’s really no discounting of the teachings, but the way people behave is a little bit flighty there. There’s some room for improvement in a lot of it. And even Jesus said, “Don’t cast your pearls before swine,” and what I think he meant by that was if people aren’t really ready for the truth, try to give them what they can handle. Give them the teachings that they can deal with. You can even see there’s some Buddhism in the very beginning of what was recorded orally, and later written down, from what Buddha taught, was one type of system. That later evolved into other types of systems, which were much more advanced, much faster paths, and not everybody’s ready for that kind of thing. Some of us, for example, I would say, we just need to keep our mouths shut and not cause any harm to anybody else, and that’s enough of a spiritual practice. For others of us, we can get involved with other types of practice, which actually start to utilize some of the energy that we have, and to work with the breath and visualizations and so forth, and actually instead of repressing anger completely and shutting it off, you really start to kind of use the energy to try to assimilate that, and integrate that into our daily life. So Buddhism to me is really more of a mind science, and a massive system of methods, which are available to help transform the sufferer into one who is completely awakened and free from all suffering, just like the Buddha. Within that framework, there are fundamentalists in Buddhism. There are fundamentalists in Christianity. So I think that if you really use the teachings of Jesus, you’re not so far off from the teachings of Buddha. I wouldn’t say that they’re completely the same, and there are philosophers out there who talk about the similarities and differences, but who are the people that you want to associate with, and how are they living their lives? That becomes a different conversation. This is the same in the 12-step community, for example, we have a saying, stick with the winners. So when a newcomer walks in there, just coming off the street and detoxing from crack or oxycotin, or something really bad, and we tell them here’s what you do, find those people who have what you want in recovery, and go ahead and stick with them. And that really works to a high degree for many people. However, depending on the group that you’re involved in, and that location in the country that you’re at, and the individual who happens to be the one that who touches you or that you connect with, you might get involved with some really sick people. There are sick people in the 12-step community, that’s why we’re all there. We say, it’s a good thing we’re not all sick on the same day, luckily. But again, within the 12-step community you will also find fundamentalists who are really kind of fascist and militant about their value system. I’ll give you an example of that. In the AA literature it says we realize, we know, and we have been told, when it comes to prayer and meditation and things like that, the world’s diverse and full, go find them. We’re going to talk about matters medical, (inaudible) and religious. I went to a meeting not too long ago, on Thanksgiving, and there was a guy slamming his hand on the table saying, “This is the only book I read, and the only book I’ll ever need.” And I was just wondering if you read the part in that book that said go read other books. So we don’t want to throw the Buddha out with the bathwater, we don’t want to throw the teachings of Jesus or Buddha or the 12-steps out, because some people, out of their own fear, stick to a rigid viewpoint, to the point where they feel that they’ve got to impose those belief systems on others. The 12-steps is supposed to be free and open for us to have a higher power of our own conception, but many, many people feel that it’s very Judeo-Christian oriented, and that if you don’t come along with the group thing, that you’re not welcome, and they don’t feel comfortable. And that’s what I like about the audience that I’m trying to address with my book, The 12-Step Buddhist.

Dr. Kent: Well, it’s been a fascinating discussion. I could keep talking with you all day, but I have to get to my next guest. I’d love to have you on again and talk more about this. It’s so deep. The book is called The 12-Step Buddhist: Enhance Recovery from Any Addiction. There’s a lot more specifics that I wanted to get into and we didn’t have time for, but there’s some real plans in this thing, and it’s a useful book for a lot of people. Where can we find out more online?

Darren Littlejohn: At the12stepbuddhist.com. I’ve got podcasts, daily tips, some blogs, all kinds of resources and other information on there. And you can order a signed copy of the book right from the website.

Dr. Kent: Well thank you so much for chatting with us.

Darren Littlejohn: Thanks for having me, I’d love to talk to you again sometime.

Dr. Kent: The 12-Step Buddhist: Enhance Recovery from Any Addiction, by Darren Littlejohn. It’s got a foreword by Robert Thurman. Go out and pick that up, it’s a gorgeous book, and some pretty amazing content for all of us. Most of us know someone going through the recovery process, pick up a copy of this book and go to the12stepbuddhist.com also, or Google Darren Littlejohn. My next guest on the show is going to be a very exciting one again. This is a good show today, and Steve Knopper is the author of Appetite for Self Destruction, and we’re going to talk about the record industry and how it’s having trouble here in the digital age. So come on back to that.

Posted by admin | Filed Under Medicine, Motivation, History, Health, TRANSCRIPTS, Spirituality, AUTHOR INTERVIEW, Inspiration, Religion, PODCAST

Paul Austin, Author of Something for the Pain: One Doctor’s Account of Life and Death in the ER

May 27, 2009 | Leave a Comment

Dr. Kent: Welcome back to the show. My next guest is Paul Austin, and he’s the author of a book called Something For the Pain. The ER is a place that we see on television in sort of glorified light, and we see in real life as sort of a more difficult life. Hopefully we won’t have to see the inside of an ER too much, but we appreciate the doctors so much. It’s my honor to speak to Paul Ethan Austin. Welcome to the show.

Paul Austin: It’s my pleasure.

Dr. Kent: So tell me about this book, Something For the Pain.

Paul Austin: The title Something For the Pain, the subtitle One Doctor’s Account of Life and Death in the ER. It’s about the way my job almost wrecked my family. It turns out that the ER can be a really stressful place to work. There’s an abundance of human suffering. It turns out that you work rotating shifts, and at least in my case it turns out I took a lot of stress home with me. So one of the major points of the book is the way in which someone’s job, you can bring that stress home with you and it can damage your family and your relationships in your family, and kind of what I did to kind of mitigate those factors.

Dr. Kent: It appears like we had a little station break and I apologize for that difficulty, and I’m back on the show now, live. I welcome myself back on the show, and we have Paul Austin, the author of Something for the Pain: One Doctor’s Account of Life and Death in the ER. We still have you?

Paul Austin: Yeah, I’m still here.

Dr. Kent: Sorry about that. So tell me, we were in the middle of, the ER is not only difficult for, obviously there’s scores of people waiting in the waiting room, thinking about their families, and scared about their loved ones, but that stress kind of carries on, it sort of sticks to your clothes when you go home.

Paul Austin: Yeah, it really can. That’s probably true with a lot of different jobs. This job is, the need is so great, there’s so many people who have a very valid claim to your time and attention. Sometimes the ER can kind of be the bottom of the funnel of the people needing to come into the hospital, and we’re trying to get people in and out safely and quickly. Understandably people can get really impatient. Nurses, more so than docs, but just about anybody that works in the ER, the people can take out their frustrations in way that they wouldn’t in their doctor’s office, or at an upscale restaurant or bar. Sometimes people can, understandably, vent their frustrations. Add that to people having heart attacks, or people in a car wreck, or someone who’s not breathing, their could be a lot of other serious medical problems of which these are all kind of a background. So the nurses and docs, and nursing assistants and ward clerks and housekeepers, all the people in the ER have to kind of figure out a way to give good care and be emotionally present to the people who need it, but yet keep their own defenses up. So that’s another aspect of the book, is how can one remain compassionate in what has become an increasingly industrial environment. So that’s another theme of the book, is how to kind of regain your compassion if you get burned out, or how to understand what compassion means.

Dr. Kent: Well, I know when I was in the emergency room I had a doctor there who made me feel really at ease, and it’s such a strange place, it’s not meant to be a warm and inviting and friendly, but at the same time, what does a doctor do to save patients’ lives, to make the at ease? And how much of that do you take with you, and how much can you leave behind?

Paul Austin: I’m glad you had a good experience. I’m so relieved for people who say they went to the ER, and they may have had to wait a while, but the doctor was nice, or the nurses were nice, or the people were competent. I think a lot of us that work in that environment are just hoping that the person we talk to had a good experience, because it can be a place where people wait a long time. Sometimes a doc or nurse may speak sharply when they don’t mean to, and I’m so glad you had a good experience. One thing that I’ve come to think about compassion is that it’s not an emotion. When I started as an undergraduate I was working my way through college as a nursing assistant in an emergency room. I was the guy who cleaned out the bedpans and pushed the stretchers to take people upstairs, and did that to pay for school. At that point I thought that compassion was an emotion, I thought it was something you felt. I have come to believe that it’s more of a discipline, that it’s more of a habit. It’s a work habit, just like a carpenter keeps things plumb and square, a carpenter measures twice and cuts once. A carpenter makes sure the angles are right before he nails it together. I think a good doc or a good nurse views compassion in a similar way. I think it has less to do with emotion and more to do with maybe philosophy or one’s personal belief system about the role of caring for people. I’ve come to the conclusion that it involves kind of opening your heart and closing your heart as a situation demands. Like, if someone comes in that’s critically ill, or they’ve stopped breathing on the way in, that requires a sort of, there’s kind of a drill that docs and nurses do together, it’s very much a team, and we kind of all know our roles, and it’s more like a pit stop at a race track than it would be an emotional event. It’s more of a technical event at that time. You really need to close down your emotions. You need just to function quickly, and efficiently and pleasantly and professionally, and without feeling much. Then later, you may need to open your heart some. It’s like if a mom comes running into the ER and her baby’s blue and not breathing, and the heart’s not beating. They hand it to the nurse, and the nurse comes running back to the ER and says we need a doctor in Room 7 now. I go in, and the nurses are trying to stick IVs in the baby, put an airway in, you put a tube down their windpipe. And then the next step is to get IV access to give them meds or fluids for whatever they need next. Often just opening the airway will do a whole lot towards resuscitating a child that age. But say you’ve got an airway in, you’re breathing for the baby with a little bag through the tube down their mouth and into the windpipe, and you’re stuck on IV. The nurses have tried a couple times and have not been able to get an IV. The next step is to establish an intraosseous line. That’s an IV that goes into the bone of the tibia. The lower leg has two bones, pretty good sized bones, called the tibia and a smaller one called the fibula. But you just stick a needle right into the bone itself. The fluid goes into the bone marrow, and from the bone marrow into the bloodstream. And it gets into the bloodstream almost instantaneously, it’s almost as good as an IV and it’s a lot faster. And to do it you just hold the baby’s little leg in your hand, and the needle’s kind of like a finishing nail. It’s a pretty good sized needle, and it’s got a little pea handle on it, and you just jam it down into the bone. You hear kind of a crunchy little pop as it goes into the bone. So it goes into the skin and through the muscle and pops into the bone. If it wiggles, it’s not into the bone. It needs to feel like a nail that’s been driven into wood to know that you’re in the right place. And then you hook an IV tube and then you go to the next step. That process of jamming a needle into an infant’s lower leg is kind of a brutal procedure. The child doesn’t feel it because they’re functionally dead, or out of it, but you practice on chicken bones, on chicken legs, at least when I was training that’s what we did. But you feel, it’s not something you feel much about. You just pop through that step and go to the next step. You bring a very, not a harsh persona, but you bring a, you want to get things done attitude to do that procedure. Now, when you talk to the mom, or the dad, you can’t bring that forceful, stick a needle in the bone personality, that would be cruel. You have to kind of open your heart and take a deeper breath and relax your shoulders and unclench your fist when you’re talking to the family. So that’s kind of a little quick example of a time where you need to be kind of harsh, or hard, kind of bring something forward that will squeak us through a problem, and then kind of open up, and soften up. What I’m trying to do, and what I think I’m getting better at doing is closing down my emotions when I need to, and opening them up when I need to. Sorry to talk so long.

Dr. Kent: Well no, it’s fascinating, and that kind of insight is, especially with these shows on television that are so obsessed with the ER, and you wonder how much of it is right, and in a lot of cases it really is brutal stuff that you have to do, but you have to do it to save people’s lives. It makes a lot of sense that you can’t come up to someone and say I just rammed a needle into your baby’s bone. You can’t do that, right?

Paul Austin: You can’t say the baby’s got a heartbeat, but probably going to be brain dead.

Dr. Kent: Right, exactly.

Paul Austin: You can’t say that. In the room, once you get then, say you get a pulse, yeah, you can’t be just real blunt with people, that would be cruel. I think TV shows do a great, great job at what they’re good at. They’re real good at getting the sights and sounds of an ER. Like if you watch that TV show ER. I’ve seen copies, I’ve seen a show or two. Not recently, so I don’t know if it still does it, but it did a real good job of getting kind of that pace, getting that sound, getting the feel and texture of the moment. I think they do an incredible job with that. They don’t, very few TV shows are able to kind of get beneath the surface of what the spiritual experience of it is, or the emotional experience, or the real experience is. And that’s what the book, I was hoping, in the book I wanted it to be as much literature as a book. I want it to have literary value just in its prose, just in the way the nouns and the verbs work on the page. I want them to be good. I was just thrilled when Norton decided to publish it, they’re my publisher and they’re known as a big, literary press. I was just so thrilled that I had at least my editor’s satisfaction, or created a work of literary value, as well as a book that’s kind of pretty honest about what my job’s like. But I think that literature can get at that. I think a good book can get at what’s really happening on the human level, or where your heart is level, more than maybe a TV show.

Dr. Kent: Right. Part of the reason this book is unique is that it’s something we really all experience in our lifetimes, the ER. If you’ve recently been to the ER with a family member, you might not want to watch a show like ER because it’s so real-seeming. But what’s your take on, you talked a little bit about it, but doctors really do need to steel their emotions in some ways. I don’t know, I think a lot of people don’t know if they could do it, in terms of where you start out in med school, operating on cadavers, and then you’re dealing with painful things all the time. How do you steel your emotions to do it?

Paul Austin: I think getting the emotional armor up into place isn’t that big a challenge. At least for me it wasn’t, maybe for my classmates and colleagues and co-workers it is. I think that the bigger challenge is how to poke some holes in that armor. What can happen is that, ok, you’ve seen the ER. I don’t know about other types of medicine, but maybe in radiation oncology, where it’s kind of a foregone conclusion that people have an illness that will probably be terminal, and all we’re going to do is shrink down the tumor enough to ease the pain, or gain a couple years survival. It may be in that situation there could be some emotional ferocity, because we’re not expecting a miracle here, so the doctor doesn’t feel that they’re a failure if the patient dies. But at least in the ER the expectation is that we’re going to resuscitate somebody, that they don’t send people to the ER to get started on hospice. They send them there because they want us to fix the problem. So if you’re the person who’s going to have to fix the problem, if you fail to fix the problem, your defenses come up pretty quickly. I think that may be human nature, to kind of feel a little defensive that someone said that, or whatever the bad outcome might be that you did your best, but couldn’t forestall the inevitable. So I think most ER people, if you start in the ER all open hearted and caring and being very emotionally involved with everything that happens, those people kind of quit. They tend to get in the way while they’re there, and then they finally quit because it’s just too emotionally painful. Other adaptations can be like cynicism, people can become kind of hard and cynical. Another thing is joking. I joke a lot at work, and sometimes the humor’s cynical and sometimes it’s not cynical. But I think that if you get too well defended, if you had scrubs that are made out of Kevlar and Teflon, which are bullet proof and nothing sticks, it’s hard to drop that when you go home. If you’re too well emotionally intact, if your barriers are up, if you’re defended against the emotional cost of doing the work, when you get home you have a hard time relating to your family, or to your friends, neighbors and stuff. So I think that the more interesting and maybe more pertinent question is how can people that work in high stress environments learn to open up a little bit, close down a little bit, open up a little bit, close down a little bit. So that when they get home they’re not closed down. Even at work they’re not closed down. It sounds like your ER doc was fairly open, right, your ER doc wasn’t some hard ass who came into the room and told you this, told you that and then left. He listened to you. What was your experience like?

Dr. Kent: I remember one thing that was neat for me, it was a specific situation, of course, but he had been a Medic in Vietnam, cause I actually went back and thanked him later on, and this is another question.

Paul Austin: Good for you.

Dr. Kent: That’s the other question, is I felt like this person had changed the course of my father’s life, and I was just sitting in the next room pretty much, with a broken arm. But you do kind of play God sometimes in the ER and some people probably do come back and say thank you.

Paul Austin: Mmm hmm. I even get some thank you notes. But it’s hard to catch us there.

Dr. Kent: Are there certain stories that kind of carry you through the years?

Paul Austin: Yeah, it’s hard to catch an ER doc at work because we work such rotating and crazy shifts. Sometimes we get notes. And most often they’ll bring by some brownies or something to thank the doc or the nurse, and that just means a lot to us.

Dr. Kent: Give us a story of something that happened that you didn’t think you could save someone and something happened, and you know…

Paul Austin: Ok, well here’s a story. This isn’t in the book, but about 8 or 9 years ago I was getting really burned out. I mean, the people who are unhappy are so verbal in the ER. They’ll call the nurse words that you can’t say on the radio. They’ll call me a word you can’t say on the radio. They’ll tell us to hurry up, “Well, hurry up.” I was getting kind of burned out. And there’s a lady came in, the paramedics brought her in. Probably a 75 year old female, she was in respiratory failure, she was just (hacking noise) with respiratory effort, just open mouthed breathing, and she was sweaty, she was pale. They couldn’t get an IV when they brought her in, so they just kind of brought her in and dropped her off and I was going to try to stick a tube in her lungs to get her on the breathing machine so we could figure out what was going on. The nurses were having a hard time getting an IV. You can’t intubate them until you paralyze them. There’s a medicine that we give them that relaxes all the muscles of the body so they can’t fight you when you’re sticking a tube down in their trachea. So I was kind of wishing the nurse would hurry up and get an IV so we could tube, and they got one. We gave her the medicine, and she just went flaccid, so I could stick the tube in her lungs, and I couldn’t get the tube in. Epiglottis is a little trap door that covers up the vocal cords, and she had this big, floppy epiglottis, and I couldn’t get under it. So the pulse ox is going down, the alarms are dinging off. So we put the mask back on her and puffed her back up and then I’m trying to stick that tube in between her vocal chords again and couldn’t see it. And we put the mask back on her face and squeezed that bag to puff air into her lungs. On the third attempt, finally, thanks be to God, I got it. I got the tube in, and by this point I was sweating as much as she was. It was just really uncomfortable. But we got her through, got her on the ventilator, she went off to the intensive care unit, and then I forgot about it. The shift went on and we saw other patients and kept people moving. A couple days later one of the nurses said, “Paul, you know that kind of chunky, white lady you had a hard time tubing?” I said, “Yeah, yeah, what about her?” “Well, she made it out of the unit and she’s on the floor now.” I said, “No kidding?” She said, “Yes, she’s on a regular ward and they’re hoping to let her go home in a couple of days.” She had been in congestive heart failure and we had given her some Lasiks and meds to make her pee, and we got her out of a case of heart failure. Anyway, so I thought I’ll go upstairs and introduce myself, and she will say thank you for saving my life, and then I’ll no longer be burned out. I thought, I have a strategy here. I was working the day shift, so I got off duty and went upstairs. Still had on my scrubs and my tennis shoes, and I went up top two, and I’ll just call her Ms. Smith. I forget her name. I said, “Ms. Smith, I’m Paul Austin. I’m one of the ER doctors, and I’m the one that took care of you when you came into the hospital.” She said, “Who are you?” I said, “I’m Paul Austin, one of the ER doctors. I took care of you in the Emergency Room.” “Are you a paramedic.” I said, “No, no, I’m just a doc.” “Cause those paramedics were so nice.” I said, “Yeah, they were nice, they were really nice. The reason you remember them and you don’t remember me is cause you weren’t conscious by the time you got to me. By the time you got to me your breathing was so bad that you lost consciousness, and I’m the one that put the tube in your windpipe to hook you to a breathing machine so we could get that fluid off your lungs.” She said, “You would not believe how sore that tube made my throat.” (laughter) What do you have to do to get a thank you from this lady? But I said, “I’m sorry it made your throat raw, but I’m glad they could get it out.” And she said, “Well, I guess I should say thank you.” Yeah, just say it, lady, so I can go home. (laughter) And she finally said, “Well, thank you.” I said, “You’re welcome.” But it was so funny. On the elevator back down to the ER locker room to get my stuff, I thought, you know, lady, you have no idea. She was oblivious. There she was, with her little pink nightgown and eating a little powdered doughnuts, little bits of white sugar all over her chest she was kind of brushing off, had no idea of how close she came to dying. I mean, that would have been boom, end game, and move to the next patient. But what I had to do, the nurse was new, and the respiratory therapist was new. I mean, the team knows, we all know when we do a good job, and we all know when we kind of blow it. So you get a lot of, I think most all of us that work there so value their relationships with the folks at work. And one thing I really like about the ER is that the nurses and docs, it’s first name, it’s not Dr. Austin. Some of the new nurses, just right out of the nursing school may say Dr. Austin, but no, just call me Paul, we’re good. And the nurses are real free to come back and say, “Are you sure you mean 10 milligrams.” “Oops, no, you’re right, 1 milligram, you’re right, decimal place.” The nurses are real good about telling me what they think. “Paul, I don’t think she was on a breathing treatment.” “Oh, ok (inaudible).” Where as nurses on the floor and maybe in other specialties, it’s not quite as equal a relationship. But the ER is real democratic kind of place, and a place where pretense and puffiness isn’t tolerated much by the nurses or the docs. We just want to move people through and it’s a great group of people to work with. I used to be a fireman for the city of Highpoint, and it was real similar like the firefighters back then. Now they got one more fire department, which is a good thing. When I was there it was all guys, but the guys at the firehouse, I mean, they believed in putting out fires and pulling people out of the houses. And there’s kind of an innocence to that. And the need, the kind of cynicism and joking and comments about the drunk in Room 2, I think most of the people I work with bring an innocent desire to help people under stress. Sometimes if I’m maybe feeling burnt out, or if I’m working too many night shifts or too many evening shifts, I have to remind myself I get to work with some of the best people I’ve ever known, just on a regular basis.

Dr. Kent: Well it’s a fascinating discussion, and I have a feeling that we could talk for hours. And this book Something For the Pain surely is chock full of these kind of stories. And I’m definitely going to crack my copy. The book is called Something For the Pain, and we’ve been chatting with Paul Austin. Tell us where we can find out more.

Paul Austin: It’s on Amazon. It should be at your local, independent book store. I have a website, paulethanaustin.com, and you can get links to the book, but it’s on Amazon.

Dr. Kent: Absolutely, and the book is Something For the Pain: One Doctor’s Account of Life and Death in the ER. It’s been such a pleasure chatting with you.

Paul Austin: It’s been a pleasure, thanks a lot.

Posted by admin | Filed Under History, Health, Medicine, TRANSCRIPTS, AUTHOR INTERVIEW, PODCAST

Karen Brody | Birth Activist

April 5, 2009 | Leave a Comment

Interview with Karen Brody | Author of Birth [18:48m]: Play Now | Play in Popup | Download

I talked with Karen Brody about her successful play and brand new book BIRTH. Fascinating discussion about a topic that people don’t broach often enough! More from Karen Brody’s website:

Hailed “The Vagina Monologues for birth” by renowned women’s health expert Dr. Christiane Northrup, Birth is a documentary-style play based on over one hundred interviews playwright Karen Brody conducted with mothers across America. It tells the true birth stories of eight women painting an intimate portrait of how low-risk, educated women are giving birth today.

Since 2006 the play been performed around the world as part of BOLD, a global movement using the Arts to inspire communities to improve childbirth choices and put mothers at the center of their birth experiences.

This special edition of the book includes the entire play, playwright’s introduction and reflections,and the impact the play has had on BOLD communities. It also includes a foreword by Christiane Northrup, MD, FACOG, author of The Wisdom of Menopause, Mother-Daughter Wisdom, and Women’s Bodies, Women’s Wisdom.

Posted by admin | Filed Under Health, Medicine, Politics, AUTHOR INTERVIEW, PODCAST

Dr. Allan Hamilton | Spirituality & Medicine

March 30, 2009 | Leave a Comment

Interview with Dr. Allan Hamilton | The Scalpel & The Soul [14:44m]: Play Now | Play in Popup | Download

I enjoyed speaking with Dr. Allan Hamilton immensely, about spirituality and medicine — two topics not often mixed in polite company!

Dr. Allan Hamilton | Author of The Scalpel and the Soul

March 29, 2009 | Leave a Comment

Dr. Kent: Welcome to Sound Authors! It’s a beautiful day out here in New York, still a little bit crisp in the air but there’s just a hint of spring coming around the corner. We have three authors on the show today and one musician; I’m excited about it. My first guest will be Dr. Allan Hamilton and his books called The Scalpel and the Soul and I’ve got a guy on who wrote a book called Abramo’s Gift – it’s a beautiful novel by Donald Greco. My third guest on the show is the youngest brother of the McCourt family. Of course there’s Frank and Maliki and this is Alphie McCourt. His book is called A Long Stones Throw, a beautiful memoir. At the end of the show I’ve got some musicians coming on as always and James Reams is joining me today with his band the Barn Stormers. So without further ado, my first guest on the show, Dr. Allan Hamilton, the writer of The Scalpel and the Soul. . Welcome to the show.

Dr. Hamilton: Thank you for having me Dr. Kent.

Dr. Kent: This is such an interesting issue. My father is a doctor and I know quite a bit about doctors just from hanging around them all my life and it’s not something you hear about too often, the soul.

Dr. Hamilton: Well it sort of one of our its we don’t feel comfortable sometimes talking about and one of the reasons that I actually tackled the topic was I went into my training and the first part of my career as a surgeon very unprepared if you will for some of the spiritual challenges and emotional challenges my patients were going to face and as you watch that process, it gradually begins to reflect on your own life and your own values and I thought that sort of took me by surprise if you will.

Dr. Kent: It’s really an experience that just about everyone has in society at one point. Being there, thinking about the scalpel and the soul as it were. In the emergency room waiting area, waiting for a family member to come out, this and that. It really is an emotional place, the hospital.

Dr. Hamilton: It is kind of a crucible and for many people it’s going to represent not just the moment of tremendous threat but also a potential challenge and even spiritual transformation. Many patients will come through a severe illness or major surgery and will have focused for them what their values really are, what they want their legacy to be and in many cases a lot of my brain tumor patients, cancer patients really have crystallized what they want their lives to be about and the purpose of their lives.

Dr. Kent: Here’s a question you might not get all the time but I have a curiosity about the word scalpel. It’s a word that came up on the campaign trail by both candidates this last year and I think we have a serious fear of that device, the scalpel and its only certain people that we trust with that and we trust them with our lives.

Dr. Hamilton: The scalpel is an interesting symbol. First off if you think about it, it really is a knife, like any other knife and yet its held with a completely different kind of grip and one of the most difficult things for young surgeons to learn is basically the way of wielding that scalpel so it actually is cutting tissue the way you want. And that when you cross that threshold, it’s really as if the scalpel suddenly has become a part of your hand, of your fingers. It’s no longer just an instrument but it carries a very special significance and you know it’s the knife that’s used in healing but still has a lot of the connotations of a knife. I always say surgery is only a few steps away from murder.

Dr. Kent: Wow. That’s a great statement, and a terrifying statement. Now, we have such a stigma attached to doctors these days. What’s your take on that? In the world of people who say I’m going to sue my doctor and this and that, there’s a real trust issue and it really does come down to there’s a fine line between murder and surgery. A lot of people think, go ahead.

Dr. Hamilton: Well I think you’re right. I think first off I think there’s a spiritual crisis going on in the midst of the whole medical health system. Medical adverse events, which is our fancy word for mistakes, errors, are the fourth leading cause of death now in the United States. Five times more people die a year from medical adverse events than those that die on the highways in America. So the publics trust in terms of public trust, the healthcare industry is right behind the food handling industry and the nuclear waste industry; we’re third.

So we really have lost the publics trust and one of the reasons is we’ve gotten farther and farther removed from the patient and the immediate relationship and sense of a partnership and the sense of being if you will united with the goal of healing. I think patients are gradually starting to feel more and more estranged. If you watch video tapes and do a study, the average time from when a surgeon walks in the room to the time the surgeon walks out with a signed consent for surgery is seven and a half minutes. So in 7-1/2 minutes you go from meeting a complete stranger to putting your life in their hands and asking people to trust a system like that I think is asking an awful lot. There’s almost no other situation in the world where we come up against that asked of us.

Dr. Kent: What’s interesting is that you talk about directly on your website, which is allanhamilton.com, there’s the soul often needs more than an intensive care unit can provide and I’ve experienced times in the intensive care unit visiting a family member and its not a place that; its an emergency place, its keeping people alive and its not a pleasant place to be. Where does the soul belong in that?

Dr. Hamilton: Well I’ll give you a very good example. I was just with a group of residents and we were next to a little boy in the ICU after surgery for a tumor. It really was an important point to remind the residents to step away from the patient’s room and the family and the immediate area if they wanted to have a discussion about certain things. My feeling was I don’t want the patient hearing a word here or a word there that has very significant connotations. I think you need to be aware that there’s an awful lot of stress in that ICU and we don’t want to add to it we want to actually address some of those emotional demands and that’s why I think we tend to look at the body in the ICU and often forget how desperate the soul is for support at the same time.

Dr. Kent: You are a neurosurgeon and I find it fascinating that someone who deals so much with a concrete part of a human beings body in such a sensitive area also thinks about the soul and a spiritual side to things. How does the physical tactile part of things connect up with the other side?

Dr. Hamilton: I think there’s a disconnect. I think one of the reasons I got so interested is because you’re working on the brain and because yes its an organ but it is a mind, it is the personality, it is the entire life experience, the values, you know, love and its all there and yet you’re just looking at an organ and at the same time very aware that the whole integrity of a person is in that organ. You can’t see it, you can’t see what love is, you can’t see where altruism and sacrifice and hard work or fear are; you don’t see that when you’re working on it, you just know that its there and you have to be aware that this is in some ways you’re inside a temple. It isn’t like any other organ. If you take somebody’s piece of bowel out or even fix their heart, you’re not changing the fundamental character of the person and yet with this surgery we can actually end up doing that or removing speech or you can confuse sending somebody up so their completely confused or have no memory. I think it makes you feel as if you’re far more connected with something beyond just the anatomy and the physical.

Dr. Kent: So let’s talk about the book itself, The Scalpel and the Soul. Its done very well and being carried by The One Spirit Book Club at Borders among other things and now why did you decide to write a trade publication? This is certainly not written for a medical journal, it’s a wonderful read. What did you want people to take away from it?

Dr. Hamilton: Well I think it’s a conversation because on one hand as I explained earlier, people aren’t talking to us and training us as physicians that we’re going to be dealing with it and at the same time you have a huge number of patients and a growing number of patients who say no, I’m not just a body with a disease I’m a human being with a soul and a heart and that has to be addressed at the same time so I think what you have is one group of people who want to open up a dialogue with their physician and I think the other thing is you have a group of physicians who are saying why cant we even have a conversation about this?

Why can’t we all know that miracles are happening every day? We all have had patients where we’ve said this patient isn’t going to survive another week and yet they say I have to wait another four months for my son to come back from Iraq so I can say goodbye and they do it. If this is just a process, how does all that happen? How did they summon the emotional strength, the spiritual strength, the will to impose their needs over a biologic mechanistic process so they could reach closure with their loved ones. That’s really what’s miraculous and that’s where you want to have the conversation between physician and patient.

Dr. Kent: How has the reaction been from your colleagues in your community? The books done very well and I’m sure many a doctor has picked this up.

Dr. Hamilton: Well surgeons, which I’m one, we’re the arch-conservative, the republicans of the medical world so I’ve had a lot of colleagues who’ve said you’ve been a surgeon 30 years, you’ve been chairman of the surgical department, how could you have sat down and written a book about spirituality like this? I’ve gotten very good reactions from the younger doctors, they give me a lot of hope because they say we’re glad somebody’s talking about this and made the subject no longer taboo. Then you have the intermediate group; I had a colleague going up in an elevator with me I’ve known for 20 years and he was saying I cant believe this book you wrote about spirituality and then he walked out of the elevator, turns around and says to me on the other hand I always know when something bad has happened to my children even before the phone rings. I said, so you have a sense of being connected to something beyond yourself and he says yeah. I said, well that’s what the books about. So I think its run the gamut.

Dr. Kent: Wow, well it’s such a fascinating title and with your background especially fascinating and I encourage everybody to go out and pick this up. The Scalpel and the Soul and of course this is available from the Reading Group at Borders, the One Spirit Book Club. What are you working on now?

Dr. Hamilton: I’m actually working on another book about spirituality and our connection with animals so that’s the second book.

Dr. Kent: I got to say I can’t wait to read that one. I’ve got a great connection with my golden retriever so.

Dr. Hamilton: Yeah.

Dr. Kent: Well thank you so much for being on the show, this has been fascinating and we can find out more about Dr. Allan Hamilton on his website, www.allanhamilton.com and everywhere books are sold. Thank you so much for chatting with us.

Dr. Hamilton: Thank you it’s been a pleasure.

Dr. Kent: My next guest on the show is a fellow named Donald Greco and we’re going to talk to him in a minute about his novel called Abramo’s Gift. Come on back for that.

Posted by admin | Filed Under Science, Health, History, Medicine, AUTHOR INTERVIEW, TRANSCRIPTS, PODCAST

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