How to Win The Doctor Lottery

Hi All, and Happy Spring!

Doctor Patient photoI’m proud to share this very personal essay I wrote for the April 2017 issue of the journal, Health Affairs, “How to Win The Doctor Lottery: Not every doctor-patient encounter is healing, and it can seem a game of chance. One patient explores what it takes to win.” Or, if you prefer, you can hear me read this essay aloud in this audio recording on the Health Affairs podcast!

If you’re looking for support for your own healing journey, I hope you’ll enjoy my recent article on ACEsTooHigh, about the importance of the medical profession becoming trauma-informed, Childhood Trauma Leads to Lifelong Chronic Illness – So Why isn’t the Medical Community Helping Patients?

Let me know if these resonate with you.

For those in the Washington, D.C. and Northern Virginia area, I’ll be speaking this Saturday at the annual Learning & the Brain Conference. Hope to see you there.

Last, but not least, stay tuned — I’ll be announcing my next book very, very soon. I hope, when I do, you’ll be as excited about it as I am!

To your wellness!

Donna

How Adverse Childhood Experiences Affect Adult Illness

A screenshot of my Q. and A. -- to watch it, click on this link: https://www.youtube.com/watch?v=pcZ_uLIB7V8

A screenshot of my Q. and A. — to watch click this link: https://www.youtube.com/watch?v=pcZ_uLIB7V8

Hi All,

Here is a recent video interview, in which I share my thoughts on How Adverse Childhood Experiences Affect Adult Illness, why our new understanding of this science must change the way we do medicine, and why I wrote my book, Childhood Disrupted. Produced by Studio4.

Hope you’ll enjoy!

Donna

Come Join Me For Talks & Booksignings in July 2015 on Childhood Disrupted: How Your Biography Becomes Your Biology, and How You Can Heal!

DSC_0090-1Hope you can come join me on Tuesday July 7th at 7:00 at Baltimore’s lovely Ivy Bookshop for a talk, chat, and booksigning!
Tuesday, July 7th, 2015
7:00 p.m.
Childhood Disrupted: How Your Biography Becomes Your Biology, and How You Can Heal — a Discussion & Book Signing
with Donna Jackson Nakazawa
http://www.theivybookshop.com/

Or, come join me on Friday, July 17th at the Annapolis Bookstore for a talk, chat, and booksigning!
Friday, July 17, 2015
7:00 p.m.
Childhood Disrupted: How Your Biography Becomes Your Biology, and How You Can Heal — a Discussion & Book Signing
with Donna Jackson Nakazawa

http://annapolisbookstore.com/

Hope to see you at one of these!

Continue reading

Talking on NPR about The Last Best Cure

I really enjoyed a great discussion today with Dan Rodricks, the host of the NPR show, Midday, on WYPR, Baltimore’s Public Radio station. Dan is smart, genuine, and asks great questions. We really delved into why I wrote The Last Best Cure, the science behind it, and how I hope it can help readers with chronic conditions. You can listen to the entire show by clicking on the podcast at this link: http://wypr.org/post/last-best-cure.

photo of dogs with glasses reading

My writing companions, Ashlie and Winnie

This photo has nothing to do with this show — I am just reposting it here because I like it and it makes me smile!

Two Wise Teachers

Photo credits to my daughter, Claire who took this photo during a snowy walk this weekend as we ventured into the woods and stream behind our house.

I spent this weekend at a two day meditation event with one of my dearest friends, and together we soaked in the amazing wisdom of Syliva Boorstein and Sharon Salzberg, who came together to teach as a duo on this snowy, rainy weekend in Washington DC.

My favorite nuggets:

Sylvia Boorstein’s teaching, “May I meet this moment fully, May I not complicate it, May I meet it as a friend.”

Sharon Salzberg’s teaching: “The most important moment of meditation is the moment you sit down to do it.”

And Syliva Boorstein’s teaching about how to handle being in busy, harried family life and not lose one’s hard won peace in the midst of it: “Try not to fall into other people’s states of mind.” I find this really wise as I raise teenagers…

My deepest gratitude to these two wise teachers.

I am particularly grateful that at the end, I received the joyful gift of a warm hug from Sylvia Boorstein, who was so kind to say such lovely things about The Last Best Cure when it came out last spring. As I told my friend Elizabeth, who is one of those wonderful kinds of friends who always keeps me honest with myself, as I grow older, I hope to become more like Sylvia Boorstein — she pretty much glows with metta. And to please remind me, when I am overreactive and small of mind, by saying, “Remember, you want to glow like Syliva Boorstein.”

Sometimes, just to meet someone whom you admire so much, whose teachings you follow, and to see how their presence changes those around them — because their compassion and loving kindness comes from such a deep wellspring the whole room can sip from it — well, that is a teaching in and of itself. Thank you Sylvia Boorstein and Sharon Salzberg (whose fabulous new book is just out, Real Happiness at Work).

Big News Coming! The Next Book!

I’m just about to announce my next book project — which I’ve signed for with Atria/Simon & Schuster. I’m going to be looking for interviewees for this one! So, stay tuned…I’ll be reaching out to you, my amazing, faithful readers.

I'll be looking for readers who want to be part of my next book... I'll announce it soon!

Subscribe to get my blog posts (option on the right) to stay informed and find out more!

A Long Ago Story

Hi All,

It has been a busy month. My son graduated from high school, my daughter graduated from middle school, I turned in my story for MORE Magazine on women, chronic illness and friendship (I’ll keep you posted on when it will appear — a mega thank you to all of you who participated!), joined in several wonderful The Last Best Cure Virtual Book Club groups with wonderful readers, and took my son with me on a work trip overseas that combined some work meetings and interviews with pleasure.

With my son in Jardins des Tuileries in Paris

Right before we left, I was cleaning my office in anticipation of starting my next book project (more on that soon), and came across a magazine story I’d written 18 years earlier, chronicling the months after my son was born, when he was suddenly hospitalized at a few weeks of age for a major surgery to correct a life-threatening condition. The story brought back many memories of the stress and terror (if you’ve ever had an acutely ill child, you know what I mean) of those days, and I wept as I read it.

I wept shockingly, in a way I do not think I wept during those long days and nights, 18 years ago. As if, for the first time, I could feel my fear, because it was finally safe to experience it, enveloped as it is now by my gratitude, 18 years later, that my son is here, so unequivocally full of life.

Rereading the words I’d written, reliving those emotions made me realize two essential things. (You can read a copy of Fortune’s Child below; I apologize if it’s hard to read — it’s a scan of the original — click on each page and then click again to enlarge.)

First, it goes without saying how lucky we are that this baby who almost got away is here with us now, that he survived.  And second, as I recalled the fear that reverberated through every fiber and cell of my being during that long year, I wept for something else.

I wept for the very young mother I was then. I found myself wishing that my older, kinder, wiser “now” self might beam back in time and sit beside that young woman, comfort her, hold her as her infant son was whisked out of her arms and away to intensive care.

This took place, I should point out, for those of you who have read my writings in The Last Best Cure about ACE scores, in the same hospital in which my own father had died when I was a child. It felt like an old record replaying, as I watched helplessly as this person I loved, too, also struggled for his life.

I wanted to go back and squeeze my young self’s hand and help her to forgive herself (I felt so certain it was my fault that my son was so sick). And to forgive the whole spinning world, which seemed cruel, unnatural, allowing a child to know so much pain. I wanted to give her a gift and say, Hey, in 18 years, you and this lovely young man will walk the streets of Paris, and you will be able to breathe in deeply, and he will be able to too, and your cells will resonate with that lightness of being that rides in with joy.

Oh my legs hurt, and I sometimes tripped on those Parisian cobblestones, and I often couldn’t keep up with my long-legged boy, given my GBS history, as we went from the Musee D’Orsay to the Tuileries to La Fete de la Musique. But he put his arm around me, slowed down, found a cafe where I might rest, and later, on we went.

The combination of finding this article, and taking this trip made me realize that although in the past 18 years there has been a whole heck of a lot of the Pain Channel, much time in the hospital, a lot of doctors (many brilliant, as in the attached article), and times when life seemed unbearably bleak, the truth is we just don’t know, can’t know, what gifts might lie ahead. We have to hold onto that — that we just don’t know what good might yet come — in our darkest suffering. Suffering is often replaced by wonder, the Life Channel flickers back on. We are not static, time is not static, pain is not static, even when it feels that way. Currents of joy come again — and it is so important to learn how to really be in that current, when it flows our way.

My son’s being here is a miracle. My healing (although not “cured”) from twice being paralyzed and so much else often feels like a miracle. My father’s early death was a tragedy, but my surviving and healing from that, too, is something close to a miracle. I could not have guessed that these things would come to be.

We just don’t know what joy is ahead of the suffering. We don’t know. But we know that everything changes. And that includes the Pain Channel transforming to the Life Channel.

Below is the rest of that article, Fortune’s Child, written and published in 1995.

Fortune's Child, Page 2

Fortune's Child, Page 3

Fortune's Child, Page 4

Fortune's Child, Page 5

Fortune's Child, Page 6

 

 

A Thought Challenge

My daughter took this photo while we were walking in the fresh spring air recently. "You should use this photo on your blog," she said. "It's how you really look everyday." And so here it is.

Today I came across a “Thought Challenge” from meditation teacher and writer Jack Kornfield, whose work I so admire. Kornfield talks about separating ourselves from our tightly gripped sense of our “self,” and seeing what happens.

Selflessness, Kornfield teaches, is not about seeing “how selfless I am.” It’s about stepping away from identifying everything as “me” or “mine.” Selflessness, he writes, “does not reject our experience in any way. We don’t get rid of anything. The experiences are the same…. All that’s changed is that we have stopped identifying with them….When identification with the small sense of self drops away, what remains is the spacious heart that is connected with all things. The Wise Heart.”

I am always in search of my Wiser Heart. So I was drawn to Kornfield’s suggestion to try this practice — to notice what happens when we stop identifying so tightly with our sense of self and me-ness. Here is his challenge: “Try today to study the sense of self. At regular intervals, pause to check in and notice how strong the sense of self is. At what times of day, in what roles or situations is it strongest? How does your body feel then? How do others respond to this? What might happen in the same situation without a strong identification with the self?”

So I did try it. I wanted to challenge myself to note in what situations (and, for me, with which people) my sense of self looms strongest. And the exercise proved so profound I felt I had to write about it here, and share what I found.

Trying this exercise helped me to have a difficult conversation with a person I often find to be trying in my life — and to handle that interaction with a wisdom and grace I had been unable to find within … until I tried Kornfield’s exercise.

The person with whom I was interacting has a good heart but also has what I like to call “Oppositional Conversational Disorder.” Have you ever met anyone like that? I’ve found that whatever I say, this person disagrees immediately, often before my whole sentence is out of my mouth. Call it conversing in a Culture of No. For instance, I say, “I was thinking…” and this person says, “Oh no, that’s not how it works…” And if I say, “That made me sad…” this person says, “Oh no, you shouldn’t feel sad.”  This person is wedded to “no” and “it isn’t” and “don’t” and “but” and “shouldn’t” and argues so reflexively it’s a habit of mind that has permeated their very nature.  But this person is also a good person, a really really good person, just not an easy person to have a meaningful conversation with, because “Oh no” or “Don’t” proceeds every sentence they say.

So I tried it. I tried letting go of my sense of me, my point of view, my being right, my… me-ness. As this person’s Oppositional Conversational Disorder reared its head and they said “Oh no it’s not because of…” I took note of how my jaw tightened. They said, “You didn’t” and my upper palette locked down on my tongue. I heard, “You shouldn’t” and a band tightened around my chest. “Don’t do it that way…” The muscles in my thigh tightened. I took a mindful breath. Look how tightly clenched my chest feels, my legs, my throat.

I replayed Kornfield’s question in my mind. “What might happen in the same situation without a strong identification with the self?”

I reminded my “self” that I am not my thoughts. Indeed, new research tells us that our feelings shift every 90 seconds.

I asked myself, Why am I identifying so closely with my sense of self, with having myself be heard and be right — when I don’t even really know what “self” is? When I know my thoughts shift every 90 seconds?

If I am not my thoughts, if I am not my ever-changing feelings, including this feeling of irritation and frustration and anger that now threatens to overwhelm me, what is my “self?” And why is my “self” reacting so strongly to what another person is saying that seems to be in judgement of “me” if that self is not real?

Gosh, I hope that makes sense.

By interjecting the question, I could step back.

This was such a freeing experience. I began to breathe. My jaw relaxed. The bands around my chest fell off. It felt so freeing. When I stepped back from that strong sense of self that I had been nursing as I heard “don’t” and “shouldn’t” I felt something else. A bubbling up of awareness. I am not my reactivity. My “self” is something much larger, much wiser. For a moment I had to hold back my sense of inner glee, and keep from laughing out loud – not at my conversational partner, who was still talking, but with the freedom I felt within.

I highly recommend trying this. In the midst of your next difficult interaction, especially if it is with someone with Oppositional Conversational Disorder, let go of your tightly held sense of “self” in your conversation. See what happens.

Here’s what happened to me. The person I was talking to stopped. They breathed. My oppositional conversational partner just looked at me after ten more minutes of conversation or so and said, “Oh, okay.”  Two words they had never said to me before.

To let that strong ID with self go during that difficult interaction changed its outcome.

I have so much left to learn.

Distressing Thoughts and Stressing Our Cells

It was when my own physician, Dr. Anastasia Rowland-Seymour, at Johns Hopkins, said this to me that I began to understand how important my own inner dialogue was to my state of well-being

What is the direct relationship between letting our mind drift — ruminating about the past, worrying about the future, focusing on distressing thoughts, what’s going wrong, what isn’t fair, or what we’re afraid will happen next — and our cellular and physical well-being?

Although we can’t peer inside our cells in real time and see how mindful calm versus a racing mind have radically different health impacts, a new study published in the journal Health Psychology, sheds new light on the question. Researchers at U.C. Davis Center for the Study of Mind & Brain have conducted the first study which shows the direct relationship between using our mental resources to manage ruminating thoughts and stay with our immediate experience — and lowering our levels of the inflammatory stress hormone cortisol.

High levels of cortisol, a hormone produced by the adrenal gland, are, as we know, associated with physical or emotional stress. Prolonged release of the hormone contributes to wide-ranging, adverse effects — and are linked to every physical and mental disease imaginable.

Sometimes it helps me to remember what “stress” really is.  Stress is really a euphemism for our thoughts. Our racing, self-flagellating, ruminating, resentful, could-have, should-have, wish-I-had, wish-I-hadn’t thoughts that catch us in their trance. Or what I call, in The Last Best Cure, the “Pain Channel.”

All too often we can’t get out of the Pain Channel’s trance. We can’t turn the Pain Channel off. We keep tuning into what it has to say, and as we do, those thoughts help promote the production of stress hormones and cytokines that are, in turn, linked to higher rates of depression, heart disease, autoimmune disease, you name it.

Other research tells us that in the lab, the negative cellular impact of stress hormones look a lot like the negative impacts of the toxic chemicals I wrote about in The Autoimmune Epidemic.

So, here is my reminder equation.
Stressed State of Mind =  Pain Channel.
Pain Channel = damaging stress chemicals circulating in our body.
Damaging Stress Chemicals = what scientists call the “Negative Floating Brain.”
“Negative Floating Brain” = greater likelihood of emotional and physical health challenges.
Greater Health Challenges = more likelihood of being in a Stressed State.

This is not to say that our state of mind creates disease. That’s far too simplistic.There is so much at play — genetics, diet, environmental toxins.

But stress chemicals certainly add to our “barrel” of factors that work against physical and emotional healing. And even if moving away from the “Pain Channel” and the Negative Floating Brain doesn’t necessarily mean we overcome whatever physical challenge we face — turning down the “Pain Channel” volume can’t help but make us feel better, whatever chronic condition we’re up against. (For more on how I see that, see my OpEd for PBS’s online magazine, Next Avenue, called, “I’m Not Cured but I am Healed.”) (I really think the title should be, more accurately, “I’m not Cured, but I am Healing.”)

The practices that help us walk away from the Pain Channel and the Negative Floating Brain really do make a difference, and they are worth our time and our commitment.

For me, as a science writer, reminding myself of the science every day helps me remake the commitment to meditate, focus on mindful breathing, loving kindness, down dogging, laughter, nature walking…all of it. The science is my guide.

Post-doctoral researcher Tonya Jacobs PhD says that in the above study, researchers taught study participants attentional skills such as mindful breathing, observing mental events, and practicing cultivating benevolent mental states, including loving kindness, compassion, empathic joy and equanimity.

Individuals whose mindfulness scores increased showed a decrease in inflammatory disease-promoting levels of cortisol.

“The more a person reported directing their cognitive resources to immediate sensory experience and the task at hand, the lower their resting cortisol,” Jacobs says. She adds that training the mind to focus on immediate experience may reduce the propensity to ruminate about the past or worry about the future, the thought processes that have been linked to cortisol release.

We are all walking around listening to the Pain Channel way too much of the time. And we know that the negative floating brain damages our immune system and our cellular health.

The question is, what are we going to do about it?

In hopes that they might prove helpful, here are two upcoming offerings.

The first is being offered by the phenomenal health advocate Elisa Rodriguez, who is launching one of the first The Last Best Cure Virtual Book Clubs to discuss and encourage us all on the journey … I’ll be joining in for a one hour discussion. I’ll also be sending signed bookplates to participants. To learn more, see Elisa’s video here. I’ve spoken with her several times now, and wow, she is just amazing. The beauty of The Last Best Cure Virtual Book Club is that you can join from wherever you are, and Elisa has found a way to make it easy and accessible to all.

The second is an upcoming retreat by my own beloved teacher, Trish Magyari, whose work I feature in The Last Best Cure. Magyari will be teaching a one day “Befriending Yourself” Mindfulness Retreat” on Saturday June 15 at Baltimore Yoga Village in Mount Washington (Baltimore, Maryland) from 1-5pm. Trish is a life-changing teacher. If you can take this opportunity to work with her, do.

I hope to hear from you about your own efforts to stay on the path.  What is working for you today?

 

How We Handle the Wear and Tear of Today’s Stress Predicts Whether We’ll Be Depressed Ten Years From Now

The way we manage our thoughts right here, today, determines how we'll feel -- and whether we'll suffer from depression and anxiety -- ten years from now. The best way to stay on a healthy path? Redirect your negative emotions today by learning to mindfully manage your thoughts.

The way we manage our emotional responses to the stresses we meet in day-to-day life  — to what is happening right now, right here, in our life — predicts whether we’ll suffer from depression and anxiety ten years from now, says a new study in today’s Psychological Science.

Researchers examined the relationship between how we handle daily stress and our mental well-being ten years later. They found that our longterm emotional health has less to do with what happens to us than with how we react to what happens to us.

The better we are at managing our emotional responses and thoughts today — to whatever problem we’re facing at work or at home or with our kids — the better mental health we’ll enjoy ten years from today. The better brain we’ll own.

When we respond with a lot of negativity and reactivity to our day-to-day stressors we’re more likely to be clinically depressed ten years later and experience feelings of “worthlessness, hopelessness, nervousness and anxiety.” We take those negative emotions with us, wherever we go.

These findings, based on a study of 711 men and women between 25 and 74, show that mental health outcomes aren’t only affected by major life events — they are also affected by the “chronic nature of our negative emotions in response to daily stressors.”

We know there are so many ways to manage our thoughts and get off the distress highway — and stay on the path. Mindfulness, lovingkindness meditation, noting our moment to moment habits of mind, breath work, yoga, seeking out acupuncture.

In The Last Best Cure I spent an entire year learning from the best experts on the planet how to redirect my thoughts, calm my mind and quiet my stress response. And every day I continue to learn. Reading studies like these helps me to re-commit to these practices everyday.

Because that’s what it takes. It’s not instant. It takes work. Discipline. But it’s also fun. It’s a relief to step away from our daily wear-and-tear stress-reactions and ruminations. A half-hour spent mindfully breathing or in walking meditation or yoga sure beats a half hour spent ruminating and rehashing the should haves and what ifs that are worrying me today, and it will pay off long into my future.

Don’t we owe ourselves that small but priceless investment in who we are, and in who we hope to become?