The International Journal of Whole Person Care

Farzin, Houman

English

Chiu, Wendy

 
VOLUME 10 ● NUMBER 2 ● 2023 ● 4-5 
© 2023 Wendy Chiu. This article is distributed under the terms of the Creative Commons License CC BY. 
International Journal of Whole Person Care 
Vol 10, No 2 (2023) 
 
 
THE FOLLOW-UP VISIT 
Wendy Chiu 
Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine and Health Sciences, McGill 
University, Montreal, Quebec, Canada 
wendy.chiu@mcgill.ca 
 
KEYWORDS: Communication in healthcare, Patient coping, Terminal illness, Caregiving experiences, 
Doctor-patient relationship 
 
 
 had a dream in which I am standing next to my husband’s doctor in a crowded elevator. He is so tall, 
his face looming so far above my head that I cannot see it when I turn to say hello. All I see is a beltful 
of pagers and reams of papers and medical instruments spilling from his white coat. This despite me 
knowing he is barely taller than I – same height when I wear heels. Feeling somewhat inappropriate to 
speak to his pockets, I say nothing, and he exits. 
 
I know he has a terminal illness. I have had patients with the same diagnosis. I have held family meetings 
to explain the symptoms and treatments and poor prognosis; to advise on long term and palliative care. 
Now I am on the receiving end of such discussions but feel like I know nothing. I know the natural course 
of the disease, yet each day seems to raise new issues. I am frustrated he is so resistant to complying with 
standard treatment while he keeps asking about experimental ones. I sometimes do not understand how 
my husband, a fellow physician, could have so little insight into his own health and abilities. Does the doctor 
realize that in the whole year since diagnosed, he has not read even a single paper on the illness? 
 
Maybe it is better not to know. He is 39 and will die before his parents. I am 30 and will be a young widow. 
He most likely will die from aspiration pneumonia. Or maybe one day he will have such a bad fall that 
something critical will get broken or contused or whatever lands people in the ER for a lengthy, complicated 
hospitalization that seems to be the last days of so many of our patients now. I know this. He is afraid he 
will not be able to breathe. We talk of making wills and mandates on our first wedding anniversary. 
I 
The follow-up visit 
Wendy Chiu 
 
5 International Journal of Whole Person Care 
Vol 10 No 2 (2023) 
 
I have learned about the significance of the follow-up visit. It has been marked on our calendar for months 
and my workweek – no, month - planned around it. He takes great pains to wear his newest shirt and be 
meticulously shaved. We arrive 20 minutes early. He totters into the examination room, proud to show he 
still can walk; oblivious to the fearful cringing faces and darting hands ready to catch him in a blink. We 
recount a litany of changes since the last visit – all for the worse. Medication suggestions are made. 
“Anything else to report?” Because there is a meeting, a sick patient on the ward, it is the end of the day. 
“No, that’s about it.” We leave. We already have overstayed our welcome. 
 
Wait! I want to tell you how my husband is a shell of his former self. He ran marathons and played tennis; 
he taught me how to ski. He survived graduate studies and medical school and was in a grueling residency 
program before quitting as strange symptoms we would not see robbed him of speed and dexterity and 
speech and competitiveness. He is witty and loving though his cognition is slowing. I pick him up after yet 
another fall and change his diapers; he picks up my spirits and changes my perspective on life. “Anything 
else to report?” “We are losing hope. Can you help us?” 
 
But I guess these are not relevant to say. I feel inappropriate speaking to his pockets. 
 
Biographical note 
Wendy Chiu is a geriatrician at the McGill University Health Centre, and was her late husband’s primary 
caregiver for over a decade until he died in 2013 from complications of multiple system atrophy. She tries 
to use the experience to better care and advocate for her patients and their families, and hopes they feel 
understood. 
 
 
 
  


The Follow-up Visit

Dubes, Lucie

 
VOLUME 10 ● NUMBER 2 ● 2023 ● 29-31 
© 2023 Lucie Dubes. This article is distributed under the terms of the Creative Commons License CC BY. 
International Journal of Whole Person Care 
Vol 10, No 2 (2023) 
 
 
 
APATHY SETS IN DURING THE THIRD 
YEAR 
Lucie Dubes 
Medical Student, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada 
lucie.dubes@mail.mcgill.ca 
 
KEYWORDS: Narrative medicine, Medical education, Psychiatry, Empathy 
 
 
 met you on a stormy day. I had already been six weeks into my psychiatry rotation and every shift had 
been confirming my interest. When I heard a young woman was being brought to the emergency by 
her friends for depressed thoughts and suicidal ideation, I got excited. I wanted to do that consultation; 
I love this patient population. When I found out you and your friends were second-year medical students, I 
wondered how it would affect history-taking and therapeutic alliance-building. I did my best at the interview: 
I made sure to give you space, to validate your experience, while asking all the screening questions. You 
are going through a lot and life has not been easy for you. I feel for you and want to help. I leave the room, 
write my report, and come up with a differential diagnosis and plan. Major depressive disorder or adjustment 
disorder, I think, is not an acute risk to self or others. We discuss a safety plan, red flags to come back to 
the emergency room, crisis resources and outpatient psychiatry follow-up. Your friends are upset: "This is 
all you can do for her now? You are going to send her home to wait for someone to call her in some indefinite 
amount of time while she is currently in distress? This is impossible, we are not leaving until something 
concrete is done." I had not seen that one coming.  
I have always been fascinated by stories; particularly when they have a blurry beginning, unclear progress 
and unfinished ending. I like stories that can be dissected, analyzed and reconstructed. I like stories that 
offer space for interpretation. I like stories so much that I considered writing before deciding on medicine. 
I 
Apathy sets in during the third year 
Lucie Dubes 
 
30 International Journal of Whole Person Care 
Vol 10 No 2 (2023) 
 
As it turned out, I was better at analyzing them than making them up. More often than not, my favourite part 
of medicine remains the "history of present illness" and "impression". This is what I think it is based on what 
you are telling me. I remember very vividly, at the very beginning of our first year of medicine, being warned 
that "Apathy sets in during the third year." Not for me, I thought. I felt like if anything, I would always be 
connected to my patients' stories.  
Back to my patient in the emergency, there was a clear mismatch between the stories her friends and I had 
told ourselves about the patient. To me, this was a patient with a low suicidal risk presenting to an 
overloaded emergency system with limited services to offer. To her friends, this might have been the first 
time they had someone close to them experiencing such intense emotional distress as to express wishes 
to die. Even after clarifying the functioning of the psychiatric emergency system and validating their 
frustrations regarding wait times for outpatient referrals, I still felt like something was missing. I could not 
ignore that the voices of these two friends resonated too close to home: they could have been mine a year 
ago. Yet, it was as if the transition from learner (as a second-year medical student) to provider (as a clerk) 
had erased my ability to relate to what it meant to be on the receiving end. It was as if now that I was 
exposed to clinical practice, I could not recall the experience of "not knowing". I was not able to avoid the 
third-year medical students' fatality, after all. 
It required me to make a conscious effort to be able to step out of my own "post-clinical exposure" 
perspective and understand theirs. I had initially agreed with my supervisor that the friends were 
"unreasonable." Yet, when he entered the room to confirm the plan, I felt a switch in my perspective. It was 
as if the naturally existing hierarchy got me closer to the shoes of the medical students, allowing me to 
understand that what was unreasonable in this interaction, was not their expectations but those of the 
treatment team. How can we expect patients to understand that an emergency room is for, "stabilizing," 
"providing acute care," and "triaging" rather than healing? How can we expect them to know that what may 
have been their first access to care is not able to care for them?  
It is in the philosophy of narrative medicine that I started finding answers – not about fixing our broken 
medical system, but rather about fighting apathy. Narrative medicine borrows from the humanities and arts 
to provide us, healthcare professionals, with a framework for approaching patients' problems holistically 
and understanding how their experience of illness and healing may be anchored into a wider narrative, that 
of their entire life as well as ours.[1] It may be as a medical student, whose life experiences could be closer 
to that of being a patient, or as an experienced physician, whose experiences may be tainted by the 
innumerable patients they have treated – and maybe more so by those they have found "difficult" or 
"challenging." Why is it that some patients make us want to move mountains when others we look forward 
to closing the door on? It would be a mistake not to understand how our past experiences, roles and 
responsibilities in the patient's story influence how we interpret it, how we present it during handover or 
condense it in discharge summaries.   
Apathy sets in during the third year 
Lucie Dubes 
 
31 International Journal of Whole Person Care 
Vol 10 No 2 (2023) 
 
Concretely, there was little else we could have done for this patient. The medical system being what it is, 
she would have to wait for a call in an unknown amount of time, telling her it is finally her turn to be receiving 
the care she needs. Yet, I would argue that a lot more ended up being done. My own positionality as a 
medical learner ended up being a therapeutic ally: I could both validate my patient’s and her friends' 
incredulity while also explain the reality of the field. I gave her a list of mental health community resources 
as well as private psychiatrists who offered rating scales. It was not much, and still appeared extremely 
unfair that one would have to spend money to access appropriately-timed care, but the three medical 
students left telling me it still felt like "something was being done." What they needed was validation that 
they had done a good thing by coming to the emergency and that their friend was going to get help. The 
limitations of this interaction were not that of the system, but my very own, in understanding how it was 
impacting the therapeutic relationship. 
Narrative medicine has not only been reported to have a healing power from patients' perspectives but has 
also been proven to do so medically. Practitioner narrative skills may alleviate cancer pain, reduce disease 
in rheumatoid arthritis, improve lung function in asthma and heighten immune response following hepatitis 
B immunization.[2] In addition to providing better patient care, narrative medicine could also offer a way of 
making us more empathetic toward our patients. By allowing ourselves to enter our patients' shoes, we 
could better understand their expectations of care, which more often than not may be as important to 
address as their "chief complaint". As future physicians, we are going to be perpetually exposed to stories, 
so why not use them to heal? 
REFERENCES 
1. Greenhalgh T, Hurwitz B. Narrative based medicine: why study narrative? BMJ (Clinical research ed). 
1999;318(7175):48-50. 
2. Fioretti C, Mazzocco K, Riva S, Oliveri S, Masiero M, Pravettoni G. Research studies on patients' illness 
experience using the Narrative Medicine approach: a systematic review. BMJ Open. 
2016;6(7):e011220. 
 
Biographical note 
Lucie Dubes is a 3rd year medical student at McGill University. She completed her Bachelors of Arts in 
Human Biology & Society at the University of California, Los Angeles and worked in clinical research for a 
few years prior to starting medical school. During her medical studies, she became interested in the Art of 
Narrative Medicine, and completed the Foundation in Narrative-Based Medicine Digital Certificate at the 
University of Toronto in April 2023.  
 
  


Apathy Sets in During the Third Year

Stoljar Gold, Alexander

 
VOLUME 10 ● NUMBER 2 ● 2023 ● 25-28 
© 2023 Alexander Stoljar Gold. This article is distributed under the terms of the Creative Commons License 
CC BY. 
International Journal of Whole Person Care 
Vol 10, No 2 (2023) 
 
 
 
ON LIFESAVING CARE AND THE 
NECESSITY OF DIGNITY 
The story of Mrs. Hassan 
Alexander Stoljar Gold 
Medical Student, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada 
alexander.stoljargold@mail.mcgill.ca 
 
KEYWORDS: Whole person care, Patient, Medicine, Surgery, Dignity, Empathy, Transformative, 
Medical student 
 
 
s a medical student in your early months, it’s difficult to disagree with the notion of whole person 
care. Of course, all doctors should see the patient before them not as a biophysiological problem 
to be solved, but as a person with a family, friends, a sense of self, a sense of dignity. This seemed 
so obvious as to be almost banal, and I often took these lessons for granted. This changed – quickly and 
dramatically – when I began the clinical stage of my training.  
The transformative experience I wish to discuss involves a patient I will call Mrs. Hassan. Mrs. Hassan was 
a librarian in her early sixties, almost the same age as my mother. She had a reserved demeanor and spoke 
French with an accent. The first time I saw her, she was unconscious.  
One surprising thing about operating rooms is how cold they are. It was my first time on the surgical side 
of the OR (I had been in anesthesia the month before), and I felt that distinct blend of caffeine-induced 
focus and early-morning fatigue. I clumsily scrubbed in, amid a buzz of orderlies, nurses, residents, fellows, 
A 
On lifesaving care and the necessity of dignity: The story of Mrs. Hassan 
Alexander Stoljar Gold 
 
26 International Journal of Whole Person Care 
Vol 10 No 2 (2023) 
 
and other medical students. In the OR’s austere environment, under harsh fluorescent lights, with the 
continuous beeping of monitors, and, like many junior medical students, in perpetual fear of contaminating 
the sterile field, I felt a combination of trepidation and excitement. Mrs. Hassan was having a major 
esophageal cancer removed in one of Canada’s best tertiary hospitals – the case was bound to be 
interesting. The attending surgeon strolled in when everything was ready, the patient under general 
anesthesia and the trainees eagerly awaiting instructions.  
For the first 45 minutes, I watched in awe. For the next four hours and 45 minutes, I tried not to zone out. 
The surgery was technical, performed with great skill using a relatively new, minimally invasive technique. 
The operation was successful, the tumour was removed, and when it was over, I watched Mrs. Hassan 
wake up in the post anesthesia care unit.  
A few days later, I was asked to present Mrs. Hassan’s case at Friday rounds. Her surgery was the first I 
had witnessed, and she was the first patient I had ever presented. I summarized the history of her illness, 
her presentation, the surgery, her status post-op. While I had not contributed to her care in any meaningful 
way, I felt in some sense responsible for her – I knew her story inside out. She was “my patient.”  
Mrs. Hassan remained in the hospital, making an uneventful recovery. About a week after the operation, 
however, her X-ray showed a distended stomach, a common complication but one requiring prompt 
attention. It was decided that a nasogastric tube (a small suction device passed through the nose and into 
the stomach) would be placed to relieve the pressure.  
A small herd of medical trainees entered Mrs. Hassan’s room. There were two fellows, a resident, two other 
medical students, and me. Mrs. Hassan was discouraged by the news of the procedure but resigned to its 
necessity. I wheeled in a screen attached to a gastroscope, which would be used to visualize the patient’s 
stomach. Another medical student sprayed lidocaine into Mrs. Hassan’s mouth and nostrils, standard 
practice to mitigate the discomfort of the nasogastric tube insertion.  
Mrs. Hassan was alone in her bed, surrounded by observers. I was to her right with the two other medical 
students. Facing me was the resident, who would perform the procedure under the supervision of a fellow. 
The resident inserted the nasogastric tube into a nostril, and Mrs. Hassan gagged. This was to be expected, 
but I assumed the tube would be rapidly placed and the discomfort would soon be over. Quite the opposite 
occurred. The resident wiggled the tube around, getting it into Mrs. Hassan’s throat and aggressively 
stimulating her gag reflex, but unable to advance it into her stomach. He then attempted the other nostril 
as Mrs. Hassan heaved. The fellow watched him, providing tips here and there. No one seemed to be 
paying attention to her.  
As a student, I understand that medical teaching is vital, but there is a time for teaching and a time for 
experts to take over. Despite repeated, failed attempts to get the tube in, the resident continued to try as 
the fellow observed.  
On lifesaving care and the necessity of dignity: The story of Mrs. Hassan 
Alexander Stoljar Gold 
 
27 International Journal of Whole Person Care 
Vol 10 No 2 (2023) 
 
At a certain point, the gastroscope was inserted. The nasogastric tube already in Mrs. Hassan’s nose, the 
thicker gastroscope was shoved down her throat as she violently choked and retched. I will not forget the 
way Mrs. Hassan began to clutch, with both hands, the armrest on the side of her bed. It was as if she had 
to grab hold of something to prevent herself from drowning. Shocking though it was, I was less surprised 
by the brutality of the procedure than by the lack of attention paid to Mrs. Hassan’s pain. As the gastroscope 
went in, everyone scrutinized the screen I had brought in, attempting to discern what was causing the 
stomach distension. Fascination with Mrs. Hassan’s condition seemed to be blinding the medical trainees 
to her suffering.  
In fairness, the young physicians felt they were doing something good for Mrs. Hassan – and they were. 
The nasogastric tube was necessary to ensure she successfully recovered from the surgery. Rarely had 
anything been clearer to me, though, that a lifesaving procedure was no excuse to leave Mrs. Hassan 
writhing without comfort. No one told her it would be over soon; no one held her hand. To say nothing of 
sedation, which, I later learned, while not routinely used for nasogastric tube insertion, should be standard 
practice during gastroscopy.  
At some point, I instinctively grabbed Mrs. Hassan’s shoulder, telling her she was doing great and it was 
almost over. It didn’t feel special; it felt natural. What felt to me so incredibly unnatural was that I was the 
only one holding her. Eventually, a nurse came in and grabbed Mrs. Hassan’s hand. Noticing the pained 
look on the nurse’s face, I knew immediately that she was seeing what I was seeing.  
The fellow eventually took over and the procedure was completed. Mrs. Hassan slumped back into her bed, 
exhausted, her face awash with snot and tears. The fellow, young enough to be her son, rubbed her head 
and said, “Sorry sweetheart but we had to do this for you.” 
There was a small chapel in the hospital. I have never been a particularly spiritual person, but after it was 
all over, I went to the chapel. It was a novel feeling for me, the sense that I needed to be there. I closed my 
eyes and silently pleaded that Mrs. Hassan would recover, find comfort, find solace. 
In the days that followed, I questioned whether I had overreacted to the situation. I was new to hospitals, 
after all. Maybe this happened all the time. When I brought up my concerns with the surgeon, he politely 
dismissed them: yes, these procedures are unpleasant, but given a lack of resources, there is really nothing 
to be done. Sedation, apparently, was out of the question.   
Still feeling a sense of responsibility, I opted to visit Mrs. Hassan a few days later. I found her in considerably 
better spirits, the nasogastric tube still in but set to be removed soon. I apologized to her for her treatment. 
She told me it was worse than anything else she had experienced – worse than the surgery – and if they 
tried to do that again, she would refuse. She couldn’t understand how the young doctors who performed 
the procedure could have behaved like that. We spoke about her grandchildren and her immigration to 
On lifesaving care and the necessity of dignity: The story of Mrs. Hassan 
Alexander Stoljar Gold 
 
28 International Journal of Whole Person Care 
Vol 10 No 2 (2023) 
 
Canada. I wished her the best and said I would come visit tomorrow, hoping I had conveyed that someone 
in that room had seen her pain, had seen her. 
In medicine, we sometimes feel that patients should realize there will be moments of discomfort and 
embarrassment and should accept it. We are helping them, and they shouldn’t blame us for doing our job. 
Yet, while there will be moments of discomfort, there should never be moments of indignity. The most skilled 
clinicians are not those who use brute force and “give it to the patient straight,” but rather those who make 
the moments of unease seem to pass in a flash.  
My experience caring for Mrs. Hassan was profoundly transformative, as it showed me the consequences 
of not treating someone as a “whole person.” The failure to recognize a patient’s suffering – either because 
we have intellectualized their pathology or because we tell ourselves we are just doing what it takes to help 
them – is catastrophic. I will not forget Mrs. Hassan, and I will see her in the patients who come under my 
care. She will remind me that patients are people deserving of kindness and compassion as they navigate 
their stay in a place of healing.  
Biographical note 
Alex Stoljar Gold is a medical student at McGill University, where he completed a Bachelor of Arts and 
Science in Cognitive Science. Alex is passionate about whole person care, with a particular interest in 
exploring patients’ experience of illness through the humanities in medicine. He is also interested in medical 
anthropology and global health.  
  


On Lifesaving Care and the Necessity of Dignity: The Story of Mrs. Hassan

Dobkin, Patricia Lynn

	
VOLUME	10	●	NUMBER	1	●	2023	●	3-9	
	
©	2023	Patricia	Lynn	Dobkin.	This	article	is	distributed	under	the	terms	of	the	Creative	Commons	License	
CC	BY.	
International	Journal	of	Whole	Person	Care	
Vol	10,	No	1	(2023)	
	
	
MIND	SPACE	
	
Patricia	Lynn	Dobkin	
Programs	in	Whole	Person	Care,	Department	of	Medicine,	Faculty	of	Medicine	and	Health	Sciences,	McGill	
University,	Montreal,	Quebec,	Canada	
patricia.dobkin@mcgill.ca	
	
KEYWORDS:	Healing; Buddhist Eightfold Path; Mind 
 
 When I forget who I am I serve you 
Through service I remember who I am 
And I know I am you.  
(Hindu adage)  
 
hat comes to mind when you reflect on the words ‘healing spaces’? As a clinical psychologist 
I think the mind has the potential to be a fertile place for healing. Before I elaborate, let’s 
consider what healing means. Dr. Mount, the founder of McGill Programs in Whole Person 
Care, wrote, “healing is a shift in our quality of life away from anguish and suffering, toward an experience 
of integrity, wholeness, and inner peace.”[1] A shift. What shifts?  
 
Following three decades of working with various paradigms to understand human illness and wellness (e.g., 
psychosomatic, cognitive-behavioural, health psychology, humanistic, existential, mind-body medicine) the 
most compelling approach for me has been Buddhist psychology. Why? Because it uses the mind to heal 
itself and foster healing in others. Buddhist psychology provides methods to unpack how the mind shapes 
suffering without relying on dogma. In my view, it fits with the mission of the McGill Programs in Whole 
Person Care.  
W 
Mind Space 
Patricia Lynn Dobkin 
	
4	International	Journal	of	Whole	Person	Care	
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“The McGill Programs in Whole Person Care are based on the premise that in situations in which treatment 
is unable to change the disease outcome, it may be possible to create a space in which healing can occur. 
Lessons about quality of life and individuation, learned in the arena of advanced illness, also have relevance 
earlier in the disease trajectory and for those who are physically well. While the existential/spiritual domain 
is known to be an important determinant of quality of life, there has been little emphasis on integration of 
these issues in health care. The Programs therefore seek to integrate the physical aspects of personhood 
along with the psychosocial and existential/spiritual ones, and to better understand how to respond to 
suffering experienced by the whole person.” 
 
The Buddhist Eightfold Path (see sidebar) aims to alleviate suffering 
via (1) right mindfulness – remembering to be aware of present 
moment experiences (body sensations, feelings, thoughts), (2) right 
concentration (being able to focus and attend), (3) right effort (energy 
directed towards wholesome states of mind), and (4) right view 
(insight). “Right” denotes skillful and wise. Moral conduct, sometimes 
overlooked in secular mindfulness circles, remains crucial in Buddhist 
philosophy. It goes beyond the ‘me’ to include the ‘we,’ recognizing 
how interconnected we all are.  This is reflected in the other facets of 
the Path, (5) right intention (do no harm), (6) right action (ethical 
approach to others), (7) right speech (truthful, non-violent), and (8) 
right livelihood (prosocial professions). All eight are vital for the 
promotion of healing in the self and others. They interact and are not 
applied in a particular sequence. For example, an oncologist who 
provides competent, compassion care (right action and intention) is 
engaged in right livelihood. The physician-patient encounter, when infused with right view (diagnosis), right 
speech (congruent communication), and right action (treatment and/or palliative care) may promote healing 
in the patient, even when cure is not possible. Inviting the patient to partner with the oncologist reflects right 
effort (not doing for the patient what s/he can do for her/himself). 
 
Let’s examine how Buddhist psychology may inform us about how the mind may promote healing in a 
medical context. I quote excerpts of clinicians’ narratives as a means of exploring this idea; I bold those 
that illustrate facets of the Eightfold Path. 
 
Dr. Sang[2], a family medicine resident, wrote about contracting COVID-19 in the early days of the 
pandemic. Her nightmare reveals what was occurring in her mind. 
 
EIGHTFOLD PATH 
Right mindfulness  
Right concentration  
Right effort 
Right view   
Right intention 
Right action 
Right speech 
Right livelihood 
Mind Space 
Patricia Lynn Dobkin 
	
5	International	Journal	of	Whole	Person	Care	
Vol	10,	No	1	(2023)	
	
There I lay, listening to the rhythmic hum of my IV. The hypnotic waves of my heart rate on the telemetry 
screen reassured me that in that moment I was okay. My eyes burned with fever and my body shivered 
with a mix of cold and fear of what was yet to come. Having worked on the wards and seen how this 
disease progresses, I knew I was either going to turn the corner and be safely transferred to the COVID-
19 ward, or I was about to crash, require intubation, and an admission to the intensive care unit (ICU). I 
glanced at my phone – 25% of my battery remained. I prayed for the former and that I would be well enough 
to update my worried family before my phone died altogether.  
 
First, her senses are described (listening, burned with fever), she is acutely aware (mindful) of thoughts 
(heart rate was reassuring), emotions (fear), and body sensations (shivered with cold), she is focused on 
the problem (concentration), and understood that the illness could go either way (insight), she wants to 
reassure her worried family (intention). 
 
Aside from the dream, Dr. Sang situates her illness experience into a medical context. She shifts her focus 
away from ‘me’ towards others and gains insight about two roles she enacts and how they influence her 
feelings. 
 
When you are hospitalized in your place of work, the boundaries between being a doctor and patient blur 
completely. My colleagues became my caregivers; those once teaching me how to collect health 
information were now privy to mine…To any physician who has been a patient, you know how challenging 
it is to accept the sick role. Being in the doctor role is comforting; you have the knowledge and some 
control over the situation. Being a patient is riddled with helplessness and uncertainty: you are a 
prisoner to your own ailment.  
 
Now, let’s consider Dr. Lemos’[3] experiences while treating an elderly woman who had contracted COVID-
19. What stands out for me is her kind intention and insight (right view) into the woman’s reactions. She 
engages in right action, speech, and livelihood concurrently. This example shows that the eight facets of 
the Path influence each other moment-by-moment such that healing in the self and other is cultivated. Dr. 
Lemos’ self-awareness guided her to act in a compassionate manner. Her generosity created an 
environment in which all (patient, nurse, doctor) could win a seemingly impossible battle. The patient 
survived against the odds.  
 
I picked up the phone and made the call. 
“Hello?” 
“Hi, it’s Dr. Lemos. I just called to check in. I got your COVID test result this morning.” 
“I had a feeling I’d be hearing from you. Ugh. I feel fine. A little tired but FINE. I don’t see what all the fuss 
is about. It’s just a bit of a sniffle and everyone around here is losing their minds.” 
Mind Space 
Patricia Lynn Dobkin 
	
6	International	Journal	of	Whole	Person	Care	
Vol	10,	No	1	(2023)	
	
I could picture her, rolling her eyes behind her round, wire-rimmed glasses and shaking her head, one hand 
curled around the cane that was her constant (reluctant) companion.   
 
“I don’t understand why I can’t leave my room.  It’s completely ridiculous.” 
 
I had learned over the years that there was nothing she hated more than being told what to do. And that 
if she truly did not want to do something, then she simply was not going to do it. Unfortunately, she had 
little choice in the matter this time – and she knew it. She just needed a place to park her frustration and it 
happened to land on my ears.   
 
I could not blame her.   
 
Because underneath the bluster, I heard the fear. 
 
I felt for her. Being in her 80’s with multiple comorbidities, the odds were against her. There was little we 
could do beyond supportive care and watch and wait for the disease to run its course, one way or the other. 
But even that warranted tight communication with the nursing team at the retirement home who were 
bearing the brunt of her care. She was lucky to have them. 
 
Dr. Tsuchiya[3], a palliative care doctor and medical educator, portrays with clarity how mindfulness helped 
him during the pandemic’s early phases in Japan. His self-awareness is striking. Note how right view led 
naturally to compassion and kindness.  
 
I was living such that I needed to pay close attention to each and every action for the purpose of infection 
control. Every deed that I usually did unconsciously became more conscious to me. Consequently, this 
enabled me to observe my own actions while examining the meaning of what I was doing. This thought 
process promoted self-awareness and consciousness of the environment that I belonged to, giving me a 
moment to make a transition from one motion to another. I believe that this is a form of informal of 
mindfulness practice.  
 
Furthermore, people became more considerate and caring about one another. Of course, people tried to 
practice social distancing which allowed them to literally keep their personal space to themselves. 
Nevertheless, this did not necessarily mean a psychological distance between people. Although Japanese 
society had prioritized economic growth over an individual’s well-being for decades, others’ health and 
life under the state of emergency became a priority. Life with COVID-19 reminded us of the most basic 
and essential aspects of life and death. People openly discussed these issues more than before since death 
and dying became more familiar. In order words, ‘idle talk’ in the ‘normal’ life was transformed. As a result, 
Mind Space 
Patricia Lynn Dobkin 
	
7	International	Journal	of	Whole	Person	Care	
Vol	10,	No	1	(2023)	
	
I would say people became kinder with themselves and others as they recognized how precious we all 
are.  
 
Dr. Courteau[4] describes a situation where she is treating an angry dying woman. She allows her own 
feelings to run their course without interfering with her compassionate care of Aliyah. Acceptance is key: 
this is how it is. She is fully alive in the moment. 
 
Aliyah is trapped in a wheelchair. She is stranded by nasal prongs attached to a noisy portable oxygen 
tank. Still, she is strong and fierce. Aliyah owns the room, holding her head high and looking straight at me, 
honest and unapologetic. She makes me want to sob and applaud at the same time. I want to join her, yell 
across the hospital corridors. I want to throw down my mask, my sterile gloves and my professional code 
of conduct. My stethoscope’s is suffocating around my neck. I stay very still. I envy her life-affirming fury. 
Today. Right now. 
 
Dr. Coles[5] characterizes how a physician can be mindful during an emergency room shift. She describes 
how this plays out in her mind and then shows us how it unfolds during a patient encounter. At the end of 
her narrative, she cites the Buddha, “Compassion is that which makes the heart of the good move at the 
pain of others. It crushes and destroys the pain of others; thus, it is called compassion. It is called 
compassion because it shelters and embraces the distressed.” She embodies this attitude by applying the 
Eightfold Path.  
 
The ER is a microcosm of any high-intensity, high-stress, high-stakes environment. Personalities and 
problems and misunderstandings can rise up and threaten the flow at any moment. Mindfulness has 
improved my capacity to greet pain, anger, frustration and confusion with grace and unattachment. 
I can recognize frustration, stress, anger, and disappointment as it arises in myself and let these 
feelings wash through me with dispassion. When the ER turns into a hurricane, I anchor back into the 
breath and maintain the calm eye of the storm.  
 
The ER physician is witness to countless intimate moments of pain, fear, stress, and vulnerability. We see 
the dark side of life, the subcultures of abuse and neglect, the realities of poverty and loneliness, the 
consequences of ignoring the body and spirit’s true needs. We also bear witness to moments of inexplicable 
beauty, compassion, and tenderness. The best kept secret in the field of medicine is this – healers want 
the very best life for their patients even if they can’t always cure or save them. They serve with a 
dedication that threatens to devour them. The flip side of that intense caring is the pain that comes with 
opening our hearts to our patient’s suffering and with knowing that it could be us, our kids, our family or 
friends and one day it inevitably will be. Although we don’t like to think of it, we all walk daily just a few steps 
away from the edge of the cliff. Mindfulness helps maintain the vigilance to stay on solid ground. 
Mind Space 
Patricia Lynn Dobkin 
	
8	International	Journal	of	Whole	Person	Care	
Vol	10,	No	1	(2023)	
	
Mr. Y was brought in by the police, his wrists in handcuffs, one hand wrapped in gauze. A cut to the palm 
during his arrest had demanded a pit stop to the ER. I examined his hand, determined that the injury was 
superficial without injury to the tendons or nerves or blood vessels. The wound was cleaned and I placed 
his palm under a sterile blue towel.  His now un-cuffed hand lay still under the bright light as I numbed the 
area around the laceration, which was long but relatively straight. I took a moment and imagined the 
movement of my hand, piercing of the skin with the needle, pulling and knotting the suture. He followed my 
instructions to stay completely still. As I began stitching, I had a fleeting thought about the violence that 
this hand might have done, the crimes it may have committed. Then the quiet monotony of suturing took 
over. When I was finished, 15 even stitches appeared on his palm, a new sliver of black crossed over his 
lifeline. He thanked me as I cleaned up and went to see the new patient in the next bed.  
 
Dr. Laneuville[5], a psychiatric resident, was redeployed to work in the ICU crowded with COVID-19 patients 
during the pandemic. In her narrative she reflects on her experience with insight and humility. 
 
One night I admit a lady from the intensive care unit who just recovered consciousness after a protracted 
week of intubation. She frowns and tells me that she would not wish this disease on her worst enemy. She 
reminds me of my mother. She is a kind, tiny, Vietnamese woman with short black hair. She tells me 
about the Asian marketplace I used to go during my childhood anticipating eating delicious banh mi. She 
embodies the furiousness of a fearless mother and the fragility of a woman who has experienced countless 
hardships...  
 
I stand two meters apart from her dressed in scrubs and a blue cape, masked, hidden. I look like an 
awkward bird. She cries and declares God saved her. I look at her with my eyes, the only part of my body 
that remains visible. I simultaneously wonder about God, the virus, and the parameters on the cardiac 
monitor. I feel small, albeit immensely privileged. Before I make my way out of the room, worrying I might 
have spent too much time in there, she asks me to write a thank-you message on the board to all her 
caregivers during the critical part of her illness.  
 
I realize something astonishing happened. Her story is probably very common. I am just another health 
care professional. But somehow, we all became wonders amongst many others – like a wave in the 
ocean, a flower in a field, a simple star in the night. It is a quiet insurrection, a successful claim for life in an 
ordinary hospital room. I am struck by the humble, undemanding beauty of this process.  
 
Dr. D. Dobkin[6], a cardiologist, echoes Dr. Coles in the way mindfulness enabled him to connect with his 
patient in a nonjudgmental manner and embody the Hindu saying quoted at the beginning of this essay. 
 
Mind Space 
Patricia Lynn Dobkin 
	
9	International	Journal	of	Whole	Person	Care	
Vol	10,	No	1	(2023)	
	
Recently, I saw Maurice W again after a several year hiatus. He had just gotten out of jail and was in mild 
heart failure, quite hypertensive and not taking any medications. He was with his brother who seemed to 
care about him. He physically looked the same but my view was now quite different. Being more 
mindful, I listened to his travails about jail, his struggles with alcohol and how he was searching for a path 
to get better. I applied my meditation skills to the clinic setting. I shared his disappointment in himself. I 
felt compassion for this young man whose life was not going well. I couldn’t tell if he had changed or I had 
changed - but it didn’t seem to matter. I felt more involved and somehow more hopeful. I was able to 
“exchange places” with him and subsequently viewed him differently. 
 
Clearly, the facets of the Eightfold Path show up in medicine whether we apply this terminology to point 
them out or not. Clinician-healers who are dedicated to relieving suffering in their fellow human beings 
engage in a profession that by its very nature is right livelihood. How their minds enable them to do so is 
evident in these examples. When they are self-aware (mindful) then they can choose to respond with 
competence and compassion. 
	
REFERENCES 
1. Mount BM. The 10 commandments of healing. J Cancer Educ. 2006 Spring;21(1):50-1. doi: 
10.1207/s15430154jce2101_15.   
2.  Sang L. A day in the life: doctor turned patient overnight. IJWPC [Internet]. 2021 May19 [cited 2022 
Nov.1];8(1):8-10. Available from: https://ijwpc.mcgill.ca/article/view/263. 
3.    Lemos V. One small victory. IJWPC [Internet]. 2021May19 [cited 2022Nov.1];8(1):11-5. Available from: 
https://ijwpc.mcgill.ca/article/view/276. 
4.   Tsuchiya S. Life with COVID-19: Learning to “Breeze in and Breeze out” in Japan. IJWPC [Internet]. 
2021May19 [cited 2022Nov.1];8(1):40-2. Available from: https://ijwpc.mcgill.ca/article/view/271. 
5.   Courteau C. Two palliative care stories. IJWPC [Internet]. 2021May19 [cited 2022Nov.1];8(1):27-9. 
Available from: https://ijwpc.mcgill.ca/article/view/266.  
6.   Coles T. The mindful shift. In: Dobkin P (ed.) Mindful Medical Practice. Cham: Springer; 2015. p. 123-
6. 
7.   Laneuville L. Superman does laundry too. IJWPC [Internet]. 2021May19 [cited 2022 Nov.1];8(1):30-2. 
Available from: https://ijwpc.mcgill.ca/article/view/267. 
8.   Dobkin D. I am my brother’s keeper. In: Dobkin P (ed.) Mindful Medical Practice. Cham: Springer; 2015. 
p. 119-21. 
 
 
 


Mind Space

Assaf Moukarzel, Zeina

English  English

Derghazarian, Sandra

 
VOLUME 10 ● NUMBER 2 ● 2023 ● 10-12 
© 2023 Sandra Derghazarian. This article is distributed under the terms of the Creative Commons License  
CC BY. 
International Journal of Whole Person Care 
Vol 10, No 2 (2023) 
 
 
SEEING WHOLENESS 
 
Sandra Derghazarian 
Brunswick Medical Centre at Glen, McGill University Health Centre, Montreal, Quebec, Canada 
sandra.derghazarian@gmail.com 
 
KEYWORDS: Transformation, Wholeness 
 
 
 
OCEAN WATER 
e were a relatively large family of four children, keeping my parents ceaselessly busy. 
Nevertheless, my parents would manage to take a week of vacation once every few years to 
go down to Mexico. During that time, my grandmother and aunts would take care of the four 
of us. We would be giddy, without the usual after-school routines and restraints. We would run noisily 
around the house and empty a package of Chips Ahoy! cookies in one evening.  
When my parents would return tanned and smiling, my father would pull out little bottles from his suitcase. 
He would explain that he had filled the bottles with ocean water and sand. After a brief moment of wonder, 
we would set the bottles on the bookshelf at the head of our beds and continue to play.  
The small bottles of ocean water impressed something upon me, but I didn’t know what. Reflecting on it 
now, it was that I was holding both a piece of nothing and something: this was simultaneously just water 
and an entire, vast ocean. It was my father’s will to share, to impart and connect which turned the water 
into the ocean. 
Today, in thinking about my transformation in medicine, those little bottles come to mind. My incremental, 
transformative moments in medicine are too numerous to tell; therefore, I offer this brief essay instead.  
W 
Seeing wholeness 
Sandra Derghazarian 
 
11 International Journal of Whole Person Care 
Vol 10 No 2 (2023) 
 
My hope in doing so is that these words will provide you solace and help dispel the self-critical fog that 
surrounds many of us.   
POLARITY 
I would have to say that in this moment, when I think of transformation in my medical career, I do not see a 
well-delineated change nor a defined process. I see my physician-self as a dynamic ocean, with waves 
crashing on a calm body of water.  
The waves are the destructive emotions and thoughts that I have had throughout my training and practice. 
They are my perfectionism, severe self-judgment and self-doubt. They are my internal criticism at my lack 
of efficiency, lack of knowledge, lack of judgment, at my inability to learn from my mistakes. They are my 
thoughts of non-belonging to medicine, of being a failure, of being too fragile, of being indecisive.  
The waves can grow big and become threatening. They can also grow small to the point of being 
imperceptible. The storm can rise in a flash, and it takes a long time to calm down. Despite it all, and 
contrary to the instability I feel when the storm comes, my internal drama is contained. That is where the 
body of water comes in.  
Underneath the waves, there lies a radiant depth. It represents my growing understanding that my approach 
contributes positively to the lives of patients. That the unachievable truth and the inescapable uncertainty 
of medicine are not my fault.  That my respect for the wholeness of patients and concern for their well-being 
sometimes has the ability to heal brokenness, though it does not heal illness. That deep respect and 
compassion are true medicine, not soft nor weak medicine. That striving to treat myself with respect and 
compassion is a journey, and that adapting my practice to my values and limitations is a commendable first 
step.  
Thus, despite the sheer power of the waves, there is an underlying, perseverant calmness. Recognizing 
this dichotomy, and allowing the bad to dissolve into the good rather than the other way around, has taken 
quite a bit of transformation.  
ESSENCE 
If I try to pinpoint which events have led to this transformation, I am unable to. The narrative of my 
transformation is a sprawling forest of individual stories. Each story is as important as the next and they are 
all connected by their roots. They are stories of physicianship, motherhood, friendship and partnership. In 
considering the wholeness of my experience, my best offering in this moment is the essence of my 
transformation.  
 
 
 
Seeing wholeness 
Sandra Derghazarian 
 
12 International Journal of Whole Person Care 
Vol 10 No 2 (2023) 
 
Transformation is 
Setting boundaries 
Instead of being crushed by what I cannot hold. 
 
Transformation is  
Accepting that not everyone wants help 
Instead of bestowing help on everyone.  
 
Transformation is 
Knowing that my intentions matter 
Instead of thinking that only outcomes do. 
 
Transformation is  
Recognizing when I am struggling 
Instead of ignoring my mounting discomfort.  
 
Transformation is 
Accepting that I need to change 
Instead of insisting that perfectionism serves my patients well. 
 
Transformation is 
Staying quiet 
Instead of uttering unnecessary words. 
 
Transformation is  
Seeing my wholeness 
Instead of only my brokenness.  
 
Thank you.  
 
Biographical note 
Sandra Derghazarian is a neurologist and a coach for healthcare workers. Her greatest aspiration is to 
advocate for kindness and forgiveness in personal and professional everyday life.     
 
 
  


Seeing Wholeness

Adawi Awdish, Rana Lee

 
VOLUME 10 ● NUMBER 2 ● 2023 ● 6-9 
© 2023 Rana Lee Adawi Awdish. This article is distributed under the terms of the Creative Commons License 
CC BY. 
International Journal of Whole Person Care 
Vol 10, No 2 (2023) 
 
 
AN ANNEALING 
Rana Lee Adawi Awdish 
Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan, USA 
RAWDISH1@hfhs.org 
 
KEYWORDS: Empathy, Connection, Presence, Death 
 
e met in a frigid Connecticut conference room during a late March Nor’easter. The obliterative 
storm had delayed our flights and made mockery of the lightweight clothing we had each 
packed. We thought it was Spring. Tiffany was a regular on the speaking circuit and had been 
invited by the state’s hospital association to deliver a talk on the lessons of her second double lung 
transplant, as a patient advocate. I was presenting on my own critical illness and recovery, as a critical care 
physician. My invitation was based on an essay I had recently published in the New England Journal of 
Medicine, and public speaking was new to me.  
She recounted having spent her childhood in a body ravaged by cystic fibrosis, tethered to breathing 
treatments, hospital beds and complicated antibiotic regimens. The first pair of donor lungs she had 
received offered a tentative way forward. When her body quickly and violently rejected the new organs, she 
believed she would die. She somehow found a way to settle into the cataclysm of her body, without 
resentment or regret, and said her goodbyes, only to be unexpectedly granted a second pair of donor lungs. 
It was disruptive, she said, finding herself alive again, having prepared herself to die. She may have even 
used the word annoyed. The audience loved her.  
Hers was a visceral, bodily kind of knowing. She was so attuned to her internal landscape, she could tell if 
her immunosuppression levels were off by how irritable she was when she was hungry, or how poorly she 
slept. In this way, she embodied the kind of intangible knowing I’d been trained to devalue. She was 
practical and oriented almost exclusively to the present. She demanded only a utilitarian competence from 
her medical team and was intolerant of errors. She lobbied for authentic integration of the patient voice, 
W 
An Annealing 
Rana Lee Adawi Awdish 
 
7 International Journal of Whole Person Care 
Vol 10 No 2 (2023) 
 
believing doing so would prevent medical errors. She genuinely and sincerely viewed compassion as added 
fluff. While it may be nice to have, she’d explain, it was not necessary for her survival. Her opposition to 
empathy baffled me.  
I had come through the entirety of my illness believing that competency was not at all sufficient. I maintained 
that medicine could not heal in a vacuum, that it required empathy, and connection. I fervently wanted more 
humility in my profession. In contrast to her laser focus on the present, my focus was generally either the 
past or the future. I had entered a kind of covenant with redemption narratives. I believed that by pressing 
on painful memories, I would access some essential truth that years of training had obscured. I thought I 
could transfigure the suffering, sublimate it into coherence that would both right the balance of what I’d lost 
during my critical illness and advance my vision of an aspirational future state. She needed and wanted the 
change to happen now, where I was content to cast a kite off into some future sky. 
Despite beliefs and timelines that were often in opposition, we shared a common purpose in wanting to 
improve healthcare by fundamentally redistributing power. Like convergent plates of earth that are 
compelled to move closer, we held each other in place long enough to ask the hard questions. Solid in our 
respective beliefs, neither of us sunk under the weight of the other. Instead, through friction, some new 
range of possibility was forced up between us.  
She was fashionable with a side of playfulness, where I tended to be plainer and more austere. She loved 
swing dancing and buying new clothes and would shop for weeks to find the perfect blazer for a 
presentation, whereas I would pack an entire suitcase of tonal clothing for simplicity. When I arrived to give 
a joint keynote in all black, she marched me to the hotel gift shop to buy a colorful floral scarf and excitedly 
showed me eight different ways of tying it.  
Though I had experienced more illness and debility than most of my peers, in her eyes I was a novice. The 
inversion was oddly liberating. It meant that on dark days I could send her a text to that said, “I feel like 
pulp. There’s just nothing holding me up anymore,” and know that she would understand. Know that she 
had probably felt like pulp herself and had long ago accepted it as the consequence of inhabiting a body. 
There wasn’t a thing I could tell her between living and dying that would have fazed her.  
“Ok, so now tell me, what’s this pulp thing about?” she’d ask, smiling through the phone. And all the thoughts 
I didn’t know I was holding in some kind of cognitive suspension would come pouring out, filling the space 
between us.  
“I don’t know,” I said, “Maybe I did the math wrong. When I found out about the cancer, I just gave them 
whatever pieces of me they needed to take. You know, I just like laid it all out at some operating room Alter, 
like a sacrifice I was trading for more time. And I don’t know, maybe there wasn’t enough support left behind 
to hold me up. Maybe the ledger of losses and gains isn’t balanced anymore. So, now I’m just pulp.”  
An Annealing 
Rana Lee Adawi Awdish 
 
8 International Journal of Whole Person Care 
Vol 10 No 2 (2023) 
 
“You’re feeling a little hollowed out right now, and that’s a hard feeling. It will pass though, it usually does,” 
she offered, leaving space for me to cry.   
“The thing is, I don’t want to find, I don’t think I can find any lessons in this. Too much has happened, and 
I just don’t sense a forward trajectory anymore. You can’t make anything out of pulp,” I said.  
“I want you to hear me say this. You don’t have to make anything out of this. Not for anyone,” she paused. 
“But you might, because it’s what you know how to do, it’s who you’ve been. You make beauty and sense 
out of terrible, difficult things.” 
 I reiterated that I was pulp now and that I planned to stay pulp forever. In fact, I now believed my job was 
not to transfigure the pulp, but to find a home there, in the sticky potage of what I had been.   
“Oh sure, you can stay in that soup if you want to. Consider this permission to not be anything other than 
what you are. Hell honey, just surviving is enough. You are enough,” she said.   
I considered her suggestion that there was nothing more to find. That I could allow myself to return to and 
remain in a more essential and natural state.  Half my heart believed her, the other half was wondering 
what form the pulp could take.  
Quickly and without warning, she dissolved into a uremic underground world, where she believed she was 
part of a government conspiracy. I stood helpless, as the scaffolding of her sanity collapsed. She would tell 
me later, when she returned from the cavernous hollow of her delusion, that she had stayed focused on 
trying to crack the code, studying the movements and actions of each facsimile of family and friend who 
entered the room. She believed that was the only way out. It was a completely terrifying experience devoid 
of any reassurance from her team. It almost sounded as if she were arguing for more compassion in her 
care. 
“What if I told you,” I said, “that in the ICU, we tell families that uremia is a pleasant way to die? That they 
should feel at peace, deciding to stop dialysis on a beloved parent or spouse, because it is a good death.” 
I cringed, waiting for her response.  
“Well, isn’t that interesting,” she sighed, and in those words, I felt how fragile knowing could be when it’s 
not built on a foundation of actual lived experience. How easily the sand of my words could be blown away 
by her sigh.  
“Is it possible,” she wondered aloud, “that you all might be describing the death from your own point of 
view? That a bloated, but quiet patient slowly dying of renal failure was not a burden to you emotionally. 
Easy for you should be easy for me.”  
An Annealing 
Rana Lee Adawi Awdish 
 
9 International Journal of Whole Person Care 
Vol 10 No 2 (2023) 
 
That was her way, heating the handfuls of shapeless sand passed between us, melting it into absolute 
transparent clarity. And despite the window her words afforded me, I still felt as if I were entering a dark, 
unmappable woods, where none of what I’d been taught was of any value. I had a deep somatic sense that 
to survive in the new place, I’d have to rewild, relearn how to trust the physicality of an experience.  
“Maybe the pulp is a good thing for you,” she offered. “Maybe it will let you seep into spaces that weren’t 
accessible before, like a mountain turning into mud.”  
The goal of our friendship was never agreement. Rather, it was one of allowing space for disagreement 
while still willingly entering the perspective of the other. The clearing that emerged in the space between 
us was the most authentically generative ground.  
The day she died, a large cardboard box was delivered to my porch, with her name and return address. I 
set it on the kitchen counter and stared at it, as if encountering her in a new form. I was not at all ready to 
regard the contents, knowing it would bring our final conversation to an end.  
When I unpacked the box, I found an ivory dress with a colorful banded waist, a delicate floral coat she had 
worn on a trip to the Netherlands, and a locket and a small note written in shaky, uremic handwriting, I love 
you always. Realizing I was wearing all black and she was still editing my wardrobe, I exhaled deeply, and 
an unexpected guttural sob emanated from my throat.  
And then, like the sea under the pull of the tide, I felt her receding until she was gone. I felt the tear of pieces 
of me that went with her, and the swell of the pieces she’d left behind.  
Biographical note 
Dr. Rana Awdish is the author of In Shock, a critically acclaimed memoir based on her own critical illness.  
A pulmonary and critical care physician, she serves as the current Director of the Pulmonary Hypertension 
Program at Henry Ford Hospital. She also serves as Medical Director of Care Experience for the System, 
where she has integrated compassionate communication strategies and Narrative Medicine practice into 
the curriculum. She is board-certified in Internal Medicine, Pulmonary and Critical Care Medicine. 


An Annealing

Pain control in childbirth is a special case because childbirth is not an illness. We are obliged to treat it differently from the pain of disease. Hypnosis can complement the best prenatal preparation.  Most women whose bodies and minds are prepared for labor, who are adequately supported throughout, and whose self-esteem is intact have safer, more comfortable childbirth and considerably less need of drugs. Hypnotic suggestion and imagery begun early in pregnancy help a woman to work with and assist her own physiologic processes. With hypnosis, a woman can be helped to transcend many limits of expectation and to participate fully in one of life’s sublime dramas

Weigens, David

Hypnosis in Childbirth: Beyond Pain Control

	
VOLUME	10	●	NUMBER	1	●	2023	●	1–2	
	
©	2023	Patricia	Lynn	Dobkin.	This	article	is	distributed	under	the	terms	of	the	Creative	Commons	License	
CC	BY.	
International	Journal	of	Whole	Person	Care	
Vol	10,	No	1	(2023)	
EDITORIAL	 	
HEALING	SPACES	IN	MEDICINE	
Patricia	Lynn	Dobkin,	Editor-in-Chief	
Programs	 in	Whole	Person	Care,	Department	 of	Medicine,	 Faculty	 of	Medicine	 and	Health	 Sciences,	McGill	
University,	Montreal,	Quebec,	Canada	
patricia.dobkin@mcgill.ca	
	
	
 
 
he word “healing” comes from the Anglo-Saxon word haelen, which means to make whole. Healing 
spaces can promote harmony of mind, body, and spirit. 
 
I invite you to allow an image of a healing space to emerge. What do you see, hear, smell? How do you 
feel? Can you venture there when the need arises?  
 
Next, I ask you to picture being an inpatient in a modern hospital. If you could create the ideal environment 
for healing, what would it be? A single room with a view and plenty of light? Quiet? Providing an aroma, 
such as lavender, to offset medicinal odours or toxic cleaning products. How about adding a plant and 
pictures of loved ones? What else could enhance your recovery? 
 
If you are a physician, nurse, or allied health care professional what do you need to heal yourself in such a 
high stake, stressful workplace? Would you enjoy strolling in gardens nearby on your lunch break? Perhaps 
spending time in a lounge where you can relax or debrief with colleagues. Having healthy food and snacks 
available may propel you through long shifts. Would you choose to attend onsite meditation sessions for 
hospital staff? 
 
Healing can be an internal experience that does not depend on how the room is arranged or seeking refuge 
in a hospital chapel. Some patients find peace through prayer, meditation or simply being fully in the 
moment. While this may seem unrealistic in a busy, crowded hospital, it may be facilitated by providing 
periods when the patient is not disturbed by staff or visitors entering their room unexpectedly.  
T
Editorial	
Patricia	Lynn	Dobkin	
	
2	
	
International	Journal	of	Whole	Person	Care	
Vol	10,	No	1	(2023)	
	
Healing, nonetheless, may be influenced by the external environment. Noise (e.g., ICU monitors) may affect 
patient and staff stress levels and emotions. Music may soothe frayed nerves. Other aspects of the external 
environment matter as well; examples are: clear directions so people can find their way through the hospital, 
wall colours (soft tones), artwork displayed in hallways, patients’ rooms decorated with meaningful items, a 
view of nature though a windowpane. 
 
We, the faculty of McGill Programs in Whole Person Care, consider that the relationship between a patient 
and health care provider can be considered a type of “healing space.” This volume of our journal is 
dedicated to healing spaces in medicine in a broad sense. I have gathered essays from five countries 
(Lebanon, France, Canada, the United States, and Australia), each considering what a healing space may 
or may not be. 
 
When submissions arrived, I noted that a few authors described spaces that were not healing. As the Editor 
I mulled this over and considered how to include them. I realized that they spoke directly to the challenges 
inherent in medical settings. For example, Dr. Moukarzel laments how the burn unit in her hospital in 
Lebanon was suffocating for her patient. She suggests improvements that would render the setting better 
for her patients and herself. Dr. Spodenkiewicz finds himself consulting with adolescents seeking mental 
health services while sitting side-by-side on a volcanic rock in Réunion, a French island, for lack of rooms 
in his unit. Dr. Farzin describes another type of impediment to healing – red tape hindering access to 
psilocybin used to assist a palliative care patient’s journey towards death with dignity and inner peace. 
Once administered, his patient was able to take the “trip” of his life while safely lodged in his beloved country 
cottage. Dr. Dobkin views healing space from the perspective of Buddhist psychology pointing out that the 
mind can be where transformation occurs. Dr. Lijoi, a family physician, shares how Narrative Medicine 
sessions for residents and faculty provides space for healing through examining literature, artwork, and 
stories. Dr. Monshat, a psychiatrist from Australia, proposes that small groups who gather in circles invite 
connection and heart-felt exchanges between people as a place for healing. Dr. Hutchinson compares the 
inner lives of characters portrayed in two books. Analogous to Dr. Dobkin’s essay, he examines how healing 
can take place in one’s mind. He recognizes, like Dr. Lijoi, how powerful narratives can be, albeit in a 
negative or positive way.  
I chose as the theme for my final volume as Editor-In-Chief of this journal what I believe represents the 
essence of our work at McGill Programs in Whole Person Care i.e., promoting healing in those who seek 
our care. The manuscripts published herein are a testament to that aspiration. It has been a joy to gather 
and publish authors’ reflections from around the world for the past eight years. 


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