privatelifeinpublichealth

The patient presented with multiple diagnoses:  Morbidly alcoholic with fits of anger, depression, anxiety, and insomnia.  His appearance was one of self-neglect with a disassociated affect.  But the doctor did not prescribe antidepressants, counseling or electroconvulsive shock therapy.  He placed a blank journal in front of the patient and positioned the pen on the page toward him.  “Write it down,” he said.  “A memory, a thought, a place.”  The patient was Nick Carraway.

Write something.  I do not mean for this to be an intimidating suggestion.  It makes no difference whether you write five paragraphs for a blog, a paper for a professional journal, or a poem for a reading group.  Just write.  What you write need not achieve perfection.  It need only add some small observation to your world.  Atul Gawande, MD. in his book Better: A Surgeon’s Notes on Performance  is writing about changing the world.  The doctor at the Perkins Sanitarium, in Baz Luhrmann’s The Great Gatsby, is telling Nick Carraway to write to change himself.  He tells Nick that it doesn’t matter if anyone else reads what he writes or if he burns it.  Just write.

Far be it from me to suggest that anyone who has a mental illness not receive necessary treatment, but there is something about the prescription of writing that is healing, that is life enhancing, that is empowering, that is both personally and publicly changing.

We all know the power of writing from the glyphs on the walls of the caves of Lascaux, to the Guttenberg printing press, to the emails and texts we now zap off and retrieve in nano seconds. John Snow’s essay On the Mode of Communication of Cholera in i849; Ignatz Semmelweis’s Etiology, Concept and Prophylaxis of Childbed Fever both had powerful, although delayed, effects on public health.  But what does writing do that changes the writer whether it is a blog, a poem, an essay, a professional paper, or The Great Gatsby?

First, there is the actual physical act of writing.  Nick starts out writing in the journal in cursive which Luhrmann conjures up as the words scrawling and draping across the screen.  In 3D, the curlicued letters actually float out to embrace the audience.

….scientists are discovering that learning cursive is an important tool for cognitive development, particularly in training the brain to learn “functional specialization,”[  that is capacity for optimal efficiency. In the case of learning cursive writing, the brain develops functional specialization that integrates both sensation, movement control, and thinking. Brain imaging studies reveal that multiple areas of brain become co-activated during learning of cursive writing of pseudo-letters, as opposed to typing or just visual practice. Other research highlights the hand’s unique relationship with the brain when it comes to composing thoughts and ideas. Virginia Berninger, a professor at the University of Washington, reported her study of children in grades two, four and six that revealed they wrote more words, faster, and expressed more ideas when writing essays by hand versus with a keyboard.

There is a whole field of research known as “haptics,” which includes the interactions of touch, hand movements, and brain function.  Cursive writing helps train the brain to integrate visual, and tactile information, and fine motor dexterity.   MEMORY MEDIC by William Klemm, D.V.M., Ph.D.       What Learning Cursive Does for Your Brain | Psychology Today.html

Then there is the whole right brain/left brain relationship in writing that connects the creative emotional side of ourselves with the sequential verbal side.  So here is what is going on in each side of our sophisticated bicameral brains that developed around 1,000 BC when a purely reactive brain was not capable of figuring out complicated stuff, and a meta consciousness was required:  thinking about thinking, desiring about desire, worrying about worries, wondering about wonder.  Julian Jaynes thought about these thoughts documented in his 1976 book The Origin of Consciousness in the Breakdown of the Bicameral Mind.

Here’s what each side of the brain does.

Writing gets the major highway system between the two sides of the brain, the corpus callosum, activated in fact, bringing a wholeness to our thoughts, our expression, our selves.  Fantasies, dreams, ideas, fears, beliefs, travel into verbal language, knowing, acknowledgement, comprehension.

So this is what happens when we write, and I can tell you it is happening to me right now.  There is a total engagement, there is a sense of being “together,”  there is what Mihaly Csikszentmihalyi calls FLOW in the book by that name, subtitled Steps Toward Enhancing the Quality of Life.  Enhancing the quality of life; isn’t that what we strive for in our personal health and public health?  (Don’t right brain panic over how to pronounce Mihaly Csikszentmihalyi .  It is actually quite simple if you don’t let all of those consonants throw you and your left brain just goes with the sequence.  First name: Me High.  Last name: Cheek Sent Me High.)  Flow is what happens when your left brain and right brain are working in complete participation with each other, when we are “lost” in experience, in creation, in process. Experiencing flow is a positive experience; in fact, some people refer to it as “optimal experience.” Flow doesn’t just happen for writers—athletes call it being “in the zone.” Artists, surgeons, dancers, and others also experience flow when they’re completely passionately focused on something they love.

So this is the fun part of being healthy, enhancing the quality of our lives, of choosing to go with the flow, of optimal experience.  There isn’t one single prescription.  It isn’t one size fits all.  There is no standard operating procedure.  Natalie Goldberg in her book on writing, Writing Down the Bones notes that journals should be big enough to write big, but William Carlos Williams, the poet who was also a pediatrician, often wrote his poems on his prescription pad.  How perfect, the prescription of a poem.

It’s all about you and doing what engages your self fully, right brain, left brain, body, soul, spirit.  Garden, bird watch, play music write music listen to music, paint, dance (actually no matter what else you do always dance,) practice yoga, solve mathematical equations, build something (I can actually get a little too engaged walking around Lowes,) heal someone, heal yourself.  And do write.  You can do it anyplace on anything at any time.  I have actually written various stories, essays, articles on the back of grocery store receipts and pay stubs.  If you feel the least bit inhibited about writing something, I recommend a book called Wreck This Journal.  If you write in this book you will never feel inhibited about writing again, in fact you might never feel inhibited about much of anything again.

“Write something,” prescribes Dr. Gawande, ”it need not achieve perfection.”

So back to Nick Carraway, (fresh faced and glowing after a nap on the couch and the accumulation of his typed pages,) and the final line of The Great Gatsby with my own edits, (and no apologies whatsoever to Mr. Fitzgerald, who would probably have loved to have been able to approve,) on this fine morning, May 27, 2013:

but that’s no matter–tomorrow we will run faster, stretch out our arms farther…and one fine morning–so we write on, boats against the current, born ceaselessly into the moment.”

Blogadenda

Some of you know that in addition to writing this blog, I write essays, professional articles, and short stories.  I wrote the following for my granddaughter and so it is titled For Sonoma at Bedtime, but it is also known as

The Mermaid and the Cowboy

Once upon a time, under the great blue green curls of the waves in the deepest most beautiful ocean, lived a mermaid with golden curls and eyes the color of the blue green waves.  With her beautiful blue iridescent tail she swam with the whales and played with the dolphins and raced with the seahorses.  She and her mermaid friends dreamed of love and adventures and flirted with the sailors on the passing ships.

Over time all of her friends fell in love with sailors and traded their beautiful iridescent tails for feet.   Ah the better to walk with on the piers and dance and love their sailors.  But the mermaid with the blue green eyes was determined to find love and keep her iridescent beauty and the power of her swimming.  So as her friends left one by one she was lonelier and lonelier but also bolder and bolder as she explored the ocean from the crests of the waves to the deepest darkest crannies of caves and she became acquainted with every living creature in the sea.

And so it happened that one night as she swam over the castle spires of a reef, a great storm blew in from some dark and violent place and the mermaid, caught in the winds of change and the rains of despair, was carried far from her home in the sea, to craggy coastlines, up muddy rivers to a sandy creek’s edge.  Covered with mud, scraped and bruised she lay on the sandy bank sleeping off the nightmare of the storm.

A cowboy, dusty and weary, walked his pony along the creek looking for an easy place to settle in for a quiet rest and to let the pony drink.   As they wandered down the bank, the cowboy was dazzled by a glimpse of iridescent blue at the edge of the water.  When he scooped into the sand he found beneath a layer of mud, golden curls and glistening scales and peachy, though scraped and bruised, arms and hands and shoulders and a face that slowly revealed, as her eyelids flickered open, the blue green of a sea he had only imagined.  And the mermaid, her vision a little blurred from the night of tears and fears, looked at the cowboy and was dazzled by the gold dust glistening in the sun that shone upon his face.

Though he was awkward, at the water’s edge the cowboy washed the mud off of the mermaid, and then bandaged her cuts and scrapes.  He made a pot of coffee on a little fire he built at the edge of the creek and took some biscuits and wild strawberry jam out of his saddlebag. The mermaid sipped the coffee and ate the biscuits with him and was warm and cozy, feelings she had never experienced in the deepness of the ocean.

For a month the mermaid and the cowboy lived on the sandy bank of the creek while her bruises and scrapes healed and his exhaustion faded.  She told him about the ocean and the creatures of the sea, the waves and the deep dark places in the underwater caves.  And he told her of the prairies and the forests, of snow and butterflies and falling leaves.  He took his guitar from his saddle and sang to her of moonlit nights and lost loves and little lambs found.  And the mermaid sang to him in the lulling voices of whales and the cadences of the dolphins and the soothing tones of the tides.  Some days the cowboy would ride off for a while on his pony and the mermaid would dip and swim and splash her tail in the creek as she grew stronger.  And once, just once, the cowboy joined her in the water and clumsily tried to swim by her side.  But he floundered, frightened by what seemed to him dark and scary beneath the surface of the water.  He sank and had to spit out the water that poured into his mouth.  And once, just once, the mermaid tried to sit on his pony and go for a ride, but her tail slipped and she fell into the grass.   She tried to maintain her dignity, but she was embarrassed and tearful.

So the days and nights passed and one morning after a night with a full moon, the cowboy and the mermaid simply said, “good-bye,” and she swam away down the creek, along the stream and into the river and out to the sea without once looking back.  And the cowboy climbed up onto his pony and rode away from the creek, across a field, through a forest and over some mountains and out onto the prairie, and he tried not to look back.

There were no calendars in the sea or on the prairie and so no one could guess how many days or months or years passed, but after many many full moons and snowfalls and campfires, the cowboy realized that he had left his heart on the sandy bank of that creek and it had been carried deep into the sea.  And after many many tides and migrations of whales and births of seahorses too many to count, the mermaid also realized that she had left her heart at the edge of that creek and it was far away somewhere on a dusty prairie.

And so the cowboy and his pony boarded a ferry, and then a boat and then a ship and they sailed around and around the world looking into the sea for a glimpse of iridescence and the blue green eyes of the mermaid he loved.  And the mermaid swam up rivers and into streams and creeks, and painfully wriggled into ponds and the shallowest of puddles on the prairie looking for a cowboy who was dusty and dazzling and who she loved more than anything.

It was a kind storm of graceful rains and fortunate strong winds that tipped the ship and beached the cowboy and his pony and that washed the mermaid out of the puddles and down the creeks and into the rivers, back to the sea where the whales and the dolphins and the seahorses conspired to carry her to a brilliant beach where she awoke in the cowboy’s arms.  In the moonlit nights of days that were on no calendar, on that beach at the edge of all oceans they sang together and danced.  And each fine morning a cowboy, holding the hand of his mermaid, swam in the blue green curls of the waves and each evening, a mermaid safe in the arms of her cowboy, sat proudly on the back of his pony as together they rode off into the sunset.