“Physician, heal thyself” is both the name of my blog and the title of this post, but I had to dig a little to find its origin and meaning. It was likely first penned in The Bible, New Testament, in both the Gospels Mark and Luke, but is spoken of by Jesus as a proverb, as a story already widely known. I am not qualified to debate religious texts, but it is generally accepted that the New Testament Gospels were written sometime after the events took place, likely passed down in oral form for as long as 50-150 years before being put in writing. Thus, there is likely a lost parable, and according to an Internet search of this phrase, interpretations range from literal meaning to a proverbial criticism of healers (including Jesus) who might have chosen to spread their healing arts abroad in preference to staying near their homes. Miraculous cures aside, would healers of the time have gone afar on ‘medical missions’ with the rudimentary healing practices of that time? What did they know and how far would they have gone? What could have led to this parable?
The medicine practiced around the time of Christ was probably influenced by fairly sophisticated Greek and Roman medical teachings, as well as ancient Egyptian practices from which these later civilizations learned a great deal about internal organs. Dissection of cadavers simply for knowledge is not a new concept, and had obviously been used in mummification by Egyptian predecessors since the organs were removed to jars during that process, but any unnecessary exploration of the internal body was considered taboo by Greek & Roman spiritual-healers, as they were thought of in those times. Most of what they would have discovered about the arrangements, if not necessarily the workings of the body came either from necessary repair of injuries, or from extrapolating the information gleaned in butchering of livestock or free-range mammals, since it was supposed, rightly so for the most part, that animals & humans would have similar anatomy and organ function. More intrepid physicians did experiment with surgical techniques to treat various afflictions, which obviously contributed to their repertoire, but undoubtedly their greatest source of knowledge in scholarly form was passed down from Egypt. The Egyptian, Imhotep, was considered the ‘Father of Ancient Egyptian Medicine’ and later attained demigod status. Asklepios, Greek God of Medicine, spawned a tradition of healing in Greece, giving rise to one of the greatest Greek physicians, Hippocrates, now considered the ‘Father of Medicine’ to modern physicians. Following the Roman adoption of these teachings, their vast Empire spread, and the contribution of Rome’s own greats, including revered and influential physician-scholars such as Galen, ensured that these medical sciences survived, thankfully, else they might have been lost with Rome’s decline. It may be possible that phraseology such as ‘physician, heal thyself’ was common teaching, likely more complex than the three words to which it was later reduced, possibly a common tenet or oath put to practitioners of healing in those civilizations. Possibly it served as admonishment or encouragement, either way, to guide healing in the manner as one would for oneself (to provide the same care to the less fortunate, maybe?), or perhaps, addressed to physicians regarding their own well-being, to heed the reminder to care for themselves and follow their own good advice, in order that they be healthy enough to treat their patients. Whatever the origin and meaning at the time, I believe it continues to have merit in our modern society. As a physician, I intend to use this process of writing as a cathartic instrument to assist me in my own healing. Perhaps it will assist someone else in finding some measure of relief as well. If so, I’ve performed a ‘healing’ deed to help another as well as myself and just maybe fulfilled an edict uttered by Hippocrates himself!
What is healing?
According to dictionary.com to heal (v.) in one sense means to effect a cure (ok, but there is no cure for RA), and in another means to restore health. Well then, what is health (n.),exactly? First, it can mean freedom from disease (uh, not gonna happen…no cure); or to have soundness of body (again, no), or mind yeah, maybe I could use some of that! Secondly, health could be interpreted as lack of the feelings of sickness I could go for much more of that. Read on to find out what I mean.
My RA being not, as yet, what I consider controlled, I am not ashamed to say that I am mostly miserable. I am not wholly unhappy, for I have a job about which I am passionate, supportive administrators whose empathy has been critical for me being able to modify my duties and to be able to continue working, compassionate and understanding patients and coworkers, a loving and sympathetic family, a fantastic and devoted husband, and the sweetest three boys who live. Despite all this, misery lurks just below the surface, becoming more apparent as each flare approaches, **(See below) sometimes preceded by 24-48 hours of fatigue, the main symptom threatening to pull me under the calm surface above. It is as much a physical sensation of being anchored, while fighting to stay above the surface to breathe, as it is a mental battle to be happy when it is appropriate to do so. One might conclude, then, the misery is in part emotional, and the fatigue is not simply physical. Both are true. Although I may hover on the verge of my happiness plateau, at times so glad it is not worse (it’s not cancer, I haven’t lost a limb, my eyesight, or my cognitive ability – Yay!), the reality of my situation sets in, and depression overrides any positives. I will talk much more about this topic in coming posts, because for me as for many others, it can be that which makes or breaks one’s healing process. I think it is important to address, and is too often ignored in traditional modern medicine, where the emphasis is placed on the physical but not the mental or emotional healing experience that occurs.
**My dad, not being a strong presence in my life, someone I see maybe every 3-4 months at family gatherings, and generally lacking emotive skills (as many men brought up on farms or under very harsh parenting his father was tough, I would describe him as an authoritarian and often brutal disciplinarian by today’s standards), arrived for a family birthday party for our youngest sons, whose birthdays are 1 month apart (well, and 2 years). He no sooner walked in the room and came to sit by me, looking like he himself could barely walk and probably living with considerable pain from what I would guess are herniated lumbar disks, gently asking how I was doing, stating he could tell I was in pain. This was right after I had the first chance to sit down in several hours in the rush to get ready for the party, which was, by my previous standards, lowkey. “Yes, I am hurting, but I just took some pain medication, so I will be ok in a while.” He is a big man, standing close to 6’7” at his tallest, but considerably shorter now. He always liked to tell my brother and me about how he could hold our newborn heads in the palm of his hand and our legs only stretched to his elbow, but he would then make a cradle of his arms and showed us the way he used to rock us. At that moment, he looked like he wanted to cradle me in his arms as he had so long ago and take my pain away. He later did pull me into his lap while I walked past him sitting at the dining table. He called me by one of his pet names he used when I was little, and said he hoped I felt better soon. I watched him struggle to stand and have to take a bit of time to extend his back from stooped to almost vertical. I know his many years of manual labor to support us took their toll. How do I feel sorry for myself seeing my own father struggle to walk, sit, stand back up, walk again? I should be throwing him a party for giving us those years when his back was good, and I should be helping to support him more now. Alas, another story for another time.**
So, while I go about riding this roller coaster of symptoms, and I still have perception of joint swelling, warmth, tenderness, stiffness, pain, and a markedly profound fatigue, most of which are not detectable by an objective naked eye, I message my rheumatologist that I believe this or that needs adjustment, but then we wait. I’m impatient, I have a job, my own patients, my family, all of whom need me to be, well, healthy, both from the physical as well as mental perspective. If I could just strike a balance, though, where I am well enough to not cancel clinic at the last moment, disrupting my patients’ schedules and have my staff scrambling to notify them and find them a spot to reschedule; not need a nap after a taxing day and leave my husband to carry the burden of the kids’ evening activities, dinner, and bedtime routines on his own; not have the energy to do the shopping, dishes, laundry, keeping the schedule, planning family gatherings, and being the finder of all lost things; not feeling sorry for myself that I would rather stay home and take something for pain than to gather with friends for a girls’ night out, or to go see a theatre production my colleague is starring in; not fighting to stay awake through an entire (parttime) workday; and finally, being able to truthfully say that I am fine when someone asks; THEN, I will have succeeded in fulfilling the “physician, heal thyself” edict to the extent I now would find acceptable, a new baseline and boundaries to live within. I very much doubt this is what the idea was behind the original source uttering these words long ago, but it would be enough for me to feel I had done it justice, at least for today.
Thank you, Dad. Thank you, Hippocrates, Asklepios, or to whomever goes this credit. I’m a physician and a healing work-in-progress. And I feel ever so slightly better already.