Can we handle the truth?

Veteran’s medical care and the private medical system. I rarely post about current events or politics.  After reading  a clear-minded, HONEST and APOLICTICAL post by Dr John Mandrola I’m making an exception.

Here are just a few thought provoking paragraphs from his post. (bold/red print is mine)

The VA healthcare system — Can we handle the truth?


“I am also connected to veterans’ healthcare. For it is in the VA system that I learned to be a doctor—a feeling doctor, an imperfect doctor, a human doctor. It’s ironic, and not often said, that the $48 billion-dollar VA healthcare system gives as much as it takes. It’s impossible to put a value on the benefit to society from the legions of caregivers who emerge from years of training in the VA system. Algorithms be damned; wealthy Americans benefit from what young doctors learn in the VA system. Veterans give when they serve in battle, then they give again as patients, as teachers.”

“And it’s not just the past that connects me to veterans’ healthcare. My wife Staci works as an attending physician in hospice and palliative care at the Louisville VA. When we share stories, I mostly tell of relieving the palpitations of the rich, she of relieving the suffering of dying veterans. Another irony of the VA: you don’t get Staci if you have private insurance.”

imagesIndicting Obamacare:

“This is a huge mistake. Obamacare fails because it lacked the courage to do enough. Its proponents avoided the truth. (Maybe they had to.) What policymakers set out to do was to correct a great American scar—that a country this rich does not provide basic healthcare to all its people. The problem was that Americans were not told the truth. A leader (or leaders) should have said that to get care to all people, excesses and inefficiency would need to be removed. Hospitals would not look like luxury hotels. Medicine and surgery would be for the ill, not the worried-well. Evidence, not eminence, would guide medical care. And prevention of disease would come not from doctors but from patients.”

“But Americans didn’t get the truth. We got magical thinking about metaphorical free lunches, insurance reform, cost-saving EHRs, patient-safety “quality forums,” and the like. Nonsense. All of it.”

“The VA system is the truth. Rationing is the truth. Triage is the truth. Imperfection is the truth.

And yes, death, too, is the truth.”


Failure to see the obvious:images-2

“You simply cannot deliver suburban excesses—the antithesis of efficient and honest healthcare–to the growing numbers of veterans. Thank goodness. Both Dr. Harlan Krumholz and Dr. Kevin Pho remind us that if evidence, not hype, is considered, the VA system performs either better than, or comparable to, the private sector.”

“Yet this should be obvious to anyone who reads anything about US healthcare. It’s clear that the private system is broken. If you hold up the US private system—with its humanity-extracting EHRs, expanding layers of bureaucracy, conflicts of interest, expense, inequalities, and geographic and racial differences in care–as a model that the VA should aspire to, you are not mastering the obvious. My colleague at Dr. Melissa Walton Shirley suggests veterans should be moved to the private system. I wouldn’t do that; veterans deserve better than our mess”.

images-1“Yes, of course, patients die waiting for medical care. It’s utter nonsense to call that a scandal. Why? Because patients die regardless of medical care, and too often, as a result of medical care. This death-denying culture has led to a major humanitarian crisis, one playing out in nearly every ICU in this country.

But please don’t misunderstand. I’m not arguing that medical care is pointless, or that we should not try to extend and improve human life. Rather, it is time to adjust the mindset that more care or faster care is always better care.”

Read the entire article click here. Can We Handle the Truth?


With Love to Bernice and Len

November 14th was the anniversary of The passing of Leonard Bornstein, the husband of my dear dear friend Bernice.  Here is my original post in Len’s memory:

Among Bernice’s many, many accomplishments as a mother, wife,  grandmother, nurse, psychotherapist, Woman of the Year when she and Len lived in Eagle Lake, Texas. (Thank goodness she’s lost her drrrrrrawl since moving back to California!) she’s a writer, poet, incredible hostess but one of my dearest, long time friends.

We met in 1985 when we were psychotherapy interns together at Long Beach Family Service. (I’m not good at numbers but as I recall we were about 20 years old, give or take a decade . . . or two. . . or three or four).
Bernice and I created the annual “Birthday Season” that I wrote about on my birthday blog post.
After you read Bernice’s poem I’ll tell you why her poem and acrylic paintings reflect how  we all share a common bond with loss.
It came too quickly
He was too young
We never dreamed
It could happen to us.
It did
So we lived each day
took evey minute
To savor life
Share joys and loss
And did.
We gave our all
To win the battle
To keep hold of life
To conquer death
We didn’t.
Death came and went
Without devastation
For we shared it fully
Believing in eternity
I do.
by Bernice Bornstein, wife of Leonard Bornstein, M.D. who died November 14, 2008 
Here’s the series of pictures Bernice painted – one for each stanza.  

“It came too quickly”
One minute we are fine and the next moment, searing, burning pain. Like the black breaking through.
“So we lived each day”
We try to “be normal”.  Bits of flashes of color (hope, relief) but always against a background of grey
                      “To keep hold of life”
We attempt to hold onto who & what had been but the
background gets grayer and the color leaves our life.
Deep grief is felt over the empty loss

Bursts of life energy periodically blossom, against the gray.
“For we shared it fully
Believing in eternity
I do.”
“Wert thou to attain to but a dewdrop of the crystal waters of divine knowledge, thou wouldst readily realize that true life is not the life of the flesh but the life of the spirit. For the life of the flesh is common to both men and animals, whereas the life of the spirit is possessed only by the pure in heart who have quaffed from the ocean of faith and partaken of the fruit of certitude. This life knoweth no death, and this existence is crowned by immortality.”

Can “Art” Be Medicine?

For the first time in my 26 years of being a therapist I have cancelled every single client and Jumbo Journal workshop for the entire week.  Some cold virus landed on me and decided to use my body to procreate.  If I didn’t feel so miserable it could be kinky.

Now I truly believe  that Creative Expression in any form – painting, dancing, singing, drawing, scrapbooking, knitting, journaling – is THERAPEUTIC.  

If I walked the walk I should be drawing, painting, collaging, singing and dancing.  Instead I just watched this video while I creatively sneezed into softy tissue and therapeutically moaned.  That’s about all the medicine I can swallow right now. 

P.S.  Please wash your hands after viewing the video because I touched it and

I don’t want you to get sick.
The transcript is below.

(Pictures are from my Therapeutic Creative Expression Workshops)

Transcript: Can Art Be Medicine?

Since the beginning of time art and the creative energy behind it has captured our imagination, energized us, comforted us, and inspired us. Creative expression has an undeniable power providing insight into what it means to be human. Is there something about creativity…how we engage with it and share it with others…that can actually improve our health? Can art be medicine?

Robert A. Gabbay, MD, PhD – Director, Penn State Institute for Diabetes & Obesity
Art has been around since the origins of our species and for it to have lasted as long as it has says something right away about how important and central it is to the human existence.

Edward Hirsch – President, John Simon Guggenheim Memorial Foundation
There’s never been a culture without art. There’s never been a culture without poetry. There’s never been a culture without music. They must be delivering something to us that we really need for our pscyhes.

Robert A. Gabbay
You think back to those days and all the challenges that existed just to survive and have food, but they still took time for art so obviously it had some value for them. And that value clearly had something to do with health. We’ve forgotten the original stuff that worked quite well before we had all the medications and technologies for treatment.

Captain Jason Berner – US Marine Corps
Here I am a strong, physically demanding warrior. Why do I have to do art? I plan battles. I plan wars. I take life if absolutely necessary. I’m not doing art.

Stephanie Paseornek – Writer, Heart Transplant Recipient
The first second that I’m writing a poem…the first second that I started typing…I lived, I breathed a little bit deeper than I had that whole time. It felt better than trying to communicate with the doctors about how I was feeling or trying to communicate with therapists about how I was feeling because in truth in those situations people are trying to help you but you don’t necessarily know how you’re feeling.

Creative engagement bfings us into the moment. It puts us in touch with who we are and connects us with others. It helps us get unstuck. It helps us move forward.

In very traumatic illnesses and very traumatic situations like war, everyone is changed.

Captain Jason Berner
I lost three marines due to IEDs…I lost several of my friends in one deployment.

Stephanie Paseornek
When I was sixteen years old I had a heart transplant. I was in the hospital for three months.

Captain Jason Berner
I found it odd that each time I did something with art therapy I felt better because there was something in me that was dying to get out. And through art I was able to express it.

Stephanie Paseornek
I remember writing about this. I remember writing to my heart. I remember asking it to please work with me. I remember really almost in letter form just saying that I know this environment isn’t natural for you…I know that you’re in a foreign place and so am I…and together we can find a home.

The first thing is to think about something that you like about being at the hospital. Is there anything you like about being at the hospital? Is there anything good about being here?

Steven M. Safyer, MD – President and CEO, Montefiore Medical Center
It’s essential to add other components into traditional medical modalities. Anything from the use of artwork to the use of light, to the use of drama, to the use of storytelling…and the engagement of the patients and the patients’ families in an art experience to help them have the optimal care they deserve.

Charlotte Yeh, MD – Chief Medical Officer AARP Services, Inc.
We are learning that storytelling and arts and emotional health is just as fundamental to well-being as your physical health.

And just thinking about it, talking about it, writing it down, expressing it obliquely, expressing it directly…that can help.

Nobody knows what a scream looks like. Make your own scream.

Helen Meyrowitz – Artist, Alzheimer’s Care Giver
And one of the ways of doing it is to say to yourself, “I am feeling lousy today. I am feeling so goddamned (sic) blue and disgusted I could just scream.” Take out a pen and make a scream. Whatever that looks like…nobody knows what a scream looks like. Make your own scream.

Linda Hettick – North Hill Memore Care
Do you have a memory of the fall leaves…what you used to do and play with them? And what would that be? I remember as a little girl we’d have a bunch of friends and we’d gather up all the leaves and make it into a big pile and jump into it. And you remember doing that?

Captain Jason Berner
I would have never have talked about what this meant. But I was able to express it through something that everybody could see what it was and see what it meant. But it wasn’t me. I was shielded in some ways…I was protected. I was able to express it in a way that was safe for me.

Melissa Walker – Art Therapist & Healing Arts Program Coordinator, National Intrepid Center of Excellence
Drama’s actually encoded as sight, sound, smell.

Captain Frances Stewart, MD – Integrative Medicine Physician, National Intrepid of Excellence
Part of the brain that’s involved in speech called Broca’s Area just really does not work as well when people with PTSD are trying to talk about their experiences.

Melissa Walker
When you’re able to process what you’ve been through using the right hemisphere and then apply words, you’re then re-integrating the brain.

Arts can reduce stress and any emotional overlays that are associated with it. And stress and emotional aspects clearly are related to a variety of hormonal changes that can then lead to disease.

Captain Robert Koffman, MD, MPH – Deputy Director for Clinical Operations, National Intrepid Center of Excellence
I really believe that in the next few years we will have some detailed examples as to what works and those individuals that come in are studied intensely. And in doing so we are able to catch them in that freefall, but at the same time hopefully inform the system in months to years to come.

If all we did was sit back and wait to begin until something’s proven, nothing will ever happen. I predict more and more we will learn the benefits of storytelling, of writing, the use of various art modalities, and we’ll use that in our enviornment to create wellness and health and prove that it works.

Meghan D. Kelly, MSEd, CCLS – Director, Child Life Programs – The Children’s Hospital at Montefiore
My dream for this work would be for it to be accessible in all venues…in the clinics, in the community, in the schools. It’s really such a valuable part of how to teach children and families how to deal with challenges in their life that I can’t imagine a single setting that it wouldn’t be appropriate to put it into.

Can you imagine if the prescription is not only for what the next pill is, or a prescription for not to have too much soda in your diet, but the prescription could also be: where’s your happiness? Where’s your pleasure? Where’s your artwork? Where’s your music? Come in and show me next time.

You don’t need to be an artist to do this kind of art that we’re talking about for healing. Anybody doing anything that feels good to do that is getting something in you out. I think the beauty here is this is all very accessible to virtually everybody.

Even though people might think that art is not the same as medicine, it was my medicine and I think that without it I would have still been sick.

Through simple things…able to create something that makes it okay to feel the way I feel…and help take that burden away.

Scientific research has already shown that harnessing the power of art can promote health and healing. It is now critical to expand these efforts. Exactly how creative expression promotes healing may forever remain somewhat mysterious. But the ability to draw on the power of art to transform and expand our lives, reduce suffering and create new possibilities is beginning to be accepted as real medicine. As real as an antibiotic or surgical procedure.

Medicine has made great strides in the past one hundred years. It’s now time to go one step further by incorporating artistic expression into the ways we provide health and healing. All will stand to benefit.

Foundation for Art and Healing

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