Farm Share Bingo


If you want to increase your mindfulness, join a CSA. A highlight of my summer is the weekly mystery bounty from our farm share or CSA (community supported agriculture).

We have participated in the First Root Farm CSA for several years and I always enjoy arriving for pickup on Tuesdays to discover what my share of the week's harvest will be. I think of this weekly adventure as farm share bingo...a root vegetable or two unused from the previous week pairs perfectly with something from this week's share, along with pantry items at home...and BINGO!

Beets, carrots, baby lettuces and spicy greens from our farm share came together with a couple of apples and a can of pineapple from the pantry into Glowing Salad this week (from my collection of favorite recipes from Debra's Natural Gourmet)...it's as pretty as it is delicious! BINGO!





My 6 Word Summary of the Mad Men Finale

OK, I'll admit it I was a Mad Men groupie, tuning in each Sunday night to have a glimpse into the dysfunctional fictional lives of the gang at Sterling Cooper advertising agency. I think the show exposed the underbelly of the not so nice features of being human, and along the way also shed light on the innate qualities of resilience. A sense of resilience wasn't predicated on noble qualities of compassion or empathy, but on self-preservation and survival.  Whatever you thought of the moral ambiguity the characters exuded and the choices they each made during the seven seasons of Mad Men, in the end the commonality for all was meeting adversity with a sense of resilience, having taken control of their experience but not the outcome of their choices.

My six word summary?.... Resilience wins even in flawed humans




Still on the Journey to Ithaca

It is commencement season, a time of new beginnings and setting forth on new adventures. This week is also Nurses Week, a week set aside each year to honor nurses. I have been reflecting on my nearly four decades in the nursing profession...what I imagined as a young nurse setting sail into the world of healthcare and where I have found myself so many years later.

Several of my nursing colleagues and I have been thinking about our stories or narratives as nurses -- where have we been, where are we going, what has shaped us and what gives our work meaning? #WhyINurse

So, in the spirit of this reflection and with immense gratitude to those who have allowed me to learn from their lives and teaching, I share the commencement address I gave several years ago as I completed my graduate work at the Tufts University School of Medicine. Several years later, I am happy to say that I am still discovering my way to Ithaca. My wish for each of you is for your journey to be long and circuitous as well.  ~Pam




Commencement Address
Tufts University School of Medicine: Pain Research, Education and Policy Program

To the faculty, administration, fellow graduates, and especially to my wonderful family; I am both incredibly honored and extremely humbled to stand before you today. 

It has been 32 years since I last wore a cap and gown and I am reminded today of that spring day so long ago in Ann Arbor, Michigan.   In 1979, the adventure on which I was embarking appeared so clear and direct, much like Homer’s Odysseus as he set off from Troy enroute to Ithaca.  But as with Odysseus, we often find our journeys far more complicated than we ever anticipated…meeting not only with trade winds and gentle seas but also with violent storms and towering waves that can batter us and throw us off course.  And so it is for the patients we meet each day in healthcare.  They, too, are voyagers on their own Homeric journeys, each filled with unique, authentic stories waiting to be told. It is up to us, in healthcare, to elicit, acknowledge, and honor these stories, to bear witness to their individual journeys and to help them navigate through difficult passages.   
When we first enter the world of healthcare our mission seems clear and direct – we want to quickly fix what we see as broken, to cure what we see as diseased.   While this is a noble mindset, we often miss the opportunity to heal when we blindly set out in this direction.  What I have learned is that often we cannot cure, no matter how desperately we try, but the potential for healing is always possible.  This statement may seem  incongruous to what we see as the measurement of medical success.  But, as we look broadly at what healing really is… isn’t it all about reducing pain and suffering…about living and dying with dignity, grace, and a sense of purpose?  We meet our patients at many points on their journeys and I see our work as assisting them in gathering the necessary tools of healing to find safe passage on their voyages. 

During the course of my studies here at Tufts I have discovered many tools of healing.  The Pain Research Education and Policy program was not on my navigational charts when I set off in 1979, but I am so grateful that I found my way here.  Through my work with inspirational faculty mentors, especially Dr. Bradshaw, Dr. Glickman-Simon and Dr. Carr, as well as Dr. Gualtieri in the Health Communications program, I have explored pain not only as a physical manifestation of injury or disease, but also as a complex pattern of psychosocial and cultural components that contribute to a sense of suffering.  Addressing the suffering has a direct impact on reducing the sensation of pain.  The Pain Research, Education and Policy Program has allowed me to explore the intersection of modern medicine, technology, ancient healing practices of the body and mind and spirit, and the innate human desire to survive adversity.  It has given me a voice in advocacy and scholarship by helping me to articulate the meaning of pain and suffering for individuals and society.  For this I will always be grateful.   

Some of you may be familiar with the poem, Ithaca, by Constantine Covafy.  It is a poem that has kept me company on my journey and I would like to offer it to you as a metaphor for this commencement, as each of us sets forth on new journeys and adventures:  

When you set out on your journey to Ithaca,
pray that the road is long,
full of adventure, full of knowledge.
The Lestrygonians and the Cyclops,
the angry Poseidon -- do not fear them:
You will never find such as these on your path,
if your thoughts remain lofty, if a fine
emotion touches your spirit and your body.
The Lestrygonians and the Cyclops,
the fierce Poseidon you will never encounter,
if you do not carry them within your soul,
if your soul does not set them up before you.

Pray that the road is long.
That the summer mornings are many, when,
with such pleasure, with such joy
you will enter ports seen for the first time;
stop at Phoenician markets,
and purchase fine merchandise,
mother-of-pearl and coral, amber, and ebony,
and sensual perfumes of all kinds,
as many sensual perfumes as you can;
visit many Egyptian cities,
to learn and learn from scholars.
 Always keep Ithaca on your mind.
To arrive there is your ultimate goal.
But do not hurry the voyage at all.
It is better to let it last for many years;
and to anchor at the island when you are old,
rich with all you have gained on the way,
not expecting that Ithaca will offer you riches.

Ithaca has given you the beautiful voyage.
Without her you would have never set out on the road.
She has nothing more to give you.

And if you find her poor, Ithaca has not deceived you.
Wise as you have become, with so much experience,
you must already have understood what these Ithacas mean.

And so, as you set sail from this commencement for your Ithaca…I wish you a long and prosperous journey, the privilege of listening to many stories, and the wisdom of healing.
Thank you and Bon Voyage.

The Language of Cancer

Have you considered the language of cancer? Battle metaphors abound..."the war on cancer", "survivor", "hero", "winning the battle", "conquering", "fought the heroic fight", "lost the battle" etc. Why do we use these metaphors with cancer but not with other diseases? For instance do we use the same language to describe someone living with or who has died from such chronic and life-limiting illnesses as chronic obstructive pulmonary disease, heart disease, diabetes? Why the difference? Language is important and the effect on ourselves and others as we identify with certain metaphors is interesting to consider. An interesting discussion of this topic in a blog post from the Dana Farber Cancer Institute in Boston

The Power of the Narrative....It's Here!!! The Healthcare Narrative Playbook

I often hear..."so what do you "do" in your work?" Perhaps the best way to describe what I "do" is that I help individuals and organizations recognize and enhance what is going right when often a lot is also going wrong. In other words, I help to cultivate resilience. What I have learned, and continue to learn each day, is that to build resilience we need to tell, share, listen and understand our narratives -- identifying the hero's journey which we all travel. In the healthcare world, the fullness of our human experience is often cloaked in a diagnosis, rendering us a series of test results, medications and prognostications. The "person" is often lost while the patient's diagnosis is tended to. We enter the healthcare world with a story but we leave with a diagnosis...how can we continue to support and hear our stories and narratives along side the diagnosis?

So it is was with great pleasure that I accepted an invitation from the Robert Wood Johnson Foundation to be one of 30 thought-leaders from the United States and the United Kingdom in the field of health care narrative to gather together in Providence RI at the Business Innovation Factory to collaborate and create the first Healthcare Narrative Playbook. I am very proud of the depth and breadth of this interactive playbook as both a resource and guide, whether we are a caregiver, patient, clinician, clergy, friend or family member, tell, share, listen and understand our experience of health, illness and healing. Here is a 4 minute video explaining the concept: Healthcare Narrative Playbook Video

What can you do with the playbook? First, take some time to peruse through the various sections. Many of us have added our personal stories to the pages. Try some of the suggestions. Sample some of the resources listed. And most of all please share widely with your friends, caregivers, and community. Finally, I would welcome your comments and thoughts about the Healthcare Narrative Playbook -- what did you find helpful and what could be improved, as this is meant to be a living, breathing document...ultimately empowering and building resilience and changing our culture of health.


The Art of Mindfulness


The art of mindfulness -- noticing beauty made exquisite by its impermanence.  A special rite of spring in Boston is the return of the hanging nasturtiums to the courtyard of the Isabella Stuart Gardner Museum. The nasturtiums are displayed just 10-14 days each year at the beginning of April. I visited the nasturtiums today and was awed by their vivid, simple majesty. Rapunsel-like plants letting down their tresses. Grateful for the moment of beauty and the promise of spring.










Find a Bit of Beauty...Countdown to Spring #8

My found bit of beauty today came in the form of a little shell that usually sits silently and unexamined on my office bookshelf. Today, I took time to really notice its amazing qualities of symmetry, translucence, bumpiness, and complex coloration of this remarkable gift of nature. My little shell friend also reminded me that it is time to re-read Gift From the Sea. What bit of beauty did you find today?

Find a Bit of Beauty...Countdown to Spring #10

"Find a bit of beauty in the world today. Share it. If you can't find it, create it. Some days this may be hard to do. Persevere."

These are the words Lisa Adams (@AdamsLisa) shared in each of her posts. I wrote about Lisa last year and have continued to follow her writing through her blog and on Twitter throughout the year. Metastatic breast cancer took Lisa's life last week. She taught us much during her time with us, especially lessons on finding beauty in the world, even when things seem anything but beautiful. I often write about the qualities of resilience -- control, commitment, challenge and connection. Lisa continually cultivated these qualities on her good days and on her difficult ones as well. I am grateful to Lisa for reminding me that it is always possible to find a bit of beauty in the world even if we need to create it ourselves.

So, in honor of Lisa, I am dedicating my blog posts for the next 10 days, as we countdown to spring,to sharing a bit of beauty that I find in the world...will you join me?

#10 Daffodils on the kitchen table