Trish #26

Trish has suffered a major brain trauma. For a subarachnoid hemorrhage is like an atomic bomb that explodes in your brain. It is a long time after the explosion before one knows exactly what has and what has not survived the blast.

After struggling for nearly three weeks; eating through a feeding tube, breathing through a respirator and experiencing the paralysis of the left side of her body -- not to mention that one of those weeks was spent in a coma and the next week hardly awake -- it is no wonder that Trish has walked a very rough road toward her recovery. When people visit her for a few minutes, they are understandably amazed at her awareness and at her ability to engage. However, her family knows that all is not well. There are serious gaps in her knowledge and ability. She sometimes expresses rather skewed perceptions of reality. All in all, her progress is indeed remarkable and consistent. We have every reason to believe that she is on her way to full recovery. That doesn't mean that we don't get alarmed and a bit scared though. The blunt truth of the matter is, for the moment, she is not yet herself in some important ways. Her perceptions of herself and of the world and the judgment she forms from those perceptions, are unreliable. They are often accurate but sometimes they are not.

This morning, I was later than usual getting to the hospital. I had spoken at a funeral and so didn't arrive until lunch time. She was not in her room. So I went to the rehab dining room and found her there, staring at her plate.

"Are you hungry?" I asked.

'Yes," she replied.

"How long has your food been here?"

"About thirty or forty minutes," she guessed.

"Then why aren't you eating it? I asked.

"I don't know," she said.

Actually, her food had been there for about five or ten minutes. The reason she was not eating was because her brain is not doing an adequate job of instructing her body how to feed itself. To satisfy her hunger she must find a way to direct her hand to take the fork and move the food from her plate to her mouth. So, even though she wants to eat and is physically capable of feeding herself, she doesn't always make the connection between the ability to put her hands into motion and the need to do so in order to satisfy her hunger. She seems to wait for her hunger to get satisfied magically. She can't seem to remember what actions are required to make it happen.

"Darling, you have to move your fork to your mouth," I said. So she began eating. I had to remind her a few more times but soon she had fed herself all she wanted to eat.

All was well until she suddenly said, "I want my apple pie! Someone has taken my pie."

I looked around. Indeed, the other patients had apple pie. She did not.

"Honey," I said, " You can't eat apple pie. Your swallowing is not yet at a sufficient level."

Exasperated, she said, "I want to go to the next level. I want to be in the apple pie level!" But soon she was laughing and we went on to her room.

A few minutes later, she asked me to bring her a bottle of water.

"Trish, you can't have water." I answered. "You can only have thickened liquids."

"All human beings have a right to drink water," she insisted.

"Yes they do. But in your case you might get strangled. Its too risky. I just can't give you water until the doctors say that it is safe."

The day seemed to go on like that with Trish exploring reality, pushing the limits, trying to understand why the world seems suddenly "out of whack." As I got steadily worn out, I kept thinking about Bob Dimon.

Bob was the man for whom the funeral was held today. He was a man in our church who experienced the most remarkable miracle two years ago. He had been a violinist with the Phoenix Symphony before sinking into a mental illness over twenty years ago. So, for years, he sat in the back of our church staring at the floor, in a near catatonic state. He walked slowly about the church with his walker, seemingly unaware of much of the world around him. However, one night a couple of years ago, an African pastor who was visiting our church, suddenly shouted out at him from the platform. "Brother, I command you to throw away your walker and run," Isaac Ogbeta said.

I nearly fainted. I saw lawsuits and newspaper articles on their way. I was ready to step up and put an end to the foolishness when, to my surprise, Bob threw away his walker. He began to run around the church in a steady gait, smiling from ear to ear. Within a few weeks, his psychiatrist took him off nearly all his medication. After twenty years of darkness, Bob was restored to his right mind. He began playing his violin and conversing freely with everyone. He became a constant joy and delight to us.

The sad part of this story is that soon after this miracle, Bob found out that he had cancer. In his hospital room one day I remarked that it seemed cruel that God would heal his mind only to allow him to suffer an incurable illness. Bob kindly rebuked me.

"Not at all,"he said. I have been able to make things right with people I have wronged. I have enjoyed the sunrise again. I have been able to read my books. I play my violin. These two years have been a gift. I would not have wanted to die with a clouded head!"

Bob then pulled out the violin that he did not play for twenty years and played Mendelssohn's Elijah for me. Before I left his room, he put down the violin and said something that will stay with me forever. "Pastor, it is far better to live in reality no matter how painful than to live in fantasy, no matter how pleasant. For years I lived in a world that I created in my own head. That was the ultimate idolatry. Now I am living in the real world and the real world happens to contain cancer."

I have rarely heard such wisdom and grace.

When we insist on creating our own isolated perception; when we will not allow our perceptions to be challenged, we descend into mental illness. For mental health is the humility and the wherewithal to constantly check our perceptions against those of others. Every human being has the ability to create whatever world he or she wishes inside the privacy of his or her own head. But to the extent that we create an inner world that does not correspond to the world outside our heads, we lose our grip on sanity. Sanity, in other words, requires humility and accountability.

Trish loves me. She calmed down after I told her that in her present state, apple pie can seriously harm her. She even accepted my claim that the water she craves is not safe for her to drink. Though Trish is a very independent woman and is not usually prone to give up her own opinions so easily, she is able somehow to understand that her brain is not yet working as it should. So she is allowing me for the moment to keep her perceptions accountable. She is not likely to get into serious difficulty as long as she does this, as long as she keeps submitting her perceptions to a "reality check."

Once again, Trish's struggle reveals an important truth. We all get mad as hatters when we become unaccountable. If no one can challenge us, rebuke us, differ or disagree with us, we are well on our way to mental illness. I have lived long enough to see spiritually powerful people become just plain nuts because they come to believe that they were too spiritual to accept correction or challenge. I have worked in mental health with patients who had become so highly respected in their fields that they rose above all correction and accountability until no one could challenge their judgment. After a while of living this way, their sanity began to unravel. Unaccountable imagination and unchallenged cognition is like a river without banks; it soon becomes a swamp. This is true in the board room and the courthouse, in the ball field and on the battleground.

In his mercy, God will place us in situations that force us to reexamine our thoughts and actions. Sometimes, he will withhold from us things that we really believe are ours by right. Sometimes, no matter how much we plead, he will not advance us to the "apple pie level" because he knows we will choke on the sweetness. The question is, will we trust him? Will we accept God's invitation to live in reality even when it is painful rather than flee to fantasy because the world we can create for ourselves is so much more convenient and pleasant?

Trish will keep emerging from the shadows. Her mental life will steadily improve. I believe this because she has the humility and the grace to trust that I love her and that I will not willingly deceive her. She believes this so strongly that she is willing to turn away from a glass of water because she suspects that for the moment her own judgment and perception is not as trustworthy as mine. When she gets well, that level of trust in me (and that level of distrust of her own judgment) will be inappropriate. As she improves, she can (and should) question my judgment and mental clarity when it doesn't seem right to her. (and believe me, she will have no problem doing that!) For the moment though, she values the search for sanity more than the sweetness of getting her own way.

I honor Bob Dimond tonight. He now has a clearer mind than any of us here below. I have no doubt that as you read this e-mail, he is meeting with Jesus and Bach. I also honor my courageous wife. She is still in the middle of her greatest struggle. But she will win. For she is armed with the same grace and humility that Bob discovered two years ago: the belief that is worthwhile to work for one's sanity by turning away from self -serving illusion in order to accept community and appropriate care from others.

In the end, sanity is merely the ability and the willingness to live in a mental environment of mutual accountability. Outside that environment lurks madness.

Trish #25

In a hospital, one must confront the "underbelly" of life. Death, defecation and physical deformity simply can't be hidden here. No one can disguise the odors, disabilities and misfortunes of human existence. So it doesn't take long before one realizes what a sanitized existence we have made for ourselves in modern times.

The quality of human life cannot rise above the level of animals until we learn to clean ourselves and to keep the more unsavory parts of our existence discrete. Hygiene and good manners protect the space we must share with others. Thus, discretion and appropriate self-care allows us to transcend animal existence. Taking care of our animal needs with appropriate dignity and grace sets us free to expand our nature into art, spirituality, economics and all the other kinds of soul-enriching tools we use in our quest to become fully human.

On the other hand, the "baser" parts of our natural lives remain, (as the word "baser" implies,) the "base," or the foundation, upon which we build all that we are. As Trish and I have learned this month, no one can enjoy art, Bible study, political discussion, economics or much of any thing else if his or her basic existence gets threatened. If you can't go to the bathroom or feed yourself then the other parts of life, however noble and important, become irrelevant and even superfluous. Hospitals rebuke our attempts to be other than human.

Somewhere in his writings, C.S. Lewis reflects upon the curious fact that human beings seem constantly amused and even embarrassed by their basic animal needs. We seem amazed that we cannot become so mature or sophisticated that we no longer need to defecate, for example. Most adolescents can be reduced to spasms of hilarity by the silliest allusion to flatulence. This amazement is amazing. It is as though we can hardly believe that we have bodies.

Of course, we do have bodies. And, according to the New Testament, we always will have bodies. For "we believe in the resurrection of the body." We are a species of embodied spirits. We touch our spirits through physical and material means and we alter our physical selves and our material environment according to our spiritual and intellectual beliefs. Spirituality and materiality interpenetrate in creating and sustaining a life that is fully human.

When Trish makes progress in her walking and swallowing, she seems to also advance cognitively and emotionally. As she gets a clearer picture of her situation and thus increases her ability to participate in her own recovery, her physical abilities seem to take a leap forward.

Christopher Reeves describes his own remarkable journey toward recovery in similar terms. He tells us that even though he was totally paralyzed, he continually imagined himself as moving and working. However, he is not trying to make a New Age kind of claim that he healed himself through imagination and mental prowess. He also found machines to move his physical body as though it were actually doing the kinds of things he imagined. This combination of applying both mental force and physical motion to overcome his disability resulted in such astounding progress that the field of neurology has had to take notice.

The lessons are clear: because we are incarnational creatures -- beings whose essence involves a state of spiritual embodiment --recovery of any sort requires both material and spiritual components.

During this current hospital adventure, I have drawn strength from the more earthy and practical parts of the Bible. The Proverbs, the Epistle of James, and even the dietary laws of ancient Israel in books like Leviticus and Deuteronomy, speak to the natural and "baser" side of our spirituality. By temperament, I am more at home in books like Ecclesiastes, St. John's Gospel and St. Paul's Epistle to the Colossians. I like soaring like an eagle. But life has a habit of teaching us that if we don't do practical things like taking a day of rest, or passing up the wrong kinds of food most of the time, or forgetting to feed hungry people, all of our pretended spirituality will sooner or later collapse. Castles in the clouds are very impressive in the comic books. In real life they are impossible to build. Real castles need a ground and a base. I suspect that the same is true for our theologies, philosophies and all other kinds of cute and complex abstractions that mesmerize and mold our thoughts.

Human beings, as it turns out, are created for transcendence. They are also created to need bedpans.

These are the two borders of our existence, the God-decreed limits of our being. No one becomes a truly spiritual person without coming to grips with this reality.

St. Joseph's hospital is filled with spiritual people. On every hand one experiences prayer and love. The kindness, the servanthood, the consistent care for the spirits and emotions of the patients and their families is remarkable and laudable. However, if the bedpans were not emptied and sterilized; if the wounds were not cleaned and dressed, all the love and concern in the world would not heal these sick people, one of whom is my wife.

Well, I'll stop now. For if I am not mistaken, I believe I have just rewritten the Epistle of James.

Trish #24

Trish was tired today. In fact, she spent much of it in bed. Her neurologist tells me that her team is delighted with Trish's progress. After all, last week she came into the unit unable to walk or swallow. Today, she can walk slowly with the help of a walker. She can eat many things and she can swallow, at least thick liquids.

Thanks to God for all of that.

Tonight, as I was getting ready to leave the hospital, Trish said to me, " I think I need to listen to a lot of music. I think music will help me recover my thoughts."

"How about us singing Amazing Grace?" I asked. "You know that really well."

"That sounds good," she agreed.

So I began to sing:"Amazing grace how sweet the sound ..."

To my sorrow, I heard her quote all the words to the song but without any melody.

"Honey," I told her, "you are SAYING the words. Talking is not singing."

"I know,"she said. "I hear the melody in my head. I just won't come out." "Lets try again," I suggested.

So I started to sing again. This time she tried to vary the pitch of her voice as best she could.

I noticed that she was finding a few of the notes. Then, for a few bars at least, she found the harmony. In her shaky voice, colored by all the trauma and confusion of this month, she sang with me:

"Through many dangers toils and snares, I have already come
Tis grace that brought me safe thus far and grace will lead me on."

I lost it. I held her and began to sob.

Tears filled her eyes in response to my own emotion.

"I don't want to upset you," I said.

"I love you," she responded.

"I want nothing in this world more than for you and I to just sing together," I told her.

"We will. We will" she responded.

Weeping endures for the night. But Trish and I have already been through the night. Its morning now; it is time for joy.

The nights of our lives have the power, if we will only allow them, to wipe away the illusions and foolishness that grip our souls. Each morning thus brings a fresh opportunity to recover all that is truly valuable and important in our lives.

The performance tonight at Barrow's Neurological Institute, Rehab Unit # 18, will win no Dove Awards. But it sure was music to my ears!