Marrette

 
 

Excerpts From Chapter Three


From Grave to Cradle to Now


Notes to Nurses, Doctors and Other Health Care Providers


As you know, objectivity, knowledge, expertise, experience, timely data and compassion are critical to your success as a health care professional. Of these, you share only compassion with the patient’s family and friends. Even that is inhibited by your necessary professional objectivity and the lack of shared history with the patient.

Even with the obvious distinctions between you, those involved may not recognize all consequences, challenges and opportunities that important distinctions present. I write about them only in this chapter, not in the following chapters, which were written by and for the caregiver who is not a medical professional. Also I recognize the degree to which my observations vary in relevance depending upon the patient’s place on the continuum from trauma through acute and critical care to their particular outcome.

The patient’s critical needs are obvious, but what about the condition of the collaterally damaged family and friends? They aren’t furniture. Anticipate their condition and work with it to achieve multiple positive outcomes. You have the effective hand.

 

 


 

Blood harmony and using the shared past



Patients in comas and patients near death must be helped to orient themselves towards life and the present place and time, which to them are relative to each moment. This realization is very important because we are all on journeys, all of the time. Those asleep, in a coma or trauma are no different in that regard. The difference between them and us is that their grasp of time, spatial orientation, and facts may be completely derailed by their brain injury. They may be unable to tell the difference between reality, dreaming or death. Being unable to tell the difference, in which direction will they orient themselves? My guess is that left alone they will orient themselves towards the near future that they perceive to be the easiest, most pain free or the most peaceful.

I assume, perhaps incorrectly, that our brains strive ceaselessly to make sense of inputs and incorporate them into meaningful directions for its host being—effectively a definition of both movement and of life itself. The opposite is entropy, a state of no energy, which is death.

Although we now know that the brain has great neuroplasticity, we know that neuroplasticity rerewiring is implemented slowly, over considerable time, perhaps as much as 10 years, much like the 10,000 hours required to learn a new skill. However, in order to survive, a traumatized brain needs rewiring immediately. The first 36 hours of healing are the most critical to survival. The brain is drowning in chaos; throw it a rope. To use another drowning metaphor, lifeguards are taught that when rescuing a drowning person they must push the lifejacket or reaching pole firmly, even harshly, into the victim’s chest or abdomen. Instinctively, the person at risk will grab it.

You can use your professionalism as that reaching pole; but you do not have with any patient the more effective reaching pole: blood harmony. I’ve borrowed the term blood harmony which refers to singing families that are able to achieve magnificent harmonies because of their shared nature and nurture. Unrelated singers, even exceptional ones, can never achieve such harmonies.

A loosely similar medical term is entrainment. I urge you to use your professional centrality to this life/death tipping point to immediately engage the family in the many ways that they can use their shared blood harmony to guide and to encourage the patient towards life and consciousness. Those many ways include: kissing (touch+olfaction, engaging chemoreceptors); hand holding; massaging; talking; story, joke and news telling; singing and music playing. For specific suggestions for families, see at Applying Blood Harmony below. Emphasize to the family that until the patient is out of danger they should use these tools as frequently as they can, with the obvious medically necessitated exceptions.

Experience convinced me that this is a powerful tool particularly in the hands of the patient’s family and friends and about which they are unlikely to be aware. Now you are. Apply this as a nursing art. Use the family and friends as additional instruments. No training required. Simple, no?

Why you? Well, if not you, who? At such a time, you have three critical things that the family does not have: the objectivity, expertise and experiences in your chosen profession. It is very unlikely that the power of blood harmony will occur to the family particularly at the onset of their trauma, at the very time that it is most needed. Direct them, guide them or suggest it to them. If you don’t believe in its “unproven” effectiveness, I ask you, “What do you, or most importantly, what does the patient have to lose or to gain by implementing it?” Furthermore, the family and friends are untreated injured. The additional professional benefit that you will create is that by engaging the family in this process, you will heal them by empowering them. By engaging them, they will be relieved to be doing something useful and potentially lifesaving. Furthermore, you reduce their trauma by giving them important tasks, instead of leaving them to flounder in the destructive maelstrom of fear, guilt, helplessness and loss. By consciously using blood harmony, even if their loved one dies, they will live on stronger, knowing that they did their best.

Clearly, your mandated responsibility is to the patient in the bed, not to the collaterally damaged relatives. But you chose your field because of your compassion for all people. I suggest that by enlisting that patient’s close family and friends effectively in the caregiving process that you will be more effective in treating that patient and will also create the collaterally healed. Even if the patient dies, you will not only take satisfaction in knowing that you did your best for that patient, but you will also take great satisfaction in knowing that you healed many other people walking your community who, in turn, will use their experience to heal others. Call it the power of one—you!


 


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