Rachel Naomi Remen — The Difference Between Fixing and Healing

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I quote from my conversation with her throughout. She is a physician and lyric writer whose long struggle with Crohn's disease has shaped her view of life and medicine. Living well, she says, is not about eradicating our wounds and weaknesses, but about understanding how they complete our identity and equip us to help others. How we cope with losses, big and small, determines our ability to be present in all our experiences and there is a

difference

, she says, between

healing

and curing. We thought we could cure everything, but it turns out we can only cure a small amount of human suffering. the rest need to be healed and that's different, it's different I think science defines life in its own way but life is bigger than science life is full of mystery courage heroism love all these things that we can witness but we can't measure or understand, but they make our lives valuable anyway.

I'm Krista Tippett and this is about being Dr. Rachel Naomi Remen beloved books, kitchen table wisdom and my grandfather's blessings have been translated into 24 languages ​​this gem of a conversation happened in 2005 you grew up, I think, like you say, surrounded by doctors and a mystical doctor, some nurses who would have been your orthodox. Rabbi Grandpa was a student of Kabbalah before it was a fashionable trend and he was a flaming mystic and he was also a magnificent storyteller. Well, what do you mean when you say he was a flaming mystic? I mean, describe that to me, what that means, oh, it means a lot.

Different things can mean something academic like studying a school of mysticism like Kabbalah, but it is also a way of seeing the world. My father, my father, my grandfather felt that the world was in constant communication with him, that there was a spirit in him. world of God in the world that could be spoken to and responded to at all times that there was a presence in the world that was holy and sacred and that he was in constant dialogue with this as he went through the events of his time, I believe Mysticism can be defined in many different ways.

I didn't know my grandfather was a mystic. No, I just knew that the world he lived in was the world I wanted to live in. Hmm, do you have this idea from Kabbalah that I hadn't known about, but I don't think maybe because you're a storyteller it was very vivid to me that this idea that at the beginning of creation the sacred was divided right into the story to tell about the bar at the beginning of things and you know the story of the world's birthday, so you told it, yes, exactly, I used to describe it, actually, Krista, this was my 4th birthday present, this story and If you want, I will tell you. yes, yes, so this is the story of the person, the birthday of the world, at the beginning there was only the sacred darkness, the eins of the source of life and then, in the course of history, at a moment in time , this world, the world.

Of a thousand thousands of things emerged from the heart of the Holy darkness like a great ray of light and then perhaps because this is a Jewish story there was an accident and the vessels that contained the light of the world, the entirety of the world broke and the entirety of the world the light of the world was dispersed into a thousand thousand fragments of light and fell into all events and all people where they remain deeply hidden to this day hmm now, according to my grandfather, the entire human race is a response to In this accident we are here because we are born with the ability to find the hidden light in all events and in all people hmm to raise it and make it visible once again and thus restore the innate wholeness of the world.

This is a very important story. For our time, we heal the world one heart at a time and this task is called tikkun olam in Hebrew. We could restore his connection between the story of sparks and tikkun olam and Jewish tradition. They are exactly the same. I didn't know that I didn't know, yes, of course, it is the restoration of the world, right, and this is, of course, a collective task involving all people who have ever been born, all people currently alive, all people that are yet to be born. We are all healers of the world and that story opens a sense of possibility, it is not about

healing

the world by making a big

difference

, it is about healing the world that touches you, the world around you, the world in the works of God, our It is, yes, yes, many people feel. helpless in the current situation, I mean, when you use a phrase like that, come out of nowhere, heal the world, it sounds like a dream, true, and a sweet and pleasant ideal, completely impossible, so a very old story comes from the 14th century and it is different. way of looking at our power and I suspect it has a I suspect it has a key for us in our current situation a very important key they say some say somewhere about that I think that's right for me well, you know, I don't want to talk politics here I'm not a political person in the usual sense of the word, but I think we all feel like we're not enough to make a difference mm-hmm that we need to be more in some way, whether it's richer or more educated or in some way or another different mm-hmm so the people we are and according to this story we are exactly what it takes and just wondering a little bit about that, what if we were exactly what it takes? hmm, so how would I live if I were? exactly what is needed to heal hmm and I think these types of questions are very important questions and exactly what is needed is precisely the given story of your life exactly exactly and you know the story that people will tell about a story like the scratched acutal um ah the birthday of the world, well you know how I can make a difference when I myself am so hurt mm-hmm, how can I make a difference when I feel like it's not enough?

You know it, but you know that it is our own wounds that allow us to make a difference. We are the right people just as we are. For example, my own wounds, my own suffering have allowed me to feel compassion for the suffering of others. Without my suffering, I would not understand the suffering of others or being able to connect with them. My loneliness allows me to recognize loneliness and to other people even when they are hidden, finding them where they have been lost in the darkness and sitting with them and knowing that just by sitting with them they will eventually find what they need to move forward.

You know, there was another story in my family, my grandmother, my grandfather's wife, the Rebbetzin, my grandfather in Russia were quite poor and they often fed the members of the community, being the rabbi's house, people would come there, so that my grandmother was used to making things stretch. and come a long way and in this country her cooler was full of food when they came to the United States because she had been hungry in Russia and the kitchen was the center of the house the cooler was full of food in every nook and cranny. filled to the brim and my family said that if someone opened the refrigerator door with that precaution an egg could fall out and break on the kitchen floor and my grandmother's response to these accidents was always the same apparently she did it. would do. look at the broken egg with satisfaction and say AHA to Davey have a biscuit and then maybe this is about our wounds you know the fact is that life is full of losses and disappointments and the art of living is to make them something that can nourish to others and you know, when I was first diagnosed I was 15 years old with Crohn's disease, yes, and the doctors came and told me I had this incurable disease, there was no one who knew what caused it.

I would have multiple surgeries and I could wait. Being dead when I was 40 was not my dream of the future when I was 15. I went into shock and my mother was with me and she didn't comfort me or hug me, she held my hand and reminded me of this. story and she said Rachel we will make a cake and it had taken me a long time to find the recipe which is mine my own recipe for this but I had an idea of ​​what might be possible and that I needed to search to find a way for me and that's what what a story can do hmm I wonder um I want to turn a corner but first I want to tell you a story briefly.

I'll just say that I went home with all this in my head and my son who is seven Isaac has a kind of mystical inclination, I think I mean that children do, but he really has a lot of depth and is thinking a lot and he I told this story about the beginning of the universe and you know, the sparks and the sacred flight. He just listened to me very quickly and said, I like that I was told this story, um, let's see, sixty-three years ago and my response was exactly the same and that's very important in stories, they touch on something that is human in us. and it probably won't change, maybe that's why you know parables, the important knowledge is beyond their stories, it's what keeps a culture together, culture has a story and every person in it participates in that story, so what history and not facts are the way the world is. fact the world is made of stories it is not made of facts although we tell ourselves facts to reconstruct history well, facts are the essence of history if you want to think about it that way, I mean, facts are for For example, I have had Crohn's disease for 52 years.

I've had eight major surgeries, but that doesn't tell you about my journey and what happened to me because of it and what it means to live with a disease like this and discover the power. of being a human being and you know, every time there's a crisis like 9/11, do you notice how the whole of America turned to the stories, I mean, where I wanted to go, where I was, what happened, what happened in those buildings, what happened to the people who were connected to the people in those buildings because that's the only way we can make sense of life is through stories and the facts are that a certain number of people died there, but The stories are about the greatness of being a human being. and the vulnerability of being a human being, I think it makes an interesting contrast also with the fact that we live with all kinds of stories in our culture, forms of entertainment and information, but that those stories always have beginnings and endings and you say that the stories of our lives stories as they work in life take time real stories take time there is a powerful saying that we tell ourselves stories sometimes we need a story more than food to live they tell us who we are what is possible For us, what we could turn to, they also remind us that we are not alone with whatever we face and that there are resources both within us and in the wider world and the unseen world that may be cooperating with us in our struggle to find a solution. way to deal with challenges and when I say a story has no ending, for example, part of my story is that you tell your little one the story of the world's birthday, that is also part of my grandfather's story, right mm -hmm and you The boy has never met my grandfather, but maybe my grandfather is woven into his life in some way, it may be a very small way or not.

I don't know, but in that sense no one's story is over. I'm Krista Tippett. and this is being with dr. Rachel Naomi tells me: Did you also train as a psychiatrist or could you really have become a professional listener as well as a doctor? I would say yes, I am trained but I have no credentials. I have spent, I would say, 3000 hours in humanistic psychology workshops. okay, learning various techniques, images, working with symbols, working with sand trees, poetry, art, anything that allows people to discover the strength in them, discover who they are, so I have a very extensive training, but I do not have a degree in psychology or psychiatry. taught in psychology schools I have taught health psychology and and all this but I am I am a doctor I am a doctor it seems to me that you have at the same time you have worked as if you had a medical practice I worked as a doctor and I specialized.

I believe in working with people who have cancer. It's true, yes, everything came up. Know. I think I have made very few decisions in my life. It's like I'm in a situation and it's very clear what. The next step is and I take that step and I think this is basically my modus operandi for leading my life, but I wanted us to have grants to study the doctor-patient relationship and then a new administration came in and we couldn't get the last piece of funding. to finish this work and I spent six months writing grants and then II was out of money and people had been calling me because I had been writing about this stuff and saying, Can I come talk to you about my problem? and I said another visitor center that I'm not a psychologist that no like Ike I don't do that no these are people sick people friends our friends our friends all kinds of people and then when I ran out of money I said well I guess I do this so I found a small office on a houseboat in Sausalito, the first office and a few people came and I decided to go talk to my colleagues in the medical community and tell them that I wanted to work with sick people. people and with their emotional problems and their struggle to live with the disease and also to recover from it and most of the doctors in the community said fantastic who has the time to talk to these people and you know, once I run out of treatments , I have nothing more to offer anyone and that's not another whole story in itself of course and let me send you my patients and within a few months I had a completely full practice and most of the people were people with cancer hmm and I started working as a person who focused my efforts on working with people with Why do you think most of the people your colleagues ended up sending you were people with cancer?

It was a particular life experience that the palliative care movement was not prepared to fully handle. okay recently, so this is before that, I mean you knew how to treat cancer, that's what we were trained to do in medical school, now we're trained differently, okay, the person's problems with cancer were something we would do. refer people to psychiatrists, but you know that these are not people who have psychological illnesses, they are people who are facing a very, very challenging life situation and who need to mobilize all their strength and the strength of their families to be able to cope. these things. to live well despite cancer it sounds like, like you say, you probably didn't plan this.

I'm sure you didn't plan this, but what you said earlier about how we're all given the lives we have and that's good enough and even what happens to us is part of what we have, seems like it's been very important in his medical practice and also how he has helped other doctors, how he has reflected on his profession, who has also struggled in his life with this debilitating disease of Crohn's disease that you were told was fatal mm-hmm I'll say it before, but Chris said I don't think that's what's wrong with us. I don't see, you know, sometimes what seems to be a catastrophe mm-hmm over time becomes a solid foundation from which to live a good life, it is possible to live a good life even if it is not an easy life and I think that That's one of the best kept secrets in America, when you say the pursuit of perfection has become a major addiction of our time, I mean, we use that word addiction a lot, but I've never heard anyone talk about it. our pursuit of perfection like an addiction.

Well, I think perfection is the greatest prize in life, in fact, it is very isolating, very separating and also. impossible to achieve, so you're always striving to become something you're not, but you know this is one of the greats, it sounds funny. I was going to say what a great choice to work with people on the edge of life, the view from the edge. of life is much clearer and the vision that most of us have that what seems to be important is much simpler and accessible to everyone: who have you touched on your path through life, who has touched you, what are you leaving behind. in the hearts and minds of other people is far more important than any wealth you have accumulated now, what is your understanding of why that simple truth that we have all heard and makes so much sense why it is so difficult for us as human beings ? beings to take seriously before reaching that limit of life for many of us I think we get distracted by stories that other people have told us about ourselves that we are not enough that we will be happy if we have material goods that goods give us will keep safe none of these stories is true what is true is that what we have is each other and again you know that's lovely and it's clearly true and yet we don't live there we don't live there.

I live there and that is why I see people with cancer and other people who have had very difficult experiences in their lives as master teachers of wisdom. It is as if the wisdom to live well were at this moment the repository of this wisdom are the sick in our culture, the sick people in our culture, after one more short break with Rachel Naomi Remen, we're putting all kinds of cool extras on our podcast, lots of poetry, music and a new feature that lives the questions, you can get it all as soon like this. published when you subscribe to be on Spotify Google podcasts Apple podcasts or wherever you want to listen about being is presented by the John Templeton Foundation The Templeton Foundation supports academic research and civil dialogue on the deepest and most vexing questions facing humanity: about us?

Why are we here and where will we learn more? Visit Templeton org, the Templeton Foundation. Be curious. I'm Krista Tippett and this is about being with wise physician and lyrical writer Rachel Naomi Remen today. Her lifelong struggle with Crohn's disease shaped her. she practiced medicine and she in turn has changed the art of healing and medical training. We are exploring what she knows about the difference between healing and curing and how our losses really help us live out what she has learned through her work with other doctors. try to listen to other doctors and let's say work on healing the field of medicine, how did that come about, start doing it actively, if again you know the next step is to listen to people with cancer at retreats.

I would hear stories about their experience with the medical system and the people in it and every year, very often, someone would come back and tell their doctor what they had experienced at the retreat and the doctor would call and I was the medical director. the medical director still in reti

remen

t and the doctor was saying aren't you doing something like this for us? I began to realize how hurt I had been by my training, the training is abusive, it is also a very, very, very difficult experience 6:20 in Medical school and 24/7 medical training of the week, they go on for seven years, seven, eight years, you know, and I began to realize how I had been cured by these people with cancer, how I had gone from being a person focused on healing and really coming to understand that we are all healers of each other, that people have been healing each other since the beginning and that my power to heal was a small part of my power to help people and wanting to help my profession too, the people who are dedicated to healing. medicine are extraordinary, you know, I.

I developed a course called Healers Are Not God, that was in 1992 and I taught it at UCSF it's a very unusual course it's an experiential course they usually don't do these things certainly not back then in medicine so it's about allowing the Young people recognize that who they are is as important as what they know in terms of how they will be able to make a difference in people's lives. It is to validate for students the human agenda in the disease. It reminds them that healing is a different relationship than a healing relationship and reminds them of their power to make a difference through their human response and connection with their patients.

It basically reminds students of the lineage of medicine. You know, I happen to see medicine as a spiritual path. That's something personal. It is a spiritual path characterized by compassion, harmlessness, service, reverence for life, courage and love. The basic qualities of the Hippocratic Oath are not scientific qualities, they are qualities of human relationships and they are spiritual qualities. Very deep spiritual qualities and we remind students of them. of the lineage and these are young students and we allow them to see that they belong to it exactly as they are, that they are already the right people to become doctors, all they need to do is learn science and know the facts without allowing themselves to be changed by that process of somehow, what is in that process?

I mean, it seems ironic and the stories you tell about how destructive medical school can be seem ironic, we think of people who go to medical school, as you say, as ordinary people. who are giving themselves over to this profession that is about healing and what you describe is an experience in which we learn to heal, okay, yes, now this is changing. I mean, obviously, 10 years ago this course wouldn't be in any of these schools. UCSF was progressive enough to give it a mm-hmm, you know, but I think the world is changing. I think we're recognizing the limitations of our science, our science, you know that little phrase, living better through science, there's no doubt that living better through some, uh, but to live well it's going to take more than just that.

I mean, if I look at myself without the eight major surgeries and the many medications, and I'm still on a lot of medications that keep me alive, I wouldn't be here. -hmm but with only these things I would be an invalid right hey hey I wanted to ask you a minute ago when you said that you think of medicine as a spiritual path and yet it seems that medicine is also a science at least in our culture and it seems that at some point and somehow the science overwhelmed or the scientific mindset even among those of us who are outsiders who, how we view science, overwhelmed whatever spiritual element there was in that, well, you know, you have to understand how natural that is, I mean When I tell you about myself when I was a child, I had severe otitis media, well, an ear infection and I developed an abscess in the bone of my skull, and sulfonamides were available at the last minute and that power was a very intoxicating power, we could do it .

Where was the insulin for people with diabetes? I mean, you, she, after what this meant, all of this, you've seen all of this in your life, oh my God, yeah, this meant a huge amount to PA. We thought we could cure everything, but it turns out. we can only cure a small amount of human suffering the rest the rest needs to be cured and that is different is different I think science defines life in its own way but life is bigger than science life is full of mystery courage heroism love all these things that we can witness but not measure or even understand mm-hmm but they make our lives valuable anyway and I say that the destructive aspects of life are also mysterious and immeasurable, okay I mean we can also observe the wrong and I think that's true.

Of course that is true, but you know that the problem is not eradicating evil. I am not sure that evil can be eradicated. I think it's part of the human condition. The problem is committing to what is important to you. You question the term objectivity, that's part of it. from a scientific framework. I think that, as a journalist, I will also say that word. You know, it's a value that has been held in many disciplines of our culture and is being questioned in many disciplines. You know, is that enough or you know? We fool ourselves when we say we are objective and if we are fooling ourselves and need to see it all again, objectivity is cognitive, in a funny way, isn't it?

But what seems important is that to understand life we ​​need to look at it through many different dimensions mm-hmm and that sometimes we understand another person better and know how to help them better when we are not objective. There is another simple statement for you, but we don't do it. Not always with Matt, yes, objectivity is a bias like anything else. I mean funniest story. I think this one is on the kitchen table. The wisdom is that this happened at Sloan-Kettering many, many years ago when I was a first-year internal medicine physician and we had a man come to the hospital to die and you know people used to come to the hospital and die, so there wasn't a movement palliative care, so if his care was too difficult to achieve at home, he would be admitted to the hospital to die and this A man came in riddled with cancer, he had osteosarcoma and his bones looked like Swiss cheese, all of these lesions were cancer and there were big snowballs of cancer in her lungs and in the two weeks or so she was with us in the hospital, all of these lesions disappeared and never came back Crysta now we were amazed, we certainly weren't frustrated, obviously someone had diagnosed it first, so what the census goes to pathologists around the country and the pathologists and the slide say classic osteogenic sarcoma, so you know.

We had a Grand Round and the slides were shown, the x-rays were shown, the man himself was shown and the conclusion of this large group of doctors was that the chemotherapy that had been stopped 11 months earlier had suddenly worked,Now the embarrassing part of this story is that I believed this for the next 15 years. I never questioned this conclusion. I think that too much scientific objectivity can blind you. What do you think now? I think that was one of the purest encounters with mystery I've ever had in my life. Life makes me wonder who we are, what is possible for us, how this world really works.

I don't have answers, but I have many questions, and those questions have helped me live better than any answer I can find. I'm Krista. Tippett and this is being with dr. Rachel Naomi Remen, you know something that I found interesting and when you write about working with doctors, you try to make them comfortable with loss and understand that as part of their lot, their jobs, their lives, their work lives, but again I mean a when you know you're talking about doctors, but you end up making interesting observations that apply to everyone else about loss, tell me about yourself, what you've learned about loss, okay, then I'll give you, I mean, here are some More smalls. quote I wrote and the way we deal with loss shapes our ability to be present in life more than anything else the way we protect ourselves from loss maybe the way we distance ourselves from life I think this is absolutely Right, that's a shocking thought, I really think it's right.

I also think that no one is comfortable with loss mm-hmm, since we are a culture of technical articles, our desire or our first response. Let's put it this way our first response to loss is to try to fix it when we are in the presence of a loss that can't be fixed, that's a lot of loss, we feel helpless and uncomfortable and we have a tendency to run away either emotionally or actually distance ourselves, yes, and

fixing

is too little of a strategy for dealing with loss, is it? You know, what we teach students is something very simple, there are medical students, yes, we teach them the power of their presence of simply being there, listening and witnessing another person. and worrying about someone else's loss, letting it matter, letting it matter, we do six hours on loss, two three-hour sessions, and the students have a very simple instruction: they are asked to recall a loss story of their own. lives and loss.

In other words, a time when things didn't go the way they wanted, when they felt disappointed, when they lost a dream or a relationship or even a family member, you know they can choose that and then They spend six hours in small groups talking about their loss. and the group has an instruction generously listened to now before this exercise we do another exercise with them where we ask them to remember a moment of disappointment and laws and to remember someone who helped them, what that person did, what they said, what message they delivered was helpful to them at a difficult time in their lives and they write these things down very concretely and then we ask them to remember a time of loss in their lives and remember someone who wanted to help them but was not helpful. they what that person did and said and what message they delivered and how they delivered the message and they write it down and then we make a big list what are all the things that helped them hear me correctly for the whole time I needed it talk talk to me the same way afterwards of my loss like they did before my doors true um sat with me touched me brought me food true what were the things that didn't help gave me advice without knowing the full story made me feel that the loss was my fault so we gathered the wisdom about what helps to heal the loss of a group of approximately one hundred students and teachers and everything is very simple and the only instruction is to listen generously again.

It takes me back to how we started talking. about the power of stories in human lives and his analogy that stories are the meat that we put on the bones of the facts about our lives and you know, I also hear, I think it's very powerful for UM to just think about this obvious fact. , but again One of these obvious facts that we don't mention very often is that loss is not just a catastrophic death, but there are many different types of loss in our lives all the time and then this kind of surprising idea that you raise about how we cope with those losses, big and small, can really help or get in the way of how we cope with the rest of our lives with what we have good, not just what we've lost.

I think so. I'm really sorry. I could put this most people try to hold on to something that is no longer a part of their lives and they stopped in their lives that way. I have come to see laws as a stage in a process, it is not the end result, it is not. The end of the story, what happens next is very, very important and you know, people respond to loss in different ways when I first got sick. I got angry. He hated all people. I felt like I was a victim and this was unfair. angry for about 10 years, I think all that anger was my will to live, uh, expressed in a very negative way and people are often angry in the context of a terrible loss, they are often envious of other people and this is a starting point, but it's over.

Over time things evolve and change and at least people who have lost a lot can recognize that they are not victims, they are survivors, they are people who have found the strength to overcome something unimaginable to them, perhaps in the past, and simply by asking to the people. That question, you have suffered a very profound loss. What have you turned to for your strength? most people haven't even noticed the strength of it they are completely focused on their pain in their pain and it's not so natural Krista yes, there is something very hopeful throughout your writing, even when it comes to loss and grief. dark and hard side of the human being, I mean that you insist, and I am not sure that modern psychiatry insists on this, that integrity is achievable for everyone, that you see that it reaches people and, sometimes, it is about people in crisis you say that integrity is never lost it is only forgotten in its entirety this includes all our wounds mm-hmm it includes all our vulnerabilities it is our classic self and you do not judge our wounds or our vulnerabilities you simply say that this is the way we we connect with each other we often connect through our wounds through the wisdom we have gained the growth that has happened to us because we have been wounded allows us to help other people so it is not an integrity of moral judgment it simply means living what that it is true from the place in you that holds the greatest truth and that truth is also always evolving.

Rachel Naomi Remen is founder of the Remin Institute for the Study of Health and Disease, Clinical Professor of Family Medicine at UCSF School of Medicine, and Professor of Family Medicine at Wright State University Boonshoft School of Medicine, her beloved books include kitchen table wisdom and my grandfather's blessings to exist is Chris Kegel Lily Percy Mariah helgerson Maya Terrell Maurice Amberleigh Erin Farrell LaRonde or the doll Toni you Bethany Iverson erin kala Saco Kristin Lim benefited Oh Casper tech Angie Thurston I will sue Phillips Eddie González Lillian will vote for Lucas Johnson Damon Lee Suzette Burley and Katy Gordon and these days around Thanksgiving we also have the tradition of thanking all the people who contribute being possible behind the scenes, including Heather Wong our transcriber Brian Carmody our press liaison Tom Fletcher Jim Hessian and the team at Betty's Partners in our Loring Park space Jerry Colonna the wonderful people at the reboot Kristin Jones Pierre and her team at the fake Baker's Daniels Heidi Grundy Mary Warner Hannah Erickson Michelle magma and our partners at Clifton Larson Allen and our outgoing board members Julie's Ellie and Jeffrey Walker we are also very grateful for mica Thor Joe Kessler and the folks at tech guru Emily Oberman and our stellar design partners on pentagram Tito Beau Tita Emily Teeth and Eraider Holly Copeland Nick Breaka and the entire Up Statement team Keith Yamashita and the folks at Sy Partners and PRX The Public Radio Exchange, including Carrie Hoffman John Barth Kathleen Anwen Sean Nesbitt Andrew Kukla wit and Paloma Orozco Special thanks to Multiversity 1440 and everyone who applied attended or enjoyed our recordings from the beginning gathering continued community and energy, which was a particular joy of last year.

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