A season of emotions: spring, trauma, and healing

Spring is an interesting time of the year for me. April 15 may actually be my favorite day, but certainly not because income taxes are due. My dad was born on April 15, but that’s not the reason either.

Let me set the scene. I lived in a beautiful home in a wooded area outside Philadelphia for ten years. The area is known as the Brandywine Valley. It’s the site of the Battle of Brandywine (September 11, 1977), the bloodiest and deadliest of skirmishes during the Revolutionary War. The Brandywine Valley is also home to individuals with impeccable lineage: the famous DuPont (chemicals) and Wyeth (painting) families.

Our modest one-acre home had a koi pond out front. The pond was spanned by a small bridge that served as a walkway connecting the front yard to the front door. The koi hibernated at the bottom of the pond during the cold months of December through March. An expert told me not to feed the fish during wintertime, because their metabolism was so slow that they would “implode” if they ate.

Come April 15, however, after several months of hibernation, with spring on the horizon and nature beginning to bloom, the koi were ready to surface and eat. I would stand at the apex of the bridge and dangle food pellets in their line of view. Conditioning would bring them to the pond’s surface. The fish opened their mouths, waiting – no, begging – for me to drop the pellets in the water. They devoured the food. Once again it was possible to begin my ritual of daily feedings from the bridge.

Life seems to start anew each spring. It holds tremendous symbolism for renewal and regrowth. I’m reminded of the classic 1949 movie It Happens Every Spring. The movie is about a chemist-turned-baseball pitcher who invents a compound that, when applied to the baseball, repels wood, so bats can’t hit it. Thus, he is able to strike out every batter. However, the pitcher is unable to manufacture the secret sauce just when he needs it the most: during the World Series. He must rely on his own skills to win the game. And of course, he does win!

My favorite baseball movie is Field of Dreams. I used to watch it every spring with my son. We are geographically distanced now, but we reenact some of our favorite scenes on the phone at the beginning of spring training. Field of Dreams is the ultimate father and son bonding movie, in my opinion. Neither of us refrains from crying at the end, when the son (Kevin Costner) asks his dad if he wants to have a catch. Such is a time-honored tradition between a father and a son, and Lord knows, my son and I have had many catches

Springtime isn’t all roses. I was traumatized in the month of April when I was a psychiatric resident, in 1981. A young man attempted suicide by jumping out of the third story of his boarding home. I was blamed for the incident because I did not evaluate him in the emergency department hours prior to the suicide attempt. In truth, I was never asked to evaluate him. Still, guilt and shame set in, the primary ingredients for depression and PTSD. I carried the burden of his injuries most of my career, never letting on that a fear of making mistakes was the main reason I eventually left practice. I decided to “come out” in 2014 and write about the incident. My article was warmly received. Several doctors wrote to me describing similar fates and circumstances related to medical errors falsely attributed to them.

The groundbreaking 1999 Institute of Medicine (IOM) report said To Err is Human. The report stressed that systems are more often at fault than individuals when it comes to medical error. I felt somewhat vindicated. But the IOM report also estimated that nearly 100,000 Americans die each year due to medical errors, which certainly grabbed the attention of the media. A more contemporary analysis by the noted physician Danielle Ofri, author of When We Do Harm: A Doctor Confronts Medical Error, indicated that the IOM account was grossly exaggerated, although she conceded that much work needs to be done to prevent medical errors. Scapegoating doctors and torturing them with malpractice suits is not in anyone’s best interest.

For obvious reasons, then, spring engenders a range of emotions in me, often extreme. In one moment, I am recalling with delight the annual spring feeding of the koi. For no rhyme or reason, dark clouds roll in regarding the “jumper,” and remorse sets in. Then memories of my father follow – mostly positive, but some negative. Thank goodness for the uplifting Field of Dreams.

John Fox, in Poetic Medicine, affirms the therapeutic benefits of writing about difficult personal problems and struggles. He states: “Whatever form of therapy fits your particular temperament, externalizing your experience by creatively expressing it on paper, and if possible sharing it with someone special who listens well, is a way to state how things are, release old hurts, set healthy directions and develop potentials that make destructive past behavior or experience more a thing of the past.”

The second chapter of Poetic Medicine is titled “The Same River Twice.” It’s a reference to Heraclitus, a Greek philosopher born in 544 BC, who said: “No man ever steps in the same river twice, for it’s not the same river and he’s not the same man.” Every day, people change because they have new experiences that shape them. They encounter new people who influence them. People (like me) read books, take courses, and travel to new places – all of which change them and encourage them to open up and be more comfortable in their own skin. You cannot step into the same river twice, because both the individual and the river are constantly changing and interfacing in different ways.

They say spring showers bring May flowers. I’m glad fall and football season have arrived.

Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia, PA. His forthcoming book is titled Every Story Counts: Exploring Contemporary Practice Through Narrative Medicine.

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