Tall, Tall Shadow

I can’t stop listening to this amazing song from Basia Bulat’s new album of the same name. I first heard it last week on Jian Ghomeshi’s show Q while driving home. It came on just as I was pulling into the driveway. I turned the engine off and sat mesmerized, my heart in my throat for the next four minutes. It came at just the right time…I’ve been struggling with the abrupt switch we’ve had here between summer and fall. I’ve been listening to this album every day since, letting the lyrics sink deeply into my bones:

“Take it to heart, you can’t run away when you know that the tall, tall shadow is yours…”

Disclosure: There’s always been something about this shift in the wheel of the year that tugs deep within, sometimes uncomfortably. I know I have a history of seasonal depression. And it’s true that right now I feel tender. Half-way across the country, a beloved elder in my family is journeying closer to the end of her life and I hate that I can’t be there right now to hold her hand.

The rains are coming and the light is fading into the endless gray that characterizes this region of the country during winter.  I try in vain to re-write the script in my head about how I deal with the gray, despite nearly eight years of evidence that this time of year has always been a struggle. If only I could think myself into a more positive attitude, I tell myself…but every cell in my body just wants to embrace the slow, dark melancholy rather than fight it. What I really want to do is channel my inner grizzly bear, find my cave, and go to sleep for the next six months.

Instead, I up my vitamin D and dust off the sun lamp and dive into a term that is based around chronic and end of life care. One of our term-long assignments is to read the blog of someone who is dying. I find myself vacillating between wanting to cry and wanting to scream. Chronic care brings up a whole slew of emotions for me–so much of it involves diseases that to me exemplify all that is wrong with our so called “health care system”.

My clinical instructor (a nurse who I respect and admire deeply), said that if he could sum up the experience of chronic disease in one word, it would be spirituality. More often than not, he sees chronic disease as a journey to find meaning in one’s life. The midwife in me totally understands this and can even see the potential beauty and transformative power of this experience.

But right now, I find no satisfaction or peace in this framing of chronic disease. My fellow students are all so excited to start clinical, for the opportunity to start feeling like a “real nurse,” to “get their hands dirty.” This is what I say, too, because it’s easier than telling the truth.

The truth is that thinking about chronic illness makes me feel angry, and not just angry, but hopeless. In my mind, the devastating prevalence of chronic illness in our country is not just a woo-woo opportunity for spiritual enlightenment on the individual level. That’s a high price to pay for some level of self-growth. In my mind, chronic disease is also the direct failing of a medical system that prizes compartmentalized care rather than holistic well-being. It’s the result of a system that prizes allopathic medicine over naturopathic medicine. It’s the legacy of deeply rooted historical disparities that target people of color in low-income communities. It’s a systemic failing on a grand scale to adequately address the life-long health care needs of an entire country.

I don’t see spiritual awakening in diabetes or emphysema or renal failure. I see a fucked up health care system driven by a senseless greed that prioritizes profit over true health. And because I’m tired and it’s fall and I haven’t found my groove yet this term, I question whether I can actually have a meaningful impact on any of it. This is when I start to question whether I will ever feel truly satisfied as a clinician when the systemic issues stare us in the face. But I think this will always be my struggle, one of my many “tall shadows” that I will continue to run away from until I can learn to make friends with it.

“Take it to heart, you can’t run away when you know that the tall, tall shadow is yours…”

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