#5 From Chapter 5, “Speaking My Truth”

Jul 14, 2026

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Introduction: Beyond Blame

Faced with a persistent or progressive illness, each of us finds shelter in a different place. It may be, for example, in companionship, in nature, or in food. But sometimes what seems to sustain may have the opposite effect. A friend’s presence may fulfill us, or may inadvertently prove toxic. The fresh, forever newness of a trickling stream may remind us we are connected to eternity or, figuratively speaking, become a torrent that washes us away. On the internet or in the news, we find a world of blame to explain our illnesses.

Adherents of New Age philosophies are especially good at finding things to blame. They’ll say your illness is caused by your cholesterol, your salt intake, the pollution you breathe, your locked-down heart, your genetics, or your blood type. Other authorities over the years have placed blame for our ills on many causes—for example, a dominating father or a submissive mother, absent parents, penis envy, hysteria (uterine related), lunacy (related to the female moon god). Some of these explanations are outmoded and now obviously incorrect; others persist, but no one cause can explain everything that goes wrong with us. The impulse to affix blame, in itself, can create far more problems than it will ever solve. Seldom is any treatment or solution foolproof—nearly all have undesirable consequences even as they may help.

In dialysis, 180 gallons of water wash the toxins from a patient’s blood. All good—but dialysis is not a perfect treatment, a cure-all: its complications are many. Here’s a note of caution from the glass half empty side of the universe: If you want to feel blissfully optimistic about an illness, yours or a loved one’s, a critical care physician is probably the wrong person to turn to. He or she will want to help, but will also recognize the down-sides of any available treatment, that there is no perfect, magical fix for many serious diseases. An editor of a gay and lesbian magazine, during the early, brutal stages of the AIDS epidemic, wrote in an article, “Let’s get this straight, right off: AIDS is not a wonderful opportunity for spiritual enlightenment. It sucks.”

I do know that blame and self-blame can eat at us as savagely as any physical illness. Far too many religions conceive of illness as just retribution for hidden sins. We berate our parents and friends for smoking, eating too much, drinking too much, being too “type A” or “type C.” New Age proponents may claim that you get sick and stay sick because you’re not in touch with your “inner child.” You choose not to envision yourself as well, or you’re addicted to your illness. They may argue that your attachment to life’s pleasures is what is taking them from you, or that, as Buddhists believe, meditation and enlightenment are the means to release yourself from suffering.

My own experience confirms what countless others have written: that the path to enlightenment inevitably leads through a swamp. As you slog through the stench and muck, you’ve got plenty to carry. Don’t add self-blame to your already heavy burdens. Illness is the Wreck of the Hesperus, the torching of the Hindenburg, the drowned hubris of Titanic. It brings us back to what we all are: flickering flames that, nearly snuffed out, may burst forth again to illuminate ourselves and those around us.

Be humble, accept defeat, and don’t envy those who seem to have found their way. They’re just a bit ahead of you. The destination doesn’t make the journey glorious. It’s the miserable journey bravely survived that takes us to the worthwhile next step. It’s time to tell our stories in a new, hopeful way. Listen as they (and you) celebrate, rather than denigrate, who we were in the time spent gathering the strength to cross to the next of this life, or to whatever comes after this life.

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Forty-seven years of practice in nephrology, critical care and ethics consultation, working with countless cherished colleagues, have convinced me that we are all rising or sinking together on a boat in peril. I thought that the archetype of the “Wounded Healer” was just old Greek stuff. This half century in medicine, plus writing these books, have convinced me I was wrong. Yes, we may have come to our professions by a desire to help others, make a living, be respected. Or was it perhaps a “Calling”? What was it within us that was calling to be healed by this work? At the 55^th year reunion of my Northwestern University medical class I asked several medical students, “Yes, but what in you called you to this work?” Their looks seemed to respond, “Please pass the butter.”

At the end of a long day do you find yourself worried that “What you gave was not what was needed, and what was needed you didn’t have to give” (Norman Maclean, “A River Runs through It”)? And needed by whom? The “patient,” the family, the community? Yourself, your family when you come home depleted?

I’ve come to believe the facades between caregivers and patients are beyond artificial: these barriers of identities, roles and presumptions block true healing for all participants. The always compassionate nurse, the bustling therapist, the perfect physician and the ill-informed, dependent patient are all death to being soothed and heard. We are trapped behind the safety of our lab coats, unemotional, untouched, sterilized of our true feelings. How we long to sit on the bedside, show our despair and joy, share what in our lives led to the guidance we’re offering our “patients”.

Most of these stories come from my and other healthcare providers’ involvement with patients and families. Listen for that voice that called out from within us, perhaps even when we were children? Consider “Foreword, why this book?”, “A doc becomes a patient – the missed diagnosis”, “A week with the dark guys”, “A thousand blossoms”, “Where hearts meet”, “Dear John – the evolution of a diagnosis”, “Do I care?”, “Spirituality? Seattle 2003”, and “When God fails”. The last is for those times when we wonder, are we doing God’s work, or the Devil’s?

I thank you all for your courage to labor long in the depths of human experience.

Your comments, questions and personal experiences will be much appreciated at my blog. There I hope we can initiate a conversation that will carry on.

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Are you a friend or family member of someone dealing with an illness? Does your heart ache, trying to figure out what they need, how to enjoy your time with them as you did before they got all tied up in being a “patient”? What should you say? Where should you sit? How much time is appropriate?

As you deal with the medical providers, are you made to feel like a crucial member of the healthcare team? Or are you shut out by visiting hours, isolation precautions and everybody too busy to give you anything but medical-ese gobbledygook? Do you fear, as Norman Maclean expressed in “A River Runs through It,” that “What you gave was not what was needed, and what was needed you didn’t have to give”?

When your loved one goes home, they’ll get discharge instructions. What instructions will you get? What will you be offered to ease your pain?

Readers will notice that I often put the word patient in quotation marks. This is to remind myself and all of us that a “patient” is a person—not a case—and should be afforded the same courtesy, kindness, and consideration as any other human being. The same applies to family and friends. You are a big part off your loved one’s life, and living through the illness with them.

Part of my message is that the division between doctor (or any other medical professional) and patient is as artificial as a lab coat and a set of scrubs. All can be barriers to successful treatment. Even more, healthcare workers come to this busy-ness of illness with our own set of wounds. We come, unbeknownst, to find our own healing. You become our healers. Ask us what in our life experiences lead to our recommendations. Are we hurting? How can we go through this crisis as colleagues, not opponents?

Though you’re present in every story in this book, consider especially “Intro: comes the storm”, “A child will lead”, “Grieving: things not worth saying that we need to say”, “Chapter 3: a time to fight”, “A crossing”, “Where hearts meet”, “He took care of me”, “Wrapped in Love”, and my Dad’s final joke, “Death of a Salesman”.

When your loved one goes home, they’ll get discharge instructions. What instructions will you get? What will you be offered to ease your pain?

Your comments, questions and personal experiences will be much appreciated at my blog, where I hope to initiate a conversation with you.

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Are you currently a “patient”? Are you struggling with fitting that designation into living the life you planned to enjoy? I often put the word patient in quotation marks. This is to remind myself and all of us that as a “patient” you are first and foremost a person—not a case—and should be afforded the same courtesy, kindness, and value as any other human being.

You are the center of all 54 stories in “Healing Together.” Some may give you insight into how others have managed various stages of their illness, from first symptom to decisions around the last of life. Many of the stories emphasize the struggles facing your family and friends, and others may give you some insight into what’s motivating your healthcare providers. See especially “Intro: comes the storm”, “Heartbeats”, “A child will lead”, “The Blessing: A Cancer Support Group after 9/11”, “Chapter 3: a time to fight”, “Where hearts meet”, “To despair and back,” “Wrapped in Love”, and “Denise and Jerry: a fine life on dialysis.”

Fifty-five years of practice in nephrology, critical care and ethics consultation have convinced me that we are all rising or sinking together on a boat in peril. I hope this book will empower you and guide you to find your way through a hard time.

Your comments, questions and personal experiences will be much appreciated to initiate a conversation at my blog, by clicking the button below.

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