book reports: God's Hotel and Seven and a Half Lessons About the Brain

Looking up the stairway in the building where I've started taking voice lessons (exciting!). Cool huh?

Seeing as I spent half the day writing that last blog post, I figured it couldn't hurt to keep going and, you know, start my diet tomorrow... And I've read two books recently, yay!

God's Hotel, by Victoria Sweet, came highly recommended by a friend. It's about Dr. [Dr.] Sweet's work at San Francisco's Laguna Honda Hospital, one of the last almshouses in the country. Which happily allowed her the flexibility to work less-than-full-time as a doctor while also pursuing a doctorate in the history of medicine on Hildegard of Bingen and, later, walking the Camino de Santiago. And right there is her point: the humanity of the place, even with its anachronistic staffing structures and supposedly outdated open wards, was wholesome and healing for both patients and staff in a way that more modern and efficient medical practices, however well-intentioned, many times just aren't. 

If you're short on time, the closing paragraphs sum up the whole thing very nicely:

            I thought about everything that had happened to me in that old place, and how important it had been. Being in that old hospital changed my life. It had allowed me to explore Hildegard and understand her Way, which was slow—fussing and fiddling, removing obstructions, nourishing viriditas, and calling in Dr. Diet, Dr. Quiet, and Dr. Merryman for every patient. It had allowed me to go on pilgrimage and realize how it was possible to be happy and cold and wet all at once, and to know the quiet that underlies activity. 

            Perhaps I could have had those experiences…someplace else.

            But no place else could I have discovered the hospitality, community, and charity that were in the walls and the air, because you had to be there for a long time to feel them and the kindness that was their source. And no place else could I have discovered the “being myself” with my patients, or the “just sitting” or the anima at the back of the eyes.

            I learned commitment there—throwing myself into the mix, regardless. Before, I’d stood back from my patients—not a lot, but a little; I was wary of the transference and the countertransference. I threw myself in, but not completely, only for that fifteen-minute visit, that two-hour workup, that two-month or even six-month period. But gradually I learned from Dr. Curtis, from Christina and Lacy, from Dr. Dan, Don Taylor, and so many others that that wasn’t being the best doctor. The best doctor walks you to the pharmacy and stands with you until you drink your medicine. They taught me that the real name for the transference and the countertransference was love, and that the doctor-patient relationship was, above all, a relationship. So in the end, if it was the end, and whatever happened in the future, I had to agree with what Dr. Curtis told me on my very first week—God’s Hotel was a gift.

Which is to say that if this all sounds a bit contrived, it's because the book is a bit contrived, but the author's messages are important: medicine is as much an art as it is a science, technology is not the answer to everything, efficiency is no substitute for humanity (and the supposed efficiencies of management consulting are often little more than shell games with not-insignificant human and even financial costs). I was left wondering, though, whether Laguna Honda was really so special, or if Dr. Sweet would likely have learned similar lessons elsewhere. Hospitality, community, and charity can be found in most places if you have the time to look for them. Could it be that a doctor naturally, as she grows into her craft, learns to not cling quite so tightly to the formulas she's been taught and to trust her intuition, the healing powers of time, and the human spirit more than the latest diagnostic test? This feels almost inevitable, part of getting older and more mature. But I guess the sticking point is that if doctors—or workers in general—are chronically overworked and under-rested, over-monitored and under-trusted, there's no space for that maturing to happen. Note to America: slow. down.

Seven and a Half Lessons about the Brain, by Lisa Feldman Barrett, came highly recommended by a different friend. I borrowed it from the library, which turned out to be a good decision: it's a super fast read and the writing is not so fabulous that it needs to be preserved for all eternity on my bookshelf. But it's worth reading. Or at least I'm part of the choir she's preaching to. Our brains are neural networks! They are not separate from our bodies! We co-create our realities and we co-create each other! Nearly everything we think we "know" is more metaphor/abstraction than physical fact! Amen, sister! Dr. Barrett says that our human brains have uniquely evolved the capacity not to think, as we always thought (ha), but rather to create what she calls "social reality." And that although there is a common physical structure behind it all...

As far as I can tell, the human mind has no universal defining features. 

Read that one again, One Spirit friends! Also:

When it comes to human minds, variation is the norm, and what we call “human nature” is really many human natures. We don’t need one universal mind in order to claim that we are all one species. All we need is an exceptionally complex brain that wires itself to its physical and social surroundings.

And then out of the blue comes:

A particularly challenging way to modify a mind is by moving it to another culture. If you’ve heard the story of the country mouse and the city mouse, or read The Prince and the Pauper by Mark Twain, or seen movies like Lost in Translation, you know how it goes. The characters are thrust into cultures so unfamiliar they don’t know how to conduct themselves. 

Imagine landing in a culture where you don’t know even the most basic things. What is an acceptable way to greet people or even look at them? How close can you stand to other people without being rude? What do unfamiliar hand gestures and facial movements mean? Your mind must acclimate to the new culture. Scientists call this activity acculturation, and it’s like an extreme version of plasticity. You’re suddenly swimming in new and ambiguous sense data, and your brain needs to tune and prune itself so it can efficiently guess what to do.

Imagine! This is a small point in a book full of much bigger ideas, but it jumped out at me for obvious reasons. Her examples seem kinda random (Lost in Translation isn't really about acculturation?), but this is something I've run into (and/or up against) more than once in my mis-adventurous life. By any objective standards I haven't strayed that far from my culture(s) of origin, and yet...even the cultural differences among the US, UK and Switzerland are numerous and not infrequently exhausting. Dr. Barrett goes on to say that children of immigrants are prone to illness because they have to use extra energy to constantly pivot between two cultures, which (1) yes thank you Dr. Barrett, I AM a horrible parent for voluntarily raising my kids overseas, but also (2) what about the immigrants themselves? and (3) of course this has a cost - but a mind "tuned" to two cultures is a mind that can see possibilities that the mono-cultural mind is completely blind to. And if we're in the business of imagining and co-creating a better world, which according to Dr. Barrett is the superpower of our species (and we can only hope she's right), exactly these minds are going to be important. Along with all the other ones, of course.