everything seems to be focused on the part of the body that is sick, damaged, failing, or out of control.
A hospital has much in common with an auto-body repair shop. It is there with its staff of specialists to diagnose, fix, or replace what it can of the physical body to get it running again. The patient and those accompanying the patient through this crisis are considered to behave well if they do not get in the way of whatever the doctors want to do with the ailing body. Troublesome patients (or their troublesome significant others) ask questions, want to understand what is wrong and why a particular treatment and not something else has been selected, bother doctors with requests, or don't respond properly. The medical setting is one in which there is a definite line of authority with the doctor in charge and others responsible for carrying out orders. A good patient like a good soldier is one who cooperates or obeys orders. Especially when cancer is the diagnosis but in many other conditions as well, the doctor's perspective is often similar to a general at war: the disease is the enemy to be fought, with the body of the patient the battleground.
Threshold Between Life and Death
When something is wrong with our bodies, we want whatever is wrong to be fixed. When something destructive is going on in our bodies, we want the disease to be stopped. We go to doctors and to hospitals with the expectation that they will take care of our bodies. That the soul might also be engaged is not our expectation. Yet, a life-threatening illness calls to the soul, taps into spiritual resources, and can be an initiation into the soul realm for the patient and for anyone else who is touched by the mystery that accompanies the possibility of death. When life is lived at the edge—in the border realm between life and death—it is a liminal time and place. Liminal comes from the Latin word for “threshold.” It is not an everyday word; it is one whose meaning I want to evoke out of the remembered experience of the reader and the collective memory of the human race, which we all have access to. Whenever we participate in something that will change us, and change how others relate to us—as when we marry, are inducted into the armed forces, or are ordained, become a doctor, or survive an ordeal— that experience is a liminal one. Whenever we are initiated into knowing something we did not know before on a body level—for example, through sexual intercourse or pregnancy—we cross a threshold. Here the mystical, spiritual, or psychic awareness of what is happening, however, determines its significance as a soul experience. So it is with a life-threatening illness, which similarly happens in and to the body and yet can profoundly affect the soul.
Illness, especially when death is a possibility, makes us acutely aware of how precious life is and how precious a particular life is. Priorities shift. We may see the truth of what matters, who matters, and what we have been doing with our lives and have to decide what to do—now that we know. Significant relationships are tested and either come through strengthened or fail. Pain and fear bring us to our knees in prayer. Our spiritual and religious convictions or the lack of them are called into question. Illness is an ordeal for both body and soul and a time when healing of either or both can result.
Once upon a time, or so it seemed, potentially fatal illnesses were unexpected tragic events that happened to young children, and terminal illnesses were mostly chronic conditions that afflicted the elderly. Diagnostic tests and biopsies have made it possible to diagnose life-threatening illnesses earlier and treat them aggressively; so much so that invasive treatments can be health and life endangering themselves. Midlife now presents the possibility of death and disability for far too many people. Not just cancer, but also diseases that affect the health of body and mind strike people in their prime adult years. There are times when midlife can feel like a medical war zone, with people dropping around us; for those of us in the health professions the impact of numbers is even greater. Life-threatening and life-changing illnesses are striking close to home. One may be threatening your spouse, your lover, your son or your daughter, your parent, your friend, or you.
To be a passive, obedient patient or, the terrain on which a battle is fought by the medical profession, goes against the grain of people who question authority, see value in alternative viewpoints, and understand that body and psyche are related. Whether as patient or as a person with love and responsibility for the patient, there are life-and-death consequences to the choices we make or allow others to make. To act out of fear or out of trust, to go with intuition or against it, to do what we know is right for us when it upsets someone else—issues that are life issues are made all the more crucial when death or recovery may depend upon what we decide. Moreover, if the battle for a medical cure is lost, doctors often abandon the field, all but avoiding the patient, who is now a reminder of defeat.
Illness as a Psychological Ordeal
The travails of being a patient and the physical illness together are an ordeal that can have a transformative effect on the soul. Psychological stress is a major part of the ordeal through which the soul must pass. When the possibility of a serious illness unexpectedly arises on a routine examination, or there is an onset of symptoms, or there is a need to be hospitalized, we may be assailed by fears and vulnerabilities. We fear—with or without justification—that we may never be our former healthy selves ever again. Those close to the patient may also be having these or similar concerns, or be having them when the patient is not.
Thoughts are shaped by how we perceive what is happening to us or to someone near and dear every bit as much and sometimes even more so than by objective information. Depending upon our psychological makeup, under such circumstances we tend to live in the present or in the future as we foresee it. If a serious illness is a potential that will only be known after the biopsy or after the workup, a person who lives in the present can often put dire possibilities easily out of mind: an attitude of “why borrow trouble?” comes naturally. A future-oriented person, on the other hand, especially one who worries or is aware of the likelihood and magnitude of the situation, may have the patient practically dead and buried before the results are in. Stress may be virtually absent for one, and off the chart for the other. When someone is in the throes of pain, limitation, weakness, or nausea, the awfulness of the moment may not only be all there is, but all there ever will be for that person, while another person faced with the same symptoms may experience this as part of a difficult time that will pass. When pain is not relieved, or obsessive negative thoughts crowd the mind, they leave little room to attend to the concerns of the soul.
Soul Moments
For soul to be heard, the mind must be still. Then thoughts and feelings can arise as if from a deep well within us. Often these thoughts and feelings are not shared. When they are, the soul looks outward for a moment, and we hope that we can truly share the depth into which illness is taking us. We wonder if we should die, will our lives have been worthwhile? What do we regret doing or not having done? What do we still want time for? Do we matter? Do the people in our lives really matter to us? Is there a God? An afterlife? What unfinished business gnaws at us? What long-buried thoughts and memories are coming back to us now? What are our dreams saying?
When we voice concerns and content such as these, we are baring our soul. At such moments, we are as if naked, and all too often when we speak of such matters, the impulse of others is to hurriedly cover up our words with a thin layer of reassurance—to which we respond by withdrawing. Revealing matters of the soul makes those who dwell in shallower waters uncomfortable. Soul-searching questions are those that people who are addicted to work or to alcohol or to superficial activities are warding off by their addictions. They do not want to be exposed to their own deep questions, as voiced by us.
Sometimes, we are caught looking inward, feeling something move in our own depths—a thought, a memory, emotion, an intuition, wisdom—and someone says, “A penny for your thoughts?” And we retreat self-consciously. Or this time we speak our concerns aloud, and there is joy at finding a soul friend. A soul-level friend is a sanctuary, a person to whom we can tell the truth of what we feel or know or perceive. When something is expressed at
