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Notes from a HealerCarving Out a Legacy Brian T. Maurer (I am indebted to Rev. Eddie Slayton for the background facts of this story.) When she first heard about the practice, the lay counselor was astounded. How could anyone, especially a young girl, take a razor knife to the skin of her own body, over and over again? She looked at the faces of the teenage girls in her group. According to the statistics, a handful of these teens probably had the telltale scars of this practice known as carving. The counselor turned to the girl next to her, and asked the teen to roll up her sleeve. Reluctantly, the girl did so, exposing the row of inch-long parallel scars that ran the length of her forearm. The counselor turned to the group. “Who else has done this sort of thing?” she asked. Slowly, first one and then another hand went up. She held her breath and waited. Finally, one last girl raised her hand. The lay counselor shook her head. “Why?” she asked. “What makes you do it?” One girl shrugged her shoulders; another looked down at her feet. A third answered: “Pain,” she said. “It’s the only way I can feel anything anymore.” “What goes through your mind when you do it?” the counselor asked. “I think about my life,” the girl said. “I think about my pain. I think about when I was raped. They used to call me a slut after that.” Another girl spoke, voicing similar feelings. “You feel like you’re just not worth anything,” she said. “You’re just a piece of trash that somebody kicks in the gutter.” That night the counselor didn’t sleep. She wasn’t the sort that brought things home with her. Yet every time she closed her eyes, she saw those scars—rows and rows of scars, each one a testimony to a prior hurt; together, a record of human suffering. The following week she discussed the issue with the staff. Together they agreed upon a plan. At the next group session, the counselor asked the girls with the scars to volunteer for an exercise. They sat in a row in front of the group. One by one the girls rolled up their sleeves, exposing their forearms. One by one the staff counselors took their positions behind each girl. In low voices they asked each teen to share the words that their scars brought to mind. As the girls voiced their responses, the counselors wrote their words with felt-tipped markers on the unblemished skin of their own forearms. Then, in a gesture of unconditional acceptance, the counselors penned a new set of words across the scarred arms of the teens: “Love,” “Grace,” “Beauty,” “Faith,” “Acceptance.” The lay counselor spoke: “These are your words now, words to cover your shame. We have taken the words you have given us—‘Pain,’ ‘Rape,’ ‘Slut,’ ‘Guilt’—they are no longer yours. Now, you are free.” Tears streamed down forgiven faces. The girls still bear their scars of course. But now they consider them to be only skin deep, reminders of what they once were. The deeper scars begin to soften as they heal. The practice of medicine is based on empirical science; the art of medicine encompasses subjective intuition. To practicing clinicians, their words might appear to count for little in the therapeutic encounter; yet we must not underestimate the power of the spoken word to initiate the healing process in the patient. And so I urge you, go after experience rather than knowledge. On account of pride, knowledge may often deceive you, but this gentle, loving affection will not deceive you. Knowledge tends to breed conceit, but love builds. —The Cloud of Unknowing About the Author Brian T. Maurer has practiced pediatric medicine as a Physician Assistant for the past three decades. As a clinician, he has always gravitated toward the humane aspect in patient care—what he calls the soul of medicine. Over the past decade, Mr. Maurer has explored the illness narrative as a tool to enhance the education of medical students and cultivate an appreciation for the delivery of humane medical care. His first book, Patients Are a Virtue, recently reviewed in The Yale Journal for Humanities in Medicine, is a collection of fifty-seven patient vignettes illustrating what Sir William Osler called “the poetry of the commonplace” in clinical medical practice. Published: November 30, 2008 |
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