“I screamed bloody murder and fell to the floor,” says Barry Boyce. “It would be weeks before I could walk again. I became a patient.”
Moving about in a vertical position, making decisions about where we’ll go next and what we’ll do—this is our orientation most of the time. But quite suddenly, our fortunes can be reversed, our planned progress aborted. We find ourselves horizontal, abruptly laid low by injury or illness, being moved about and talked about as we stare at the ceiling from a bed or a gurney. We are a patient in a hospital.
Not long ago I stepped in a hole in an old country barn. Instantly, I screamed bloody murder and fell to the floor. It would be weeks before I could walk again and months before I could walk properly without pain. Being in a cast with a severe ankle sprain is not such a big deal and time will certainly relegate it to the status of mere nuisance. But because the doctors thought I needed my ankle screwed together, for a few days I was a patient. It enabled me to see how vast the difference can be between the patient and the non-patient worlds. The myth of indomitable forward progress wears thin at the edges.
I’ve avoided the hospital far too much. As I pass it everyday on the way to work, I give little mind to the hundreds of patients in there and their families in all stages of pain and woe. When you go there, as a patient or not, you see that two very different but somehow strangely related things go on in the hospital: recovery and deterioration. The fear of the latter lurks in the air.
Recovery, the regaining of strength and life, returning afresh to what we did before, is an enormously affirming process. Of all the good words, healing is one of the best, and for me the recovery from even this minor injury has been encouraging, in the original sense of the word. It brings courage to know that the body repairs itself and that vigor returns.
But at some point, it doesn’t. You imagine the interruption in your forward progress will come about straightforwardly, but more than likely it will not. When you are a patient, you will be lying there looking up and your doctor will present you not with certainty, but with a theory. Medicine is the art of the discernible. The body does not provide a clear-cut diagnostic read-out.
More often than not, the theory will confuse you, presented as it will be in the arcana of medicine. It is your own body, your most intimate pal, but its parts and its functions have names and addresses that are complicated and foreign.
At times, doctors will come early in the morning and speak about you as much as to you, and present you with the best guesses that they can make. We have all known (or have been) people who have waded (and waited) through various hypotheses and possibilities—a roller coaster of hope and fear about which it will be: recovery or its opposite.
In such difficult conditions, often while under medication, patients are expected to carry on complicated logical conversations at early hours of the morning about the future course of their bodies and what may or may not be done. Opinions and platitudes are offered all around, but in the end it is the patient who must lie in the bed in a flimsy open-backed shirt and look at the ceiling and contemplate the unfolding uncertainty.
The thing about being a patient is indeed the patience. Patienthood is so disorienting and foreign at first because it involves surrender. It is a receding, a going back, rather than a going forward. It is allowing things rather than dictating them and that’s why it’s such an insult.
Precisely because it involves allowing experience to come to us, having to let the future unfold, holding still when we want to lurch forward and break, seeing very clearly our reflex and counter-reflex of expectation and disappointment, being a patient can be a powerful eye-opening experience.
The people who work in hospitals for the most part are acutely sensitive to what patients go through and will try to work with it. They see it regularly; they cannot help but be touched by it. The hospital itself, though, seems profoundly the opposite, cold and factory-like. It hardly fosters contemplation. As so many features of modern life, it has become an industry, and an industry is everything that being a patient is not: impatient and product-oriented.
The earliest hospitals arose from spiritual aspirations. The great Indian emperor Ashoka established some of the first known hospitals, after he became Buddhist. In medieval Europe, the monasteries cared for the sick and kept pharmacies and gardens of medicinal plants. One of the first hospitals in North America, the Hotel Dieu de St. Joseph in Montreal, was looked after by one of the oldest orders of Catholic nuns.
Perhaps we are slightly misguided today in making our health like we make our machines. The more industrial it becomes, the more it becomes someone else’s concern, at least until we become a consumer of that particular product. When our unending forward progress is interrupted, it is not the industry that will make our experience as a patient more rewarding and revealing. It is the hospitality.