Conversations
Season
1
Episode
45
|
Dec 7, 2023
From Hardship to Healing with Laurel Braitman
Author Laurel Braitman speaks about her memoir, What Looks Like Bravery, which explores her relationship to her physician-father, and her professional journey toward a career teaching writing to clinicians.
0:00/1:34
Conversations
Season
1
Episode
45
|
Dec 7, 2023
From Hardship to Healing with Laurel Braitman
Author Laurel Braitman speaks about her memoir, What Looks Like Bravery, which explores her relationship to her physician-father, and her professional journey toward a career teaching writing to clinicians.
0:00/1:34
About Our Guest
Laurel Braitman, PhD is a writer, teacher and secular, clinical chaplain-in-training. She is the author of the NYT bestseller Animal Madness: Inside Their Minds and the new memoir What Looks Like Bravery: An epic journey through loss to love. She is the director of Writing and Storytelling at the Stanford School of Medicine’s Medical Humanities and the Arts Program. Laurel is also the founder of Writing Medicine, a global community of writing healthcare professionals. Her work has appeared in the New York Times, The Guardian, Wired, California Sunday, National Geographic, Radiolab, National Public Radio and many others.
About The Show
The Nocturnists is an award-winning medical storytelling podcast, hosted by physician Emily Silverman. We feature personal stories from frontline clinicians, conversations with healthcare-related authors, and art-makers. Our mission is to humanize healthcare and foster joy, wonder, and curiosity among clinicians and patients alike.
resources
Credits
About Our Guest
Laurel Braitman, PhD is a writer, teacher and secular, clinical chaplain-in-training. She is the author of the NYT bestseller Animal Madness: Inside Their Minds and the new memoir What Looks Like Bravery: An epic journey through loss to love. She is the director of Writing and Storytelling at the Stanford School of Medicine’s Medical Humanities and the Arts Program. Laurel is also the founder of Writing Medicine, a global community of writing healthcare professionals. Her work has appeared in the New York Times, The Guardian, Wired, California Sunday, National Geographic, Radiolab, National Public Radio and many others.
About The Show
The Nocturnists is an award-winning medical storytelling podcast, hosted by physician Emily Silverman. We feature personal stories from frontline clinicians, conversations with healthcare-related authors, and art-makers. Our mission is to humanize healthcare and foster joy, wonder, and curiosity among clinicians and patients alike.
resources
Credits
About Our Guest
Laurel Braitman, PhD is a writer, teacher and secular, clinical chaplain-in-training. She is the author of the NYT bestseller Animal Madness: Inside Their Minds and the new memoir What Looks Like Bravery: An epic journey through loss to love. She is the director of Writing and Storytelling at the Stanford School of Medicine’s Medical Humanities and the Arts Program. Laurel is also the founder of Writing Medicine, a global community of writing healthcare professionals. Her work has appeared in the New York Times, The Guardian, Wired, California Sunday, National Geographic, Radiolab, National Public Radio and many others.
About The Show
The Nocturnists is an award-winning medical storytelling podcast, hosted by physician Emily Silverman. We feature personal stories from frontline clinicians, conversations with healthcare-related authors, and art-makers. Our mission is to humanize healthcare and foster joy, wonder, and curiosity among clinicians and patients alike.
resources
Credits
The Nocturnists is made possible by the California Medical Association, and people like you who have donated through our website and Patreon page.
Transcript
Note: The Nocturnists is created primarily as a listening experience. The audio contains emotion, emphasis, and soundscapes that are not easily transcribed. We encourage you to listen to the episode if at all possible. Our transcripts are produced using both speech recognition software and human copy editors, and may not be 100% accurate. Thank you for consulting the audio before quoting in print.
Emily Silverman
You're listening to The Nocturnists: Conversations. I'm Emily Silverman. Often we underestimate how a career in medicine impacts not just us, but the people in our lives, our parents, our children, our partners, even our friends. Whether our careers inspire others, or create blockages in our personal lives or sometimes a mix of the two, the rigors of the health profession touch many more people than just those working inside of it. Today's guest isn't a physician, but her father was and her relationship with him inspired her to pursue a career helping clinicians find their voice. Her name is Laurel Braitman and she's a writer, teacher, secular clinical chaplain in training, and author of the recent memoir, What Looks Like Bravery: An Epic Journey Through Loss to Love, which we'll be talking about on today's episode. In addition to her memoir, Laurel is the author of New York Times bestselling book Animal Madness, which examines how animals, just like humans, have feelings. Laurel has a doctorate in history and anthropology from MIT, and has helped numerous students, staff and clinicians tell their stories in her role as the Director of Writing and Storytelling at the Stanford University School of Medicine. In my conversation with Laurel, we talk about what it was like to grow up with a father who was a surgeon, and who spent many years suffering with terminal cancer. Laurel talks about how his legacy impacted her emotionally and professionally, why she decided to become a secular chaplain, and why she feels that there's a very thin line between the clinical and the spiritual. But before we go on, let's hear Laurel read an excerpt from her memoir, What Looks Like Bravery. Here's Laurel.
Laurel Braitman
Prologue: Santa Paula California, September 1994
It was a warm Saturday afternoon and the Santa Ana winds ruffled the tops of the avocado trees. I was at home with two good friends, all of us 16 years old, draped like hormonal Dali clocks over the living room furniture while we watch The Bodyguard on VHS and painted our nails.
No one was surprised when I knocked over one of the bottles. I paused the movie and went into my parents’ bathroom to get the nail polish remover Mom kept under the sink. I glanced at myself in the mirror. Disappointed as usual, by my wild hair, tight cheeks, and how little I looked like someone Kevin Costner might want to carry to safety. Kneeling down and reaching into the cabinet, I pushed aside the bottles of rubbing alcohol that dad used to clean the stump on his amputated leg and the tray of stainless scissors he had brought home from his job at the hospital. I was moving a multipack of Dove soap when I saw it– a small plastic pill bottle. It was strange, not labeled like everything else in the cabinet. It didn't look like the transparent orange prescription bottles that came from the pharmacy either. My body sensed danger before my mind did. Something clenched in my chest; my pulse started to throb in my face.
There was a handwritten note rubber banded around the bottle. I unrolled it carefully.
"No one should have to do this for a friend," it read. "But here you go."
My throat went hot and dry as the winds outside. I steadied myself on the cabinet door. It hit me. Dad had a suicide plan. And he kept it in the bathroom like a box of Q-tips or Mom's Velcro rollers. Underneath the message was the name of a drug and dosage instructions written out longhand.
I had no idea how long the bottle had been there, or when he was going to use it. But I knew I couldn't ask. I could tell no one about this, not even mom or Jake, not ever. I understood without being told that I wasn't supposed to know dad had a plan or that anyone had helped him or that this was barreling towards us like a car whose brakes had gone out. I let myself feel my pounding terror for just a few more seconds. And then I rewound the note and put the bottle back exactly where it had been. Standing up, I took a long breath, summoning every bit of power I had, and shoved my fear and panic down as hard as I could– burying them so deeply that for the longest time, I thought they were dead and gone. Only you can't kill feelings. Just like bad boyfriends or lost cats, they tend to come back when you least expect it.
Emily Silverman
I am so thrilled to be here speaking with Laurel Braitman. Laurel, thank you for being here.
Laurel Braitman
It's such an honor.
Emily Silverman
So, Laurel, we've known each other for a few years. And I've always loved you and your work, particularly the work that you do at Stanford School of Medicine, helping medical students and other health professionals with their stories and their writing. But I never really knew why you did that work. And I'd always been curious. So what a gift to be able to read this book and learn more about your family and your story. And I just really enjoyed it. So thank you for writing it.
Laurel Braitman
Thank you for reading it. And for having me here.
Emily Silverman
Maybe let's begin talking about your parents, because they're such great characters in this memoir. And in the book, you say that your parents actually grew up city people. So your dad grew up in downtown Baltimore, not far from Johns Hopkins, which is where he went to med school, also where I went to med school. And your mom was the daughter of an optometrist in Beverly Hills. And yet these urban people marry each other and move to this ranch in California, where they're taking care of trees and donkeys and bees and their fishing. And I'm just wondering, where do you think that came from, this desire to live a more rural life?
Laurel Braitman
I think it was their version of rebelling in some way, against the structures that contain them, either consciously or not. And I think they were seeking a kind of freedom in the landscape and a lack of oversight. And also, they were just deeply curious people who like to learn new skills. And there's nothing like becoming a farmer or buying a dilapidated farm and trying to rehab it to teach you how little you actually know. And they also both loved the natural world and found so much joy in it, and solace, particularly as things got harder in their lives, that I think it was a natural fit than wanting to really just try something new. They approached it as just a big adventure, at least at first.
Emily Silverman
And this is where you grew up. You come of age, in this beautiful, picturesque ranch. What was it like to grow up there?
Laurel Braitman
Oh, it was magical. You know, it's actually where I'm talking to you from now. And it remains magical, although now I have responsibilities here. So as with most parts of adulthood, you know, it's great, and also mildly disappointing. But it's still beautiful. And it was an incredible place to be, you know, I had such freedom. I had such safety, I could take risks in a way that I think if I was in an urban place might have looked really different. And I developed a confidence outside by myself at a really young age that I think comes with growing up in a wild place.
Emily Silverman
What kind of risks, like physical risks or other types?
Laurel Braitman
Oh, definitely physical risks. I'd leave the house in the morning, my mom would tie up a little sandwich for me and a bandana and tie it around the end of the stick. And I would go forth, I was just an avid reader. And so many of the kids in books that I loved did the same thing. And so I would leave, there was no worries about me, I certainly could have fallen into the creek and drowned. Or I could have been eaten by a mountain lion. But my parents didn't really worry about things like that. They worried about other stuff. My brother too, you know, we both had just such incredible freedom, physically, that we could disappear for hours, and we weren't worried about people being worried about us. And there was just such peace and freedom and that for me, and also I had to teach myself how not to be bored, which is a gift I'm really grateful for.
Emily Silverman
And your dad was a surgeon. So I'm curious about a couple of things. One, how was he able to toggle between this outdoor rural lifestyle and then the hospital getting himself back and forth alone? The commute? I'm thinking like, how did that work? And then second, tell us a little bit about your relationship with him growing up because you say in the book that you were very close and that you were each other's becoming. So tell us more about your dad.
Laurel Braitman
Well, oh my god. I mean, I needed 100,000 words to tell the world about my dad is the truth. He was a cardiothoracic surgeon, and he was rabidly interested in so many different things, including me, which was the gift of my life to be loved like that and also if anyone out there who has been loved by a parent deeply bent on achievement, you know, it can be its own burden. We fought a lot. He's the only person I know who's as stubborn as me. And I know he felt the same way about me. And so we were really close. But we were also really similar and often risked burning each other alive with the intensity of our feelings and passions and opinions. And he really pushed me for better or worse, in terms of how he balanced his life as a rancher, and as a surgeon, I would say he didn't do anything else. And he wasn't in an academic teaching hospital. The ranch is about an hour and a half from LA, but it feels like it's in another solar system. So his commute to work was only 15 minutes. He worked at first at the county hospital, and then a private hospital here in town, but it's a pretty small town, with a bunch of his mentors from Hopkins. And then he did his residency at UCLA, and then a fellowship in New York for surgery. And a lot of those mentors I found out much later, really wanted him to stay in these big academic medical centers, but he wanted to get out and he could be cantankerous, and now that I've met other cardiac surgeons, I realized that's the type. But growing up, I thought it was only me and my dad. He was deeply committed to what he believed was right. And sometimes that wasn't what his administrators or other people at the hospital thought was right. And so he was always kind of getting into arguments and such. And I think, being in a smaller town and having time out on the ranch, I think it gave him a kind of agency and, again, freedom that he really craved and would have had to trade if he stayed in New York City or UCLA, and he wouldn't have been able to live soberly.
Emily Silverman
You mentioned your dad's stubbornness. And that definitely shines through in his character and also, as he's grappling with his diagnosis of bone cancer, and you talk about how persistent he was in trying to heal himself. And you talk about how he ordered his own scans in the beginning. And then later, he persuades a friend of his, a surgeon, to do an operation on him that the surgeon is sort of ambivalent about doing but he does it anyway, because he's a good friend. So what was it like to watch your dad fiercely fighting for his life in that way?
Laurel Braitman
Oh, I mean, it was lessons that I practice every day, you know, just so your listeners understand. When I was three, my dad was diagnosed with osteosarcoma, which is an aggressive bone cancer, he was a little bit older than the norm. He was 42. And I was three and a half. My brother wasn't born yet. My mom found out while they were away at the Mayo Clinic, for his leg amputation that she was pregnant with my brother. They owed money on the ranch, they had his medical school loans to pay off. Still, they were just starting out in their careers as ranchers. And also he really was brand new, as a heart surgeon. So it was like a big scary piano falling out of the sky and on top of us. And his initial prognosis was very, very short. It turned out he had mets in his lungs. And particularly in the early 1980s, when this was happening, that was a death sentence. Chemo for bone cancer was still really new, really toxic. And so we were basically told to say goodbye to him, he was told to get his affairs in order. And then as you say, he didn't die. The opposite was true. He ended up pursuing very aggressive treatment, to basically trade parts of himself for time with us in the end. And so yeah, he flew around everywhere, he begged friends to help him, he did a lot of experimental protocols. And that was that stubbornness that we were talking about earlier. He was also lucky, he'd be the first person to tell you that. He had mets that were excisable, he did respond on a couple of different occasions to the new chemotherapeutics. And so he bought himself time: he was lucky, he was privileged, he could get consults for free, people would pick up his phone calls because he was a physician. So it was also kind of another time in medicine. I'm not sure you'd be able to do that today in quite the same way.
Emily Silverman
As I was reading the story of him doing all of this, you know, I definitely felt admiration for his persistence. But you and I have also talked about this other theme, which is so common among doctors, and arguably, especially among surgeons, which is this inability to express needs or be open about vulnerability and things like that. And so I'm wondering, did you see that in him? And what are your thoughts on that part of it? Because it's just so common among medical professionals to deny that part of themselves?
Laurel Braitman
Oh, yeah. I mean, if I had to explain in one line of why I work with healthcare professionals now it would be this. I have seen firsthand the cost of invulnerability on a personal and a familial and even a professional level. And I wouldn't wish that on anyone. I think you exist and many of your listeners and my students and colleagues in a world in which vulnerability is punished and you've done so much wonderful work on The Nocturnists to talk about these things. Shame in Medicine goes hand in hand in that right? If you are in a field in which vulnerability can actually be punished financially, when it can have ramifications for your career, there's such a disincentive to be vulnerable and how are you supposed to be one way at home and another way at work? My father was kind of a Jewish ranchy marlboro man. It's a small venn diagram of people, but that's who he was. And I think, in one way, his illness set him free, a little bit like, I'm not sure if he hadn't received a terminal diagnosis again, and again, sequentially for many, many years, if he would have been as forthcoming with his feelings with my mom, my brother, and I. I think he wasn't someone that expressing his smushy side came easily to and I think it embarrassed him a bit, but knowing that he was dying, lit a flame beneath him to say the things that he really wanted to say, and that he knew we needed to know to exist and thrive without him. So I think I would never say that there is a silver lining to terminal or chronic illness, I wouldn't I think we have way too much pressure on us in American culture to do those things. But I will say that an unintended consequence of his disease was that it set him free to communicate in a way that I really don't think he would have otherwise.
Emily Silverman
I'm remembering a scene in the book where you're sitting with him in the car, I think, and you ask him, "What are we supposed to do when you die, when you're gone?" And he says, "Have a party." And obviously, there was a part of that that's beautiful, like to think of things as a celebration of life and you know, not dwelling on the tragedy and remembering the good times and things like that. But I think you're right, this shying away maybe from the sadness of that reality. And you know, I'm a parent, I just had a baby a little over a year ago, and been thinking a lot about the unique way in which I will screw up my kid. And just, you know, reading your book, obviously thinking about how our stuff, our personality that transmits to the next generation. And there's a part of your book, where I think a friend asks you to describe what you're feeling. And you say, it's like a lake, the lake is both inside me and outside me, it feels like I can't even dip my toe into the lake, or I'll drown. I think the lake might be sadness. But it's confusing, because I don't actually feel sad. And so I'm wondering, do you think that lake metaphor is representing something you inherited from him? And what does it feel like to be in that space?
Laurel Braitman
Yeah, I mean, I can say with certainty, now that I've gone swimming in the lake and lived to tell the tale. It didn't kill me, I didn't drown. But I did spend decades worried about it, we inherit so many beautiful and painful things from our parents, as you're talking about. And one of the things that I inherited was my dad's conviction that you are privileged, you are blessed, you are lucky, even though this terrible thing is happening. You have so much, you have so much more than other kids your age, you don't have to worry about where the next meal is coming from, you're going to be able to go to college, I'm encouraging you to follow your dreams, you don't have to worry about having a roof over your head. That was the family message was basically nothing to see here. We are excellent, keep going. And I internalized that deeply. And he wasn't wrong. I am insanely privileged. It's just that privilege doesn't protect you from pain. And I lived for so long feeling that way that if I admitted how much I was suffering, that it was somehow a betrayal of him or myself, and that I had no right to hurt, because look at all these other nice things. And that worked for a very long time well into my 30s. That worked. And then as I discussed in the book, more and other losses piled up on top of the loss of him. And it got to a point where I was forced to look at these feelings that I had been running from basically since childhood and try and figure them out. And the person that really pushed me to do that is that friend, she was actually my girlfriend at the time – Connie Hockaday. And I owe her just so much because she would ask me how I was and when I said fine, she refused to fall for it. And she really pushed me and I was in my mid 30s and I couldn't answer honestly, when someone asked me how I was. And that was kind of shocking. So I had to do some real work at a time where from the outside, I think people thought I was killing it. But I couldn't tell my girlfriend why I felt bad. Something that simple.
Emily Silverman
I love the part of the book where you're listening to This American Life. And you hear a story about The Sharing Place, which is a place I believe, where kids go to process grief. And you find a local version of this called Josie's Place and you cold call them. And you end up meeting this woman named Pat and asking if you can attend her program. And she's like, "Sure, you can attend as a facilitator" and you're like, "No, can I attend as a child?" And you do end up attending as a facilitator, but tell us a little bit about Josie's Place and what you learned from those kids.
Laurel Braitman
Oh, my gosh, we need so many hours. I will tell you this, the training to be a great facilitator for kids at Josie's Place changed my whole life. I think that so often we write off children, and particularly adolescents and teenagers because their feelings can be so big, or change so quickly, I truly don't think we take their wisdom as seriously as we should. So what happened was, yes, I begged Pat Murphy, who is the founder and director of Josie's Place, to take me on as a kid. And she definitely thought it was creepy, but she didn't want to offend me, I think. And she told me that I could be a facilitator. And not only that, but that most of the facilitators had had losses as kids, so that I'd be in good company. So that's what I did. And the things that I learned from these kids was part of the title of the book, I learned bravery and courage from these kids, because they were facing the things that I had spent so long running from, and they were getting the kind of support in their lives, that was a container to help them face these things, so that they weren't burying it, and then would end up running from relationships once they hit midlife. So I learned things like the worst thing that you can do when you're sad is try not to be sad. And that was from a young girl whose mom had just died, I believe of colon cancer. There were so many lessons for me, that I think really all tie back to the fact that you can face that which hurts you. And it doesn't mean you'll be stuck there forever. In fact, the only way to new and different feelings is to let the ones you're scared of in, to let yourself feel them. And for a lot of these kids, you know, they didn't have as much choice. And they were getting a different narrative through places like Josie's Place about how to process or think through or play through for the most part, you know, a lot of kids and adults frankly, can't verbalize their negative feelings. And so when someone like when my girlfriend was asking me, "How do you feel?" I didn't have words for it. And that's a real common childhood experience. You can't verbalize it. You can't make a narrative around it. So what do you do, you play tag, you build the pillow fort, but you do it along with other kids who have suffered a really big loss, so you don't feel alone while you're doing it. So some of it wasn't a profound kind of intellectual lesson. It was really just being around a whole passel of other people who'd had a similar life experience, and being able to laugh and play and cry and argue and wrestle, you know, it was just kind of a normalizer. And I think that in itself is really good medicine.
Emily Silverman
I want to stay with this for a moment, just because it was really one of my favorite parts of the book. Like how, when the kids are going through this grief process, play is their work. And you talk about something called the volcano room where they go, you also talk about a room that is set up like a hospital room with a hospital bed and IVs and the kids are able to go in there and roleplay a bit. Can you bring us kind of into the almost magical realism of these roleplay exercises in games that the kids play because I just think that's so fascinating.
Laurel Braitman
One of the most incredible things I learned from grief therapists and facilitators and volunteers that work with kids going through a loss is how incredibly healing and medicinal frankly imaginative play is. You're describing a place called the Dougy center which is actually in Portland, Oregon, and it's kind of a mothership for kid grief support around the world. I cannot say enough wonderful things about this place. And inside the Dougy center, they have a room that is the exact replica of a hospital room, and it is incredible. There is even a curtain on the little ball bearing strip that is the sound of hospitals. There is a tiny X-ray machine. There's X-rays of things like turtles and fish. There are tiny doctor's hats. There's tiny doctor's coats, there's tiny stethoscopes, there is equipment painted on the wall. There's a tiny IV stands and for the parents, this is what the directors of the Dougy center told me when they were walking around on the tour. Parents opened the door to this room, and they're just like, eek and they immediately don't want to go in. Yeah, it's scary, it looks scary. And the kids, they opened the door to this room, the kids just rush in, it's one of the kids favorite rooms in the entire center. And that's because they go in there. And it gives them ultimate power. Usually, in a context, they had no power whatsoever. Many of these kids had to say their final goodbyes to a parent inside of a hospital room. They have memories of being in a hospital room, they have their own feelings about it, they were kept at arm's length, or maybe they were allowed to crawl into a hospital bed. But it was such an alienating, alienating and foreign experience for them to be in the hospital room. And here in the Dougy center that is full of love and joy, and they are protected and safe. They run in there, and they make up their own stories. So often kids will do things like imagine wings, and fly back to the scene of an accident and have a conversation with someone that they love that they weren't able to have. Or they will come into the hospital room and they will pretend help someone in the hospital bed, either imagined or real from their life. But really, they use their imagination to go back in time, and rewrite the endings into things they wish they'd been given in real life. And so it's a way to use imagination as a form of time travel, or as a pen to go back in and change the stories they were given for the better and to give themselves power in a situation where they didn't have it. And that's just an incredibly profound thing.
Emily Silverman
You talked about how you went swimming in the lake of your sadness. And that's part of the arc of the book is you diving in, I guess we could say. And you've also talked about how your path leads you toward this chaplain program. And you're filling out the application. And it's like, Are you a priest? Are you a rabbi or you know, and you're like, I'm not any of these things. But you do have a handful of really profound spiritual experiences as part of this swimming in the lake journey. One of them which I thought was so funny and cool was the experience of going and visiting with this psychic medium who gives you advice and who seems kind of legit in the book. And then there's another part where you go on this retreat where you're fasting for days and going out into the wilderness. And in that state, there's these hallucinations that come in messages that comment so profoundly spiritual experiences? Where are you settling out in your spirituality? And how are you planning to bring that into your job, or your work as a chaplain for people and families who are suffering with illness?
Laurel Braitman
You're the first person to ask me about this. And I'm profoundly nervous about that. We both inhabit very clinical qualitative, quantitative spaces. And the idea of Deans of the Stanford Medical School, this reading about my visions of the afterlife, is something that does keep me up at night, I am not gonna lie. I'm like, will I have a professorship tomorrow? But I felt like I needed to share it just like I needed to share it with you. It didn't feel separate from the research I was doing for this book, it didn't feel like any of the reporting that I've done over my career as primarily a popular science and medicine writer. I am a deeply skeptical person. And so the fact that these experiences happened to me, it's really interesting. I have a doctorate from MIT. I mean, I'm not an engineer. But definitely I am someone with a healthy dose of skepticism, and I am an evidence-based person. So when I have had spiritual experiences in my life, and certainly, up until recently, I kind of tamped them down. And then what I realized through the course of living through the years of writing this book, and also then writing this book, and having to process some of these experiences to make meaning for others, is that I realized, if only there was a firm dividing line between the research and the spiritual, and there just really isn't, and I just didn't want to keep pretending that there was, is the truth. And I feel like the best physicians, for example, have always been spiritual. They may be secular, they may not be forcing their beliefs on a patient or a colleague. But certainly, they approach the art of medicine and it is truly an art with a spirituality of purpose, basically, that you approach your work with meaning, you know that it's bigger than you, that you know that your patient represents more than just themselves. While they are also an individual, you are engaged in a project that began long before you and will outlast you. So I think to say that this is separate than my work with clinicians. I just don't think it's true. So I want to make that clear. I think that I've been probably a secular chaplain for a long time now. When I think about my teaching, the workshops I lead, the kind of work I do with healthcare professionals, it's absolutely spiritual. It's helping other people reconnect with their meaning, why they do what they do, particularly when things get hard, and to process their most difficult life experiences in a way that make them either lighter to carry or at least help them bring lessons from those experiences that they can use to help others. And I think that to me is what chaplaincy means. I've just been doing it as a professor of anesthesia. I'm not an anesthesiologist, just happens to be where my appointment is at the medical school. But I would say we like to think there's divisions between these things, and I really don't think there are.
Emily Silverman
So what is a chaplain, you talked about the work that you do leading writing workshops and storytelling workshops for health professionals, but will there be a component of your work where you are more patient facing and helping patients and families? And if so what does that look like? Is that at Stanford? Or is that in a clinical setting? And what does the future hold in that sense?
Laurel Braitman
I had no idea what a clinical chaplain was until I started going to the ethics meetings at the Stanford Hospital. And I was so amazed. First, I saw people with a name tag that said spiritual care on it. I was like, what is that I want a name tag like that. That's amazing. They'd have their hospital badge with their security stuff on it. And then they would have a little printed flag that said spiritual care. And I just loved the idea of these people wandering around the hospital tagged spiritual carer. And so I wanted to know what they do. And she's in the book. But Emily Linderman is a chaplain that I met at Stanford who was incredible, was working as an architect actually, left architecture to become a chaplain, and now trains chaplains. And through getting to know her and watching what she did on the wards, and also how she thought about things just really changed me, and I thought was so brave and so interesting, and really helped people, you know, navigate some of the biggest, most challenging moments of their lives, and worked really well with their care teams too. And I just didn't know that was an element of medicine. And so I started my training, but it was right before the pandemic. And it's been on pause, and I can't wait to dive back in, I really would like to do clinical chaplain time. And I would like to have more patient-facing time. I've just started offering workshops for patients and caregivers as a part of a book tour that would make book tours more fun. And I've been working with clinicians for a while now. And I wanted to do something for patients and caregivers. So I think probably I'm a writing chaplain, if such, I am a secular writing chaplain, if such a thing might exist. And I would like to do that anywhere, anyone would have me is the truth.
Emily Silverman
Tell us a bit about what it's like to work with health professionals and medical learners, because in the book, you talk a lot about the achievement-itis that you live with, this way in which every grant every fellowship, every book, every achievement, that did something for you, as you were moving through this story, and I found that really relatable. And I'm assuming a lot of the medical professionals will also find that relatable because as you say, the profession of medicine does tend to magnetize overachievers, and people who sort of use, as you say also in the book, use excellence as an analgesic, which I loved and I also related to. So where are you at with your achievement-itis? What is your relationship to it? And how do you talk to medical students about that?
Laurel Braitman
Great question. You know, first of all, I still have achievement-itis. I just started coming on this podcast. You know, someone asked me recently, like, "Who's this book for?" And I wanted to be like, "Oh, every human on planet Earth." It's just that I think now I have an understanding after doing a lot of the work that's in the book, that I will always be this person. So will you be and there's nothing wrong with that. And that's also why I feel like working in medicine is so comforting. I like our people. I relate to them, and I love them. And I think it's just that what has shifted is the why and what I'm hoping to get out of it. And what I want for the next phase of my life is not that I want to achieve less or do less or chase less shiny prices. It's that I don't want to be motivated by fear and anxiety or the idea that if I get the prize, then it will bring back people that I love, it will prove to myself that I am good, not bad. And I will feel better. That is what I'm trying to change, not the chasing, but the motivation for the chasing and also going into the chasing to knowing that I'm going to be me on the other side just holding a trophy. And I don't think I actually believed that for a long time. I think as you said, I was using it as an analgesic on feelings I didn't want to have. I was using excellence to keep some of the shrieking voices on mute. And eventually that stopped working as I think it does for many of us. All you need is one extra disappointment and all of a sudden, excellence as a coping strategy stops working quite so well. And so I wouldn't wish any crushing disappointments or terrible diagnoses or losses or natural disasters on anybody. But when they come for you, man, you are forced to your knees, and you were forced to develop a new way of getting through because the old ways aren't serving you.
Emily Silverman
So as we come to a close, just to share with the audience, like you invited me I think last year it was to a writing workshop. And it was so Laurel, it was like a writing workshop. And it was on a farm and there was this delicious dinner. And then you said Emily, go teach the students over there by the barn where there is lavender that was freshly picked that is drying in the barn. And so I show up to this barn and it smells amazing. And we're sitting around and chairs and talking and under this giant tree, and I just I loved that so much. And so is that the vision? Is it bringing healthcare workers into nature and having them engaged with their stories? Is this scalable? Should it be scalable? What is your wish for these people and bringing into the future some of the work that you're doing?
Laurel Braitman
Oh, thank you for asking me that. Yeah, of course, it's scalable. Maybe not the lavender, California approach, you know, that might not work in Philly. But the Philly version is possible, right? All that is doing is admitting that these clinical students, or the physician faculty, or the nurses or whoever it is that I'm working with in a given moment, that they are whole people, and that they should be encouraged to be whole people that work too, and that by learning to tell your own story, and to talk about your own most challenging or beautiful or most haunting experiences, you become better at articulating what matters to you. And often that transmits into a clinical context. It can't not. I had someone who was not a physician, I desperately want my physicians to be people. I want them to bring their whole selves into the room. Sometimes it's just like a minute where like, the fourth wall breaks, and you get a humanitarian connection with your healthcare provider where you're just like, Oh, I got it, you know, I got it. There's some smidge of connection that surpasses the clinical, it feels so good. And it doesn't just feel good to the patient. It feels good to the physician too. And I also think it's a way to humanize healthcare, which is deeply inhumane in many ways, certainly in the United States and many other places on both sides, on both sides. I truly believe that unhealthy healers can't heal anybody else. I just believe that heal thyself first. I truly believe that that is not just a cliche. And I think one way to do that is to inject the humanities back into medicine, where they started. Our ancient physicians were artists, they were holy people in much of the world, they still are. And I think the great divide that happened in western medicine a century or two ago now was to our great, great detriment. I don't think the medical humanities should be in a tiny closet inside of medicine. I think they're part of everything. So that's what I would say is that really, it's just making humanity one of the core tenants of medicine on both sides of the desk or the exam table.
Emily Silverman
I think that's a great place to end. I have been speaking with Laurel Braitman about her amazing memoir, What Looks Like Bravery. Thank you so much, Laurel, for being here today.
Laurel Braitman
Thank you so much. You are good medicine.
Emily Silverman
Thanks for listening. This episode of The Nocturnists was produced by me, Emily Silverman and Jon Oliver. Jon also edited and mixed, Rebecca Groves assistant producer. The Nocturnists Executive Producer is Ali Block and our Chief Operating Officer is Rebecca Groves. Our original theme music was composed by Yosef Munro and additional music comes from Blue Dot sessions. The Nocturnists is made possible by the California Medical Association, a physician-led organization that works tirelessly to make sure that the doctor-patient relationship remains at the center of medicine. To learn more about the CMA, visit cmadocs.org. The Nocturnists is also supported with donations from listeners like you. Thank you so much for supporting our work. If you enjoy the show, please help others find us by telling your friends about us, posting your favorite episode on social media, or leaving us a rating and review in your favorite podcast app. To contribute your voice to an upcoming project, or to make a donation, visit our website at the nocturnists.com And specifically, if you're interested in our upcoming series on uncertainty, check out our website. You can sign up to learn more information as that project goes under development. I'm your host, Emily Silverman. See you next week.
Note: The Nocturnists is created primarily as a listening experience. The audio contains emotion, emphasis, and soundscapes that are not easily transcribed. We encourage you to listen to the episode if at all possible. Our transcripts are produced using both speech recognition software and human copy editors, and may not be 100% accurate. Thank you for consulting the audio before quoting in print.
Emily Silverman
You're listening to The Nocturnists: Conversations. I'm Emily Silverman. Often we underestimate how a career in medicine impacts not just us, but the people in our lives, our parents, our children, our partners, even our friends. Whether our careers inspire others, or create blockages in our personal lives or sometimes a mix of the two, the rigors of the health profession touch many more people than just those working inside of it. Today's guest isn't a physician, but her father was and her relationship with him inspired her to pursue a career helping clinicians find their voice. Her name is Laurel Braitman and she's a writer, teacher, secular clinical chaplain in training, and author of the recent memoir, What Looks Like Bravery: An Epic Journey Through Loss to Love, which we'll be talking about on today's episode. In addition to her memoir, Laurel is the author of New York Times bestselling book Animal Madness, which examines how animals, just like humans, have feelings. Laurel has a doctorate in history and anthropology from MIT, and has helped numerous students, staff and clinicians tell their stories in her role as the Director of Writing and Storytelling at the Stanford University School of Medicine. In my conversation with Laurel, we talk about what it was like to grow up with a father who was a surgeon, and who spent many years suffering with terminal cancer. Laurel talks about how his legacy impacted her emotionally and professionally, why she decided to become a secular chaplain, and why she feels that there's a very thin line between the clinical and the spiritual. But before we go on, let's hear Laurel read an excerpt from her memoir, What Looks Like Bravery. Here's Laurel.
Laurel Braitman
Prologue: Santa Paula California, September 1994
It was a warm Saturday afternoon and the Santa Ana winds ruffled the tops of the avocado trees. I was at home with two good friends, all of us 16 years old, draped like hormonal Dali clocks over the living room furniture while we watch The Bodyguard on VHS and painted our nails.
No one was surprised when I knocked over one of the bottles. I paused the movie and went into my parents’ bathroom to get the nail polish remover Mom kept under the sink. I glanced at myself in the mirror. Disappointed as usual, by my wild hair, tight cheeks, and how little I looked like someone Kevin Costner might want to carry to safety. Kneeling down and reaching into the cabinet, I pushed aside the bottles of rubbing alcohol that dad used to clean the stump on his amputated leg and the tray of stainless scissors he had brought home from his job at the hospital. I was moving a multipack of Dove soap when I saw it– a small plastic pill bottle. It was strange, not labeled like everything else in the cabinet. It didn't look like the transparent orange prescription bottles that came from the pharmacy either. My body sensed danger before my mind did. Something clenched in my chest; my pulse started to throb in my face.
There was a handwritten note rubber banded around the bottle. I unrolled it carefully.
"No one should have to do this for a friend," it read. "But here you go."
My throat went hot and dry as the winds outside. I steadied myself on the cabinet door. It hit me. Dad had a suicide plan. And he kept it in the bathroom like a box of Q-tips or Mom's Velcro rollers. Underneath the message was the name of a drug and dosage instructions written out longhand.
I had no idea how long the bottle had been there, or when he was going to use it. But I knew I couldn't ask. I could tell no one about this, not even mom or Jake, not ever. I understood without being told that I wasn't supposed to know dad had a plan or that anyone had helped him or that this was barreling towards us like a car whose brakes had gone out. I let myself feel my pounding terror for just a few more seconds. And then I rewound the note and put the bottle back exactly where it had been. Standing up, I took a long breath, summoning every bit of power I had, and shoved my fear and panic down as hard as I could– burying them so deeply that for the longest time, I thought they were dead and gone. Only you can't kill feelings. Just like bad boyfriends or lost cats, they tend to come back when you least expect it.
Emily Silverman
I am so thrilled to be here speaking with Laurel Braitman. Laurel, thank you for being here.
Laurel Braitman
It's such an honor.
Emily Silverman
So, Laurel, we've known each other for a few years. And I've always loved you and your work, particularly the work that you do at Stanford School of Medicine, helping medical students and other health professionals with their stories and their writing. But I never really knew why you did that work. And I'd always been curious. So what a gift to be able to read this book and learn more about your family and your story. And I just really enjoyed it. So thank you for writing it.
Laurel Braitman
Thank you for reading it. And for having me here.
Emily Silverman
Maybe let's begin talking about your parents, because they're such great characters in this memoir. And in the book, you say that your parents actually grew up city people. So your dad grew up in downtown Baltimore, not far from Johns Hopkins, which is where he went to med school, also where I went to med school. And your mom was the daughter of an optometrist in Beverly Hills. And yet these urban people marry each other and move to this ranch in California, where they're taking care of trees and donkeys and bees and their fishing. And I'm just wondering, where do you think that came from, this desire to live a more rural life?
Laurel Braitman
I think it was their version of rebelling in some way, against the structures that contain them, either consciously or not. And I think they were seeking a kind of freedom in the landscape and a lack of oversight. And also, they were just deeply curious people who like to learn new skills. And there's nothing like becoming a farmer or buying a dilapidated farm and trying to rehab it to teach you how little you actually know. And they also both loved the natural world and found so much joy in it, and solace, particularly as things got harder in their lives, that I think it was a natural fit than wanting to really just try something new. They approached it as just a big adventure, at least at first.
Emily Silverman
And this is where you grew up. You come of age, in this beautiful, picturesque ranch. What was it like to grow up there?
Laurel Braitman
Oh, it was magical. You know, it's actually where I'm talking to you from now. And it remains magical, although now I have responsibilities here. So as with most parts of adulthood, you know, it's great, and also mildly disappointing. But it's still beautiful. And it was an incredible place to be, you know, I had such freedom. I had such safety, I could take risks in a way that I think if I was in an urban place might have looked really different. And I developed a confidence outside by myself at a really young age that I think comes with growing up in a wild place.
Emily Silverman
What kind of risks, like physical risks or other types?
Laurel Braitman
Oh, definitely physical risks. I'd leave the house in the morning, my mom would tie up a little sandwich for me and a bandana and tie it around the end of the stick. And I would go forth, I was just an avid reader. And so many of the kids in books that I loved did the same thing. And so I would leave, there was no worries about me, I certainly could have fallen into the creek and drowned. Or I could have been eaten by a mountain lion. But my parents didn't really worry about things like that. They worried about other stuff. My brother too, you know, we both had just such incredible freedom, physically, that we could disappear for hours, and we weren't worried about people being worried about us. And there was just such peace and freedom and that for me, and also I had to teach myself how not to be bored, which is a gift I'm really grateful for.
Emily Silverman
And your dad was a surgeon. So I'm curious about a couple of things. One, how was he able to toggle between this outdoor rural lifestyle and then the hospital getting himself back and forth alone? The commute? I'm thinking like, how did that work? And then second, tell us a little bit about your relationship with him growing up because you say in the book that you were very close and that you were each other's becoming. So tell us more about your dad.
Laurel Braitman
Well, oh my god. I mean, I needed 100,000 words to tell the world about my dad is the truth. He was a cardiothoracic surgeon, and he was rabidly interested in so many different things, including me, which was the gift of my life to be loved like that and also if anyone out there who has been loved by a parent deeply bent on achievement, you know, it can be its own burden. We fought a lot. He's the only person I know who's as stubborn as me. And I know he felt the same way about me. And so we were really close. But we were also really similar and often risked burning each other alive with the intensity of our feelings and passions and opinions. And he really pushed me for better or worse, in terms of how he balanced his life as a rancher, and as a surgeon, I would say he didn't do anything else. And he wasn't in an academic teaching hospital. The ranch is about an hour and a half from LA, but it feels like it's in another solar system. So his commute to work was only 15 minutes. He worked at first at the county hospital, and then a private hospital here in town, but it's a pretty small town, with a bunch of his mentors from Hopkins. And then he did his residency at UCLA, and then a fellowship in New York for surgery. And a lot of those mentors I found out much later, really wanted him to stay in these big academic medical centers, but he wanted to get out and he could be cantankerous, and now that I've met other cardiac surgeons, I realized that's the type. But growing up, I thought it was only me and my dad. He was deeply committed to what he believed was right. And sometimes that wasn't what his administrators or other people at the hospital thought was right. And so he was always kind of getting into arguments and such. And I think, being in a smaller town and having time out on the ranch, I think it gave him a kind of agency and, again, freedom that he really craved and would have had to trade if he stayed in New York City or UCLA, and he wouldn't have been able to live soberly.
Emily Silverman
You mentioned your dad's stubbornness. And that definitely shines through in his character and also, as he's grappling with his diagnosis of bone cancer, and you talk about how persistent he was in trying to heal himself. And you talk about how he ordered his own scans in the beginning. And then later, he persuades a friend of his, a surgeon, to do an operation on him that the surgeon is sort of ambivalent about doing but he does it anyway, because he's a good friend. So what was it like to watch your dad fiercely fighting for his life in that way?
Laurel Braitman
Oh, I mean, it was lessons that I practice every day, you know, just so your listeners understand. When I was three, my dad was diagnosed with osteosarcoma, which is an aggressive bone cancer, he was a little bit older than the norm. He was 42. And I was three and a half. My brother wasn't born yet. My mom found out while they were away at the Mayo Clinic, for his leg amputation that she was pregnant with my brother. They owed money on the ranch, they had his medical school loans to pay off. Still, they were just starting out in their careers as ranchers. And also he really was brand new, as a heart surgeon. So it was like a big scary piano falling out of the sky and on top of us. And his initial prognosis was very, very short. It turned out he had mets in his lungs. And particularly in the early 1980s, when this was happening, that was a death sentence. Chemo for bone cancer was still really new, really toxic. And so we were basically told to say goodbye to him, he was told to get his affairs in order. And then as you say, he didn't die. The opposite was true. He ended up pursuing very aggressive treatment, to basically trade parts of himself for time with us in the end. And so yeah, he flew around everywhere, he begged friends to help him, he did a lot of experimental protocols. And that was that stubbornness that we were talking about earlier. He was also lucky, he'd be the first person to tell you that. He had mets that were excisable, he did respond on a couple of different occasions to the new chemotherapeutics. And so he bought himself time: he was lucky, he was privileged, he could get consults for free, people would pick up his phone calls because he was a physician. So it was also kind of another time in medicine. I'm not sure you'd be able to do that today in quite the same way.
Emily Silverman
As I was reading the story of him doing all of this, you know, I definitely felt admiration for his persistence. But you and I have also talked about this other theme, which is so common among doctors, and arguably, especially among surgeons, which is this inability to express needs or be open about vulnerability and things like that. And so I'm wondering, did you see that in him? And what are your thoughts on that part of it? Because it's just so common among medical professionals to deny that part of themselves?
Laurel Braitman
Oh, yeah. I mean, if I had to explain in one line of why I work with healthcare professionals now it would be this. I have seen firsthand the cost of invulnerability on a personal and a familial and even a professional level. And I wouldn't wish that on anyone. I think you exist and many of your listeners and my students and colleagues in a world in which vulnerability is punished and you've done so much wonderful work on The Nocturnists to talk about these things. Shame in Medicine goes hand in hand in that right? If you are in a field in which vulnerability can actually be punished financially, when it can have ramifications for your career, there's such a disincentive to be vulnerable and how are you supposed to be one way at home and another way at work? My father was kind of a Jewish ranchy marlboro man. It's a small venn diagram of people, but that's who he was. And I think, in one way, his illness set him free, a little bit like, I'm not sure if he hadn't received a terminal diagnosis again, and again, sequentially for many, many years, if he would have been as forthcoming with his feelings with my mom, my brother, and I. I think he wasn't someone that expressing his smushy side came easily to and I think it embarrassed him a bit, but knowing that he was dying, lit a flame beneath him to say the things that he really wanted to say, and that he knew we needed to know to exist and thrive without him. So I think I would never say that there is a silver lining to terminal or chronic illness, I wouldn't I think we have way too much pressure on us in American culture to do those things. But I will say that an unintended consequence of his disease was that it set him free to communicate in a way that I really don't think he would have otherwise.
Emily Silverman
I'm remembering a scene in the book where you're sitting with him in the car, I think, and you ask him, "What are we supposed to do when you die, when you're gone?" And he says, "Have a party." And obviously, there was a part of that that's beautiful, like to think of things as a celebration of life and you know, not dwelling on the tragedy and remembering the good times and things like that. But I think you're right, this shying away maybe from the sadness of that reality. And you know, I'm a parent, I just had a baby a little over a year ago, and been thinking a lot about the unique way in which I will screw up my kid. And just, you know, reading your book, obviously thinking about how our stuff, our personality that transmits to the next generation. And there's a part of your book, where I think a friend asks you to describe what you're feeling. And you say, it's like a lake, the lake is both inside me and outside me, it feels like I can't even dip my toe into the lake, or I'll drown. I think the lake might be sadness. But it's confusing, because I don't actually feel sad. And so I'm wondering, do you think that lake metaphor is representing something you inherited from him? And what does it feel like to be in that space?
Laurel Braitman
Yeah, I mean, I can say with certainty, now that I've gone swimming in the lake and lived to tell the tale. It didn't kill me, I didn't drown. But I did spend decades worried about it, we inherit so many beautiful and painful things from our parents, as you're talking about. And one of the things that I inherited was my dad's conviction that you are privileged, you are blessed, you are lucky, even though this terrible thing is happening. You have so much, you have so much more than other kids your age, you don't have to worry about where the next meal is coming from, you're going to be able to go to college, I'm encouraging you to follow your dreams, you don't have to worry about having a roof over your head. That was the family message was basically nothing to see here. We are excellent, keep going. And I internalized that deeply. And he wasn't wrong. I am insanely privileged. It's just that privilege doesn't protect you from pain. And I lived for so long feeling that way that if I admitted how much I was suffering, that it was somehow a betrayal of him or myself, and that I had no right to hurt, because look at all these other nice things. And that worked for a very long time well into my 30s. That worked. And then as I discussed in the book, more and other losses piled up on top of the loss of him. And it got to a point where I was forced to look at these feelings that I had been running from basically since childhood and try and figure them out. And the person that really pushed me to do that is that friend, she was actually my girlfriend at the time – Connie Hockaday. And I owe her just so much because she would ask me how I was and when I said fine, she refused to fall for it. And she really pushed me and I was in my mid 30s and I couldn't answer honestly, when someone asked me how I was. And that was kind of shocking. So I had to do some real work at a time where from the outside, I think people thought I was killing it. But I couldn't tell my girlfriend why I felt bad. Something that simple.
Emily Silverman
I love the part of the book where you're listening to This American Life. And you hear a story about The Sharing Place, which is a place I believe, where kids go to process grief. And you find a local version of this called Josie's Place and you cold call them. And you end up meeting this woman named Pat and asking if you can attend her program. And she's like, "Sure, you can attend as a facilitator" and you're like, "No, can I attend as a child?" And you do end up attending as a facilitator, but tell us a little bit about Josie's Place and what you learned from those kids.
Laurel Braitman
Oh, my gosh, we need so many hours. I will tell you this, the training to be a great facilitator for kids at Josie's Place changed my whole life. I think that so often we write off children, and particularly adolescents and teenagers because their feelings can be so big, or change so quickly, I truly don't think we take their wisdom as seriously as we should. So what happened was, yes, I begged Pat Murphy, who is the founder and director of Josie's Place, to take me on as a kid. And she definitely thought it was creepy, but she didn't want to offend me, I think. And she told me that I could be a facilitator. And not only that, but that most of the facilitators had had losses as kids, so that I'd be in good company. So that's what I did. And the things that I learned from these kids was part of the title of the book, I learned bravery and courage from these kids, because they were facing the things that I had spent so long running from, and they were getting the kind of support in their lives, that was a container to help them face these things, so that they weren't burying it, and then would end up running from relationships once they hit midlife. So I learned things like the worst thing that you can do when you're sad is try not to be sad. And that was from a young girl whose mom had just died, I believe of colon cancer. There were so many lessons for me, that I think really all tie back to the fact that you can face that which hurts you. And it doesn't mean you'll be stuck there forever. In fact, the only way to new and different feelings is to let the ones you're scared of in, to let yourself feel them. And for a lot of these kids, you know, they didn't have as much choice. And they were getting a different narrative through places like Josie's Place about how to process or think through or play through for the most part, you know, a lot of kids and adults frankly, can't verbalize their negative feelings. And so when someone like when my girlfriend was asking me, "How do you feel?" I didn't have words for it. And that's a real common childhood experience. You can't verbalize it. You can't make a narrative around it. So what do you do, you play tag, you build the pillow fort, but you do it along with other kids who have suffered a really big loss, so you don't feel alone while you're doing it. So some of it wasn't a profound kind of intellectual lesson. It was really just being around a whole passel of other people who'd had a similar life experience, and being able to laugh and play and cry and argue and wrestle, you know, it was just kind of a normalizer. And I think that in itself is really good medicine.
Emily Silverman
I want to stay with this for a moment, just because it was really one of my favorite parts of the book. Like how, when the kids are going through this grief process, play is their work. And you talk about something called the volcano room where they go, you also talk about a room that is set up like a hospital room with a hospital bed and IVs and the kids are able to go in there and roleplay a bit. Can you bring us kind of into the almost magical realism of these roleplay exercises in games that the kids play because I just think that's so fascinating.
Laurel Braitman
One of the most incredible things I learned from grief therapists and facilitators and volunteers that work with kids going through a loss is how incredibly healing and medicinal frankly imaginative play is. You're describing a place called the Dougy center which is actually in Portland, Oregon, and it's kind of a mothership for kid grief support around the world. I cannot say enough wonderful things about this place. And inside the Dougy center, they have a room that is the exact replica of a hospital room, and it is incredible. There is even a curtain on the little ball bearing strip that is the sound of hospitals. There is a tiny X-ray machine. There's X-rays of things like turtles and fish. There are tiny doctor's hats. There's tiny doctor's coats, there's tiny stethoscopes, there is equipment painted on the wall. There's a tiny IV stands and for the parents, this is what the directors of the Dougy center told me when they were walking around on the tour. Parents opened the door to this room, and they're just like, eek and they immediately don't want to go in. Yeah, it's scary, it looks scary. And the kids, they opened the door to this room, the kids just rush in, it's one of the kids favorite rooms in the entire center. And that's because they go in there. And it gives them ultimate power. Usually, in a context, they had no power whatsoever. Many of these kids had to say their final goodbyes to a parent inside of a hospital room. They have memories of being in a hospital room, they have their own feelings about it, they were kept at arm's length, or maybe they were allowed to crawl into a hospital bed. But it was such an alienating, alienating and foreign experience for them to be in the hospital room. And here in the Dougy center that is full of love and joy, and they are protected and safe. They run in there, and they make up their own stories. So often kids will do things like imagine wings, and fly back to the scene of an accident and have a conversation with someone that they love that they weren't able to have. Or they will come into the hospital room and they will pretend help someone in the hospital bed, either imagined or real from their life. But really, they use their imagination to go back in time, and rewrite the endings into things they wish they'd been given in real life. And so it's a way to use imagination as a form of time travel, or as a pen to go back in and change the stories they were given for the better and to give themselves power in a situation where they didn't have it. And that's just an incredibly profound thing.
Emily Silverman
You talked about how you went swimming in the lake of your sadness. And that's part of the arc of the book is you diving in, I guess we could say. And you've also talked about how your path leads you toward this chaplain program. And you're filling out the application. And it's like, Are you a priest? Are you a rabbi or you know, and you're like, I'm not any of these things. But you do have a handful of really profound spiritual experiences as part of this swimming in the lake journey. One of them which I thought was so funny and cool was the experience of going and visiting with this psychic medium who gives you advice and who seems kind of legit in the book. And then there's another part where you go on this retreat where you're fasting for days and going out into the wilderness. And in that state, there's these hallucinations that come in messages that comment so profoundly spiritual experiences? Where are you settling out in your spirituality? And how are you planning to bring that into your job, or your work as a chaplain for people and families who are suffering with illness?
Laurel Braitman
You're the first person to ask me about this. And I'm profoundly nervous about that. We both inhabit very clinical qualitative, quantitative spaces. And the idea of Deans of the Stanford Medical School, this reading about my visions of the afterlife, is something that does keep me up at night, I am not gonna lie. I'm like, will I have a professorship tomorrow? But I felt like I needed to share it just like I needed to share it with you. It didn't feel separate from the research I was doing for this book, it didn't feel like any of the reporting that I've done over my career as primarily a popular science and medicine writer. I am a deeply skeptical person. And so the fact that these experiences happened to me, it's really interesting. I have a doctorate from MIT. I mean, I'm not an engineer. But definitely I am someone with a healthy dose of skepticism, and I am an evidence-based person. So when I have had spiritual experiences in my life, and certainly, up until recently, I kind of tamped them down. And then what I realized through the course of living through the years of writing this book, and also then writing this book, and having to process some of these experiences to make meaning for others, is that I realized, if only there was a firm dividing line between the research and the spiritual, and there just really isn't, and I just didn't want to keep pretending that there was, is the truth. And I feel like the best physicians, for example, have always been spiritual. They may be secular, they may not be forcing their beliefs on a patient or a colleague. But certainly, they approach the art of medicine and it is truly an art with a spirituality of purpose, basically, that you approach your work with meaning, you know that it's bigger than you, that you know that your patient represents more than just themselves. While they are also an individual, you are engaged in a project that began long before you and will outlast you. So I think to say that this is separate than my work with clinicians. I just don't think it's true. So I want to make that clear. I think that I've been probably a secular chaplain for a long time now. When I think about my teaching, the workshops I lead, the kind of work I do with healthcare professionals, it's absolutely spiritual. It's helping other people reconnect with their meaning, why they do what they do, particularly when things get hard, and to process their most difficult life experiences in a way that make them either lighter to carry or at least help them bring lessons from those experiences that they can use to help others. And I think that to me is what chaplaincy means. I've just been doing it as a professor of anesthesia. I'm not an anesthesiologist, just happens to be where my appointment is at the medical school. But I would say we like to think there's divisions between these things, and I really don't think there are.
Emily Silverman
So what is a chaplain, you talked about the work that you do leading writing workshops and storytelling workshops for health professionals, but will there be a component of your work where you are more patient facing and helping patients and families? And if so what does that look like? Is that at Stanford? Or is that in a clinical setting? And what does the future hold in that sense?
Laurel Braitman
I had no idea what a clinical chaplain was until I started going to the ethics meetings at the Stanford Hospital. And I was so amazed. First, I saw people with a name tag that said spiritual care on it. I was like, what is that I want a name tag like that. That's amazing. They'd have their hospital badge with their security stuff on it. And then they would have a little printed flag that said spiritual care. And I just loved the idea of these people wandering around the hospital tagged spiritual carer. And so I wanted to know what they do. And she's in the book. But Emily Linderman is a chaplain that I met at Stanford who was incredible, was working as an architect actually, left architecture to become a chaplain, and now trains chaplains. And through getting to know her and watching what she did on the wards, and also how she thought about things just really changed me, and I thought was so brave and so interesting, and really helped people, you know, navigate some of the biggest, most challenging moments of their lives, and worked really well with their care teams too. And I just didn't know that was an element of medicine. And so I started my training, but it was right before the pandemic. And it's been on pause, and I can't wait to dive back in, I really would like to do clinical chaplain time. And I would like to have more patient-facing time. I've just started offering workshops for patients and caregivers as a part of a book tour that would make book tours more fun. And I've been working with clinicians for a while now. And I wanted to do something for patients and caregivers. So I think probably I'm a writing chaplain, if such, I am a secular writing chaplain, if such a thing might exist. And I would like to do that anywhere, anyone would have me is the truth.
Emily Silverman
Tell us a bit about what it's like to work with health professionals and medical learners, because in the book, you talk a lot about the achievement-itis that you live with, this way in which every grant every fellowship, every book, every achievement, that did something for you, as you were moving through this story, and I found that really relatable. And I'm assuming a lot of the medical professionals will also find that relatable because as you say, the profession of medicine does tend to magnetize overachievers, and people who sort of use, as you say also in the book, use excellence as an analgesic, which I loved and I also related to. So where are you at with your achievement-itis? What is your relationship to it? And how do you talk to medical students about that?
Laurel Braitman
Great question. You know, first of all, I still have achievement-itis. I just started coming on this podcast. You know, someone asked me recently, like, "Who's this book for?" And I wanted to be like, "Oh, every human on planet Earth." It's just that I think now I have an understanding after doing a lot of the work that's in the book, that I will always be this person. So will you be and there's nothing wrong with that. And that's also why I feel like working in medicine is so comforting. I like our people. I relate to them, and I love them. And I think it's just that what has shifted is the why and what I'm hoping to get out of it. And what I want for the next phase of my life is not that I want to achieve less or do less or chase less shiny prices. It's that I don't want to be motivated by fear and anxiety or the idea that if I get the prize, then it will bring back people that I love, it will prove to myself that I am good, not bad. And I will feel better. That is what I'm trying to change, not the chasing, but the motivation for the chasing and also going into the chasing to knowing that I'm going to be me on the other side just holding a trophy. And I don't think I actually believed that for a long time. I think as you said, I was using it as an analgesic on feelings I didn't want to have. I was using excellence to keep some of the shrieking voices on mute. And eventually that stopped working as I think it does for many of us. All you need is one extra disappointment and all of a sudden, excellence as a coping strategy stops working quite so well. And so I wouldn't wish any crushing disappointments or terrible diagnoses or losses or natural disasters on anybody. But when they come for you, man, you are forced to your knees, and you were forced to develop a new way of getting through because the old ways aren't serving you.
Emily Silverman
So as we come to a close, just to share with the audience, like you invited me I think last year it was to a writing workshop. And it was so Laurel, it was like a writing workshop. And it was on a farm and there was this delicious dinner. And then you said Emily, go teach the students over there by the barn where there is lavender that was freshly picked that is drying in the barn. And so I show up to this barn and it smells amazing. And we're sitting around and chairs and talking and under this giant tree, and I just I loved that so much. And so is that the vision? Is it bringing healthcare workers into nature and having them engaged with their stories? Is this scalable? Should it be scalable? What is your wish for these people and bringing into the future some of the work that you're doing?
Laurel Braitman
Oh, thank you for asking me that. Yeah, of course, it's scalable. Maybe not the lavender, California approach, you know, that might not work in Philly. But the Philly version is possible, right? All that is doing is admitting that these clinical students, or the physician faculty, or the nurses or whoever it is that I'm working with in a given moment, that they are whole people, and that they should be encouraged to be whole people that work too, and that by learning to tell your own story, and to talk about your own most challenging or beautiful or most haunting experiences, you become better at articulating what matters to you. And often that transmits into a clinical context. It can't not. I had someone who was not a physician, I desperately want my physicians to be people. I want them to bring their whole selves into the room. Sometimes it's just like a minute where like, the fourth wall breaks, and you get a humanitarian connection with your healthcare provider where you're just like, Oh, I got it, you know, I got it. There's some smidge of connection that surpasses the clinical, it feels so good. And it doesn't just feel good to the patient. It feels good to the physician too. And I also think it's a way to humanize healthcare, which is deeply inhumane in many ways, certainly in the United States and many other places on both sides, on both sides. I truly believe that unhealthy healers can't heal anybody else. I just believe that heal thyself first. I truly believe that that is not just a cliche. And I think one way to do that is to inject the humanities back into medicine, where they started. Our ancient physicians were artists, they were holy people in much of the world, they still are. And I think the great divide that happened in western medicine a century or two ago now was to our great, great detriment. I don't think the medical humanities should be in a tiny closet inside of medicine. I think they're part of everything. So that's what I would say is that really, it's just making humanity one of the core tenants of medicine on both sides of the desk or the exam table.
Emily Silverman
I think that's a great place to end. I have been speaking with Laurel Braitman about her amazing memoir, What Looks Like Bravery. Thank you so much, Laurel, for being here today.
Laurel Braitman
Thank you so much. You are good medicine.
Emily Silverman
Thanks for listening. This episode of The Nocturnists was produced by me, Emily Silverman and Jon Oliver. Jon also edited and mixed, Rebecca Groves assistant producer. The Nocturnists Executive Producer is Ali Block and our Chief Operating Officer is Rebecca Groves. Our original theme music was composed by Yosef Munro and additional music comes from Blue Dot sessions. The Nocturnists is made possible by the California Medical Association, a physician-led organization that works tirelessly to make sure that the doctor-patient relationship remains at the center of medicine. To learn more about the CMA, visit cmadocs.org. The Nocturnists is also supported with donations from listeners like you. Thank you so much for supporting our work. If you enjoy the show, please help others find us by telling your friends about us, posting your favorite episode on social media, or leaving us a rating and review in your favorite podcast app. To contribute your voice to an upcoming project, or to make a donation, visit our website at the nocturnists.com And specifically, if you're interested in our upcoming series on uncertainty, check out our website. You can sign up to learn more information as that project goes under development. I'm your host, Emily Silverman. See you next week.
Transcript
Note: The Nocturnists is created primarily as a listening experience. The audio contains emotion, emphasis, and soundscapes that are not easily transcribed. We encourage you to listen to the episode if at all possible. Our transcripts are produced using both speech recognition software and human copy editors, and may not be 100% accurate. Thank you for consulting the audio before quoting in print.
Emily Silverman
You're listening to The Nocturnists: Conversations. I'm Emily Silverman. Often we underestimate how a career in medicine impacts not just us, but the people in our lives, our parents, our children, our partners, even our friends. Whether our careers inspire others, or create blockages in our personal lives or sometimes a mix of the two, the rigors of the health profession touch many more people than just those working inside of it. Today's guest isn't a physician, but her father was and her relationship with him inspired her to pursue a career helping clinicians find their voice. Her name is Laurel Braitman and she's a writer, teacher, secular clinical chaplain in training, and author of the recent memoir, What Looks Like Bravery: An Epic Journey Through Loss to Love, which we'll be talking about on today's episode. In addition to her memoir, Laurel is the author of New York Times bestselling book Animal Madness, which examines how animals, just like humans, have feelings. Laurel has a doctorate in history and anthropology from MIT, and has helped numerous students, staff and clinicians tell their stories in her role as the Director of Writing and Storytelling at the Stanford University School of Medicine. In my conversation with Laurel, we talk about what it was like to grow up with a father who was a surgeon, and who spent many years suffering with terminal cancer. Laurel talks about how his legacy impacted her emotionally and professionally, why she decided to become a secular chaplain, and why she feels that there's a very thin line between the clinical and the spiritual. But before we go on, let's hear Laurel read an excerpt from her memoir, What Looks Like Bravery. Here's Laurel.
Laurel Braitman
Prologue: Santa Paula California, September 1994
It was a warm Saturday afternoon and the Santa Ana winds ruffled the tops of the avocado trees. I was at home with two good friends, all of us 16 years old, draped like hormonal Dali clocks over the living room furniture while we watch The Bodyguard on VHS and painted our nails.
No one was surprised when I knocked over one of the bottles. I paused the movie and went into my parents’ bathroom to get the nail polish remover Mom kept under the sink. I glanced at myself in the mirror. Disappointed as usual, by my wild hair, tight cheeks, and how little I looked like someone Kevin Costner might want to carry to safety. Kneeling down and reaching into the cabinet, I pushed aside the bottles of rubbing alcohol that dad used to clean the stump on his amputated leg and the tray of stainless scissors he had brought home from his job at the hospital. I was moving a multipack of Dove soap when I saw it– a small plastic pill bottle. It was strange, not labeled like everything else in the cabinet. It didn't look like the transparent orange prescription bottles that came from the pharmacy either. My body sensed danger before my mind did. Something clenched in my chest; my pulse started to throb in my face.
There was a handwritten note rubber banded around the bottle. I unrolled it carefully.
"No one should have to do this for a friend," it read. "But here you go."
My throat went hot and dry as the winds outside. I steadied myself on the cabinet door. It hit me. Dad had a suicide plan. And he kept it in the bathroom like a box of Q-tips or Mom's Velcro rollers. Underneath the message was the name of a drug and dosage instructions written out longhand.
I had no idea how long the bottle had been there, or when he was going to use it. But I knew I couldn't ask. I could tell no one about this, not even mom or Jake, not ever. I understood without being told that I wasn't supposed to know dad had a plan or that anyone had helped him or that this was barreling towards us like a car whose brakes had gone out. I let myself feel my pounding terror for just a few more seconds. And then I rewound the note and put the bottle back exactly where it had been. Standing up, I took a long breath, summoning every bit of power I had, and shoved my fear and panic down as hard as I could– burying them so deeply that for the longest time, I thought they were dead and gone. Only you can't kill feelings. Just like bad boyfriends or lost cats, they tend to come back when you least expect it.
Emily Silverman
I am so thrilled to be here speaking with Laurel Braitman. Laurel, thank you for being here.
Laurel Braitman
It's such an honor.
Emily Silverman
So, Laurel, we've known each other for a few years. And I've always loved you and your work, particularly the work that you do at Stanford School of Medicine, helping medical students and other health professionals with their stories and their writing. But I never really knew why you did that work. And I'd always been curious. So what a gift to be able to read this book and learn more about your family and your story. And I just really enjoyed it. So thank you for writing it.
Laurel Braitman
Thank you for reading it. And for having me here.
Emily Silverman
Maybe let's begin talking about your parents, because they're such great characters in this memoir. And in the book, you say that your parents actually grew up city people. So your dad grew up in downtown Baltimore, not far from Johns Hopkins, which is where he went to med school, also where I went to med school. And your mom was the daughter of an optometrist in Beverly Hills. And yet these urban people marry each other and move to this ranch in California, where they're taking care of trees and donkeys and bees and their fishing. And I'm just wondering, where do you think that came from, this desire to live a more rural life?
Laurel Braitman
I think it was their version of rebelling in some way, against the structures that contain them, either consciously or not. And I think they were seeking a kind of freedom in the landscape and a lack of oversight. And also, they were just deeply curious people who like to learn new skills. And there's nothing like becoming a farmer or buying a dilapidated farm and trying to rehab it to teach you how little you actually know. And they also both loved the natural world and found so much joy in it, and solace, particularly as things got harder in their lives, that I think it was a natural fit than wanting to really just try something new. They approached it as just a big adventure, at least at first.
Emily Silverman
And this is where you grew up. You come of age, in this beautiful, picturesque ranch. What was it like to grow up there?
Laurel Braitman
Oh, it was magical. You know, it's actually where I'm talking to you from now. And it remains magical, although now I have responsibilities here. So as with most parts of adulthood, you know, it's great, and also mildly disappointing. But it's still beautiful. And it was an incredible place to be, you know, I had such freedom. I had such safety, I could take risks in a way that I think if I was in an urban place might have looked really different. And I developed a confidence outside by myself at a really young age that I think comes with growing up in a wild place.
Emily Silverman
What kind of risks, like physical risks or other types?
Laurel Braitman
Oh, definitely physical risks. I'd leave the house in the morning, my mom would tie up a little sandwich for me and a bandana and tie it around the end of the stick. And I would go forth, I was just an avid reader. And so many of the kids in books that I loved did the same thing. And so I would leave, there was no worries about me, I certainly could have fallen into the creek and drowned. Or I could have been eaten by a mountain lion. But my parents didn't really worry about things like that. They worried about other stuff. My brother too, you know, we both had just such incredible freedom, physically, that we could disappear for hours, and we weren't worried about people being worried about us. And there was just such peace and freedom and that for me, and also I had to teach myself how not to be bored, which is a gift I'm really grateful for.
Emily Silverman
And your dad was a surgeon. So I'm curious about a couple of things. One, how was he able to toggle between this outdoor rural lifestyle and then the hospital getting himself back and forth alone? The commute? I'm thinking like, how did that work? And then second, tell us a little bit about your relationship with him growing up because you say in the book that you were very close and that you were each other's becoming. So tell us more about your dad.
Laurel Braitman
Well, oh my god. I mean, I needed 100,000 words to tell the world about my dad is the truth. He was a cardiothoracic surgeon, and he was rabidly interested in so many different things, including me, which was the gift of my life to be loved like that and also if anyone out there who has been loved by a parent deeply bent on achievement, you know, it can be its own burden. We fought a lot. He's the only person I know who's as stubborn as me. And I know he felt the same way about me. And so we were really close. But we were also really similar and often risked burning each other alive with the intensity of our feelings and passions and opinions. And he really pushed me for better or worse, in terms of how he balanced his life as a rancher, and as a surgeon, I would say he didn't do anything else. And he wasn't in an academic teaching hospital. The ranch is about an hour and a half from LA, but it feels like it's in another solar system. So his commute to work was only 15 minutes. He worked at first at the county hospital, and then a private hospital here in town, but it's a pretty small town, with a bunch of his mentors from Hopkins. And then he did his residency at UCLA, and then a fellowship in New York for surgery. And a lot of those mentors I found out much later, really wanted him to stay in these big academic medical centers, but he wanted to get out and he could be cantankerous, and now that I've met other cardiac surgeons, I realized that's the type. But growing up, I thought it was only me and my dad. He was deeply committed to what he believed was right. And sometimes that wasn't what his administrators or other people at the hospital thought was right. And so he was always kind of getting into arguments and such. And I think, being in a smaller town and having time out on the ranch, I think it gave him a kind of agency and, again, freedom that he really craved and would have had to trade if he stayed in New York City or UCLA, and he wouldn't have been able to live soberly.
Emily Silverman
You mentioned your dad's stubbornness. And that definitely shines through in his character and also, as he's grappling with his diagnosis of bone cancer, and you talk about how persistent he was in trying to heal himself. And you talk about how he ordered his own scans in the beginning. And then later, he persuades a friend of his, a surgeon, to do an operation on him that the surgeon is sort of ambivalent about doing but he does it anyway, because he's a good friend. So what was it like to watch your dad fiercely fighting for his life in that way?
Laurel Braitman
Oh, I mean, it was lessons that I practice every day, you know, just so your listeners understand. When I was three, my dad was diagnosed with osteosarcoma, which is an aggressive bone cancer, he was a little bit older than the norm. He was 42. And I was three and a half. My brother wasn't born yet. My mom found out while they were away at the Mayo Clinic, for his leg amputation that she was pregnant with my brother. They owed money on the ranch, they had his medical school loans to pay off. Still, they were just starting out in their careers as ranchers. And also he really was brand new, as a heart surgeon. So it was like a big scary piano falling out of the sky and on top of us. And his initial prognosis was very, very short. It turned out he had mets in his lungs. And particularly in the early 1980s, when this was happening, that was a death sentence. Chemo for bone cancer was still really new, really toxic. And so we were basically told to say goodbye to him, he was told to get his affairs in order. And then as you say, he didn't die. The opposite was true. He ended up pursuing very aggressive treatment, to basically trade parts of himself for time with us in the end. And so yeah, he flew around everywhere, he begged friends to help him, he did a lot of experimental protocols. And that was that stubbornness that we were talking about earlier. He was also lucky, he'd be the first person to tell you that. He had mets that were excisable, he did respond on a couple of different occasions to the new chemotherapeutics. And so he bought himself time: he was lucky, he was privileged, he could get consults for free, people would pick up his phone calls because he was a physician. So it was also kind of another time in medicine. I'm not sure you'd be able to do that today in quite the same way.
Emily Silverman
As I was reading the story of him doing all of this, you know, I definitely felt admiration for his persistence. But you and I have also talked about this other theme, which is so common among doctors, and arguably, especially among surgeons, which is this inability to express needs or be open about vulnerability and things like that. And so I'm wondering, did you see that in him? And what are your thoughts on that part of it? Because it's just so common among medical professionals to deny that part of themselves?
Laurel Braitman
Oh, yeah. I mean, if I had to explain in one line of why I work with healthcare professionals now it would be this. I have seen firsthand the cost of invulnerability on a personal and a familial and even a professional level. And I wouldn't wish that on anyone. I think you exist and many of your listeners and my students and colleagues in a world in which vulnerability is punished and you've done so much wonderful work on The Nocturnists to talk about these things. Shame in Medicine goes hand in hand in that right? If you are in a field in which vulnerability can actually be punished financially, when it can have ramifications for your career, there's such a disincentive to be vulnerable and how are you supposed to be one way at home and another way at work? My father was kind of a Jewish ranchy marlboro man. It's a small venn diagram of people, but that's who he was. And I think, in one way, his illness set him free, a little bit like, I'm not sure if he hadn't received a terminal diagnosis again, and again, sequentially for many, many years, if he would have been as forthcoming with his feelings with my mom, my brother, and I. I think he wasn't someone that expressing his smushy side came easily to and I think it embarrassed him a bit, but knowing that he was dying, lit a flame beneath him to say the things that he really wanted to say, and that he knew we needed to know to exist and thrive without him. So I think I would never say that there is a silver lining to terminal or chronic illness, I wouldn't I think we have way too much pressure on us in American culture to do those things. But I will say that an unintended consequence of his disease was that it set him free to communicate in a way that I really don't think he would have otherwise.
Emily Silverman
I'm remembering a scene in the book where you're sitting with him in the car, I think, and you ask him, "What are we supposed to do when you die, when you're gone?" And he says, "Have a party." And obviously, there was a part of that that's beautiful, like to think of things as a celebration of life and you know, not dwelling on the tragedy and remembering the good times and things like that. But I think you're right, this shying away maybe from the sadness of that reality. And you know, I'm a parent, I just had a baby a little over a year ago, and been thinking a lot about the unique way in which I will screw up my kid. And just, you know, reading your book, obviously thinking about how our stuff, our personality that transmits to the next generation. And there's a part of your book, where I think a friend asks you to describe what you're feeling. And you say, it's like a lake, the lake is both inside me and outside me, it feels like I can't even dip my toe into the lake, or I'll drown. I think the lake might be sadness. But it's confusing, because I don't actually feel sad. And so I'm wondering, do you think that lake metaphor is representing something you inherited from him? And what does it feel like to be in that space?
Laurel Braitman
Yeah, I mean, I can say with certainty, now that I've gone swimming in the lake and lived to tell the tale. It didn't kill me, I didn't drown. But I did spend decades worried about it, we inherit so many beautiful and painful things from our parents, as you're talking about. And one of the things that I inherited was my dad's conviction that you are privileged, you are blessed, you are lucky, even though this terrible thing is happening. You have so much, you have so much more than other kids your age, you don't have to worry about where the next meal is coming from, you're going to be able to go to college, I'm encouraging you to follow your dreams, you don't have to worry about having a roof over your head. That was the family message was basically nothing to see here. We are excellent, keep going. And I internalized that deeply. And he wasn't wrong. I am insanely privileged. It's just that privilege doesn't protect you from pain. And I lived for so long feeling that way that if I admitted how much I was suffering, that it was somehow a betrayal of him or myself, and that I had no right to hurt, because look at all these other nice things. And that worked for a very long time well into my 30s. That worked. And then as I discussed in the book, more and other losses piled up on top of the loss of him. And it got to a point where I was forced to look at these feelings that I had been running from basically since childhood and try and figure them out. And the person that really pushed me to do that is that friend, she was actually my girlfriend at the time – Connie Hockaday. And I owe her just so much because she would ask me how I was and when I said fine, she refused to fall for it. And she really pushed me and I was in my mid 30s and I couldn't answer honestly, when someone asked me how I was. And that was kind of shocking. So I had to do some real work at a time where from the outside, I think people thought I was killing it. But I couldn't tell my girlfriend why I felt bad. Something that simple.
Emily Silverman
I love the part of the book where you're listening to This American Life. And you hear a story about The Sharing Place, which is a place I believe, where kids go to process grief. And you find a local version of this called Josie's Place and you cold call them. And you end up meeting this woman named Pat and asking if you can attend her program. And she's like, "Sure, you can attend as a facilitator" and you're like, "No, can I attend as a child?" And you do end up attending as a facilitator, but tell us a little bit about Josie's Place and what you learned from those kids.
Laurel Braitman
Oh, my gosh, we need so many hours. I will tell you this, the training to be a great facilitator for kids at Josie's Place changed my whole life. I think that so often we write off children, and particularly adolescents and teenagers because their feelings can be so big, or change so quickly, I truly don't think we take their wisdom as seriously as we should. So what happened was, yes, I begged Pat Murphy, who is the founder and director of Josie's Place, to take me on as a kid. And she definitely thought it was creepy, but she didn't want to offend me, I think. And she told me that I could be a facilitator. And not only that, but that most of the facilitators had had losses as kids, so that I'd be in good company. So that's what I did. And the things that I learned from these kids was part of the title of the book, I learned bravery and courage from these kids, because they were facing the things that I had spent so long running from, and they were getting the kind of support in their lives, that was a container to help them face these things, so that they weren't burying it, and then would end up running from relationships once they hit midlife. So I learned things like the worst thing that you can do when you're sad is try not to be sad. And that was from a young girl whose mom had just died, I believe of colon cancer. There were so many lessons for me, that I think really all tie back to the fact that you can face that which hurts you. And it doesn't mean you'll be stuck there forever. In fact, the only way to new and different feelings is to let the ones you're scared of in, to let yourself feel them. And for a lot of these kids, you know, they didn't have as much choice. And they were getting a different narrative through places like Josie's Place about how to process or think through or play through for the most part, you know, a lot of kids and adults frankly, can't verbalize their negative feelings. And so when someone like when my girlfriend was asking me, "How do you feel?" I didn't have words for it. And that's a real common childhood experience. You can't verbalize it. You can't make a narrative around it. So what do you do, you play tag, you build the pillow fort, but you do it along with other kids who have suffered a really big loss, so you don't feel alone while you're doing it. So some of it wasn't a profound kind of intellectual lesson. It was really just being around a whole passel of other people who'd had a similar life experience, and being able to laugh and play and cry and argue and wrestle, you know, it was just kind of a normalizer. And I think that in itself is really good medicine.
Emily Silverman
I want to stay with this for a moment, just because it was really one of my favorite parts of the book. Like how, when the kids are going through this grief process, play is their work. And you talk about something called the volcano room where they go, you also talk about a room that is set up like a hospital room with a hospital bed and IVs and the kids are able to go in there and roleplay a bit. Can you bring us kind of into the almost magical realism of these roleplay exercises in games that the kids play because I just think that's so fascinating.
Laurel Braitman
One of the most incredible things I learned from grief therapists and facilitators and volunteers that work with kids going through a loss is how incredibly healing and medicinal frankly imaginative play is. You're describing a place called the Dougy center which is actually in Portland, Oregon, and it's kind of a mothership for kid grief support around the world. I cannot say enough wonderful things about this place. And inside the Dougy center, they have a room that is the exact replica of a hospital room, and it is incredible. There is even a curtain on the little ball bearing strip that is the sound of hospitals. There is a tiny X-ray machine. There's X-rays of things like turtles and fish. There are tiny doctor's hats. There's tiny doctor's coats, there's tiny stethoscopes, there is equipment painted on the wall. There's a tiny IV stands and for the parents, this is what the directors of the Dougy center told me when they were walking around on the tour. Parents opened the door to this room, and they're just like, eek and they immediately don't want to go in. Yeah, it's scary, it looks scary. And the kids, they opened the door to this room, the kids just rush in, it's one of the kids favorite rooms in the entire center. And that's because they go in there. And it gives them ultimate power. Usually, in a context, they had no power whatsoever. Many of these kids had to say their final goodbyes to a parent inside of a hospital room. They have memories of being in a hospital room, they have their own feelings about it, they were kept at arm's length, or maybe they were allowed to crawl into a hospital bed. But it was such an alienating, alienating and foreign experience for them to be in the hospital room. And here in the Dougy center that is full of love and joy, and they are protected and safe. They run in there, and they make up their own stories. So often kids will do things like imagine wings, and fly back to the scene of an accident and have a conversation with someone that they love that they weren't able to have. Or they will come into the hospital room and they will pretend help someone in the hospital bed, either imagined or real from their life. But really, they use their imagination to go back in time, and rewrite the endings into things they wish they'd been given in real life. And so it's a way to use imagination as a form of time travel, or as a pen to go back in and change the stories they were given for the better and to give themselves power in a situation where they didn't have it. And that's just an incredibly profound thing.
Emily Silverman
You talked about how you went swimming in the lake of your sadness. And that's part of the arc of the book is you diving in, I guess we could say. And you've also talked about how your path leads you toward this chaplain program. And you're filling out the application. And it's like, Are you a priest? Are you a rabbi or you know, and you're like, I'm not any of these things. But you do have a handful of really profound spiritual experiences as part of this swimming in the lake journey. One of them which I thought was so funny and cool was the experience of going and visiting with this psychic medium who gives you advice and who seems kind of legit in the book. And then there's another part where you go on this retreat where you're fasting for days and going out into the wilderness. And in that state, there's these hallucinations that come in messages that comment so profoundly spiritual experiences? Where are you settling out in your spirituality? And how are you planning to bring that into your job, or your work as a chaplain for people and families who are suffering with illness?
Laurel Braitman
You're the first person to ask me about this. And I'm profoundly nervous about that. We both inhabit very clinical qualitative, quantitative spaces. And the idea of Deans of the Stanford Medical School, this reading about my visions of the afterlife, is something that does keep me up at night, I am not gonna lie. I'm like, will I have a professorship tomorrow? But I felt like I needed to share it just like I needed to share it with you. It didn't feel separate from the research I was doing for this book, it didn't feel like any of the reporting that I've done over my career as primarily a popular science and medicine writer. I am a deeply skeptical person. And so the fact that these experiences happened to me, it's really interesting. I have a doctorate from MIT. I mean, I'm not an engineer. But definitely I am someone with a healthy dose of skepticism, and I am an evidence-based person. So when I have had spiritual experiences in my life, and certainly, up until recently, I kind of tamped them down. And then what I realized through the course of living through the years of writing this book, and also then writing this book, and having to process some of these experiences to make meaning for others, is that I realized, if only there was a firm dividing line between the research and the spiritual, and there just really isn't, and I just didn't want to keep pretending that there was, is the truth. And I feel like the best physicians, for example, have always been spiritual. They may be secular, they may not be forcing their beliefs on a patient or a colleague. But certainly, they approach the art of medicine and it is truly an art with a spirituality of purpose, basically, that you approach your work with meaning, you know that it's bigger than you, that you know that your patient represents more than just themselves. While they are also an individual, you are engaged in a project that began long before you and will outlast you. So I think to say that this is separate than my work with clinicians. I just don't think it's true. So I want to make that clear. I think that I've been probably a secular chaplain for a long time now. When I think about my teaching, the workshops I lead, the kind of work I do with healthcare professionals, it's absolutely spiritual. It's helping other people reconnect with their meaning, why they do what they do, particularly when things get hard, and to process their most difficult life experiences in a way that make them either lighter to carry or at least help them bring lessons from those experiences that they can use to help others. And I think that to me is what chaplaincy means. I've just been doing it as a professor of anesthesia. I'm not an anesthesiologist, just happens to be where my appointment is at the medical school. But I would say we like to think there's divisions between these things, and I really don't think there are.
Emily Silverman
So what is a chaplain, you talked about the work that you do leading writing workshops and storytelling workshops for health professionals, but will there be a component of your work where you are more patient facing and helping patients and families? And if so what does that look like? Is that at Stanford? Or is that in a clinical setting? And what does the future hold in that sense?
Laurel Braitman
I had no idea what a clinical chaplain was until I started going to the ethics meetings at the Stanford Hospital. And I was so amazed. First, I saw people with a name tag that said spiritual care on it. I was like, what is that I want a name tag like that. That's amazing. They'd have their hospital badge with their security stuff on it. And then they would have a little printed flag that said spiritual care. And I just loved the idea of these people wandering around the hospital tagged spiritual carer. And so I wanted to know what they do. And she's in the book. But Emily Linderman is a chaplain that I met at Stanford who was incredible, was working as an architect actually, left architecture to become a chaplain, and now trains chaplains. And through getting to know her and watching what she did on the wards, and also how she thought about things just really changed me, and I thought was so brave and so interesting, and really helped people, you know, navigate some of the biggest, most challenging moments of their lives, and worked really well with their care teams too. And I just didn't know that was an element of medicine. And so I started my training, but it was right before the pandemic. And it's been on pause, and I can't wait to dive back in, I really would like to do clinical chaplain time. And I would like to have more patient-facing time. I've just started offering workshops for patients and caregivers as a part of a book tour that would make book tours more fun. And I've been working with clinicians for a while now. And I wanted to do something for patients and caregivers. So I think probably I'm a writing chaplain, if such, I am a secular writing chaplain, if such a thing might exist. And I would like to do that anywhere, anyone would have me is the truth.
Emily Silverman
Tell us a bit about what it's like to work with health professionals and medical learners, because in the book, you talk a lot about the achievement-itis that you live with, this way in which every grant every fellowship, every book, every achievement, that did something for you, as you were moving through this story, and I found that really relatable. And I'm assuming a lot of the medical professionals will also find that relatable because as you say, the profession of medicine does tend to magnetize overachievers, and people who sort of use, as you say also in the book, use excellence as an analgesic, which I loved and I also related to. So where are you at with your achievement-itis? What is your relationship to it? And how do you talk to medical students about that?
Laurel Braitman
Great question. You know, first of all, I still have achievement-itis. I just started coming on this podcast. You know, someone asked me recently, like, "Who's this book for?" And I wanted to be like, "Oh, every human on planet Earth." It's just that I think now I have an understanding after doing a lot of the work that's in the book, that I will always be this person. So will you be and there's nothing wrong with that. And that's also why I feel like working in medicine is so comforting. I like our people. I relate to them, and I love them. And I think it's just that what has shifted is the why and what I'm hoping to get out of it. And what I want for the next phase of my life is not that I want to achieve less or do less or chase less shiny prices. It's that I don't want to be motivated by fear and anxiety or the idea that if I get the prize, then it will bring back people that I love, it will prove to myself that I am good, not bad. And I will feel better. That is what I'm trying to change, not the chasing, but the motivation for the chasing and also going into the chasing to knowing that I'm going to be me on the other side just holding a trophy. And I don't think I actually believed that for a long time. I think as you said, I was using it as an analgesic on feelings I didn't want to have. I was using excellence to keep some of the shrieking voices on mute. And eventually that stopped working as I think it does for many of us. All you need is one extra disappointment and all of a sudden, excellence as a coping strategy stops working quite so well. And so I wouldn't wish any crushing disappointments or terrible diagnoses or losses or natural disasters on anybody. But when they come for you, man, you are forced to your knees, and you were forced to develop a new way of getting through because the old ways aren't serving you.
Emily Silverman
So as we come to a close, just to share with the audience, like you invited me I think last year it was to a writing workshop. And it was so Laurel, it was like a writing workshop. And it was on a farm and there was this delicious dinner. And then you said Emily, go teach the students over there by the barn where there is lavender that was freshly picked that is drying in the barn. And so I show up to this barn and it smells amazing. And we're sitting around and chairs and talking and under this giant tree, and I just I loved that so much. And so is that the vision? Is it bringing healthcare workers into nature and having them engaged with their stories? Is this scalable? Should it be scalable? What is your wish for these people and bringing into the future some of the work that you're doing?
Laurel Braitman
Oh, thank you for asking me that. Yeah, of course, it's scalable. Maybe not the lavender, California approach, you know, that might not work in Philly. But the Philly version is possible, right? All that is doing is admitting that these clinical students, or the physician faculty, or the nurses or whoever it is that I'm working with in a given moment, that they are whole people, and that they should be encouraged to be whole people that work too, and that by learning to tell your own story, and to talk about your own most challenging or beautiful or most haunting experiences, you become better at articulating what matters to you. And often that transmits into a clinical context. It can't not. I had someone who was not a physician, I desperately want my physicians to be people. I want them to bring their whole selves into the room. Sometimes it's just like a minute where like, the fourth wall breaks, and you get a humanitarian connection with your healthcare provider where you're just like, Oh, I got it, you know, I got it. There's some smidge of connection that surpasses the clinical, it feels so good. And it doesn't just feel good to the patient. It feels good to the physician too. And I also think it's a way to humanize healthcare, which is deeply inhumane in many ways, certainly in the United States and many other places on both sides, on both sides. I truly believe that unhealthy healers can't heal anybody else. I just believe that heal thyself first. I truly believe that that is not just a cliche. And I think one way to do that is to inject the humanities back into medicine, where they started. Our ancient physicians were artists, they were holy people in much of the world, they still are. And I think the great divide that happened in western medicine a century or two ago now was to our great, great detriment. I don't think the medical humanities should be in a tiny closet inside of medicine. I think they're part of everything. So that's what I would say is that really, it's just making humanity one of the core tenants of medicine on both sides of the desk or the exam table.
Emily Silverman
I think that's a great place to end. I have been speaking with Laurel Braitman about her amazing memoir, What Looks Like Bravery. Thank you so much, Laurel, for being here today.
Laurel Braitman
Thank you so much. You are good medicine.
Emily Silverman
Thanks for listening. This episode of The Nocturnists was produced by me, Emily Silverman and Jon Oliver. Jon also edited and mixed, Rebecca Groves assistant producer. The Nocturnists Executive Producer is Ali Block and our Chief Operating Officer is Rebecca Groves. Our original theme music was composed by Yosef Munro and additional music comes from Blue Dot sessions. The Nocturnists is made possible by the California Medical Association, a physician-led organization that works tirelessly to make sure that the doctor-patient relationship remains at the center of medicine. To learn more about the CMA, visit cmadocs.org. The Nocturnists is also supported with donations from listeners like you. Thank you so much for supporting our work. If you enjoy the show, please help others find us by telling your friends about us, posting your favorite episode on social media, or leaving us a rating and review in your favorite podcast app. To contribute your voice to an upcoming project, or to make a donation, visit our website at the nocturnists.com And specifically, if you're interested in our upcoming series on uncertainty, check out our website. You can sign up to learn more information as that project goes under development. I'm your host, Emily Silverman. See you next week.
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