Lori is here today with a chief complaint of dizziness and headache. At least that’s what my medical assistant tells me. But after practicing family medicine for almost twenty years, I’ve learned that there’s usually more to the story.
I recognize the expectation to match the story and physical exam to a reasonable diagnosis, especially one that the patient can trust. All in 20 minutes. No pressure at all!
As I braid the threads of Lori’s tale with her answers to my questions about her symptoms’ OPQRST (onset, provocation, quality, region, severity, and time), the tapestry of her suffering feels incomplete. I sense that there is something more. We investigate some possible causes, and I learn that stress and sleep deprivation may be contributing to her symptoms.
But rather than focusing on her pain, I’m inspired to try a different approach. Curious about Lori’s stress and sleep deprivation, I learn that she desires to go back to graduate school. After years of dedication to a partner, children, and grandchildren, she yearns to fulfill her own dream.
Something inside me opens more fully to the grace, meaningfulness, and dimensionality of Lori. With humility, I hold this iconic moment with such reverence that tears begin to fall. Lori is not reducible to her chief complaint or to the diagnoses I am about to type into her medical chart for this visit.
I wonder what else there is to create/discover with other patients, beyond their chief complaints and official diagnoses.
The next day, I sit in meditation and become aware of some uncomfortable physical sensations. My mind races in search of possible causes and fixates on possible diagnoses. But I relax back into my seat and the soulmaking dharma paradigm. Born of somatic sensations and a fullness of intention, an image of wind chimes appears. These words soon follow:
When the wind of anxiety is strong
Let the breath smooth its intensity
Sounding the chimes of care within
What feels like pain becomes a song
Vibrations shaping new landscapes
Dimensions of dukkha beyond diagnoses
Tell me, who are you now?
We are more than symptoms and sensations, more than what gets documented in the electronic medical record or even in the stories we tell. May tender exploration of inner landscapes allow us to see and sense self, other, and the world with soul.
Palo Alto, California