Episode 1 – Seeing the Patient Before the Disease with Nurse Connie Kishbaugh

Former nurse Connie Kishbaugh understands the importance of seeing patients as whole people. Connie shares her insights into this aspect of patient care in an interview with Dr Jan Bonhoeffer.

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Transcript

Jan: Thank you Connie, thank you for meeting today.
Connie: Oh, I’m so grateful for you asking.

Jan: Lovely to see you. We haven’t seen us for, what is it, more than half a year now is it?
Connie: Yeah, it’s been quite a while. It was last August. No, it was earlier than that. April, maybe.

Jan: Time flew. And the last time we spoke, it’s still very vivid to me, what we talked about, and the stories you shared.
Connie: For me as well.

Jan: Thanks for joining today. I wanted to just touch base with you again because your story is so amazing.
Connie: Thank you.

Jan: The heart lived life that you live is so inspirational to me, and so I’m very grateful that we have a chance to talk together and maybe share some of this with the Heart-Based Medicine community.

Connie: I would like that very much.
Jan: Connie, so many things that you’ve done in your life. You worked as a nurse.

Connie: Mm-hmm (affirmative).
Jan: I wonder if you could tell me what your experience was when you were a trainee, a nurse trainee, when you started all of this.

Connie: When I first began my nursing training, I was in a college program, and we did team care for the day that we were on the floor doing our clinical practices. My very first patient, my role in the team that day was to be the information gatherer, and my very first patient was a woman in her early 50s with the diagnosis of pancreatic cancer, and she was about to have a surgical procedure the next day. So I went to the library and looked up pancreatic cancer and the Whipple surgical procedure, and from that moment on, I was hooked.

Connie: This disease, cancer, which is not one disease at all but over 300 different types of diseases, was just so fascinating to me, and it was just so intellectually stimulating to dive into the depth of complexity that lies within this diagnosis. So if there was any chance at all to work with a cancer patient during my whole training process, I took that opportunity. I asked for those patients to be assigned to me. That was my first position.

Connie: After I was licensed and working, my first position was on a unit that had all private rooms, and we had a number of cancer patients who were bedded there because we were doing radiation implants at the time and they couldn’t be in the other rooms. And the surgical oncologist liked the rooms, and the hematologist liked the rooms because they could have their leukemia and blood disorder patients in a private setting, and so they would be isolated, as [inaudible] isolation was doing then.
Connie: And so of course I asked every day to be assigned to the cancer patients, and it just grew from there. I have to admit that I have worked with the most magnificent physicians throughout the course of my career, and particularly in my very first position, I used to make rounds when they made rounds when the physicians and interns and residents made rounds, and fellows, I would go along with them to patients’ rooms.

Connie: And the physician noticed my interest, and he brought me, in America, the American Cancer Society puts out this huge big volume, and it’s called the Cancer Book, and it was bigger than a normal book, bigger than a classroom book, and he said, “Here, I want you to read this.” And [inaudible 00:05:12], okay. It took me about two weeks to get through the book. But then on rounds he would ask me questions, like include me in the questions and expect me to have answers ready. His acknowledgement of my interest in his training and taking me under his wings was just an incredible experience.

Jan: Beautiful. This is so important. And probably from your input and from your perspective on the patient, coming from the nursing training, in addition to just who you are, but with this additional piece of shaping, you could actually complement his knowledge and his perspective, so together you could actually provide more value for the patient.

Connie: Yes we could, because I could bring to it the emotional aspect, what the patient was going through, what the family was experiencing, what their fears and their hopes were, so that there was more than just the physical focus on the physical issue. The patient was seen as a whole.

Jan: That is so important to patients.
Connie: So important. It’s so much of what you’re doing, exactly.

Jan: So to what degree, if you look back at all the fantastic physicians that you had the opportunity to work with and all the knowledge that you could acquire in the world, and through all the things that you learned in your training and in your experience, if you look back at your professional life, what would you see as the most important part of healthcare?

Connie: I think the most important part of healthcare, and this does not diminish at all the physician’s knowledge, but the most important part of healthcare and the piece that goes beyond that and gives the patient, how to say this, gives the patient the sense that they are seen and that they are heard and that they are cared for, not just as a body in need but as a whole being, and I think that is the most important part, because that heals the spirit, which allows the body to heal.

Jan: I couldn’t agree more. If I listen as a physician to what you’re saying, I would say, “Hang on a minute. I took the patient’s history, I listened to the patient, and I asked at least two dozen questions, and so I know everything about the patient. And yeah, maybe I didn’t ask about their brothers and sisters so much, but the core thing, the diagnosis and the disease and the problems they have and the presenting complaint and all the good things in their medical history, I know everything about them. I did listen to the patient a lot.” If I was the prototype physician, and I’m sure you’ve seen many of me like that, what would be your advice? What did I miss? Where did I actually not listen?

Connie: I think I would ask you if you, when you were talking with the patient and asking all these questions, were you really looking at the patient? Were you maintaining eye contact? Were you really feeling into what this patient was telling you, and were you asking more than just the physical information or the disease related information? Do you know if this patient has support at home? Is his family involved in his care? What are his hopes? What are his fears? What can you do to make it better?

Jan: If this was a role play here and I was to say, “Yeah, thank you, nurse. But I’m the doctor, I need to take care of the disease, and that’s your thing,” would you agree with me?

Connie: I don’t agree with you. No, I would not agree with you, I wouldn’t. I’m not a very confrontive person, so I would find some way to let him know how much his demonstrating his caring for the patient would help in the patient’s ability to tolerate the treatment, in their ability to follow directions, in their willingness to do the many, many things that we ask of them.

Jan: That’s interesting. So as a nurse, you know the situation where the physician had an interaction with the patient, and then you’re still in the room, or then you come into the room and the doctor is already busy, rushing away, and you’re left with them. Can you share some of these moments? What were those moments where you felt like something was missing, and that’s where the physicians could have done so much better?

Connie: One thing that I always do is have physical contact with the patient. I’ll either have a hand on his arm or hand or shoulder, if they’re lying on the table, but just have physical contact with the patient. Hold eye contact. Really listen. Just hold him in my heart and in my space and feel him, and feel the family members that are in the room as well, and always ask the question, do they feel that they heard everything that they had to hear from the physician? Was there anything else that I could tell them, or was there something that he said that they didn’t understand? Is there something that I could clarify for them?

Jan: Could you pinpoint when you kind of, time warp back, when you use your time machine I guess and you just flip back through all the memories and the situations, is there a typical situation, or is there the one typical thing where you felt like this is always missing, this is always where kind of patient and physician miss each other?

Connie: When it became abundantly clear to me was when we began electronic medical records, and there was a computer in every single patient room. For whatever reason, I don’t know, the computers were always situated for the physicians to be on the computer, his back had to be to the patient. So he may turn his head to ask the question, but turn right back while the answer was being given. So there was actually no sense from the patient side that the physician had heard them, just that he was typing.

Connie: And of course the patient doesn’t know what he’s typing, whether it’s accurate, or if he’s being heard. So there was that disconnect. There was brief eye contact to ask the question, and then back with your back to the patient to enter the information. And so that’s when the disconnect became even greater than it had been in the past with the physician being in a hurry and asking the questions and leaving the room quickly. But that was when it really was just so clear to me.

Connie: And right about that time was when I was feeling within myself and within my own medical practice, what I was doing as a medical practitioner, that I wasn’t doing enough to support the patient spiritually, or in any way other than physically, because most of my interactions involved some kind of invasive procedure. It was either drawing blood or giving a shot, or just doing something. And when you feel as ill as cancer patients feel, even taking a blood pressure is invasive because a cuff hurts when your body hurts [inaudible] hurts. So I started looking for ways that I could interact with the patient that weren’t invasive but that would give them a greater sense of being cared for in a different way.

Jan: Tell us about that journey. That’s such an amazing work that you then pursued.

Connie: I learned from my teacher, Arjuna Ardagh, this ancient, ancient practice of heart meditation, and I began to go into the space of heart meditation whenever I would enter the exam room with the patient and the physician, and not from anything that I was doing or any force I was putting out or anything, it was just that the heart space was opened in the room, and the communication between the patient and the physician changed. I mean, the physician was attuned to what the patient was saying, and the patient felt heard and didn’t have fears about asking questions that they might in the past they felt the doctor didn’t have time for, because that was what was being presented to them all along. But now they felt they could talk about their fears, their worries, their hopes, and seeing that just emboldened me to do it even more.

Jan: Amazing. So you actually empowered the patient to trust and to really share what matters most to them, rather than a patient with the idea of having to comply with the physician’s metrics.

Connie: Exactly, exactly.
Jan: Wow, that is so amazing. So this meditation that you’re talking about, this heart meditation-

Connie: Yes.

Jan: If you told me this story about 10 years ago, I would probably, inside I would go like, yeah, that’s a kind of woo-woo thing. Here’s somebody doing some heart feeling thingy, and that changes how the patient behaves and this actually changes how the physician behaves, although they don’t even know about it. That’s like a double-blinded, randomized, controlled, no placebo trial, right? Or full placebo, double placebo trial. Nobody knows what you do. It’s some energy work, and things happen in the room magically.

Connie: I know, it sounds-
Jan: Is it magic? Is it spooky?

Connie: It’s miraculous. It is that. It’s not magic, it’s available to every single soul.

Jan: So what is it? Can you share with us what is it actually that you do? You come into the room and you know that this is going to be an important moment. Here’s a patient, cancer patient, truly suffering, lots of things on their heart, lots of things on their minds, and here’s a physician, and you’re in the room. What does it actually look like, that situation? What do you actually do in this moment?

Connie: I actually take a deep breath, clear my mind, and just, it sounds so easy to do, and it is with practice, just open my being, my sense, my heart to what is present for each of them, and then breathe that in, and bless it and release it into spaciousness, and open my heart to just receive everything from them so that they are freed to interact with each other.

Jan: When I listen to you, the first steps, the first point, where this starts, the very starting point of this exercise is empty your mind. So that is, whatever I know about the patient, whatever ideas I may have, whatever to do lists I have with all the patients in all the other rooms, whatever time constraints I’m very aware of, I’ve got like five minutes with the patient now, these are all the realities, right? So how do you do this? Is this something we can practice? Is this something we can learn? It doesn’t seem very intuitive. When I’m in a stressed hospital environment and you’re very aware of this, how do you actually create this moment of disconnect, to really let all of this go and just be available for what may happen now without knowing what will happen, complete openness? How do you actually step out of your busy busy?

Connie: The most important factor is intention. I think to just … For me, it’s having the intention of presence, and having a practice, a daily practice that allows me to access presence so that I know how to do it instantaneously. I was just gonna say, I’m not special.

Jan: You’re very special. You’re very special.
Connie: But it’s available to everybody to do that as well.

Jan: So you would practice this in the morning as a breathing. So you focus on your breathing. You take a moment in the morning before the day’s craziness starts, and you focus on your breathing. Do you do something with your breathing, or you just observe the breathing, or what happens?

Connie: I don’t. I just … There.

Jan: I can feel it, even through Zoom. It’s just a very loving presence. You’re accessing this, the love that you feel. I can feel it. Thank you. What is it that you have observed? So when you actually go there and when you open your heart and you just radiate the love that you have, and you’re saying everybody has that and it’s a flame that everybody is allowed to kindle and can practice to kindle and to grow, what is the effect that this has on the patient when you do this, just that very moment that you showed so beautifully?

Connie: The effect is that I am met in that exact same way, because all defenses get dropped. When you’re in that space, there’s no need for a defense because you’re meeting heart to heart. And when you’re meeting like that, there are no barriers. So truth emerges, and even in conversation with friends, if I drop into that space, they come with me. And conversations move from opinion to being truly open and heartfelt, not just speaking from rote and from all the, we have catchphrases that we use in our life, but it comes from a place of deep sincerity and deep willingness to hear and to be seen.

Jan: And it seems obvious that when you make yourself available and when you make yourself vulnerable, and you’re available as a human being as you are, that kind of gives the other the invitation or the ability or the allowance to also be who they are without having to play something.

Connie: Exactly.

Jan: So we get to learn more about who the patient actually is.
Connie: Exactly.

Jan: And they feel heard and they feel seen. And so when we have all the painful things that we need to do to them, we will have more leeway and more trust possibly to do so. This kind of care, this really living the care, it seems to me that this changes the attention we give to our patients. It changes the way we give attention to a patient, even if we’re looking at their paper charts or electronic charts. If we are connected with them, we kind of give … It’s like the difference between treating your own child or treating a patient.

Connie: Exactly.

Jan: So now it’s not a patient anymore, now it’s somebody you actually care for, somebody you’re really heart connected. So do you feel that if this was something that was part of medical training, part of nursing training, part of a training for therapists, this would actually improve the quality of care?

Connie: Oh, I firmly believe that. I really feel that our medical schools do such a brilliant job of teaching physicians the chemistry and the physicality and the mechanics of the body, but we are sorely behind in teaching physicians how to heal. They can cure and they can take care of, but healing the patient is something that, in the way that I speak of healing … Yeah, like a spiritual healing almost.

Jan: Can you give us an example of where you saw, and certainly there’s a lot to treatment in cancer patients, very intensive treatment, and sometimes there is cure, as defined by the biomedical outcome markers, and sometimes cure is not equal to healing.

Connie: No, exactly. Exactly.

Jan: Can you remember a situation or a story where this was a case, where you felt like possibly there’s some treatment here and some cure here, but really the healing isn’t there, or the other way around, where you felt that a different approach to the patient has actually added that element of healing?

Connie: The situation that leaps to mind immediately was, I guess he was a gentleman who was probably in his early 50s, that seems to be the age group, but he had esophageal cancer, and he did well with the surgery and he did well with the followup chemotherapy and the pre-surgical chemotherapy, and he was doing well, and he just didn’t believe that he was doing well. And we could show him the results and talk to him, and he was actually … He just dwindled because he didn’t believe that he was doing well and that his cancer was in remission. His fear I think actually killed him.

Jan: So what did he die of? He didn’t die of the cancer at the end?

Connie: No, he died of malnutrition.

Jan: Wow. And is this a peculiar situation, where the physician would say, “Here we have a patient with cancer, and we treated the cancer, but now we also have an eating disorder, and so unfortunately the patient then died of the eating disorder.”
Connie: It wasn’t exactly an eating disorder because he had a feeding tube, and so he was being fed. We don’t really grasp the strength of the, I don’t know if you want to call it emotion, or the psyche, to create and affect change in the body, and it can be positive or it can be negative.

Jan: So here, the physicians didn’t have a biomechanical explanation for why the gut wouldn’t absorb the nutrition, or why everything seemed normal and in remission and all the lab values showed it was all good, but the patient couldn’t accept that.
Connie: Couldn’t accept it, yeah.

Jan: And your impression was that was ultimately the cause of … That caused him to die.
Connie: Yes.

Jan: Wow, amazing. Can you remember a situation where it was the other way around, where for example, the way that you were present in the room with them, that that has actually helped them to cross the bridge?

Connie: Yeah. Actually, this was a 19-year-old woman, young woman with cervical cancer, and her cancer was, if she’d go into remission, it would only be for months at a time before it would relapse again, and she had been being treated for three years I think at this point. Her physician was, he was very … He was emotionally attached to his patients, he was personally emotionally attached, but he wasn’t able to show that to the patient. He heard, I just knew and had conversations with him about how painful it was for him to lose a patient, but it was almost impossible for him to present that to the patient.

Connie: And it was a time when he had to tell her again that the cancer had relapsed, and they had to begin treatment again. And I was in the room with them, because it was such a deep time that I was in the heart space, and they cried together. And I’m going to. You know, it was just amazing. And she just chose not to go through treatment again and to experience, because she was feeling well in her body, she was done with the effects of the chemotherapy, and so she was feeling strong, and she wanted to enjoy the time that she had. She didn’t want to have the rest of her life spent in treatments.

Jan: So there was a moment of peace.
Connie: Complete, yeah. It was amazingly beautiful and so freeing. The freedom that she just radiated, having made that, coming to peace with what was happening in her body and being empowered to make the choice to live the way she wanted to.

Jan: So a healing that at the end has probably led to her death.
Connie: Yes. She had a beautiful life in that time that was left to her.

Jan: Thank you. Healing and treatment and cure is not always the same.
Connie: Not always at all.

Jan: So bringing these two together-
Connie: Yes.

Jan: Would be something that certainly I have missed at medical school. If there was something that you would recommend to young nurses and young doctors to integrate the two, what would it be?

Connie: That’s a beautiful question. I think outside of the system until the system catches up, it would be really to find your own way of coming to peace and to really identify why you’re doing the work. Is it for you or is it for the other? And to live that.

Jan: This is something that is very difficult, very challenging to do if you’re alone.

Connie: Yes.
Jan: It’s very helpful when either there’s a coach available or there’s a teacher available or there’s a more senior nurse, a more senior physician who can help and introduce.

Connie: Mm-hmm (affirmative).
Jan: Being at peace in a system as you call it that is very stress prone is not so very easy.
Connie: No, it’s not.

Jan: So you well remember the times when you were sleep deprived and when you had too many patients to actually really care for, and there’s this notion that if I take time for a patient to really be there and to really listen and to really tune in, that this takes time that I don’t have.

Connie: Do you know, the truth is it takes no more time at all. It’s just the time that is valuable at that moment. And that moment is going to happen whether you’re paying attention to the patient or not. So you’re giving value to the moment by really opening your heart and soul to that person before you. The time passes, tick, tick, tick, no matter what. And it actually doesn’t take any more time.

Jan: Do you remember those moments when you had like five things to do, and here’s chemo one, here’s radio, and you need to pick up that other patient coming back from theater, and then it’s like, ah, what am I gonna do, how can I [inaudible 00:38:00].
Connie: Exactly.

Jan: And then let’s say, then you actually go and pick up that patient from theater or intensive care, bringing them back to the ward, and now you have that moment. And you know, still, the other things are still looming here, you still have that long to-do list.
Connie: Yeah.

Jan: How do you actually step out and really be there, present? Is that something that is inborn? Is that a gift or a grace, or is it something we can learn?

Connie: Again, all I can say it’s intention. You know, it’s taking a second after you’ve gotten them from the gurney to the bed to put your hands on their arm and let them know you’re with them, and that all they have to do is ask.

Jan: It’s these very short moments that really go a long way. You were involved in a project, in a large study, where you actually tested, or wanted to see what difference does it make if we conceptualize and live nursing in a way that you just highlighted, in a more loving way. Can you tell us a little bit about that?

Connie: Ask me the question again.
Jan: You were involved in a study, you were involved in a project where you tested, I think in the community-

Connie: Yes, yes, yes.

Jan: Where you tested basically heart-based nursing let’s say, very conventional nursing.

Connie: Yes.

Jan: Can you tell us a little bit about that and your experience with it?

Connie: Yes. The population of that project were all patients who were on phase two trials, who were getting drugs that we tested… Because there was absolutely nothing left in our bag of tricks that we knew would work, they were being tested with anti-cancer medications just to see what the outcome would be, but with absolutely no, there never is any guarantee, but this was absolutely no guarantee.
Connie: And they were seen in their home setting, and I did the nursey-nurse things, and then had the opportunity to spend as much time as it took to really have conversations with them about what their goals were in life, about what they wanted to, what did they want to talk to with their family members, what was it that they had always wanted to speak, what was the one thing that if they had no time to do anything else, what was the one thing they wanted to share with their family, and then move them, mentally prepare them and emotionally move them from treatment to hospice care.

Connie: And that transition was so smooth and uneventful. It came to them, I mean it wasn’t the doctor making the decision, it came, just like the young woman with cervical cancer, it came to them when they wanted to stop grasping for life and actually live it.
Jan: So quite in parallel to their medical history, there was a life history and a biography unfolding, and you almost describe, I almost see like two parallel tracks. One is by medical history, and my current situation, my signs and symptoms, my diagnosis and my prognosis, and then there is this trial situation in the field of medical ignorance. And then almost in parallel to this is another track, which is my life story, my personal life story, my emotional involvement, my upbringing, my family, my friends, what I care for, and the prospect of that. Why are they so disconnected?

Connie: Why do we see our body as something separate from everything else that goes on around us?

Jan: Do you sometimes get the feeling that the cause of disease, the cause of cancer, is maybe not the mutation or the whatever, genetic or expression problem or the [crosstalk] something more deep or different?

Connie: I have mixed feelings about that, simply because if I … Because I don’t ever want to place blame on the patient, you know. And if we were ever to say, “Well, you lived a very stressful life and because you didn’t know how to handle your stress or didn’t take care of it, now you have cancer.” That would be horrible. It’s the same as like I would never call someone out who had lung cancer for smoking. We were ignorant in the 50s and 60s and 30s and 40s and forever until when, the 80s? So I wouldn’t ever want to lay blame on someone for that. But intellectually, I think that there is, of course, there’s a correlation with how much stress we carry in our bodies and how that damages cells, and how that can cause a cell to go awry and become a malignant cell.

Jan: You’ve seen the other side too, I guess, in all the years that you worked with cancer patients, you’ve seen situations of spontaneous remission.

Connie: Absolutely. Absolutely. And there are specific cancers that are known to go into spontaneous remission, and those are the cancers that are most tied to the immune system. So now we’re working with individual immune stimulators as a part of cancer treatment, so it’s a really fascinating field that’s emerging in that.

Jan: I’ve sometimes heard stories, and I’m trying to understand this better, this is really a fascinating phenomenon, this spontaneous remission, and quite often it’s put down to chance, like statistical distributions, and yeah, some cells go kind of funny and then you get the cancer, and yeah, sometimes there’s some repair happens and things turn back to normal again. And in the middle, you have the regular cancer, and then you have the outliers.

Connie: Yeah.

Jan: I’m always interested in the outliers. There’s a lot to learn.

Connie: Exactly. And those outliers, it would be, I don’t know how you could do it ethically, if you had two groups of people who you knew had cancers that could, help the possibility of spontaneous remission, and one of the groups you gave special attention to and did heart-based medicine with and had conversations with about their life and their dreams and their hopes, and the other ones got standard treatment, what would the outcome be? How many more in this group would go into spontaneous remission than in this group? How long would it last?

Jan: I don’t see an ethical problem with that. I mean it might, at this point, very few benefit from truly heart-based medicine, and there are so many wonderful physicians out there truly caring for their patients, and there’s so many wonderful nurses truly caring for their patients. And yet the potential to go into the direction that you’ve outlined and demonstrated so beautifully is tremendous. We’re just scratching the surface on how much deeper we could go there.

Jan: Given that our baseline is that the biotechnical medicine prevails quite dramatically, I wouldn’t see an ethical issue of introducing something heart-based in one of the arms. So yeah, it’s an interesting question. Is adding love to a treatment, if that is one of the drugs prescribed, what might be the ethical concerns around that? I guess part of it is history, that the patient-healthcare provider relation was abused at times, and that barriers were not respected and there was trespassing, and I guess that’s where a lot of the ethical rules and requirements are coming from.

Jan: You mentioned before you were touching patients. That is an integral part, is to touch patients. At the moment, there’s still this whole no touch that’s quite big, probably informed through fear, legal fear, harassment or whatever, kind of informed by an abuse of intimacy. But what you were talking about is a healthy intimacy between the healthcare provider and the patient, a trusted relation, and one where the love shared is about the Greek word, [curas 00:50:44], as in charity, rather than anything that is self centered. Did you ever see this as a problem in your practice, that closeness, physical contact with patients, intimacy in the most beautiful form, is this something that has been a problem? Is this something where patients feel like, oh, I don’t want this?

Connie: I’ve never experienced, I’ve never felt that any of my patients ever experienced a pull back from it. And it may be because of the discrepancy in the physical things that have to be done to them, and then just a gentle hand on their shoulder is so welcome, as opposed to someone coming at them with a tourniquet and a syringe. And you can just feel them [inaudible 00:52:09], you know, just … And I that also, families, cancer is still quite a scary thing, and I think families are hesitant to … Because one of the things that I always talk about with families is not stopping any intimacy at all that you have with the patient. If you’ve been a family that’s hugged all the time, keep hugging, to the extent that you can be physically intimate. Just be as close with each other as you possibly can. There’s nothing that says that that’s contraindicated. It’s not contraindicated in any care.

Jan: It’s finding a balance. So it’s finding a balance between taking the time and opening your heart while kind of staying abreast of all the things you need to do and all your requirements given by the system and given by the amount of patients you care for, or the number of patients you care for. What did you do when you were out of balance?

Connie: When I was out of balance, I would get a massage, I would do yoga more, and I would spend time with my friends.
Jan: Refueling your heart battery.

Connie: Absolutely, yeah. Bringing myself back to center, back to balance, back to [inaudible 00:54:23], and back [inaudible 00:54:25].

Jan: So when you renew your own battery, when you renew your own energy set, you bring this back to the patient and you allow them to tap into this vast battery available to them.

Connie: One of the things that I learn over and over and over and over again is that love is limitless. Like you can’t give it away until it’s gone, because it’s never gone because it just keeps circling, you know. It’s coming back to you as much as you’re giving away.

Jan: You know this, many healthcare providers, many colleagues, whether nurses, doctors, therapists that I meet, know the feeling of depletion very well. They really know the feeling that at the end of the day they feel like I’ve been given so much, and I gave everything, and I didn’t have breakfast, I didn’t have lunch, I just cared for the patients and tried my best today, and now I’m really worn out, I feel depleted and I need to go back now and I need to go back home. When you describe this circle of renewing energy, that sounds like a different approach, and it sounds like that at the end of the day, that means you’re still in the circle.

Connie: Exactly, yeah. It is. I mean, and there is a physicality to it. You can be physically exhausted, but you’re never out of this.

Jan: Such an important difference, thank you, is the difference between being physically tired or, yeah, either my muscles are tired or I’m tired of thinking and focusing and this kind of tiredness, and a feeling of depletion and a feeling of exhaustion, emotional exhaustion.

Connie: One of the benefits of we’ll call it heart-based medicine, one of the benefits of that is that it’s not a job, and so you’re not doing a task. You’re just loving.

Jan: And you even get paid for it.

Connie: You get paid for it.

Jan: Yeah. It doesn’t feel like a job.

Connie: Yeah.

Jan: It’s not a job. It’s not something I own, it’s not something I can give away. It’s something that we may participate in as a healthcare provider and as a patient, and if we both participate in it, then that circle starts to flow. If you were a teacher today in the nursing school, how would you teach this to your students?

Connie: I think that one thing I would teach them would be meditation techniques, and I would teach them the heart meditation, and I would have them consciously interact with patients in that way so that they could see for themselves, like have a little clinic within the course, and have them interact with patients so that they could see the benefits for themselves. And also, just what I said about this not being a job, because if we said, “Okay, now you have to learn this and you have to go into each room and you have to do that,” you just teach them that this is actually, it’s a natural way of being. We’re just asking you to come home to your heart. We’re not asking you to do something else, you know.

Jan: Did you sometimes feel that this is in conflict with what you learned and what you need to do and with the protocol and completing the charts?

Connie: No. The only time I felt stressed was when I wasn’t with patients. You know, when I had to deal with the politics of medicine.

Jan: In what way, if you were to design a ward, what would be the things you would make sure that they were in place?

Connie: I would make sure that there was comfortable seating by each bed. I would make sure that there were beautiful pictures, scenes of nature. I would make sure that there wasn’t that harsh medical lighting that’s in every room, more like ambient sunlight kind of lighting. I think I would like there to be, not everybody likes music so maybe not, but if it were music, it would be like just soft instrumental soothing sounds, water, waves, the sound of waves, and the sound machine kind of thing that just really gentles the soul down. And I would want there not to be any clocks in the room, because I wouldn’t want anybody, any caregiver looking at the clock and seeing how much time they … I’ve already been in this room two minutes, I only have three minutes left, and I still have to do this, this, and this.

Jan: Beautiful.

Connie: Yeah.

Jan: An environment that allows relaxation. An environment that doesn’t feel like make disease away, but bringing on health.

Connie: Yes.

Jan: When you connect with patients in a loving way, doesn’t this also shift the focus from the disease or the deficiency or the problem to their potential, to what’s strong in them, to their infinite source of energy and life?

Connie: Beautifully said. Yes, it does. It does.

Jan: What does that do to their signs and symptoms?

Connie: In my experience, it’s not that the signs and symptoms necessarily go away, but they don’t become the focus, or they stop being the focus, that more important things in life become the focus.

Jan: Isn’t that something that we can all … It’s something that touched me always when I worked with people who lived with chronic pain, how incredibly strong that focus is in the beginning when the pain is new, and how it completely fills the screen. And at some point, as they go through rejecting and not accepting the pain and wanting to run away from it and pushing it and being aggressive with it and then finally giving in and letting go, at some point when they have learned to live with the pain in a way, that’s what happens. The focus is kind of shifting a little bit and says, “Yeah, the pain is part of my reality, and there is something else. And that something else may actually strengthen my body, soul, and mind to deal with the pain. So it opens a resource that wasn’t available when I was focusing on the pain only.

Connie: Yes, exactly.

Jan: And in our medical training and in our routine medical care, tapping into this resource isn’t really part of the protocol.

Connie: No, it’s not. Yeah, that we typically do.

Jan: When somebody said what you do is psychosomatic medicine-
Connie: Really?

Jan: Would you agree with that?
Connie: Well, I suppose if you want to put a label on it, that would be a label that you can put on it.

Jan: One of the possible labels.
Connie: Yeah. It doesn’t make it any less valid or effective.

Jan: I would really love to share the video, share your radiant eyes and your radiant smile with the Heart-Based Medicine community, just to give the feel of what this is, to share heart, just like a volcano. It’s so beautiful to see. You’re such a blessing to everyone who knows you, including all the patients that were blessed to be treated by you and blessed to be with you.

Connie: Deeply received.

Jan: Thank you, Connie. Thank you, sharing so much.
Connie: Thank you.

Jan: If you agree, I would love to take this recording and we will see, it’s a little bit more than an hour, and we can see if this is
something we would both feel comfortable to just share it as it is, so others if they’re interested, they can see this and appreciate your message. I’d love to serve sharing your message for everybody following your tracks.

Connie: Thank you. I would love that.

Jan: And we can see if we can create smaller pieces from it, where we feel like, you know, here are a few sections that we want put together. I will create that recording and create a transcript of it, and we can see if we want to take some parts of it and condense it into a smaller compressed message possibly. I don’t have much experience with this so far yet, and maybe you have.

Jan: Okay, great. So it’s an experiment, and we can see what it looks like. I could give it to somebody who knows how to handle these video clips and how to make a podcast with them and how to handle all of that, and then I will share it with you and you can give me a thumbs up and yes, we can share this with others, or no.

Connie: Okay.
Jan: At this point, the Heart-Based Medicine community is very small. There’s just a few hundred people who start to be interested now. We just opened the doors in January.

Connie: Wonderful.

Jan: And so there’s just a few people now, and we’re trying to invite others to join. So if you know people, if you know colleagues, if you know healthcare professionals who might be interested in this work, then please let them know about this, and we hope to build a community that will hear your message and that will contribute their messages, and so together we can maybe create a field that will invite the next generation of healthcare providers to learn from our experience and maybe take something from it and add their part to it and develop it further.

Connie: That would be wonderful.
Jan: Nice.

Connie: Thank you for opening the possibility of this becoming a part of medical practice. You are giving a tremendous gift to the world with this.

Jan: Thank you. I’m part of a puzzle, and I would love to bring people like you together with others, so that together we can create a field that may bring some change.

Connie: Yeah.

Jan: Thank you so much for taking the time today.
Connie: Thank you for asking me.

Jan: We will exchange a little bit the information that we’ve shared and we’ll exchange the files and you can look at them and tell me what you think, and you may or may not know that in September 12, 13, 14, we will have the first Heart-Based Medicine summit. We will want to bring together as many as we can, and we don’t know how many it’s going to be.

Connie: That is so exciting.

Jan: And that’s going to be in San Francisco.
Connie: Fantastic.

Jan: So we want to create a program for two days where we wish to bring everybody together for two days, and invite speakers and create an open space session where really everybody can speak up, where everybody can convene a group and for half an hour, three quarters of an hour, work with a group, and you may have a topic that you would really like to discuss with people in the room, or you may want to offer a practice, or you may want to actually learn something that you don’t know, and you’re saying, “I want to talk about this because I don’t have a clue, and I want to know.” So it’s a completely open space. Part of this conference will be this. So one half day will be without an agenda, where at the beginning of the half day we will create the agenda together, whatever comes up at the moment, and then see what groups will form and see who will want to interact and how we then kind of move this Heart-Based Medicine field forward together.

Connie: That is so exciting.

Jan: Yeah. So if you want to and if you’re interested, mark your calendar, and in the next one or two weeks, we will really have the venue confirmed and the dates confirmed-confirmed. But it looks like it’s gonna be this weekend, what is it, 12, 13, 14 of September this year. So I’d love to see if you could come, I’d love to meet you. That’d be really wonderful.

Connie: That would be lovely.

Jan: I think you’re probably gonna be in February now at the lab, right? At [Jonah’s] lab?

Connie: Yes. I leave Friday to go.

Jan: Very soon.
Connie: Yup.

Jan: Nice, thank you. This is great. I wish I could come. Time doesn’t allow right now. We’re building the Child Health Center here in Basel, and it’s taking all, oof, all energy and space right now, so it would be very hard to justify to go away for a week, so I won’t be able to join. Maybe I’ll join for just half an hour or so and we’ll share about heart-based medicine.

Connie: That would be wonderful.

Jan: So that everybody is aware. But I won’t be able to come. Maybe if it works for you, it would be wonderful if you could come to San Francisco.

Connie: I’ll put it in my calendar-

Jan: Fabulous.
Connie: And make plans for that.

Jan: Great.

Connie: Get your information.

Jan: Lovely. Thank you so much, Connie.

Connie: Thank you. We’ll talk soon.

Jan: We will. Thank you. Take care. Bye, bye.

Connie: Bye.