My previous book, Re-humanizing Medicine: A Holistic Framework for Transforming Your Self, Your Practice, and the Culture of Medicine focused on the dehumanizing aspects of contemporary medicine for both clinicians and patients. I sought to find a holistic framework that we could use to create a “counter-curriculum of re-humanization” within ourselves as clinicians so that we could transform the way that we work with patients and to influence the culture of medicine through a “compassion revolution.” I have long been interested in trauma and its effects on personal identity, relationships and culture. The first research project I worked on as a medical student, with Deb Klamen and Linda Grossman was on the traumatic aspects of medical training, “Posttraumatic Stress Disorder Symptoms in Resident Physicians Related to Their Internship,” Academic Psychiatry, Vol. 19, No. 3 (Fall 1995): 142-149.
In this book with Joseph, we focus on trauma, specifically for returning veterans. Much of Posttraumatic Stress Disorder (PTSD) can be understood as the conditioning of the nervous system to function in a combat-ready mode. This nervous system conditioning is part and parcel of the acculturation process that occurs as civilians go through boot camp and become warriors. Upon returning home, the nervous system conditioning persists and the acculturation process is challenging. We know that people who have spent time immersed in another culture often experience “reverse culture shock” on returning home.
As I sought a holistic framework in my first book for re-humanizing medicine, in this book with Joseph we use another holistic framework – the medicine wheel – which is an organizing framework that can help us bring together within ourselves and society experiences that are difficult to go through. Joseph teaches us about the medicine wheel from his own personal visions and experiences. The medicine wheel consists of four external directions: the north, the south, the east, and the west. It also has four internal directions: the spiritual, the emotional, the mental, and the physical. Walking the medicine wheel means that we seek to experience all of these aspects of our being in order to be whole people, or as Joseph calls it “Becoming a True Human.” We can use the medicine wheel to re-orient ourselves when we become lost in the outer or inner landscapes of our lives. Trauma is one way that we can become disoriented, but Joseph teaches that disorientation and even pain are necessary and that when we approach our pain intentionally we can use it in a transformative way to guide us through the initiation of who we were into who we are becoming. A large part of healing from trauma comes through changing our orientation toward pain and the role it plays in our lives.
As Joseph teaches us in the beginning of his book, Sound: Native Teachings + Visionary Art, “Enter this book of my teachings as if you were climbing down into a kiva for a sacred ceremony. Do not come to be instructed. Come to be initiated,” (Rael, 3). The path of the medicine wheel that we offer in this book should be approached in the same way – as an initiation which is a transition between roles and cultures.
Joseph and I have greatly enjoyed the process of writing this book, so much so that we have already started on our next book together, Becoming Medicine. In this next book we will travel to the center of the medicine wheel, into the center of the heart, in order to learn more about what it means to become a healer and a visionary. -David Kopacz, MD