Health workers learn to heal selves as well as patients

Dr. Carol Winograd hums Hebrew melodies at work. She avoids hospital corridors, preferring to traverse the wards by walking outside and turning her face to the sun.

She sits on patients' beds rather than awkwardly leaning over them to listen to their lungs. Often she places her hand on their shoulders. She cries when patients die. She even attends their funerals.

All of this, Winograd says, "sustains us both — me and the patient."

Winograd is both doctor and patient. A geriatrician at Stanford University Medical Center and associate professor at Stanford's Medical School, Winograd is battling her own chronic illness.

"I've done a lot as a doctor to sustain myself and my patients. What I've learned as a patient I hope to use from the doctor side again," she said.

Unlike TV doctors who deliver children, sign death certificates and give cancer diagnoses in less than an hour without breaking a sweat, real-life medical professionals say the stresses of their vocations drain them — both physically and spiritually.

Five medical professionals discussed what they do to help themselves, and thus help their patients, at Sunday's "Refa'einu: Judaism and Healing for Health Care Professionals Conference."

Nearly 200 doctors, nurses, rabbis and therapists attended the daylong seminar at Fort Mason Conference Center in San Francisco. It was presented by Ruach Ami: Bay Area Jewish Healing Center and co-sponsored by more than a dozen Jewish and medical organizations.

The morning's plenary panel titled "Caring for Others, Caring for Ourselves" included Winograd; Dr. Robert Saper, a family physician in Berkeley and assistant professor at UCSF School of Medicine; Margo Frank, a social worker at the Jewish Home for the Aged in San Francisco; Jean Bronstein, a psychiatric nurse at Stanford University Hospital; and Rabbi Alan Lew of Congregation Beth Sholom in San Francisco.

Saper, who spoke first, defined the issues.

Healing, he said, "is different than curing. Disease is a biological process. Illness is a subjective experience of disease. It's physical, spiritual and social.

"To cure is to eradicate. Healing is more complex. It's about comforting…peace…the relationship between the doctor, oneself and God."

To help patients in the healing process, Saper asks them about religious and spiritual beliefs, conscious and unconscious fears, and how they cope with their limitations.

"Often this is the first time they've shared their experiences," Saper said. His role, he continued, is to "listen with a quiet mind and an open heart. The experience is holy.

"We can only aspire to be a vehicle of God — compassionate to the patient and ourselves, to witness pain and discomfort without running in fear or impotence."

Saper derives the strength to do this by breathing deeply and focusing on the Hebrew letters of God's name — yud hey vav hey — and by taking time to pray for patients who die.

"Stress and burnout are just unprocessed grief and loss. [These] rituals are healing for me and allow me to go on with my other patients," Saper said.

Like Saper, Frank derives sustenance through ritual — meditation, yoga and saying the Sh'ma each morning."This helps me feel connected to myself and to God. I cannot give without sustaining myself," she said.

Bronstein also recites the Sh'ma each morning, performs breathing exercises and "thinks about God's plan for me." She listens to Jewish music to and from work. She allows herself to cry, to feel joy, "whatever I need that day."

Not surprisingly, Lew — former director of the Zen Center in Berkeley — also focuses his regenerative energies on breath control and meditation on yud hey vev hay. "To be absolutely present [in this way] is to communicate with God. This runs through all of my daily life. Especially in healing," he said.

Winograd offered perspective from both sides of the bed. Just days before the conference Winograd called her doctor. She was very ill.

"We spoke of what we were to do — the two of us," Winograd said, her voice weak although amplified by a microphone. "I said, `Do nothing.'"

The next day, she was feeling better. "I had the wisdom of my own body to know how to heal myself."

In addition to listening to her body's cues, Winograd takes a "barrel of Jewish stuff" to the hospital with her for any extended stay. That includes Jewish books and tapes she listens to on her Walkman during all medical procedures. She plasters artwork — her own and those of her favorite artists — all over the walls.

She follows doctors' orders, including advice to "do what is your passion." She recently flew to Chicago for an art exhibit.

"Two days with Monet, just looking. I came back and slept for a week," Winograd said. "It fed my soul. It sustained me when I thought I was going to die. When I didn't think I had the strength, these things [art, Judaism] kept me going."