This book is a refreshing take on the importance of taking a holistic approach in understanding illnesses, especially chronic conditions, as it documents a medical doctor’s personal health challenges that spanned over a decade, and the subsequent paradigm shift in the way she practises medicine. It is rare to hear doctors sharing their own unresolvable chronic health issues, as the author Dr Li said - she had always operated from a perspective of us (doctors) vs them (the sick). One of her grief experienced during her journey of illness was how could help others when she as a doctor could not even heal herself?
Her personal story: she was a sensitive and quiet child who decided an an early age to be “strong” because she was tired of being seen weak, and who stumbled upon medicine as a path. She went through years of grueling training, suffered the sudden loss of her fiance, buried that pain and just kept going. But all these, plus lack of awareness of other risks eg toxic emotional and physical exposure all added up and caused thyroid issues and chronic fatique. Yet all the medical tests came up ok and she became one of those classic “difficult patients”.
Her journey and lessons are in the 15 steps below, which is also roughly how she structures her book. I will higlight a few points that resonated with me.
Some are born naturally more sensitive – not just emotionally but via the sense organs. Dr Li contrasts herself with her husband David. She is sensitive to noise, takes time to transit between tasks esp when she is unwell, while her husband is full of energy, can transit quickly from one task to another, and is immune to a messy house. But she said “the more disordered I became on the inside, the more order I needed around me”. I feel the same way too. I am ruffled by sounds, the wind on my skin, and also to bright light. When work stress messes with my head and I feel fragmented mentally and emotionally, going through the process of tidying my environment is therapeutic and having a clean and ordered environment is less stressful than a messy one.
Her fatigue also makes her want to have distance from people because engaging them is exhausting so she pushes them away, yet she longs for connection. I can understand this paradox.
Another point that really resonated with me is the point about spaces. I have always believed that negative spaces are just as important, if not more important, that positive spaces. Eg a painting hung with sufficient wall space allows us to appreciate it more; in yogic practise of pranayama, paying attention to and lengthening the duration of kumbhaka, the space in between breath, is so important; and rest between activity is critical. Dr Li was referring to labour pain, and how her midwife taught her the importance of the spaces in between, so that the pain is not one continuous pain, but to harness the space and time between the pain so one can tolerate the pain better.
This is very similar to Buddhist teachings - we learn that there is always a rise and a fall. But we only notice the rise of our physical and emotional sensations, not the process when it is subsiding. So we think that our experience is one continuous rise (eg pain of an hour, a year or 10 years). Memory in particular, makes us think of the event that caused our emotional pain and triggers it again, even when the painful event is over. And then it subsides but we do not notice it subside, and then we think about the painful event again and we suffer the rise of the emotional pain again. I think that is why some people think their life is like a continuous emotional pain . The emotional pain actually comes in spurts, and if we can notice that it also subsides, that there is space in between the emotional pain and that it is possible to lengthen that space in between, then we can see the possibility moving towards healing.
Another very important point is about the neuroplasticity of the brain, of which she learned from reading a book called “The Brain that Changes Itself” by Michael Doidge (I am reading that now, fantastic book). The brain can change itself because it can develop new neuropathways. And I learn a very important point about the science of pleasure - certain practises can increase levels of dopamine, the key chemical involved in motivation and pleasure. And that the dopamine pathway works by priming, or conditioning responses, so that the release of dopamine triggers the release of yet more dopamine, which is why repetitive small acts of pleasure are also dopamine producing. Given enough repetition, then neural pathways of arousal become heartier – the principal of neuroplasticity – and give enough repetition, the genes for pleasure might also turn back on - the principle of epigenetics.
Other useful points to know include the mitochondria - which are powerhouses energy production in the cells. That their numbers can grow or shrink (eg aging or lack of exercise), and their health can also be robust or weak (toxicities, nutrient difficientcies and inflammation). Exercise can increase both the number AND function of mitochondria.
So all in all, I love this book. Encouraging for us to care for ourselves and live a life that is in sync with ourselves.
The 15 Steps:
1. Ask new questions
2. Reset your inner clock
3. Give yourself permission to receive
4. Get a daily dose of nature
5. Detoxify the house
6 Let your intuition tell your thinking mind where to look next
7. Change your thoughts, change your genes
8. Inhabit your body
9. Heal the gut
10. Break old habits that no longer serve you
11. Practise pleasure. It's serious work.
12. Investigate hidden root causes
13. Survive love and loss
14. Reclaim your purpose
15. Find your story, the real one