Bringing New Stories to Healthcare

Skywoman gratitude, Cinderbiter worthiness, and Windigo healthcare

Last week, my uncle asked me an impossible question. He asked me how I would fix the American healthcare system. To be honest, my answer was bleak, because I’m not sure there is a policy solution or systematic solution. I suspect things might change because doctors and nurses, patients and caregivers get fed up, and leave the system. When I got home, I sat down to write about the questions that would need to be answered to find systematic solutions to the mess we’re in. I saw that we spend $250 billion dollars on unnecessary administrative costs and $1000 per person on medications. I read about insurance claim denials as a strategy to reduce costs for insurance companies, but exhaust and deplete everyone else, financially and emotionally. I used the systems thinking I learned in my masters program and drew a diagram that looked like a spaghetti monster. I started thinking about the questions we would need to ask and problems we would need to solve to be able to face these massive problems. Then I realized that was not the story I wanted to tell at all. 

In Braiding Sweetgrass, Robin Wall Kimmerer calls attention to the work of Gary Nabhan, who wrote that we can’t begin with healing and restoration without a “re-story-ation”. He wrote in regards to the human relationship to the land, but I think it also holds within the relationships to our bodies and each other. These relationships have become so out of whack that we need $1000 of medication to achieve some sort of balance, but don’t have enough regard for each other to ensure that everyone has what they need to either pay for that medication or prevent the need for it in the first place. Rather than asking questions about what would be necessary for Medicare for All to be a beneficial change to our healthcare system, I began wondering where we need new stories in health. 

1. What do we owe, and to whom?

In Braiding Sweetgrass, Wall Kimmerer compares the story of Skywoman to the story of Eve. Eve’s story is one of exile, earning what you have through the work of “subduing the wilderness” as Kimmerer puts it. 

The Skywoman story is one of many versions of how Turtle Island (North America) came to be. Skywoman fell through a hole in her world into the sky of our world, twirling downward like a maple samara. At that time, our world was only sky and water. On her way down, she tried to grab onto the tree of life from her world to catch herself. In grabbing that tree, she found herself holding all sorts of seeds, fruits, grasses, which she clutched tightly. Some geese met her in the sky and guided her safely downward, but they could all see she would need land to survive. 

Turtle offered up his back to be land, so then they just needed soil. Many creatures tried to dive down deep enough to reach some dirt, but none could do it. Then muskrat, considered the weakest diver stepped forward and offered to do it. He dove down deep, deep. He was gone a long time until all the creatures assumed the worst. After a while, they saw a few bubbles and muskrat’s body floated to the surface, but when they looked closer they saw he did, indeed, have the handful of earth they needed. In some of these stories, muskrat is resurrected because Creator was moved by his generosity. In some stories he is not, but regardless Skywoman was moved by the generosity of these creatures. She spread the dirt on Turtle’s back and she sang and danced her gratitude. The land grew and grew as she danced her thanks. Then she reached into her pack and spread the seeds. She tended them and they flourished, creating food and medicine for herself and all of the creatures who had helped her. 

Photo by Bob Walsh.

So, the first story that needs to change to improve our health is the story of what we owe to the earth and our fellow creatures. For, in truth, we owe them everything. Other creatures must die so that we can live, and that gives us an obligation. Contained in the story of Skywoman are guides for ethical hunting, family life, ceremonies. Our story doesn’t need to be Skywoman. In fact, it probably can’t be, it needs to be our own story, which can incorporate the beauty of Skywoman, but holds our own guides for right living, for creating thriving life. (If you’re interested in how stories and cultures have mixed throughout history beyond simply stories of conquest and appropriation, check out this episode of The Emerald podcast.) Perhaps Skywoman helps Epona, from the Celtic creation myth, keep the last surviving man and woman (who become the first man and woman) safe from the sea giants. Perhaps Yggrdrasil, the tree of life from Germanic mythology, is the Tree of Life that Skywoman reached out for as she fell to earth. How these old stories are woven together to make a new story is less important than that we are weaving again. Changing the story from subjugation to connection, is necessary for a lot of reasons, but human health is definitely one of them. 

Of course clean air and clean water are essential for human health. Healthy soil is needed to make healthy food. However, there are other, more subtle components of disconnection that deteriorate human health. Species loneliness is one example. Richard Powers, another amazing author of The Overstory and Bewilderment, speaks of species loneliness as as the way human beings have cut ourselves off from the non-human beings inhabiting our world. Michael Vincent McGinnis, the originator of the term said, “Species loneliness in a wounded landscape moves us to want to restore our relationship with place and others, or to put it another way, modern humanity yearns to reestablish and restore an ecology of shared identity.” We are not meant to only interact with humans and pets. Our bodies and spirits need to tend to the earth, are designed to do that work, and other creatures benefit when we tend well. 

We also owe things to our fellow humans too though, and I think we keep moving farther and farther from that. In The Dawn of Everything, the authors, David Graeber and David Wengrow, write about how the culture of hospitality, which was a key value of nearly every ancient culture on the planet. This hospitality recognized the inherent value in all people, even, or especially, those who do things differently than you. It actually gave people more freedom to wander and explore, because they knew they would be well-received wherever they went. The gifts you received from the hospitality of others weren’t transactional, where I travel to your house and you travel to mine and we give each other the same amount of food and drink. They also weren’t free, you did carry some obligation after relying on the hospitality of others. The gifts you receive weaved you into a set of relationships. It could be as small as remembering your grandma’s birthday and sending her a card, or as human as treating the wanderer as we would want to be treated as we wander, or as big as remembering that if we are good stewards of the gifts we receive, they harmonize with nature’s increase. This includes how we care for those who cannot care for themselves, which I’ll address more in the next question. 

2. What makes a person worthy?

When my oldest daughter was nearly 5 years old, we read a beautiful book during advent, which we have read each year since. Each day featured an animal and the special lessons each animal had to teach us during this time of waiting. On Christmas, we read about Jesus. The story about him discussed divine universal love. I asked my daughter what we had to do to earn that divine love, she responded in her wise, mystical way, “Just be born.” She is, of course, correct. However, my adult brain struggles with this all the time. 

Our current story tells us that our worth is entirely tied up with what we produce. Healthcare, of all places, should be the place most able to challenge that story. We work with people who face physical and emotional obstacles to producing and achieving all the time. We can see the inherent worth of each person that we are caring for, but our actions and systems aren’t in accordance with this. We link access to healthcare to employment. We don’t provide time, space, resources for people to care for their own loved ones who are unable to be productive like children, elders, and the disabled. Even those who want to perform this difficult work are often unable to because they would lose their job or lose enough income that they couldn’t get by. 

Doctors tend to fall for this false story more than most. We tie so much of our self-worth to our achievements, so that when we fail or are physically or mentally unable to achieve, we feel lost, adrift, worthless. Since dependence on others is an unavoidable condition in our lives, tying it to feelings of failure and worthlessness is a recipe for disaster and the mental health struggles we see both for those who work in healthcare and those who don’t. 

The tale of Cinderbiter challenges our ideas of only a certain kind of achievement or worthiness. In the story, a young man is chided by his father and his brothers because he spends all day dreaming by the fire. A serpent is wrapped around their island, appeased only by animal and human sacrifices. This cannot go on forever, but the residents are out of ideas. Except for our young man, who steals his father’s fastest horse, three embers from the crone’s fire, and the king’s boat. He uses these to sail into the belly of the serpent, cuts the serpent’s liver open and places the embers in the liver, causing the serpent to die. As he collapses, the serpent becomes the Faroe, Shetland, and Orkney islands.

The hero of our tale, is considered “worthless”, by those around him, but he possesses the gift of thinking differently. He sees solutions where others don’t know to look. Our children, elders, and disabled often possess this gift too. I think we, too, can find solutions to many of our health problems, by looking at health from a different angle. 

Photo by John Wolfstone

3. What is health? 

Our current definition of health is quite narrow. Usually a doctor is singularly focused on your physical health, separating the mind, body, and emotions into different boxes. My very first newsletter (one year ago this Thursday), I wrote a bit about the story I use to explain human health: 

Human health is far more complicated than simply physical health. In yogic philosophy, the koshas, or layers of existence that compose a human body, provide a useful framework for thinking of the many layers of health and healing we need to address to reach wholeness:

• The physical, material body.

• The energy body, which flows in and around the body. This is fueled by breath, food, and the universal life-force. Keeping this energy flowing freely also impacts the health of the physical body. 

• The emotional body, the thinking mind and emotions, which flow in and around the energy body and physical body. Our thoughts and emotions impact the energy flow around us and thus the health of our energy and material bodies. 

• The wisdom body, which is home to our inner knowing and wisdom. When we tune into this inner knowing, we can align our thoughts, energy, and bodies with actions and experiences that serve our deepest purpose. 

• The bliss body, a state of deep inner peace and joy, in which we can sense our connection to all of creation and the sweetness of all life.

However, to be able to heal people at these different levels, we need to think very differently about how we perform healing and healthcare in this country. 

4. What is our top priority in healthcare as an industry? 

My experience of the priorities of healthcare is that cost-effectiveness and efficiency are the gods of modern American healthcare. In other words, we bow to the almighty dollar. This is Windigo healthcare. Windigo are monstrous creatures from several indigenous traditions. I am most familiar with Ojibwe tales about Windigo. Windigo start as people, but through extreme hunger, cold, and isolation become Windigo. Typically, Windigo are cannibal monsters. They eat human flesh, but are never satisfied. They grow and grow, and their appetite grows with them. 

Windigo healthcare consumes the time and money. It consumes the spirit of the patient and the healer. In general, Windigo tales are cautionary tales about the dangers of greed and isolation, and the importance of community. In story, when Windigo are defeated, it is sometimes in the summer, where abundance makes it easy to be grateful and connected. Reflecting on the Windigo story raised many questions that were more  interesting to me than whether our politicians can facilitate the conversations necessary to implement a Medicare for All that isn’t simply a wasteful, bloated, behemoth. Here are a few:

• What if we had stories that emphasized that sharing what you have when everyone has little as even more important that when everyone has plenty? 

• What if we trusted that others would do that for us? 

• What if healers were given an abundance of time to do their work? 

• What if that time gave them understanding of a whole human, their food, air, water, purpose, housing, social connections, rest, stress, movement? 

• What if healers were equipped with medicine, ceremony, and power to positively impact people’s lives in those realms? 

• What if healers (and all people) were given time, space, and resources to meet their needs? 

• What if healers (and all people) were nurtured and tended to within community?

Would it cost more money? Possibly, it would take more time and heart to do this well. Or would taking this time reduce the need for insurance, medications. Would it reduce mental illness, cancer, and autoimmune diseases? Would it heal a whole person instead of simply fixing a number on a lab test or a blood pressure machine? 

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I have been writing about Braiding Sweetgrass a lot lately, and it has been very alive for me these days. I am wondering, if others would be interested in experiencing this book communally. In the Catholic church, we have a practice called Lectio Divina. It is a way of interacting with scripture very personally. In it, you may take note of certain words or images that jump out at you. You also may look at parts of the scripture that you find comforting or confronting. If the passage is about a specific topic you may reflect on how you are being called to do that thing in your life. There is so much wisdom in Braiding Sweetgrass and so many subtle, personal calls to action, I wonder if others would be interested in having a monthly Lectio Divina group to discuss a passage from Braiding Sweetgrass. I’d share the passage and some reflection questions and we could just chat about our experience of the passage in the comments. Please let me know if you’re interested in participating. If so, I’ll start including the passage once a month, likely on a Thursday or Friday.