The Nest in the Stream
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“In a quiet, gradually illuminating way Michael Kearney introduces us to a few key spiritual and emotional discoveries he made during his work as a palliative care doctor and as a novice in Native American rites of passage. The writing is clear and beautiful, the lessons easily taken to heart, and the vision truly inspiring. I loved reading this book and know that its wisdom will stay with me, lightening the burden.”
—Thomas Moore, author of Care of the Soul
“In this dear book, Michael yet again takes us deeper, closer. He nudges us to see that to understand someone is to care for them. Yes, love them. This book is most directly about the cautions and craft of caregiving. And it is about receiving too, as though by necessity these come together. This is the sweet reciprocal loop that Michael has been pointing out to me for many years now and I’m so glad he’s offered us more stories and intimacies to reify this subtly potent point. For all its quietness, this book is full of brave explorations just beyond the line of familiarity. And since he dares to look and see—we can too.”
—B.J. Miller MD, Zen Hospice Project, presenter of 2015 TED talk What Really Matters at The End of Life
“Kearney’s work is deep, thorough, risky, elegant and poetic. He is an exemplar for all those who come to realize that self-healing is a necessary condition for helping others to be healed. It is a win-win bargain. This is a warrior’s path, redefining the meaning of manhood and bravery and engaging the deepest and most challenging purposes of life.”
—Edward Bastian, PhD, Director Spiritual Paths Foundation
“Michael Kearney has written a wonderful book. I read it in one sitting and was left with a new sense of the preciousness of life and present again to the longing to make a difference in other people’s lives that motivates whole person care. It should be mandatory reading for all medical students and physicians in practice. But its interest is not limited to people with medical expertise. I find it hard to imagine a person who would not enjoy and benefit from this soul-nurturing book.”
—Tom Hutchinson MD, Medical Director McGill Center for Whole Person Care, McGill University, Montreal
“Michael Kearney’s The Nest in the Stream is a deeply moving account of the author’s search for healing in lives filled with pain: his patients’, his own, and the world’s. Throughout, his relationship with nature is paramount and profound. He finds his way into its inner reaches, and it ripples through the fine-grained net of his sparsely elegant poetic prose. The reader is grateful for the gift of this singular book: its sure and subtle vision as well as its genius for finding connectivity everywhere, indeed for realizing that one is this very connectivity. In the end, the reader comes to know that being at one with ‘all our relations’ is the heart of healing.”
—Edward S. Casey, Distinguished Professor of Philosophy, SUNY at Stony Brook; Distinguished Visiting Faculty, Pacifica Graduate Institute
“I started the book and could not put it down for three hours. It weaves between clinical experiences and philosophical and spiritual insights of some of Kearney’s previous works and personal biography like a Celtic knot. It is a unique form of biography that bridges the personal with the universal.”
—James Morley, PhD, Professor of Clinical Psychology, Ramapo College of New Jersey
“You and I, and our home, this threatened planet, share a common journey through pain, in a quest for healing and wholeness. Whatever our perception, each of us is involved as both sufferer and caregiver. In this sensitive, wise and wondrously revealing memoir, physician and wounded healer Michael Kearney plumbs the depths of his personal path while drawing on a galaxy of inspired teachers. This is a profoundly important book.”
—Balfour Mount MD, Emeritus Eric M. Flanders Chair of Palliative Medicine, McGill University, Montreal
“I always know when a book has entered into my soul when I find myself drawing on it frequently in my clinical practice and personal life. This is such a book! I am sure it will make a deep impact on others in the helping professions and those who care about themselves and others.”
—Mary L.S. Vachon, PhD, RN, Adjunct Professor, Department of Psychiatry and Dalla Lana School of Public Health, University of Toronto
“Beneath, above, beside, and inside the life we think we are living, lays another life, often cast out of our awareness. This wider life is not only our experience of being held by nature, but the fact of our being part of nature. Michael Kearney brings this other life into focus as he shares lucid stories of experiencing interconnection with other-than-human nature. As a wounded healer, Kearney awakens us to how we often deal with grief and suffering. He offers pathways to standing in our wider home, as we turn toward suffering with an open heart.”
—Mary Watkins, Chair MA, PhD, Depth Psychology Program, Pacifica Graduate Institute, Santa Barbara
“There is no one in the field of medicine and healing I respect more than Michael Kearney, MD. Whenever a book of his appears it is a reason for celebration. But when he writes about suffering in an ever-deepening way until in the end of the book one feels one has traveled to the underworld and back, one is awestruck. His words have the power to confront loneliness and make us feel embedded in the social and natural world around us. This is a story of the suffering of humans and of Nature, and of a doctor who admits his fear of pain yet who doesn’t flinch. Anyone who has ever suffered will find this book a revelation. I sure did!”
—Robert Bosnak, PsyA, Jungian psychoanalyst, author of Tracks in the Wilderness of Dreaming
“Some seeds need to be scarified—cracked open in the grit of a creek-bed, say, making them amenable to water—before they can become seedlings, then saplings, then great, shade-making trees. This is the story of such a journey. A magnanimous, gently wise, at times wrenchingly vulnerable account of one man’s gritty ‘heart-work’ done for the sake of all our relations. Read it and be cracked open. Read it to remember things you perhaps didn’t know you forgot. Read it to root deeper into this earth and into your life. Read it and be returned.”
—Teddy Macker, author of This World
Parallax Press
P.O. Box 7355
Berkeley, California 94707
parallax.org
Parallax Press is the publishing division of Plum Village Community of Engaged Buddhism, Inc.
Copyright © 2018 by Michael Kearney
All rights reserved
Cover and text design by Jess Morphew
Cover and interior art © CPD-Lab/iStock/Getty Images Plus
Author Photo © Stephanie Baker
Ebook ISBN 9781946764010
Library of Congress Cataloging-in-Publication Data
Names: Kearney, Michael (Physician), author.
Title: The nest in the stream : lessons from nature on being with pain / by Michael Kearney.
Description: Berkeley, CA : Parallax Press, [2018] | Includes bibliographical references.
Identifiers: LCCN 2017042774 (print) | LCCN 2017044445 (ebook) | ISBN 9781946764010 (Ebook) | ISBN 9781946764003 (pbk.)
Subjects: | MESH: Pain Management–psychology | Faith Healing–psychology | Spiritual Therapies | Nature | Personal Narratives
Classification: LCC RZ401 (ebook) | LCC RZ401 (print) | NLM WL 704.6 | DDC 615.8/52–dc23
LC record available at https://lccn.loc.gov/2017042774
v5.2
a
To my grandsons Elliot, Alex, and Finn,
and to all the grandchildren
If we surrendered
to Earth’s intelligence
we could rise up rooted, like trees.
Rainer Maria Rilke
Contents
Cover
Title Page
Copyright
Dedication
Author’s Note
Foreword
BY JOANNA MACY
ONE
Beginnings
MONDAY EVENING, MAY
A SEARCH FOR HEALING
RELATING TO PAIN
TWO
Seven Stories of Nature Connection
FIRST: COLMAN’S WELL
SECOND: THE OTHER SIDE OF THE ROAD
THIRD: THE LAND
FOURTH: THE NEST IN THE STREAM
FIFTH: UP ON THE HILL
SIXTH: THE TREE OF LIFE
SEVENTH: POLARIS
THREE
Endings
MONDAY EVENING, JUNE
LESSONS FROM NATURE
A STORY ENDS
INTO THE DEEPER STREAM
Notes
About the Author
Acknowledgments
Author’s Note
While I am grateful to many individuals for their help in the writing of this book, I am especially indebted to my Native American teachers, Wolf and Lisa Wahpepah. They have welcomed me into their community and given me permission to share what I have learned. I hope I have recorded their words and described their culture with sensitivity and accuracy. That is my intention. I am grateful for the trust they placed in me.
Wolf and Lisa have made clear to me that the particular ways they perform ceremony, which I describe in the book, reflect the teachings they received from their elders. They emphasize that among the more than five hundred tribal nations in North America, there are many legitimate and varied ways of conducting Native ceremonies. Another Native elder, having read the manuscript, made the same point to me. She spoke of how the land itself shapes the ceremony, and put it like this: “There are as many ways of performing ceremony as there are differences in the landscape.”
Foreword
BY JOANNA MACY
The Nest in the Stream is the story of a man who dared to face his moral discomfort as a physician and question the medical model of his training—even his own suitability for that profession—when he realized the inadequacy of what he had been taught in the face of his patients’ uncontrollable pain and suffering. The book soon moves beyond his personal story to examine how we relate to our world in this time he calls a “tsunami of suffering.” It also shows us how life comes to meet us when we are not afraid to be present to that pain. So the journey described here is a journey for each of us.
The query that leads Dr. Michael Kearney on his quest is how to be with our pain. I recognize it well. It is the persistent question that has beckoned and teased me over the last fifty years of my engagement in issues of social and ecological justice. It gave rise to the experiential group process called The Work That Reconnects, whose seeds I have helped to sow in many lands. It is a question we need not so much to answer as to stand before it; indeed, it is crucial that we do this because we have become artists of avoidance. That avoidance takes countless familiar forms from busyness and distraction to intellectual debate and obsessions with self-betterment. But we are not terminally lost in our escapism, for—I am convinced—our deepest longing is to rejoin our world, open to the company of our brother-sister beings, and let that larger life be our guide as it thrums through us.
I rejoice that this book carries so clearly the voice of the man himself—his keen but gentle attention, his unassuming fidelity to his own experience. This is how I came to know Michael Kearney when, some half dozen years ago, he began taking part in interactive seminars of The Work That Reconnects. Since then his reflections and queries have enriched my own.
In this book, as in our conversations, he shares life-changing moments in nature and in traditional practices—Native American, Celtic, Buddhist—and how these moments transform his life as a physician and, more broadly, his life in the world. In so doing, he describes his experiences, but he does not prescribe them. And because he is not trying to persuade or convince, we open ourselves to these experiences; we let them combine and interweave with our own.
As I read over this exquisitely crafted book, I realize that it is offering us a hero’s journey for our time. As Joseph Campbell has written, the hero/heroine must descend below the surface of conventional life and confront—even embrace—the shadow or monster lurking in the subliminal depths before returning with greater insight to the challenges and achievements that await.
As a physician and as a deeply reflective human being, Michael Kearney leads us farther. He shows us that, in addition to the greater presence of heart and mind we gain from having embraced the pain we had not known how to tolerate, something more occurs. Something new emerges. An answer comes. It comes through nature in living forms—in a robin, a wolf, a covey of ladybugs, a cottonwood tree, the North Star. We need not be surprised: both the scientific and the spiritual revolutions ushering us into the Third Millennium reveal that our Earth is alive. We are not alone here. We are invited back into the pulsing give and take of life itself. If we dare to be real with what we feel, we rediscover the larger being we live within, and enter once more the Great Reciprocity at the heart of the universe.
Berkeley, California
September 2017
MONDAY EVENING, MAY
As I go into Ben’s hospital room, it is dark; the window blinds are closed. Ben has advanced cancer of the bowel. He is thirty years old and not doing well. He will finish his latest round of chemotherapy this afternoon and then he will go home. He has lost ten pounds in the past two weeks, even though he says he has been eating fairly well. I ask him how he is doing. He says his colostomy has not worked since yesterday morning and that his belly feels tight. He looks tired and I can tell from how he is moving about in his bed that he is in pain.
Just nine months ago, Ben was diagnosed with locally invasive rectal cancer. I was asked to see him as the physician with the palliative care team in the hospital. We had been consulted by Ben’s oncologist to try to help him with his pain and to offer emotional support to him and his family as they struggled to cope with his new and serious diagnosis.
When I met Ben and his mother for the first time, Ben was in a room on the oncology floor. I entered his room and found him lying on his side; his rectal pain was so bad that he could not lie flat. I recall how he looked on that first visit—his bright brown eyes, his young bearded face, and the intricate, colorful tattoos on both his arms—and I remember how his mother, Juanita, was sitting at his bedside, her face full of sadness and concern. Ben appeared so strong and well. What had struck me most was his vibrancy, his openness, his gentle directness. He had welcomed my involvement in his care. I had felt happy to meet him.
Unfortunately, since then, things had gone badly for Ben. Despite surgery and first- and second-line chemotherapy, his tumor had recurred and spread throughout his pelvis. He went to Los Angeles for a second surgical opinion and was told that no further surgery was possible. He had had multiple readmissions to the hospital since then for chemotherapy and symptom control.
This current admission had been to start third-line chemotherapy, but afterward his discharge was delayed until now because of severe pelvic pain and other symptoms, which have only recently started to settle down. Ben is due to go home this evening to his grandparents’ house. He had moved in to look after them prior to being diagnosed with cancer. His grandfather was very ill himself with end-stage heart disease and had recently been enrolled in hospice care. His grandmother had kidney failure and was on dialysis.
Ben had often spoken to me about his granddad. They are very close. He told me that when he had first received his cancer diagnosis, his grandfather had prayed that he could take on Ben’s suffering for him.
A little while ago, Ben’s nurse had told me that she had just heard his g
randdad’s condition had deteriorated. She did not know if he was aware that his grandfather was close to death. This could affect his discharge plan.
I ask Ben if he has had news from home. He says no. I tell him I had heard that his granddad is not doing so well and that I wanted him to be aware of this so he will not be surprised when he gets home.
“I’ll cheer him up,” Ben replies. “Last time when I got home and he saw me, it cheered him up.”
“You will, Ben,” I say with as much conviction as I can muster. “You will cheer him up.” I say goodbye to Ben for now and tell him that the nurse with our community palliative care program will call him tomorrow to make sure he’s doing okay. I tell him that I look forward to seeing him when he comes back in two weeks for his next round of chemo.
Despite all his difficulties, Ben has big plans for the future. Recently, he told me that even though he had had a job with a delivery company before becoming ill, his real passion is working with wood. For a few moments, his face lit up as he described different types of timber and shared his plans to open a wood shop with a friend when he is well again. He has not given up hope. He so wants to get well and carry on with being a thirty-year-old.
I have been working with patients like Ben for as long as I have been a doctor. While it can be challenging to control pain such as his, there is always something to do—a dose adjustment here, a new medication there, another line of treatment to explore—and I am grateful for the advances in pain management and interdisciplinary teamwork that have made such a difference for patients like Ben. Finding medical answers is not the problem. The real challenge is something deeper, something more subtle, pervasive, and intractable: those elements of human anguish that lurk within and around and beyond the physical pain, the nonphysical dimensions of pain that do not have an easy fix. That is what I have seen for some days now in the dark rings under Ben’s eyes and in his flat expression as he lies in his dim-lit, shuttered room. My medical training had done nothing to prepare me for such distress.