Zachary Sager: Nurturing Medicine
Selected Excerpts
“As a third-year medical student I began to keep a vegetable garden. Digging in the yard was a stress reliever, a reprieve from memorizing diseases and pathways. I’d return home from the hospital and walk through the garden pulling weeds and watering plants, and then pour over books about seed saving, composting, and canning. I watched the plants grow, flower, fruit, wilt, and eventually die, repeating each year. Over time, the garden grew, incorporating more and more plants, and then drip irrigation, compost piles, and then chickens—their shells and droppings returning to the earth, helping the garden grow. I reasoned that I could take the same approach in school and residency and apply it to gardening. The more I know, the more I can do and the more I can control.”
“I saw that in the garden, death was expected and ordinary. But in medicine, death was a dreaded failure. If I had looked harder, diagnosed sooner, found the right treatment, maybe the inevitable could be staved off.”
“Death Valley, despite its dry and hot climate, is home to more than 1000 species of plants, including wildflowers that bloom after rainfall in the spring. Sometimes, years will pass between large blooms, the ecosystem waiting for the right conditions. Like plants, people can thrive in inhospitable places. Every day I see individuals who have endured overwhelming trauma only to find meaning and growth as life fades, making time for laughter, connecting with distant relatives, and renewing frayed bonds with those closest to them.”
Discussion Questions
Take a few minutes to reflect on your relationship with gardening and nature.
What insights does Dr. Sager learn about death from his gardening? Does this resonate with your own thinking about death?
Dr. Sager also gains a new perspective on trauma and resilience through his reflections on nature. Does this perspective resonate with you?
How might you use the garden metaphor to approach caring for your patients, loved ones, or yourself?
Reflections from #MedHumChat
“I used to have a black thumb, even managing to kill succulents, then I took to evaluating my plants 2-3 times per week for water, repotting, feeding etc and they’re thriving, and I find I think of it as rounding on my plants.” —@jennifermcaputo
“I was struck by how gentle the process of death can be when we look at it as a natural part of life. As opposed to the violent, unnatural deaths we sometimes subject patients to in-hospital. Death as failure plays into the idea that "we should do everything.”” —@alessacolaMD
“…I saw people who had such difficult and downright terrible experiences in life, but in the process of dying would find strength to flourish, forgive, thrive. It really taught me how resilient individuals are.” —@ZacharySagerMD
“…while we can see ourselves as gardeners, we are the plants too. We need rich soil, we need to be tended too and take care of ourselves in order to grow. Reminding myself that I'm a plant prioritizes my own self care.” —@ZacharySagerMD
“This metaphor has really helped me conceptualize how as physicians we are no more “god-like” than a gardener is with their garden. They merely help the garden along but the flowers/plants/nature do their thing and the gardener is just a piece of the cycle.” —@BriChristophers
About this #MedHumChat
“Nurturing Medicine” was paired with a passage from God’s Hotel, a book by Victoria Sweet for a #MedHumChat discussion March 6, 2019 exploring The Body as Garden.
We were honored to be joined by special guest Dr. Zachary Sager, MD (@ZacharySagerMD) for this #MedHumChat.
The pieces for this chat, along with the discussion questions, were selected by Colleen Farrell.
About the Author
Dr. Zachary Sager, MD (@ZacharySagerMD) is a psychiatrist and palliative medicine provider at the Boston Veterans Affairs (VA) Healthcare System who has an interest in psychological trauma, substance use and aging.