Rachel Remen: Damming the River
Selected Excerpt
At the beginning, I reacted to suffering and limitation with rage. At fifteen, when I had become very ill, I needed to consult my disease on the simplest matters. Would it allow me to eat a piece of cheese? Did I have the strength to walk up this flight of stairs? Would it be possible to sit through the movies without needing to leave because of agonizing stomach pains? The authority of this disease would brook no argument from me. It still shapes my life, but with a far lighter hand.
Perhaps only an adolescent can feel the sort of rage I felt then. I hated all the well people, hated the side of my family that passed me these genes. I hated my body. I was in this state of rage for almost ten years.
Shortly before my final year of medical training, things changed. I had been offered the opportunity to be senior resident at a fine training hospital. Yet I barely had enough strength to do the work I was presently doing. Here was one more dream stolen. That afternoon I drove to the old beach house that had been given to our hospital for the use of faculty and staff. In turmoil, I walked wearily along the water’s edge, comparing myself to others my own age, people of seemingly boundless vitality. I came up wanting. I remember thinking that this disease had robbed me of my youth. I did not yet know what it had given me in exchange.
Discussion Questions
How does this piece help you connect with the patient experience?
The emotions in this piece shift between anger, rage, and vitality building up “the power of a dammed river.” How do you process constantly shifting emotions?
We’ve all experienced dynamic and complicated emotions over the last 2 years, how have these pieces helped you unpack those emotions?
Reflections from #MedHumChat
“The sheer emotional turmoil of this piece really strikes me - Illness is so confusing on so many levels and so multidimensional, I think Dr. Remen’s words speak to that uncertainty and help any reader experience a glimpse of it” —
@CarlySokach“This piece reminds me that our patients who live with chronic disease do so through different lenses + that these lenses can drastically change w/ time. It’s important to see the person first + to remain curious about their unique experience.” —@LaurNavitskyMD
“Remen writes, “I needed to consult with my disease on the simplest matters.” I relate with this as a migraineur and a student with chronic headaches.” —@mm_brockmeyer
About this #MedHumChat
“Damming the River” was paired with the poem “Instructions on Not Giving Up” by Ada Limon for a #MedHumChat on Nov 3, 2021 about Unpacking Emotions.
The pieces for this chat as well as the accompanying discussion questions were curated by Carly Sokach (@CarlySokach).
About the Author
Dr. Rachel Naomi Remen is a Clinical Professor of Family and Community Medicine at UCSF School of Medicine and the Founder and Director of the Institute for the Study of Health and Illness at Commonweal.