The Myth of the Cave and the experience of illness

In this paper, I will consider, from a number of philosophical and real‐life perspectives, what happens to us when we fall ill and what the experience of falling ill tells us about the nature of our being. I will take up the oft used Myth of the Cave from Plato's Republic and use this as a means to interpret the experience of falling ill. Plato gave us the allegory to show that what we think we know might not be all there is to know and that what we take for truth may not, at least, be the whole truth. I will argue that The Myth of the Cave provides an allegorical basis for coming to understand ourselves as finite and mortal through the experience of illness. We emerge from the dark safety of our everyday lives into the world of illness; this brings us up short as we come face to face with our own mortality. To make the argument, I will use examples from my own experience of illness and some of those other which have been recounted to me. I will also refer to the work of Havi Carel on illness and mortality, the conception of illness as leading to a feeling of not‐being‐at‐home with our bodies (unheimlich) discussed by Frederick Svenaeus, and Gadamer's notion of illness as a loss of equilibrium. Underpinning the argument throughout will be Heidegger's existential analysis of dying in which he discusses the experience of anxiety and the way that separates us from the world of involvements.     

Encounters in a world of pain: an autoethnography.

Pain, a major health problem in the United States, is a highly complex and subjective experience that is poorly understood by many medical, psychological, and rehabilitation practitioners. In this paper I use a qualitative research methodology, autoethnography, to present a personal narrative about my experience of chronic pain. In this research I am both the research participant and the researcher. I begin with my personal narrative. I then problematize conceptions about chronic pain and discuss them from the point of view of my own narrative and from stories and ethnographies in the literature. Finally I reflect on how occupational therapists can more effectively work with persons with chronic pain.     

Egyptian families caring for a relative with mental illness: a hermeneutic study

ABSTRACT: The care of people with mental illness often rests with their families. The way families manage this experience has been explored widely in the literature; however, the added complexity of migration has been given little attention. The difficulty of conducting research with people from non‐English‐speaking backgrounds often precludes their voices and experiences from being heard, further compounding marginalization and misunderstanding of their needs. The aim of this study was to understand the experience of Egyptian families caring for a relative with mental illness in Australia. Seven participants from Egyptian background, caring for a relative with mental illness, were included in this study. A hermeneutic phenomenological approach, informed by the work of Heidegger, was used. Data were collected through in‐depth audio‐taped interviews conducted in the Arabic language, which were then translated and transcribed in English. Data analysis revealed five themes: Why did it happen? How do I protect my loved ones? What has it done to me? What has it done to us? How do I survive? Findings of the study have the potential to raise health‐care professionals' awareness of the needs of Egyptian families, their beliefs, values, and coping with mental illness.     

Exemplar

As I gain more experience as a practitioner, I find I am increasingly able to articulate my personal philosophy of nursing. I have learned that, as a professional nurse, my personal values and philosophies of nursing do affect the nature of the care I deliver and the quality of relationships I form within my daily practice. Becoming involved in an incident like the following has enabled me to develop an understanding of complex interpersonal and interprofessional situations. Unspoken grief, the devastating death of a child and the behaviour that surrounds such an event are part of what makes my experience with Kate and her parents so important to me. By reflecting on this incident, I have developed a new insight and have found new meanings from my experience. This has further allowed me to uncover and explore the implications this might have in my future practice.     

Ethnic differences in pain perception

Abstract

Pain is a complex multidimensional experience, which includes both a sensory and emotional component. With the increasing prevalence of multicultural societies consisting of numerous ethnic subgroups, each with differing beliefs, values, and customs, it has become increasingly important for the physical therapist to recognise how varying populations may experience pain differently. The purpose of this review is to describe the current healthcare literature regarding ethnic differences in pain perception; from this it can be ascertained that diverse ethnic groups express the quality and intensity or frequency of pain differently, and use varying amounts of analgesics in an attempt to control their pain. Physical therapists should recognise this and understand the implications this may have in the way patients express and communicate their pain. Recognising these individual differences, and that a patient's response to pain depends on their physiology, personality, life experiences and ethnicity is essential in developing the patient–therapist relationship, appropriate management strategies, and optimal outcomes.     

Cultural attitudes and beliefs about pain.

Patients and health professionals bring their own cultural attitudes to the communication and interpretation of the patient's pain experience. In this interaction, it is the health professional's knowledge and attitudes that dominate the response to the patient's experience of pain. In Saudi Arabia, a multicultural foreign and local health care team is challenged to understand the cultural beliefs and attitudes toward pain of both patients and team members. To increase cultural understanding and knowledge, a collaborative inquiry project using a culturally diverse group was conducted to learn about cultural attitudes and beliefs on the causes, treatment, and experience of pain. This article presents the knowledge gained from the collaborative inquiry journey of action and reflection.     

Smear test from the point of view of women who undergo it

This research is the result of my experience with women in cervical cancer prevention at the Gynecology and Obstetrics National Health Clinic of the Federal University of Minas Gerais. I tried to understand what it means to women who are submitted to a smear test. To achieve this, I have used a qualitative research, in a phenomenological approach. I gathered the data from interviews about the main subject. The analysis of those eleven interviews have helped me to build three analytical categories that are the located structure of the phenomenon, as follows: A--The preventive cervical cancer examination: a woman as a human being conscious of the world; B--Facing the smear test: manifestation of the existence; C--Working with the health professional during the examination: as interfaces of the attendance.     

The erect walking of the soul or: the dignity of a broken life

Getting the diagnosis of "paraplegia" means an extremely deep cut into someone's life. Suddenly everything is changed. Questions are arising: Why me? What is the meaning behind this? Pastoral care accompanies patients and their families during these hard weeks and months. There is time for people and their pain. It is not about offering easy solutions but about helping people to find their own language to express their inner experience and hopefully in the end, to find their own way with the disability. There is hope that something new can arise from the fragments of one's former life.     

A father's grief: dealing with stillbirth

In the end each person's experience of stillbirth is unique. There is no right or wrong way to grieve and each person defines it uniquely (Pilkington, 1993). My own experiences have shown me that it is important for the father to be strong and to take responsibility for what needs to be done, yet acknowledge his grief. My wife and child were the most important people at that time, and while I needed to grieve, I felt I could do it only my way, and at a time when I felt I had completed my initial responsibilities. I do not feel guilty about being strong, nor do I feel guilty about being weak. I do feel bad about being too proud and not seeking more support from groups set up specifically to help parents. Three years down the track, I still miss my daughter and still think of her. I have another child, who can never replace Angel, and when she grows up, she, too, will learn about her older sister.     

Indian Summer

This story is about my experience with the Oglala Lakota (Sioux) on the Pine Ridge Indian Reservation in South Dakota. For 6 weeks, as part of my last elective in the Community Health Intercultural Nursing Program at the University of Maryland, I made home visits with a Community Health Representative (CHR). Dianne Iron Bird, the CHR with whom I traveled, and a woman who was close to my age and stage of life, was largely responsible for my view of the reservation and for the level of acceptance I had in people's homes. My experience was rich and rewarding. It afforded me the opportunity to participate in a different kind of health care. I used this exercise in story-telling to test my knowledge and understanding of the Lakota's world view. By definition, it is my view of both my world and theirs. Using literal rather than abstract language helped me to see both worlds from a new perspective.     

Relationships in pain: the experience of relationships to people living with chronic pain in rural areas

The aim of the study was to develop new understanding of the lived experience of relationships for rural people living with chronic pain. Rural residents have greater difficulty accessing health services and providers. This is especially important to those living with chronic pain who often find themselves isolated from professionals who could potentially offer support. A phenomenological study with seven participants who had experienced chronic non-malignant pain for 2-29 years (Mean = 13) was recruited via a number of approaches and data analyzed using van Manen's framework. The themes that emerged from the analysis were as follows: pain as silence; privacy as a way of protection; no place out here to get support; and dealing with health-care professionals who do not understand. Lack of specialist services and support in rural areas means people with chronic pain are placed in even more vulnerable situations. Nurses remain at the forefront of service delivery in rural areas; hence, their role in management of people with chronic pain is vital in supporting them to maintain meaningful contact with others, including health professionals.     

Experiences of women in face of pain from acute myocardial infarction

The aim of this study was to understand the meanings of the experience of pain suffered by women during acute myocardial infarction (AMI) and to identify their immediate actions in face of pain. This qualitative research used the Symbolic Interactionism theory and the Grounded Theory methodology. Forty-three women were interviewed at the University Hospital. The central category expressing the pain experience was that it was "a break with day-to-day life". The categories that expressed such break revealed that in face of increasing pain those women felt dominated and afraid of dying because they had lost control over their bodies and their lives. They did not recognize the occurrence of AMI and at first resisted to look for assistance by attempting to alleviate the pain. In face of the unbearable pain and their impotence to control it, they asked for God's salvation and help from surrounding people and finally resorted to medical assistance.     

Financial management for entrepreneurs

Thousands of nurses are leaving corporate life and the bedside for the world of entrepreneurship. It is a healthy sign for the profession. Being in business is one of the best ways to learn about ultimate risk-taking, an experience woefully lacking in the world of hospital- or corporate-based nursing. There seems to be no way to soften the ultimate risk of embarking on a business, although each person can certainly learn what worked for others and what to avoid. In this article, I outline some of the key things that worked and did not work for me during my 20-year stint as a nurse entrepreneur.     

Culture and pain: a Mesoamerican perspective.

Culture has been identified as a factor that influences a person's reaction to and expression of pain. Research in the area of pain and culture has not established a clear link between cultural meanings and attitudes associated with pain and pain behaviors. The purpose of this ethnohistoric study was to explore the beliefs related to the experience of pain within ancient Mesoamerica. The six themes that emerged from this study represent efforts related to the discovery of the epistemics of cultural meanings of pain in contemporary Mesoamerican cultures, specifically Mexican-Americans. These findings serve as a benchmark from which to understand Mexican-American meanings, expressions, and care associated with pain.     

From acute pain to chronic pain: a personal journal

In 1985 I had back surgery, and I began to keep a journal. I thought it would help me track my progress. I wrote in it often, sometimes two or three times a day. It became a lifeline for me. Four years and ten volumes later it tells my story, the story of my struggle with pain.     

A metaphysical journey in a comatose state.

This paper is about the intense experience of being in the hospital in a comatose state resulting from an aneurysm with a massive brain hemorrhage and two subsequent surgeries. The event begins with a premonition of what will happen from a street name. The experience of brain surgeries, along with the fine care of the nurses, left me with a truly memorable impression. This paper describes the various feelings and strong emotions that I experienced while in a comatose state. It suggests that a patient in a comatose state can exist in a deep state of emotions close to ecstasy. The paper concludes with gratefulness to all the people who followed me step by step on this journey.     

Of cheese and choice

I am standing by the cheese cabinet in our local supermarket.(This is poetic licence, you understand. I am actually sittingat my PC, but my recent supermarket experience is so vivid thatI have no difficulty reliving it.) I am in a state of high anxiety.In front of me are uncountable types of cheese. There is Canadian,Irish, Welsh, New Zealand and English. There is mild, mature,extra-mature, vintage and farmhouse. There is low fat, fullfat—presumably ‘high fat’ would be a marketingdisaster—and vegetarian. There are special cheeses inexpensive waxy paper,     

Autoethnography: reflective journaling and meditation to cope with life-threatening breast cancer

Autoethnography is a qualitative research approach whereby the researcher shares personal stories that relate to the broader cultural context. Living through breast cancer showed me how reflective journaling and meditation can help one to cope with locally advanced breast cancer. The purpose of this autoethnography is to assist nurses in gaining a greater understanding of the primary cultural implications of (a) unresolved emotional issues from the past complicating current treatment and recovery for locally advanced breast cancer, and that (b) reflective journaling and meditation can provide an opportunity to "socially reconstruct" past psychological injury. In this example of autoethnography, I reconstructed the past by re-experiencing childhood wounds through meditation, accompanied by myself in the role of the nurturing mother providing comfort and support to the wounded inner child. That approach affirmed me in my current mothering role and provided imagery of the comfort that I was lacking in my childhood. Such duality empowered me toward self-acceptance and self-worth. Loss, grief, fear, and anxiety are considered universal states and emotions that interfere with quality of life. Finding meaning in suffering can heal pain and free energy for the pursuit of justice, peace, and joy.     

Meanings of giving touch in the care of older patients: becoming a valuable person and professional

Touch is central to nursing and health care workers frequently touch their patients, consciously or unconsciously in their interactions with them. Most literature has studied touch from a patient perspective, thus inquiry about professionals' experiences are rare. The aim of this study was to illuminate meanings of giving touch in nursing care of older patients. To understand the meaning of lived experiences of giving touch in care of older patients, interviews with 12 health care professionals in northern Sweden were analysed using a phenomenological-hermeneutic approach influenced by the philosophy of Ricoeur. The findings show that giving touch in the care of older patients is a transforming experience, where one suddenly perceives oneself as both a valuable person and professional who no longer powerlessly confronts patients' haunted and disrupted bodies, but who, by means of touch, has gained power to ease this suffering. The experience also transforms the way one regards older patients. Instead of seeing a severely demanding patient suffering from dementia and/or pain, one is able to see the person behind the disease as a human being, like oneself. A relationship described as calm, friendly and humane is created between caregiver and patient when giving touch, a relationship that transcends the moment of touch and influences one's way of caring. This understanding is presented using the theoretical framework of the philosophy of Marcel. Giving touch has the power to shed new light on health care professionals' experiences of caring for older patients suffering from dementia and/or pain, giving them the power to be a valuable person and professional.