Our mission at HealthPartners and Park Nicollet is to improve health and well-being in partnership with our members, patients and community- begs the question, “what is the difference between health and well-being?” Recently, I attended a panel discussion at St. Thomas with my wife and daughter that elucidated the differences between the two.
The conversation, described as “living well in broken bodies,” featured Matthew Sanford, director of Mind-Body Solutions and Dr. Bruce Kramer, the former dean of education at St. Thomas. While driving home from a Thanksgiving gathering in Iowa, Matthew, age 13 along with his family slid off an icy highway. His older sister and father were immediately killed and Matthew shattered his thoracic spine resulting in complete paralysis below his chest. In his book, Waking, a Memoir of Trauma and Transcendence, Sanford describes how his treatment team, allied to the usual medical model, encouraged him to overcome and compensate for the paralysis by teaching him to ignore his lower body while focusing all of his efforts on developing upper body strength. Although this approach improved his functioning, it failed to promote his healing. Many years after the accident, he began a journey toward healing his emotional and spiritual wounds by practicing adaptive yoga in an attempt to reconnect with his lower body. Through Matthew’s Mind-Body Solutions he now teaches yoga to the “temporarily able-bodied,” referring to those of us without visible disabilities, but for whom aging will cause a loss of functionality,” and adaptive yoga to individuals with disabilities.
Matthew is Bruce Kramer’s teacher. For the past few years, Dr. Kramer has been living with Amyotropic Lateral Sclerosis (ALS). He describes ALS as “death by a thousand paper cuts” as it involves small but progressive loss of muscle functioning until only eye movements remain. Dr. Kramer movingly talks about dealing with ALS in his blog entitled Dis Ease Diary.
Bruce and Matthew, each situated in their own wheel chair, discussed living well within the confines of their bodies. They harbored no illusions of ideal health, yet they both exuded an impish well-being. The following excerpt from Bruce’s October 18th blog entitled “Endgames” telegraphs well-being as it flows from the pain of an individual who views life as it is:
I cannot help but feel robbed, not of immortality, but of the 30 years of healthy old age that I honestly thought was my future. ALS provides the perfect corrective to the best of plans. She grants knowledge that our imperfect physical envelopes in which we place so much importance, given to us for such a short time, always fulfill their design destiny and break down utterly and completely. There are so many ways to shorten our lives, and when you consider how many ways you could go, how easy it is to experience catastrophe, how unremarkable is death, then dying before one’s so-called time should probably be seen as more the norm than the exception. The 30 or so years that I like to believe would have been mine were it not for ALS are so minuscule in the scheme of the universe, that it is tempting to diminish their importance, to believe they are meaningless.
But they are my 30 years, and I had dreams and plans.
I planned to sleep in the arms of my one true love, to be awake, so very awake to her presence in my life. I planned to be there for my boys and their true loves and the children that they would have. I planned to cook birthdays and anniversaries, Thanksgiving and Christmas, three-day weekends and one night chili cookoff’s, holidays and holy days. I planned to be the husband and father and grandfather of legend. I planned to bring a rational voice and compassionate love to the education of children, the emotional healing of people, the design of systems. I planned to be the best friend anyone could ever have. Before ALS, I could see those plans opening into limitless vistas.
I am cured of planning, at least for the moment. Now, I pay attention to the losing – hand dexterity, back strength, neck strength, vocal presence – all of these to go along with the legs and arms and torso already gone. And with the losses, I have struggled to play catch-up and turn to new ways and old ways that I now realize are just barely ahead as the losses pile up behind. And yet, I am not cured. I still have plans – final words, time spent, memories, music.
I plan to end in a better space, always a better space.
If there is anything that I have learned from ALS, it is that the bad times are like changeable weather. If you have patience, things will begin to turn around. There is no big event, no one thing that turns me away from feeling sorry for myself toward that person I want to be. In spite of my whining, I work hard for spaces devoid of soul-killing feelings – deep resentment, crushing bitterness, prolonged anger. It isn’t that I don’t own major reserves of these feelings, but grim feelings have no payoff, they depress colors, muffle sounds, numb the touch and leave me hopeless in dis ease. So I do my best to acknowledge them, communicate them, concentrating on things that bring me back into the here and now space where the beauty of living is so much clearer, even if it feels shortened by circumstance.
And the endgame is just one end, opening new beginnings.
Dr. Kramer’s words prompted me to recall individuals I have encountered who appeared healthy but clearly did not convey a sense of well-being. These individuals ruminated about past regrets, coveted more and more tangible gains or lived for some future state which was already in the past once it arrived. Matthew ended the session with a wish for the audience that clearly flowed from a sense of well- being: “may you have the strength and courage to allow your life to change you.”
Please use comments below to describe your thoughts about health and well-being.