Coming Together to Heal the Healers

 

 

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It is stressful enough to treat cancer, a spectrum of diseases with few cures. But imagine the strain when oncology physicians, nurses and others are isolated, working in the midst of political strife, often with few resources. Such is the case in the Middle East, where caregivers cannot easily collaborate across national boundaries to understand and manage the extent of the cancer experience there.

Understandably, these tensions were evident in the annual meetings that began in 2003 of the Middle East Cancer Consortium (MECC), established by the Ministries of Health in Israel, Jordan, Egypt, the Palestinian Authority, Cyprus, and Turkey. The consortium, supported largely by the U.S. National Institutes of Health, is designed to reduce the incidence and burden of cancer in the region though collaboration and joint research. Oncology doctors and nurses also attend by invitation from many other countries in the region, such as Pakistan, Lebanon, Saudi Arabia and India.

But then, in 2005, something unexpected happened.

Aziza Shad, MD, the Pakistani-born Chief of the Division of Pediatric Hematology/Oncology at Georgetown University Medical Center (GUMC), invited two of her GUMC colleagues to the meeting, which she had been attending due to her interest in developing pediatric oncology programs in the Middle East.

These associates – Aviad Haramati, PhD, and Nancy Harazduk, MEd, MSW – were invited to talk about the science and application of Mind-Body medicine. But they did more than that. Haramati and Harazduk divided the 80 participants into two groups and led them through several mind-body exercises.

They asked the physicians, nurses and social workers to meditate and to experience guided imagery by imagining themselves in a “special place. We introduced stress management and self-awareness techniques to the faculty,” says Haramati. “The goal is to teach practitioners to care for themselves, to heal the healer.”

While political tensions between the participants’ countries of origin were not overtly discussed, it was one of the subterranean currents flowing through the exercises, he says. “The deeper theme is being present, talking about oneself, and confronting issues on a personal level.

“Within each caregiver there is a person, not just a member of a country,” Haramati says.

The impact was immediate. “They discovered they could bridge the gulf between them using this humanistic approach to care. All the practitioners face the same constraints and stresses and they found more that unites them than sets them apart,” says Harazduk, who directs the Mind-Body Medicine Program at Georgetown University School of Medicine (GUSOM).

Haramati and Harazduk, and, lately, Michael Lumpkin, PhD – all members of the GUSOM program – have attended the annual MECC meetings ever since; their sessions lasting 2 hours on each day of the 3-day meeting. They have expanded their “experiential” components to include drawing, narrative writing and even shaking and dancing, a form of active meditation.

They say that the connections established between these participants, who are on opposite sides of the political divide, is quite remarkable. In one recent group dance exercise, where men and women are interspersed in a circle, an Israeli woman saw a Jordanian woman hesitate in taking the hand of the male next to her due to religious constraints, Haramati says. The Israeli woman seamlessly inserted herself so that the Jordanian could take the hands of women on both sides of her.

In another session, two women – an Israeli and a Palestinian – learned in a group discussion that they had each lost a son to conflict between Israel and the Palestinian Authority. “They each shared their loss and began to cry. They then spontaneously went to the center of the group and hugged each other, saying how sorry they are because they are each a mother to a son,” Harazduk says. “It was extremely emotional and very, very healing.”

“I am an Orthodox Jew who wears a kipa (skullcap) on my head when I lead my group, which might cause some to be hesitant in being forthcoming,” says Haramati. “But it is amazing to note how pre-conceived notions or potential biases disappear and personal connections are established if one becomes present and authentic with the right intentions. People begin to come together who never would otherwise.”

The work they have done at MECC is just a brief version of the program offered to medical students at Georgetown every year. The Mind-Body Medicine Program began in 2002 and now entails an 11-week course of two-hours a week to medical students who choose to take it – and about one-third do. The students can also take advanced courses during all four years of their education. “The purpose is to create a safe place so students can learn about themselves by being open and authentic with one another. They become closely connected to each other and with the faculty facilitators and stay that way,” Harazduk says. “We stress collegial cooperation and compassion as opposed to competition. The students have a sense of the bigger picture, focusing not so much on grades but on how to be better physicians and more complete human beings.”

Because each group is small (no more than 10 students and 2 facilitators), between 7 and 15 simultaneous sessions are offered each semester, necessitating considerable numbers of trained faculty. The faculty, from across the University community, are carefully selected for training in the mind-body techniques and then become facilitators. The Dean of Medical Education, S. Ray Mitchell, MD, is one, for example.

This interest by many physicians and researchers has not only changed the faculty, but has led to incorporation of complementary and alternative medicine into the medical school curriculum, Haramati says. “We brought acupuncture into anatomy and neuroscience, biofeedback into physiology, and the science of stress reduction into endocrinology.”

Given that more than 1,200 students and faculty have participated to date, the Georgetown Mind-Body Medicine Program is considered one of the most robust programs in the world, and a model to emulate. Other branches of the Georgetown campus are also enthusiastic - the business and law schools have started similar mind-body endeavors.

While the stresses seen in participants at MECC may be particularly intense, the mind-body techniques work across all populations, Haramati says. “This is about being authentic, about having the ability to shut out constraints and external influences—at least temporarily,” he says. “We all have different roles to play, but at the end of the day, we are all people.”

By Renee Twombly, GUMC Communications