Show notes
Dr. Rana Awdish is one of those rare humans who can speak from both sides of the hospital bed with complete authority, and somehow make you feel understood in the process. She's a critical care physician whose first book, In Shock, is a landmark medical memoir about becoming critically ill on the last day of her fellowship in her own ICU and it was one of the books that helped Kristin make sense of her own co-survivor experience after my cardiac arrest. Rana's new book is Aftershock: Learning to Reinhabit My Body After Illness, and it picks up where In Shock left off: not the dramatic part, but the harder part, the years of PTSD, the process of learning to trust her own body again, and the realization that medicine doesn't own healing. We talk about her experience of being repeatedly hospitalized in her own ICU, the embodiment work she had to do to unlearn what medical training takes from you, and the specific, extraordinary moment when she was sitting at her window watching snow that looked like dividing cells and understood, with total certainty, that she had cancer, before any test confirmed it. She then tried to schedule her own surgery before the pathology came back. The biopsy came back positive. Her body was right.
Kristin asks us both the question I've been avoiding: is humor a deflection? I can't fully say it isn't. There's a pretty direct line between making a wearable defibrillator comedy video the moment I got home from the hospital and not having fully processed what happened. Rana's concept of "externalizing", putting difficult things outside yourself so they live somewhere other than inside your body, maps uncomfortably well onto what I do. We also get into interoception (a new word for me, as Kristin noted with zero surprise), moral injury, and what Rana would tell healthcare professionals who reflexively dismiss patients who say they know something is wrong. She's a professor at two medical schools, and the line I keep thinking about is this: "There's so much in our training that causes us to believe we have to have the answer or we have no value." This is one you'll want to sit with for a bit. I'm still sitting with it.
Takeaways:
Medicine doesn't own healing.
Humor and creativity can be externalizations as much as they are healing
Interoception, the nervous system's awareness of internal body states, is real, measurable science, not woo
Living with a foreshortened sense of the future is a predictable and poorly-addressed consequence of surviving critical illness
Physicians are trained to function without physical or emotional needs, and the deprogramming required to reconnect with their own bodies is real and difficult
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