Spiritual Awakenings and Practices for Good Health
Kevin Y. Kawamoto
Special to The Hawai‘i Herald
Resilience — the ability to bounce back from significant adversity and lead a meaningful, purpose-driven life — was the underlying theme of Dr. Randal Wada’s keynote speech at the seventh annual “Journeys to Wellness” gathering on Oct. 13 at the Community Church of Honolulu. Readers may remember Herald contributing writer Alan Suemori’s profile on Dr. Wada in the June 26, 2017, Hawai‘i Herald. The accomplished pediatric cancer specialist, president of the lifesaving Hawai‘i Cord Blood Bank and university educator has pioneered groundbreaking research and treatment that has helped children with cancer survive their disease.
But one thing Wada conveyed during his talk was that treating people with a serious, and even terminal, illness requires more than just specialized medical knowledge. Aggressive, invasive procedures may not always be in the best interest of the patient. At times, it may be better to acknowledge the limits of medical treatment and remember “to live for today,” while also retaining hope for tomorrow.
“Living for today” may involve using nice things that had been set aside for special occasions, fulfilling dreams on a bucket list such as a long-planned vacation to a remote destination, or resolving simmering conflicts with loved ones. These are acts that contribute to healing — for example, the healing of damaged relationships — regardless of whether the progression of a disease can be stopped.
This philosophy of patient-centered communication resonated with the goals of Journeys to Wellness VII, which brought a diverse group of people together to reflect on different ways to achieve “a healthy and harmonious body, mind, spirit and community,” according to the Rev. Dr. Wally Fukunaga, founder of the Sunrise Foundation, the nonprofit interfaith organization that is the event’s primary sponsor. A cancer survivor himself, Fukunaga pulls together a team of enthusiastic supporters each year to develop a daylong program that offers inspirational speakers and musicians, a small but appealing “wellness fair” and a series of afternoon workshops. The workshops addressed subjects such as “Millennials’ Pursuit of Wellness in Today’s World,” “Improve Everything, Including You!,” “Meditation and Principles of the Martial Arts,” “Pathways to Your Peak,” “Mindfulness: A Way to Enhance Awareness and Reduce Stress” and “Good Soil: Organic Farming, Holistic Health and Sustainable Communities.”
Participants could also meet with Dr. Wada and respondents to continue discussing the topic, “Resilience and Mortality: Conversations Your Doctors Wish They Could Have With You,” in a more intimate and informal small-group setting.
In his keynote speech, Wada reflected on how the field of medicine has changed over the decades, in both good and not-so-good ways. While he acknowledged the advances in Western medicine — due to antibiotics, vaccinations and technologies that can prolong people’s lives — Wada also observed that in simpler times, physicians tended to take the time to talk with their patients, getting to know them and their circumstances better. In short, they were able to have conversations.
“There’s a lot more that we can do [today],” he said, “but, ironically, we spend less time talking to our patients.” Meaningful two-way communication is important because it helps the physician understand what is really important to the patient and what kind of treatment decisions would be most appropriate given the patient’s particular life goals and expectations.
Wada also shared a number of tips for how people facing health challenges can build resilience into their coping skills, emphasizing the importance of trying to look at things in the most constructive way possible.
“Resilience is not so much about what happens to you, but how you deal with what happens to you,” he said.
Wada referenced research that has been conducted on resilient people over the years, including the work and writings of the late Norman Garmezy, a University of Minnesota developmental psychologist who studied resilience in children. Others have built upon that trailblazing research. A few key findings are summarized below.
Resilient people learn how to ride out the storm, seeing adversity as being a temporary rather than permanent condition. They think, “This is hard now, but it’s not going to stay this way forever.” They acknowledge that adversity, or bad events, are challenging, but that they are not the cause of those events and can choose how to react to those events. And, they are able to move from the “global to the specific,” meaning they do not generalize that their whole world is a mess, but rather that this one specific challenge that they are going through, whatever it is, is pretty bad. Resilient people also seem to be better able to view adversity as an opportunity to learn and grow, or to find meaning in the adverse experience. The way a person frames or thinks about adversity can affect their ability to cope with it.
In the context of significant health challenges, Wada recommended that patients get as much information as possible to help them understand what is happening to their body, what to expect and what can be done, and then address all medical problems that are draining them of strength. Seek answers to questions and ask for support. Additionally, address other problems in their life that are draining them of energy. Wada talked about real-life cases in which health care providers were able to help dying patients achieve closure by really listening to what the patients wanted to do with the remaining time they had left. He reminded the audience that it takes time to adjust to losses in life and grieve over them, and that sometimes the affected patient may feel weaker before they begin to feel stronger.
Finally, Wada said it is important to face the reality of one’s mortality. “Everybody dies in the end,” he said. One of the conversations people should be having with their physicians and their loved ones is about “transition versus intervention” — in other words, choosing when to continue treatment and when it is time to stop. A serious and prolonged illness can take a toll on a patient’s quality of life. There are times when decisions have to be made about whether it is no longer helpful to continue treatment. Accepting the reality of dying allows individuals to use their remaining time meaningfully and, in an ironic sense, regain their lives by refocusing on what is most important to them.
A practical communication tool that health care providers can put into practice is to show patients empathy through both words and actions. Wada shared the N.U.R.S.E acronym technique that can encourage dialogue built on trust and understanding.
N stands for “naming” the emotion, acknowledging the patient’s feelings while talking with him or her. U stands for conveying an “understanding” of the emotion or situation. R stands for showing the patient “respect.” S stands for showing “support.” And E stands for the willingness to “explore” feelings further to broaden and extend the conversation.
Wada observed that good communication skills are useful beyond the health care setting — for example, in relationships at home between spouses. “If you’re mindful,” he said, “once you try it, it’s highly effective.”
Since 2014, Journeys to Wellness has recognized three community leaders each year with its Puaka‘ana o ka lä (Rise Up!) awards for their “longstanding and significant contributions toward the promotion of wellness of the body, mind and spirit to our people and community.” This year’s honorees were longtime civil rights advocate and diversity proponent at the University of Hawai‘i at Mänoa Dr. Amy Agbayani; Rev. Dr. Teruo Kawata, a religious leader who devoted decades of his life advocating for peace and justice locally and abroad; and popular comedian Frank DeLima, who has visited more than 350 schools throughout Hawai‘i, using comedy to promote learning, wellness and leadership.
Prior to this year’s Journeys to Wellness event, Fukunaga was concerned that attendance might not be as robust as in past years. However, registrations ticked upward closer to the event, and ultimately, perhaps providentially, the final headcount turned out to be healthy, pleasing the organizers.
“Yesterday’s Wellness event had a special power,” Fukunaga communicated in an email the following day. He described the event as “intimate, connecting and uplifting” from start to finish. Participant evaluations will help to plan next year’s program.
To learn more about the Sunrise Foundation and upcoming events, visit www.sunrisefoundationhawaii.org
Kevin Y. Kawamoto is a longtime contributor to The Hawai‘i Herald.