The Dance of Relationship: TED & Pilobolus

Many of you are familiar with the TED talks.

TED stands for Technology, Entertainment, Design. It started out (in 1984) as a conference bringing together people from those three worlds. Since then its scope has become ever broader.

The annual conference now brings together the world's most fascinating thinkers and doers, who are challenged to give the talk of their lives (in 18 minutes). Many of the talks are captured on video and posted on the TED website.

This extraordinary 14 minute video shows two dancers from the Pilobolus dance company, - entwined, apart, struggling, emerging. I found it so captivating that at some point I stopped thinking about what it might mean and just got wrapped up in the fluidity of their movements.

Others will have different interpretations, but for me, this dance is the dance of relationship, of a couple, or all couples, striving to balance separateness and merging, elation and suffering. This is an exquisite piece. I hope you enjoy it.

Grand Rounds at Happy Hospitalist

This week's medical Grand Rounds is up at Happy Hospitalist. I'm pleased my post about saying goodbye to my dear dog is included.

The Two Sides of Back Pain

I did too ambitious a plow pose in yoga class today, and heard my back make a suspicious popping sound. When I rolled out of the position, I couldn't sit up straight. Bent over like a crone with a cane, I inched my way to my car and made it home. I have been icing my back and crunching Advil for the last few hours.

My reaction to my body failing in any way is so convoluted since the peak days of suffering with a pain condition. On the one hand, I want to shout, "I've paid my dues. I earned a lifetime get-out-of-pain card. Pass me by and give that 20 year old in purple spandex a broken finger nail instead.

On the other hand, it's a bit delicious to have a normal person's ailment. Something with a known cause, a clear treatment, and most importantly, an end date. I'm seeing my chiropractor tomorrow and expect to be down-dogging again by the weekend.

GrandRounds is up at Parallel Universes

A very interesting collection. Please have a look at Parallel Universes. I am honored that my post is among his top 5 picks.

TheTragedy of Self Immolation

Sometimes you stumble upon something and it makes you realize, no matter what your suffering is, how privileged you are.

The May 22 issue of the New England Journal of Medicine had an article that stopped my heart cold. It is entitled, Driven to a Fiery Death - The Tragedy of Self-Immolation in Afghanistan.

It begins with these tragic statistics:

"Afghanistan, a country with 32 million residents, has been engaged in constant conflict for the past 30 years. This instability and insecurity have resulted in a stark economic climate and a very low life expectancy. More than half of the people in Afghanistan live in poverty, and 40% of the adult labor force is unemployed. Life expectancy is 44 years, and annual mortality is 20 per 1000 residents."

Against this backdrop of destitution, the authors superimpose a horrendous tragedy.

"70 to 80% of female Afghanis are forced into marriages, and 57% are married before 16 years of age; 84% of women are illiterate as compared with 69% of men, and women are half as likely as men to have completed primary school. Afghan women have a fertility rate of 7.5 births per mother, and with a skilled birth attendant present at only 14% of births, the country's maternal mortality is the second highest in the world."

These facts, however, do not represent the worst tragedy. That is yet to be described.

"The Afghanistan Independent Human Rights Commission and the Afghan Ministry of Women's Affairs report the identification of 106 cases of self-immolation (by women) , in 2006; if these events are considered instances of violence against women, they account for 5 to 6% of all such violence reported that year."

"Self-immolation is the act of burning oneself as a means of suicide."


Half of these cases were women between the ages 16 to 19. This is a picture of a young burn victim. The gauze over her face is used to keep flies off.



"Often, self-immolation was said to have occurred after victims spoke out against or sought help in alleviating the violence to which they were subjected — but were ignored." Violence perpetrated by husbands, in-laws, and husbands' other wives.

To burn yourself, because it must be a lesser torture than those to which you are subjected every day by your husband, by your family; to disfigure yourself as testimony against those who have savaged you; to seek release in death not through the quietness of a knife but through the explosiveness of fire -- it stops my heart. I don't know what to do.....

Is donating money to groups on the ground, working for women's rights in Afghanistan enough? No...but it's a start.

Sheila & Harry: A Story about an Under-Functioning/ Over-Functioning Couple

Over the past several years, Sheila, age 80, has been the designated patient. Her closest friends are her doctors whom she believes understand her best. In any given week, she may have two to four appointments. She takes a jumble of medications, some of which are not compatible with each other, and intermingling them can cause the symptoms they are intended to alleviate. As the months go by, she spends more and more time on the couch.

Lately, a new dynamic seems to be setting down roots. Her husband, Harry, age 82, has had several serious falls which resulted in hospitalizations followed by lengthy rehabilitation and physical therapy. Last week, he caused a car accident and is back in the hospital, soon to go to another rehab facility. He is miserable, in pain, and non-communicative.

The kicker is that Sheila, rather than sinking deeper into the folds of the couch, has risen. She is becoming the competent one who deals with paperwork and arrangements and information. She has even started swimming three times a week.

In short, the worse he gets, the stronger she becomes. From my work, I know this is not an uncommon pattern - the under-functioning/ over-functioning couple.

Have you seen this pattern in your family? How about in your own relationship?

Grand Rounds at Health Business blog.

Grand Rounds is up at the Health Business Blog. Have a look. I'm pleased my post on doctor etiquette was included.