Introduction to Kitchen Table Wisdom

Everybody is a story. When I was a child, people sat around kitchen tables and told their stories. We don't do that so much any more. Sitting around the table telling stories is not just a way of passing time. It is the way the wisdom gets passed along. The stuff that helps us to live a life worth remembering. Despite the awesome powers of technology many of us still do not live very well. We may need to listen to each other's stories again.

My grandfather had early on, in a manner worthy of Socrates himself, engaged me in the search for what is Real. His world, inhabited by an immanent and personal god was one of the two worlds of my childhood. He was a grave and scholarly man, elderly by the time that I was born, an orthodox rabbi who spent much of his time studying the texts of mystical Judaism. The books of the Kabballah he had brought with him from Russia were old, written out by hand in Hebrew on very thin paper. As a small child, I would sit under the table as he studied them, stroking his purple velvet carpet slippers and daydreaming.

The other world of my childhood was the world of medicine. Among two generations of my grandfather's children there are three nurses and nine physicians. When I was young I thought you became an adult and a doctor as part of the same process. I learned early the right thing to say when I was asked what I wanted to be when I grew up. I was the only pre-med in kindergarten. When my grandfather died he left me in his will the money to go to medical school. I was seven years old.

As I grew older, the weight of these family expectations began to grow heavy. My uncles and cousins were men of science, distant, cultured, intellectual and successful. Like my father, they rewarded me for having the right answers. My grandfather had rewarded me for having the right questions. I admired these doctors but I had loved my grandfather and his way of questioning life. At twelve, my closest male cousin and I both wanted to be rabbis. We both became doctors.

I think I ultimately chose medicine because of a novel I read when I was about twelve, a story about the life of Saint Luke called The Road to Bithynia. Historical novels were the LSD of the fifties, an easy escape for a generation of bored postwar adolescents. I was addicted to them.

I had not known that Luke was a physician. The Road to Bithynia had originally appealed to me because The Gospel According to Luke was my favorite part of the Christmas story. The book was written by a physician, Frank Slaughter, who told Luke's story with all the power and credibility of his own personal knowledge of the practice of medicine. I read the novel four times, stunned to find that all physicians were not like my uncles, that it might be possible to be a physician in a way that my Grandfather would have understood. That being a physician could become a means to better know and serve life and the source of life. The novel offered the hope that someone like myself might find a place in medicine, without needing to choose between my grandfather's way of life and that of his sons.

The day it all began stands out in my memory: my father carrying my belongings to my room at the medical student residence, my mother unpacking my clothes and lining my drawers with special paper as always, working as partners until there was nothing left to do. I remember the uneasy conversation and at last closing the door behind them. How much they had wanted to stay, to share in this last-night-before-the-first-day of medical school. But at twenty, I had wanted to face this momentous thing by myself.

I looked at the carefully folded clothes, the shelves empty of books, the hard and narrow bed and the bare surface of the desk. The room felt impersonal, monastic even, very different from the feminine bedroom I had slept in the night before. It would be my home for four years. Tonight it felt cold and somehow unsafe.

I felt a familiar doubt, a fear that I was doing the wrong thing, that I was not cut out for this and would fail at it. As a philosophy major, I had barely been admitted to Cornell's school of medicine. The interviewer had looked at my honors degree in Wittgensteinian philosophy, commented that my major was "irrelevant" and entered into a brisk discussion of genetics, his own life work. I had held my own, but secretly I knew I was no scientist. Secretly, I found science colorless and cold. Full of hard edges. Like this room.

Hugging myself, I turned toward the only window. Earlier, I had glanced out and noticed that it looked onto the city street. I had a brief impression of unrelieved greyness. But it was night now and there across the street was the main entrance of the hospital, one of the best known in the world. It was blazing with light.

From where I stood I could see the main building and the two wings enclosing the great semicircular driveway. An endless flow of cars came and went, bringing sick people, people in trouble and those to whom they mattered. I stepped to the window deciding to watch for a while, just until the lights went out. A little before midnight a crowd of people, many wearing white, arrived and a little after midnight, a great many other white clad people left and found their way to their cars in the parking lots. The shift had changed. I got the blanket from the bed, wrapped myself in it and pulled up a chair. Cars, ambulances, taxis, and police cars continued to come and go. I nodded off several times, awakening each time to find nothing had changed. By four a.m. I realized that these lights never went out. People were there, always, for anyone in crisis, anyone in pain. The lights were being passed from hand to hand. And as of this morning, I was a part of this. I knew nothing yet, but I belonged.

In my Grandfather's synagogue there was a light that never went out. All synagogues have such an eternal light. It signifies that the unseen presence of God is always in this place. Comforted, I got up and went to sleep. Over the next four years I can't remember ever having the time to look out that window again.

It is not possible to be in a twenty-four hour-a-day intensive training program for many years and not be changed by it. We worked seven days a week, thirty-six straight hours on and twelve hours off, for most it. When we were off we slept. Denial of the body, its needs for sleep, comfort and even food was the very foundation of the schedule. No one complained. It was just the way that we all lived. Many of the rooms I worked and studied in had no windows. Often I did not know what day it was or even the time. I remember watching the nursing shift going past me, day after day. I would look up and see Miss Harrison and know it must be morning again. Often I had not slept since I had last seen her. Once during my internship, my mother, visiting me in the house staff residence, was horrified to open my closet and find that I did not have a winter coat. "Where is your coat ?" she gasped. I had not known it was winter. I had not been outside the hospital and its underground tunnel systems in over a year.

On one very rare summer afternoon off I remember travelling home to visit my parents on the subway, realizing only after a while that I had been unconsciously scanning the veins of the bare-armed people around me wondering whether my skills with a needle were good enough to allow me to successfully draw blood from them. This sort of training changes the way you see things, the way you think. Gradually things that had been central in my previous life became vague and faded into the background and other things more heavily rewarded became overdeveloped. After a time I just forgot many important things.

Thirty-five years ago, I was one of a few women in my residency training program and my male colleagues generally assumed that, as a woman, I had a greater comfort and skill in meeting the emotional needs of patients. Actually, at the time nothing could have been farther from the truth. In many ways I was emotionally less well developed than some of the men I worked with daily. Throughout four years of medical school I had competed successfully with men and had fiercely and single-mindedly cultivated the very qualities of decisiveness, objectivity, competence, judgment, and analytical thinking that were most respected in the group. These qualities had become even more important to me than to the men as I struggled to overcome what was widely perceived by them to be a gender handicap.

Yet the same teammates who so painstakingly treated me as if I were a man, called on me in situations that made them uncomfortable. Often when we were all working the clinic or the emergency room, each seeing patients in our own examining rooms, there would be a knock on my door. Opening it, I would find another house officer standing there ill at ease who would say something like, "My patient is crying...can you come?" I was no more comfortable than he in such situations but I realized early that this was part of my ticket to acceptance and so I would go and listen while someone shared with me their concerns and their experience of actually living with the disease we had diagnosed.

At first, I was surprised that people with the same disease had such very different stories. Later I became deeply moved by these stories, by the people and the meaning they found in their problems, by the unsuspected strengths, the depths of love and devotion, the rich and human tapestry initiated by the pathology I was studying and treating. Eventually, these stories would become far more compelling to me than the disease process. I would come to feel more personally enriched by them than by making the correct diagnosis. They would make me proud to be a human being.

These stories engaged me at another, more hidden point. I too suffer from an illness, Crohn's disease, a chronic, progressive intestinal disease which I had developed at the age of fifteen. So for me, these conversations eased a certain loneliness. This was a different sort of connection than the easy banter and camaraderie I enjoyed with the other medical residents. This was the conversation of people in bomb shelters, people under siege, people in times of common crisis everywhere. I listened to human beings who were suffering, and responding to their suffering in ways as unique as their fingerprints. Their stories were inspiring, moving, important. In time, the truth in them began to heal me.

Most of the stories we are told now are written by novelists and screen writers, acted out by actors and actresses, stories that have beginnings and endings, stories which are not real. The stories we can tell each other have no beginning and ending. They are a front row seat to the real experience. Even though they may have happened in a different time or place they have a familiar feel. In some way they are about us, too.

Real stories take time. We stopped telling stories when we started to lose that sort of time, pausing time, reflecting time, wondering time. Life rushes us along and few people are strong enough to stop on their own. Most often, something unforeseen stops us and it is only then we have the time to take a seat at life's kitchen table. To know our own story and tell it. To listen to other people's stories. To remember that the real world is made of just such stories.

Until we stop ourselves or more often, have been stopped, we often hope to put certain of life's events "behind us" and get on with our living. After we stop we see that certain of life's issues will be with us for as long as we live. We will pass through them again and again, each time with a new story, each time with a greater understanding until they become indistinguishable from our blessings and our wisdom. Its the way life teaches us how to live.

When we haven't the time to listen to each other's stories we seek out experts to tell us how to live. The less time we spend together at the kitchen table the more "how-to" books appear in the stores and on our bookshelves. But reading a book is a very different thing than listening to someone's lived experience. Because we have stopped listening to each other we may even have forgotten how to listen, stopped learning how to recognize meaning and fill ourselves from the ordinary events of our lives. We have become solitary; readers and watchers rather than sharers and participants.

The kitchen table is a level playing field. Everyone's story matters. The wisdom in the story of the most educated and powerful person is often not greater than the wisdom in the story of a child and the life of a child can teach us as much as the life of a sage.

Most parents know the importance of telling children their own story, over and over again, so that they come to know in the tellings who they are and to whom they belong. At the kitchen table we do this for each other. Hidden in all stories is the One story. The more we listen, the clearer that Story becomes. Our true identity, who we are, why we are here, what sustains us, is in this story. The stories at every kitchen table are about the same things, stories of owning, having and losing, stories of sex, of power, of pain, of wounding, of courage, hope and healing, of loneliness and the end of loneliness. Stories about God.

In telling them, we are telling each other the human story. Stories that touch us in this place of common humanness awaken us and weave us together as a family once again.

Sometimes when I ask people to tell me their story they tell me about their achievements, what they have acquired or built over a lifetime. So many of us do not know our own story. A story about who we are, not what we have done. About what we have faced to build what we have built, what we have drawn upon and risked to do it, what we have felt, thought, feared, and discovered through the events of our lives. The real story that belongs to us alone.

All real stories are true. Sometimes when a patient tells me their story, someone in their family will protest. "But it didn't happen quite that way, it happened more like this." Over years I have come to know that the stories both these people tell me are equally true, equally genuine and that neither of them may be "correct," an exact description of the event much as a video camera might have recorded it. Stories are someone's experience of the events of their lives, they are not the events themselves. Most of us experience the same event very differently. We have seen it in our own unique way and the story we tell has more than a bit of ourselves in it. Truth is highly subjective.

All stories are full of bias and uniqueness, they mix fact with meaning, they are more real than right. This is the root of their power. Stories allow us to see something familiar through new eyes. We become in that moment a guest in someone else's life, and together with them sit at the feet of their teacher. The meaning we may draw from someone's story may be different from the meaning they themselves have drawn. No matter. Facts bring us to knowledge, but stories lead to wisdom.

The best stories have many meanings; their meaning changes as our capacity to understand and appreciate meaning grows. Revisiting such stories over the years, one wonders how one could not have seen their present meaning all along, all the time unaware of what meaning a future reading may hold. Like the stories themselves, all these meanings are true.

Knowing your own story requires having a personal response to life, an inner experience of life. It is possible to live a life without experiencing it. Most children experience life more fully than we do. Children are aware of the particulars. For a child the time between Halloween and Christmas is made up of thousands and thousands of fully experienced moments. That takes longer to live through, longer to go by. After forty, Christmas seems to come three times a year.

I was once a pediatrician but I am no longer : for many years now I have listened to the stories of people with cancer and other life-threatening illnesses as their counselor. From them I have learned how to enjoy the minute particulars in life once again, the grace of a hot cup of coffee, the presence of a friend, the blessing of having a new cake of soap or an hour without pain. Such humble experience is the stuff that many of the very best stories are made of. If we think we have no stories it is because we have not paid enough attention to our lives. Most of us live lives that are far richer and more meaningful than we appreciate.

We carry with us every story we have ever heard and every story we have ever lived, filed away at some deep place in our memory. We carry most of those stories unread as it were until we have grown the capacity or the readiness to read them. When that happens they may come back to us filled with a previously unsuspected meaning. It is almost as if we have been collecting pieces of a greater wisdom sometimes over many years without knowing.

My mother was a woman who was full of stories. As a public health visiting nurse she had sat at many kitchen tables, drinking tea and listening. At the age of eighty-four she chose to have cardiac bypass surgery, because it was the last chance she had for life. Even so, the odds were long; four chances in ten that she would not survive the operation. But my mother was not your ordinary elderly lady. She had lived her life as a maverick and a risk taker and to her those odds looked good. On the morning of her surgery, I came to her hospital room two hours early only to find that her surgery had been moved forward and I was barely in time to kiss her before they took her upstairs. Despite the sudden change in plans and the daunting odds she was facing, my mother was peaceful, even radiant.

"Oh good!" she greeted me. "You're here! There was something that I wanted to tell you. I just wanted you to know that no matter what happens here, I am satisfied and I hope you will do whatever you can to be satisfied as well." Then she smiled her charming, rakish smile and they took her away. These were her final lucid words to me.

For a long time I thought about these words, trying to understand what they had meant. My mother had achieved a great deal in her life but I did not think it was this that had given her such ease and contentment in the face of possible death. Slowly I have come to understand that the key to this sort of satisfaction lies in the inner world, the world of stories and memories. It comes, not from any outer achievement but from the richness of experiencing life and sharing the inner experience of life with others.

After thirty-five years of being a physician and more than forty years of living with my own life threatening illness, I too am a woman who is full of stories. Stories I have lived and stories I have been told. I have stories about being a daughter, a granddaughter, a friend. Stories about being a patient and stories about being a doctor. Stories other doctors and patients have told me. Stories about my cat. Stories about things I do not understand. If I were sitting at your kitchen table the way a family physician used to do, these are some of the stories I would bring there with me.

Every one of these stories has helped me to live.