The Wisdom of Father Steve

I was surprised and delighted to run into Father Steve LaCanne at a celebration of life over the weekend (he officiated). Those with a HealthEast connection may recall that he was the longtime Director of Spiritual Care at St. Joseph’s Hospital, in downtown St. Paul, Minn.

Photo: Joan Frenz

And direct our spirits he did! Father Steve shared the following passage from Thomas Wolfe, which is a great meditation for the week:

To lose the earth you know, for greater knowing; to lose the life you have, for greater life; to leave the friends you loved, for greater loving; to find a land more kind than home, more large than earth—

—Whereon the pillars of this earth are founded, toward which the conscience of the world is tending—a wind is rising, and the rivers flow.

Father Steve is now semi-retired and splits his time between Minnesota and Florida. ✸

Charles Burton, M.D., R.I.P.

Chuck Burton, my most important clinical mentor, died in late 2020. He’s been much on my mind as a celebration of life on September 12th approaches.

Chuck was a neurosurgeon who specialized in restorative spine surgery. He helped thousands of patients by performing surgery, but probably helped even more by refusing to operate.

Chuck Burton, left; David Frenz, right. Glen Stubbe | Star Tribune

Chuck was a disciple of I.M. Tarlov, the famous neurosurgeon and author of The Principle of Parsimony in Medicine. The principle, also known as Occam’s razor, takes many forms including this version on the back of Chuck’s business card

And “less” often meant counseling sometimes desperate patients that they were unlikely to benefit from surgery.

Chuck, more than any other physician who I’ve met, practiced primum non nocere (first, do no harm). This began early in his career and intensified over time as he saw the actual harms of surgery in all of the second opinions that he rendered.

A few other dictums (and here):

  • Osler’s Rule: Treat diseases, not symptoms
  • Gabel’s Rule: Don’t just do something; stand there
  • Holmes’ Rule: Surgery is guilty until proven innocent

where the latter means that the clinical trials need to be compelling and patient selection must be meticulous.

Chuck has left a void in my life—but that void means that I had the opportunity* to be mentored by a great physician and remarkable human being. He’ll live on in the care that I deliver and the students and residents who I mentor. ✸


* I owe that opportunity to Bob Moravec, M.D., former medical director at St. Joseph’s Hospital in St. Paul Minn. It’s a great story and post for another day.

Ace!

I don’t golf often or well but still have some “muscle memory” from my teen years in Brainerd, Minn. Today, I carded a hole in one while golfing with Ayden, our 13-year-old son*

  • Where: New Hope Village Golf Course, New Hope, Minn. Our first visit!
  • Hole: 4
  • Club: 5 iron
  • The Shot: The green has a wicked slope from right to left with a bunker to the right. An elderly golfer behind us noted that she always plays to the right, which seemed like solid advice. My ball landed on the right edge of the green and rolled downhill into the cup. I was stunned, Ayden was elated and the elderly golfer was absolutely tickled ✸

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* For whom I hope to caddie in college—he’s nearly a scratch golfer on youth courses

Naperville, July 2005

Life has ways of surprising you when you least expect it. One of those moments occurred for me in a Fairfield Inn in Naperville, Illinois. We were visiting Joan’s relatives in Chicago and I hung back at the hotel while our kids napped.

I had purchased a copy of Parabola at a nearby Barnes & Noble. This passage from T.S. Eliot (cribbed, actually, from St. John of the Cross) jumped out at me:

In order to arrive at what you do not know
You must go by a way which is the way of ignorance.
In order to possess what you do not possess
You must go by the way of dispossession.

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This was both startling and counterintuitive. Up until that point, life seemed additive—knowledge and experiences building on a foundation of prior knowledge and experiences, stretching back years into childhood. Eliot was suggesting otherwise and I knew in that instant it was true. ✸


Postscript [08/09/2021]. Here’s a related passage from Anthony de Mello: “They didn’t teach me how to live at school. They taught me everything else. As one man said, ‘I got a pretty good education. It took me years to get over it.’ That’s what spirituality is all about, you know: unlearning. Unlearning all the rubbish they taught you.”

WYNTK Finale

We filmed the tenth and final installment of Hazelden Publishing’s What You Need to Know (WYNTK) Series today. Our set was at the beautiful Westminster Presbyterian Church in Downtown Minneapolis.

Many thanks to Wes Thomsen, Sylvia Jaurez, Brad Hadsall, Chris Dougherty and Jennilee Park for conceiving and producing the series. I’m looking forward to our next adventure! ✸


Postscript [08/03/2021]. “Where are you in the program overviews?” Please see Alcohol starting at 1:17 and Nicotine & Vaping starting at 2:20. And, there is much more in the full products.

Happy New Year

I just completed a year of mindfulness* meditation with Muse, the brain-sensing headband. And what an amazing, consciousness expanding year it was! Many thanks to InteraXon for developing and bringing Muse to market. Also much appreciation for Stephan Bodian and Sister Mary White, my meditation teachers.


* Sort of. My practice has evolved from mindfulness to awakened awareness. (Please see Stephan Bodian’s masterful Beyond Mindfulness for an exploration of both.) Accordingly, I’ve adapted the way that I use Muse: I’ve turned off Feedback, Birds and Background (Session Volume Settings), which reduces the temptation to manipulate attention. Muse mainly serves as a meditation timer when configured in this way, although, as a doctor, I love to review the resulting EEGs.

Summer Institute for Medical Students

I’m privileged to serve as faculty for another year of Hazelden Betty Ford’s Summer Institute for Medical Students (SIMS). Here are my PowerPoints and some additional resources.

Many thanks to Kari Caldwell for involving me in SIMS and also the Professionals in Residence (PIR) program!


Postscript [07/30/2021]. I’ve long advised medical students and residents to acquire some psychotherapy skills, regardless of their eventual specialty. Motivational interviewing (MI) and cognitive behavioral therapy (CBT) are relatively easy to learn and have broad clinical utility.

Some MI resources include:

  • Miller WR, Rollnick S. Motivational Interviewing, 3d ed. New York: Guilford Press, 2013 [classic textbook]
  • Sim MG, Wain T, Khong E. Influencing behaviour change in general practice. Part 1—brief intervention and motivational interviewing. Aust Fam Physician 2009;38(11):885-888 (PMID: 19893835; and here)
  • Sim MG, Wain T, Khong E. Influencing behaviour change in general practice. Part 2—motivational interviewing approaches. Aust Fam Physician 2009;38(12):986-989 (PMID: 20369152; and here)
  • Hall K, Gibbie T, Lubman DI. Motivational interviewing techniques—facilitating behaviour change in the general practice setting. Aust Fam Physician 2012;41(9):660-667 (PMID: 22962639; and here)
  • Searight HR. Counseling patients in primary care: evidence-based strategies. Am Fam Physician 2018;98(12):719-728 (PMID: 30525356)

In terms of CBT, I highly recommend the professional trainings at the Albert Ellis Institute, starting with the primary certificate practicum. Some other resources include:

  • DiGiuseppe RA, Doyle KA, Dryden W, Backx W. A Practitioner’s Guide to Rational Emotive Behavior Therapy, 3d ed. Oxford: Oxford University Press, 2014 [classic textbook]
  • Harden M. Cognitive behaviour therapy—incorporating therapy into general practice. Aust Fam Physician 2012;41(9):668-671 (PMID: 22962640; and here)
  • Stuart MR, Lieberman JA. The Fifteen Minute Hour, 6th ed. Boca Raton: CRC Press, 2019 [please see, in particular, Chapter 4]
  • Frenz DA. Another Arrow for Your Quiver: REBT for SUD. Minneapolis: David A. Frenz, M.D., 2018 [PowerPoint presentation]

Some Thoughts About Thinking

I recently did a corporate “lunch and learn” on metacognition, which is our singular ability to think about our thoughts (as far as I can tell, my dog has no such capacity). This would appear abstract and likely impractical but it is actually the key to mental health.

I’m happy to work at the level of things and thoughts. The former generally involves practical solutions (problem solving) while the latter consists of philosophical solutions (e.g., cognitive behavioral therapy). But I’m much more interested in the thinker—that’s where the ultimate solution lies.

The “thinker” in this context is consciousness or awareness, which is always present but seldom appreciated. As Rupert Spira counsels, “Allow the experience of being aware to come into the foreground of experience, and let thoughts, images, feelings, sensations and perceptions recede into the background. Simply notice the experience of being aware. The peace and happiness for which all people long reside there.” Elsewhere, he advises, “Be knowingly the presence of awareness.”

You can find my PowerPoint here or by clicking on the image above. ✸


P.S. If this sounds like mindfulness, it might be. Mindfulness has become one of those everyday words that now lacks meaning, or at least a shared understanding. For an interesting perspective, please see Stephan Bodian’s Beyond Mindfulness:

“For all its wonderful benefits, the practice of mindfulness has another downside: it tends to maintain the subject–object split, the gap between the one who’s being mindful, the act of being mindful, and the object of mindful attention. In other words, no matter how mindful you become, there’s always a you that has to practice being mindful of an object separate from you. As a result, mindfulness perpetuates the very sense of separation it’s designed to overcome.”

Being & Doing

I recently simplified my life. The superficial, corporate explanation is that I wanted to work less and spend more time with my family. That’s all true but behind it is the perennial tension between being and doing.

Thomas Merton and Wei Wu Wei both explored this apparent dichotomy in the 1950s. The latter noted, “Doing is an avoidance, an escape, a running away from Reality.”

And Merton observed, “We do not live merely in order to ‘do something’—no matter what. … On the contrary, some of us need to discover that we will not begin to live more fully until we have the courage to do and see and taste and experience much less than usual.”

So when people ask me what I’m going to do with my newfound time, the answer is that I plan to be, which is different than passivity and idleness. ✸