“Go Placidly Amid the Noise and Haste. Remember What Peace There May be in Silence.” – Max Ehrmann, Desiderata, 1927
Recently, I was counselling a patient in the clinic who was experiencing exacerbations of migraine, fibromyalgia, and insomnia all at the same time. Her medications were only helping minimally, if at all. She was miserable and starting to lose hope. Turns out she was dealing with a tremendous amount of stress and anxiety due to life events beyond her control. That evening, in looking for some words of wisdom to share with her and others like her, I came across a copy of Max Ehrmann’s prose poem, Desiderata, which has been beloved for decades as good advice for the human soul. And though the words are 90 years old, they are still just as meaningful as when they were first written in 1927, maybe even more so. And I wonder if they shouldn’t be used for patient education and treatment in the clinic.I had first become familiar with the Desiderata about thirty years ago, when I was in medical school. The poem had been included, interestingly, in an issue of the Journal of the American Medical Association. As I read it, I found great comfort and wisdom in Ehrmann’s world view and advice. I cut the page out of the journal and taped it to the corner of my desk. My favorite line is the one that says, “Nurture strength of spirit to shield you in sudden misfortune. But do not distress yourself with dark imaginings. Many fears are born of fatigue and loneliness.” Over the ensuing years I referred to it often and tried to heed the advice it offered. Later in life, I shared it with my children as they were growing up and experiencing their own struggles and anxieties. So I think it only makes sense to share it with patients who are battling their own stress demons in their day to day walk. And newer research tends to support the notion of doing so.
You see, there is a lot of new thinking about how migraine and related illnesses take hold in people. It is clear that there is a genetic component or family connection. But it seems that the situation is much more complicated than strict genetic inheritance or learned behaviors. Scientists are now talking about a relatively new field of study, called epigenetics. This concept holds that people may inherit a genetic predisposition for a certain illness or set of symptoms. But that genetic risk only gets activated under certain conditions, such as chronic stress or fear, probably because of the release of “fight or flight” chemicals in the brain and circulatory system. And this may explain why some members of a given family “inherit the family curse” of migraine, while others seem to dodge the bullet. It may also explain why victims of childhood abuse are more likely to suffer from migraine and associated conditions. At any rate, recent lines of investigation have started to focus more on epigenetics in the area of migraine and related disorders. And many feel the results are starting to help us understand the underlying cause and origins of this unique disabling medical condition much better.
Meanwhile, the medicines we currently have may be partially helpful. But we would be mistaken to underestimate the power of stress management and relaxation techniques in helping people cope with disabling headaches and other disorders. And I think a good dose of the Desiderata may be just what the doctor ordered. Especially if it can help people lower the adrenaline and other stress hormones in their body. See what you think for yourself. Read it daily for a month, meditating on its meaning to your life, and see if you feel better. You might be surprised. Here’s hoping you will and that you will share a little bit of your newfound peace and tranquility with others.
Until next time, be well. And remember, you are not alone in your struggles!