Listening for Life

We as humans don't always appreciate the incredible automatic work our bodies do to keep us alive, like the silent rhythmic symphony of our heartbeat. In this episode, Naomi Zikmund-Fisher shares two deeply personal stories from her pregnancy that reveal what it's like when the body suddenly feels unsafe, when the symphony becomes chaotic. From an abruptly racing heartbeat that left her questioning whether her body could sustain her unborn child to an emergency treatment that temporarily stopped her heart, Naomi invites listeners into the emotional landscape patients often experience in healthcare. She talks about the importance of validation even when symptoms are uncertain or evolving, the power of small acts of support, and the value in preparing patients for what medical interventions may feel like. I loved how each of her stories ends with the sound of a heartbeat.

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Transcript

Prelude

Naomi Zikmund-Fisher (00:00)

That same part sent up another message, a gift. It said, less than a minute.

Show Introduction

Nate Houchens (00:24)

Hi and welcome to Boundless Moments, the storytelling podcast that brings sacred moments to life through the voices of those who lived them. I'm Nathan Houchens. Support for Boundless Moments comes from the Sacred Moments Initiative. 

At Boundless Moments, we are careful to ensure that all stories comply with healthcare privacy laws. Details may have been changed to ensure patient confidentiality.

All views expressed are those of the person speaking and not their employer.

Some stories featured on Boundless Moments may contain themes or content that could be upsetting for some listeners. We encourage you to use discretion and take care of yourself while listening.

Introduction: Naomi Zikmund-Fisher

Nate Houchens (01:07)

Naomi Zikmund-Fisher is a clinical social worker in private practice, specializing in the aftereffects of trauma and emotional neglect. Therapist is her second career, having been a special education teacher and then a school principal until age 40. In her words, she went through a phase in which, if she didn't go back to grad school every seven to 10 years, she developed a rash. Luckily, that phase has passed, leaving three master's degrees in its wake. 

Outside of work, Naomi is an avid storyteller and four-time Moth StorySlam winner. She's an active volunteer with the National Lawyers Guild, fighting fascism in Michigan and nationally. She's the author of Across the Chasm: A Caregiver's Story, a book she wrote about her experiences during her husband Brian's bone marrow transplant 26 years ago. You may recall that Brian was our last guest on Boundless Moments. Together, Naomi and Brian live in the Ann Arbor, Michigan area and are the proud parents of two adult children and a cat named Turtle. 

Introduction: Listening for Life

Nate Houchens (02:10)

We as humans don't always appreciate the incredible automatic work our bodies do to keep us alive, like the silent rhythmic symphony of our heartbeat. In this episode, Naomi shares two deeply personal stories from her pregnancy that reveal what it's like when the body suddenly feels unsafe, when the symphony becomes chaotic. From an abruptly racing heartbeat that left her questioning whether her body could sustain her unborn child to an emergency treatment that temporarily stopped her heart, Naomi invites listeners into the emotional landscape patients often experience in healthcare. She talks about the importance of validation even when symptoms are uncertain or evolving, the power of small acts of support, and the value in preparing patients for what medical interventions may feel like. I loved how each of her stories ends with the sound of a heartbeat.

The Story: Listening for Life Part I: Reassurance

Naomi Zikmund-Fisher (03:18)

I certainly had heard the term “thready pulse” before. I watch hospital dramas. But I don't think I ever really knew what it meant until I had one. 

I was literally standing around doing nothing when, all of a sudden, my heart started racing. But unlike what you expect when your heart was racing, it wasn't pounding. It was fluttering and it was fast.

And it felt very scary and fairly dangerous. Hearts keep you alive and this one didn't seem to be working properly to keep me alive, let alone my baby… because I was pregnant. 

I immediately called my doctor's office and got the resident on call and she heard what was happening and asked me a few questions and I told her my pulse was, I think, 172. She put me on hold for a good long time and when she came back she said, Mrs. Zikmund-Fisher, are you sure you know how to take your pulse? I told her I did and she said I'd better come to the ER. 

My husband picked me up and we took off for the ER and we got there and they immediately put me on a monitor and I saw that 175 pop up on the screen right before it went back to normal. They ran a bunch of tests. They said, we believe you, we saw it. And eventually they, after checking a bunch of different things, they sent me home. 

That night in the middle of the night, I woke up with terrible, terrible stomach pain. And I took myself to the bathroom and I was weak and dizzy. And I was sitting there in the dark on the toilet and I felt like I was going to pass out. But more importantly, I felt like I was going to die. 

I used all the energy that I had left in my system to moan loudly. And thankfully, my husband heard me and came in and sat with me. And eventually, after longer than it should have been, I had the most unbelievable diarrhea I've ever had in my life. Followed every half hour by another bout, till by morning, everything that was coming out of me was clear. 

I had emailed my family doctor the night before when I came home from the hospital, and he had already emailed back and said he wanted to see me and that his office would call. And when they did, I said I really needed to get in fast. So, they told me to come in and I saw my doctor who had been my doctor for a very long time. And he checked me out and talked about what was happening and did a lot of hmmm. And he looked at my test results from the night before and wondered if I might be having a thyroid storm, but we needed to redo a bunch of the tests. 

I was so weak and dehydrated. I was drinking juice out of a sippy cup because I could barely hold it up and I was afraid it would spill. And he said, I think you're okay, but we're just gonna have to see. 

So that wasn't a very satisfying answer. And right at the end of the visit, he said what he always said at the end of my visits, which was, is there anything else I can do for you? And I said, yeah, can we listen to the baby? He said, didn't they have you listen to the baby at the hospital last night? And I said, no. I really couldn't imagine that after everything that had happened, everything was okay. I was really scared. I was pretty sure I was going to live at this point, but it didn't seem like my body was supporting a second life. 

So the doctor got out the DopTone and put it on my belly and immediately you could hear the fetus's heartbeat. 

And I started to tear up.

And he looked at me and he said, do you feel better? 

And then I started crying in earnest and I said yes. 

And he started to tear up. 

And he said, me too.

The Story: Listening for Life Part II: Resilience

Naomi Zikmund-Fisher (07:39)

It was a few months later, I woke up early in the morning with what I now knew was a bout of SVT, supraventricular tachycardia. I waited because they had told me this is benign, but I eventually woke up my husband, told him what was happening. The thing about SVT is it may be benign, but it is incredibly draining and it really does not feel like your heart is doing anything to help you out.

So I did all the maneuvers that they tell you to do. They all involve some form of what they delicately call bearing down, which you may know better as pretending to poop. Nothing worked. It just kept going. So we got in the car and headed for the ER. It's about six in the morning. 

What I remember is that the sound of the monitor that they put me on was absolutely deafening. From those same medical dramas, I know what a heart monitor is supposed to sound like. You've heard it. It goes boop boop, boop boop, boop boop. Except mine wasn't. It was going dee dee dee dee dee dee dee dee dee dee dee dee. And this time the numbers on the screen were over 200. 

So the doctors start trying to get me to do vagal maneuvers, bearing down. And I tried again, but it didn't convert my heartbeat. And finally, one of the doctors came over to me and said, “Okay, I think what we're going to need to do here is convert it chemically. We're going to put medication into your IV. It's very safe for the baby. It will pass through your system very quickly. It goes in quickly. It works quickly. And it goes out quickly. And so whatever happens will last less than a minute. 

Now some people say it feels like stepping into a hole, but it lasts less than a minute. 

And some people say it's like something heavy being dropped on your chest, but it lasts less than a minute. 

The main thing you need to know is that whatever happens, it will last less than a minute. 

Are you ready?” 

I said I was ready as I was going to be. 

They put the medication into my IV and immediately two things happened: One was that a sumo wrestler sat down hard on my chest… and the other was that the room went absolutely silent.

I couldn't quite wrap my head around what was happening. It was uncomfortable and something was wrong and I just couldn't quite figure out what it was. And somewhere from deep under that sumo wrestler, some part of me sent up a message. It was one word, “flatline.” And I realized that the room had gone silent because my heart had stopped beating and the monitor had stopped making noise.

Just as I was trying to wrap my head around that and what that meant, and that was kind of bad, that same part sent up another message, a gift. It said, “less than a minute.”

Almost as soon as it had sent up that message, I heard, doot-doot, doot-doot, doot-doot, and the sumo wrestler got up. And I thanked that part. And it said, you did it. You're strong. You made it. Thank God.

Interview

Nate Houchens (11:31)

I’m here with Naomi Zikmund-Fisher, who just shared that story of being in healthcare, receiving really urgent healthcare, and having a relationship with her family doctor that sounds pretty profound to me, as well as some really terrifying healthcare journey. Although less than a minute, I'm sure it felt like an eternity. Thank you so much for sharing that story, Naomi.

Naomi Zikmund-Fisher (12:00)

Thanks for having me, Nate.

Nate Houchens (12:02)

What a powerful reminder of our own mortality, especially when you are pregnant. Tell me more about what was going through your mind, not just for your own safety and health, but also for your unborn child.

Naomi Zikmund-Fisher (12:18)

I fancy myself a pretty educated person, a pretty educated patient. Definitely, this was my second pregnancy and I had read up on a lot of things and I had had some complications with the first one. So I sort of had a running list in my mind of things that might happen. And this just wasn't on it. It just wasn't a thing that I knew could happen. 

And for it to be my heart and so obviously my heart and I could feel it just was terrifying because we take a lot of things for granted, but one of them is that your heart just keeps beating and you don't have to do anything. And something was really wrong. 

Honestly, I think at first, when it first happened, my first thought was for me, because I need to have a heartbeat. But pretty quickly thereafter, it's like, okay, even if I'm okay, what is this doing to the baby? I hadn't read about that in What to Expect When You're Expecting or something like that.

Nate Houchens (13:14)

There's no brochure that says SVT is going to pop up and it might be really damaging and worrisome. Yeah, I I'm reminded of the things that we take for granted. Like you said, our heartbeat continues to go on and on. Our breathing continues on and on. Our brain is able to take in new information and process it in meaningful ways. And then I think about all the people that grapple with those organs or others where you suddenly can't take it for granted anymore. And just walking to the kitchen table is a struggle.

Naomi Zikmund-Fisher (13:54)

Yeah, definitely.

Nate Houchens (13:55)

Yeah, I feel for you. That sounds really terrifying.

Naomi Zikmund-Fisher (13:59)

Thanks.

Nate Houchens (14:00)

I remember early on in COVID, and I'm a physician. I was taking care of patients. I think we were all sort of terrified of COVID. I think that I've only had COVID once. And it was the worst sore throat that I had ever had to the point of, I had to psych myself up for any kind of drinking fluids. Forget about solid food. Forget about it. And for almost two weeks, I was drinking maybe a cup of water a day. And on day like 13, I decided, okay, if things don't turn the corner by this afternoon, I have to go to the emergency room. Like I'm dehydrated, I feel weak, I feel like I'm really starting to think about my own mortality here. I, and my social situation was such that there weren't too many people around. And I was kind of like, okay, this is getting more and more dire. And I can only imagine that's kind of how you felt in the bathroom that night after going to the emergency room.

Naomi Zikmund-Fisher (14:59)

Yeah. As it turns out, in addition to the SVT, I'm fairly prone to vasovagal response. And so, I wind up in these moments when I feel like I'm going to pass out. But it doesn't... There's feeling like you're going to pass out and then there's feeling like you're going to die. And it definitely feels like I'm going to die. I've actually had... I'm a therapist, but I've had to do a fair amount of work in my own therapy on helping myself remember that even though it feels like I'm going to die, I'm not. So those moments won't be so terrifying for me.

Nate Houchens (15:32)

What do you tell yourself in those moments? How do you remind yourself?

Naomi Zikmund-Fisher (15:36)

I literally say that. I say, this feels like I'm going to die. It's okay that it feels that way. I'm not crazy. And it turns out I'm not. And I just need to remember that. 

And the other thing that I tell myself that I've learned to tell myself is there's always a solution. Because often at these moments, I both feel like I need to use the toilet and like I'm going to throw up. And that's sort of a tough choice to have to make at this point, right? And to just say, you know what, it's okay. Like everything will get cleaned up if there's a mess, it's okay. There's always a solution.

Nate Houchens (16:14)

There's always a solution, right? Taking that perspective, I think, can be really, it can take a situation where we don't have much control or agency and get a little bit of it back.

Naomi Zikmund-Fisher (16:26)

Yeah, definitely.

Nate Houchens (16:28)

Yeah, thank you for that. For those listeners who haven't heard the term vasovagal, this is sort of a situation… Think of fainting, right? Think of a noxious stimulus like getting blood drawn. Think of standing in the heat for a long time and feeling faint. That's sort of a vasovagal reaction. And it's all about the complex interplay between nerves and blood vessels in the body that can cause drops in blood pressure and fainting.

So that is a tough spot to be in Naomi. That is a bad combo.

Naomi Zikmund-Fisher (17:00)

I'm not a fan. Zero stars do not recommend.

Nate Houchens (17:02)

No. Hard pass.

I'd love to explore a little bit more about your relationship with your family doctor who you mentioned in the first story. That moment when your doctor said, is there anything else I can do for you? And you said, can we listen to the baby's heartbeat? Tell me more about what that experience was like and maybe what led to the ability to have that moment with your doctor.

Naomi Zikmund-Fisher (17:32)

Grant Greenberg was my family doctor from 2002 to 2016. He saw both me and my husband and our, at the start, four-year-old daughter and then did my prenatal care with the second pregnancy. 

This was long before there were portals or phone trees or, you know, you didn't call and get the triage service, you got your doctor's office. And I just used to email him questions all the time and I think we both discovered we kind of enjoyed each other's company. It was nice. At this point, I trusted him. I trusted that he knew me, that he had my best interests at heart, that he understood that really he's a family physician in the best possible way, that I'm a whole person and I come from a whole family. And that context is super important. 

So, I knew that I could ask him things like, hey, I'm really worried about whatever, can you just reassure me why I shouldn't be? And he would answer that question. He wouldn't just say, don't worry about it. He would always answer my questions. 

So by the time this happened, he'd been my doctor for probably three years and we'd exchanged a lot of emails and particularly around the care of my kid because kids get sick so much more than adults. And I just, I trusted him and I trusted that he cared about my family. 

And even like the night before, when I came out of the ER and I emailed him and he said, I want you to come in in the morning and I emailed him back and I said, I'll be at work making the world safe for democracy. I don't know why I said that. It was a kind of silly thing to say, but that's what I said. You know, we were joking. As it turned out, I didn't go to work that day, but I didn't know that the night before. And in fact, when the doctor's office called, you know, whoever the staff member was who called me, they talked to me for a minute and then he said, I have to ask you this. Are you actually making the world safe for democracy?

Nate Houchens (19:27)

An opportunity for a humble brag, right?

Naomi Zikmund-Fisher (19:30)

Yes, yes, right. I really don't know why I said that. It has nothing to do with anything. 

So, when I went in, I knew I could talk to him both about my symptoms and what had happened the night before and what had happened in the middle of the night, but also I could talk to him about how scary this was and how upsetting it was. And he would care about that and that was part of my clinical picture. 

You know, he's taken care of all, you know, my husband, me, both of my kids. My parents-in-law moved to Michigan at, I can't remember what year, but they moved here and he was their doctor. My niece lived with us for six months, he was her doctor. And when he left, we've stayed in touch. Not every minute of every day, but particularly, I'll often send him a text when if I'm waiting in the ER or I just gotten some weird health news, but also just, you know, hey, here's a... Here's a picture of my kid who just graduated from high school. Can you believe it? And he lets me know about his family and whatnot too. So it was a professional relationship, obviously, certainly when it started, but it really was a profound connection and really important as my family went through a variety of different health issues.

Nate Houchens (20:54)

When someone cares about you as a person and not just whatever it is that is troublesome to you that day, it is just profound, in your words. I had a primary doctor who did the same thing, of course would go through some of the screenings and the checks and the symptoms and the sort of stuff, but then would say, yeah, how are you doing? What's going on in your life? Tell me about how you're feeling. And in this day and age, that is as rare as hen's teeth, right? I mean, it just feels like such an oddity now. But those individuals who take the time and energy to examine and explore what's important to someone and how they're doing and what their family is like and what their life is like outside their symptoms and health really, really profoundly impacts my journey through healthcare and I'm sure many others.

Naomi Zikmund-Fisher (21:50)

Yeah. Just a little anecdote. When I was pregnant with my first one, we lived in Pennsylvania and we went to a family practice and my husband had a very serious health scare. He wound up having a blood disorder that required a bone marrow transplant. And I was pregnant with our first kid when that happened. I went for, and I had some preterm labor symptoms right around the same time. And the question was, could I continue to work or not?

I was at a prenatal visit with the family doctor who sees both of us and he said, so how's Brian doing? And I said, well, they're running some tests and we're really not sure and we're waiting for a second opinion on this. And he said, yeah, I think you can't work. He wasn't making something up, right? I mean me working was an open question and this was one of the possible answers, but he was looking at it in the entire context of how much stress I was under and what would be best for me and the baby holistically. And took me off work.

Nate Houchens (22:48)

Yeah, understanding that context, understanding all the other moving pieces of your life to the extent that is feasible is a mark of a really caring and trusting individual.

Nate Houchens (23:22)

Naomi, I wonder if you might share with me what was going through your mind and your body and your heart and your soul or however you want to describe that when your family doctor asked you, do you feel better after hearing your baby's heart?

Naomi Zikmund-Fisher (23:43)

It was a kind thing to say, right? It showed that he was concerned about me as a whole person and not just what was going on with me physically. 

To me, the real powerful moment was when he asked me if I felt better, I said yes, and he said me too. It was so very clear on just a very basic level that he was not just doing his job. He was not just going through the motions and doing good medicine, which I'm sure he also was doing, but he cared that I was okay. And I think that was the first moment in that pregnancy when I realized, oh, he cares that the baby's okay too. It had not occurred to me really that he would feel bad if something happened to the baby. He would care that I felt bad, because I knew him that well, but like, no, he actually cared about this. 

We're Jewish and on the eighth day after birth, baby boys are circumcised. We had decided, if it was a boy, because we did not find out ahead of time, that we were going to have the circumcision done at our doctor's office. And we talked to him about it ahead of time. And I asked, can I bring in the prayer book and we'll say the prayers. And he said, yep, that's fine. And I said, do you think your staff will mind? He said, I don't care whether my staff minds. And so that's what we did, because our second kid is assigned male. 

There are various prayers that you say, and hoping for a happy life for the baby and that the parents have the privilege of walking them to the wedding canopy and various things. And one of them is a prayer for the healing of the baby. And I remember distinctly that was the only one that he said amen to, that the doctor said amen to. I was like, again, he cares about this baby, which of course I do too. So, there's a, you know, we can bond on that and it makes me trust him when later my kid has bronchitis or whatever.

Nate Houchens (25:35)

It's those moments that I find so difficult to describe that are such strong signals of interpersonal care. Right? He cares about me and I care about him and he cares about my child. And you're right, that is just an absolute trust builder, an empathy builder. That's beautiful. That's really lovely that you can share those moments with your doctor.

I want to shift gears to the second story, if we could, the one that brought you to the emergency room with the deafening heart monitor and the greater than 200 pulse, the vagal maneuvers that didn't work. 

Tell me a little bit about when they gave you that really fast-acting medicine. Again, all in the context of being pregnant and recognizing that your own health is in play and that of your baby as well. 

Tell me a little bit about the voice. You mentioned a voice that sort of came up and reminded you that, well, this is flatline first… and then also the gift, as you said, of it'll be less than a minute. Where do you think that voice came from? Whose voice do you think that was?

Naomi Zikmund-Fisher (26:51)

So, you know, I'm a therapist and one of the modalities that I use is internal family systems. And very briefly, in internal family systems, we talk about parts. Everybody has parts and that's normal. And then there's a self with a capital S and the Self is sort of the overarching one who sees all the other parts and can put everything in context and has perspective.

And I think this is probably my clearest example of my Self. That in a moment when whatever part was in charge at the moment, could not in any way figure out what was going on. It just knew it was bad and it was scared. That my Self was able to put the pieces together and say, ah, you know, I can see what's happening here. You're not hearing the heart monitor. That's what's happening, Naomi. That's a flatline. Which wasn't good news, but it was still useful news to realize what was happening and then was also able to put the pieces together and say, hey, the doctor did say less than a minute, which sort of cut through the fear and the confusion. I remember being extremely confused and scared. So to answer your question, it was me, but it was like my very best self.

Nate Houchens (28:10)

Your very best self, that's great. 

For those listeners that are less familiar with IFS, are there any resources or places that they can go to learn more about IFS or other sort of forms of social work and therapy?

Naomi Zikmund-Fisher (28:28)

Oh wow, okay. So probably the best online resource about IFS is the IFS Institute and they have information, lots of information for clinicians and trainings and whatever, but also resources about what is IFS and how to find an IFS therapist and whatever. 

There's a book, Dick Schwartz who's the founder of IFS, there's a book that many people like to read which is No Bad Parts because a lot of us think of, you know, like I said, well, that's my very best self, which is there's an implication that these other parts are bad or some of them. But every part has its job and it may be using a strategy to do that job that isn't working or is getting in your way or, you know, is this maladaptive in some way? The part's still good. It's still trying to help. And IFS therapy is basically working on getting all of the parts acquainted with self, letting self be in the lead and then so some of these more difficult moments and difficult feelings don't need to take you over.

Nate Houchens (29:34)

Yeah, I am only a novice to say the least about IFS, but it seems like parts are doing their job in order to protect, in order to ensure that you can remain safe. Just as when we watch this in dramas and other sort of TV shows or movies, sometimes the execution isn't the best. But the heart is in the right spot, to use a turn of phrase.

Naomi Zikmund-Fisher (30:02)

So to speak in this case.

Nate Houchens (30:03)

So to speak, yeah. That wasn't even on purpose.

Naomi Zikmund-Fisher (30:07)

I think in this case, the part that was kind of in charge, it was focused on me staying alive, right? And so it wasn't really thinking about the whole context of everything that's going on and understanding all the little details. It was sort of a very young, very primitive part that was saying, you know, this is bad. And okay, I mean, it wasn't wrong. But that part's job did not include understanding what was going on in the heart monitor or remembering what the doctor had said.

Nate Houchens (30:39)

What do you think are the circumstances or the situations in which that particular part thrives, right? The one, is it like chaos? Is it like confusion and fear? What kinds of things cause that part to sort of get activated for you?

Naomi Zikmund-Fisher (30:57)

Yeah, so I don't know that thrive is a word that I'd use, activated is a word that I use. So certainly the perception of serious danger. You know, I have other parts that I use all the time at work and at home that are, you know, they're smart and they make good decisions and they can reason things out. And this part is activated at moments when we don't have time for that. Like the danger is here, it is right now, and its job is to tell me do something. And that's what it was doing.

Nate Houchens (31:29)

Yeah. Do you have advice for doctors or other healthcare professionals on how to kind of coach through something like that? Because clearly it was time sensitive, right? It was urgent. It was necessary to do something fairly quickly. What kinds of things can healthcare folks do to communicate what to expect in those more urgent and sort of chaotic circumstances from your perspective?

Naomi Zikmund-Fisher (32:00)

I actually think the ER doc did a pretty good job under the circumstances. He told me what to expect without any certainty of what exactly it would feel like to me. But he also clearly knew that I was going to be scared. And so he sort of pre-planted the less than a minute so that when it happened, I would have that. 

You know, I would say in general, telling people what to expect, briefly succinctly, not claiming to be certain when you're not. And acknowledging in whatever way how this is likely to feel emotionally is really important. And that's what allows you to build the kind of relationship where the person's going to be able to tell you if they're really scared or if they don't trust what's happening or if they think something's wrong.

Nate Houchens (32:45)

I like how you phrase that, just acknowledging that this comes with a variety of emotions and often complex ones, but having fear and worry and hesitation and maybe trust, right? I've just met you and now you're going to put something in my bloodstream that you're saying is going to cause wild things with my heart. I think acknowledging that complex interplay of emotions is something that healthcare professionals can do better.

Naomi Zikmund-Fisher (33:19)

I've thought a lot since this happened about whether I think he should have told me it's going to stop your heart. On the one hand, I'm very much an advocate for give all the information, people can handle it, you know. And at the same time, given that time was of the essence, I think if he had told me that, I wouldn't have wanted him, you know, I would have had way more questions and we didn't have time for that. He did the best job that could be done sort of threading the needle to get the medication into me, which was what needed to happen with enough information but not so much information that it was gonna slow it down.

Nate Houchens (33:52)

I hear you. That is a very difficult situation to be in of giving full truth telling while also recognizing that that comes with a whole array of responses that are possible.

Naomi Zikmund-Fisher (34:07)

I have a pet peeve about doctors who tell me not to worry.

Nate Houchens (34:12)

Oh, me too. It's the worst. It's the worst.

Naomi Zikmund-Fisher (34:15)

Because if I wasn't going to worry, then I wouldn't be asking the question in the first place. 

Nate Houchens (34:20)

Exactly.

Naomi Zikmund-Fisher (34:21)

So I'm already worrying. Tell me why I shouldn't worry. 

I can remember at one point I had some kind of growth on my nose and they were going to biopsy it. My doctor was working with a med student and the med student came in first and talked to me about what we were going to do and blah blah blah. And do I have any questions? And I said yes. And they were pretty sure it was benign but they wanted to be sure. And I said, okay, so I know we're pretty sure it's benign, but what's the next step if it's not? And she said, it's probably benign. Don't worry about that.

I paused for a minute, even thought, okay, well, what should I say back? And then I thought, well, you know what? My regular doctor is going to be in here in a second and I'll ask him. Honestly, I made a real point of asking him while she was in the room so she could hear how else you could answer that question.

Nate Houchens (35:07)

Yeah, a little bit of role modeling goes a long way in those situations. I'm with you. I think, you know, reassurance can be helpful in many different circumstances, but not by itself. Right. It needs to come along with some acknowledgement and some validation of the concern underneath it and some explanation as to why you shouldn't worry as much. So I'm with you 100 percent on that.

Nate Houchens (35:52)

I wonder if you would tell me a little bit about your inclination for storytelling. You have participated in and won the Moth StorySlam competition four times. What is it about storytelling that speaks to you?

Naomi Zikmund-Fisher (36:11)

So I think there's a cultural backdrop that Eastern European Jews at least are, we’re storytellers. There's a cultural norm that you illustrate your points with stories. Sometimes you don't say things directly, you just say, I have a story about that. 

And growing up, the way you got the floor, and I was the youngest kid, the way you got the floor was having a good story. So I got good at it. 

As I've gotten older and expanded my horizons and whatnot, there are some issues with this, right? Because a lot of times in our culture, if you're telling somebody something that happened to you and the other person comes back with a story about something that happened to them, it feels like they're not listening. Whereas culturally, for me, if you tell me something and I say, I got a story about that, what I'm saying is I get you. Let me show you how much I get you because I've got a story that goes right with that. But I've had to sort of learn who can I do that with and who can I not.

And then there's the problem that, you know, I look at life as a series of stories to be told, but sometimes, particularly my children don't want to hear every single story or they've heard this one 17 times. So figuring out I have this itch to tell a story. That's what I do to connect to people. That's how I was raised. So discovering the storytelling community around where I live and I've listened to The Moth forever and getting involved in telling stories at the Moth. I can tell my story and no one's gonna tell me, I don't want to hear this. And you know, my kids may have heard the story that I'm telling 500 times, but this audience hasn't. It scratches that itch for me. 

And I've made some absolutely marvelous friends who are also regulars in the storytelling community around here. And there's something very special about getting a deep dive into something that's happened to somebody. You usually find out a whole different aspect than you might have already known about the person, even if you know them well. So, I love it.

Nate Houchens (38:17)

The intimacy that I think gets established right away in a story of this kind and of yours is, you know, in our medical and psychotherapeutic literature, sometimes they're called sudden intimacies, these sacred or boundless moments. I'm reminded that storytelling fora like the Moth, like I hope our podcast, is a way for individuals to really open themselves up and share a very intimate set of details about an experience that they had to a wide array of people who have essentially signed up and have said, I would very much like to know about you, to know about your experiences as a form of connection.

Naomi Zikmund-Fisher (39:06)

You know, if I met you at a cocktail party and I just started telling you about my experience getting adenosine in the emergency room, that might be a little odd, right? We just met, why are you telling me this? Why are you telling me about this voice? You know? 

But again, like I know when I get up at the Moth, this is what they asked for, right? They want to hear this. And they're not going to judge me for having told it. They're not going to think that's weird because that's why we're both there.

Nate Houchens (39:34)

That's why you're there. This is the community. This is how we express ourselves and appreciation for others. That's so cool. 

I'm reminded also, earlier in this interview, when I started telling my own healthcare story of being like, yeah, cool, I heard all your story and now you listen to mine. Yeah, it can be taken so many different ways by different peoples and their own experiences and their own upbringings and cultural sort of norms. I can see how people would be like, oh hmm, thanks. That was very dismissive and you didn't listen at all to what I had to say.

Naomi, I just want to thank you so much for sharing yourself with us, recognizing, I think, the power that you have to be able to share yourself and to highlight moments in healthcare that have really gone as well as they could for you and for your family, and the ways that healthcare folks can actually encourage moments like those. It really is insightful, and I think we are able to learn from those insights. Thank you.

Naomi Zikmund-Fisher (40:46)

Oh you are so welcome and thank you for having me.

Nate Houchens (40:48)

My pleasure. Any other sort of final thoughts before we wrap?

Naomi Zikmund-Fisher (40:53)

I work with a lot of clients who are very frustrated with their healthcare because I think that just happens, right? And particularly the system, as you certainly know, has all kinds of roadblocks to doing things well. From the patient's point of view, it is possible to have a positive relationship with your doctor and to get your questions answered and to establish trust. But it's really hard. And I empathize with people who say, you know, well I asked my doctor about that and he didn't answer me. Well, okay, he needs to.

Nate Houchens (41:28)

Yeah, as with any relationship, it takes effort. It takes work. And for physicians, nurses, for LPNs and medical assistants, it's about taking that extra time and energy in getting to know folks.

Naomi Zikmund-Fisher (41:44)

And so often, you don't have the time. And that's, through no fault of your own.

Nate Houchens (41:49)

Yeah, that's the system. That's right. That's the system. And I think better appreciating and rewarding the time that people take to acknowledge and validate worry, not just reassure, all right, and try to put a bandaid on it. That is where I think we can be headed. 

What an honor it is to talk with you, Naomi. Thank you again. And I so look forward to hearing more stories from you.

Naomi Zikmund-Fisher (42:16)

Thank you.

Postlude

Nate Houchens (42:34)

We would love for you to be a part of this movement, and we would be honored to hear your story. If you have experienced a moment of grace, connection, or empathy that changed you, we invite you to submit it for consideration to be shared on Boundless Moments by sharing, you not only contribute to a collective celebration of human connection, you may also inspire others to recognize and cherish the sacred moments in their own lives. To discover more about sacred moments and to share your own story, please visit sacredmomentsinitiative.org.

This episode of boundless moments was produced, edited, and mixed by Nathan Houchens. Our program manager is Jessica Ameling, and our publishing and social media manager is Rachel Ehrlinger. Our podcast is made possible by the Sacred Moments Initiative, a humanistic project whose aim is to study, catalog, and share sacred moments. Learn more at sacredmomentsinitiative.org. Boundless Moments is also made possible by donations from listeners like you. Thank you so much for supporting our work in sharing sacred moment stories. If you enjoyed this episode, please subscribe to the show wherever you get your podcasts and drop us a rating or review to help others connect with us. I'm your host, Nathan Houchens. Thank you for joining and until next time, be well.