Focus:
Understanding that your nervous system is listening, and giving it signals of safety.
Repetition:
My nervous system is safe.
My body knows how to heal.
I am held. I am whole.
When You Are the One Being Cared For
There is a moment that splits a life in two. You can remember the version of yourself who existed before the phone call, the test result, the collapse in the kitchen, the ambulance ride, and the version who walked out the other side of it. Time before. Time after. And in between, a doorway that no one prepared you for.
If you are reading this in the after, you already know what I mean. If you are reading it in the before, God willing you may never need these words. But most of us will, eventually. Either we will walk this road ourselves, or we will walk it with someone we love.
This letter is for the long road of illness, the one that begins with a shock and unfolds into months or years of caregiving. It is for those caring for a child, a spouse, a parent. It is also for the much harder lesson of being cared for, of letting another person hold us when we cannot hold ourselves. And it is, more than anything, a letter about peace and joy as a real and ancient medicine that the Saints knew, that survivors describe, and that modern science is finally beginning to measure.
The Moment Everything Changes
The first stage almost no one warns you about is the diagnosis itself. The emergency. The fall. The seizure. The moment a doctor says the word that you will hear on a loop for the next several weeks of your life.
This is trauma in the most technical sense. The nervous system encodes that instant differently than ordinary memory, you will remember the pattern on the chair, the smell of the room, the exact tone of the voice that told you. The body knows when its world has just changed shape, and it floods. Cortisol. Adrenaline. The breath gets shallow and stays there.
For some people the freeze comes first, a strange numbness, the inability to cry, a sense of watching it all from the ceiling. For others the flood comes immediately. There is no right way for a body to respond to a shock. There is only what your body does.
And then, often within hours, the doing begins. You have a child to keep alive, or a parent to advocate for, or you yourself must figure out how to keep functioning while the ground is still shifting.
This is when the long stage opens up, the months and sometimes years where survival mode becomes the new operating system. You did not choose it. You walked through a door you did not know was there, and the door closed behind you, and now you have to learn how to live in this new room.
The Toll We Do Not See Coming
Almost no one anticipates the physical cost of being sick or of caring for someone who is. The hours spent indoors under fluorescent lights. The hospital chairs. The kitchen counter you lean against while heating up another meal. The slow drying-out of the body that comes from being indoors, away from sun, away from soil, away from the rhythm of weather and birds and wind.
Movement falls away because there is no energy for it, or no time for it, or because the body in question is on bedrest. Posture collapses. The diaphragm shortens. The fascia, which loves to glide and slide and be touched, begins to stiffen from disuse. The lymph, which depends on movement and breath and laughter, begins to pool.
Then there is the research stage. Many of you reading this know it intimately. You sit up at midnight with one tab open to a peer-reviewed journal and another to a forum and another to a substack and another to a YouTube video of a practitioner you have never heard of. You print things out. You highlight. You take notes. You learn an entire new vocabulary, cytokines, methylation, mitochondria, mast cells, viral reactivation, central sensitisation. You become, by sheer necessity, your own clinician.
And then you try things. The supplements. The protocols. The diet shifts. The therapy. Some help, some do nothing, some make you feel worse. Trial and error is exhausting in a way that the well-meaning friend who asks “have you tried turmeric?” could never understand. You are not browsing a wellness aisle. You are building a raft, plank by plank, while already in the water.
Underneath all of this, a quieter erosion is happening. You are not at church the way you used to be. You are not at the homeschool co-op, or the dinner table, or the bonfire, or the parish breakfast. You stop being asked to things because you have had to say no so many times that people have learned to stop offering. The casseroles, if they came, came in the first three weeks and then stopped. Six months in, no one is bringing you food anymore, and yet you are still in the same fight. This disconnection from community is one of the heaviest costs of long illness, and one of the least named. We were not made to suffer alone. The Body of Christ was never meant to be a room of one.
And running underneath everything, like a tape playing on a loop, is the inner program of need-tos. I need to research this. I need to make this appointment. I need to find a new practitioner. I need to figure out what I did wrong. I need to push through. I need to be better tomorrow than I was today.
This is survival mode, and it is what the nervous system does when it perceives an ongoing threat. But survival is not living. You can survive for a long time without ever once feeling joy, or peace, or wonder, or the slow Sunday-afternoon happiness of being alive in your own kitchen. And the body cannot heal in survival mode. Heal is a parasympathetic word. Survival is a sympathetic word. We have to find a way back.
Peace and Joy Are Not the Reward for Healing: They Are the Medicine
This is the turn in the road, and I want you to feel it under your feet.
Peace and joy are not what you get after you are well. They are part of what makes you well. They are not the trophy at the end. They are the medicine you take along the way.
The Saints knew this in their bones.
Saint Hildegard of Bingen wrote that the soul is set in the body as sap is in a tree, meaning the soul circulates through the body and brings life to every limb. When the soul is starved of joy, the body knows.
Julian of Norwich, who suffered terrible illness herself and received her revelations from a sickbed, gave us perhaps the most quoted line in all of Christian mysticism: “All shall be well, and all shall be well, and all manner of thing shall be well.” She did not say this because her circumstances were well. She said it because she had glimpsed something underneath circumstances that was steadier than circumstance. That seeing was itself the beginning of her healing.
Saint Thérèse of Lisieux, dying of tuberculosis in her twenties, decided that her little way of love, the smile through pain, the patience with an annoying nun, the offering up of a difficult night, was itself her vocation.
Padre Pio, who suffered for decades, gave us the phrase that should be on every refrigerator of every chronically ill household in this country: Pray, hope, and don’t worry.
Saint Paul wrote from prison, in chains, that we should rejoice always, and again I say, rejoice (Phil 4:4). He wrote this from a cell. He did not write it from a vacation. He wrote it from the place where rejoicing seemed least reasonable. That is precisely where it becomes medicine.
Dr. W. Lee Warren, a neurosurgeon who lost his nineteen-year-old son and walked through years of brutal grief, named his book Hope Is the First Dose for a reason. He signs off his correspondence with the Latin phrase Dum spiro, spero, while I breathe, I hope. This is not pretending. This is not bypass. This is the deliberate, willed, practised decision to drip hope into the bloodstream of a body that is fighting for its life.
Hope is a chemical event. It changes what your immune system is doing. It changes what your heart rate variability is doing. It changes what your gut is doing. Hope is not soft. Hope is metabolic.
Gerald G. Jampolsky, the psychiatrist who founded the Center for Attitudinal Healing in California in the 1970s and worked for decades with seriously ill children, built his entire body of work on a simple idea: that fear and love cannot occupy the same space at the same time, and that the deliberate release of fear is itself a healing event. His little book Love Is Letting Go of Fear has been carried by countless patients and caregivers for almost fifty years. He was not saying that positive thinking cures cancer. He was saying that the soil in which your healing happens, the inner environment, the emotional weather, matters. Two people can receive the same diagnosis and the same treatment, and the one who finds a way to love anyway, to laugh anyway, to forgive anyway, will heal differently than the one who tightens into fear.
This is why I keep saying that reverence is the biggest medicine. Reverence puts you in your body. Reverence reminds you that you are a creature, made by a Creator, held in a vast and ordered creation that does not need you to fix it before you are allowed to enjoy it. Reverence is parasympathetic. Reverence drops your shoulders. Reverence opens the diaphragm. Reverence lets the lymph move. You can practise reverence in a hospital bed. You can practise it while throwing up. You can practise it while feeding someone who can no longer feed themselves. It is free, it is portable, and it changes the chemistry of every cell that hears it.
The Sun, the Soil, the Forest
The other great medicine of the long road is creation itself.
There is a man named Dean Hall whose story I keep returning to. He was an active cancer patient with leukaemia and lymphoma in 2013, given a grim prognosis, when he decided to swim the entire 187-mile length of Oregon’s Willamette River. He swam it in twenty-two days, mostly in forty-degree water, with his seventy-nine-year-old father paddling alongside him in a kayak. When he finished, his doctors could not find his cancer. They had never seen anything like it.
He did not set out to cure himself. He set out, in his words, to prove that his diagnosis did not define him, and to leave a legacy of courage for his daughter. Healing was what happened along the way.
I do not believe in accidents. I believe that when a man immerses himself fully in cold water, in moving water, in sunlight, in the company of his father, in purpose, in nature, he is putting himself back into the conditions a body was designed to heal in. His remission was not a fluke. It was the body responding to the rich, ancient environment we have all been pulled out of. He calls it the wild cure. The Church would call it the goodness of creation. Same thing, different language.
The sun is not just vitamin D. UV light on the skin shifts the skin microbiome, modulates immune cells, regulates circadian rhythm through the eyes and the SCN, and changes the expression of hundreds of genes related to inflammation and repair. Time in the sun is not optional for healing. It is foundational. For anyone living with chronic illness, four or more hours a day on bare skin, across the course of the day, is the optimal dose, and, frankly, the non-negotiable one.
A single session of full-body sun exposure has been shown to shift the human microbiome by as much as fifty-one percent. That is not a tweak. That is a wholesale remodeling of the bacterial population that your immune system depends on. Get outside, take off the clothes you decently can, and let the sun do its ancient work.
The soil is a microbial cathedral. There is a bacterium in living soil called Mycobacterium vaccae that, when inhaled or contacted through the skin, behaves like an antidepressant, it raises serotonin in the prefrontal cortex and reduces inflammation throughout the body. Children who grow up touching soil have stronger immune systems and lower rates of allergy and autoimmunity for the rest of their lives. Adults who garden, who walk barefoot, who handle compost, who keep their hands in real dirt, are dosing themselves with a microbial pharmacopoeia that no supplement can replicate. The dirt under your fingernails is medicine.
The forest is its own dispensary. Trees release compounds called phytoncides, volatile oils that they use to defend themselves against pests, and when we breathe these compounds in, our natural killer cell activity rises measurably, and stays elevated for days. Japanese researchers have studied this for decades under the name shinrin-yoku, forest bathing, but the practice is as old as humans. A walk in real woods, slow enough to hear the birds, long enough to smell the leaf litter, is a clinical intervention. It is not exercise. It is exposure. You are putting your body into the medicine.
Spend as much time outside as a human being can possibly spend. If you are a caregiver, take the patient outside wrapped in a natural fibre blanket, wool, linen, cotton, and lay them on the ground. A person whose nervous system is dysregulated does not belong sitting up in a chair, where the body has to brace and hold itself against gravity. Lying down on the earth, under a soft natural-fibre blanket, lets the body finally surrender and receive.
Take the meeting on the porch. Eat outside. Pray outside. Cry outside. Nurse the baby outside. Be in the weather. Let the wind touch your face.
Fluorescent lighting, by contrast, is deeply problematic for the human microbiome, the flicker, the spiked spectrum, the absence of full-spectrum sun all signal to the body that it is in an unnatural environment, and the skin and gut bacterial populations shift accordingly. Your body wants you under the sky.
When You Truly Cannot Go Outside
There are seasons when going outside is not possible. Acute illness. Post-surgery. Bedbound days. Mast cell flares. Brutal winters. Hospital stays.
For those days I want to give you something concrete, because lying in bed staring at a ceiling for ten hours will hollow a person out in a way that nothing else does.
Open a window. Even cold air. Even rainy air. The exchange of indoor and outdoor air changes the microbiome of the room you are in within minutes. The sounds of birds, wind, rain, even just the soundtrack of weather happening outside the glass, tells your nervous system that you are still inside a larger world.
Lie close to the window so the light from the sun can fall across your face, even through the pane. This is not as good as being outside, but it is far better than being in an interior room under artificial light. The body knows.
Keep beautiful nature books within arm’s reach of the bed. A book of photographs of mountains, of oceans, of forests, of birds. A book of the night sky. A field guide to wildflowers. Looking at images of nature lowers blood pressure and cortisol within minutes, this has been measured in studies on hospital patients given views of trees through their windows versus brick walls. The brick wall group needed more pain medication, healed more slowly, and was discharged later. The patients who could see a tree did better. If you cannot have the tree, the picture of the tree is the next best thing. The body is responding to the visual information.
Play recordings of birdsong and stream water and wind through pine. There are free recordings of every habitat on earth available online. A small speaker and a cup of warm tea and the sound of a forest at dawn, while you lie in your bed with the window cracked, is a real intervention. Pair it with Gregorian chant, or with the slow movements of a Mozart piano concerto, or with the silence of just the birds. You are giving your nervous system the ancient sounds it is built to recognise.
Visualisation Is Not Magical Thinking, It Is Physiology
There is a body of research now, decades deep, on what guided imagery and visualisation actually do in the human body. Patients who visualise their immune cells engaging with cancer cells, who visualise tissue repairing, who visualise themselves as well, show measurable changes in immune markers, in cortisol, in heart rate variability, in wound healing time. Olympic athletes have used visualisation for decades to train movement patterns without injury. Stroke patients use it to rebuild motor function in limbs they cannot yet move. The brain does not entirely distinguish between vivid imagining and doing, the same neural pathways fire, the same physiological responses follow.
This is not woo. This is the design of the human being. The body is wildly responsive to what the mind holds.
If you spend your days visualising yourself sick, exhausted, finished, defined by your diagnosis, your body will receive that information and respond to it. If you spend even a portion of your day picturing yourself well, picturing your body knitting itself back together, picturing yourself walking in the woods next spring, picturing yourself at the Easter Vigil with your family, your body receives that too. You are not lying to yourself. You are participating in your own healing.
A simple practice: ten minutes a day, eyes closed, in a comfortable position, breath slow and low into the belly. Picture light or warmth or water (whatever image your interior recognises as healing) moving into the place in your body that needs it. Picture the cells doing their good work. Picture yourself a year from now, on a porch, breathing easy. End with thanksgiving.
This is not strange. This is what humans have done in prayer for thousands of years, held an image in the mind’s eye and let the body be shaped by it. Ignatian contemplation does this with scenes from Scripture. Lectio divina does this with the word. The mechanism is the same. You are letting an image and a truth settle into the body.
Your Illness Is Not Your Identity
Somewhere in the long stretch of being sick, almost all of us do the very human thing of taking on our illness as a name. I am a Lyme patient. I am a mould survivor. I have POTS. I have endo. I am autoimmune.
In the early days this is necessary, you have to name the thing to fight it, and you need to find your people, and a label is a tool. But there is a point in the journey where the label starts to wear you instead of you wearing it. The condition becomes the headline of who you are. Your wardrobe, your conversation, your social media, your friend group, your inner monologue, all of it organises itself around the illness. And once that happens, healing has a much harder time getting in. The self has rearranged itself around being sick.
An illness is a communication from the body, not the identity of the soul. The body is saying: I need support here. Something has gone out of balance. Please listen.
That is information. That is invitation. That is not you.
You are a soul made in the image of God, beloved before you were born and beloved after every diagnosis, and your illness is no more your identity than a flat tire is the identity of the car. You can be a person living through illness without becoming the illness. The distinction matters more than I can say. It is the difference between a season and a life sentence.
Coming Out of Caregiving Mode
And then comes the strangest stage of all, and the one we talk about least: the stage of starting to be well again. Or mostly well. Or well-ish. Or not as sick as you were.
The shape of this stage is awkward, because the muscles of survival mode are now well-developed and the muscles of normal life have atrophied. You have spent so long being the patient or the caregiver that you do not quite know how to be a regular person again. The need-tos are still running. The research tabs are still open. The phone calls to the practitioner are still scheduled. The body has gotten better, but the mind has not yet noticed.
This is the moment to begin to live as a well person, even if you are not one hundred percent well. This is the moment to put the books back on the shelf, to stop reading the substacks during dinner, to go to the picnic, to say yes to the invitation, to plant the garden. Living as a well person is itself a way of becoming one.
Your body needs to be told, by your actions, that the emergency is over. That it is safe to come down. That you are going to take it for a walk now, and feed it real food, and let it laugh at a movie, and let it sleep without monitoring the night.
And a gentle reminder: do not chase one hundred percent. One hundred percent is a phantom. It will recede in front of you for the rest of your life if you let it. There is no human alive at one hundred percent, not the marathoner, not the monk, not the centenarian on the front porch of her farmhouse. There are only people who are well enough to live their lives, and people who have decided that they are.
Chasing one hundred percent will keep you in caregiving mode forever, because there will always be one more thing to optimise, one more deficiency to address, one more thing to try. At some point, the chase itself becomes the new illness. The stress of healing perfectly will undo the healing.
Decide that you are well enough today. Decide it again tomorrow. Decide it in the morning when you feel a twinge and your mind wants to spiral. The decision is not a denial of what your body is doing. It is an orientation of your whole self toward life. You can address the twinge with a remedy or a meal or a rest, and then return to the business of being alive.
When Symptoms Return: It Is Never a Setback
Once you are mostly well, you may experience symptoms again in the future. A flare in the spring. A migraine after a hard week. A flutter in the chest after too much coffee. A bad night of sleep that brings back the old fog.
And in those moments, the temptation will be to read it as failure. I am back to square one. I have undone everything. I am sick again.
Please do not do this. It is not true, and it is not kind to your body, and it slows down what would otherwise be a quick recovery.
A symptom is not a setback. A symptom is a communication. The body is saying: I need a little extra support here. Maybe you have been pushing too hard. Maybe the weather changed. Maybe you ate something that did not agree with you. Maybe you have not been outside enough this week. Maybe a stressful conversation got under your skin.
The body is asking, gently or loudly, for the tools you already have. Meat stock. Sun. Sleep. Salt. A bath. A walk. A nap. A confession. A laugh. A friend. A prayer.
The toolkit you built during the long road did not go away, you just stopped needing to use it every day, and now you need a small dose of it for a small season. Use the tools. Trust your body. Then go back to living.
On Letting Yourself Be Cared For
I want to close with the part that almost no one teaches us, because it is the hardest.
If you are the patient, you are going to have to let yourself be cared for. By a spouse. By a parent. By a grown child. By a friend who shows up with soup. By a member of the parish you barely know.
This will feel intolerable. You will want to apologise for needing help. You will want to refuse the soup. You will feel like a burden, and the feeling will be so painful you will be tempted to push everyone away just to make it stop.
Do not push them away.
Letting yourself be loved is its own form of obedience. Christ Himself accepted the help of Simon of Cyrene on the way to Calvary, the Savior of the world received help carrying His Cross. If He could let Himself be helped, you can.
If you do not let yourself be cared for, you steal from the people who love you the grace of caring for you. You also model for the next generation that suffering must be borne alone, and that is not the Body of Christ. The Body bears the weak member. That is how the Body has always worked.
And accept help even when the help is not perfect. The casserole has too much cheese. The friend talks too loudly. The cleaning lady puts your things in the wrong drawer. The relative folds the laundry the wrong way. Imperfect help is still help, and imperfect help is always, always better than zero help.
You are not in a season where you can be a hard grader. Receive what is offered, thank the person sincerely, and let it be enough. The people offering imperfect help are practising love, and your job is to let them.
And if you are the caregiver, an equal word: you must also be cared for. You cannot pour out indefinitely from a vessel that no one is filling. Take the meal. Accept the babysitter. Go to confession. Take the walk. Cry to your sister. Sit in the sun. Eat the steak. Light the candle. Read the psalm.
The Lord did not call you to be a martyr to caregiving. He called you to love, and love that is not nourished becomes resentment, and resentment is not love. Care for yourself with the same tenderness you give the one you are caring for. They will heal better. You will heal better. The whole household will breathe again.
And the same rule about imperfect help applies to you. Take help even when it is not the help you wanted. The neighbour who offers to mow the lawn but does it badly. The relative who watches your spouse for an hour but plays the TV too loud. The friend who brings the wrong groceries. Some help is always better than zero help, and you are not in a position to wait for ideal. Receive what is offered. Thank the giver. Move on with your day. The lawn does not need to be perfect. You need to rest.
You are not your illness. You are a soul on a road, and the road is long, and the road is hard, and the road is also lit with sun and lined with friends and watched over by saints and tended by the Great Physician Himself.
Peace is medicine. Joy is medicine. Reverence is medicine. So is the sun on your face, and the dirt under your fingernails, and the soup someone brought to your door, and the small daily decision to be alive today even when you are not yet whole.
Dum spiro, spero. While I breathe, I hope.
May it be so for you, this week and the next, and the long good road that lies in front of you.
I am so proud of you and love you all!
References and Further Reading
Warren, W. Lee, MD. Hope Is the First Dose: A Treatment Plan for Recovering from Trauma, Tragedy, and Other Massive Things. WaterBrook, 2023.
Warren, W. Lee, MD. I’ve Seen the End of You: A Neurosurgeon’s Look at Faith, Doubt, and the Things We Think We Know. WaterBrook, 2020.
Jampolsky, Gerald G., MD. Love Is Letting Go of Fear. Celestial Arts, 1979 (still in print, multiple editions).
Jampolsky, Gerald G., MD. Teach Only Love: The Twelve Principles of Attitudinal Healing. Hay House, 2000.
Hall, Dean. The Wild Cure: From Death to Life on Oregon’s Longest River. See also thewildcureway.com for interviews and films on his remission and nature-based recovery.
Julian of Norwich. Revelations of Divine Love. Written c. 1395 from her sickbed; available in many modern translations.
Saint Hildegard of Bingen. Causes and Cures (Causae et Curae) and Physica, her medical writings on the body, the soul, and the healing properties of creation.
Saint Thérèse of Lisieux. Story of a Soul. Her account of the “little way,” written during her own terminal illness.
Saint Paul. Philippians 4:4–7; 2 Corinthians 12:9–10. On rejoicing and on strength made perfect in weakness.
Padre Pio of Pietrelcina. Pray, Hope, and Don’t Worry: Quiet Moments with Padre Pio, daily reflections compiled from his letters.
Ulrich, R. S. (1984). View through a window may influence recovery from surgery. Science, 224(4647), 420–421. The original hospital window and tree study.
Li, Q. (2010). Effect of forest bathing trips on human immune function. Environmental Health and Preventive Medicine, 15(1), 9–17. On phytoncides and natural killer cell activity.
Lowry, C. A., et al. (2007). Identification of an immune-responsive mesolimbocortical serotonergic system: potential role in regulation of emotional behaviour. Neuroscience, 146(2), 756–772. On Mycobacterium vaccae in soil and serotonin.
Doidge, Norman, MD. The Brain’s Way of Healing. Penguin, 2015. On visualisation, neuroplasticity, and recovery.
Turner, Kelly A., PhD. Radical Remission: Surviving Cancer Against All Odds, and Radical Hope. Hay House. Common factors among unexplained recoveries.
Practitioners whose work informs this protocol: Mary Ruddick, Jen Donovan, Jules Horn, Brooke McPoyle, Dr. Jack Kruse, Dr. Eric Berg, Dr. Andrew Huberman, Dr. Ken Berry, Dr. Becky Plotner, and Amanda Panacea.