“Surely, I must be close to the top,” I panted to myself as I looked up the seemingly endless switchbacks that climbed the 4500 feet of elevation from the ground where I had camped to the top of Mt Whitney, the highest peak in the lower 48 states. “Not even close,” I answered as the realization that the small, brightly colored points on the otherwise dun-colored talus slope were not wildflowers, but fellow ascending hikers. There were many more steps to go to reach the sky, and each one of them required effort to overcome the pull of the earth.
Hiking 250 miles in 25 days on the famed John Muir Trail in California’s Sierra Nevada this summer, I developed a deep intimacy with gravity. This force of nature is so easily ignored in the developed world of right angles and concrete in which we live most of our lives. But when one is traversing a massive upturned block of granite that runs a third of the way up California’s spine, it’s a relationship that can’t be easily ignored.
When one hikes in the Sierra, the ground is rarely flat. You’re either going up a hill or down a slope most of the time. And because you’re carrying 40 lbs of gear, clothing, and food on your back, you notice the pull of gravity all the more. When you’re on foot, there is no engine to overcome the pull of gravity as you ascend a mountain pass. And when you’re coming down the other side of that pass, your knees and hips become the brakes.
Even when I was done for the day and set up in my camp, I couldn’t escape reminders of gravity—if I put my cup down on an uneven rock, I could end up with my dinner spilled on the ground, and if I inadvertently lay my tent on a slight grade, it was not uncommon to find myself sliding down to the bottom of the tent before the night was over.
Civilization has defeated this constant awareness of gravity with the spirit level and the plumb line. Most days, I rise from a flat bed, walk across the level hardwood floor, sit in the interior of my car, park in a garage at work, and then ascend to the even plane of my office ensconced within the squared box of an elevator. Even a flight of stairs is a sequence of level surfaces connected by an even rhythm of risers. It’s only when I choose to walk up or down a hill that I feel gravity’s pull. In the Sierra, this is not difficult to find, but in our busy lives, so often lived in the ether of our minds, we lose touch with gravity. We have to take time to be grounded.
In psychiatry, we are called to be a grounding force, a gravitational pull back to center for our patients. We try to be the brakes when mania pulls our patients faster and faster downhill. Sometimes, not long after we have to “get out and push” to help the same patients over the hill of depression.
We help patients come back into the weight of their beings when fearful thoughts send their minds into the strata of anxiety. The conversations that we have with patients about the most intimate aspects of their lives are filled with gravitas; we help our patients carry the weight of their sorrows, wounds, and disappointments. We also help them unload this weight so that their packs are lighter for the next hill. At the top of the pass, we get to share in their satisfaction of having overcome gravity, and, together, we can enjoy the sweeping views of where we have come.
Andrew Penn was trained as an adult nurse practitioner and psychiatric clinical nurse specialist at the University of California, San Francisco. He is board certified as an adult nurse practitioner and psychiatric nurse practitioner by the American Nurses Credentialing Center. Currently, he serves as an Associate Clinical Professor at the University of California-San Francisco School of Nursing. Mr. Penn is a psychiatric nurse practitioner with Kaiser Permanente in Redwood City, California, where he provides psychopharmacological treatment for adult patients and specializes in the treatment of affective disorders and PTSD. He is a former board member of the American Psychiatric Nurses Association, California Chapter, and has presented nationally on improving medication adherence, emerging drugs of abuse, treatment-resistant depression, diagnosis and treatment of bipolar disorder, and the art and science of psychopharmacologic practice.
The views expressed on this blog are solely those of the blog post author and do not necessarily reflect the views of Psych Congress Network or other Psych Congress Network authors. Blog entries are not medical advice.