Betting on Love

Betting on Love

Over the past couple of decades, medical researchers have started to confirm what writers, poets, and philosophers have known for thousands of years—love heals.

"Love is among the most important factors that contribute to health," explains Cleopatra Caldwell, associate professor at the University of Michigan School of Public Health. "By this I mean feelings of affect, warmth. It gives meaning to life ... when we are touched, there are positive physiological reactions that can be measured."

It's not so hard to believe that love can decrease stress, depression, neurodegeneration, and anxiety, or that it can improve cardiovascular function, immune defense, memory, and feelings of pleasure and an overall sense of well-being—all of which can be found in the literature. But for various reasons, many people hold themselves back from giving and receiving love—or they just don't know how.

Our culture teaches us self-reliance is a virtue. But in reality, it doesn't take too long for most adults to run into a crisis that they can't handle on their own. It takes a great deal of humility to reach out in such times, but I have learned that these crises can become gifts in breaking through our ego so that we can allow the love and care of other people in.

For some people, the myth of total self-reliance melts away gradually. For me, I can tell you the exact date and time on which I met my emotional Waterloo: it happened at two minutes before midnight on New Year's Eve, in 1994. That's when my daughter, Amelia, died right after she was born—then came back to life again.

I'll spare you the technical details of the rare medical condition (velamentous placenta) that was responsible for Amelia's traumatic birth. Instead, I'll cut to the quick: Amelia's brain had been deprived of oxygen for some time, and tests showed signs of significant damage. The doctors at the University of Chicago Hospitals didn't tell us this at first—no doubt because they were so busy just keeping Amelia alive. None of her major organs were working on their own, so her body was covered by tubes, wires, and monitors.

I'll never forget the immense joy and sadness when a kind nurse allowed me to hold Amelia for the first time. The nurse carefully bundled up all the wires from the monitors and gently, reverently placed my daughter in my arms. Of course I felt the joy that she was alive, and fighting so hard for us. But my heart also felt great sadness, because I realized, in the three days I had been camping out in the neonatal intensive care unit, I had yet to see her eyes open. Was this, then, to be my future, looking always into the face of a child who could never look back?

All the doctors and nurses said they were astonished by Amelia's progress as, each day, another organ came on line; another tube was removed. "A miracle baby!" they declared, and they praised my strength, too, as I sat next to Amelia's incubator, hour after hour, so I could be there when she finally woke up. But she never woke up, and she never cried, and she never moved—was this, then, to be my future?

I never let my husband—or anyone—know what I was feeling. If I cried at all, I cried alone; I was taught to be strong, after all, and very self-reliant.

On the day of Amelia's release from the hospital, a doctor showed us the results of EEG tests that revealed the extent of the damage to her brain. He proclaimed that Amelia did not have much chance of ever living a normal life. We were instructed to give her anti-seizure medicine because she had had one seizure shortly after birth, probably due to trauma. But my mind couldn't take in anything past the "no normal life" part. Because I knew it wasn't just Amelia's life that wouldn't be normal.

It was mine; my husband's; our two-and-a-half-year-old son, Zach's. My brain was repeating the doctor's words as my husband put Amelia's sedated body in the car seat for what should have been her triumphant first ride home. When we got home, I finally allowed myself to collapse, sobbing, into the arms of my big sister Peg, who had come from a thousand miles away to help for a whole month. "But remember, she's a miracle baby!" Peg reminded me. "Maybe Amelia isn't finished surprising you yet!"

Peg spent her days trying to keep Zach out of trouble, and I fed and stood watch over Amelia, wanting to be sure I was there when she opened her eyes. But the days passed into weeks, and weeks passed into months, and Amelia never woke up.

Because I was so sleep-deprived and distraught when Amelia was discharged from the hospital, I did not hear, understand, or remember how important it was for her to stay on her medicine, and so one day, when she was about three months old, I tried an experiment and skipped a dose. I wanted to see how much of her lack of consciousness was a side effect. Now I know I was wrong—I do not recommend that any parent change or stop a child's medication without consulting a doctor first—but at the time, I didn't see how her brain could possibly heal unless we had a chance to bond with each other.

Within hours I was gratified to see a glimpse of her brown eyes, which locked into mine. Every day she spent more and more hours awake, studying our faces, taking in the shapes of furniture, curtains, clothing, and stretching her arm towards the light streaming in through the window.

When I took Amelia in for her biweekly EEG test and evaluation with Dr. H, the pediatric neurologist, the nurse noticed the change in both Amelia and me right away. But when I told her I had stopped Amelia's medicine, she was upset, and left to make her report to Dr. H.

A supportive, warm, wise doc in his seventies, Dr. H was not wearing his usual smile when he entered the room about ten minutes later, and I feared the worst. He bent over the day's test results, then watched Amelia, who had completely transformed since her last visit, and now gurgled and happily lunged at my nose. When Dr. H took both of Amelia's hands in his, Amelia suddenly turned towards him and shot him an irresistible smile. Almost despite himself, Dr. H smiled back, then seemed to be struggling with himself. Finally he said to me: "You did the right thing. Amelia's brain has healed."

I took this to mean that Amelia's test results finally showed no damage. In fact, I learned later that Amelia's brain had—and still has—the same damage as when she was born. But I think, when Dr. H used the word "healed," he was drawing on years of experience seeing patients' brains recover from trauma. Also, seeing Amelia and me relating so well together, he was taking a bet on the healing power of bonding. And by affirming me as a mother, he was taking a bet on love.

Dr. H told me to come right in again if we ever needed him, but added that he doubted we'd have to. For two days I was elated, and then the strangest part of this story happened. For the next six weeks, I was plunged into the deepest, darkest despair, diagnosed with post-partum, and placed in an outpatient program.

I think I'd stayed strong because I had to, and when a doc told me Amelia was okay, I gave myself permission to let go. At the time, it was humiliating, but now I see that period as a great gift. People who had been casual friends in our Quaker Meeting brought us casseroles, held me when I cried, and became close friends. During my days in the outpatient program I made friends whom I would never have met otherwise. The hospital was located in a primarily African-American neighborhood, and we shared an intimacy in group therapy that people normally don't share—especially not across racial lines. My ego was broken, and I say this in a positive way. I believe unless and until our ego is broken, we cannot be free of our cultural myth of total self-reliance—and we cannot benefit fully from the sublime pleasure and pain of love in community.

Amelia is 18 years old now, and if you were to look at her and talk with her for any amount of time, you would never guess she died when she was born. She plays ice hockey, writes plays and poems, and plans to change the world. She's a straight-A student and already has scholarship offers from four colleges. And I know, on that bittersweet moment when I drop off Amelia at college next fall, I will have many, many people to thank. It takes a village to save a baby who has only the wisp of a chance of a normal life—and I also know that village saved me and our whole family.

 About this Image

  "Betting on Love" author Madeline Diehl, with her daughter, Amelia (center), and Deepa Ranganathan, a physician who played a key role in saving Amelia's life 18 years ago. This photo was taken at Amelia's high school graduation, June 2013.

"Betting on Love" author Madeline Diehl, with her daughter, Amelia (center), and Deepa Ranganathan, a physician who played a key role in saving Amelia's life 18 years ago. This photo was taken at Amelia's high school graduation, June 2013.

Madeline Strong Diehl is a freelance writer based in Ann Arbor.

When Society Bets on Love

As medical researchers cover new ground in confirming and measuring the benefits of love, public health researchers like U-M SPH Associate Professor Cleopatra Caldwell and her associates are finding ways to apply this knowledge to society. Caldwell's seminal 2004 project in Flint, a community-based participatory research collaboration, shed light on how improving the communication and parenting skills of nonresident fathers in the African-American community positively affected their own health while significantly strengthening the social safety net for their sons.

"This is not rocket science," said Caldwell, who plans to expand her research by studying nonresident fathers and their sons in a Chicago neighborhood, and eventually to include daughters and mothers.

Caldwell's Flint study revealed that appropriate expressions of love reinforce and benefit the health and well-being of both fathers and sons, and that there are many ways that father-son relationships can be supported by the community. Many men grow up in a culture where fatherhood is defined as being the provider, explains Caldwell, and this can leave unemployed nonresident fathers without a way to feel involved—unless they learn that there's a lot more to fathering than a paycheck.

"We saw grown men crying in our sessions," Caldwell recalls. "Some told us they didn't understand how much their sons needed them."

Among the 332 nonresident African-American fathers who participated in Caldwell's study, those who reported a good relationship with their sons drank less alcohol and reported fewer symptoms of depression. Fathers with drinking problems requested help after the men realized how important they were to their sons. It is also possible, says Caldwell, that their sons may make better health choices because they had the counsel of their fathers, and they felt loved. Contrary to the "deadbeat dads" stereotype, current research is finding that nonresident African-American fathers are more likely than the nonresident fathers of other ethnic groups to be actively involved in the lives of their children. So Caldwell's work can have great impact in the African-American community as a whole.

It seems logical that love impacts health on a community level as well as on a personal level, and Caldwell and her associates are trying to discover where and how community agencies, hospitals, and other key social resources can develop scientifically based interventions to help family members learn how to nurture and communicate love. "This kind of heart-to-heart communication between fathers and sons needs to happen in a safe place, and we work with our community partners to find and create that space," she says. "By engaging nonresident fathers, we fill a gap that can make a big difference in a young boy's life—and his father's as well."

The Physician's Art of Compassion

Recent survey data show that while 75 percent of physicians believe they provide "compassionate care" to their patients, fewer than 50 percent of patients say they receive such care from their doctors.

And that's a problem, says physician Joel Howell, who defines "compassionate care" as care that takes into consideration a patient's family and overall situation. "How do you get doctors to understand their patients not simply as biological entities with a disease," Howell asks, "but as human beings with families, emotions, and lives outside of what can be captured with a CAT scan or DNA analysis?"

One way, he suggests, may be the arts.

"You can understand what it means to be human by studying biochemical pathways and anatomical relationships and cost-benefit analyses of the human body," says Howell, a professor in the U-M School of Public Health; Medical School; and College of Literature, Science, and the Arts. "On the other hand, if you want to understand what it means to love, to experience the depths of despair or joy, the great artists are another way of trying to understand that."

For the past four years, Howell and his colleague Sanjay Saint, professor of internal medicine, have been exploring art's power to help doctors prepare for a profession where choices are often complex and "tolerance for ambiguity" is a critical skill. Howell and Saint co-direct U-M's Medical Arts Program, which partners with the University Musical Society and other area arts organizations to introduce some 120 medical students and residents a year to concerts, art exhibitions, dance performances, plays, works of literature, and behind-the-scenes discussions with artists and arts experts.

The aim is to help young physicians deepen both their compassion and their tolerance for ambiguity by addressing issues that don't always get addressed "as effectively as possible elsewhere in the curriculum," says Howell. "Such as how to understand death, how to be comfortable reveling in ambiguity when you don't know what to do and yet you have to make decisions. Textbook science draws nice graphs and charts and says, ‘This is what you do next.' The real world is not like that. Real medicine is not like that."

Ashley Dehudy, a 2009 SPH graduate and fourth-year U-M medical student, says the program has been eye-opening. "It's very easy to read textbooks and publications and discuss disease in a matter-of-fact sort of way, but learning how to think about the gravity of an illness, and how it impacts the many facets of an individual's life and his or her well-being, is a more difficult process. I think we are helped in that process by attending events that are often inspired by the same gamut of emotions that surround health care, from joy to despair." Dehudy also believes the program has improved her observational skills.

Howell and Saint are studying the program's impact and expect to publish their findings in 2013.

For more on U-M's Medical Arts Program visit The Medical Arts Program website.