Nature's Nurturing and Healing Impact

Posted by Martha Twaddle, MD, FACP, FAAHPM

Nature's Nurturing and Healing Impact
Martha Twaddle, MD, was recently named International Visionary in Hospice and Palliative Medicine by the American Academy of Hospice and Palliative Medicine.

I recall a particular late morning in my garden, one of those late fall days when the sky is vivid blue and cloudless; the air holds the crispness of impending winter around the envelope of sunny warmth. The image still so vivid in my mind was a rose bud—still tight in its emergence with the petal tips deeply blushed with pink. With more warmth and sun, this bud was so full of potential to be a fragrant blos­som.

Yet the hint of frost on its green collar was the harbinger of another destiny, of unrealized fullness, a life cut short. This image was particularly powerful for me at that moment, as my student, our Fellow in Pal­liative Medicine, had been on the journey of a compli­cated twin pregnancy and had delivered just a few days earlier. One of her twins died within hours of the birth: such potential, beauty; such life unrealized, unable to blossom. That fragile rose bud crusted so lightly with frost gave expression to my grief, became of metaphor and a way of "making sense" of suffering.

My awakening to the power of the garden and gardening as instruments of healing occurred rather abruptly. Almost 75 percent of my grandparents had been raised on farms, so having "dirt on my hands" was hardwired into my very substance. Many early memories, particularly of my maternal grandmother, Beulah Matson, were nested in the garden. Grand­mother Matson spent more of her adult life as a widow than married, raising three children on her own. Her garden was clearly her sanctuary. I can see her—stand­ing close to 5'1" when she inhaled mightily, with her wide-brimmed crownless hat and well-worn gloves (which she frequently did not wear), gowned in cu­lottes with an apron—in her garden. My engage­ment ring was willed to me by her—it almost wasn't, as she acciden­tally planted it with the tulips one year. The day lilies in my garden (and before that, my moth­er's garden) were those she hybridized—she did this as a novice, but also as a botanic explorer of sorts who loved plants. In my college years, my studies in biology and biochem­istry at Purdue were heavy in botany; plants and green hideaways were always where I sought to be when I needed "sanctuary." Any important papers I needed to write, including my applications to medical school and the personal statement for medical residency pro­grams, were written in a garden. And yet, through this time, I was unaware of what drew me and of my inher­ent need to be among the sounds, smells, textures—the soothing and healing aesthetics of a garden.

It was not until I started my work with the dying that I discovered that the best way to process these journeys, to unpack what I had witnessed, to review the story of lives lost, was on my knees and with dirt on my hands. I could somehow make sense of death in the cycle of the garden, reclaim hope in the emergence of tender plants, grieve the losses with a trowel, shovel, and rake—feel my body alive and physically healthy. Perhaps this was a needed reassurance in witnessing so much illness and death. The epiphany—the con­nected meaning—occurred one day when I had gone to a funeral home to sign the death certificate of a woman named Dorothy, for me a needed observance if not ritual of closure. Dori had been my pa­tient for several years, and I had been her phy­sician in her diagnosis of lung cancer, easing its swift and breathtak­ing luge ride, and sup­porting her through her death. I recall her on the night she died, lying in bed, eyes closed, but with a soft smile and a whisper: "you know, Martha, I'm really going to miss you." As I drove home from the funeral home that afternoon, I stopped at a nursery and bought a tree. And it hit me. A tree for Dori, a copper-roofed bird feeder for Barb, a rambling rose for Chester, the hydrangea for Kay . . . many of the losses, those rich with relationship and love—were memorialized in my garden through plants and garden fixtures. I shared this realization with a colleague as I drove home—the tree flapping through my sunroof—and his response to me was, "Well Martha, I'm glad you have a few acres of land—because given the work you do, you're going to build an arboretum."

Suffering, either directly from illness and its impact or through com­passion, requires a means and place to facilitate ease and healing. For me, this place is to be found—most effectively and powerfully—in the garden.


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