She sometimes refers to her death, euphemistically, as The Event.
She speaks of it matter-of-factly, almost clinically, devoid of freighted emotion one might expect from a woman whose heart stopped for 22 minutes one afternoon 23 years ago on the deck of a Sacramento swimming pool, and whose resuscitation and arduous rehabilitation changed her life in so many ways.
Then again, Joyce Mikal-Flynn hardly qualifies as typical.
Even before the 1990 heart attack that has defined her life and given her renewed purpose, she had been a classic outlier. Driven and intense, totally Type A+, Mikal-Flynn was a nurse practitioner with a thriving practice, a triathlete who was pushed and pushed back in competition with legendary pro Sally Edwards, a doting young mother of three and spouse to a high-profile corporate husband. She neither had the time nor inclination to wallow in maudlin emotions.
Post-Event, she eventually used her inner-Ironwoman will to defy the odds and most doctors expectations to rebuild her life, synapse by firing synapse, step by halting step, thought by positive thought. She arrived, ultimately, at a higher existential plane where her new-normal life is richer and fuller than before.
Not only is she back practicing her profession as well as teaching nursing as a tenured professor at California State University, Sacramento and running marathons and sending her three children off into adulthood, Mikal-Flynn has developed a new approach to rehabilitation.
Based on her experience and those of other survivors of life-altering accidents or illnesses, her concept of metahabilitation promises nothing less than turning devastation and disempowerment into self-actualization, and showing those whose corporeal selves may have atrophied that their emotional or spiritual growth can blossom if approached in the right manner.
Her self-published book, Turning Tragedy into Triumph, (JMF Co., $16.50, 148 pages) details her story and those of six others who, due to accident or illness, saw their worlds come crashing down careers and marriages ended, senses of identity obliterated, once-ordinary daily routines turned monumentally difficult but refused to succumb. Using her medical background to buttress her personal experience, Mikal-Flynn has sought in the book to teach doctors and occupational therapists that rehabilitation alone is not enough, that a psychic transformation can go hand-in-hand with levels of physical recovery.
Heres the deal, Mikal-Flynn said, starting with one of her pet phrases, the thing that drives me crazy is physicians and other health-care people taking away that sense of hope. Who knows what youre going to do, post-accident? I dont know. You have to instill hope. Theres a hope of your life being a wonderful life. There is that hope. Sometimes, these people that I wrote about hung onto the thinnest thread of that hope. And look where it got them to huge growth experiences.
Of course, Mikal-Flynn, 58, concedes that her story is atypical. One of her cardiologists, Dr. Roger Van Winkle, once told her You are the luckiest person I have ever met. I have never met anyone who had that much CPR and is alive and sitting up speaking to me.
But rather than considering herself an exception among near-death cohorts, Mikal-Flynn sees her ordeal as an example of how she forced herself to shake off my ego and resentment, and move forward.
When asked how, as she writes, people can find meaning in their suffering, Mikal-Flynn leans in and puffs her lips to blow her brown bangs back into place.
Listen, she said, There are only two ways to deal with this: One is to sink into that despair and desperation and I can understand why youd do that. The other one is to say, I dont know why all this happened but somewhere along the line, if I work with what I have to do the basics: getting up, getting out then I can start coming out on the other side.
I do not minimize peoples pain. These things are not fun and Id never challenge somebody on it and (say) You just need to get over it. No, no, no. But you need to grow as a result (of the event). Heres the deal: Im so tired of motivation. People tell me, Joyce, your storys motivational, but motivational stories are a dime a dozen. What I want to do is to say, (My) story is just to allow you to see possibilities. Because just hearing a motivational story is not enough. If it was, everybody would be (cured). I never sit around telling somebody, This is the best thing that could happen to you.
Proving doctors wrong
But, in a way, it was for Mikal-Flynn. Two years after The Event, through rigorous occupational therapy and counseling, she regained all her cognitive functions and proved wrong the cardiologist who told her shed never run again.
Saddled with aphasia, she basically had to relearn the language and, as her husband, Terry, noted, figure out how to run the microwave oven again. She battled depression, too, once flirting with suicidal thoughts. She would, early on, take walks around the block and forget where home was. Her kids were on their own when having to construct their Sutters Fort fourth-grade projects; mom was just trying to remember their middle names.
So Mikal-Flynn, when she later returned to earn her doctorate at St. Marys College in Moraga, remembered her initial struggle and the turning point, a moment of clarity when she decided to fight to embrace her new life rather then morosely accept its perceived limitations. Much like Elizabeth Kubler-Ross stages of death, Mikal-Flynn developed a six-stage model of rehabilitation: acute recovery; the turning point; the treatments; acceptance and adaptation, regeneration; and taking on the future. She even copyrighted the term metahabilitation. Meta, she said, because it goes above and beyond a simple return to normalcy that rehabilitation promises.
Then, she set out to interview others like her who had taken the same path after catastrophe. Among the six survivors profiled in the book are Jerry, a dentist who was paralyzed due to an air embolism while diving and lost his practice; Dominic, a college rugby player paralyzed in a car accident; and Connie, a mountain climber who suffered major head trauma in a 30-foot fall.
After varying periods of grieving the loss of much of their physical capabilities, the subjects whom Mikal-Flynn interviewed set about re-evaluating their lives in terms of not what they no longer could do but what possible new opportunities arose as a result of their catastrophic accidents or illness. Jerry the dentist, for instance, became an expert witness in civil and criminal trials involving dentistry after losing his practice. He also defied doctors expectations by learning to walk again, albeit haltingly and with crutches, after years of dedicated therapy. Dominic the rugby player has started a foundation to help other ex-athletes transition to para-sports.
What Mikal-Flynn calls transforming consciousness others might simply call a positive attitude that led them to recover mentally and, sometimes even physically, when they could have easily succumbed to reduced expectations. By whatever term, their stories reinforce the books thesis that the established medical model for rehabilitation often does not aim high enough in dealing with patients and their levels of recovery.
When I had my event, the thing that drove me nuts was everybody telling me what I could not do, she said. Nobody said, OK, for (driven) people like you, heres what well do.
She acknowledges that her metahabilitation stance has drawn criticism from some doctors, who believe it gives some patients false hope, and from some patients who may think they are failures if they dont succeed in reaching a certain plane of consciousness.
But Dr. Dean Elias, Mikal-Flynns dissertation adviser at St. Marys, defended the research and concept of metahabilitation. Her results may be anecdotal but, my, what compelling anecdotes.
All these people she talked to had a transformation of consciousness, Elias said. They became different in a way that was more participatory in the whole of life. They gained a sense of their own agency. I think the medical establishment is doing what it gets paid to do, which is to keep things normal. She has discovered something that seems abnormal but in a very positive way.
Far from being Pollyanna-ish, Mikal-Flynn said she simply would like caregivers to focus on what the patient confined to a wheelchair or dealing with severe cognitive damage can do and tell them.
Whats going to happen in the future, we dont know, she said.
She laughs and tells the story about herself from when she had newly awakened from her coma in the hospital and confronted in the hospital corridor that cardiologist who told her shed never run again. She told the doctor, You dont know me. ... I will come through this. You dont know who you are talking to, then turned on her heels and got lost on the way back to bed. The doctor said, loud enough for Mikal-Flynn to hear, Wow, shes yelling at me and she cannot even find her room.
... for a while
It does, she admits, take a certain kind of doggedness of spirit to embrace metahabilitation.
One thing Mikal-Flynn discovered in her interviews is that people needed time to grieve for their previous selves. Dominic the rugby player, for instance, mourned the loss of movement in his legs for weeks before he vowed to pursue other goals.
I say to them: Its an absolute necessity to grieve the life you knew. But were going to come back and get you because we cant let you stay there. You have to get angry, scared of everything you have to do. Thats a natural response to trauma, but now you have an opportunity to move forward, and lets look at how you want that to look like.
Mikal-Flynn presents such a strong, impenetrable presence that its difficult to believe she, too, dealt with depression. Her husband, Terry, recounts some dark days.
She was really, well, theres no other way to say it: She was really pissed off about what happened to her, he said. Here she was this accomplished nurse practitioner whod done some pretty amazing athletic things, but he couldnt remember when the kids birthdays were.
It really upset her when people would say to her, Oh, God must have bigger plans for you. She was like, Come on, really? But she had a breakthrough one night when she finally said, I cant live like this anymore.
And so began her metahabilitation. And, true to her books thesis, shes found her life fuller than before The Event. She, of course, wouldnt wish a 22-minute heart stoppage on anyone, but in the fullness of time, it has benefited her.
People tell me Im, I dont know, softer now? she said. I was kind of hard-edged before.
Heres the thing: Ive always been a very driven person. But this has given me insights into my own life and what works and what might work with other people.
Im just trying to get people like I was away from the (culture of) victimhood.
Call The Bees Sam McManis, (916) 321-1145. Follow him on Twitter @SamMcManis