Once Upon a Time

By William Noonan Ph.D.

Once upon a time, an evil sorcerer stole a magic crystal orb, a troll-like imp turned himself into a poisonous fruit tree, and a giant abducted a princess and hid her in his Castle of No Return. These are images from folk tales that you would expect to find in Grimm’s Fairy Tales, but they are not. They are metaphors used by people who have undergone heart, liver and kidney transplants, to describe their experiences of illness, the miracle of transplantation and the journey to healing.

Recently, I was sponsored by Good Life Resources (a patient-centered pharmaceutical company designed to ease the financial and paper burden for people who require constant medication) to conduct a workshop at the Transplant Recipient International Organization Conference in Las Vegas, Nevada. The workshop was for people who wished to create folk tales that metaphorically captured their experience of transplantation. The workshop was not intended to create literary works of art, but was an opportunity to discover meaning through the use of imagination and fantasy. Transplantation is a modern medical procedure that has offered new hope for thousands of people. Tissue matching, drugs and surgical skills have made transplantation a viable choice for treatment rather than an experimental venture. Yet, with the exception of live kidney donors, the patient and transplant professionals depend on the gift of an organ from a person who has died.

The knowledge and skill of transplant technology has advanced dramatically since the first kidney transplant in 1959. It has outpaced our ability to comprehend that in spite of death, a deceased person’s organ can live on in the body of another. We can understand a martyr who willingly lies down his or her life for another, but in the case of transplantation, it is a freak, unexpected accident that unleashes the possibility for a new life.

A woman hears a heart beat within her chest which hours earlier beat inside the body of a stranger. A slight distention under a man’s left rib cage is a conscious reminder that his insides have been rearranged by someone else’s kidney. The donor’s organ enters the diseased body of a living other and heals the infirmity.

Transplantation has ushered into the human realm of experience an event that confounds rational explanation. The metaphorical language of folk tales offers an alternate way to make meaning out of disruptive experiences.

As participants in the workshop in Las Vegas shared their memories, their transplant experiences were carefully crafted into the metaphorical language of folktales. The plot lines of their personal tales were based on traditional folk tales, yet the contents of the stories were the creation of their imaginations.

Many folk tales begin with a misfortune, an insufficiency, or the loss of a valued object. The problem invites a journey towards a resolution. For all the members of the workshop, the failure of a vital organ set them on a unique journey. Participants shared with each other what had been taken away from them by illness. Then, they imaged their personal loss as a stolen valued object.

For example, one woman who had received a kidney transplant felt deprived of time and freedom. Her story began with a town whose life centered around a golden clock with numbers made of jewels.

All the townsfolk arranged their activities to the time of the clock. This special clock ran on a soft, gentle wind that always blew through the town. One day, a gray fog descended on the town. When it moved on, the townspeople discovered the clock had stopped. There was no wind. The wind had been stolen. Her story went on to describe the journey of the clock keeper’s search for the wind.

Another man, who had encephalopathy, a disease that made him appear drunk and confused, imaged the loss of his decision-making ability as a crystal orb that George, the mayor, used to wisely govern the affairs of the town Fa-La-La. In the misty mountains lived an evil sorcerer named Sir Rosis and his evil pets, Encephalopathy, Creatnine, and the ugly brothers, T. Bilirubin and D. Bilirubin.

The evil sorcerer looked down from the misty mountains and was jealous of the good things in Fa-La-La. He was determined that he would get the Orb and things would be good in his kingdom. One night Sir Rosis sneaked down from the mountains and stole the Orb. But the Orb wouldn’t answer the sorcerer’s questions and in a fit of rage the sorcerer hurled the crystal Orb from the mountains into the Valley of the Gray Fogs, where it lodged in the Tree of Life.

Well, things became bad in Fa-La-La. The crops failed because the farmers didn’t know when to plant or harvest. The fish didn’t bite and the hunters came back with no game. The people quarreled and were unhappy. When they would ask George a question he wouldn’t know the answer. George would go to lunch, and get lost. Someone would have to find him and all the people in the land said “Poor old George, he’s lost it.” This man’s story continued along the plot line of a classical folk tale. After the villain has stolen the valuable object, a call for help is made. A hero/heroine appears (in this case, George the mayor, as the victimized hero) and sets out to find the stolen object. On the way, the hero/heroine meets a provider, a helper who has the magical means to recover the stolen object, but the hero/heroine must first pass a test.

Upon passing the test, the hero/heroine receives the magical means and is transported to the place where the valued object is hidden. Each sequence of action represents an aspect of the transplant experience. Due to limitations of space, the entire tale cannot be presented. But a fascinating part of the process occurred when several participants became “stuck” trying to create a metaphor for the experience of waiting for and eventually receiving the donor organ. In each instance, the resistance revealed unresolved feelings around the necessity of a person dying in order for them to live and around their complete dependency on external circumstances.

The man’s story was progressing nicely until he came to the part where George, the mayor of Fa-La-La, arrived at the Tree of Life with the crystal Orb lodged in its trunk. During the session, the man was able to express his frustration at not knowing what to do next. He couldn’t have the character, George, chop down the tree or harm it in any way. That would represent his taking an active role in bringing about his donor’s death. I suggested that he relax and trust what he saw in his magination. After five minutes he interrupted the group discussion, shouting, “I’ve got it!” This is what he saw.

After waiting many days at the foot of the Tree of Life, George finally heard a great noise approaching through the forest. It was a horrible crashing and thrashing noise. George jumped to his feet and climbed a nearby tree. Across the forest, he could see a blind woodcutter dressed all in black coming toward him swinging a black axe. As the axe touched a tree it would fall to the ground. George watched in horror as the woodcutter approached his tree swinging his black axe in front of him. When the axe touched the Tree of Life it exploded in a great flash of light and George was thrown onto his back and the crystal Orb landed in his lap.

Through the construction of this story, the man made sense of his experience by metaphorically representing Death as the blind woodcutter. Death showed no discrimination. Death cut down one tree (Life) after another. The man just happened to be in the right place at the right time, when Death struck a stranger down with the right organ tissue match.

The man’s difficulty with assuming a passive role in waiting for the death of another human being was resolved by his acceptance of the randomness of life events and the recognition of death as the Great Equalizer.

The man came to this understanding through the creation of his personal folk tale. The process of creating a story engages the right side of the brain. According to neurological research, the right side of the brain is active in processing metaphorical types of communication and mediating emotional processes. Image making stimulates unconscious associations and begins to shift patterns of meaning which forge a new reference of understanding in the conscious mind.

The shift in understanding not only prompts new insights, but creates a sense of unity. In a letter following the workshop, the man wrote that the story making process “helped me to bring the transplant experience together and view it as a continuous whole. Always before I had looked at it as a fragmented experience, sort of a series of unrelated events.” Narrative form was used as a pattern for unifying the events in his life into unfolding themes, appropriate resolutions and meaningful significance.

Transplant recipients have stories to tell. Their stories are amazing journeys out of illness to new life. They have approached the boundary lines of life and death. At those outer regions of human experience, the language of metaphor retrieves the power of the event and the depth of emotions. The creation of a narrative bestows meaning on life.

Article originally appeared in Words on the Wing: Issue 6, Winter 2001


Bill Noonan teaches at Marylhurst University in the Business Department, the Art Therapy Department and the Religious Studies Department. He also teaches the philosophy series of courses at Columbia Gorge Community College and is the chaplain for the Hospice of the Gorge where he comforts the dying and counsels the bereaved.


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