Felt Helpless Research Articles

“IF I AM OLD, YOU CAN NOT TELL ME THAT I HAVE JUST BREAST CANCER PATIENT”: A PHENOMENOLOGICAL STUDY

“IF I AM OLD, YOU CAN NOT TELL ME THAT I HAVE JUST BREAST CANCER PATIENT”: A PHENOMENOLOGICAL STUDY Abstract Objective: This study aimed to investigate the post-surgery experiences of elderly breast cancer survivors. Methods: Semi-structured interviews were conducted with 12 elderly breast cancer patients (> 65) after surgery. To evoke the themes illuminating these women's experiences, we employed phenomenological analysis. Results: Three main themes emerged as a result of the research: "This is not ideal at this age but there is nothing I can do," "I am no longer self-sufficient," and "We are different, I am old." For elderly women, the phrase "removing the breast" is difficult to hear. Most elderly people could not even look at or touch the area. They asserted, however, that being healthy is more crucial than caring about one's physical appearance given one's age. They were unable to care for themselves, carry out independent daily tasks, or clean the house. It had a significant impact on the elderly to be dependent on others for these tasks. Those who were assisted felt grateful; those who were not supported felt helpless. The elderly were burdened more because of their age and various health issues. On the other hand, elderly patients who underwent cancer surgery experienced a fear of passing away. The elderly wanted information or assistance with their issues, but they were unsure of where to turn. Conclusion: Elderly breast cancer patients experience different issues due to the particular challenges of old age. Based on this knowledge, members of the healthcare team should follow a different roadmap than the particular strategy for performing breast cancer surgery on elderly patients. Cancer diagnosis, breast loss, the physical burden of comorbidity, the psychological burden of dependency, and the inability to care for oneself should all be considered when providing care and treatment for elderly individuals. Keywords: Breast cancer surgery; elderly patients; experience; geriatric oncology; phenomenology.

Adolescent Patients'experiences of Mental Disorders Related to School Bullying.

The purpose of this study was to explore the real inner experience and nursing needs of adolescent patients who suffered from school bullying, and to develop a treatment plan to restore adolescent mental health. Using the maximum difference sampling method, 15 adolescent patients were interviewed by psychologists and nurses, and the interview results were analyzed by topic induction. Among the 15 participants, 12 (80%) felt helpless, 13 (86.7%) had serious negative emotions, and 10 (66.7%) felt anxious about personal growth. Based on the semi-structured interviews, the psychological states of participants were summarized into three themes: Helplessness, Severe negative emotions, and Anxiety about personal growth. Under the theme of serious negative emotions, it was further divided into three sub-themes: Frustration and Distrust, Rebellion, Insecurity and depression. These themes reflected the significant impact of school bullying on the psychological status of the participants. The internal experience of adolescent patients with mental disorders caused by school bullying mainly includes helplessness, serious negative emotions and anxiety about personal growth. It is recommended to evaluate and diagnose patients' existing and potential health problems individually during clinical treatment and care. On the basis of comprehensive assessment, psychological counseling should be provided and support from family and school should be sought to promote positive mental health and personal growth of adolescents.

“Maintain Professionalism”: Nurses’ Experiences in Caring for Patients with Malignant Fungating Wounds in Taiwan

ContextMalignant fungating wounds (MFWs) occur among 5%–15% of patients with terminal cancers, the uncontrollable symptoms result in serious psychosocial issues, thereby reducing the quality of life. Caring for MFWs impacts caregivers, including healthcare personnel. While existing studies are patient-focused, the impact of care experiences and associated support for nurses has not been examined. ObjectivesTo explore the experiences in caring for patients with MFWs among nurses in Taiwan. MethodsQualitative study with a phenomenological approach by thematic analysis was conducted with semi-structured interviews. About 15 nurses who cared for patients with MFWs at local district hospitals in Southern Taiwan. ResultsFour themes were identified to describe the phenomenon: (1) Fear of Unpredictability (2) Maintaining Professionalism (3) Feeling Helpless (4) Rationalizing the Negatives. The themes illustrated the distress of managing physical symptoms and highlighted how nurses strived to promote comfort for patients. Nurses felt helpless about the incurable nature of MFWs but found a way to suppress their feelings. ConclusionThe findings suggested the need for addressing the emotional well-being of nurses who take care of patients with MFWs. Future studies should identify effective coping strategies for nurses’ health when caring for this population.

Online Balint Groups in Iran during the Covid-19 Pandemic.

When Covid-19 was declared a pandemic, most people felt helpless, fearful, and demoralized while health care workers put their own lives at risk to support and heal others. The uncertainties expressed by experts and the ambiguous and protracted nature of the pandemic compounded the sense of frustration caused by the scarcity of protective equipment and effective medications. This combination of factors led to exhaustion, burnout, and moral injury. As a result, mental health practitioners worldwide realized that health care staff needed to stay motivated and resilient. Our contribution in this regard was to start Balint groups throughout Iran, online, for a full year. We learned some lessons worth sharing. Our insights were wrapped around challenges but proved helpful to preserve the integrity of delivering medical services in times of crisis.

The Unknown Journey: Uncertain Experiences in Mothers of Infants With Congenital Heart Disease Before Undergoing Open Heart Surgery

Most children with complex congenital heart disease (CHD) require open-heart surgery within one year of birth to survive. Thus, new mothers of infants with CHD are faced with making unexpected and difficult decisions. This study was designed to explore the essence of the maternal uncertain experience prior to infants with CHD undergoing open-heart surgery. In this study, a phenomenological approach was used and data were collected using open-ended interview guidelines structured around the Uncertainty in Illness Theory. Nine mothers of infants with CHD who had received open-heart surgery were interviewed in a hospital interview room within two weeks the operation. Colaizzi's (1978) data processing procedure was applied in the post-interview analysis. Five themes emerged: (1) Hit bottom and felt helpless; (2) Hit the road - An overwhelming sense of emergency; (3) The crunch - Do your best to accept destiny (4) Disease brought the unknown; (5) Hope in uncertainty. The high-risk nature of and their unfamiliarity with the surgery made the participants experience illness uncertainty. The medical system should develop more-structured CHD information and provide emotional support in a timely manner to alleviate illness uncertainty in mothers of infants with CHD.

Determining factors that maintain physical function or increase frailty using the Kihon checklist among community-dwelling older adults: a six-year longitudinal study in Agano, Japan

BackgroundA significant increase in the older adult population in Japan will significantly increase healthcare costs. This study aimed to examine the risk factors contributing to robustness transitioning to frailty in older residents.MethodsParticipants were aged 70 in 2016 and 76 in 2022. Participants were evaluated using the Kihon Checklist (KCL).ResultsParticipants for this longitudinal study included 444 older persons who completed the KCL surveys in 2016 and 2022. The follow-up rate was 80.6%; therefore, 358 participants were included in the analysis. The median KCL score increased significantly from 2 to 2016 to 3 in 2022 (p < 0.001). The prevalence of robustness significantly decreased from 60.9 to 48.6% (p = 0.042). In a stepwise logistic regression analysis, robustness was independently associated with regular continuous walks for 15 min and a body mass index of above 18.5%. The following variables were associated with the transition to prefrailty: experiencing a fall in the past year and not going out at least once a week. For the transition to frailty, the variables were turned to family or friends for advice, experienced a fall in the past year, and felt helpless in the last two weeks. The independent factor for the transition from prefrailty to frailty was having a BMI of less than 18.5. In contrast, the independent factor for improving from frailty to robustness or prefrailty was going out at least once a week.ConclusionsWe recommend maintaining continuous walking for more than 15 min, maintaining a BMI of at least 18.5, and going out more than once a week to improve being house-bounded and depressive mood, not only to prevent the transition to prefrailty or frailty but also to improve frailty.

An Overview on Social Withdrawal-Hikikomori in Japan and Support in the Context of COVID-19 Pandemic

The spread of the COVID-19 pandemic has affected every aspect of human life and lead many families to experience the pandemic as stressful. Due to Coronavirus lockdown, many people lost their livelihood and felt helpless, bored, or even depressed. The long lockdown might have led to social isolation and mental health problems, especially Hikikomori – a phenomenon of social withdrawal in Japan. Over 1 million Japanese who live as “Hikikomori” who had totally withdrawn from society, now face a dire situation, left alone and unable to cope. The government has supported them in many ways to bring them back to society. This support has played an important role in helping Hikikomori whose life is totally supported by their parents and relatives, to overcome the impacts of the crisis. However, factors contributing to Hikikomori’s reduced health and well-being should be investigated to find appropriate measures for the current situation.

LOVE OR OBLIGATION TO “SEE THEM THROUGH:” BURDENS AND GAINS IN CAREGIVING FOR CENTENARIANS

Abstract In Hong Kong, the population of centenarians increased from about 3,000 in 2011 to over 10,000 in 2021. The growth of this population has led to challenges concerning how far family caregivers, who are usually older adults themselves, could care for their spouse or parents. In 2021, we launched the 2nd Hong Kong Centenarian Study and included the voices of family caregivers. Notwithstanding the increased difficulties of caregiving during COVID outbreaks, our interviews with 120 caregivers revealed low to moderate scores of caregiving burden and gains (measured by 4-items from the Zarit Burden Scale and 5-items from the Positive Aspects of Caregiving Scale). Female and older (aged 70 or above) caregivers reported more emotional distress, burden, and poorer self-rated health, while younger caregivers (less than 70 years old) sustained a wider social network. Financial stress was related to smaller social network size and more emotional distress. When being asked what sustained their motivation to care for their spouse or for their parents, “filial obligation to see them through” and “repaying for love” were answered as key motivators. Caregivers also derived pride and satisfaction from contributing to the remarkable longevity of their loved ones or from witnessing their loved ones recovering from life-threatening traumas (e.g., falls, hospitalization), but felt helpless when faced with escalating care needs due to their own deteriorating physical health and capacities. “Double-old caregiving” will become more common, and society will need to overhaul the care system to support these motivated families who have escalated care needs.

Nursing Experience of a Patient with Acute Kidney Injury Facing the First Hemodialysis

&lt;p&gt;本文描述一位因腎功能損傷伴隨致命性高血鉀風險，使其面臨初次血液透析之護理經驗，經團隊評估後，需長期血液透析的個案，其日常生活受限、家中角色改變進而產生無力感，照護期間為2020/1/16~2/2。護理過程中藉由直接照護、身體評估、主動關懷及開放性會談等方式收集資料，發現主要健康問題有：一、呼吸喘，二、透析飲食執行度不佳，三、無力感。照護期間透過圖表（卡）教導個案測量水腫情況，並透過水壺、磅秤讓個案學習飲食及水份控制技巧，與其搭配營養師衛教及食品營養成分資料庫，增加個案對飲食資訊管道，並考量個案生活習慣下建立提醒機制，如：製作小吊飾或手機鬧鈴等個別性護理措施，加上家人支持、宗教信仰成為心靈上慰藉及腎友的經驗分享，引導個案接受目前扮演的角色，與疾病共存生活。建議往後照顧類似案例能融入家屬的參與，並思考如何強化醫療成員自我主動學習心理諮商輔導課程意願，讓往後面對此案例時能有更好的因應之道。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;This paper describes the case of a patient with worsening renal function accompanied by electrolyte disturbance who required long-term hemodialysis after assessment by a medical team. The patient felt helpless due to restrictions in daily life and changes in their family role. The care period was from January 16 to February 2, 2020. In this period, observations, direct care, physical evaluation, medical record inspection, active concern, and open interviews were used for collecting information. Major health problems found included the following: 1. shortness of breath; 2. poor execution of dialysis diet; and 3. a sense of powerlessness. During the care period, picture teach the case to measure edema, and let the case study dietary water control skills through the use of water bottles and scales, nutrition-related information websites and several types of reminder mechanisms were employed, such as using cell phone charms or mobile alarms, to help the patient understand correct information on various dietary components and accept their current family role. This was done to make living with the disease easier for the patient. We recommend the inclusion of family participation for future studies on care of patients with similar conditions. Also, we should think of devising ways for increasing medical staff&amp;rsquo;s willingness to proactively take psychological counseling courses so that they can respond better to such cases in the future.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Legal Protection to the Auction Winner with Good Intentions of Mortgage Rights on Grosse Minutes of Auction Number 780/14/2019

The government has provided legal protection to auction winners who take part in the auction with good intentions and in line with the rules, including those that are specifically regulated in the Regulation of the Minister of Finance Number 27/PMK.06/2016 concerning Auction Implementation Guidelines. The auction winner of Grosse Minutes of Auction Number: 780/44/2019 felt helpless and burdened by not being able to own the tangible object of what he purchased in the auction because the previous owner or mortgage giver objected to emptying the tangible object voluntarily. This problem made the auction winner burdened to forcibly vacate the tangible object from the auction he won and results in new legal actions. This research was conducted through library research to collect secondary data from primary, secondary, and tertiary legal sources. The owner of the Grosse Minutes of Auction number 780/44/2019, who won this auction and had good intentions, should be provided legal protection. This is done to uphold the principles of justice and give the auction winner legal security over his ownership of the tangible auction objects (land and building) that had been purchased. Article 1977, paragraph 1, of the Civil Code (hereafter referred to as the Civil Code) provides legal protection for purchasers who have good intentions. In essence, this article protects purchasers of movable property. According to Article 1977, paragraph 1 of the Civil Code, whoever controls movable property that is not in the form of interest and receivables that are not required to be paid to the bearer is declared to be the ownerKeywords: Legal Protection, Auction Winner, Grosse Minutes of Auction

Symptoms and risk factors for depression among college Freshmen students

Introduction: Depression is an illness with a combination of associated symptoms of which the dominant one is a depressed mood of mind accompanied by the feeling of sadness and/or anxiety and/or irritability. It is a lengthy illness (lasting at least 2 weeks). Objective: The study aimed to describe the symptoms and risk factors for depression among adolescent males and females of college freshman students. Methodology &amp; results: this is a descriptive observational and cross-sectional community–based study that was conducted on 200 college freshmen students in 4 medical colleges (medicine, dentistry, pharmacology and nursery) at the International University of Africa at Khartoum state in 2014. The age group was 16 – 19 years. The study revealed that 20 (10%) students felt sad, 16 (8%) felt anxious, 57 (28.5%) felt empty, 64 (32%) felt hopeless, 49 (24.5%) felt guilty, 24 (12%) felt worthless, 70 (35%) felt helpless, 21 (10.5%) felt irritable and 39 (19.5%) felt restless. Also, one or more of the following; loss of interest in activities 68 (34%), lack of energy 90 (45%), problem concentrating, remembering information or making decisions 75 (37.5%), problems falling asleep or sleeping too much 102 (51%), loss of appetite or eating too much 46 (23%), thoughts of suicide or suicide attempts 9 (4.5%) and aches, pains, headaches, cramps or digestive problems that do not go away 30 (15%). The risk factors include fear of failure, demands on time, financial pressures, low self-esteem, separation of their usual network support and poor coping strategies. Recommendations: It was recommended to provide each college with a social worker/psychiatric nurse to early recognize the symptoms and risk factors for depression in first-year college freshmen, observe their behavior, educate them and their teachers and families about the symptoms and risk factors for depression and early recognition/prevention of depression and suicide.

STUDI FENOMENOLOGI: PENYINTAS COVID-19 DI KECAMATAN KROYA KABUPATEN INDRAMAYU

The Coronavirus-19 disease was first discovered in Wuhan, China in December 2019. This virus quickly spread to various countries, one of which was Indonesia. People infected with Covid-19 will experience complex problems. The purpose of this study is to explore more deeply about the life experiences of people infected with Covid-19. This study used a qualitative research design with a descriptive phenomenological approach. Data were taken by interview seven participants used indepth interview techniques, then the research results were analyzed used the Colaizzi method. The results of the research on the life experiences of survivor Covid-19 in Kroya Subdistrict, Indramayu Regency are described in four themes, namely: 1) Felt helpless when they know they are positive for Covid-19, 2) Felt difficult to undergo independent isolation, 3) Motivated to recover, 4) Take care not to get infected with Covid-19 again. The four themes can be interpreted that the meaning of the life experiences of people infected with Covid-19 are pleasant and unpleasant experiences when they were initially positive for being infected with Covid-19, underwent isolation, and negative from the Coronavirus.

Mental health status and quality of life of people with disabilities in social isolation

Introduction: at this critical moment of the COVID -19 pandemic, we observe the social withdrawal and the break from the routine of individuals in society, for people with disabilities who need adequate support and a routine of more intense and effective activities may feel a greater need for care and attention of family support for solving everyday problems. Objective: to identify factors associated with the impact of the pandemic on the quality of life of individuals with disabilities and their caregivers. Methods: a virtual survey was carried out with parents and caregivers of people with disabilities to identify the main factors associated with the impact of the Pandemic on daily life and social relationships between family and community. Results: of the parents and caregivers we had access to and answered the questionnaire, 90% are residents of the ABC region of São Paulo. Their children and adolescents with disabilities are between 4 and 18 years old. The main scores of caregivers on difficulties in care during the pandemic, 70% felt helpless at some point, 17% had difficulties in performing self-care activities, 42% had anguish and fear during the period, 83% have the greatest responsibility for household decisions, and about 50% can share those decisions. Conclusion: the main complaints about the care of people with disabilities during the COVID-19 pandemic are related to the feeling of fear and anguish that affects decision-making and family relationships, which influences self-care activities and mental health of this population.

Moral Injury.

Moral Injury.

The psychological effects of staying home due to the COVID-19 pandemic

The most significant individual safety measures taken during the COVID-19 pandemic include physical distancing, quarantine, and isolation. Although such steps are taken to control the spread of the pandemic, they may also cause various psychological problems. This study attempts to identify individual perceptions of staying home due to the COVID-19 pandemic through metaphors, and examines the relationship between these perceptions and stress, depression, and anxiety. This research utilizes a mixed method design called the embedded design. The analyses were performed on data collected from 96 women and 80 men aged 18–57. Qualitative data were analyzed using a content analysis technique, while quantitative data were analyzed through the Kruskal-Wallis test. The findings showed that most of the participants viewed staying home as confinement, experienced boredom/depression because of staying home, and felt helpless. On the other hand, some participants concentrated on the positive sides of staying home and considered it a responsible behavior, an opportunity, and a requirement for feeling safe. The individuals who viewed staying home as confinement and a cause for boredom/depression experienced more psychological problems, whereas those who perceived it as a responsibility or opportunity experienced fewer psychological problems. Considering the literature on the contribution of positive thinking to the well-being of individuals, as well as the lower levels of psychological problems in individuals who maintain their positive perspectives despite the negativities of staying home due to the pandemic, we recommend that mental health professionals focus on the development of positive feelings and thoughts in their interventions.

Patients' experiences of asthma exacerbation and management: a qualitative study of severe asthma.

Exacerbation is a defining feature of severe asthma, and oral corticosteroids (OCSs) are frequently prescribed to manage exacerbations. This qualitative study was conducted to examine the experience of patients with severe asthma, with a focus on asthma exacerbation and OCS treatment.Adults with severe asthma were recruited from three tertiary hospitals in South Korea. Data were collected through in-depth qualitative interviews. Verbatim transcripts were analysed using Colaizzi's phenomenological method to uncover the meaning of the participants’ experience. Recruitment of participants continued until thematic saturation.14 patients with severe asthma were recruited. Four theme clusters emerged: 1) experience of asthma exacerbation; 2) impact on life; 3) OCS treatments; and 4) disease perception. The patients experienced severe physical and psychosocial distress from asthma exacerbations, felt helpless due to failed efforts to prevent exacerbation and were living a restricted life due to fear of exacerbation. They feared OCS side-effects but had no other choice than to rely on OCSs because other interventions were ineffective. Most had poor knowledge and understanding of severe asthma and the long-term health consequences.Asthma exacerbation affects wide aspects of life in patients with severe asthma. Several components may underlie reliance on OCSs, including experience of distress during exacerbation, fear of future exacerbation and lack of proper knowledge about the long-term health consequences of severe asthma and OCS treatments. A multi-disciplinary approach is warranted to support the patients and to provide systematic education about the long-term health implications of severe asthma.

Birth experience from the perspective of the fathers

PurposeAs men nowadays often attend the delivery of their own child, they also have to go through the labor period. In this study, the condition of the expectant fathers attending labor was evaluated.MethodsIn 2016, fathers who went through labor with their partners in the University medical center of Mainz were interviewed within the first days after delivery and 6 months later. They received a “Fathers questionnaire” concerning their motivation, the valuation of their attendance, their emotions during labor, and concerning the service in the labor ward. Six months later, they also received the validated Impact of Event Scale questionnaire (IES-R). In total, 318 participants answered the “Fathers’ Questionnaire”, 226 the IES-R.ResultsFather’s attendance during labor was considered to be beneficial for fathers themselves (254, 79.8%), for the mother (272, 85.5%), for the newborn child (187, 58.8%), for the relationship (234, 73.6%). Only four could not see a purpose in their attendance. 73 men (23%) felt helpless, 47 (14.8%) were overwhelmed by the situation, 116 (36.5%) felt fear, 299 (94%) were happy to be present at birth, 27 (8.5%) felt traumatized by experiencing their partners in labor. According to the IES-R, none of the 226 men surveyed showed all symptoms of post-traumatic stress disorder.ConclusionChildbirth is related to positive and negative emotions. Positive emotions are predominant, but come along with negative feelings. In this survey, posttraumatic stress disorder did not occur among men after delivery. Nevertheless, fathers’ needs should be kept in view.

Psychological Profile and Disease-coping Strategies of Patients on the Waiting List for Liver Transplantation

AimTo determine the psychological characteristics of patients on the liver transplant waiting list; to analyze the implications of the patient's psychological profile on coping with the disease. Material and methodsStudy population: patients on the liver transplant waiting list. Psychological-profile: Socio-personal history; Mini Mental State Examination; Brief-Symptom Inventory of psychopathological problems; International Neuropsychiatric Interview; Family APGAR questionnaire; Social Support Questionnaire. Coping with the disease: A questionnaire about mental adaptation to the disease. Patients were recruited for the study at the time when they were included on the waiting list. ResultsThe patients (n=112) had the following characteristics: 68% of the patients had symptoms of emotional psychopathology, with 48% being of a depressive, anxious and obsessive–compulsive type, respectively. In terms of social and family support, 27% had the perception of being in a dysfunctional family (slight – 23%; serious – 4%). What is more, according to the Global Support Index, 21% had non-functional social and family support. Coping with the disease: 8% were well-adapted to the disease, the remaining 92% were poorly adapted; of which, 79% had a weaker fighting spirit, 51% expressed anxiety and concern about coping with the disease, 34% found they resorted to fatalism, 29% were in denial and 27% felt helpless. ConclusionsOnce liver patients are included on the transplant waiting list, they poorly adapt to the disease, with important emotional implications that result in psychological alterations.

Perfil psicológico y estrategias de afrontamiento ante la enfermedad de los pacientes en lista de espera para un trasplante de hígado

AimTo determine the psychological characteristics of patients on the liver transplant waiting list; to analye the implications of the patient's psychological profile on coping with the disease. Material and methodsStudy population: patients on the liver transplant waiting list. Psychological-profile: Socio-personal history; Mini Mental State Examination; Brief-Symptom Inventory of psychopathological problems; International Neuropsychiatric Interview; Family APGAR questionnaire; Social Support Questionnaire. Coping with the disease: A questionnaire about mental adaptation to the disease. Patients were recruited for the study at the time when they were included on the waiting list. ResultsThe patients (n=112) had the following characteristics: 68% of the patients had symptoms of emotional psychopathology, with 48% being of a depressive, anxious and obsessive-compulsive type, respectively. In terms of social and family support, 27% had the perception of being in a dysfunctional family (slight-23%; serious-4%). What is more, according to the Global Support Index, 21% had non-functional social and family support. Coping with the disease: 8% were well-adapted to the disease, the remaining 92% were poorly adapted; of which, 79% had a weaker fighting spirit, 51% expressed anxiety and concern about coping with the disease, 34% found they resorted to fatalism, 29% were in denial and 27% felt helpless. ConclusionsOnce liver patients are included on the transplant waiting list, they poorly adapt to the disease, with important emotional implications that result in psychological alterations.

The Black Pearl and the White Pearl

The Black Pearl and the White Pearl Peter Deadman (bio) A practitioner of Chinese medicine, I am also co-founder of Infinity Foods—an organic and natural food business—and the Brighton Natural Health Centre, a charity devoted to health and well-being. I am principal author of A Manual of Acupuncture and of Live Well Live Long: Teachings from the Chinese Nourishment of Life Tradition, plus numerous articles on Chinese medicine and related subjects. I regularly give lectures and workshops on Chinese health promotion and qigong throughout the world. After several decades of writing academic works, I was moved to attempt fiction and attended a creative writing course at my local university. This short piece arose out of an assignment to write a "fairy story." It is informed by my experiences of qigong, psychotherapy and a love of the Daode jing. Fiction generally suffers when it has a message to extol, but I hope this is not too blatant here. The message of course is that we have to embrace both the dark and the light, learn from suffering, and hold to the vision that by always remaining open to learning we can eventually attain some level of wisdom. The Story "Come, children, your grandfather wishes to speak to you." Kun and her brother Tian followed their mother into Old Li's rooms. They loved their grandfather but there was always something a little intimidating about passing through his red lacquered doors. Grandfather Li was sitting cross-legged on the raised platform where he now spent most of his daylight hours. When they were younger the children were allowed to jump onto the carpeted platform and marvel at the woven tigers and curl in grandfather's lap. But now they [End Page 225] felt a new constraint. It was partly that they were older now, and partly because today there was something different about Old Li. He sat very still and seemed a little stern. "Sit down, my children," he said, and then spent an age looking down at them and sipping his tea. Finally he nodded to himself. "Yes, you are old enough. I have decided that it is time you learned the legends." Kun, the eldest by less than the time it took to clean and wrap her, turned towards her twin brother. Her eyes warned him that they were to say nothing and to sit absolutely still. She knew this moment marked a turning point, a step on the path to adulthood. Grandfather began: "You have only known peace, my children, and so have all of us alive today and for many generations back. But it was not always so. There was a time, long long ago, when all harmony was lost. War broke out between the provinces, and even between villages and families. The love between men and women turned to bitterness, and children were lost and bewildered. Farmers destroyed the irrigation ditches and crops of their neighbors, and soon hunger added to the misery of the people. "Some appealed to the gods of heaven for mercy and others turned to the older spirits of the earth. Yet even this became grounds for hatred and fury, as the followers of the different religions came to blows and burned each others' temples. It was as though a fiery darkness had fallen on the whole civilized world and many gave up hope. "Now in those days our own family was blessed with a powerful leader. Because of his courage and great strength he was known as Warrior Li, although he was gentle by nature. You children have kowtowed and burned incense in front of his portrait since you were babies. But until now you have never known why. "Warrior Li watched with great pain as the conflict raged. He was a strong man and able to intervene physically in most disputes, but now he felt helpless and saw that his strength was like dust in the wind. He could neither eat nor sleep and just lay on his bed in the heaviness of despair. Then one afternoon he finally did fall asleep and a vision came to him in a dream. He was standing by the edge...