Looking at my late fall garden, I’ve been thinking about yew trees. My vegetable garden is winding down…the last ripe tomatoes hang from yellowing leaves, and the kale bolted weeks ago. If you’ve read my other blogs, you’ll know I often look to growing things and dirt in order to make sense of my life as a doctor.
The fall garden is ripe for metaphor. Do I look for continued signs of growth (as evidence that I am a successful gardener)? Am I relieved to be done with watering (and happy to turn my attention elsewhere)? What if I were a hungry worm sifting through the compost? Or a hummingbird in search of nectar from flowers long gone?
Over a year and a half into Covid-19, I’ve been noticing how polarized opinions are regarding vaccination, treatment, and prevention. Patients and physicians alike are frustrated by the waxing and waning debates over third boosters, continued speculation about off-label treatments, and outright fallacies being projected as truth. Some responses to this uncertainty are to:
A. mistrust and dismiss science, seeking only alternative treatments.
B. request only conventional treatments, dismissive of anything viewed as alternative or fringe-y.
C. ask only for “natural remedies,” neither embracing nor dismissing options so long as they can be sourced with a minimum of processing or chemicals.
Is it necessary to choose just one of these views? Are they the only options? What do we miss out on when we pick a choice?
Let’s go back to the yew tree. Pacific yews in particular, but to begin let’s include their European cousins.
How do Yews Grow?
Yew trees are among the oldest beings alive on earth. It’s difficult to date them, due to their growing habit. As a yew ages, the inner part of the tree decays, and so the rings used to date a tree are destroyed. In Fortingall, Scotland, there lives a yew estimated at over 2,000 years of age. (Other estimates range between 3,000 and 9,000 years for this particular tree. It’s hard to date a tree that continues to die and re-grow.)
The empty center of very old yews provides space for young shoots to grow in a sort of protected nursery. And, when its branches touch the ground they re-root, beginning their own life as offspring of the central mother-tree.
Each part of the tree secretes poisonous chemicals that ward off predators, which may be part of why the yew lives so long. The Fortingall tree’s longevity and ability to withstand changes in climate have led to people breaking off pieces of it, hoping it will impart longevity.
The Mystical Yew
Most European yews stand next to churches, typically in their graveyards, on grounds that were previously pagan worship sites.
Celtic druids saw the yew as sacred and planted it close to their temples to use in death rituals, and in ancient Greece parts of the yew were used in ceremonies to purify the dead before they entered into hades.
Graveyard yews are said to entwine their roots into the bones of the deceased, absorbing the evil spirits and allowing the dead safe passage into the afterworld.Alfred, Lord Tennyson, said “Thy fibres net the dreamless head / Thy roots are wrapt about the bones.”
The Greek physician Galen said that the noxious air surrounding a yew could take one’s life, and yet other traditions hold the contrasting view that yews provided protection from death. One of the five magical trees in Ireland, yews hold the secret to resurrection and immortality. (See here for more on the lore of yews.)
Yew Trees & Chemotherapy
Our cultural obsession with “natural remedies” as being distinct and “better than” developed drugs has long puzzled scientists and doctors, since many mainstream pharmaceuticals are derived from natural sources, just as some toxic chemicals are also entirely natural – like cyanide and hemlock. Not all natural things are good, and pharmaceuticals aren’t necessarily “unnatural.”
The widely-used chemotherapeutic drug Taxol was derived in the 1960’s from the Pacific yew tree. Those poisonous substances secreted by all parts of the tree, when studied and isolated, yielded a potent medication that has activity against breast, ovarian, and lung cancers and Kaposi’s sarcoma. (Read more here about other plant-derived drugs) Taxol’s mode of action is to halt mitotic activity, leading to cell death. Sound familiar?
Another Use for a Yew
When deciding in what sort of box to place my deceased parents’ ashes, it seemed obvious to choose one made of yew tree. Its smooth, yellowed wood with tight grain and dark knots would have met my father-the-woodworker and mother-the-gardener’s nods of approval. And the thought of it absorbing whatever residual evil humors permeate their ashes reassures me, as does the knowledge that the yew’s longevity means the box will not decay (at least in my lifetime).
I am tempted towards similarly reductive ways of thinking about their lives and death, explaining their end as tragic, or romantic, or inevitable. Not dissimilar to looking at my fall garden; categorizing each plant, insect, and animal visitor as “alive” or “dead.” But the cat inhabiting Schroedinger’s box is infinitely more complex before the box is opened. And my garden, as well as the yew box, is inherently capable of teaching me something about life and death that is far greater than anything I might conclude based on my own preferences for that which is alive over that which is dead.
Does it Matter Which View to Take?
Whether one sees the yew as a biological wonder of longevity, a mystical guide or protector from death, or a source of potent chemicals to battle cancer, are these points of view mutually exclusive? In her book Storycatcher, Christina Baldwin writes of stories that heal, stories that help us make sense of our lives. That the yew tree makes a chemical that “wards off” the evil that is cancer is perhaps just another way of saying that the tree absorbs the evil humors of the dead.
Indigenous cultures look to their shamans for healing. These individuals are seen as a bridge between this world and the next, and shamans are sought for their ability to escort souls to the afterlife, much like the yew tree.
Lewis Mehl-Madrona is a present-day physician trained in family medicine and psychiatry who writes and does research into the juxtaposition of indigenous practices and Western medicine. Most encounters with a shaman involve storytelling and a journey.
There is something about a story that invites a quality of listening which isn’t aimed at answering a question. If we don’t need to label the cat as alive or dead, we might find ourselves relaxing into hearing something about “cat-ness” that transcends what we previously believed, giving us a way forward that we didn’t see when we thought our only option was to open the box.
From the start of medical school, physicians are trained to be storytellers. Though couched in terms of “morning report”, or Grand Rounds, the way in which we learn to relay a patient case obeys the rules of story. There is the introduction of the protagonist (identify the patient), there is a framing of the problem (the chief complaint), there is the presentation of context (other medical problems, family and social history), and there is the journey (to cure, or complication, or death). What I think we’ve lost is the magic of a good story. Rather than see ourselves only as reporters of events, Mehl-Madrona points out that we are the present-day shaman healers, story-ing our patients back towards health, or on to the afterlife.
The yew tree, and my garden, invite me to listen generously to a story of how beginnings and endings are blurry. When I stand in the place of the worm, I perceive how limited my vision was. And when I loosen my grip on my opinion, I open up space for options unseen.
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