Kirkepiscatoid

I got to thinking of a comment I left on another blog today in relation to something that was rooted in pain and loss, and it got me to thinking about the process of healing when it comes to our woundedness, and decided to elaborate a little more.

Honestly, I don't know much about the process of how we heal after we suffer loss. But I do know a fair bit about the pathophysiology of physical wound healing. My world calls the two ways we heal from wounds either "healing by first intention" and "healing by second intention."

Healing by first intention mostly refers to wounds that are incised wounds that have been sutured. The perfect example would be when you go to your doctor to have a skin lesion excised. After the excision, the edges are sutured together. The wound heals faster because the edges have been approximated by sutures. When enough collagen comes in to hold the two edges of the area together, the stitches are removed, and a scar forms. Scars in this manner tend to be neater, lighter, and not contracted, compared to the scars of an open wound.

Healing by second intention is a much slower process. This refers to an open, gaping wound that is not sutured. It takes a lot longer for the wound to "granulate in", and the scar is more irregular, sometimes "puckered", messier. It scabs over, and the larger the wound, the more likely the scab will be damaged. The tensile strength of this wound is not as good as one healed by first intention. It is at more risk of dehiscence (coming apart) than a sutured wound is. But it still becomes at least a "serviceable" repair.

I am realizing that most of the things that lead to our own woundedness are injuries in which we are stuck letting it heal by "second intention." These are the things that happen to us without warning and leave big, gaping holes. They tend to be soft and messy for some time. The scabs are more fragile; in fact, we may well pick at the scab ourselves. They are more likely to become infected. When they scar, they pucker and leave more visible marks. When they do heal, they are more likely to break apart or become infected. But eventually, over time, they do fill in and become at least "serviceable." The scars may be ugly, or at the very least we think they are ugly and at that point, they might as well be, simply because if we see ourselves that way, "they are what we see."

How, then, do we even begin to strive for a life that "heals by first intention" instead, whenever possible?

I am going through a process in my life right now that will probably result in me "having to excise some lesions." I am not looking forward to it, just in the same way no one looks forward to surgery except "to get it over and be done with it." I realize it's either that, or let the chips fall where they may, and risk having an open, gaping wound that is not amenable to being sutured. But I know this is my best chance for having a solid, trustworthy scar...one that will lighten and fade and not need revision.

I like to think that the disciplines of my faith are the "ability to throw sutures" in this process. I think by engaging in regular and disciplined prayer and study, we up our chances of being able to stitch our wounds at a time it matters in the healing process--early on. Sometimes, the only thing that hold our wounds together and keeps them from bursting apart ARE the sutures.

But the day always comes we need to remove the sutures. Even with the sutures gone, though, their effect lasts.

But that still does not guarantee "the perfect scar." Sometimes we remove the sutures a little early, and there are gaps. Sometimes you get part of a suture buried in there and it has to fester out. Sometimes a perfectly healed wound, in certain conditions (like too much pressure) rips back open anway. This is not a perfect process.

Also, this doesn't address those open granulating wounds that heal by second intention. It is too late to suture those wounds. Sometimes those scars need to be revised, because they are unsightly, or because they do not have sufficient tensile strength. Sometimes we never let wounds heal properly because we keep picking at the scabs of them. Where are the disciplines of our faith in this?

I like to believe in this case, it has more to do with creating a favorable environment for time to heal these wounds, as does the covenant of community with which we share a common life. I will be totally honest here. I have never been a huge fan of "intercessory prayer" per se. Yet I mostly accept it because of its covenantal nature...that somehow this environment of prayer is a favorable environment that can maximize the healing powers of time and our healing potential within us.

That doesn't mean that prayer can stop a gaping wound from becoming infected. It doesn't magically protect the tissue from becoming necrotic and dead. But I think what it does do is create the best environment possible for whatever will happen, to happen.

I can't begin to understand the first thing about what "healing" is in a totally spiritual sense. But I do believe that the natural world is my window to all things beyond the natural world...and the natural world tells me that I carry scars that I scarcely notice anymore. Somewhere along the line they were healed, but I could not tell you an exact moment in time when that happened. I carry other scars that I know will always be more noticeable. But there are days I don't notice them.

I have been blessed in that my "obvious" scars are not disfiguring. Would I feel this way if I had awful, disfiguring scars? I don't know; I can't even begin to say. But I do know I trust the natural process that I see, and I know I have some disfiguring scars in my soul, even if I don't have any on my skin. I know that some of those scars have softened over time, even if they have not totally healed, and I have the ability to hope for more healing, coupled with the natural process of wound healing that I understand.