Visions and Voices
SYNOPSIS
Illustration by Eva Vázquez
The Nocturnists’ Emily Silverman tells a story about how medical school satisfied much of her curiosity about the human body—but how some mysteries remain, especially related to her dreams.
LISTEN
storyteller
Emily Silverman is an internal medicine physician at UCSF and Creator of The Nocturnists. Her writing has been supported by MacDowell and published in The New York Times, The Virginia Quarterly Review, JAMA, CHEST, McSweeneys, and more. She was the Hellman Artist-in-Residency at the UCSF Memory and Aging Center in 2020 and served on the COVID Crisis Group, which recently published the book, "Lessons from the COVID War." She lives with her husband and daughter in San Francisco, and tweets @ESilvermanMD.
Guest Host
Ashley McMullen is an assistant professor of medicine at the University of California, San Francisco, and a primary care internist based at the San Francisco VA Hospital. She is also a Houston, TX native and lifelong book nerd, who grew up nurtured by her mother, a pediatric nurse, and grandmother, an ordained minister. Ashley’s work focuses on the role of narrative and storytelling in medical education, and as a mechanism for healing, advocacy, and improving care across differences. She was the host and producer of The Nocturnists’ Black Voices in Healthcare Series, and is the current co-host of the story-telling podcast with Kimberly Manning called, The Human Doctor.
RESOURCES
Mentioned in the episode:
CREDITS
Hosted by Ashley McMullen
Produced by Emily Silverman, Jon Oliver, and Carly Besser
Edited and mixed by Jon Oliver
Emily’s story was coached by Nina Wise and performed live in San Francisco in October 2022 at “Sleep & Dreams: Music, Neuroscience & Stories of Slumber,” a performance by The Nocturnists, UCSF’s Memory and Aging Center, Global Brain Health Institute, and San Francisco Conservatory of Music
Ashley McMullen’s interview with Emily was recorded in February 2023
The Nocturnists original theme music by Yosef Munro
Additional music by Blue Dot Sessions
Illustration by Eva Vázquez
This episode of The Nocturnists is sponsored by FlipMD from GoodRx.
This season of The Nocturnists is sponsored by The Physicians Foundation.
The Nocturnists is made possible by the California Medical Association, and people like you who have donated through our website and Patreon page.
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TRANSCRIPT
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The Nocturnists: Stories from the World of Medicine
Season 5: Episode 9: "Visions and Voices"
Episode Transcript
Note: The Nocturnists is created primarily as a listening experience. The audio contains emotion, emphasis, and soundscapes that are not easily transcribed. We encourage you to listen to the episode if at all possible. Our transcripts are produced using both speech recognition software and human copy editors, and may not be 100% accurate. Thank you for consulting the audio before quoting in print.
Ashley McMullen
You're listening to The Nocturnists: Stories from the World of Medicine. I'm your guest host Ashley McMullen. I’m thrilled to be here with you all. If you know me, you know I’m a huge fan of The Nocturnists, so what an honor it is for me to serve as your guest host for this episode.
In the fall of 2022, The Nocturnists produced a live show on the theme of Sleep & Dreams in collaboration with the UCSF Memory and Aging Center, the Global Brain Health Institute, and the San Francisco Conservatory of Music. And through a series of interesting events, which you’ll hear about later, Emily shared a story on stage at that event for the very first time since starting The Nocturnists in 2016.
In her story, Emily talks about a few mysterious dream experiences she’s had over the course of her life, and how her usual strategy of seeking answers in medical textbooks left her empty handed.In the conversation that follows, Emily and I get to talk about dream symbolism, Emily’s strange experiences with sleep paralysis, and the places she turns when science fails to explain.
But before we get there, here’s Emily.
Emily Silverman
When I was a little girl, I would sit at the kitchen table and look at my hand. And I would wiggle my fingers and wonder: How could a thought cause my body to move? This curiosity is part of what propelled me to medical school. When I arrived at medical school, I read voraciously. I sat wrapped in all of my lectures. I was ecstatic as I looked at blood under the microscope–the red cells, the white cells, the platelets. I love looking at the lymphoid tissue under the microscope–so purple and beautiful. I love learning about the heart, the lungs, the liver, the spleen–what it all did, and how it was all connected. I think I had this hunger to understand who I am, what I am, and how it all worked. I sometimes joke with my friends that it wasn't until the end of medical school that part of me felt like I could calm down. I could finally relax. But there were still some questions that I had that weren't answered by medical school. And many of them had to do with my dreams.
Now, despite going through medical training, and all of the 28-hour call and sleep deprivation, I'm actually a pretty good sleeper. I fall asleep hard, and I remember my dreams. I still remember one of the first dreams I ever had. I'm about five and I'm in my parents' large carpeted bedroom and there's a plastic slide in the middle of the room. And I'm going up and down the slide with some other children who are going up the ladder, down the slide, up the ladder, down the slide. But it's not a happy thing. It's not fun. And I realize, eventually, that it's because in the corner of the room, there's an adult human skeleton. And it's watching us. And I know that if any of us step out of line or go down the slide wrong, that this skeleton is going to come over to us and make us be in big trouble. The next thing I know, I find myself at the bottom of this skeleton looking right up at, it right into its face, right into its eye sockets. And I said to it, "Are you a real skeleton?" And it looked down at me and it said, "Yes, I'm real." And then I woke up. And I had what we have after a dream for a couple of minutes where I was asking myself in bed as a little girl, "What is real?"
The next dream I remember, I was about nine or 10, and in a way it wasn't quite a dream. It was actually an episode of sleep paralysis, which now you're all experts on. So I was laying in bed, and I woke up, but my body was still paralyzed. I could open my eyes about halfway and look around the room, but everything was blurry and my consciousness was sort of mixed. I was half asleep and half awake. And it's in this in between state that often people will have hallucinations. And in this case, I heard a voice. It was the voice of a man, and it was whispering to me. First, it said my name, "Emily Silverman. Emily Silverman." And then it asked me a question. It said, "Are you pretty? Are you pretty?" Suddenly I can move my body again, and I looked around the room–again, I'm about nine or 10–and I drew the logical conclusion, which was there's got to be someone in my room. So I got up. I went into my parents bedroom, and I shook my dad awake. And I said, "Daddy! Daddy! There's someone in my room." And he came out all groggy in his pajamas, looked around my room, and then looked at me and he said, "Emily, there is nobody in this house." And I remember that I actually didn't feel reassured. Because if there was nobody in this house, then what did I hear?
The next dream I remember is from medical school. So again, I'm in voracious reading mode, just like imbibing everything that I can about the human body and biology and neuroscience. I have another episode of sleep paralysis, but this time, instead of hearing a voice, I saw something. So I woke up in bed. And I see in the silhouette of my window is a man standing there, can't see his face, all in silhouette. And he's wearing a bowler hat. And he's just watching me. And then I wake up, and I say to myself, "Oh, that was another one of those sleep paralysis episodes. You've read about those in textbooks. How interesting." And I kind of blew it off until a couple of years later, when, for no particular reason, I decided to Google this image: “sleep paralysis, man in a hat.” And I found something really interesting, which is, this is a very common hallucination for people around the world who have sleep paralysis–across countries, across cultures, across languages. Which led me to ask: If this is all just a figment of my imagination, why are so many of us seeing the same thing?
The most recent dream was actually just last year. It was a difficult time of life. I was having a bit of job stress. And I was also having some family stuff happen. My mom had just died. I had just connected with my birth mother. I'm adopted. And I was pregnant. So I had a dream. And I woke up again in the dream, except this time, it wasn't sleep paralysis. It was something else. It's something called a lucid dream, which is this bizarre state where you wake up in the dream, and you can actually look around and make decisions and manipulate the dream environment. And so when I woke up, I was in an elevator. And there was four floors, and I was on the third floor and I decided, boop, I'm going to hit the fourth floor, go up one story. Elevator starts going up. Then it keeps going up. And then it keeps going up. And it's going faster and faster and higher and higher. And I'm quite sure that we've gone up way more than one story. And I start to get scared and I start to panic. And I look around I'm trying to find a way out. And I turn to the wall of the elevator and I see a peg in the wall. And hanging from the peg is a giant leather purse. And inscribed on this purse are three messages, and they're numbered 1, 2, 3. The first message says, "Divorce yourself from all problems." The second says, "Kindness = kin." And the third message–the third message I lost.
When I woke up, I laid in bed, thinking about these messages. I still think about them. I'm not really sure what they mean. In a way I feel like the first message was related to my job stress. Maybe it's communicating to me that one way to deal with your problems is not to over-identify with them. The second message feels connected to my new issues around motherhood and navigating that space–this idea that kindness and kin are somehow connected feels important. And I wonder what the third message said. So these are the questions that I have. I fear that I won't be able to find the answer to them in medical textbooks. And so then I wonder, "Where do I find the answers?" Thank you.
Ashley McMullen
All right, are we doing this?
Emily Silverman
Yeah.
Ashley McMullen
All right. I love it.
Emily Silverman
Take it away. Do whatever you want.
Ashley McMullen
All right, cool. Well, first of all, I was just reminiscing about the last time we were on the mic together–I think the most recent times when we were recording in the studio when you were interviewing me. So it is really nice to be on the flip side, and what an honor to be able to interview you on your own podcast.
Emily Silverman
Oh, my goodness. I would have no one else.
Ashley McMullen
That warms my heart. Well, it's good to have an excuse just to sit down and chat and particularly about the story that you told back in October 2022. What inspired you to put together this live show? And what was that process like curating these stories?
Emily Silverman
I was always really passionate about the arts and storytelling and felt like it was hard to find collaborators at UCSF. I mean, there's people like you, of course, but there's just not a centralized hub where people like us can find each other. And I was actually in New Hampshire at a artists retreat totally unrelated to UCSF. And I met this poet, and she said, "Oh, what's your deal?" And I said, "Oh, I'm at UCSF." She was like, "Oh, I was the UCSF Artist in Residence." And I was so embarrassed, because I was like, "What is the UCSF Artist in Residence?" And so sadly, it took me flying all the way to New Hampshire to learn about this program, which is actually housed at the UCSF Memory and Aging Center, which is part of the neurology world of UCSF. And Bruce Miller is the head of that center. And he has this program called the Hellman Visiting Artist in Residence. And so when I got back from New Hampshire, I sent him an email and I said, "We have to meet, because I don't know how I didn't even know about you and that you existed." So I still remember I went down to Mission Bay and had lunch with him in his office. And of course, it was like glass everywhere. He served me lunch, there was like a menu, and it was just so fancy. And we had lunch. And he was just telling me about how much he believes in the arts and sciences working together to generate creative ideas and move all of the work at the MAC forward. And then he was kind enough to invite me to be the Artist in Residence the following year. Of course, that was when the pandemic hit, and so there was a bit of a delay. But part of my work as Artist in Residence was to collaborate with them on some kind of live experience. They already have a partnership with the San Francisco Conservatory of Music. So we decided to do a show together, kind of the three of us, so it was going to be UCSF Science, the SF Conservatory of Music, and then The Nocturnists Storytelling. And Bruce and his team actually chose the theme of sleep and dreams. But when they picked that theme, I was super excited, because as you can tell, it's a topic that's very close to my heart.
Ashley McMullen
You know, I've been to so many Nocturnists live shows, and I mean, all of them are incredible. But I in my memory cannot remember a single one where you were a part of the lineup. So correct me if I'm wrong–I don't know if this was the first time that you actually told your own story. But again, I really want to know what that decision was like for you to share on this stage.
Emily Silverman
Yeah, I was really resistant to it initially, because as you just said, Ashley, normally, I'm the host and the emcee. So I'm backstage and it's other people who are standing in the middle of the stage telling their story. But what happened was, we had our first Zoom meeting with Bruce to brainstorm the show. And we were talking about how we were going to find the storytellers, and putting out a call, and doing all the usual things that we do. And Bruce sent me a DM in the Zoom chat, and he was like, "Why don't you tell a story?" And I kind of blew it off and I was like, "Oh, that's just Bruce. Like, you know, he, whatever. He doesn't know what he's talking about." Hi, Bruce. And I was just kind of ignoring it and thought it was a silly idea. But then I was talking to another friend, Nina Wise. She's a Bay Area artist, storyteller, performer, coach, dancer, multidisciplinary artist, and we met down at the Esalen Institute in Big Sur. She's very, like spiritually aware, and just an amazing person. She's in her 70s. And I was chatting with her. And this came up that the sleep and dreams show was coming. And then she too said, "You know, I think you should tell the story, because it's already a different format than the usual Nocturnists shows, because you have the science and you have the music. So it's kind of the perfect venue to experiment and try this out." And she also said, "It will also give you empathy for your performers, because you will have gone through the experience–all of the coaching and all of the nerves–and then when you ask others to do it, you'll know better what you're asking them." So at that point, I caved and I said, "Okay, I'll do it." And then of course, I was terrified.
Ashley McMullen
Oh man. As one of your former performers at a live event, that actually makes me feel very validated. Because I was quite nervous, too. But what an incredible series of events to get you to be on the stage, a little bit of arm twisting, some side messages in those DMs–I have to say a lot of good stuff happens on those side DM conversations on Zoom. So thank you, Bruce. Let's turn to your story. Hearing this a couple of times, my initial thoughts were, number one: I'm so jealous that you're able to sleep so well, all the time, as someone who has struggled with insomnia since residency. And also just this very deep fascination with the fact that you're able to remember your dreams so vividly and over a long period of time. I'm curious, do you still remember your dreams like this even into adulthood and now as a newish mom?
Emily Silverman
I do not always, but a lot of the time.
Ashley McMullen
Yeah.
Emily Silverman
A lot of the times in the morning, I'll turn over to my husband, and tell him about my dreams. Which is probably kind of annoying, because in a way, nobody really likes to hear someone else's dream. But I'll be like, “It was like White Lotus, and I was at a hotel, and there was this giant snake. And then it zoomed out over the entire world. And then I realized there were multiple snakes. And that was like..." This is literally a dream that I had just like three or four nights ago that I was explaining to my husband, and he's kind of like making his coffee. And he's like, "Uh huh, yeah, uhuh."
Ashley McMullen
Yeah.
Emily Silverman
So yeah, I do have pretty good recall. I'm not sure why.
Ashley McMullen
I love that I was actually in the course of listening to your story envisioning Boaz being the recipient of so many–
Emily Silverman
He is.
Ashley McMullen
–of these fresh experiences. Circling back to the dreams that you shared on the show, I can't wrap my head around the fact that the first dream you shared was from when you were five years old. I can barely remember a lot from that time, let alone my dreams. And so, it sounded like you were in this room going up and down slides with some friends, but with this giant skeleton watching over you. And I'm curious if you could talk a little bit more about that. And why do you think it's stuck with you all these years?
Emily Silverman
I think part of the reason why I remember it is because it stuck with me back then. And so it was a dream that I recalled and I think told friends about when I was five, when I was eight, when I was 10. You know, I kind of kept recalling it again and again over the course of my life and probably it's morphed and changed and isn't as with memory and in perfect recollection. But I don't know why it's stuck with me. My story coach was Nina Wise, the woman I told you about. She coached me through the story. And I remember she really wanted me to build out that scene and to describe the skeleton. And initially was pushing me in the direction of really conveying the terror and horror of the skeleton almost like a horror movie. And it wasn't feeling right. And so I was talking with her and I realized that it didn't feel like a villain in a horror movie, like Night of the Living Dead or anything like that, but it actually felt more like a parental figure.
Ashley McMullen
Wow.
Emily Silverman
And the carpeted room where this dream took place–it was my parents bedroom. And it was more a feeling of like not wanting to get in trouble or punishment, than "I'm going to get you," that kind of thing. So there must be something in there about being a kid and having parents and rules and punishment and not wanting to get in trouble. I think there's something just emotional wrapped up in there that stuck with me.
Ashley McMullen
Wow. Like we can spend the rest of this interview like teasing that apart. I mean, that's really fascinating to think about–the juxtaposition of the fact that this should theoretically be like a fun game type scenario with a slide and friends. But there's kind of this imposing desire to want to play by the rules and not get into trouble, so to speak. The next two dreams you talk about in your story, both involving this experience of sleep paralysis. And it sounds like this was a recurring theme, perhaps throughout the show. And I'm wondering, can you talk a little bit about what sleep paralysis is and how you've experienced it?
Emily Silverman
Yeah, so sleep paralysis is this phenomenon where you're asleep, and then you wake up, but your body is still paralyzed. And so what happens with me is I'll wake up, and I can only open my eyelids halfway. So I can kind of see the room, but it's blurry. And my body can't move. But interestingly, it doesn't really feel like being paralyzed. Because your consciousness is still in the dream body. So if you think to yourself, like move your arm, it kind of feels like you're moving your arm. But it's your dream arm, not your real arm. Does that make sense?
Ashley McMullen
Yeah.
Emily Silverman
And so you're kind of in this in between space where you're half awake and half asleep. And I think because you're in that in between space, your consciousness opens itself up to hallucinations. And so for me, that has been auditory and visual. And when it first happened, it was very bewildering. I didn't know what it was or what was happening. And then of course, as I learned what sleep paralysis was, and what hallucinations were, it started to disturb me less and less, because I could kind of diagnose myself.
Ashley McMullen
Yeah. Is this something that you've experienced often? I've only heard more about sleep paralysis in the context of certain sleep medications, or people who've been sleep deprived for a while. How have you experienced it?
Emily Silverman
I've experienced it intermittently throughout life, starting from the time I was a child. But it's not something that strikes me every night. It'll happen, maybe, I don't know, every few months, something like that.
Ashley McMullen
It's happened for me, I think I can recall maybe one time. It was actually pretty frightening, something that I actually never wanted to experience again. And it didn't help having certain medical shows on cable networks talking about people who are awake during anesthesia. So in my mind, it kind of coalesces into this very kind of frightening, disturbing experience. But it seems like for you, you're able to at least distance yourself from the experience and not be so overwhelmed or frightened by it.
Emily Silverman
Yeah. Over time, I was able to recognize what was happening as it was happening, which made it less frightening. And I think in some cases actually opened the door to curiosity. Like I remember one time, I woke up, and I was having sleep paralysis. And I said to myself, "Just get out of bed." And I got out of bed, and then my consciousness sort of like slid back into my body. And then it was like, "Oh, wait, you're not actually out of bed. You're still in this body." And I was like, "Try again, try again," almost like an experimental way. And so then I think at one point, I got out of bed and was able to, like walk almost halfway down the hall to the bathroom before my consciousness like sucked back into my body, and then I found myself back in bed. And when I see like sci fi films, talking about astral projection, I'm like, "Oh, is that what I was doing? Like, is that real?" But who knows. And that's kind of part of my story. Its like, I feel embarrassed even posing that as a question to a community of scientific minded peers and colleagues. But when you've had that lived experience, you can't help but ask, "Was there any part of myself that was indeed and walking down the hall? Or was that all just imagined?" I don't know.
Ashley McMullen
I love these opportunities to kind of pull ourselves outside of some of the rigidity around scientific thinking and really appreciate just like the awe and mystery and wonder of what it means to live in this conscious body. Before we touch more on that, I actually want to dig a little bit into the dream that you had in medical school. As you're describing this man and the bowler hat and his silhouette just staring at you–that to me actually felt like a bit of a horror movie. I find it equally enthralling that you decided to actually Google this image, years after the fact. How did you decide to do that? And what were you thinking about this image, this man, when he first appeared in that dream in medical school?
Emily Silverman
I don't know what inspired it. It would be much more linear and logical to say that I had this experience, and then the next day I woke up and I Googled it. But that's just not true. What is true is that I didn't Google it until years later. Maybe I was remembering it and felt like googling it. I don't know what moved me to Google it. But when I did, I was pretty floored. If you Google it, all these articles pop up. And they have really scary illustrations. And it talks about how people around the world who have sleep paralysis will often see this figure: a man in a top hat or a bowler hat, whatever kind of hat you want to call it. And the illustrations actually looked quite a bit like what I saw.
Ashley McMullen
Wow.
Emily Silverman
And I talked about it with Boaz, who is very, very much in the camp of like, "No, this can all be explained by brain science." Like he's very kind of anti-supernatural, whatever. And he had an interesting hypothesis, which is that people hallucinate people, because that makes sense. Like, we're people and so it makes sense that we hallucinate someone else in the room with us. But that the reason that hat is there, is to make it clear that it's a human. Because without the hat, it would just be kind of a tall, blobby figure. And so the hat is what gives it that quality of like, "Oh, this is a person." So he thinks the hat is the brain's way of communicating, "That's a person in the shadows." But I don't know. I don't know if that's right.
Ashley McMullen
Yeah. I mean, I definitely can resonate with that theory. At the same time, I'm pro-supernatural–like weird stuff happening that we can't explain. Immediately, I had to Google what a bowler hat actually looks like. Because I don't see a lot of people that I know walking around with one. Were there any theories that you came across that did feel like perhaps or it's just still too unknown?
Emily Silverman
In the articles that popped up when I Googled this, they talked about how this must be some real being, like a real entity, a man in a hat, who goes around haunting people in their sleep. But that didn't really resonate with me, either. Like, I just don't see how that could be. I mean, who knows?
Ashley McMullen
Yeah.
Emily Silverman
I think for me, I fall in the middle where it's this idea of a collective consciousness. And maybe there's just something, I don't know, something about the collective consciousness that wants to see this image. Maybe it represents something about us as people. But I'm not sure if it's true that this is like a real thing that's out there. Who knows?
Ashley McMullen
Well, I liked the fact that it seemed to be true across a number of differences–like culturally, geographically–of the things that we can focus on that unite us. It is kind of cool to me to think that there's this particular entity or vision that has touched people across so many different divides. So, I like the collective consciousness theory. This last dream that you touched on, you describe it as a lucid dream. So the kind of dream where you're asleep and you can kind of interact and kind of change the outcome. And you describe it at that time, you're going through a number of things that were impacting you personally–your job, and the loss of your mom, and also anticipating being a new mom. And you described being on an elevator that you had decided, "I'm just going up one floor." Next thing you know, it's going past one floor, two floors, it's going higher, it's going faster. And when I'm listening to this, I was like, "Man, I can think of times in my life where I'm just trying to, like, get to one place, but it's taken me somewhere else, too far too fast." And I'm curious, like, what did the elevator represent for you? Or is that something that you've thought about?
Emily Silverman
For a long time, I subscribed to this worldview of materialism where like things exist, and that's kind of it. And to the extent that we're conscious, it's just an epiphenomenon of like neurons. And I really was inculcated into this Western medical reductionist worldview and model. But in the last three to five years that's started to crack. And I can't exactly explain why, but I've just been opening myself a lot more to uncertainty and to mystery. And like I said in the story, I've always had this hunger to understand reality and I've always turned to science to get answers, not just the medical sciences, but even the physical sciences. I love reading about relativity and quantum mechanics and those sorts of things. But I feel like I kind of got as far along as I could, in the sciences without having the math that I would need to have to understand it at a deeper level, and just hit a dead end and realized that the science had taken me to the edge of what it could in terms of my understanding of reality, and what it is and how its structured. And that if I wanted to continue searching, that I was going to have to look to different models and different worldviews. And some of those have been more spiritual reading texts, like the Tao Te Ching, which is this old Chinese text. And I don't know. And so I think maybe the elevator has to do with being catapulted into this whole new realm, different thinkers, different, just such a different way of apprehending truth. And I think I still have a lot of work to do in that department. As you can probably tell, like, I'm very cognitive. I'm very, very up here. And as much as I love reading about spirituality, and even individuals who have had spiritual experiences of like openness, and spaciousness, and all, you know, all of that, I still don't really have those experiences myself as much. And I think it's because I am kind of intellectualizing it still. But maybe in the dream it was one way to get some direct experience of the unknown.
Ashley McMullen
I love that. I'm trying to contain my desire to dive more into that because it resonates so deeply. And I think that sometimes being so steeped in sciences and medicine, at least I can say for myself, I can feel this idea that science in the way that we interpret it has exclusive rights to what's true. And being able to break ourselves apart from that, and welcome more uncertainty, more exploration of these phenomena that don't fit neatly into the empirical type thinking that we'd like to employ. Talking a little bit more about these messages that you discovered in the elevator in your dream was, "Divorce yourself from all problems." And the second one was, "Kindness is kin." And I was just like, "Wow. Like, random, but also not random." Like, you know, you could easily make the connection to some of the things that you were dealing with at the time–job related stress and pregnancy. I just wanted to talk a little bit more about how you were thinking about those messages at the time, and perhaps how they resonate today, if you thought about them again?
Emily Silverman
It's still really mysterious. I don't know where those words came from. The first one, "Divorce yourself from all problems," I mean, I was pretty burned out working as a hospitalist at that time. And so I think the concrete reading of that would be kind of like, "Quit your job," which is what I ended up doing. I mean, I'm still attending two weeks a year and hold a volunteer faculty appointment. And so I'm still maintaining my affiliation with the university. But I'm not a full time employee of medicine anymore. And so maybe one argument is like, that's what that message was trying to tell me. But it also feels deeper than that. Like, "Divorce yourself from all problems." And there's a part of me that actually rejects that statement, because there are so many problems in the world having to do with health care, and injustice, and climate, and you know, things happening in the news and politics. Like, I don't want to be someone who sits by and doesn't jump in and vote and you know, organize and attack the problem. And so in some ways, this advice of, "Divorce yourself from the problem," like what could that mean? And as I'm talking, I'm noticing the use of the word divorce, which I usually think of in terms of marriage. Why divorce and not separate? Or contain? Or, I don't know, what do you think? Can I get your opinion?
Ashley McMullen
Yeah, actually, I was thinking about that word, too. And you even mentioned in your story, talking about not overly identifying with our problems. And I think I've struggled with this too. As a primary care physician, believe me, I've had my fair share of thoughts about quitting my job on any given week. But it's interesting, just looking at the new cycle as well, this initial desire for me to run away to the woods and just keep everything in the background. But this idea of like, not ignoring your problems, or turning away from the problems, but like, not letting it be a part of you, so to speak. Because when you think about it, with a marriage, the idea is that two people become one. Like you're units, you're you're together, there's an overlap of your personhood. And so divorcing yourself from your problems doesn't mean that they disappear, but that you're not attaching yourself to them in a way that might change you.
Emily Silverman
I should pay you for this.
Ashley McMullen
I'm here all day.
Emily Silverman
Like, you're like Joseph in the magic technicolor dreamcoat analyzing my dreams. Well, what do you think about the next one, "Kindness = kin?" There was an equal sign. So it said, "Kindness equals kin." And I think that's really interesting, too, because it's not even a sentence. It's more like a mathematical statement. I don't know where this came from. And I think that's really the crux of the story. It still actually bothers me to this day. Did this come from my subconscious or my unconscious? Because if it did, like, I, that's crazy to me, because it just seems like the sort of thing I never could have come up with in my conscious mind.
Ashley McMullen
Is this something that you repeat to yourself on a daily basis?
Emily Silverman
Or did it come from outside of myself somewhere? And that's a really big question. That is a question that, as I say, in the story, a medical textbook can't even begin to answer.
Ashley McMullen
I guess you know, as we're getting close to probably time here, I wanted to just settle in on this, this message that you didn't quite grasp the third message that wasn't there. Do you think it's out there? Do you think that it's something that you're still searching for? Or have you kind of let the uncertainty settle around that?
Emily Silverman
You know, I still have the sense memory in my body of reading that third message. So there was something there, and I read it, and it hit. But then when the hand of consciousness or whatever, like, pulled me out of the water back to awakeness. It's like, it slipped out my fingers, and it just like sunk to the ocean floor and I'm never gonna find it. And I mentioned that to a friend of mine and she was like, "If it was that important, it'll come back in some way, shape, or form." And so that's what I try to tell myself. But it is very frustrating. If you can imagine like, having something precious in your hand, and then you drop it or you lose it. I wish I could have held on to it. But alas, it's gone. I don't know. Maybe that's the lesson. Maybe there's a lesson in there too, something about there never ever really being closure. And that part of living is that open door.
Ashley McMullen
Wow. I love that. I do hold out hope that that message will make its way back to you at the exact time that you need it. But also recognizing that lesson of being at peace with being able to let some things go unsaid, unread, but living through it anyway, despite the uncertainty. Is there anything else that you think we should touch on or that you want to share that I didn't invite during the conversation?
Emily Silverman
No, I'm just smiling, looking at your face on this screen and just realizing how much I miss you and how much I would love to spend some time together soon. And also how grateful I am that you agreed to step in and do this. I am just really honored that you are interviewing me today on The Nocturnists.
Ashley McMullen
Well, if we can spend a few more seconds gushing over each other, I want to just express how deeply neutral the feeling is, how excited I was to see the invitation and deeply humbled and honored that I would be the person that you consider for this. And also how much I love our friendship and the facts of how we met, how our relationship has grown, that we find ourselves here at a flipped interview on The Nocturnists and again how much love I have for you in this platform and looking forward to working together more.
Emily Silverman
Thank you and everyone listening should also check out Ashley's podcast, The Human Doctor with Kimberly Manning. It's truly an amazing podcast with storytelling and just great personalities and so check that out. See here I am, jacking the, hijacking the host.
Ashley McMullen
I'm not mad at it. Well, thanks so much, Emily, for this conversation. It's been really enlightening and given me some food for thought, so it's been a pleasure. Cheers.