This essay will appear in the October/November issue of Ozarks Living Magazine, under my column Grow Your Health
In Somerset County, New Jersey, a 600-year-old tree sits in a church cemetery, dying. It is the oldest white oak in the country. Older than the church itself, which was built in 1717, the tree has gained status for events in history that have taken place in its presence. In 1740 English evangelists James Davenport and George Whitefield preached to more than 3,000 people under the tree; allied French troops under General Jean Baptist de Rochambeau marched past the great oak on their way to the Battle of Yorktown, VA.; and, President George Washington is said to have picnicked by the tree. It stands approximately 100 feet, has a circumference of 18 feet, and a branch spread of 150 feet. Trees have profound and wide-reaching importance as living creatures themselves, and in support of the lives of everything on this planet. Furthermore, the symbol of the tree has numerous cultural meanings throughout human history.
The thought of this tree and its wise old age has me thinking about the stories that tree rings can tell us. I like the word “dendrochronology” which is the study of data from tree rings. We can learn a lot from studying this timeline of the tree. Dendrochronology can help us plot events in history, date materials and artifacts made from wood, assist in radiocarbon dating, inform us about environmental conditions of the past, present, and climate change of the future. Like the timeline of the tree, represented by its rings, our own life timeline reveals so much of who we are.
In my practice as a doctor I have fine-tuned my ability to take a patient history. I recall one of my first mentors, the late Dr. John Stone. “Listen to the patient,” he would say. “They will tell you their story.” He wrote in one of his poems, Gaudeamus Igitur: For you can be trained to listen only for the oboe/out of the whole orchestra/For you may need to strain to hear the voice of the patient /in the thin reed of his crying/For you will learn to see most acutely out of/the corner of your eye/to hear best with your inner ear/For there are late signs and early signs/For the patient’s story will come to you like hunger, like thirst. My colleague, Dr. Terry Wahls, calls her version of the timeline the Vitality Timeline, a choice of words I prefer over the vernacular “Functional Medicine Timeline” that I learned in my training. The Vitality Timeline stands squarely in the history of the oral tradition of storytelling. We begin with the chief concern, then go back to the beginning and work through the story. I ask about the family history, including the type of place where the person was born. I want to know the prenatal history, birth details, whether my patient was breast or bottle-fed, early childhood experiences, family dynamics, illness history, antibiotic or toxin exposure. I want to know how they sleep, eat, move, manage their stress, and love. Together we will try to pinpoint the triggering event. The triggering event is the pivotal moment when the person last felt well, and what was going on in their life when things changed. We will also look at factors that tend to perpetuate or “mediate” the ongoing pattern of illness. It can be a striking revelation when the Vitality Timeline is plotted out on paper, an “ah-ha” moment, when suddenly the relationship of events in our lives makes sense as one cohesive whole.
I am reminded of the patient I saw in my office with over 30 years of chronic daily headaches. I asked him why he thought he might be suffering from such intractable headaches and he said he did not know. The headaches started at age 16. During further examination of his timeline the patient told me he was forced to leave his home at 17 years old. “Why?” I asked. “Because my father told me to leave. He never liked me. It was a chaotic household. We were never close.” The father had been a military man and the patient believed he had suffered wounds of war that prevented him from having close relationships with those around him. It is likely the wounds run deep for this patient, too. These adverse childhood events send signals to our DNA that switch on parts of the genetic code to create a state of hypervigilance. Our cells, responding to a perceived threat, send out inflammatory messengers to protect the self against attack. Headache evolves. Stress hormones, cortisol and adrenaline, surge throughout the body. The pupils dilate and the eyes become sensitive to light. Hearing becomes acute, so the ears are sensitive to sound. Muscles activate. Tension is felt in the neck and shoulders. The digestive system slows down. Nausea ensues. We may think we have moved past old wounds and spoken words of forgiveness, but the unconscious mind does not always follow along. Or there will be an answer and you will know too much forever, says Stone, in the same poem, recited to the 1982 graduating class of Emory University School of Medicine. At its best the timeline does much more than plot the events in the history of our lives. The Vitality Timeline reveals the climate of our lives over the years, and how this shapes our unique experience of the world, our past, present, and future.
The local community of Basking Ridge has employed heroic efforts to save the tree. Over the years steel rods and cables were attached to support the weight of its branches, and concrete poured to fill a large cavity inside the trunk. The soil has been tested, and the tree examined for disease and bugs, the news article reassures us. The tree is watered, trimmed, and pruned. But the imminent future of the tree remains unknown. We will wait. For now, what I do know, is my patients will continue to tell me their stories. I will listen, as I should. Stone continues, For their breath is our breathing and our reason. But today I will just think about the tree and all that it can tell us about its life and what it has witnessed.
Ken Sharlin, M.D.
 John Stone. “Gaudeamus Igitur,” from Renaming the Streets. Louisiana State University Press, 1985.