Understand what we thirst for

Whether for water or meaning, it’s a primal force.

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A child wearing a wool hat holds a glass and drink water from it.

Johnny McClung on Unsplash

Quenching thirst is a global problem. It can also be profoundly personal, impaired by illness. For nurses, it can be ethically and emotionally difficult, when treating dying patients. But is there ultimate relief?

Thirst is the subjective sensation of a desire to drink something that cannot be ignored. The world is thirsty; globally, 703 million people lack access to clean water. That’s 1 in 10 people on the planet.

Thirst is a life-saving warning system that tells your body to seek satisfaction through swallowing fluid. It works in partnership with other body processes - such as changes in blood pressure, heart rate and kidney function - to restore fluid, and salt, levels back to where they belong. Failure of any part of this beautifully balanced system leads to dehydration (or water intoxication), and perhaps to seizures, swelling of the brain, kidney failure, shock, coma and even death.

Sometimes it’s difficult to quench thirst, because of problems with supply. According to the World Health Organization, at least 1.7 billion people used a drinking water source contaminated with faeces in 2022. Sometimes in war, water is weaponised, with systematic destruction of water sources and pipes. Water laced with rat fur, arsenic and copper has meanwhile been reported in prisons across the USA.

At other times, there may be “water everywhere, but not a drop to drink” because of individual problems with swallowing. As a nurse, some of my most heartbreaking moments have been when I have been unable to fulfil a need as basic as a patient’s thirst; when even thickened fluids have led to intense coughing and distress, and a realisation that I can only moisten mouths and give so-called “taste for pleasure”: very small amounts of a favourite liquid or taste using a soft toothbrush, or a circular brush gently sweeping around the mouth and lips to release some of the liquid - even, and especially, at the end of life when the patient is unconscious.

Difficulties in drinking are common in dementia when fluid can seem foreign and swallowing a surprise to the system. It’s thought that over 50 per cent of people in care homes have an impaired ability to eat or drink safely; 30 to 60 per cent of people who have had a stroke and 50 per cent of those living with Parkinson’s may struggle to swallow.

Other conditions that may affect swallowing include multiple sclerosis, cerebral palsy, and head and neck cancers. Diabetes is characterised by a raging thirst owing to problems with insulin (diabetes mellitus) or an imbalance in antidiuretic hormone levels (diabetes insipidus). In intensive care, patients are predisposed to thirst through mechanical ventilation, receiving nothing by mouth, and as a side effect of some medications. But thirst is a “neglected area” in healthcare, writes palliative care researcher Dr Maria Friedrichsen.

“Knowledge of thirst and thirst relief are not expressed, seldom discussed, there are no policy documents nor is thirst documented in the patient’s record. There is a need for nurses to take the lead in changing nursing practice regarding thirst.”

Is there another thirst that is also being missed in nursing, and in life in general – a spiritual thirst, beyond the physical desire to drink? In his book, Living in Wonder, writer Rod Dreher argues that humans are made to be spiritual, and that a critical sixth sense has been lost in a “society so hooked on science and reason”. We humans crave love in our deepest selves; we have an insatiable thirst for everything which lies within – and beyond – ourselves. Auschwitz survivor Viktor Frankl, who was later appointed professor of psychiatry at the University of Vienna, became convinced that human beings have a basic “will for meaning.” “The striving to find a meaning in one’s life,” he wrote, “is the primary motivational force in man.”

In the harsh sun of a Middle East day, an ancient story of a man and a woman encountering each other at a water well illustrates this dual thirst for water and meaning. The man, Jesus, thankful for a drink of water given to him at the well by an outcast Samaritan woman, said that “Everyone who drinks this water will be thirsty again, but whoever drinks the water I give them will never thirst. Indeed, the water I give them will become in them a spring of water welling up to eternal life.” In that midday sun, such imagery made a powerful statement.

Being mindful of spiritual thirst when drinking water is something also captured in a Ghanaian proverb and pictured perfectly in the many birds that drink by gravity, so tipping their heads back when they swallow.

“Even the chicken, when it drinks,

Lifts its head to heaven to thank God for the water”.

Unsatisfied thirst is part of the human condition, we long for something more; it’s living proof of our immortality, says French poet Charles Baudelaire. Despite his Olympic success, athlete Adam Peaty said that society didn’t have the answers he was seeking, and that a gold medal was the coldest thing to wear. He “discovered something that was missing” when attending church for the first time, and now has a cross with the words “Into the Light” tattooed across his abdomen, symbolizing his spiritual awakening. We are more than mechanical machines with physical needs. We are rather gardens to tend in a dry and thirsty land, with souls in need of intensive care.

Explainer

Care

Creed

30 June 2023

6 min read

Bed rotting and an old art of rest

In a culture where “exhaustion is seen as a status symbol,” bed-rotting is an emerging trend. Lianne Howard-Dace reflects on self-care and how to rest and refresh.

Lianne Howard-Dace

Lianne Howard-Dace is a writer and trainer, with a background in church and community fundraising.

a sleeper pulls a blanket up over their head.

There’s a trend doing the rounds on TikTok which is attracting a fair amount of comment; the practice of taking (at least) a day in bed to recuperate when you’re running low on energy. Gen Z are - with characteristic directness - calling it ‘bed rotting’.

At first, this sounds like nothing new. People have been taking to their bed for centuries. Gen X might’ve called it vegging out, millennials would call it a duvet day.

From the discourse that’s sprung up about bed rotting though, it seems like some bigger questions are being explored around this trend. Firstly, Gen Z are reclaiming the need to stay in bed by branding it as a form of self-care. This picks up on some broader wellbeing trends online, where people are trying to decouple their sense of worth from their productivity. This train of thought picked up steam during the Covid-19 pandemic, and seems to continue to be something people are wrestling with.

As others are pointing out... is getting to the point of needing a day to rot in bed is really a good approach to self-care?

I rather like the visceral nature of the phrase ‘bed rotting’ and I’m sure that, whichever generational cohort we fall into, we can all relate to the occasional need to totally switch off to refresh and recalibrate. However, as others are pointing out, a second consideration is whether getting to the point of needing a day, to rot in bed, is really a good approach to self-care. Or would more preventative measures be the better way to care for yourself? Some commentators on TikTok have suggested that a combination of other gentle activities would actually be better at delivering the desired results than lounging in bed alone.

Dr Saundra Dalton Smith suggests in her book Sacred Rest that there are seven types of rest: physical, mental, spiritual, emotional, sensory, social and creative. Whilst bed rotting provides perhaps three or four of these types of rest, it may not provide the long-term refreshment sought if it doesn’t nurture the other parts of us as well.

Should we all just be expected to mindfulness our way out of a mental health crisis or yoga our way out of chronic pain?

While framing this extreme need for rest as self-care may give people permission to stop and reduce the stigma of doing nothing, it also puts the onus on the individual. I think the risk of self-care narratives in general is precisely in the focus they put on the self. While it can be healthy and empowering to take action to improve your wellbeing, it also draws attention away from the societal systems and structures that are contributing to everyone feeling so exhausted all the time. Should we all just be expected to mindfulness our way out of a mental health crisis or yoga our way out of chronic pain? Or should we be looking more widely at what is going on in the world?

This tension between taking responsibility for my own wellbeing but also reflecting on how I relate to the wider concepts of work, productivity and success is a very live, everyday issue for me. I have fibromyalgia, a chronic health condition characterised by fatigue and widespread muscular pain. Whilst conventional medicine gives some relief, I have to manage my energy levels very closely and intentionally pace myself to avoid my symptoms flaring up, though sometimes it is out of my control.

Unfortunately, if I were to let myself get to the point of desperately needing to bed rot it might take me a week or two to fully recover. I have to resist the urge to say yes to every invite and make sure I have a balance of work, rest and play in each week. This is helped by the privilege of being able to schedule my work around my own needs, it would certainly be much harder if I was tied to a very strict working pattern. In a way, it's like I have an early warning system for burnout, and I’ve become very attuned to fluctuations in my mood, energy or pain levels that might indicate the equilibrium is off.

As part of my energy management strategies, I have also found that the ancient practice of sabbath from the Judeo-Christian tradition has helped me to both take regular time to rest and to remind myself that I am a human being, not a human doing.

In Genesis, the opening poem of the Hebrew scriptures, we hear that after six days of hard work creating the universe, God rested on the seventh day. For thousands of years, Jews and Christians have attempted to learn from this and incorporate a day of rest into each week. The practice also exists in Islam.

Each Sunday I try to do as little as possible and particularly to disconnect from digital channels, because I know they often take more energy than they give me.

The way that this plays out in people’s lives ranges from very strict observance to more loosely held rules and rituals. However, you approach it, there is much to be learned from this ageless wisdom. I initially began practicing sabbath myself when I went freelance and realised how easily I could end up working seven days a week if I didn’t pay attention. This was six months or so before the first Covid-19 lockdown in the UK and I was extremely grateful to have established this habit in my life when that occurred.

For me, sabbath isn’t just ensuring I’m squeezing rest into each week but also creating rhythm. It punctuates my week and gives everything else breathing space. Each Sunday I try to do as little as possible and particularly to disconnect from digital channels, because I know they often take more energy than they give me.

In The Ruthless Elimination of Hurry, John Mark Comer helpfully suggests two simple criteria to decide whether something is permissible on the sabbath. Is it rest or worship? If it’s not one of those two things then it can wait. For me, worship usually means going to church, but for you that could be something else that helps you connect to something bigger than yourself and experience a sense of wonder. Perhaps immersing yourself in nature, or engaging with an awe-inspiring work of art.

Another helpful piece of advice about sabbath I heard from Annie F. Downs on Instagram:

“If you work with your hands, sabbath with your mind. If you work with your mind, sabbath with your hands.”

As someone who spends most of my working week creating content on a computer, this is a useful reminder not just to read and journal on my sabbath but to swim, crochet or cook as well.

Lastly, Jesus said “The sabbath was made for man, and not man for the sabbath”. This reminds me to do sabbath in a way that is life-giving for me, even if that looks different to what works for others. These guidelines have helped me establish a practice of sabbath which provides clarity and routine, whilst being expansive enough to allow me to give myself whichever type of rest I need at a given time. Occasionally I do just bed rot, but usually I do things that restore me and bring me joy, whether that’s taking a walk or cycle if I have the energy or simply taking my lunch to the beach.

Of course, I’m not always perfect in the way I sabbath. That’s why it’s called a practice. But I do notice I flag later in the week if I’ve skip it. So, even if I occasionally switch the day or bend one of my rules for a practical reason, I keep coming back to it.

If you don’t already, I really encourage you to try the routine of sabbath for yourself. Pick a day of the week that works for you, put some boundaries in place, try it for a few weeks and adjust accordingly. Treat it as an experiment, a gift to yourself and perhaps as a little way to opt out of the madness of modern life for a beat. And by all means, bed rot if you need to. As Brené Brown says: