​Sandbridge, Virginia Beach, United States by Jae Bano

The lipid (cholesterol) and Hbaic (3 month blood sugar average) results are released online by my primary care physician. After a few months of changing the exercise routine due to a chronic piriformis injury, and celebrating Diwali, Thanksgiving, and Christmas with so much food, I know the numbers won’t be good.

Taking a few deep breathes, I click on the lab links. The numbers confirm my apprehension. Shoulders slump, the heart sinks in disappointment.

Judgmental thoughts abound. How could you possibly think hiking and walking would be enough? Can’t you control your food choices and intake? Isn’t it a bit hypocritical to offer advice to patients you can’t even follow yourself? The thoughts threaten to submerge the heart even more in the brewing anger, fear, and sadness conjured by them.

Mindfully aware of the thoughts, feelings, and effects they have on the body, I recognize an old pattern based on past causes and conditions. The lab values feel like health grades, a kind of report card defining my wellbeing. If the numbers are outside of a certain range, then I have failed.

Ouch! This hurts. It’s unpleasant. Does it have to be, or am I adding on extra arrows of suffering that don’t need to prick so sharply?

I don’t like the numbers, but like final semester grades, they don’t define what I’ve learned about physical, emotional, and spiritual wellbeing. I wonder what a wise teacher, loved one, or good friend might say to me in this moment to help me remember kindness.

Sweetheart, this is an invitation to the biggest wellbeing party of your life! How does your body want to move, to dance? What do you want to eat at this party that is not only sweet or savory when swallowed, but will last to support deep loving connections with self and others?

Radiant, the heart emerges with more care, communicating with a curious mind to expand a narrowly focused lens on experience. With a panoramic view, I think of my colleagues and other physicians who balance the wellbeing of patients with their own wellbeing every day, sometimes to their own detriment. Ahh, others experience this, too.

Though I work part-time, have so much support at home, and cannot attribute a change in health status to work alone, I know other physicians suffer from exquisite burnout. Burdened by the overwhelming weight of patient care, demanding electronic medical records that threaten the physician-patient relationship, and never-ending administrative duties that seem to proliferate at an alarming rate, mindlessness can feel like the only easy way out.

According to Diana Winston, Director of Mindful Education at the UCLA Mindful Awareness Research Center (MARC), mindfulness is “paying attention to your present moment experience with openness, curiosity, and a willingness to be with what is.” For years, I worked with definitions like this in meditation, movement practices, silent retreats, and meetings with a mentor. The “paying attention to present moment experience with openness and curiosity” piece was starting to make sense. The mind got it, but the heart still wasn’t convinced.

When I learned about Kristen Neff and Chris Germer’s research and teachings on self-compassion, and began to integrate them into mindful practices, the heart began to trust the combined capacity of heart-mind to communicate with the body, to be in tune with each other and sense when there was an imbalance of thoughts, feelings, and sensations leading to dis-ease. The capacity to stay with these experiences led to internal freedom and joy independent of external circumstances.

To this day, mindful self-compassion gives me the strength to stay with difficult patients and circumstances, to touch intimacy and vulnerability without overwhelm, to celebrate healing with patients in a larger context than ones limited by disease states and problem lists.
 
Clearing
by Martha Postlewaite

Do not try to save
the whole world
or do anything grandiose.
Instead, create
a clearing
in the dense forest
of your life
and wait there
patiently,
until the song
that is your life
falls into your own cupped hands
and you recognize and greet it.
Only then will you know
how to give yourself
to this world
so worth of rescue.
 
May we all create a clearing in the dense forest of our lives. May mindful self-compassion bring back the meaning in medicine.

The email subject line announces the release of this quarter’s publication. It’s finally here! After one and a half months of anticipation, I wonder how the article on diversity and inclusivity in healthcare will land on colleagues.

Will they comment on the compassion, insightfulness, or skill of writing? Will they see me in a different light, beyond the part time family physician who doesn’t ‘work as hard’ as others? Will they appreciate the need for diversity and inclusivity awareness? Will they feel inspired to learn and implement some of the suggestions?

Holding my breath, I close the email. There are patients to see, an electronic medical record inbox to attend to. The thoughts almost lift me off the chair, out of the body and to another place far from here.

Earth to Kaveri. Feel your feet on the ground, sits bones on the chair, breath moving through you. You have work to do. The email can wait.
 
*****
 
After the dinner dishes have been rinsed, the dishwasher loaded, the family immersed in their evening rituals, I click on the email that links to the newsletter. Scrolling the contents, the heart sinks when I find my article towards the end of the publication, confined to one page, a majority of the original content missing.

What the hell! is my first reaction. I feel like someone has just taken away a prize I never won and stripped me of all false pretensions. Feeling angry, hurt, and exposed, who am I right now? The beautiful writer whose article didn’t make the front cover?  The kind, mindful physician who is really an imposter?

There is a strong urge to email the editor with these woes. Excuse me. There’s been a terrible mistake. But something inside encourages connection to the earth for grounding, awareness of breath to notice the subtle transition between stillness and movement, a warmth in the heart to encourage gentleness, and remembrance of the body as 60% water. Water takes on the shape of any container it fills. Can I take on the shape of this moment?
 
*****
 
Like inflated balloons being twisted and shaped by a clown at a children’s party, I wonder how many selves were created between writing the article, waiting for its release, and watching for impact. Judgments begin to arise. Hasn’t DPP6 taught you anything by now? There are only 4 months left in the program. Better figure it out soon! The midback tightens where the stone of shame is carried on the shadow side of the heart.

In meditation, compassion and humor are also present, gently popping the inflated balloon selves with pinpoint precision. Awww, Sweetie. Of course these balloons were present. Past karma, causes and conditions. The balloons are pretty frickin’ hilarious, aren’t they? Feel free to cry, laugh, or do both. It’s all welcome here. Metta fire from the heart holds the shadow side in loving awareness.
 
*****
 
An email is composed to the editor, thanking them for inclusion of the article in this quarter’s publication. An inquiry is made about changes to the article from its original content. The email ends with metta blessings for the holidays. Another email is received from the CEO of our organization expressing appreciation for the article.

Regardless of the number of painful ‘ego I’ deaths occurring with this experience, the emergence of ‘elemental i’ is totally worth it.

Grounded in Earth.
Breath sensing the subtle transition between stillness and movement.
Metta fire to encourage gentleness.
Body as 60% water, taking on the shape of this moment.

Not self, infinite space holding all of life’s dramas. An open heart learning to love what is real.

*****

(Come explore ego I and elemental i through meditation and reflective journaling. For information click here.)

Born into this moment,
each breath is a wave
erasing past selves carved in sand.
Still, I try to build
a grand sandcastle of ego
further inland for protection,
till the sea swallows it whole
into a belly of no becoming.
Birthed again from the womb
of wholesome intentions,
returning as a song that leaves its shell
to join the collective chorus for peace.
 
Each moment I am born into a new molecular configuration, erasing past selves carved in sand. This is a blessing and a curse. A blessing in that the slate of deficiencies can easily be erased. A curse in that even a grand sandcastle of ego built further inland for protection is defenseless against the sea.

Who am I trying to be? An acclaimed poet/writer? A popular family physician with good reviews? A mindful, compassionate mother? A wise meditator? A sacred feminine conduit with direct access to the Great Mother? An expert on diversity and inclusivity?

Who am I trying to run away from? The ideal housewife and daughter? The productive physician? The body that can be in better shape as evidence by certain chronic conditions? The anxious one? The mother who failed? The callous one?

Just typing all these selves makes my head spin. It’s like strolling through an open bazaar with a new outfit in mind. The vendors come at me from all directions displaying their colorful wares. “This is an exclusive dress. Hand stitched. Best price in town. You won’t find it anywhere else.”

​Who ever said I was for sale??

I’m tired of trying to be someone. Trying to impress. Trying to build a sandcastle of ego that will last.

Let the sea swallow me whole into a belly of no becoming. Birthed again from the womb of wholesome intentions, may i connect, create, have compassion for a larger sphere than this small sense of self.

May i return as a song that leaves its shell to join the collective chorus for peace. This eternal song of generosity, wisdom, kindness, patience, determination, joy, compassion, mindfulness, and faith has no name. It doesn’t belong to anyone.
​
And it can still be shared.

This is a verbal garbage dump without
a forethought of what will harm the heart-
speeches, judgements all aimed at
protecting one’s own view while
the unreal other is suffering, too.
 
This could be a love letter, a truce
one brave act of forgiveness,
the walls of division crumbling
because one side is tired of living
inside a limited potential for peace.
 
Shedding tears of individual and collective harm this morning in meditation. So mentally and physically tired by this country’s political climate. Reflecting on dependent origination, karma, and not-self, I realize how important my spoken and written words are.  Do I want to contribute to what this is, or what this could be?

Dear Piriformis Muscles,
 
I hear the burning call of anger
The quivering fear with each step
Disappointment and impatience asking
Where do we go from here?
 
I’m sorry I mistrusted you
Left you all alone
When you needed me most
Needed someone to understand
 
I’m here for you
For as long as the healing takes
Here to hold you, support you
Grateful for your special part
 
In keeping this body whole
 
For the last month, I’ve heard the burning call of anger, the quivering fear with each step, disappointment and impatience asking, “Where do we go from here?”.

Eleven years of mindfulness and compassion practices weren’t enough. I needed help. “Help me understand what I’ve forgotten, what I need to know now!”

Who was I calling out to, and why wasn’t self-compassion working?

As the piriformis muscles continued to burn and ache with each step, I turned to supportive family, wise friends, and healers who might help me remember. This is what I discovered.

Honesty. I can’t heal what I can’t feel. I’m so used to having a plan, knowing the answer, using spiritual practice to bypass what’s asking for direct attention here and now. Why feel if I know what will heal? The problem with this logic is that I can’t possibly know what will heal, until I’m honest about the anger, fear, disappointment, and impatience present. Until I’m really willing to listen to them, let them be as they are, and show me what is standing behind them. They are not roadblocks to compassion, but doorways.

This is what I’m feeling right now. It’s OK. It’s not bad or wrong. There’s space for these feelings.
 
Compassion. Compassion is the softest thing I know that cushions the hard edges of reality. It’s what I often use to shield my heart against the extra arrows of self-judgement. It’s easier to practice compassion for someone else who is suffering, and feels selfish, self-indulgence to include myself in the circle of compassion. Over the years, self-compassion became the parent, partner, best friend I was seeking, the ally who never let me down.

 I care about this pain. Others have bodies that break down and disappoint them, too. It’s not my fault.
 
Patience. I’m still surprised by how often I use self-compassion to bargain with life. Look, I’m being gentle and kind. Why is the burning, aching sensation still here? Why do I still feel stiff like the Tin Man? Isn’t self-compassion the oil needed to lubricate this stiffness so I can move pain free? Patience asks me to wait, to let the answers come in geological time. Sometimes, I’m not sure I can wait that long, but am always surprised and humbled by the outcome when I surrender to the elements that shape each and every experience.

This won’t last forever. Everything changes. May I be patient with the impatience.
 
Gratitude. When physical, emotional pain strike, it’s like a large, dark stain on a beautiful dress, a hole in a perfect picture, the uninvited guest to a party. Help! Bring my old life back! The negativity bias deletes all memories of these piriformis muscles supporting the birth of a beautiful child almost thirteen years ago, meditation and yoga postures that have offered profound joy and peace, hikes that have brought me closer to the womb of the Divine Mother than ever before.
​
Thank you for carrying this body, for supporting each brave step as best as you can into the future unknown.
 
Trust. If old age, sickness and death are inevitable who or what can I trust? Why even try to celebrate the 10,000 joys if sorrow is just around the corner, waiting to shadow the light? I’m not sure there is a simple answer to these questions. For me, it’s a partner who wonders what I am trying to prove, recommending I take Advil and rest the body that is being pushed to continue the elliptical and yoga stretches despite obvious signals of discomfort. It’s a teenage daughter who offers glimpses of care and concern by gently patting my behind despite raging hormones and peer conditioning. It’s a mother who cooks and offers to do the dishes when she sees me wincing in pain. It’s a friend who recommends a gentle chiropractor because she knows what I want in a healer. It’s other friends who offer up compassionate listening presence like the sweetest dessert when I have forgotten how to offer it to myself. It’s a chiropractor who alleviates my fears by reminding me of the body’s intuitive capacity to heal itself. It’s Qigong helping to move stagnant energy and encourage flow. It’s wild turkeys on a hike reminding me that life still goes on, a dim sun with so much potential to burn through the fog with love, the Great Mother promising to always be there no matter how this body ages or whether I have direct access to Her.
 
The people, places in my life will come and go, but there will always be someone, something to remind me of what matters most.
 
May this reflection inspire all beings everywhere without exception. May we learn to stay with our own experience, so we can support others on their healing journey.

I couldn’t love her the way she needed to be loved. I couldn’t support the last three months of her life as the cancer was slowly invading her digestive tract, pancreas, and lungs the way a bad nightmare does, except she never got to wake up.

I was too busy being angry and hurt over sibling dynamics, feeling invisible, outfitting her with a traditional standard I had come to despise. It was easy to conveniently forget her safe escort on three different buses we needed to take to and from the orthodontics office, the way she would tear her old Indian saris and sew them into long skirts because she knew I loved them, the house filled with the scent of masala 24/7 so we would never starve while growing up.

Why was I still hungry?

*****

We honored the 5-year anniversary of her death through puja. I was drawn to the diya like a moth to a flame, singing with a fervency during the arti that felt misplaced. Who was this 45-year-old woman child hearing her mother singing, seeing her soul, her name in the sacred fire?
​
Who was the sister blaming her brother for distance and insensitivity, blaming herself for deficiency and vulnerability?

*****

A few days later in yoga practice, I felt intuitively called to listen to one of my favorite bhajans. A torrential downpour of emotion flooded the mat. I was grieving all the things I expected of Mummy, all the blocks to loving her just as she was. There was no dam to hold anything back, nothing between me and this moment.

Forgiveness was palpable both ways.

*****

She’s lacing up her black Converse, noticing a brown mark on one side of a shoe. She stands to retrieve a wet washcloth to wipe the shoes she is so proud of.

I comment on the mark. Maybe it’s a scuff from my sandal the other day as we were walking to the library. She glares at me with that entitled teenage look, punishing with silence and a hug withheld before biking off to school.

“I let you go with love”, I call out cheerfully.  “You know where to find me!”

*****

We think we have forever with loved ones, a lifetime to heal a suffocating heart that can barely breathe.

Can we compassionately bow to each thought, feeling and sensation sculpted from the cycle of dependent origination into a solid self? Can we be patient with practice, trust wise teachers, good friends, and tenderness to slowly crack the plaster open?

Opening to vulnerability is not natural. It takes so much courage and support. I carry these verbal snapshots of unconditional love like passages from the holy books, knowing things will change.

The plaster will harden with conditional love and soften with practice again.

Note: 

puja: a prayer ritual performed by Hindus of devotional worship to one or more deities, or to host and honor a guest, or one to spiritually celebrate an event

diya: an oil lamp used in the Indian subcontinent, notably India and Nepal, usually made from clay, with a cotton wick dipped in ghee or vegetable oils

arti: a Hindu religious ritual of worship, a part of puja, in which light from wicks soaked in ghee (purified butter) or camphor is offered to one or more deities

bhajan: any song with religious theme or spiritual ideas, in a regional South Asian language

Cycle of Dependent Origination: A chain of causes which result in rebirth and dukkha (suffering). By breaking the chain, liberation from suffering can be attained.

Marriage Mandala

I’ve waited my whole life for you
to say the right words,
to woo me with poetry
and an instrument to play
the song in my heart
that I sing to myself
when the world misunderstands.

How could I have missed
the gentle intimacy,
the drunken look in your eyes,
palms pressed in Namaste
to the sacred feminine flame,
the humble bow to your consort
in all her many moods?

Let’s circle the fire like we did long ago-
no one leading, no one following,
the earth bearing witness,
the air surrounding us offering
space to move as we must,
tears of frustration and joy marking
each brave step into the unknown.
 
Just when you think your partner isn’t looking, listening, or understanding, look again. Listen. Patiently wait for understanding based on cellular memories of gratitude. Memories of disappointment and deficiency will just weigh you down and induce amnesia for the sacred.

There is no such thing as a fairytale relationship, romantic or not. The grass is always greener in a movie, a book, or someone else’s story. For me, the magic occurs inside the heart mandala when all the moving parts invite me to look, to listen, and be patient for understanding.

I don’t always like the entangled pattern I see. The elements of earth, air, fire and water ask me to wait, to feel their presence internally and externally till the pattern alchemically transforms into something I recognize but didn’t trust before due to past conditioning.

The emerging pattern cuts through greed, hatred, and delusion with fierce compassion, gentle wisdom. All moving parts begin to settle.

The elements of wind and fire are strong in me. How do I not blow past and burn everything in the way? How do I allow the neurotic wind in this breath to be carried to the place it needs to be, rather than striving to get there? How can this passionate fire for practice burn with wise discernment?
​
Intuition, lead the way…

Everything is welcome in the circle-
warmed by the sun, cooled by the moon
spiraling in, then ambling out,
the labyrinth of transformation never linear.
She dances, dripping the blood 
of womb wisdom with each step,
the seed of creation born
from misogynistic misunderstanding.
This is a brave new world where 
ancient ways are not murdered
but nurtured inside the mandala,
till a dakini can speak with fierce precision
and act with exquisite compassion.

After attending a daylong with Llama Tsultrim Allione based on her book, Wisdom Rising: A Journey into the Mandala of the Empowered Feminine, I felt a uterine contraction calling to write this. With all that is going on externally (Trump’s presidency) and internally (feeling the damage to the earth and each other), I need a safe container, a sacred circle where everything, all emotions are welcome.

There is sudden and clear recognition that the path of healing is not linear, but like walking a labyrinth, spiraling in then ambling out. To arrive at the center of wise understanding, one must cultivate patience, allow the experience to gestate within till a seed is born from misogynistic misunderstanding.

This is a brave new world where ancient ways can inform us, energize us to speak with fierce precision and act with exquisite compassion.