Each day as I leave for work,
Mummy imparts the ancestral
blessing of Jai Shri Krishna
punctuated by Have a nice day.
A nice day is when each patient
is on time, no dirty laundry
hanging outside their neatly packed
suitcase of symptoms I hope will
disappear after the appointment is done.
 
Today, I challenged the notion
of a nice day, invited a few patients
with heavier suitcases to stay awhile,
to unpack their symptoms and the
stories underneath them. I learned
that I don’t have magic medicine
to soothe every ailment or a perfect 
plan to permanently cure disease.
 
What I can offer is a loving look 
that says I see you as more 
than a problem list of diagnoses,
supportive listening presence
that hears the wish for wellbeing,
compassionate hands holding
all the places that feel broken
inside patients, inside myself
trusting something larger than
us both to guide the way.
 
*****
 
What does it mean to wish someone a nice day, a nice weekend, a nice vacation? For me, there is often a mental labeling that is associated with nice. It could mean good, smooth, easy, joyful, happy, no drama, etc.
 
And I know that this perpetual notion of nice goes against the natural rhythms of life. Things are often far from perfect. The seventy something year old patient with a long list of complaints who can’t come in at a later appointment and is trying to fit into a 20-minute slot, now 10 minutes after rooming and me running behind schedule. The driver who weaves in and out of two lanes on community roads as if it were a racetrack. This body that misbehaves physically, emotionally, and spiritually despite my best efforts to heal it (more like control it). A virus that continues to mutate despite advances in science, technology, public health, and so much more.
 
When I challenge the notion of a nice day, perfect life, or anyone, anything that catches me off guard, the attention widens, deepens to notice what else in present. What have I missed? What can I remember? What wholesome heart-mind states will help to hold what is happening with humor, compassion, care, wisdom, patience, trust, beauty, courage, among other things?
 
It takes energy to widen and deepen the attention. I’m not always in the right heart-mind state to do so. It helps to remember that I am not a limitless source of energy, that sometimes it’s best not to confront uncomfortable situations when tired, hungry, sleep deprived, reactive, or any other indication that I am likely to cause more damage than repair. I also need to wisely discern what is in my control, and when I’m trying to drive a car without the right keys.
 
Expending too much energy in multiple directions against the flow of life is useless. I can tell when the body is physically exhausted, the mind agitated and still trying to formulate an alternative plan, the heart whispering to just stop and remember a different way. When I heed the heart’s advice, body and mind slow down. Full exhalations occur before the next inhalation, so there is more space for wholesome qualities to enter.
 
*****
​
As a healer, family and community member, the burden of guilt sometimes outweighs the freedom to travel the path of least resistance. I’m learning that it’s not all up to me or in my hands, AND I still care. In certain situations where I don’t have magic medicine to soothe every ailment or a perfect plan to permanently cure disease, the gift of steady, loving presence is profound. When I trust in the mysterious unfolding of each being’s life (including my own) and apply energy in a manner that supports healing and freedom, there is less ego attachment and more connection to the moment. There is also recognition that things will change, that what’s useful now may need adjustment in a different scenario, trusting something larger ​than the ego self to lead the way.

Timeless

Sit still. Isn’t it exhausting
to be someone else,
to visit places in your head
that promise happiness but can’t
convince your heart to stay?

Peace doesn’t arrive
when you’re on vacation.
Sometimes it’s during a pandemic
when you’re stuck at home,
closing your eyes and waiting--
​
suspended in the darkness
of not knowing
between sunset and moonrise,
a horizon of questions
loving presence will answer.
​

Denying Death

We attend my grandmother’s funeral virtually,
watch the priest and my uncle
perform the last rites and rituals
purifying her body with ghee and rice
for a peaceful soul release.
The screen ceremony feels surreal.

Children and grandchildren speak of Ba’s cooking,
her generosity, her home, her heart
that always flowed in the direction of love
as great grandchildren lay rose petals
over her body, palms pressed in
Jai Sri Krishna they are learning.

I keep thinking that Ba is just sleeping.
At any moment she will wake up and ask,
Tamē manē kēma rāndhatā chō?
Jō tamanē bhūkha lāgī hōya
tō manē tamārā māṭē rasō'i karavā dō.**

Beside me grief flows in violent waves
through my mother, tears unable to relieve
the pressure that such loss builds inside.
As we watch the coffin pushed into the furnace,
a whimpering sound escapes from somewhere
I don’t recognize, an ancient, primal call.

I see the faces, feel the bodies
of everyone I love, including myself
burning back to bones, to dust,
leaving this world with nothing
except the lives we touch,
and the peace we can leave behind.

**Why are you cooking me?
   If you are hungry,
   then let me cook for you.

The Deepest Peace
(inspired by The Deepest Peace by Zenju Earthlyn Manuel)

Drawn to the fuchsia tinged light
reflected in Dumbarton Bay,
I’m moved by the stillness of shorebirds
wading in shallow waters,
waiting for the day to begin.

All meaningful action is born
from this womb of silence.
​
I must also pause, feel
this earth-driven calm within,
before speaking and acting,
before spreading my wings,
checking in with the wind
when it’s best to take flight.

2020 has been a year of many things. I won’t pretend to know what it has been like for you. I have heard from many that they wish to have a different 2021. But what does this mean exactly? Less suffering with no COVID, police brutality, political division, physical, emotional, social, and economic stress? More joy in gathering with others to commemorate the beginning and ending of life (and everything in between), travel, return to school and work, seeing the smiles of others?

I also wish for a different 2021. And I’m paying attention to where I plant seeds of loving intentions- where I’m forcing something to grow/change, where I’m slowly letting go, patiently waiting for something to take root.

On December 24, I received my first COVID vaccine with a mixture of dread and hope. Dread that I’d be one of the few cases who developed a serious adverse reaction.  Hope that this would be a positive step in the fight against COVID. I’m relieved that the only nuisance was a sore arm for a few days, and I’m still diligently tracking symptoms through Vsafe.

I realize that there is still so much uncertainty. Will I build immunity to COVID? How long will the antibodies last? Am I safe to be around patients? Are they safe with me? What does this vaccine mean for us all heading into 2021?

Recognizing the fear and doubt in these questions, I’m aware that these thoughts, emotions and the physical manifestations of uncertainty within are not alone. There is also awe at the timeline and sound scientific data supporting the vaccine’s efficacy, gratitude for meaningful work, incredible colleagues, loving family, health, abundant food, shelter, and so much more.

Most of all, there is a deep bow of reverence to the practices of mindfulness, lovingkindness, compassion, joy, and equanimity with meditation and writing carrying me through some of the darkest times of post-partum depression and anxiety, losing my aunt-mom to cancer, chronic sacro-iliac, gluteal muscle pain, and COVID-19. Though Western medicine and other modalities have been supportive, it is these practices that saved me from sacrificing this heart-mind-body to fear and doubt.

To this end, I’d like to support others in planting loving intentions for 2021. Will you join me here? However you choose to heal and support yourself in 2021, may you remember that love and wisdom are so much larger than fear and doubt. What you plant now affects everyone and everything around you for days, weeks, months, and years to come.

Nisargadatta Maharaj  said, “Wisdom tells me I am nothing. Love tells me I am everything. And between the two my life flows.”

May the idea of a separate self dissolve with the wisdom of shared journeys. May love connect you to all.

Dear One, I never promised you
a pain or worry free life.
I did promise to always receive your
questions with curiosity and interest--
watching them grow like saplings
from mother to grandmother answers
just as the oaks in this preserve do.

Roots grow deep in underground
wisdom that is not always apparent.
Branches stretch far and wide 
towards a loving sun,
towards other tree beings
living in darkness and light.

Keep visiting this place,
even in the middle of winter 
when all looks lifeless 
and feels hopeless--
when a dormant heart seed
inside its protective shell 
is whispered to life
with breath and faith
in these words.

Suffering does not occur in a vacuum. It always occurs in relation. The patient who comes in with chest pain and high blood pressure because a beloved relative died of COVID complications in India and they cannot grieve or participate in last ritual rites with family. The patient who expresses grave concern for their son’s safety in returning to work during a pandemic, policing, and protests. The friend who practices medicine in a part of the United States where political division is threatening peace. The Earth still offering oxygen and sustenance despite continued abuse and neglect.

Healing also occurs in relation. It’s hard to heal if there is a sense of disconnection from ancestors, biological and spiritual family/teachers, the land, each other, and ourselves. How do we re-connect, re-awaken, re-member? While healing is a journey and there is no perfect answer, the following practices are offered as possible places to begin the contemplation.

Embodying Kuan Yin

Kuan Yin is the bodhisattva of compassion, the One who listens to the cries of the world. Embodying her feels like a tall order sometimes. How can I listen to others if I can’t hear what’s happening within? Life is overwhelming and overscheduled. How can I unplug from the endless to do and to be list?

I’m learning that Kuan Yin is not only the One who listens to the cries of the world, but also the One who stays till there is ease. There’s a sincere commitment to listening, to staying with the experience for the purpose of understanding. This does not mean that pain disappears, what’s broken is easily fixed, or questions have clear answers. The ease feels like a deep stillness beneath surface waves of experience, a stillness that patiently waits for the waves to dissipate for clarity. As I learn to stay with personally challenging experiences, there is more capacity to be with the suffering in others.

Connecting with the Natural World

1. Find something from the natural world inside or outside of your home. This might be a leaf, a rock, a seashell, a piece of fruit, a grain or rice, a feather, etc.
2. Practice internal mindfulness by noticing what’s present in breath and body with eyes closed for a few minutes. Then slowly open your eyes and practice external mindfulness in relational with this object. How are you different than the object, how are you the same?
3. Then with reverence and humility, listen to what the object has to tell you. What does it have to teach you?

 
Here is poem written on retreat in relation with a seashell:
 
Listening
 
she picked you up from the wet sand
because you looked pretty,
her keepsake from the RV camping
trip off the Mendocino Coast
 
forgetting
you were once the home
of a precious sea-being
just as her body is her home,
 
how she wouldn’t want
to be taken without consent,
how next time she can ask the water
or lift you up to her ear--
 
your mollusk spirit whispering
home is always sacred
no matter how small
or large you are
 
The Five Earth Touchings

Touching the Earth is a practice developed by Thich Nhat Hahn to fill your heart with remembrance of family, spiritual, and land lineage, so blessings of abundance can be offered to those you love, and the process of forgiving those who have hurt you may begin. It is practiced ‘to celebrate the positive and transform what needs to be transformed’.
​
This practice may precipitate unwelcome, unpleasant feelings, especially if you have experienced trauma or other feelings of disconnection. It is offered here as a healing modality to practice in a safe space with others, a trusted teacher or therapist. It is not meant to spiritually bypass what is true for you. Please honor your direct experience.
 
Questions for Inquiry

The following questions can be used for reflective journaling:

1. Think of your country(ies) of origin (ethnic roots). Now think of the country where you reside. Is there anything about the history of the country where you reside that needs to be narrated differently or questioned?
2. How can you be in reciprocal relation with life? What does it mean to set an intention of minimizing harm to other beings, the Earth, yourself?

 
****

Deeply nourished by recent retreats, water is humbly offered to trees in the backyard. It’s a small gesture of gratitude compared to their teachings on grounding, rooting regardless of external or internal climate, on letting go with trust that what’s needed will grow in season.

(Deep bows to Erin Treat, Brian Lesage, Amma Thanasanti and Kaira Jewel Lingo for sharing these teachings, and to their teachers and respective lineages. Suffering does not occur in a vacuum. It always occurs in relation. Healing also occurs in relation.)

​cobalt violet sunrise
over the bay
infusing the heart
with a quiet joy
priming it to meet
the day’s suffering
with peaceful presence
reflecting back hope
when sunrises
are forgotten

I see you Mara, conjuring dreams
of no control and not belonging,
replaying old classics in movie mind
as if they are the whole story.

What if I lay on my back, fully
surrendered to what’s playing
without needing to control content,
breathing into the body’s story?

May I trust the heart’s compassion
to support new stories or resilience-
loving presence a cocoon
nurturing metamorphosis within.
​

On the healing journey, the tendency is to resist pain and prefer a cure. I am no different. If there is an antibiotic that can treat an infection, a cast that can mold broken bones, a treatment that can offer relief, then I will vigorously support it.

And there are some things that don’t have immediate answers, remedies that can’t readily alleviate suffering. For sacroiliac and gluteal muscle discomfort, I’ve tried yoga, Qigong, Ayurveda , homeopathy, acupuncture, medication, chiropractic care, physical therapy, nature therapy, meditation, writing, dream interpretation, talk therapy, and mostly recently art therapy.

After typing out this list, whispers of judgment arise. Maybe if you weren’t complacently sitting around and doing more research for the perfect therapy, your ass wouldn’t hurt so much. Or maybe you aren’t spending enough time with one modality, expecting a miracle and instant gratification.

The whispers are met with smiles. Understanding the yearning for relief from suffering, the heart patiently responds. Dear One, you don’t need to try so hard. Surrender the resistance as best as you can. I will never leave you.

Surrender does not mean abandoning the healing modalities that are helping. It means not placing the burden of expectation on any one modality to produce a definitive answer, a cure.

​As a family physician, it’s a privilege to support a patient’s wellbeing. When there is a reliable treatment for dis-ease, we both appreciate the gifts of modern medicine. It’s harder to work with a diagnosis that is uncertain, it’s treatment even more elusive.

As I learn to cultivate loving presence and stay with this body, may it support healing presence with others.

It’s the transitional state that is often overlooked and dismissed.

What a joy to be on this retreat with Anne Cushman. Thank you for helping me process the perimenopausal transition!

****

A Woman’s Worth

Perimenopause mother tree,
rooted in old beliefs
of a woman’s worth.
Don’t let the foliage,
the fertility fade away
as green leaves still cling
to memories of summer.

Let one brave leaf bleed
from bright yellow
to burnt crimson,
inspiring others to fall
so barren branches
can practice the art
of letting go.

A woman’s worth
is not in the promise
of spring blossoms,
but a willingness to ground
in the truth of her season,
to nurture what is
still growing within.

****

Menses

Menses, I’ll miss you, the way you are a slow trickle in a creek or a rushing river of sloughed off endometrial lining. I’ll miss the pelvic cramping that starts as mild movement on the PMS Richter scale, then slowly crescendos into larger seismic waves.

Do I take an Advil, silencing the uterus, or do I breathe through wave after wave of sensations ripping through the lower belly, allowing the uterus to speak? It doesn’t have to be a boxing match between Western medicine and Eastern philosophy, does it?

I’ll miss the tampons, the Always pads ranging from regular, long, and extra-long/overnight so you don’t stain underwear, pajama pants, or bed sheets. Why was I so ashamed of you?

Though this womb well is almost dry, I will think of you every time I sustain a cut, or care for a bleeding patient. It doesn’t matter where the blood comes from; it’s a sign of life, a heme-rich stain of your wisdom tattooed everywhere I used to look away.

With the pandemic forcing more families to stay at home, the lines between school, work, and home are blurred with unclear boundaries. I’ve talked with patients, extended family, and friends who are struggling to maintain decent communication in closed quarters where most of life is happening these days. The internal aversion is also exacerbated by unhealthy air quality from raging California fires, limiting outdoor activity and escape.

For the first few months of travel limitations and social distancing, I felt that I was doing OK, even celebrating the sweet connections to my family. After an RV trip where we are all in even tighter quarters than at home, rubbing up against each other with every movement, something inside me snapped. Was it perimenopausal mood fluctuations, past patterns finally catching up with me, other causes and conditions? Do the reasons even matter?
 
Patience

Opening to what’s happening in the relational field requires so much patience. I love my family dearly, but I’m not always going to like them, especially when we disagree. The nature of life is change. There is nothing new about this concept. We are not fixed beings, but processes doing our best to acclimate to external forces. And everyone has their own way of adjusting.

Pausing and taking a few deep breaths before speaking or acting can make a difference between clarifying connection or disastrous disconnection. I recently listened to a podcast outlining a four-step approach to communication designed to increase clarity, minimize miscommunication, honor each person’s individuality, and build a shared sense of trust and respect for long-term success. Remembering intentions for healthy relationships, I was grateful to implement the practice a few times in conversation.

Patience is not about getting my way or forcing a certain outcome. It’s gently engaging eye contact, using words as windows instead of weapons, and awareness of body language internally and externally.
 
Presence

Close relationships can often lead to perceived nuclear fallouts when monkey mind is active. It’s so easy to get triggered by past hurt with an overlay of old scenes coloring what’s actually happening. It’s also tempting to stay focused on thoughts like train schedules flashing in the mind, constantly rechecking details for the future in case I miss the train.

How can I trust the present moment as it’s playing out, especially when I’m conditioned to fight, flee or freeze when it’s uncomfortable based on the thoughts and feelings arising? Present moment awareness is all about dropping below the story line, below the cranium to feel the story as sensations in the body, connecting with whatever I am sitting, standing, walking, or lying down on as gravity reminds me to let go of everything but this moment. Beginner’s mind is all about a certain innocence and curiosity for the moment rather than prematurely predicting an ill-fated outcome.

So how do I transform monkey mind to beginner’s mind when conditioning is strong? I keep coming back to the practice of mindfulness or sati, returning again and again to the breath (or other meditation anchor) to remember. I could be lost for seconds, hours, days, even years, and presence is like a breath of benevolence. It doesn’t judge or ask why I left, why I don’t feel safe, why I feel the way I do. It simply opens the door, no questions asked, with an enthusiastic and heartfelt Welcome home! I’ve missed you.
 
Possibilities

2020 is certainly a year of much distress and heartache for many. And I need to remember that this suffering is not new. Our ancestors have faced such trials and tribulations, and so will our children. There is no escape from sickness, aging, and death, or the dissatisfaction that arises in response to it. While grief is a guarantee to all who live, so is gratitude. If everything is in a state of flux, then I must bring a sense of blessing to that change through heart practices like the Brahmaviharas.

Yesterday, I had the opportunity to practice metta with Ayya Anandabodhi. I’ve learned metta as a traditional Burmese practice of silently and systematically repeating phrases of goodwill towards myself, a benefactor, dear friend, neutral person, and difficult person. Ayya Anandabodhi led a guided metta meditation that revealed the radiant, unconditional, boundless qualities of metta. I began by visualizing and lighting a diya inside the heart, breathing into it to fuel the flame of love. With each outbreath, I was invited to send that sacred flame of metta above me, below me, around and everywhere, allowing it to spread in all directions. If specific beings arose as natural recipients, that was fine. If not, that was fine, too. There were no ‘shoulds’, no comparing to past practices, no predictions for the future, just one woman’s heart feeling more expansive and free from conceptualization than ever before. I remembered my own goodness and the capacity to hold distress in loving arms.

When I don’t resonate with a family member, can I also remember their goodness? It helps to reflect on the times when I have felt connected, and all the things I appreciate about them. Relationships are not easy. They are complex and rather messy. They can also be exquisitely tender and redeeming, growing the heart to hold beauty and terror in the same loving space.
​
Writing this does not guarantee safe passage for future encounters. It does provide a template for embodied understanding and growth. I am still learning…

There is a space
where ordinary self
and higher self meet,
between thumb
and forefinger,
touching briefly
to decide
who will win.
 
What if both
are necessary
for the journey?
May the place
where they meet
be a guide
for compassion
and wisdom.
 
The balance is
what leads to peace.


It’s typical for anxiety to arise before I leave for a trip. Did I make a complete list of what to bring? What if I forget something? Will I fit in with the group that is not my usual spiritual family and sense of safety? How will body, mind, and heart behave on the trip without the support of meditation, yoga, and altar props? When I return, will I have space and time to unpack, do laundry, and attend a virtual retreat comfortably before going back to work?

I’ve spent so many years identifying with the ordinary self, engaging in spiritual practice to annihilate her, leaving no trace but a perfectly enlightened higher self. But ordinary self still worries, still feels things, still senses restlessness manifesting as tension in the body.

What if both ordinary and higher self are necessary for the journey? Ordinary self has taught me to deepen the heart’s wellspring of compassion, to connect with others in shared vulnerability, taking turns giving and receiving support. Higher self has taught me patience and the sacred pause before speaking and acting unskillfully, how to embody RAIN, and offer care to what’s needed. Both have taught me to be on the lookout for beauty and bathe in the joy of living, especially in the face of impermanence.

May the place where ordinary self and higher self meet in the Gyan mudra be a guide for compassion and wisdom.

The balance is what leads to peace.