(This poem was first written after receiving a steroid injection for frozen shoulder in April 2023. It's humbling to a be patient on the receiving end of a doctor's advice...)

Four minutes discussing the risks
and benefits of the procedure,
the doctor’s confidence and my worry
sparring in the silence that follows.
 
Four inches of thin stainless-steel injecting
steroids into my shoulder joint,
thoughts of relief and regaining range
of motion subdued by lancinating pain.
 
A fast baseball pitch and loud pop.
A gunshot wound to the right shoulder.
A bomb detonated close to the upper arm.
Four lives embodied in my own.
 
Four drops slide down my cheeks,
the waterfall of reserves drying out.
What will replenish trust as
therapeutic possibilities dwindle?
 
Four steps into another exam room,
I greet a patient in pain.
Before assessing and assuming,
asking about the story…

(This was first written a few months after my father died on Wednesday, August 30, 2022. It was submitted to a few publications and rejected each time. Perhaps I need to rest it here, invite it back into my own heart, and not seek anyone's approval but my own. May it offer some healing insights for others...)

It’s 1:45pm on an ordinary Wednesday in August.  A time when children returning home from summer day camps are cooling down with orange or berry flavored popsicles. A time when the sun is lazily strolling through a clear blue sky, too warm and weary to move any faster.

It’s a carefree time for most. But not for my brother.

Papa is sitting on the sofa slightly slumped over, his eighty-one-year-old spine yielding like an old, soft coat hanger to the weight of end-stage congestive heart failure, kidney disease and Parkinson’s. His signature salt and pepper beret hangs low over his forehead, covering his eyes.

After a few friends and relatives leave, my brother assumes he is just resting.

Until he moves closer to tap Papa on the shoulder, and Papa completely keels over like a marionette no longer guided by higher hands.

****
​
On Monday, two days before Papa dies, I receive a phone call from him.

“I miss you.”

His voice is magnetic, drawing me out of the embodied, grounded place I’m trying to reach. I hold the memories of this man’s significance in my life at bay; they are visitors I am not ready to confront. Right now, I’m at the gynecologist’s office waiting in an exam room to discuss treatment options for perimenopause. The appointment was rescheduled after I missed the last one visiting him in the hospital.

“I miss you too, Papa.” The response manages to push its way past the conglomerate rock of emotions stuck in my throat.

Seconds later, Dr. M rushes in like a whirlwind, eyes me on the phone, and backs out of the exam room. Clearly my phone call is more important than her services. I’m not sure I agree.

“Papa, I need to go. I’m at the gynecologist’s office. Call you later.”

Tenderness for my own wellbeing, my own healing process pulls me away from the call. Perimenopause is changing my inner landscape so much, that I feel like a foreigner inhabiting a strange body. But the force of guilt is equally strong. My nervous system is flooded with intense feelings, sacroiliac joints burning from prolonged sitting with Papa at the hospital for several hours and at my brother’s place now that he is home on Hospice.
​
Papa is still dying. After several hospitalizations for congestive heart failure, his heart is more susceptible to fatal arrythmias that can only be managed in an acute setting. As much as Papa wishes to prolong his life, quality of life outside of a hospital with loved ones is most important to him.

My thoughts are interrupted by a soft knock on the door. Dr. M reenters the exam room. I guess I’ve decided to stay. It seems like a logical decision, and my heart yearns for more guidance.

As I’m driving home from the appointment, I try to call Papa back. My sister-in-law answers. “He’s sleeping.”

“I’ll try to call him later.”

*****

I work on Tuesday and Wednesday to see a backlog of patients trying to catch up on two years of delayed medical care since the onset of COVID. They’re still afraid of the virus and all its variants, but cancer, complex pain, and confounding mental illnesses are strong competitors. My heart feels even more fragmented trying to meet everyone’s demands. Am I caring for anyone successfully?

The opportunity to call Papa later never comes. I am not there. I don’t get to say goodbye.

“Well, whose fault is that?”, my inner critic chastises. “You’re SO selfish, always putting your needs before others, even the man who raised you like his own daughter. You left your cousin brother alone to face his death. How could you?”

Another voice tiptoes into the conversation. This one feels like it’s coming from an older, wiser place. It might even be ancestral. “Dear One, it’s true you were not physically there in his last moments. You were consciously caring for so many depleted beings. Can you remember the times you were present to care for Papa in meaningful ways?”

I don’t see Papa again until my brother, sister-in-law, and I dress him in traditional white clothing at the funeral home for the final viewing before cremation. His skin is oddly smooth from the effects of funeral makeup, but it can’t hide the slight tension in his jaw, as if he is still objecting to this unsolicited outcome.

Memories that were once conveniently sequestered can no longer be held back. A shy eighteen-month-old girl arriving with her mother from India after her parents separated, trusting a strange man (her maternal uncle) at the airport to embrace her as one of his very own. Frequent trips to Yosemite and other national parks, weekend trips to Golden Gate Park and Ocean Breach in San Francisco where Papa instilled a deep reverence for the natural world and Gandhi’s principle of compassionate action in me. The time when he drove down from San Francisco to Los Angeles in my gap year between college and medical school, because I had contracted tonsillitis with a nasty secondary allergic reaction to the antibiotic, and I had begged him to come.

Flooded with guilt and grief, I question him silently. “Papa, am I worthy of this rite?”

His demeanor conveys neither judgment nor approval.

*****

The choices we make can restore or haunt us. Sometimes it’s not so black and white. I still see Papa’s face, hear his voice in the pleas of my dying patients.

“Help me!”.

Sometimes I recoil in fear and overwhelm, forgetting how to access the spirit of healing that extends beyond each exam room.

Sometimes I stay with compassionate courage and fierce tenderness, softening the boundaries between who is doctor and patient, who is parent and child.

Most days I’m learning to navigate the shifting landscape of change and loss without a clear road map, assuaging guilt with self-forgiveness, and caring for myself and others in significant ways.

Mindfulness teacher and author Jack Kornfield said, “If your compassion does not include yourself, it is incomplete.” As Papa once told me, even Gandhi needed a day of rest and silence.

​radiant eye nestled in a bed
of silver-feathered lashes
I long to see your face

veer the steering wheel
to the right shoulder 
of Dumbarton Bridge

and kneel down  
among shorebirds 
humble supplicants

wading in bay waters
warming up to your light
but I can’t stop

feeling the pressure
of time driving me
towards the mundane

while you still follow
patient as you are
waiting to make 

eye contact
when I am still
and ready

There is a glass heart that vibrates to the storms outside. Hi atop a mountain island locked in a tower, this heart holds the flame of possibility.

Who will understand it? What will free it?

As storms rage on, and waves crash against the shore, the heart fears its own fragility. What will become of the flame if the heart breaks?

Seeing this image in meditation, sensing its meaning to unfathomable beyonds, all the hurt places begin to relax.

The heart wobbles in response to uncertainty. The flame flickers. A crimson drop falls on each wound of vulnerability, anointing it with delicate grace.

Bowing to this image, she senses there is still more to create/discover.
 
*****
 
There are other hearts. Hi atop a mountain island locked in their own towers, these hearts also hold the flame of possibility.

She senses the distance between them. Sometimes the distance feels insurmountable;  sometimes they are so close. Their hearts also quiver to the vulnerability of opening, of breaking, uncertain if their flames can withstand the wind and rain of circumstance.

She gasps in quiet recognition. Perceptions of abandonment can seclude her from a loving, connected world.

As storms rage on, and waves crash against the shore, she takes the exquisite risk of opening, breathing into her own heart to brighten the flame of possibility. Sensing the flame in others, near and far, the exchange of warmth is like a sacred diya connecting all and strengthening divinities within.

​When you feel all alone,
tangled up in knots of doubt
replaying how it should be,
just stop and surrender,
hands up to the gun of blame.
You are not the only one who has
arrested themselves so painfully-
judge, jury and life sentence
sharpening the bullet inside you.
 
Forgiveness is not a free pass to 
avoid responsibility or make amends.
It is a delicate key to your
painful prison of perceptions.
Each time you place a hand
on where the bullet entered,
listen inward for the truth.
Causes and conditions, 
compassion and curiosity…
 
There is a larger heart that is
breathing and beating for us all.

Two Wings
 
soaring above
lush green hills
empty of agenda
full of possibility


​Butterfly
 
flapping its wings
grasses ripple out
movement felt 
beyond the hills
awareness is that vast

​Caste in bronze resin sitting on top of a ferocious lion, she commands attention at center stage. Endowed with power from multiple male deities to defeat the demon Mahishasura, she wields the weapons of a chakra, conch, bow, arrow, sword, javelin, trishula, shield, and a noose to clear all obstacles. Bejeweled in crimson and green ornaments adorning her crown, ears, neck, and waist, she embodies the cycle of death and rebirth, endings and beginnings necessary for all human experience.
 
My mothers never prayed to her. I wonder if paying attention to her now will strengthen and heal the maternal line.
 
To her right sits a smaller being caste is the same bronze resin. He was known to wear simple saffron robes and walk barefoot for miles in search of suitable space for long periods of meditation. 
 
I still don’t understand how he abandoned his wife, Yasodhara or his son, Rahula in search of enlightenment. Can enlightenment still be found as a householder? As I try to reconcile this paradox in heart and mind, I am still grateful for the Four Noble Truths, the Eightfold Path, the numerous lists as treasure maps to freedom. Maybe he didn’t abandon his family, but sacrificed the comforts of a safe, opulent life for something far more valuable.
 
To his and her left is another small being cast in the same bronze resin. She hears the cries of the world and stays till there is ease. Her demeanor is relaxed, yet ready to spring into action and alleviate suffering at a moment’s notice. She is the embodiment of the most caring 911 system I have ever seen. I’m still exploring hidden caves of compassion inside her world.
 
Above them all hovers a spirit in flight wearing colorful feathers in solidarity with the winged friends surrounding her. Trapped in 2D and a mahogany frame, she yearns to gather momentum and fly on wings of creative intuition, to leave the limitations of 8.5. X 11“ flat space in favor of more dimensionality without rules. She embodies the wisdom of stillness and movement, the space needed for meaningful transformation to occur in divine time. She understands that the wonders of the world were not created overnight.
 
Each day I light a candle, bowing in humble reverence to each of these beings, to their symbolism and the qualities they inspire in me.
 
I still feel this heart encased in layers of misunderstanding, a hidden gem polished by years of devotion.
 
One day there will be a dissolving of all separation. One day, I will be free to love as I was meant to.
 
There is no doubt.

​emptying the space 
of preconception 
new ways of looking
​are possible 


When things change, I get scared. Expending more energy on what class I can attend, what book I should read, or who I should talk to, I forget the invitation to just rest in uncertainty.

There is also tremendous compassion for how hard it is to feel windy thoughts jarring the mind, waves of painful emotions crashing against the shores of a tender heart.

A few days ago I was driving home from work. Heavy winds howled like banshees shaking the small electric car to the core of vulnerability. I thought I was going to die.

Arriving home in one physical piece, but many psycho-spiritual pieces, I tried releasing the visceral threat through words and tears in the arms of my loving, attentive partner.

I still felt broken.

I had no control over so many things: the body changing in perimenopause, friends and colleagues having meaningful plans that did not include me, miscommunication with my mom and teenager, patients and families who were not heeding my recommendations.

Yet, the following images arising in different meditations have offered some  comfort and clues along the way.


1.) An image of mysterious eyes crying colorful streaks of tears that veil the face. Allowing rivulets of difficult emotions to flow through the heart space can be beautiful and meaningful.

2.) An image of a woman placing hands on belly and heart, as if the body were a stringed instrument. Her hands feel the vibrations of sacred music from within, her fingers strumming along to create/discover more.

3.) An image of wind and waves threatening to break a protective structure shaped like a rib cage encasing a multifaceted jeweled heart. Sensations of fear and doubt arising as the jeweled heart smashes against its protective walls. As I grant autonomy to the heart, reverence and trust arise in the process, as well as wisdom and courage to love and be loved.

4.) An image of a mind cluttered with preconceived ideas of past experience. I wonder what it might be like to perceive experience with humility, soft and elastic edges, with the enthusiasm and wonder of a child trusting in benevolence. New ways of looking are possible.


****
​

When things change, I get scared. Sometimes I even want to hold onto this writing, these images…as if they are a talisman to protect me from uncertainty. 

Then I remember the true nature of trust. As self, other, and world change, so will words and images. The deepest letting go is letting go of it all, trusting the next words, the next image, the next stepping stone to appear when it feels impossible to cross the floods. 

Crossing Over

I’ve crossed over to the other side
without a bridge, without a map.
I wish I could tell you how,
leave a detailed set of instructions
so it would be easier for you
and you wouldn’t have to suffer.

She asked me to let go,
leave everything behind.
To walk on water you must
take one step at a time,
trusting that the next
stepping stone will appear.

She was right.

Desire is not just about 
reaching the other side.
It’s about resting 
between movement,
exhaling to inhale,
trusting the next breath,
the next step
towards something
that is already here
when the perception 
of distance
and depth 
is challenged.