exhale completely
blow out the candle
before the next wish
the next year

this poem
still conceptual
let it go
let it go
 
Exhaling, blowing out a metaphoric candle after a recent birthday, I’m already thinking of the next email, the next thing on the to do list, the next wish, the next year.

It’s EXHAUSTING!

It’s why I love meditation so much, the free gift that no one else can give me, sacred time I give back to myself for all the ways I’ve missed out on my own life.

Exhaling completely, I’m surprised by how much space there is internally, the capacity to hold whatever is next without betraying this moment. For 20-30 minutes a day, I don’t need to be anyone, do anything, go anywhere. It’s a conscious letting go, dying with each outbreath to be reborn again and again with a little less dust in the eyes and a stronger capacity to love.
I still hold on to many things, including these words, still conceptual, like directions to a place I already am.
​
What would it mean to let go, to let life come to me rather than chasing it?

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.

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.)

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.

There is a key that I’ve found through these practices, unlocking mysteries, answering questions I’ve had over lifetimes. I’m so afraid to lose this key, guarding it sometimes to the detriment of my relationships with loved ones. What if I forget? What if I’m not perfect in practices, in life? Will I spiral down into the womb of bloody postpartum darkness where thoughts threaten connection and unwanted emotions signal abandonment? Who will love me then? Will I be strong enough alone? Can I remember these practices without the key?

Menstrual cycles are irregular. Moods shift like unpredictable weather patterns. Gripping the key tightly- identities of a meditator, writer, physician, healer, mother, wife, daughter, family member and friend, I don’t want the life I’ve so carefully constructed over the last fourteen years to change. If it does, I only want it to change for the better (whatever that means).

In meditation this morning, I heard the following words. Awareness that this practice is not about perfection or self-improvement, but trusting the heart without expectation. What if I toss the key into the ocean, allow the waves to swallow this house of sand?

Loving awareness is everywhere. It’s time to let go of the key…

It’s noontime. I’ve just finished seeing my last patient of the morning. As I head back to my workstation and pick up my phone, there are some texts from the Dasher who delivered food I ordered from Door Dash. I notice the last few texts are pictures.

There’s a white bag of food with a receipt attached standing against the backdrop of a door with a sign on it, one of the many generic gray doors that lead into buildings 1, 2, and 3 on the Fremont campus. The last text reads, “Your order was dropped off. Please refer to this photo your Dasher provided to see where it was left.”

In a blind fury, I rush outside to try and find the food, completely ignoring the picture’s details, other texts and calls explaining how the Dasher tried to reach me, where and how long he was waiting. I also suddenly develop selective amnesia for the disclaimer Door Dash gives about food being left at the door to protect Dashers from COVID exposure.

Circling the buildings like a hungry hawk ready descend on its prey, I’m not only interested in finding my food, but also the Dasher to instruct him on how to do his job. I call him and arrogantly explain my position as a busy physician seeing patients, how he should have waited, how leaving the bag where he did is completely unacceptable. He agrees to drive back to where he left the bag, and calmly suggests I take a look at the picture and instructions he left while he is on his way.

Ironically, we simultaneously arrive at the same door where he left the food. Except there is no white bag. He doesn’t know what to say. I continue to sing the same song of entitlement and how this is all a big inconvenience for me, oblivious to what he must be thinking or feeling. As he leaves, all I can think of is the lunch hour quickly being compressed into 45 minutes, 40 minutes, how I will have to drive out for food, a missed opportunity to catch up on work.

On my way back up to the office, I run into my medical assistant who tells me that a nurse saw the bag and delivered it to me. Taking a seat at my desk, I take a few bites and reflect back on the time between picking up my phone, seeing the texts and sitting here now.

In my contracted state, I conveniently forgot to slow down, to breathe, to see the larger picture. Sure I was hungry and concerned that the food I purchased was not easily accessible, but I completely dismissed the Dasher’s experience (his attempts to communicate the details of where he left the food, his unfamiliarity with the Fremont campus, possible health concerns, other orders he might be trying to fulfill).

 
****
 

Power and privilege can be dangerous when we see only what we want to see, the 10% of the iceberg that seems obvious to us, when we only hear our version of the story. We don’t realize how accepting our narrative as the only truth can cause unnecessary harm. This is where slowing down, taking a few deep breaths, getting curious, and extending compassion beyond one’s own know-it-all mind, prized body, and small heart helps to include others in the circle of awareness.
 
Power and privilege can also detrimentally impact collaboration and delivery of healthcare. False assumptions and ensuing judgments of a patient, care team member, or any employee of Sutter Health  by race, ethnicity, citizenship, religion, gender identity, sexual orientation, age, weight, socio-economic status, education level, job status, etc. to the point where is impairs their safety and wellbeing, are the damaging results of implicit bias.

How you choose to explore the 90% of the iceberg that’s submerged, the dark cold places shaped by causes and conditions of cultural upbringing, societal influence, etc., is up to you. Where do you wish to inspire meaningful change in your sphere of influence? There are plenty of ways to melt the ignorance and a solid, separate sense of self. This writing is an invitation to find out how you wish to proceed in expanding the circle of awareness.


****


Looking out the office window at the trees, I take in oxygen and release the carbon dioxide confusion I’ve been carrying for the last half hour. Then, I breath in the air of this Dasher’s reality, and breath out a compassionate apology and gratitude for the food in front of me. I pick up my phone to text him.
​
Thank you. The food found its way to me. Forgive me if I looked, sounded angry. Maybe you are new to this facility and want to limit your exposure. Please stay safe. (prayer hands emoji)
 

Bubbles and Butterflies by Shirley Reede

I was grateful for some quiet time to unplug from work - sit, walk, read, write, and engage with the Bikkhunis from Aloka Vihara and poems from the Therigatha on a home retreat for a few days.

 
Tissa ~ Third
 
Why stay here
in your little 
dungeon?
 
If you really
want to be free,
make 
every
thought--
a thought of freedom.
 
Break your chains.
Tear down the walls.
 
Then walk the world--
a free woman.
 
 
In the silence, a life pattern I’ve known about for some time resurfaced for contemplation.
 
I rely on specific outcomes, conditions for happiness.
 
Since the pandemic changed our way of life in March, I’m reflecting on identity, what really matters to me, and how I want to contribute to the wellbeing of others based on my own dance with life.
 
I was filled with ideas of healing hope, gift wrapping them faster than others could open and enjoy them. “Would any physician like peer support, mindfulness training? How about compassionate support? Would any patient like a mindfulness consultation, a tailored mindfulness meditation created just for you? Step right up and sign up for a mindfulness for stress shared medical appointment, or an online six-week meditation and reflective journaling class.”
“Take me out of respiratory clinic! That isn’t where my talent is. As every place is being hit hard economically, medicine is no exception. I’d like to make a living (right livelihood) offering mindfulness as medicine in addition to Western medicine.”
 
Just typing all this out and reading it aloud makes me realize how much energy I’ve directed into willing a certain outcome.  I’ve also strategically tried to plan trips when other vacation plans were cancelled for safety reasons, and constantly check my phone to see if I’m receiving emails or texts that align with my ideal future. What have I missed along the way?
 
There is so much compassion for this heart-mind that dearly loves mindfulness, not just for stress reduction, but for the deep and profound ways the teachings have changed and healed my life. Of course I am passionate about this! I just need to remember that is not the medicine for everyone. Or, the package it comes in, the way that it’s offered may not work for everyone.
 
As much as I enjoy and am committed to Western medicine for its miracles and healing opportunities, it does not always integrate body, mind and spirit the way meditation and writing do. I understand why it feels like a part of my healing energy, my creative spirit stagnates when it doesn’t flow the way I envisioned it would.
 
Life is asking me to be on the lookout for joy and wonder like a toddler delighting in summer bubbles and butterflies. Life is also asking me to get curious, to be patient, to delight in the care received from others and be on the lookout for opportunities to extend care to others. 
 
Having a distinct vision for joy, wonder, and care is not wrong. It’s the attachment for things to be a certain way that causes suffering. It’s the limiting beliefs that cause distress. Anything short or different from The Vision is a failure, not good enough, all my fault.
 
 
Letting Go (inspired by Tissa ~ Third)
 
Why stay here
in your little 
world?
 
If you really
want to be happy,
make 
every
moment,
a moment of care.
 
Open your mind.
Let go of limiting thoughts.
 
Then meet each moment
with curiosity and wonder.
 
 
May we all let go of life patterns that cause suffering. May we let go into life’s mysterious unfolding.
May we be on the lookout for joy, wonder and care in each moment.
 
(Please share information about this class with anyone interested. As I am learning to let go, I can still advertise😉!)

The Dakini Speaks
© Jennifer Welwood

My friends, let’s grow up.
Let’s stop pretending we don’t know the deal here.
Or if we truly haven’t noticed, let’s wake up and notice.
Look: Everything that can be lost, will be lost.
It’s simple — how could we have missed it for so long?
Let’s grieve our losses fully, like ripe human beings,
But please, let’s not be so shocked by them.
Let’s not act so betrayed,
As though life had broken her secret promise to us.
Impermanence is life’s only promise to us,
And she keeps it with ruthless impeccability.
To a child she seems cruel, but she is only wild,
And her compassion exquisitely precise:
Brilliantly penetrating, luminous with truth,
She strips away the unreal to show us the real.
This is the true ride — let’s give ourselves to it!
Let’s stop making deals for a safe passage:
There isn’t one anyway, and the cost is too high.
We are not children anymore.
The true human adult gives everything for what cannot be lost.
Let’s dance the wild dance of no hope!
 

 
When I first heard this poem some years ago, it sounded bleak. Dance the wild dance of no hope? With a passion for beauty, creativity, singing, dancing, and music, I simply could not relate. I also couldn’t resolve the spiritual and creative parts of me that sometimes felt as odds with one another. Dhamma retreats that involved sitting, walking meditation, then more sitting and walking mediation for hours and days on end felt dry, as if something were missing. (Maybe this is why I insist on writing, sometimes singing and dancing on silent retreats when no one is looking or listening.)

Now, change and uncertainty have taken center stage. The Dakini speaks, and I am listening. Have I truly missed the deal here? I’m starting to wake up and notice. For me, uncertainty is so unsettling because of my patterns of control. Though I’ve told others this pandemic is not a sprint, but a marathon, I find myself at many imaginary finish lines hoping the race is over.

I want to travel, eat at my favorite restaurants, go on retreat, get together with family and friends, see patients in person, have my hair cut and colored, and not virtually! And I recognize these are minor inconveniences to have, as many others are suffering in real and devastating ways.

So how can I not act so shocked and grieve certain losses fully like a ripe human being? It helps to acknowledge these “losses” with honesty, without spiritually bypassing the true feelings of impatience, anger, sadness, fear, and overwhelm that may be present. The ripeness includes a clear, wise mind asking, “What’s happening now?” and a spacious, compassionate heart asking, “How am I relating to this?”

It’s important for me to remember that this practice is not perfect. Judgements and resistance still arise. All my habitual patterns of control (blaming others, blaming myself, food and retail therapy, meticulously cleaning, strategically planning) are implemented one after the other in the name of protecting the self. And so many things influence the fight-flight-freeze reaction and the tend and befriend response: physical, emotional, economic stability, practice history, etc.

Most days, I find that I am somewhere in between both physiologic processes. A quivering belly, rapid heart rate, and tense muscles are met with earth connection, warm breath, and fluid understanding of not acting so betrayed. Impermanence is life’s only promise, so what COVID-19 is teaching me is not new. I was just in denial.

Just as Toto pulled back the curtain to the great Wizard of Oz revealing an ordinary man, can I strip away the unreal and live with the real, giving myself completely to this one true ride? I’m tired of making deals for a safe passage. If there isn’t one, and the cost is too high, what does it mean to dance the wild dance of no hope? If there is no ground, what can I stand with, stand for?

I don’t have perfect, complete answers to these questions. Like many of you reading this, I’m still sensing my way into ‘answers’, trying to be as patient, honest, compassionate, and open as I can be along the way. Two words, concepts arising in meditation and life practice over the last few days are wholeness and goodness. Despite feeling broken, imperfect, and disconnected at times, I recognize that my purpose as a physician, meditation/movement practitioner, parent, and writer is not to cure everyone, but tap into an energy of healing that happens whenever the heart-mind is truly present and listening. And goodness isn’t a Pollyannish ignorance of the severe and overwhelming destruction caused by this pandemic, but stories of care I’m seeing, experiencing, and hearing about each day.

If impermanence is life’s only promise, then let my response be wholeness, goodness, and care, knowing that it is imperfect. What will your response be?
​
As you sit, stand, walk, and lie down with this ground of uncertainty, what is still true for you? The Buddha said, “Hatred does not cease by hatred, but only by love; this is the eternal rule.” May you connect with what is still true for you. May this guide you, support you, nourish you in the days and weeks to come.

(This post was inspired by Sebene Selassie, Sharon Salzberg, and Vesak.)

​It’s not going to happen to me. It happens to older people, people with end stage cancer, daredevils who take risks. The tears I’ve been shedding these past few weeks are for other people who have died from COVID-19 complications, others who are affected socially, emotionally, economically, and physically by this pandemic. Not me.

A few days before my birthday, I started to feel pain in the chest wall. A slight tickle in the throat foreshadowed an ominous cough. But without shortness of breath and a fever, I wondered if this was anxiety or the beginnings of a diagnosis the whole world is keen to keep at bay. Were all those tears for others, or were some to help water seeds of understanding for this life?

With years of mindfulness practice and contemplations of impermanence, one would think I’ve considered the possibility of dying. I’m embarrassed to say that this heart-mind lives in a protective bubble of delusion. Even when my aunt, who was like a mother to me died from a poorly differentiated unnamed cancer six years ago, I still didn’t believe it could happen to me.

Till now. This virus has an eerie way threatening everything. A regular day at work in the outpatient setting with business casual clothing is now replaced with scrubs, tennis shoes, and sometimes full HAZMAT ensemble. A casual trip to the grocery store requires gloves, a mask, hand sanitizer, six feet between patrons, and timing to avoid long lines. Walks in the neighborhood on a sunny spring day feel strangely quiet, as if the outside air will kill on contact.  Zoom has become the virtual safe space where it’s all happening.

As physicians, we dance with illness and wellbeing on a regular basis. We even have end of life discussions with particular patients where prolonging life may sacrifice quality of life and personal wishes. But how often do we contemplate our own mortality?

What’s happening locally and globally is tenderizing this heart- mind like never before. There is a visceral (as opposed to cognitive) understanding that I will not live forever. This body may one day become immune to Covid- 19, but it cannot escape death as it’s natural end.

If you knew that your time on earth is limited, who or what would really matter? Would it be the white hairs showing through darker ones on video visits or zoom calls, or a heightened sense of touch from loved ones sheltering at home with you? Would you still answer “fine” to all the questions from colleagues, family and friends on how you are doing, or would you pause and follow the question to see where it leads?

I believe we have a responsibility to contemplate our own mortality, or at least begin to ask the hard questions. Our patients are facing the fear of sickness and death daily, hourly, every second, in every question asked and every look of a brewing storm just below the surface of feigned tranquility.

How do we find a middle way between anxious overwhelm and blatant denial? Perhaps it starts with opening to what is here, one slow breath, one small step at a time, not trying to predict an unknown future or take shelter in a past that no longer exists. When distracted by thoughts of wishing it were different or that you were elsewhere, the gentle invitation is to return to the present moment with as much kindness, and as little judgment as possible, to notice what’s happening inside your body and heart.  If the present moment is too triggering or overwhelming, it’s skillful to open in baby steps with lots of support.

The energy and effort required for this practice are not the same as striving for good grades, extracurricular activities, and letters of recommendation required for college, medical school, and residencies. You don’t get more points for overperforming. It takes a certain humility and courage to let go of labels, ideas, concepts to touch the bare truth.

Mark Nepo writes, “We waste so much energy trying to cover up who we are when beneath every attitude is the want to be loved, and beneath every anger is a wound to be healed and beneath every sadness is the fear that there will not be enough time.

When we hesitate in being direct, we unknowingly slip something on, some added layer of protection that keeps us from feeling the world, and often that thin covering is the beginning of a loneliness which, if not put down, diminishes our chances of joy.

It’s like wearing gloves every time we touch something, and then, forgetting we chose to put them on, we complain that nothing feels quite real. Our challenge each day is not to get dressed to face the world but to unglove ourselves so that the doorknob feels cold and the car handle feels wet and the kiss goodbye feels like the lips of another being, soft and unrepeatable.”
​
As we slowly unglove our hearts from all the protective armoring, may we skillfully connect with ourselves and each other, honoring the grief and gratitude arising along the way.