​Praying to the porcelain god (not knowing if the Andean gods hear me), I am emptied out from both ends. Have the indigenous ways failed, or am I just not ready to receive their healing potential?

My patient, loyal, husband stands by, watching and waiting for what’s needed next. He doesn’t remind be of the Diamox I could have taken the day before arriving to Cusco, Peru to minimize the effects of altitude sickness like he did. He doesn’t judge the muña tea I drank in cupfuls, believing it would be enough.

Instead, he waits and honors my autonomy. Can you stay up for another hour after the nausea, vomiting, and diarrhea have subsided? Then the Diamox has a chance to stay in your system.

****

We exit the Vista Dome train headed for Auguas Calientes at kilometer 104, the beginning of our two-day Inca trail trek. Filled with trepidation and excitement, so many aversive and awe-inspiring thoughts pass through. I wonder which ones will prevail.
​

​

​Within the first few miles of the trek, it’s clear that this is more than a ‘moderate’ hike as advertised. There are many large, steep stone steps to scale, and it is much warmer than expected.

Feeling wobbly in the legs and as if the heart and lungs will explode beyond my rib cage from the altitude and exertion (despite the Diamox I am now taking, and muña mist I am inhaling while doing earth salutations to Pachamama), there is a desperate attempt to grasp at anything that will inspire perseverance.

At first I chant the Metta Sutta, tuning into the heart’s emotional resonances to soothe aversive thoughts and mistrust in the body. I also imagine others beings near and far championing my efforts at various points along the way.

It works for some time. Until judging, comparing mind returns with a vengeance. Everyone is passing you up, Kaveri. You are the caboose in your group. Even older hikers are more fit than you are!

There needs to be more space beyond the thoughts arising in my head and uncomfortable body sensations. 

Becoming more porous to sounds of flowing water, footfalls and voices from other hikers, appreciating the bright colored gossamer wings of various mariposa species against the lush green backdrop of the Andes mountains, wild orchids gracing the path, and precision of ancient Incan ruins in tune with the seasons, there is less of a self to protect. It still requires some soothing.

I try not to look beyond the steps a few feet in front of me. Just this step. Just this breath. It’s easier trust this moment and the next one if I don’t need to manage the whole journey beyond what I can see and handle.

I hear Pachamama’s voice:

Life can be perceived as a punishment when things go wrong, or a blessing of small and large miracles in each moment. Like weather patterns and moods, perceptions often fluctuate between the two.

And that’s ok.

****

A few days after the body and mind have had a chance to rest and recuperate, I am reminded of some images that visited me before leaving for Peru.

In the first image, a figure of love in the form of the fictional panda character, Stillwater sits tall like a mountain. He asks me to sit next to him and look down into the water he is overlooking. What do you see?

At first all I see are dark, murky swirls with some flashes of a being filled with aversive, doubting thoughts.

When Stillwater asks me to look again, I catch glimpses of a beautiful iridescent heart that appears to extend beyond the water, beyond space and time.

In the second image, there is a magical tree that bears fruit in various shapes and colors. Each being grows from a fruit, nourished by a unique umbilical branch from the same mother tree. No two being are exactly the same, and they can shift into another shape or color.

I humbly bow to this tree for its beauty, meaningfulness, and implications for each being to extend into unfathomable beyonds, beyond the shapes and colors that are limited to a still-life painting.

We are dynamic beings, more than our skin, shape and color. We have a rich inheritance, no matter how we perceive our family tree.

May all beings see and sense in soulful ways that inspire healing and adventure.

The art class is located inside a studio in a small suburban shopping center next to an Indian grocery store. As Rachel and I walk in, we exchange exuberant facial expressions. Instead of a woman in midlife, I feel like a kindergartener about to fingerpaint. Our eyes widen in excitement as we take in the mosaic tiles and beads neatly separated by colors in small bowls at each workstation. Turkish mosaic lamps and candle holders of various designs are on display throughout the room to inspire our imagination.

“Where should we sit?”, I ask Rachel.

“Let’s sit at the edge of the table so we have more room to move around”, she replies.

“Good idea!”

We place our belongings on two chairs facing each other each other near the studio entrance. Taking our seats, Rachel and I introduce ourselves to a couple sitting next to us. We each begin to use a paper template in front of us to map out design ideas before gluing the mosaic tiles onto the glass globe of our respective lamps.

When our instructors indicate that it’s time to transfer the mosaic tiles and beads onto the glass, I panic. My design is ready, but it doesn’t look or feel like the images I had envisioned for the lamp prior to class. I begin to doubt the colors and shapes I’ve chosen and start to compare my design to those of our neighbors and Rachel.

This is not how this class is supposed to unfold!

To make matters worse, I cannot retain the exact design when I start to glue the mosaic pieces onto the glass. It takes gentle effort and patient precision, two things that are not included in our art supplies as my perception of time begins to contract.

“Let’s just get this over with”, my mind silently shouts as my heart sinks. The kindergartner come middle aged woman feels like she’s messing up. I try to remain positive, plastering a smile on my face and making polite conversation with Rachel and the couple next to us. Inside I feel tense but continue to diligently glue each piece into place.

The pieces are crooked with spaces between them, and the larger designs are not symmetrically spaced around the glass globe. A part of me remembers the joy of art as process over art as product, but that part is stifled by the need to finish the product in the studio time remaining.

*****

The next day, I remove the glass globe and try to fill in the spaces with the plaster provided in the take home kit. Mixing the powder with too much water, the plaster is too thin to stick to the glass. Frustrated, I proceed to wash off all the excess runny plaster. In the process, some beads fall off the glass globe.

Ugghh! This shouldn’t be happening.

Ah, but it is!

Who said that? The voice does not return till I walk away from the mess I am making.

Perfection assesses whether someone or something is worthy, worthwhile. It sees in black and white. This is either all good or all bad. Perfection thrives on fear, rigid judgments, restlessness until perfection is achieved. It’s fragmented, believing happiness resides in a limited range of experience. It’s a constant uphill climb, and forever exhausting.

Wholeness invites all aspects of a mosaic experience, understanding the picture is incomplete with any piece left out. It’s patient, allowing mental and bodily formations to communicate, as the heart bathes the experience in whatever wholesome factor is needed for unification. Wholeness perceives above below, around any fixed view to see and sense with soul, to cultivate contentment in all circumstances.

Perfection or wholeness? Where do you want to live, Kaveri? Even this dual reflection is a cause for suffering. Know that you are shaped by both, that each influences the other, and bow to the full range of life experience.

*****

I decide to walk away from the art project, reflecting on the process instead of the final product. Art is very similar to the meditation process. If my attention is tense, tight, narrow, and analytical, I will perceive the experience as unpleasant. If my attention is more relaxed, soft, expansive, and observing in nature, the experience can be neutral, maybe even pleasant.

Ideas of perfection, wholeness, process and product all swirl around in the limited space of my cranium. I take them to the meditation cushion and sit. Like pinballs, they keep bumping up against walls until there is no controller trying to save and define them. Fixed, judgmental attention transforms into relaxed, loving awareness as metta permeates through the entire space.

May I be gentle with the process.
May there be confidence in the beauty of awareness.

Just as the bell punctuates the end of the meditation sit, an insight arises. Beauty is not limited to a final work of art or an artist. It is also inherent in wholesome mind states brought to any artistic or meditative process. Viewed this way, nothing is an ugly mistake. No parts are left out.

Feeling more curious and connected to the Turkish mosaic lamp, I hold it with tenderness, patiently gluing each small bead back on one by one with crazy glue. Giving it another 24 hours to dry, I wait for my partner to help me assemble it when he has time.

What’s the rush?

(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.

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.

​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. 

be gentle, be loving
patient and proud
of the wind and tears
that carved a goddess
from suffering

Kwan Yin’s kindred spirit
is learning to listen
to the cries of the world
and stay till there is ease
as she listens to her own body

the dance of sensations
ok as she is
a caged heart
trusting her wingspan
to fly beyond the bounds
of fear and unmet expectations

she is still exploring
she is still unfinished

(Listen to audio version here)

(If you would like to listen to the audio version of this talk, click on the link above.)
​
​The picture changes. Have you noticed this? People, places, things I’ve loved and wanted to hold on to are no longer the same. Family pictures that we took when my daughter was a baby are different now. She’s no longer a cute little cherub, but a tall, lanky teenager complete with acne and attitude.

The picture of who I wanted to be as a mother was so radically different than who I actually was. Instead of having my shit together and nursing my daughter lovingly, I looked like I hadn’t slept for days, felt irritable all the time, blamed anyone and anything in my way (especially myself), and couldn’t breastfeed beyond about 6 weeks.

For those of you who have ever been first time parents, you know it’s challenging. Even if you haven’t been a parent, anything you take on that is new and unfamiliar can be difficult: adopting a pet, starting a new job or school, caring for an aging family member, losing a job, moving to a new place, a new medical or psychological diagnosis in you or a loved one, and so on.

But stress, discomfort, dis-ease, is not just about meeting moments of difficulty in life. We all face challenges. What makes certain ones more stressful than others? 

2600 years ago, the Buddha had a word for stress. In Pali, the language spoken by the Buddha in India at the time, the word is dukkha. Just living this human life, we know that pain is inevitable.  But the added stress is optional. There’s a saying that illustrates this point well: pain x resistance = stress. If pain is inevitable, then what adds to the stress?

It’s our resistance to what’s happening moment to moment. The desire to hold on to the way my body used to be in less discomfort and able to do certain yoga poses, the aversion to burning, searing, aching, throbbing sensations in my left gluteal muscles, sacroiliac joint and right shoulder, the delusion that none of this should be happening, that I should be able to fix it, that this experience of pain is unique to Moi and no one else has ever felt this way.

What are you currently holding on to in your life? What are you pushing away? How are you daydreaming or misunderstanding a current situation? It may help to place a hand on your heart or a part of the body that is hurting, breathing into any discomfort with as much tenderness and compassion as you can muster. If that feels awkward, then imagine a comforting presence here with you now, breathing with you, understanding you, loving you just as you are. 

With our body’s, our circumstances, the people and things in our lives ‘forever’ rotating through like a slideshow, what can we come to rely on that is real, that will provide some measure of robust comfort when the picture is always changing? How can mindful awareness frame the experience in curiosity, kindness, and remain intimately connected regardless of whether we like, dislike, or believe what we are seeing?

There’s a song that I love from high school called ‘Pictures of You’ by an 80’s band called The Cure. The lyrics start out:

I've been looking so long at these pictures of you
That I almost believe that they're real
I've been living so long with my pictures of you
That I almost believe that the pictures
Are all I can feel
 
I realize now that expectations I had of myself as a new mother, as a person with this current body, even of my daughter as they are now, are all rooted in past or future stories of what could have been, what should have been.

This moment, right here, right now can be so exquisite, unburdened by past blame or future worry. For me, The Cure for stress is to identify more with the picture frame, and not the changing picture. Easier said than done, right? It’s hard to believe this when there are constant messages and advertising of the perfect picture, the perfect body, the perfect life on Facebook, Instagram, the media and beyond.

Mindfulness practice trains us to notice when we are lost in a story that isn’t true, when emotions feel like weather systems that will last forever and are actually changing all the time, when sensations define who we are and don’t need to be taken so personally. 

Learning to identify more with the picture frame, the frame of mindful loving awareness rather than the picture of changing circumstances takes time. If you are fairly new to mindfulness practice, you may uncover thought patterns and old habits you haven’t seen before. Things can feel worse before they feel better.

Know that you aren’t crazy or doing anything wrong. This is completely normal. In firefighting, the term backdraft is used to describe the sudden introduction of air into a fire that has depleted most of the available oxygen in a room or building. Similarly, when you bring attention to patterns of desire, aversion, and delusion, they can initially feel more intense.

This is when it’s helpful to practice with the support of others- a trusted teacher or therapists, wise, loving spiritual community. I’ve also found it useful to bring a spirit of creativity, adventure, and play to these practices. Like learning to cook a dish, play an instrument, grasp a new language, ride a bike, or train yourself in any unfamiliar skill, it can feel so cumbersome if approached with rigidity or expectations of immediate results. Yuck! Who wants to do that?

And, it takes a certain amount of gentle discipline, curiosity, kindness, patience, trust, determination, care, compassion, joy, beauty, resilience, and forgivingness to keep practicing, at least in my recipe book. Your healing journey may need similar or different ingredients. You won’t know till you try, keep showing up, adding a little more of this, taking out a little bit of that.

After 15 years of practice, I still identify with the picture, and sometimes forget about the picture frame. What’s changing is the capacity of this heart-mind to notice sooner, rather than later what’s needed to frame every experience in some aspect of love. It doesn’t matter how long it takes me. What matters most is my willingness to try. I’d like to share a poem that I think speaks to this "Cure for It All" by Julia Fehrenbacher.
 
This life isn’t what I expected. This practice isn’t what I expected. And it’s inspired such a radical honesty in me to try and see things as they are. Nothing more. Nothing less.  Anything else just doesn’t make sense.

Burning gluteal muscles, stabbing shoulders
hives when exposed to heat or stress.
Is it Long COVID or just a coincidence?
I never tested positive, had antibodies before the vaccine.
So easy to give into despair like bleak
landscape after a nuclear explosion,
waiting for something to grow,
to give meaning to this pain.
When the evening news, the internet, work emails
and patient messages all beg for better days,
I turn to gratitude practice for solace.

I’m grateful for physical and osteopathic therapy,
for medications that help ease the pain
when another pandemic surge feels overwhelming.
I’m grateful for family holding me
with humor and household help,
for colleagues and medical staff
as smiling crescent moons
in the darkness of a sobering reality.
I’m grateful for teachers, friends, a practice
inspiring the framing of all phenomena
in beauty, wholeness and healing love.

Covid-19: you think you’re so smart,
the best magic show around with variants
evading immune systems and vaccines.
You can invade, inflame, and injure,
but you cannot insist I believe you.
Let me be a source of healing
first internally then externally--
clear water mirroring a sunrise hope
in others clouded by doubt,
beginning again and again
till their last breath or my own.