If you could only take a few people, a few things with you on a long trip, who or what would you take? I’m not talking about some exotic trip away from home, but the trip that you live every day from the moment your eyes open to the minute you fall asleep, and the cycle you repeat each day till you breathe your last breath.

What really matters to you? Who or what do you trust to carry you to the destination you seek? Do you travel with rigidity, considering the journey a failure if you don’t land where expected? Or do you course correct with wisdom and still love yourself when you miss the mark?

I’ve contemplated these questions for some time. Blown around by the eight worldly winds: pleasure/pain, gain/loss, success/failure, praise/blame, I’m tired of packing people and things along for the ride that shake things up unnecessarily without purpose.

 
El Capitan

sitting like a mountain
massive in this moment
no thoughts can blow me away

 
So I made a list of what supports faith in the journey, and what hinders it.
​

Supports to Faith:

- meditation (simple healing breath, heart-mind framing each moment in wisdom and care)
-pausing, waiting for what’s shaken up to settle so that speech, action can be more skillful
-Dhamma mentoring, classes, retreats, talks
-spiritual friends who mirror my True Nature
-family and patient challenges reminding me of Bodhisattva vow (on your way enlightenment, will you take us with you?)
-seeing how I’ve met challenging situations before, inspires trust that I can do it again
-Nature, unconditional loving Mother who nurtures calm, beauty, patience, wisdom, understanding, and trust
-writing strengthens the whispers of inner champion who takes inner critics’s concerns and transforms them into healing, wise words
-inspiration from music, movies, reading
-heart connections with family, friends, patients, clients, strangers
-embodied, grounded presence
-deleting Facebook account (cultivating contentment, simplicity over comparing mind, creating space in my calendar, my life)…ok, so I’m back on Facebook, and I need to remember aspiration over expectation
 
 
Hindrances to Faith:
 
-physical, emotional pain
-losing someone or something dear
-when something breaks, looks unappealing, increases aversion
-disagreement, disconnection with those I am close to
-prolonged exposure to bad news
-relying on astrology for good news, things to look forward to
-scattered, thinking presence
-alarm going off in the middle of a disturbing dream
-too many choices, not trusting the future
 
Practicing with these contemplations this month, I’ve discovered a few things. I can cultivate an unconditional love for this body-heart-mind, no matter how it is feeling. Despite a medical system that requires so many competing components for attention, I can connect with patient stories and not just make it to the end of the day disconnected and depleted. The allure of technology does not need to eclipse the possibility of contentment found in each moment.
 
And, I’m still a being doing her best to course correct with wisdom, still learning to love herself when she misses the mark. May the labyrinth of life allow for a natural spiraling in, then circumambulating out, never knowing if the center is reached and still carrying its intention with each step.
 

The cozy configuration of our family nest during the pandemic is about to change. The news of my in laws coming soon to stay with us for a significant length of time rattles the bones, leaves the nervous system unsettled.
 
It’s tempting to spiritually bypass what’s here, to suppress thoughts, feelings and sensations that aren’t congruent with my partner or rebel against cultural tradition. It’s also easy to blame others for misunderstanding my need for space and silence.
 
The Practice is asking for ease, curiosity, patient benevolence, a reliance on certain support systems, and remembrance of beauty, joy, hidden gifts.
 
Ease
 
Sitting in meditation each day is like relaxing back into my favorite chair or cushion, leaning the weight of my body and worries against a giant redwood tree that knows how to root and endure. The breath makes its loyal sweep from head thoughts to heart feelings to gut sensations, gathering them all in its tender embrace, unifying the pieces into one collective, sacred experience.
 
Curiosity
 
From this grounded place, questions about perception are asked without expectation of an exact or perfect answer. What’s happening now? Who am I taking myself to be? How am I relating to others? To space? To time?
 
Patient Benevolence 
 
Once I have attended to my own authentic inner experience in an honest, compassionate way, I can begin to let others in, to get curious and ask about their experience, to sense the multidimensional aspect of relationships and vast space of the Brahmaviharas. Love is not a limited resource trapped inside my own heart. It can flow both ways...towards myself and others. 
 
May I be happy, as well and safe as I can be, peaceful and at ease.
I care about my suffering.
May I know joy.
May I trust in the mysterious unfolding of my life.
 
May you be happy, as well and safe as you can be, peaceful and at ease.
May you care about your suffering.
May you know joy.
May you trust in the mysterious unfolding of your life.
 
 
May we be happy, as well and safe as we can be, peaceful and at ease.
May we care about our suffering.
May we know joy.
May we trust in the mysterious unfolding of our lives.
 
The term ‘patient’ benevolence helps to remind me that there is no fixed timeline for this process, no need to get anywhere, become anyone too quickly if it doesn’t feel like an embodied experience. Rushing the process can cause more harm.
 
Reliance on Certain Support Systems
 
It’s so easy for me to let anxiety and aversion eclipse the whole truth of any given moment. Sometimes I miss sweet family connections, opportunities for beauty and joy.
 
When this happens, the skillful, compassionate, and wise move is to lovingly separate from others so I can connect back with myself to remember. (Sati, the Pali word for mindfulness means ‘to remember’). Through meditation, mindful movement, time in nature, reflection and writing, listening to music and singing, I hear that one clear voice calling out for me to listen. I can also reach out to wise ones who offer safe shelter for the nervous system to settle, the bones to rattle less.
 
I need to take things one breath, one step at a time, slowing down so the contraction of time does not scatter my attention in multiple directions to dissipate and waste energy.
 
Remembrance of Beauty, Joy, Hidden Gifts
 
When there is resistance to unpleasant perception, animal instincts of survival kick in. Can I fight? Can I run away? Can I play dead, sleep, and wake up when it’s safe, when it’s all over? 
 
Is it ever truly all over???
 
 Zen Master Setcho Juken said, “Here in the dragon’s jaws: many exquisite jewels.”
 
For me, the jewels of practice have shined in so many ways—the width of loving-kindness, the depth of compassion, the length of joy unmeasured by circumstance, the groundless ground of equanimity that does not crack in any mind-heart-body quake, seeing all parts of myself reflected in other beings, other animals, the Earth, and vice versa, everything mentioned and not mentioned in these words, the unborn, the unheard, the unseen.
 
*****
 
I am ready to welcome my in-laws, welcome all that arises internally and externally with this shift. I am not the same person I was before. My partner, daughter, mother, and in laws are also not the same. I know it will not be perfect, that I may forget what I have learned, written, practiced and embodied over time.
 
When this happens, how blessed I feel to return to these words, this heart-mind, these intentions to embody The Practice as best as I can like Kali, Durga, Lakshmi, Kwan Yin, Tara, a Dakini, a redwood, willow, oak tree, all phases of the moon, a lotus (including muddy, tangled rhizome roots, long stem, and budding blossom), the uterine journey from menarche to menopause, the elemental forces of Nature...the Divine Feminine in all her many moods and manifestations!

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.

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.

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.

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.

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.