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.

As a front-line family physician, I’m used to offering compassionate care to patients, and listening to the care team at work. I’m used to holding space for meditation and reflective journaling classes, supporting family and friends in ways that feel wholesome.

And sometimes it’s overwhelming. With the recent pandemic, the constant barrage of news, work email updates, protocols constantly changing, and questions, there has been little time to contemplate what’s happening within.

This body is also in greater pain than normal. After several months of physical wellbeing with PT and engaging in movement practices I love (yoga, hiking, walking, Qigong), the body has decided to speak (scream at times). I’m sure it’s contributing to the overwhelm with fear eclipsing the things I usually see and remember.

Over the years, I’ve cultivated a strong lovingkindness and compassion practice to face challenges. But somewhere along the way, I’ve forgotten to pause for fifteen seconds six times a day to really let joy’s sunlight reach all the dark places within me. To help me remember, I joined an Awakening Joy course.

For a few days I was diligent with the practice, opening like a sunflower to moments of gratitude throughout the day. The pain in the sacroiliac joints and gluteal muscles was improving. Yeah, I thought. I’m on the right path!
Then the body screamed. I’m doing the PT daily. I’m trying to take it easy physically. Where am I going wrong??? In a state of despair and overflowing tears, I reached out to people who could help me remember what I was forgetting. The incoming texts/emails of care and support definitely helped me to remember a few things.

1.) I must put my own oxygen mask on first before I can take on the suffering of others. This means meeting my own suffering with compassionate care and asking, What’s needed now? I’m not always in a quite space to listen, so it’s important to take this time when possible, pencil in an appointment for myself, like I did this morning. 

2.) S.O.S.  I heard this acronym through a prerecorded webinar my work offered titled “Managing the Unknown”. When you notice that you are on information overload, and the brain, body and heart cannot take any more, STOP what you are doing. Stop clicking on more news links online, more email. Stop engaging in conversation that is echoing doomsday. Stop immersing yourself in more secondary trauma. OBSERVE the thoughts and feelings within with kindness. If that’s hard, imagine a kind, supportive being/presence with you. Stay here as long as you need to really listen internally. SWITCH to something that is positive and nourishing – a cup of tea, a conversation with a friend, music, a walk, journaling, humor, etc. (I’ve also heard this as  S.T.O.P.: Stop. Take a breath.  Observe thoughts and feelings. Proceed with something nourishing. 

3.) Stay informed so that you have the latest information from the CDC, WHO, your local state, county, and health care professionals AND ask yourself what else you need to hear so that the scales are balanced. It’s easy to listen to statistics, worsening conditions, and conversations around you that accentuate the negative. What do you need to hear that’s positive? Where can you find this? It might be an inspiring quote, book, movie, song, story, prayer, etc. If you are having a hard time looking, ask others! Try this one on:

"My friends, do not lose heart. We were made for these times. Ours is not the task of fixing the entire world all at once, but of stretching out to mend the part of the world that is within our reach. Any small, calm thing that one soul can do to help another soul, to assist some portion of this poor suffering world will help immensely. It is not given to us to know which acts or by whom, will cause the critical mass to tip toward an enduring good. One of the most calming and powerful actions you can do to intervene in a stormy world is to stand up and show your soul.”  
-Clarissa Pinkola Estes, Jungian psychoanalyst, author of Women Who Run with the Wolves. 

4.) Which brings me to my next point. Be a calm presence where you can be. Today I had the opportunity to speak with a relative overseas, a local business owner, and a stranger while shopping for groceries. The questions that used to sound like massive missiles attacking were surprisingly welcome. The conversations included some of what I am sharing here. If staying calm is not possible (it’s not expected, even for me), then can you be generous in other ways? Can you call someone who is currently quarantined, or check on them in other ways that do not place yourself at risk? Do you have an extra toilet roll, hand sanitizer, can of food that you’re saving for The Apocalypse? Do you know of neighbor you can share this with, someone who is restricted financially, physically, or by some other means?  Generosity cultivates abundance of heart and mind, widens survival of the fittest perspective into one of interdependence. Just be sure to wash your hands thoroughly with soap and water for at least 20 seconds, and don’t share if you’re sick.

5.) Impermanent/Imperfect/Impersonal. Physical pain and global pandemics can feel permanent, imperfect, and personal. It sure feels perpetual, messy, and personal to me right now. But if I take a closer look, there are moments when the body isn’t raging, even parts that feel neutral or pleasant. There are times when corona virus is not the main news infecting body, mind, heart, and spirit. It was not the main news when I dropped my daughter off or picked her up from school, on a mini retreat this morning in sitting and walking meditation, while brushing my teeth or taking a shower. 

It can also help to remember that others are affected by what’s happening, just as you are. Knowing that so many lives have been affected, what can you keep doing regularly to maintain some sense of normalcy? (If you or someone you know has been significantly harmed physically, emotionally, financially, etc. please grieve the way that you need to. ‘Normalcy’ may be the last thing you need to hear/read.) Maybe it’s the way you comb your hair, brush your teeth, sip morning coffee or tea, go for a walk/run, meditate, eat, work, hug/kiss healthy family members, sing, dance, or any number of things you normally do (and are still doing:) Though change is inevitable, it’s healthy to maintain contact with who/what is familiar. It can nurture a sense of safety in times like this.
 
 
 
surrender
to a beating heart
an unsettled belly
a hand on each one
just sensing
just breathing
prana providing companionship
through every future unknown
 
 
This post is not written to negate the true feelings that are here: fear, anger, loneliness, despair, etc. It isn’t a spiritual bypass to a happier place untouched by illness or suffering. (If you know of such a place, let me know!). I needed to sit with all the paralyzing thoughts, feelings, and physical manifestations of them. I will likely be sitting with them for some time. Surrendering to a beating heart and unsettled belly, I placed a hand on each one, just sensing, just breathing, prana providing the companionship that was so desperately needed. I know that this simple act is not enough to heal the world, but it is certainly “mending the part of the world that is within my reach” through every future unknown.
 
May these reflections be of benefit to all beings everywhere without exception.

​​Woke up with a pounding headache
Stayed up late last night
Come sit on the zafu
With everything as it is
Thoughts chasing the future
Replaying the past
It’s always better somewhere else
Or is it
Belly tensing against today
What do I need to do
What will the weather be like
Should have stayed asleep
For a better meditation
Waking up later
To practice again
It’s ok sweetheart
Welcome home
Just as you are
Finding the breath as ally
Soothing the body
Gathering swirling thoughts
Collecting them as mementos
For the heart to hold
Getting quiet
Sitting like a mountain
Unmoved by the weather outside
Breathing in oxygen
Breathing out carbon dioxide
Symbiosis with trees
Appreciation
Breathing in his suffering
Breathing out compassion
Breathing in her struggles
Breathing out support
Breathing in their confusion
Breathing out understanding
Breathing in the joy
Of this practice
Breathing out the wish
May others experience this too