​On a walk at Calaveras Big Trees National Park, the park ranger paused to pay homage to two giant sequoias that shared the same trunk. The trunks were originally separate, and fused together after a fire for mutual benefit and survival.

I thought of my mother and daughter, how the umbilical connection was severed between us at birth, how the sacral, sacred burning in my body was a sign.

I reflected on all the beings I have pushed away on this camping trip and beyond, the yearning to share the same base, something tender beyond ideas of a separate self.

In meditation, the image of the conjoined sequoias arose, inspiring metta for my teachers, for me, for my mother and daughter, for all the beings at camp, and beyond. It wasn’t my body-heart-mind responsible for such vivid and vast imagination, but tapping into a larger, loving life force inherent in all things.

Listening to the bell resound at the end of the sit, I was clinging- to the bell, the sequoias, the feeling, fearful that I would walk back into a black and white world where beings scurried frantically around like mice to make meaning.

I will continue to disagree with others and feel the pain of separation. I will also persevere in tenderness, beauty, and Soulmaking.

It’s what I was born to ‘do’, and who i already am.

(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.

Suffering does not occur in a vacuum. It always occurs in relation. The patient who comes in with chest pain and high blood pressure because a beloved relative died of COVID complications in India and they cannot grieve or participate in last ritual rites with family. The patient who expresses grave concern for their son’s safety in returning to work during a pandemic, policing, and protests. The friend who practices medicine in a part of the United States where political division is threatening peace. The Earth still offering oxygen and sustenance despite continued abuse and neglect.

Healing also occurs in relation. It’s hard to heal if there is a sense of disconnection from ancestors, biological and spiritual family/teachers, the land, each other, and ourselves. How do we re-connect, re-awaken, re-member? While healing is a journey and there is no perfect answer, the following practices are offered as possible places to begin the contemplation.

Embodying Kuan Yin

Kuan Yin is the bodhisattva of compassion, the One who listens to the cries of the world. Embodying her feels like a tall order sometimes. How can I listen to others if I can’t hear what’s happening within? Life is overwhelming and overscheduled. How can I unplug from the endless to do and to be list?

I’m learning that Kuan Yin is not only the One who listens to the cries of the world, but also the One who stays till there is ease. There’s a sincere commitment to listening, to staying with the experience for the purpose of understanding. This does not mean that pain disappears, what’s broken is easily fixed, or questions have clear answers. The ease feels like a deep stillness beneath surface waves of experience, a stillness that patiently waits for the waves to dissipate for clarity. As I learn to stay with personally challenging experiences, there is more capacity to be with the suffering in others.

Connecting with the Natural World

1. Find something from the natural world inside or outside of your home. This might be a leaf, a rock, a seashell, a piece of fruit, a grain or rice, a feather, etc.
2. Practice internal mindfulness by noticing what’s present in breath and body with eyes closed for a few minutes. Then slowly open your eyes and practice external mindfulness in relational with this object. How are you different than the object, how are you the same?
3. Then with reverence and humility, listen to what the object has to tell you. What does it have to teach you?

 
Here is poem written on retreat in relation with a seashell:
 
Listening
 
she picked you up from the wet sand
because you looked pretty,
her keepsake from the RV camping
trip off the Mendocino Coast
 
forgetting
you were once the home
of a precious sea-being
just as her body is her home,
 
how she wouldn’t want
to be taken without consent,
how next time she can ask the water
or lift you up to her ear--
 
your mollusk spirit whispering
home is always sacred
no matter how small
or large you are
 
The Five Earth Touchings

Touching the Earth is a practice developed by Thich Nhat Hahn to fill your heart with remembrance of family, spiritual, and land lineage, so blessings of abundance can be offered to those you love, and the process of forgiving those who have hurt you may begin. It is practiced ‘to celebrate the positive and transform what needs to be transformed’.
​
This practice may precipitate unwelcome, unpleasant feelings, especially if you have experienced trauma or other feelings of disconnection. It is offered here as a healing modality to practice in a safe space with others, a trusted teacher or therapist. It is not meant to spiritually bypass what is true for you. Please honor your direct experience.
 
Questions for Inquiry

The following questions can be used for reflective journaling:

1. Think of your country(ies) of origin (ethnic roots). Now think of the country where you reside. Is there anything about the history of the country where you reside that needs to be narrated differently or questioned?
2. How can you be in reciprocal relation with life? What does it mean to set an intention of minimizing harm to other beings, the Earth, yourself?

 
****

Deeply nourished by recent retreats, water is humbly offered to trees in the backyard. It’s a small gesture of gratitude compared to their teachings on grounding, rooting regardless of external or internal climate, on letting go with trust that what’s needed will grow in season.

(Deep bows to Erin Treat, Brian Lesage, Amma Thanasanti and Kaira Jewel Lingo for sharing these teachings, and to their teachers and respective lineages. Suffering does not occur in a vacuum. It always occurs in relation. Healing also occurs in relation.)

With the pandemic forcing more families to stay at home, the lines between school, work, and home are blurred with unclear boundaries. I’ve talked with patients, extended family, and friends who are struggling to maintain decent communication in closed quarters where most of life is happening these days. The internal aversion is also exacerbated by unhealthy air quality from raging California fires, limiting outdoor activity and escape.

For the first few months of travel limitations and social distancing, I felt that I was doing OK, even celebrating the sweet connections to my family. After an RV trip where we are all in even tighter quarters than at home, rubbing up against each other with every movement, something inside me snapped. Was it perimenopausal mood fluctuations, past patterns finally catching up with me, other causes and conditions? Do the reasons even matter?
 
Patience

Opening to what’s happening in the relational field requires so much patience. I love my family dearly, but I’m not always going to like them, especially when we disagree. The nature of life is change. There is nothing new about this concept. We are not fixed beings, but processes doing our best to acclimate to external forces. And everyone has their own way of adjusting.

Pausing and taking a few deep breaths before speaking or acting can make a difference between clarifying connection or disastrous disconnection. I recently listened to a podcast outlining a four-step approach to communication designed to increase clarity, minimize miscommunication, honor each person’s individuality, and build a shared sense of trust and respect for long-term success. Remembering intentions for healthy relationships, I was grateful to implement the practice a few times in conversation.

Patience is not about getting my way or forcing a certain outcome. It’s gently engaging eye contact, using words as windows instead of weapons, and awareness of body language internally and externally.
 
Presence

Close relationships can often lead to perceived nuclear fallouts when monkey mind is active. It’s so easy to get triggered by past hurt with an overlay of old scenes coloring what’s actually happening. It’s also tempting to stay focused on thoughts like train schedules flashing in the mind, constantly rechecking details for the future in case I miss the train.

How can I trust the present moment as it’s playing out, especially when I’m conditioned to fight, flee or freeze when it’s uncomfortable based on the thoughts and feelings arising? Present moment awareness is all about dropping below the story line, below the cranium to feel the story as sensations in the body, connecting with whatever I am sitting, standing, walking, or lying down on as gravity reminds me to let go of everything but this moment. Beginner’s mind is all about a certain innocence and curiosity for the moment rather than prematurely predicting an ill-fated outcome.

So how do I transform monkey mind to beginner’s mind when conditioning is strong? I keep coming back to the practice of mindfulness or sati, returning again and again to the breath (or other meditation anchor) to remember. I could be lost for seconds, hours, days, even years, and presence is like a breath of benevolence. It doesn’t judge or ask why I left, why I don’t feel safe, why I feel the way I do. It simply opens the door, no questions asked, with an enthusiastic and heartfelt Welcome home! I’ve missed you.
 
Possibilities

2020 is certainly a year of much distress and heartache for many. And I need to remember that this suffering is not new. Our ancestors have faced such trials and tribulations, and so will our children. There is no escape from sickness, aging, and death, or the dissatisfaction that arises in response to it. While grief is a guarantee to all who live, so is gratitude. If everything is in a state of flux, then I must bring a sense of blessing to that change through heart practices like the Brahmaviharas.

Yesterday, I had the opportunity to practice metta with Ayya Anandabodhi. I’ve learned metta as a traditional Burmese practice of silently and systematically repeating phrases of goodwill towards myself, a benefactor, dear friend, neutral person, and difficult person. Ayya Anandabodhi led a guided metta meditation that revealed the radiant, unconditional, boundless qualities of metta. I began by visualizing and lighting a diya inside the heart, breathing into it to fuel the flame of love. With each outbreath, I was invited to send that sacred flame of metta above me, below me, around and everywhere, allowing it to spread in all directions. If specific beings arose as natural recipients, that was fine. If not, that was fine, too. There were no ‘shoulds’, no comparing to past practices, no predictions for the future, just one woman’s heart feeling more expansive and free from conceptualization than ever before. I remembered my own goodness and the capacity to hold distress in loving arms.

When I don’t resonate with a family member, can I also remember their goodness? It helps to reflect on the times when I have felt connected, and all the things I appreciate about them. Relationships are not easy. They are complex and rather messy. They can also be exquisitely tender and redeeming, growing the heart to hold beauty and terror in the same loving space.
​
Writing this does not guarantee safe passage for future encounters. It does provide a template for embodied understanding and growth. I am still learning…

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

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

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

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

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

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

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

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

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

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

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

 
****
 

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

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


****


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

Bubbles and Butterflies by Shirley Reede

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

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

I’m surprised by the negative polarization against police officers after the death of George Floyd, and so many others. Don’t get me wrong. There are many overwhelming emotions moving though this heart-mind as they may be for you (anger bordering on rage, unspeakable fear, deep disappointment and hurt to name a few). Unnecessary violence masked in innocence, fueled by ignorance and implicit bias is never a good thing.

I can’t just point my finger at all the cases of police brutality. This may sound crazy, but the folks I find myself practicing Tonglen for first are police officers Derek Chauvin, J. Alexander Kueng, Thomas Lane, Tou Thao, and other officers, as well as George Floyd and others meeting death in savage, inhumane ways. How on earth did these officers think that what they were doing was OK, “equally” protecting the lives of all citizens? How are we as a society (you and I) contributing to macro and micro acts of violence on a smaller scale in the places we hold power?

I want to remember that not all police officers are like those who are getting the greatest publicity right now, that there are those who have deep respect and reverence for African American lives. And, this is also a wake-up call for more training and awareness, not just for the “guilty” officers, but for us all. As you are moved to demonstrate the yang of fierce compassion in whatever way you feel is right, please be a contemplative warrior for meaningful change looking at the 3 fingers pointing back at you when it’s so easy to place blame elsewhere.
​
Here is one way you might consider growing in awareness, making an intentional shift from racial innocence and distress to racial literacy and harmony within community.

It needs the right temperature to bloom 
To open to its surroundings 
In full disclosure without apology 
For the time it took to recognize 
It’s power and purpose 
For the time it took to grow
​
I used to think there were only 
Two realities for this lotus heart--
Stuck in the mud of suffering
Or fully open to the sun
And never contemplated 
The possibility of still blooming


After reading an article from The Mindful Self-compassion February newsletter, I was struck by these words:

“And so, for today, I practice self-compassion by congratulating myself on how far I have come – and I refuse to beat myself up over how far I have yet to go.”

How often do I hold myself to a higher standard, some ideal that’s hard to perfect?  If I’m stuck in the mud of suffering, I must have done something wrong. I forget that causes and conditions affect certain outcomes that are beyond my control. And if I’m in full bloom, radiant and joyfully open to the sun, there is a subtle expectation that it must always be this way. No other version is worth acknowledging.

As I was having dinner with a dear friend this week, she pointed to the jasmine bud in my teacup. I stopped paying attention to it after pictures were taken and we were savoring dinner and sweet conversation. “Look. It’s still blooming!”

It’s helpful to remember that just as the jasmine tea bud needs the optimal temperature to bloom, so does this heart-mind. It takes time to understand each moment and what it requires. There are times when skillful speech and action are the norm, and times when I’m triggered by old patterns. To open to my surroundings in full disclosure without apology, to feel power and purpose at the core of my being, I need to remember there are more than two realities.

I am not a static being, but forever changing. There is forgiveness for forgetting that I am still blooming.