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.

​cobalt violet sunrise
over the bay
infusing the heart
with a quiet joy
priming it to meet
the day’s suffering
with peaceful presence
reflecting back hope
when sunrises
are forgotten

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…

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😉!)

​​Whether you are caring for patients, clients, family, pets, others, the Earth, take some time in silence to recharge and connect with your deepest intentions for being alive. You are not an unlimited resource. Thank you for your care.

​

​Dear Healthcare Workers,

Change is inevitable. With the current pandemic, change at work (and elsewhere) is likely faster than you ever expected. How can you meet these moment to moment changes, acknowledging the thoughts and true feelings underneath them? How can you remember the body that is holding so much right now? Who or what can you count on in challenging times? What does connection, collaboration, and self-care mean to care for others?

If these questions resonate, then perhaps you will find this guided mindfulness meditation for healthcare workers useful.

Thank you for caring!
​

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.