The serene smile on his face softens the limp in his gait, the cane transformed from a resented crutch to welcome companion. Hiking with my own SI joints and gluteal muscles on fire, I’m curious how this fellow hiker (at least two to three decades older) can embody such joy and ease in the midst of an imperfect body.

As we approach one another, I pause to find out.
How do you make this look so easy?

His smile widens, his eyes beam against the backdrop of the sun’s radiance. Flanked on either side by guardian coast live oak and madrone trees, the scent of forest infusing the air between us, I sense that I am in the presence of a mysterious messenger.

I just keep walking till I can walk no more.

****
​
Do you have any meditation and writing classes going on? I’m really struggling with several things.

The tone of her email concerns me, as if she is barely hanging on by a thread, searching for a lifeline to strengthen her tenuous connection to what matters most.

As we begin the mindfulness consult, I can tell she is testing the waters. Will she drown in the revelation of her story, her tears, or will the exchange offer some insight to guide her back to safe harbors?

Nearing the end of our session, she is very clear about what would be helpful in a guided meditation.

In addition to recognizing, allowing, and investigating the uncomfortable thoughts, feelings, and sensations, I need to remember gratitude, joy, and trust my capacity to be with this.

****

I stopped the Ultram, doc. It just caused constipation, and didn’t do anything for my knee pain.

The patient proceeds to share what he is learning after a few sessions of physical therapy. And suddenly, there’s a clarity that could not have come any sooner till now, because the ignorance of separation was always clouding my perception.

Can I watch you walk from this chair to the door and back?

Like an infant curious to explore a new dimension of movement, he rises slowly from the chair without his cane. Placing the right foot forward, he leads with the trusted leg, and pauses. I sense the anticipatory anxiety, the concentration, the yearning to heal as he lifts the left leg and places the left heel on the ground, doing his best not to let the left knee buckle under him.
​
I feel like a proud parent watching her child take those precious, memorable first steps. As if the patient can read my mind, he grins and ambulates to the best of his ability.

Baby steps, doc. Baby steps.

****

The resistance and resentment I’ve carried for years against chronic pain is slowly starting to dissipate. From the hiker, I’m inspired to keep living, keep persevering till I can walk no more. From the mindfulness consult, I’m learning that this heart-mind-body can open to unpleasant circumstances with compassion, patience, and trust, balancing the scale weighed down by difficulties with appreciation and joy for what often gets overlooked. From the patient, I’m motivated to take bold baby steps in the midst of burning pain without needing to be a strenuous hiker or yoga practitioner who can perform all poses perfectly.

Be on the lookout for mysterious messengers in your life. They are what make this life worth living, and the learning never stops…

​In meditation, it's possible to let the limiting sense of self settle, and allow the larger space of self to emerge.
​

​Pain can be a pathway to suffering, or a poetic prescription for healing.

Restlessness, Metta, and True Nature

There’s a restlessness inside me--
checking the phone, the weather
checking for missed emails, calls, texts.
Am I ok as I am?
Are others ok because of me?
When did the external funhouse
mirrors get so distorted?
When did abandonment
become the only story?

May I be patient with anxiety and restlessness,
and trust something precious beyond this.

A few Winecup clarkias stand out
amidst Pacific poison oak.
Beautiful growth is possible anywhere.
The trill of a red-winged blackbird
invites joyful sound meditation.
Magnetic Mama Earth guides footsteps
to avoid stepping on western
whiptails activated by amygdalas.
So I’m not the only one!
A summer breeze blows
the breath inside out.

Am I ok?
​
There is no one left to answer…


No Timeline for Love

I don’t need to fill my heart completely 
before I can show you love.
I just need to see the thorn,
feel the sharp point against softness,
wrap the wound in tenderness
as scar tissue learns to love
in its own healing time.


Soon

These days of cutting okra and long
beans together will soon be over--
hearing knives slice through dark
green flesh at different rhythms,
watching the way your air pods
hang from your ears
as a slight smile crosses your lips,
wondering what you’re listening to
and if you’ll still like that song in college,
or who you will choose to love.

Or the way I turn to you
with partially cut vegetables
that you will chop into smaller pieces
the way your mother did back in India,
breaking down larger pieces of life,
seasoning with spices and cooking slowly
into food the family can easily digest
until arthritic hands can no longer chop
or vision fades into final darkness.
​
Soon all I will have are these words,
and memories of three generations
cutting okra and long beans
side by side by side.
What used to seem so mundane
now feels like sacred ground.
Please help me to be here!
Soon we will all be gone.


Emptiness

emptiness
is fullness
still healing
till she can let go
completely


Receiving
​
everything
is a gift
unwrapped slowly
by your perception

For years I've gone on retreat, escaping family and home to find freedom. Little did I realize that freedom can be found within my own home, that refuge in a Brahmavihara happens wherever, whenever the heart is willing to feel, and surround all experience in its embrace.

Deep gratitude to Brian Lesage and Sangha for this sacred, unique, configuration, to family and friends for being there with food, hugs, kisses, laughter, and conversation when needed, to colleagues for covering my time off from work, and patients for trusting this practice to widen/deepen my understanding of compassionate care.

The sound of bristles against gums and bone.
Water cascading from the faucet and gurgling in my mouth.
Mint flavored tooth paste awakening taste buds
as soles of the feet plug into Mama Earth.

This is enough entertainment--
a simple sense opening of gratitude
for teeth that masticate complex textures
into bite sized bits I can swallow.
 
When there is mindful presence for simple things like brushing my teeth, life is more manageable. It’s so much easier to unitask than multitask when there is appreciation for the task at hand.

There are teachings on liberation called disenchantment (nibbida) and dispassion (viraga). If I can see the ways in which I’m caught in certain traps of dissatisfaction, there’s hope in slowly letting go without sustaining rope burn.

I can’t force or will myself to let go. I need to understand the stories I’m believing, the enchantment of the false refuge. What does it offer? Is it lasting? I also need to trust that relinquishing it will offer something more satisfying in its place.

Let’s take the number of times I check my phone in a day. Why? As I investigate all the reasons— for connection, comfort, safety, information, entertainment, and wellbeing, I wonder what would happen if I checked it less often.

Could this moment give me what I have been chasing elsewhere? Could it offer something more precious?

“It’s the simple things in life that are the most extraordinary.” (Paulo Coelho)
​
May an embodied understanding of this truth be realized a bit more each day.

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!

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 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😉!)