Published in Pulse.

(This was first written a few months after my father died on Wednesday, August 30, 2022. It was submitted to a few publications and rejected each time. Perhaps I need to rest it here, invite it back into my own heart, and not seek anyone's approval but my own. May it offer some healing insights for others...)

It’s 1:45pm on an ordinary Wednesday in August.  A time when children returning home from summer day camps are cooling down with orange or berry flavored popsicles. A time when the sun is lazily strolling through a clear blue sky, too warm and weary to move any faster.

It’s a carefree time for most. But not for my brother.

Papa is sitting on the sofa slightly slumped over, his eighty-one-year-old spine yielding like an old, soft coat hanger to the weight of end-stage congestive heart failure, kidney disease and Parkinson’s. His signature salt and pepper beret hangs low over his forehead, covering his eyes.

After a few friends and relatives leave, my brother assumes he is just resting.

Until he moves closer to tap Papa on the shoulder, and Papa completely keels over like a marionette no longer guided by higher hands.

****
​
On Monday, two days before Papa dies, I receive a phone call from him.

“I miss you.”

His voice is magnetic, drawing me out of the embodied, grounded place I’m trying to reach. I hold the memories of this man’s significance in my life at bay; they are visitors I am not ready to confront. Right now, I’m at the gynecologist’s office waiting in an exam room to discuss treatment options for perimenopause. The appointment was rescheduled after I missed the last one visiting him in the hospital.

“I miss you too, Papa.” The response manages to push its way past the conglomerate rock of emotions stuck in my throat.

Seconds later, Dr. M rushes in like a whirlwind, eyes me on the phone, and backs out of the exam room. Clearly my phone call is more important than her services. I’m not sure I agree.

“Papa, I need to go. I’m at the gynecologist’s office. Call you later.”

Tenderness for my own wellbeing, my own healing process pulls me away from the call. Perimenopause is changing my inner landscape so much, that I feel like a foreigner inhabiting a strange body. But the force of guilt is equally strong. My nervous system is flooded with intense feelings, sacroiliac joints burning from prolonged sitting with Papa at the hospital for several hours and at my brother’s place now that he is home on Hospice.
​
Papa is still dying. After several hospitalizations for congestive heart failure, his heart is more susceptible to fatal arrythmias that can only be managed in an acute setting. As much as Papa wishes to prolong his life, quality of life outside of a hospital with loved ones is most important to him.

My thoughts are interrupted by a soft knock on the door. Dr. M reenters the exam room. I guess I’ve decided to stay. It seems like a logical decision, and my heart yearns for more guidance.

As I’m driving home from the appointment, I try to call Papa back. My sister-in-law answers. “He’s sleeping.”

“I’ll try to call him later.”

*****

I work on Tuesday and Wednesday to see a backlog of patients trying to catch up on two years of delayed medical care since the onset of COVID. They’re still afraid of the virus and all its variants, but cancer, complex pain, and confounding mental illnesses are strong competitors. My heart feels even more fragmented trying to meet everyone’s demands. Am I caring for anyone successfully?

The opportunity to call Papa later never comes. I am not there. I don’t get to say goodbye.

“Well, whose fault is that?”, my inner critic chastises. “You’re SO selfish, always putting your needs before others, even the man who raised you like his own daughter. You left your cousin brother alone to face his death. How could you?”

Another voice tiptoes into the conversation. This one feels like it’s coming from an older, wiser place. It might even be ancestral. “Dear One, it’s true you were not physically there in his last moments. You were consciously caring for so many depleted beings. Can you remember the times you were present to care for Papa in meaningful ways?”

I don’t see Papa again until my brother, sister-in-law, and I dress him in traditional white clothing at the funeral home for the final viewing before cremation. His skin is oddly smooth from the effects of funeral makeup, but it can’t hide the slight tension in his jaw, as if he is still objecting to this unsolicited outcome.

Memories that were once conveniently sequestered can no longer be held back. A shy eighteen-month-old girl arriving with her mother from India after her parents separated, trusting a strange man (her maternal uncle) at the airport to embrace her as one of his very own. Frequent trips to Yosemite and other national parks, weekend trips to Golden Gate Park and Ocean Breach in San Francisco where Papa instilled a deep reverence for the natural world and Gandhi’s principle of compassionate action in me. The time when he drove down from San Francisco to Los Angeles in my gap year between college and medical school, because I had contracted tonsillitis with a nasty secondary allergic reaction to the antibiotic, and I had begged him to come.

Flooded with guilt and grief, I question him silently. “Papa, am I worthy of this rite?”

His demeanor conveys neither judgment nor approval.

*****

The choices we make can restore or haunt us. Sometimes it’s not so black and white. I still see Papa’s face, hear his voice in the pleas of my dying patients.

“Help me!”.

Sometimes I recoil in fear and overwhelm, forgetting how to access the spirit of healing that extends beyond each exam room.

Sometimes I stay with compassionate courage and fierce tenderness, softening the boundaries between who is doctor and patient, who is parent and child.

Most days I’m learning to navigate the shifting landscape of change and loss without a clear road map, assuaging guilt with self-forgiveness, and caring for myself and others in significant ways.

Mindfulness teacher and author Jack Kornfield said, “If your compassion does not include yourself, it is incomplete.” As Papa once told me, even Gandhi needed a day of rest and silence.

There is a glass heart that vibrates to the storms outside. Hi atop a mountain island locked in a tower, this heart holds the flame of possibility.

Who will understand it? What will free it?

As storms rage on, and waves crash against the shore, the heart fears its own fragility. What will become of the flame if the heart breaks?

Seeing this image in meditation, sensing its meaning to unfathomable beyonds, all the hurt places begin to relax.

The heart wobbles in response to uncertainty. The flame flickers. A crimson drop falls on each wound of vulnerability, anointing it with delicate grace.

Bowing to this image, she senses there is still more to create/discover.
 
*****
 
There are other hearts. Hi atop a mountain island locked in their own towers, these hearts also hold the flame of possibility.

She senses the distance between them. Sometimes the distance feels insurmountable;  sometimes they are so close. Their hearts also quiver to the vulnerability of opening, of breaking, uncertain if their flames can withstand the wind and rain of circumstance.

She gasps in quiet recognition. Perceptions of abandonment can seclude her from a loving, connected world.

As storms rage on, and waves crash against the shore, she takes the exquisite risk of opening, breathing into her own heart to brighten the flame of possibility. Sensing the flame in others, near and far, the exchange of warmth is like a sacred diya connecting all and strengthening divinities within.

be gentle, be loving
patient and proud
of the wind and tears
that carved a goddess
from suffering

Kwan Yin’s kindred spirit
is learning to listen
to the cries of the world
and stay till there is ease
as she listens to her own body

the dance of sensations
ok as she is
a caged heart
trusting her wingspan
to fly beyond the bounds
of fear and unmet expectations

she is still exploring
she is still unfinished

(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.

Burning gluteal muscles, stabbing shoulders
hives when exposed to heat or stress.
Is it Long COVID or just a coincidence?
I never tested positive, had antibodies before the vaccine.
So easy to give into despair like bleak
landscape after a nuclear explosion,
waiting for something to grow,
to give meaning to this pain.
When the evening news, the internet, work emails
and patient messages all beg for better days,
I turn to gratitude practice for solace.

I’m grateful for physical and osteopathic therapy,
for medications that help ease the pain
when another pandemic surge feels overwhelming.
I’m grateful for family holding me
with humor and household help,
for colleagues and medical staff
as smiling crescent moons
in the darkness of a sobering reality.
I’m grateful for teachers, friends, a practice
inspiring the framing of all phenomena
in beauty, wholeness and healing love.

Covid-19: you think you’re so smart,
the best magic show around with variants
evading immune systems and vaccines.
You can invade, inflame, and injure,
but you cannot insist I believe you.
Let me be a source of healing
first internally then externally--
clear water mirroring a sunrise hope
in others clouded by doubt,
beginning again and again
till their last breath or my own.

“The path unfolds in two dimensions: horizontal and vertical. The horizontal path spreads forward and back across chronos, tic-toc, sequential time: minutes that flow like sand through our fingers. Here and then gone. The vertical path extends as kairos, deep time. The fullness of ripening moments swell and then narrow, like heartbeats, thumping out their fleshy rhythm. Horizontal time propels us. Deep time nourishes and sustains us.”

After reading these words by Pamela Weiss, something shifts inside me. It feels like the missing link, the connection I’ve been looking for to understand the relationship between fear and faith. Fear is a contracted state, a constant push-pull dynamic between what’s here, what’s missing from the past, and what’s needed for the future. Fear is judgmental, blaming anyone who cannot guarantee its safety. And, it is just one breath, one heartbeat away from faith waiting to surround it, to hold it in a steady, tender embrace.

One week ago, I had the joyful privilege of joining Jackie Long and circles of women for yoga on the beach in Half Moon Bay to raise funds in memory of loved ones who passed from cancer. Moving through sun salutations in praise of our star humbly hiding behind clouds, surrendering to sandy earth in child’s pose as vibrations of pounding surf were felt beneath us, it was an exhilarating experience.

Though I was aware of the sacroiliac joints and gluteal muscles previously re-injured by certain yoga poses, I believed it could be different this time. Sacred cause, sacred place, sacred instructor, sacred people, sacred body…there was no need to be scared. It would be different this time.

As the week and my body unfolded from the yoga experience, I began to feel twinges of discomfort. Prior experience, body wisdom, patience, compassion, and determination helped me tend to the pain lovingly with modalities that would promote healing.

Fear has not vanished. There are still whispers of judgment from time to time— the horizontal path conjuring flashbacks of past painful outcomes, predicting future catastrophes, each choice I make flowing like sand through my fingers. Where can I find true refuge? Where can I feel safe?

Today, the sensations are the loudest they have been throughout this week. What does it mean to lovingly embrace fear, to surround it with faith? Faith is expansive. It does not judge, but speaks with wisdom, sensitivity, patience, curiosity. I don’t know what will happen, and I’m with you every step of the way. Loving attention heals no matter what. Like a mighty grandmother oak, faith roots in vertical time, each moment while simultaneously reaching up and out for connection.

rooted in this moment
branches reaching out
cultivating a deeper faith
to surround fear and doubt

​As I learn to take refuge in this abiding faith, may it serve as refuge for others. May I trust what I cannot see, yet feel growing deep within, reaching up and out for connection.

​rocks polished
with the soft cloth
of loving attention
the gems are emerging
 
Have you ever had one of those days where it feels like you got up on the wrong side of the bed, and you want to go back to sleep?
 
I recently had one of those days.
 
Words were hit like racquet balls in conversation with family members instead of catching them, holding them for a while, and then playfully tossing them back. My low back, sacroiliac joints, and gluteal muscles were starting to complain again, as if I wasn’t taking good care of them. I was hungry and nauseous from the Suprep Bowel Kit solution in preparation for a colonoscopy.
 
Instead of stringing undesirable events together on a continuous chain of aversion, I was surprised by the care that showed up between and around these events.
 
Bathing the body in compassionate breath, I also took a breath for others in similar situations. There was awareness of imperfection, impermanence, and the impersonal nature of it all. I noticed the way my partner and mom would check up on me periodically to see how I was doing. I pictured loved ones saying the exact metta words I needed to hear, wrapping me in a warm blanket of love and understanding.
 
May you polish these rocks of aversion with the soft cloth of loving attention.
 
May you stay in the present moment and notice the care around you.
 
Don’t misunderstand me. I didn’t like any of the confusion in conversations, the physical discomfort, or the unsettling gastrointestinal sensations. (I won’t even go into the bowel details!) If I had gone back to sleep, I would have missed out on the gems emerging with practice, with time.
 
****
 
Waiting in the pre-op room, I answer the nurse’s questions about my medical history, medications taken, and sign all the necessary consent forms. When it’s time to find a vein suitable for IV access, the nurse comments that I’m a ‘hard stick’ (venous access will be difficult due to small, less prominent veins and some degree of dehydration from the bowel prep).
 
Hard stick.
 
The words pierce a hole in the bubble of equinimity I’ve created in preparation for this procedure. Or is it a bubble of resistance?
 
The nurse attempts to find IV access in my right arm, ‘threading’ the needle to reach a vein. When this is unsuccessful, she tries again with my right hand, again ‘threading’ the needle to contact a vein. After the second failed attempt, two more nurses are called in to try.
 
Each nurse takes an upper extremity searching for a suitable vein, a way to pop the bubble of resistance and access vulnerability. I feel like a pin cushion as tears begin to fall for the sharp, lancinating sensations felt in my right arm and hand.
 
I didn’t sign up for this. This wasn’t even on the consent form. This isn’t supposed to happen!!!
 
Allowing the tears to flow, the irritation at the first nurse for poking me twice and all the nurses for asking me repeatedly if I’m ok (do I look ok to you?), and the unpleasant physical sensations to be here just as they are, I’m asked to befriend another round of aversion.
 
Breathing in self-compassion, breathing out compassion for other patients who have felt like pincushions, I notice that there is a little compassion for the nurse as well. I have also asked colleagues for help when faced with certain challenging procedures in patient care.
 
Thank you asking for help when you did.
 
The nurse looks at me with genuine care.
 
Of course. I wasn’t going to stick you again. I usually don’t have trouble with IV access. You were a hard stick.
 
The words don’t feel as sharp as they did before. Rocks polished with the soft cloth of loving attention, the gems are emerging.
 
****
 
It doesn’t matter how many times aversion arises, because it will, again and again. It’s how I relate to it that matters most.