​
I’m fascinated by the intersection of emptiness and metta.

This month I received a birthday gift that I did not want - a flare up of chronic SI joint and gluteal muscle pain. Still there was significant appreciation for emptiness teachings.

I wasn’t a victim of a single cause or condition. Nor was I an expert on perfect management in extinguishing the burning sensations of pain. Perceptions of pain were determined by my relationship to it. When it took center stage, the attention shrunk, and there wasn’t much space for anything else.

Seeing and sensing through the eyes of the Brahmaviharas, the areas of pain transformed into an island of discomfort in a sea of healing modalities and support. The attention stretched to include ice, Advil, supportive family members, joy for my partner getting back in shape, a compassionate physical therapist, concerned patients expressing empathy, an image in supine meditation posture of the heart space pumping a champagne like bubbly substance to the rest of the body that softened, soothed, and allowed experience to be as it was, even held in celebration.

What if time is empty - past, present future - all empty of a single cause or condition that made me? What if this pain is not mine, and belongs to a divine intelligence?

The universal song is composed of both high and low notes. When dukkha arises, may I remember that others experience this, too. When sukkha arises, may others experience this, too.

“When self, time, separation, and even suffering are seen as empty, a devotion to the endless commitment of love is felt without burden.” (Seeing that Frees, Pg 327)

Don’t lose yourself.
Don’t assume you know 
what I need either.
Create what you need 
out of this image for healing,
and discover that I am more
than your limiting ideas 
of what others need.

All being suffer, have this volcanic
eruption of dukkha from within-
undigested material that 
attacks only in darkness 
when one is most vulnerable.
What is the remedy, the tincture 
of trust that will cure?
Grant me autonomy
and I will show you…

*****

There is humility in this image, the image that I thought was me and is now more than mine. “The Medicine” for my suffering changes moment to moment, day to day. “The Medicine” for the suffering of others also changes moment to moment, day to day.

What a gift to be able to stay close to myself, to fill out and resonate with the energetic and emotional body, to cultivate space and ease in this vihara, to impact space and ease in others.

*****

Benevolent breath
Fill me with purpose
Receive my inadequacy
As a distant memory
You are the baseline beat
To every song I sing
My entry into this world
My exit off this stage
​
Stay with me
Remain with me
Watch and pray
That I fill this body
Completely 
To honor you
To know myself
To sense the song in others
And begin the improvised duet 

There is never a dull moment to practice.

Is it night sweats caused by extra spice or sugar from dinner last night, a muscle spasm from a disturbing dream, or something else? The condition has been ongoing for three years, evading a specific diagnosis, even by my own medical mind.

I do not like this mysterious condition that causes a significant portion of the back body and limbs to tense and contract. Trying to attack it with many modalities, including hormone replacement therapy, dietary changes, cooling the ambient temperature of the room, more conscientious and calming sleep hygiene before bed, I'm up again this morning before the alarm.

Fearful and frustrated, I’m inspired to try a different approach. Laying on my back, the support of the bed supported by the earth is grounding. Compassionate breath fills the whole body with a soothing, intimate massage from the inside out. Metta flows in abundance. A fire is lit in the heart’s hearth in reverence for this phenomenon, trusting the body's wisdom for a meaningful practice to arise.

Susurrations of the words contraction and  e x p a n s i o n  are heard from another dimension, imploring me to embody them in this one. I realize I’m dealing with a duality! A vision of a flower expanding in sunlight on the inbreath and contracting in darkness on the outbreath begins to fill the body. Expansion depends on contraction; contraction is born from expansion.

I slow the breathing down intentionally to feel the whole transition of bud to blossom, growth to compression. Bud and blossom are not separate, connected by a meaningful continuum. I’m invited to love the whole cycle, softening the preference for one or the other. The effect is humility and awe at the design of human experience. The blossom, the expansion is only part of the sacred story.

There is never a dull moment to practice.

​Climbing up the steep hill at Foothills Park,
I reflect on this faint sensation
pushing from the back, pulling forward
without regard for the body’s buy in,
the heart’s sensitivities, the mind
taking over the whole endeavor
as if speed and production are key.
How often do I push patients, pull
at the loose ends of family and friends
to get somewhere, get something done,
the checklist seemingly complete
so I can finally stop and breathe?

I’m so tired of this conditioning,
this need to move at the pace
of a ticking time bomb ready to explode.
What would it mean to find my own rhythm,
heed the call of heart time not measured
in seconds, minutes, hours, even days
but in compassion, curiosity, creativity-
slowing down to create/discover
what it means to move at own pace?

Practicing with the Five S’s

Space/Splendor - Zoming out of the difficulty to notice space around it and anything pleasant to help balance the difficulty and not go into all-or-none, catastrophic thinking.

Sensations- Rather than trying to doctor the pain into a diagnosis (hard to abstain since it’s my profession), noting the sensations as ‘throbbing’ or ‘burning’ rather than ‘pain’.  It makes it less personal.

Self-compassion - Placing a hand on the hurt place and recognizing that others experience this, too. If I cannot feel the self-compassion, then inviting a figure of love to inspire it.

Not-self - Reflecting  on past inner and outer causes and conditions, present inner and outer causes and conditions contributing to the pain. Empty of a single cause or condition, and full of love.


There is a benevolence 
That softens a tangled mind
Agitated heart and tense body
Till they are all aligned 
To inhabit the moment 
With such intimacy and tenderness 
That a bright yellow center
Attracts bees to make honey
Make sweetness, make love
With all the hurt places-
Blood orange petals radiating
Metta in all directions
​Wishing for all to be free

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.