Double, double toil and trouble

Posted on February 12, 2013 by amindfullife

“Boil thou first in the charmed pot.
Double, double toil and trouble;
Fire burn and cauldron bubble.”
“Fair is foul and foul is fair.”

(the witches of Shakespeare’s Macbeth)

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Once again today my class met and found itself engaged with week four of our mindfulness programme.  A week past, of engaging with unpleasant events. With noticing them arise.  Noticing the emotions, thoughts, and sensations that they bring with them. Marveling at the effect that they have on us.  Unraveling some of the triggers for these unpleasant events, noticing how our perception of events can make all the difference between labeling them as pleasant or unpleasant.  What about neutral?  Noticing how events can either take control of how we react or we can have some choice in how to respond.  Noticing in our sitting that not reacting to small discomforts, such as the pressure points arising from the chair, allow these sensations to transform, and even possible to disappear.  A class of sharing with one another what it was, and how it was, that “my blood boiled”!  And of noticing, that when we perhaps are able to stay and sit with the boiling, to just wait a moment longer, that at times the boiling may settle all of it’s own accord.

One of the participants spoke, a couple weeks ago, of her tremendous anger at the suicide attempt of a young extended family member that resulted not only in harm to themselves but also destruction of property.  She shared today how having waited and stayed with her anger, sitting for the past two weeks with it, and not reacting in haste, allowed her yesterday for the first time to visit this relative in hospital with an open heart, even as she was fearful and uncertain of the meeting, and to be able to deeply listen to and hear the distress and suffering behind the act and offer compassion rather than judgement. This ability to sit for a while with the anger allowed an open hearted and wholehearted engagement, offered support where little was before forthcoming, and an opportunity to meet with and open to the suffering of this young person that would otherwise surely have been missed.

As a young child I was very fearful of anger and of expressing any loud or overt negative emotions, even as I was a cheerful, happy child.  At home it seemed anger and displeasure was frowned upon, my father, to my young self, loomed large, scary and authoritarian.  I grew up with a sense that strong emotions in me were not acceptable.  Not surprisingly I was a moody teenager and not in the habit of sharing my thoughts or emotions with my parents.  It has become somewhat of a journey in my growing up to understand the value of allowing these difficult emotions that are present in my life, in myself, and give them recognition.  Allowing them to be present without judgement or feeling shame in their simple presence.  So heart wrenching to hear others have the same predicament.  “What do I do with these feelings of immense anger?”  What to do?  For now?  Perhaps nothing.  Just stop awhile, sit, breathe, be.  And stay with these most difficult of emotions with a sense of kindness toward the self that is suffering through this.  Just sit, breath, be, without needing to push away, react, or suppress.  Allow the burning and the boiling, for it is a charmed pot.  All is not always what it seems.  And in allowing the difficult emotions we enable and open the space for recognizing the joy, the love, and the laughter.  For myself, at times I am still overwhelmed by the intensity of these emotions, but I know they will pass through for now, and my heart will have been opened just that split crack more.  To let more of the light in, to feel the warmth of this moment.

How is it with you today?

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Trust your wound to a teacher’s surgery.

Flies collect on a wound.  They cover it,

Those flies of your self-protecting feelings,

your love for what you think is yours.

Let a Teacher wave away the flies

and put a plaster on the wound.

Don’t turn your head.  Keep looking

at the bandaged place.  That’s where

the Light enters you.

And don’t believe for a moment

that you’re healing yourself.

by RUMI

reproduced in Saki Santorelli’s book Heal Thy Self, Lessons on Mindfulness in Medicine.

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It’s never about some other time

Posted on February 4, 2013 by amindfullife

The real gift and the crux of our difficulty is our constant and entirely natural experience of vulnerability.  Trying to live without feeling vulnerable means we do not understand the fierce nature of the reality we inhabit.  In closing off our vulnerability, we close off the authentic exchanges that tell us we are actually having a real conversation.  Vulnerability is the door through which we walk into self-understanding and compassion for others.  Being enlightened does not mean we assume supernatural powers of find a perfection that exalts us above the daily losses other human being are subject to; enlightenment means we have accepted thoroughly our transience, our vulnerability and our imperfections and live just as robustly with them as without them. David Whyte from The Three Marriages: Reimagining Work, Self, and Relationship.

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Attending my youngest daughter’s school awards ceremony (where the girls very quaintly still have to curtsy on stage when receiving awards, and she’ll not forgive me for the disclosure….!) a week ago or so, I was starkly reminded at how easily we can live our lives in denial.  How easily we shut down the authentic exchanges that allow any real conversation.  Denial of this moment, the only moment we have to live.  Denial of the many life affirming wonders that surround us each day even as we may be enclosed by continually difficult conversations.  Denial of the anxiety that there may be no better moment than this now.  Denial of the courage that it takes to meet this moment openly and with compassion, and in the moment that this courage is denied, the real struggle and suffering arises.

We continuously crave the next moment of ‘better’ that may never come. Even as we hope and long for it.  A moment different from this uncomfortable now.  A moment more bearable than that which we turn away from.  We had, like many parents, attended the annual award ceremony.  Commiserating with our daughter that she’d missed her desired number of A’s by one percentage point, we were immensely proud of her for having found her way through a very difficult year of teenage turbulence, and pleased for some of the other girls we have known since they were little toddlers gain the recognition for their immense talent and achievements, despite their own very difficult circumstances.  One of the mother’s point of view on the day was “life starts when school is over”.  The pain and denial of this moment, of teenage angst, of confusion and uncertainty that would surely pass, and hopefully be done with.  Once school was out.  And real life started.   I felt the blooming of surprise, slowly unfolding horror, and then sadness for the teenager involved whom I know to be struggling on many fronts. Are these difficulties to be denied and belittled and to wait for all to be better, of course, once school is out?  The choice made not to engage with how this moment unfolds.  And in that choice the opportunity to meet life with courage, beauty, and grace is missed.  A moment of denial met in a similar way by a family I met with this morning.  A teenager, with much the same angst, dreams, and confusion, dying of a terminal bone cancer, with parents who time and again refuse the offer of engagement to meet this difficult moment.  The most difficult, that of facing a child’s certain death.  How else but to long for a different, a better tomorrow.  But as we deny this moment the voices of these children become only ever quieter.

Meeting this moment of difficulty without denial demands the courage to allow our vulnerability to show.  As per David Whyte, to allow our vulnerability to be the ‘door through which we walk into self-understanding’, and perhaps more importantly ‘compassion for others’.  For me opening the door of compassion for others allows a window to be opened on my own heart, on my own need for courage to sit with my moments of vulnerability and acceptance of anything and everything that may show up.  All may never be well again, a better tomorrow may never come, and all we may have is the engagement with this moment in all it’s complicated, confusing, and painful glory.

Jon Kabat-Zinn tells us – ‘it’s never about some other time”.  Do not seek for a future that may not happen.  This is a lesson I have had to learn over and over again this past year.  As I strive to have my life be different to how it is, I paradoxically find my reserves and capacity for unconditional love and patience for my children and their individual needs expand beyond measure.  In other areas I am not so sure and there are plenty who feel the edge of my irritation, impatience and impulsivity.  Yet through all of this I strive to accept my life just as it is, even as the actuality of how that presents in my day is variable.  Life does not start when all is well.  When school is done.  When the kids are grown.  When we retire.  When everything is perfect.  Life is happening now, good, bad, easy, difficult, and all the gradients in between.  There is only one chance to experience this moment fully.  This moment, happening right now.  Don’t miss it.  Live it fully.  Be open, passionate, and vulnerable with all that shows up.  In loving this life now, and all around us through whom we engage with it, we are truly and robustly alive.

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Skull and crossbones

Posted on January 25, 2013 by amindfullife

Sitting again today in my favorite orthodox colleague’s office as he puts up a drip for my daughter.  A dear kind soul and friend who listened deeply to my story of distress and worry, earlier this past year, when few others did and we had no answers for what was going wrong with my daughter’s health.  Who had the presence of mind to confer with the rheumatologist who ultimately made the first diagnosis and has been her treating specialist ever since.  Offering his time whenever I call to say “please, I need you” and we need another IV cortisone infusion, “can we come in tomorrow?”  Some one to listen to my concerns about the multitude of medication I am involved with in administering to my own child, and, as a contemporary, can understand my theme for this week.  Can hear and appreciate my sudden panic about the amount and toxicity of all these drugs, let alone the continued severity of the illness, and can reassure me through his eyes of improvement witnessed.

The theme for this week…?  Ruminating around my brain? Poison! Toxic substances! Coming up against the ultimate ‘poison point’. What is your poison point?  What is that point where you feel you are crossing a perception barrier in your mind?  Perhaps that point where just ‘this one more thing’ is that bit further than feels acceptable.  Have you ever reached it?  Crossed it?  It may not even be anything to do with health or medication.  I encounter it often, though, in my daily work, especially around the issue of morphine.  When I start that dreaded discussion with patients and families around taking morphine for significant persistent pain, the many preconceived ideas and accepted notions, ones at times we did not even know we had, come out, the ‘poison point’ shows up.  For morphine the issue tends to be around fears of addiction and the starting of morphine indicating that this life may soon be coming to an end.  The fear of the unknown and the unknowable.  Coming up dramatically against the true impermanent nature of this life. It often takes much time and assurance to get past this ‘poison point’, to reassure that addiction is rare, especially when persistent pain is the natural antidote, and many, when pain is relieved, see improvement in quality of life, and at times even quantity of life.  Even for me, who is daily immersed in this, it took a second opinion visit last year with my daughter in Cape Town with the head of the paeds rheumatology department there, who commented that he had rarely seen a teenager in so much pain before, to see what I refused to see, to ensure that I respond to my daughter’s requests for significant and adequate pain control.  To finally agree to start her on opioids.  So I have nothing but compassion and understanding for the resistance to meeting and engaging with the ‘poison point’.  For that perception barrier is a difficult one to see, to meet, to acknowledge, to engage with, and ultimately to cross over.

This week, having long ago acclimatised to opioid patches for my daughter I ran up against my own ‘poison point’ barrier.  So very insidiously and unannounced.  That one medication, that when I was at medical school in the 80’s was perceived as the most toxic medication to administer.  My friend and colleague today agreed with me and came up with the same name.  Methotrexate.  So odd this personal poison point, having quite easily come to terms with newer more toxic medications that my daughter takes for her autoimmune arthritic disease.  But methotrexate, this week, was just that poison point too far.  Especially as I was the one to administer what her rheumatologist had so blithely scripted, without any fuss what so ever.  Point 5mls subcutaneously administered once a week.  Well, having stopped the other medication last week, observing the symptomatology dramatically increase again this week, waiting to start this new medication, with the increased pain, weakness, fatigue, and more, keeping my daughter bedbound upstairs, as the stairs were too steep to come down on her own during the day, we finally started the methotrexate a few days early.  Easy to draw up, right?  Easy to find the appropriate spot.  To push in the needle and slowly inject.  But somehow when I was drawing out the needle I started to sweat, to be overcome but a sudden realisation of what I had done.  I had just injected ‘the most toxic medication of my med school memory’ into my own child.  I had crossed that ‘poison point’ barrier. In that moment there is no help for this thought, for this sensation, for this realisation.  Even as rational thought tries to push against this emotion. Even as symptoms start to settle again within days.

This week, the irony not lost on me, a week of starting a new mindfulness program.  The topic engaged with in week one is present moment and perception.  As well this week training the new team that will be working with us from the adult palliative care service in paediatric palliative care all about dealing with affected families, communication, dealing with loss and changing expectations, pain in children, bereavement, caring for the carers.  A constantly present felt irony of learning and experiencing the intimacy of my work from the inside out, from within my own life, my own family.  This experienced role of being mother to a child with significant illness and how one is treated as patient, as parent, and the often disempowering role of both.  Even today as I pushed my daughter in a wheelchair, for the first time this way due to her weakness, through the hospital I work in, to have my colleague administer her cortisone infusion, experiencing the emotions of – frustration with the multiple lifts that didn’t work; the many able bodied doctors and students that blocked up the few working lifts when they could walk the stairs; noticing how the orderlies are often the ones who are most helpful to patients as the medical staff (of which I am one) hurry by on their more important way. The many others that easily smile and help.  How trivial these frustrations can be.

Surprise and perception.  Many constantly arising.  How is it we only often see only that which we expect to see or hear?  That when we allow our filters to open and to engage more with the way things truly are  we find them to be so different to what we imagine.  The surprise and perception in my own learning of letting go of expectations of how my daughter’s recovery course should be.  A constant lesson in humility and love.  Learning to be with whatever arises every day.  Whatever needs she has of me.  To let go of my need for it to be any particular way, to accept that there is no help for me in this, or even for her.  We walk this road one moment at a time.  And if dealing with the ultimate poison point barrier is part of this journey, then that too can be engaged with. I’m sure there will be another one that arises in the future.

The only help for now is the refuge of being kind, of being compassionate, of ensuring love and connection, to my self, to my daughter, to my family, to those that love and care for us, and even to those that have no idea and may be unintentionally hurtful.  Learning anew each day as I sit with loving kindness to direct compassion my own way, just as I teach it of others, and to all those I love who are affected by this orbit of suffering, and by suffering of their own.

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(photo courtesy of Tara Brach FB page)

“Most of us need to be reminded that we are good, that we are lovable, that we belong. If we knew just how powerfully our thoughts, words, and actions affected the hearts of those around us, we’d reach out and join hands again and again. Our relationships have the potential to be a sacred refuge, a place of healing and awakening. With each person we meet, we can learn to look behind the mask and see the one who longs to love and be loved.”~ True Refuge by Tara Brach

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Rituals of life

Posted on January 21, 2013 by amindfullife

Space. Time. Tea. Water. Chair. Quiet. All things necessary for re-starting this ritual of writing again.  Having gotten through the rituals of the end and now the beginning of the year.  The annual almost four week country wide shut down that happens each year when schools complete their year long cycle, businesses close, and the yearly calendar comes to an end.  The annual migration to the coast from the Highveld.  Holidaying at the beach. Time to recuperate, reflect, relax.  We hope and long for.  Not always so.  At times it becomes a ritual of collapsing into emptiness.  More recently it seems our rituals have become compressed.  Less and less time getting away.  More and more time working on holiday.  More and more collapse.  Less time allocated to gently moving through the ritualistic events that mark our lives.  The rhythms of this moment.  The cyclical nature of it all.  The losses.  The grief.  The celebrations.  The graduations.  The births.  The beginnings.  The new adventures. The deaths.

Just before my own holiday began one of my dear little patients took his leave.  He had with great courage and grace, and an amazingly uncomplaining and accepting nature, been bedbound these last months of his life.  With his slow and steady decline he ensured that his parents and his young brother had enough time to acclimatise to the painful reality that his short life would too soon come to an end.  He waited for Christmas to pass. A ritual marking for many of the end of the year, of gift giving, family and love.  And as the day passed into night, his little body breathed its last, and the ritual of grief, of honouring, of remembering, of celebration, too found its way.

The rituals, however our cultural, spiritual, family and religious norms may set them out, of honouring our grief, of taking time, and not rushing back into the normal pace of life is part of this journey of life.  However you find yourself this moment with grief, with rituals that may sustain and nurture you, bringing solace, grace, and kindness into your lives, knowing that there is no right or wrong way to do this. Whatever is your way and brings you and your family ease of being is the right way. I know many who read this blog are engaging this very moment with the realities of grief and loss.  May you know that whatever ritual brings kindness, love, beauty, and help into your life, enables this grace filled process of working with grief, and honouring your loved ones, your memories, and your loss.  May you sustain rituals that support and care for you and those around you.

And on this beautiful Summer Day, a poem from Mary Oliver by the same name.  A poem whose ending question continues to keep alive for me the rituals of life and grief, love and living, of rebirth each moment into the next, an invitation with which I find I can step out into this new year and look about for those who might join me on this journey.

The Summer Day

 

 

Who made the world?

 

Who made the swan, and the black bear?

 

Who made the grasshopper?

This grasshopper, I mean —

the one who has flung herself out of the grass,

the one who is eating sugar out of my hand,

who is moving her jaws back and forth instead of up and down –

who is gazing around with her enormous and complicated eyes.

Now she lifts her pale forearms and thoroughly washes her face

Now she snaps her wings open, and floats away. 

I don’t know exactly what a prayer is.

I do know how to pay attention,

how to fall down  into the grass, how to kneel down in the grass,

how to be idle and blessed, how to stroll through the fields,

which is what I have been doing all day.

Tell me, what else should I have done? 

Doesn’t everything die at last, and too soon? 

Tell me, what is it you plan to do with your one wild and precious life?

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time will come

Posted on December 31, 2012 by amindfullife

When I have seen Time’s fell hand defaced

The rich-proud cost of outworn buried age;

When sometime lofty towers I see down-razed

And brass eternal slave to mortal rage;

When I have seen the hungry ocean gain

Advantage on the kingdom of the shore,

And the firm soil win of the watery main,

Increasing store with loss, and loss with store;

When I have seen such interchange of state,

Or state it self confounded to decay,

Ruin hath taught me thus to ruminate

That Time will come and take my love away.

This thought is as a death which cannot choose

But weep to have, that which it fears to lose.

Shakespeare Sonnet 64

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Looking back on the movement of time over this past year it is worth reflecting a while on what has gone before.  A year of love, loss, change, grief, joy, and every moment choosing anew to live this life just as it unfolds.

 

For many of the families I have had the priviledge to be of service to this past year, the year has included the great loss of a precious child, and for the some even more than one, from the newly born, to adolescents on the brink of adulthood, and includes the very recent loss of a dear young boy I had the joy in helping care for at home these past nine months, who waited until Christmas had just passed before he too took his leave from this world, leaving a family, like many others, with beautiful memories and trying to make sense of it all.  This search to make sense of our world may be that which enables us to keep facing overwhelming circumstances anew, even as we wish to turn away from them and have them be different.

 

A visit this past week to Helen Martin’s Owl House in Nieu-Bethesda was a fascinating and unsettling reminder of how we all try to make sense of our particular experiences and world view, bring light into the shadow parts, and reflect our desires outwardly, and how some of us, at the extremes, fail this journey, even as we strive desperately in the expression.  The Owl House visit will probably find its way into many more posts in the next while, such is impact of her work and struggle.  A visit that left me with a reminder to accept the struggle, the difficulty, the shadows, the fear “that time will come and take my love away”, and be grateful for the light, for the passion, for the joy and the love.  Grateful for a capacity to meet the journey this life offers in its unfolding.

 

Thank you for taking the time to meander through my blog musings these past four months, and for the many kind responses I have received here and personally from around the globe.  If anything I write inspires you to take more time and care with your every moments, to be more present for those you hold dear, to be mindful, courageous, compassionate, loving and kind, then that is enough for me to continue this vulnerable journey of musing in public and making sense of my life and thoughts in this form.

 

May 2013 bring you many blessings, peace, joy, and the capacity to face your life with passion and live to the fullest.  If you don’t already know the Great Secret, it’s worth repeating – this life will end for all of us one day, so be sure to live it fully.

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Zinakekele – Care for yourself

Posted on December 22, 2012 by amindfullife

This time of the year is often experienced as a time for care – caring for others; caring for ourselves.  Time for rest, and time for others we care about.  Time to reflect on the blessings that are part of our lives, even as for many they are daily filled with difficulty.  Today my unexpected blessing came in a dynamic little package called Blessing.  A little boy, mischief on two feet, who had been referred to our hospital team more than a year ago for help with placement.  He had already since his birth spent more than six months in the hospital, his mother having died soon after and his father becoming scarce.  Family not able to care for him, and Blessing still a scrap of a little thing at that time, was in need of care.  And with help, care he got.  A hospice and home that has given him love, health, attention, and energy all this past year, enabling his personality of mischief and activity to shine.  A gift of a blessing.

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Caring, we all need to survive and to thrive.  A young mother this week reminded me, “We all need just a little bit of care.”  She had phoned me to ask, could I come in to the hospital where she was three times a week with her son for dialysis, a part of my ‘kids’ now for the past three years.  A single mom herself with many life challenges to overcome, including not being employed.  She had found a job advertised at the hospital itself she could apply for and needed my help with the application.  Simple help like filling out the form itself, and being assured that she and her son would cope with this change.  When I teased her about getting me to come especially for this to the dialysis ward on a public holiday she replied “Doc, you know, we all need just a little bit of being cared for sometimes.  I am so much alone in this!”, and how right she was.  We all just need to be shown some care, some attention, and some love to make it through and thrive in this seemingly difficult world of ours.

My father recounts how when he was a young man, finding himself in a strange city, struggling for a place to stay, employment, schooling, sleeping at the train station and surviving on five potato rosti a day, he was shown care by a chaplain who seemed to keep an eye out for young displaced men such as him.  He inquired about my dad’s life, his history, the trade he’d learned as bricklayer, and by the next day returned to meet him with an offer for employment, a place to stay, and eventually somewhere to finish his schooling which enabled my father to get to university and gain a profession.  Without that first act of caring life would not have unfolded for him in the way it had.  Caring, that now gets handed down through the generations.

In response to the terrible violence of this past week my youngest expressed a desire to visit again before Christmas the hospice and home she volunteers at for community service.  A home for ill and orphaned children that takes in some of my hospital kids, and where we found a place for Blessing last year.  My daughter had felt a deep desire to show some care, to share the gifts of love and health and family she has aplenty with little ones not so blessed.  To continue and pass on the care for self and for others.

So even as you may find this time of year one of difficulty, of grief, of experiencing loss, of perhaps being alone, take some time to care, for yourself and for others.  The gift of being able to care is a blessing we can all share in.  One of our social auxillary workers, who sadly died this year, wrote the following poem for the closing session of a mindfulness program that the staff had participated in.  She had an enormous capacity for caring, and always had a house full of children, but during the program she also learned the necessity to care for herself that supported the caring for others.  She has expressed this caring so much more succinctly than anything more I could write.

Wishing you well this season of rest, holiday spirit, endings and renewals into a new year, new moments of caring and being cared for.

The Positive Side of Life

Caring for yourself

You may think living on earth is expensive

It does include a free trip around the sun every time

It depends on you how are you using that free trip

Remember, just care for yourself.

 

Care for yourself

It is not late to do that

Once you do that you will learn to

accept things that you cannot change.

Courage to change things you can

Remember, just care for yourself

 

Care for yourself

Make a space for your thoughts and yourself

Notice and listen to your body

From head to toes

Attend to each part of your body

And the sounds around you

Then courage to change things you can.

 

Care for yourself

Then you will learn to look after others

You may be the world to another person

Just remember to care for yourself.

Care for yourself

“Zinakekele”

D R Khambule

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Getting out of the way

Posted on December 14, 2012 by amindfullife

It’s taken me a while to get back to writing a new post, even as my mind and heart is preoccupied, my commitment to this blog writing demands that I not abandon it, to just write, no matter how imperfect. My apologies ahead of time for the pure introspection herein.  Hopefully the fog will clear as summer sunshine creeps in.

Having become, these past couple weeks, caught up in anger, distress, blame, regret, frustration, in grief, and pain and loss, in railing against the seemingly unfairness and cruelty of this world, and the at times inhumane and impossible behaviour of human beings.  Being, as always, preoccupied by this every day human condition of ours.  Jon Kabat-Zinn, one of my teachers, speaks about the paradox of the only way to change anything, including ourselves or the world, is by getting out of our own way, by giving ourselves over and trusting in things exactly as they already are, without pursuing anything, especially the thinking mind. It’s taken me a while to begin anew this process of getting out of my own way, of trusting in things exactly as they already are, yet again.

To begin anew I have been this week pondering the nature of being lost.  Grappling with this process of getting out of my own way, with the knowing of a mind that is caught up in the experience of loss and being lost.  Grappling with how being lost scares and paralyses me, and inquiring deeply into exactly what it is about being lost that sets my usual sense of stability akilter.  Grappling with the knowing of a lifetime’s experience of change, of living in countries engulfed in conflict, of a family history of war and loss imprinting a difficulty of adapting to being lost, to experiencing loss, to having no control, even as there is enormous capacity to manage the reality of change and loss.  Grappling with how this year’s overarching theme has extensively been about being lost and experiencing loss, loss on relatively grand scale, as human lives go, too many to detail.  And this week, after months of struggle, the devastating closure, as a consequence of fraud, of an organisation I have loved being a part of these past many years, a team I have grown and thrived with.  A great loss, even as I know the work will continue, albeit within a different container, a loss not only to the organisation and its staff, but also to the many other organisations, families and children touched and supported by our work.

Other losses this past year even more personal, experienced by my daughter, loss of trusting in the normal expectation of teenage health, life’s dream and promise derailed for now, that has demanded a coming to terms with and an embracing of a daily process of a breaking of heart of sorts.  Certainly a daily breaking of mine, as I confront not being able to fix any of it.  Changes and loss so personal and intimate for self, family, relational, and work, that challenge and confront my perception of accepting being lost.  Being at a loss.  Experiencing loss.  Even as I daily counsel families and parents through this very same process I experience intimately how this process is not something I can think myself out of, much as I certainly have tried.  How the intimate experience of being lost and of loss demands of me to start anew again.  Accepting that the only way through this, eventually, is to be still, to truly get out of my own way.  To let go of everything I think I know and to give over to allowing, accepting, and trusting that being still, being here with life just as it is, is all that I can do.  That even as I feel lost, life knows where I am and where to find me, and that the path keeps unfolding at my feet.

Being lost, and our perception of how this plays out for us in our lives, is a theme we work with early on in an MBSR course.  Often using the instructions given to youth in American Indian tradition on finding their way through the woods, woods of many different kinds, as told by David Whyte in his book Heart Aroused.

LOST

 

Stand still. The trees ahead and bushes beside you

 

are not lost.  Wherever you are is called Here,

 

and you must treat it as a powerful stranger,

 

must ask permission to know it and be known.

 

The forest breathes.  Listen.  It answers

 

I have made this place around you,

 

if you leave it you may come back again, saying Here.

 

No two trees are the same to raven.

 

No two branches are the same to wren.

 

If what a tree or a bush does is lost on you,

 

you are surely lost.  Stand still.  The forest knows

 

where you are.  You must let it find you.

 

So even as you may feel lost or are experiencing loss today, for a moment allow yourself to get out of your own way.  Momentarily cease the attempt to think your way through this experience.  Stop. Sit. Breathe. Be.  Allow life to find you, just as it is, no matter how painful.  Allowing the unfolding of life to be of its own time, may save this heart from breaking anew each moment of every day.

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Livid and the colour grey

Posted on December 4, 2012 by amindfullife

That morning, an encounter, that will long be seared into the wrinkling folds of my brain.  I was running late, knowing they would be waiting.  A teenager and his family, cared for by our team over the past weeks, my nurse, already sitting with them.  I was alerted to things being not quite right by a warning shot from the ward sister: – “he looks terrible today”.  The consultant whom I knew well, who had referred him to our team, shrugged exasperatedly, greeting me briefly.  My sensors were thrown wide open.  I had already expected some of this.  I knew that they might have run low on pain meds over the weekend, as I had received an email.  My offer for the necessary prescription to be collected had been rebuffed.  But prepared, I was not.  Not at all!  Not prepared for that which met me as I walked into the consultation room and the instantaneous anger that arose.

It took me only a few short moments to understand what was present. My response was instant, was livid.  It must have briefly shown on my face, and in my body language  (never having been very good at my masks when faced with the suffering of children).  The parents themselves blanched, not quite knowing where to look, my nurse, relatively new to the team, was close to tears with distress as she felt the enormity of what was present.  To give time to settle, time to become fully present to myself and to everyone in the room with care and compassion, to compose myself having voiced my disbelief and displeasure at the evidence of a young person in terrible pain, to settle the unexpected tears I heard creep into my barely suppressed shaking voice, I paid attention to and settled in with the littlest ones in the room.  The younger siblings I had asked the parents to bring to this next consultation so we could talk together about how they were managing the impending death of their brother.  Giving me, and all of us, some time for a gathering of ourselves, time to figure out how we all got here, to this painful, terrible, colour of grey.

The colour of pain that day was all absorbingly, unnecessarily, terrifyingly still and grey.  Hanging on by the fingertips grey, frail body squared against pain grey, eyes sunken into fine folds of anguish grey, completely consuming the atmosphere in a room bursting with not wanting to see.  So I did the only thing I could at that moment.  I shooed everyone, bar the one with the grey pain, out the room and started back at the beginning again.  Pain control now, and plan again for the days ahead. Find out what more was needed and ensure an adequate plan for care.  Meet one by one and together with each and everyone who showed up that day.  Usually my consultations are fairly flexible, with much meandering around of discussions.  My team has the privilege of time.  Livid, however, demands of me to be more decisive and directed.  It’s not an emotion commonly felt, but one that alerts to this being a watershed moment of how to show up, the importance of a particular issue at hand.  This time it alerted to advocacy around adequate pain control, advocacy around improved understanding, caring for and managing the dying process for a young teen, advocacy for a son who would subsume his own needs to ensure family harmony.  Livid slowly settled, and enabled traumatic skeletons to be revealed by a complicated and secretive family.  A family in need of deep care and listening, with a life journey to be normalised, facing the death of a child in the only way they knew how.  A family, who every day, is living the colour of pain grey.

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A world of AIDS

Posted on December 1, 2012 by amindfullife

This day, for the past 24 years, has been about raising awareness around HIV and AIDS. For many of us, especially here in South Africa, this one disease has become central to our lives.  This is true for many of those we care for and have cared about over the years.  First identified in the early eighties, I still remember the early confused, almost hushed, discussions around this disease while at medical school, and how it slowly crept its way onto the agenda and how then the floodgates opened, causing so much destruction along the way.

Over the years I have been involved with many affected by AIDS and infected with HIV.  Some experiences don’t fade.  The first time I remember consciously choosing to attend differently to someone with AIDS was in the very early 90s as a young doctor in Sydney. I was doing a two-week locum rotation through the infectious diseases ward.  During these early years of HIV/ AIDS decimating the gay community in Australia, there was still much fear and stigma around this new disease.  One of the AIDS patients on the ward was terminally ill.  This still being in an era before any effective treatment was identified.  The instructions to all of us were to wear gloves whenever we took bloods or examined him.  Finding these demeaning and more isolating of this man who had already been abandoned by his family, had lost his life partner to AIDS, and whose children were actively being kept away from him, I chose to take blood and examine him without gloves and took to sitting with him, hearing about his family, his loves, his dreams, his losses, and his fears.  A simple act of compassion and touch that was a catalyst for many things to fall into place, including the courage to insist on seeing his children, to talk openly with his family about his illness, and to accept less a position of isolation.

My own children have had three carers over the years who  helped me raise them during their early childhoods, enabled me to work part-time, and fulfilled a role of mothering to them that was loving, patient, and unconditionally accepting, at a time when I was struggling with the role of motherhood.  All of these women have themselves succumbed to this disease, a loss that is still felt acutely.  As a way of honoring them today, I leave the last word to my son, at boarding school far away from home, who posted this on his facebook page.  A young man also affected by this disease that has caused so much loss for many of us and still challenges us every day.

“As we watched the movie “Philadelphia” today, discussed the HIV/AIDS issue and stood in the shape of the AIDS ribbon holding candles, I thought of home and of all the people there affected by this disease. But also, I thought of Mariette, a woman who played a large part in my early life and gave me my middle name “Bongani”, which means, “to be thankful.” I am thankful for having known Mariette and her daughter, and though Mariette may be gone, her love and grace lives on in her daughter and the happiness she gave me in my early days. AIDS is a difficult topic, but it is also a human topic, affecting people who we love and care for and who form part of our lives. The best thing we can do is show love no matter what; if one thing defeats AIDS, it should be love. “

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Tribute to a life of courage

Posted on November 24, 2012 by amindfullife

A somewhat different post today, but an obituary in the Financial Times weekend paper touched me in a way few have in recent times.  A woman who defied the great might of bullies and organised crime of the modern era – the drug cartels – and has finally paid with her life.  Some of you may know of this brave young woman – Dr Maria Santos Gorrostieta Salazar.

Mexico ex-mayor killed after surviving two attacks

The former mayor of a town in western Mexico, who had survived two earlier assassination attempts, has been beaten to death.

The body of Maria Santos Gorrostieta, 36, was found in a ditch with a blow to the head three days after her family had reported her missing.

When she was mayor of the town of Tiquicheo she was twice shot at by gunmen, who also killed her husband.  (Courtesy of BBC News)

I certainly hope many of you have heard her story, one of integrity, of courage in the face of great personal risk, of not giving in to fear, and the capacity for vision and service.  A woman’s life story and history of service that should be heard and retold many times and honored, as a tribute to all who stand up in the name of justice against often insurmountable odds.  A tribute to those who consciously chose to show up and be present, pay attention to what has heart and meaning, tell the truth, and be open to all outcomes.

Copied in below is part of a statement of hers published after the second attempt on her life that took that of her husband and at a time when she displayed her mutilated torso, replete with colostomy bag, to the public as evidence of her commitment.  I hope this tragic story of courage may inspire you to give just a little more of yourself every day when all we may be faced with in our comfortable daily lives is speaking out a little louder, telling our truth with greater courage, and being of service to those we work with in a manner that gives testimony to integrity and honour.

 

To many, it may seem an act of insolence to show my wounds such as they are, but it was necessary because I had to give my version of the facts, what it really meant to be attacked like that and the traces that these attacks left on me and my people. Because everybody else could say, unsay, talk, invent, defame, except me; and now is the time and place to do so.

What you can see doesn’t need much of an explanation; I simply want your understanding, support and consideration, because despite the fact that I show myself as somebody strong and unbreakable, inside of me, I am still a woman, fragile, a dreamer, a romantic, a mother, but one thing for sure, with an unquenchable determination to continue with my mission of service as head of this administration to which I was elected, and to help those who have less and that still live in a state of great vulnerability.

Throughout this year, I am here with an open mind and a quiet heart, several memories come to mind that no doubt history will judge me on; all I want to say is that walking on this rocky path has not been easy, that it has been permeated with disappointment and despair. I’ll tell you that whatever trench I get, I will defend it with sword and cape, I am faithful to my ideals and to achieve my conviction and my objectives, always convinced that truth and authenticity will set us free. I am grateful with all my heart to those persons who have trusted in my work, to my children, my mother, my brothers, friends, collaborators and to the city that has given its unconditional support.

 I have walked a long road towards freedom, and I have tried not to hesitate. I’ve stumbled along the way, but I’ve discovered that great secret; that after climbing a hill, one finds that there are many more behind that. I’ve given myself a moment of rest to look at the glorious landscape that surrounds me, the view back towards the road I’ve traveled. But I can only rest for a moment, because freedom brings with it responsibilities and I don’t dare fall behind. My long road is not yet finished; the footprint that we leave behind in our country depends on the battle that we lose and the loyalty we put into it. Today, it is a privilege to be part of the history of Tiquicheo.

With love,

Dr. Maria Santos Gorrostieta Salazar

 

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