Whose mountain are you living?

Perhaps having spent this week in the shadow of The Mountain, it is apt to reflect on mountains.  If you have never been to Cape Town this should definitely be on your list of destinations to visit.  And if you live in Cape Town, you are very familiar with the ways in which the mountain is central to the lives of the inhabitants living on or around its slopes, or even out on the flats.  The mountain is the north star by which one can navigate, no matter how lost.  And as I wing my way home across the base of Africa, above the clouds, thoughts from the week stay with me.

This past week.  One of re-imagining and re-navigating my life.  Inquiring deeply into its nature, the nature of my work, and the supportive and nurturing networks of family, friends and colleagues that have so magically grown over the years.   A week with other carers in this world of working at the edges of death, dying, and living every moment.  A week of launching a palliative care network for children, being a part of various presentations and workshops, and ending with the territory of mindful practice and attending.  Attending to our personal lives.  To that very personal space we often neglect to tend and nurture.

As carers for others we are want to leave the tending of self to the very end.  Something that we imagine takes up too much time or have no time left over for.  But it does not have to be difficult, complicated, or take any time at all.  It can be very simple.  Three tools and exercises shared in the workshop today are activities all of us already know how to do.  Already have as a part of our lives.  Perhaps placing them within a new context helps us recognise them as self care.  In a room full of health care workers only about five volunteered that they already have a daily practice of self care.  How curious?  Consider this.  Do you eat every day?  Do you sleep every day? Do you wash, look in the mirror, and get dressed every day?  Well if you do these things.  And I am taking a risk here and assuming that 99.9% of you said yes to all three.  You already have a daily practice of self care.  It is only the thinking mind that keeps us from this recognition.  Our bodies know this as self care.  It is perhaps the attitude with which we engage in this self care that can make all the difference.   How many of you breathe every day?  And now that figure must have gone up to 100%.  So congratulations all of you who already know how to tend to your self.  You have activities already in place in your daily lives that ensure capacity to care, to be present.  The step to conscious self care is a very small one from here.  The step is just to notice.  To recognise.  To be kind.  Above all to be kind.  To allow your life to be inhabited by kindness for whatever shows up in this moment with care.  In doing so you will be able to care for the magical unfoldings of your life, even as you may care for others through very difficult and challenging times.

Three simple homework tools to practice for this next week

1.  When you get up in the morning, greet yourself in the mirror with kindness, saying “Good morning.  So good to see you.”

2.  Remember to STOP through your day.  Especially when a stop sign presents itself, or the urge to do something reactive (if you can know this at the time)

STOP of course is :

Stop;
Take a breath;
Observe what is going on in your body, your thoughts, your emotions, around you;             Proceed with caution, grace, kindness, and renewed energy to engage in this            moment of your life.

3.  Notice the ways you already care for yourself each day and bring kindness and attention to this care.  Do it exclusively at the time of noticing.  Don’t have that meeting in the shower in the morning.  Ever noticed how crowded the shower can be in the morning?  The meeting could actually wait until the meeting happens in real life.  Water is the scarce resource of the 21st century.  Give it the respect it deserves.  When having a shower, experience the shower.  When eating, experience the eating.  Be in one place at a time and give you brain a break from being divided between where you want to be and where you actually are.  Just be there.  Be here.  For now.  It may surprise you, the beauty of where this actually is.  And who knows where this noticing may take you?

Ah, yes.  Sorry.  And the mountain? You may ask.  So one of my favorite meditations is one called the mountain meditation. One that uses the power of imagery to enter into and deepen the world of attending to this moment.  The mountain is solid, stable, and strong, even as the weather patterns, seasons, and times of day may change.  I first encountered the mountain meditation with the suggestion to imagine a mountain that one has perhaps visited, or even seen in a photo.  This never felt quite comfortable for me until I allowed the image of a mountain, the felt sense of a mountain, to emerge from within of its own accord.  No postcard vision for me, but a strong felt inner sense.  Allowing the inner knowing and emergence.  Or not.  If nothing, working with that too.  And in the emerging I was held by this knowing of my mountain, my story, my personal narrative.  Not the perfect one I long to encounter or be with.  And in this engaging with my mountain I could slowly begin to understand the narrative of how this mountain, despite seemingly otherwise at times, is solid, has a firm base, and can weather what ever storms affect its slopes.  So as I’ve meandered through this writing I come back to my original question.  Whose mountain are you living?  Have you stopped lately to pay attention?  You may find you are living another’s dream mountain.  Or, that you are precisely, exquisitely, beautifully, as best you can, living your own.

And while you continue to examine this mountain, remember three simple tools: greet yourself each day, STOP on occasion, and care for yourself in the ways you are already doing, with kindness and care.  Lastly.  Do remember to have some fun!

My time in the clouds is coming to an end.  See you on the other side as you contemplate the path ahead.  You may think this journey is mapped out and that there is a path laid out that you are treading.  But, as a friend reminded me recently, our path is made only by the walking of it.  One footstep at a time.

Traveler, your footprints

Are the path and nothing more;

Traveler, there is no path,

The path is made by walking.

By walking the path is made

And when you look back

You’ll see a road

Never to be trodden again.
Antonio Machado (in brief)

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Vast ocean of I don’t know

When I embarked on this journey of befriending the world of I don’t know I had no idea how deep or vast this ocean would be.  If I had known, that after more than ten years (well, maybe a life time!) of learning to stay present to myself when the anxiety of I don’t know raises its head, that after all this time I will only feel like I’ve just been dipping my toe in, I may have refused this journey.  Fortunately perfect vision is only granted us in hindsight and often we undertake journeys with anticipation and delight, …or in this case, get thrown off the edge when we hesitate too long.  This journey of mine of staying present to the I don’t know mind certainly did not start off gently.  But then it never has been a gentle experience.  I went hurtling over the edge to find myself swimming  in its vast ocean.  Of all places, at a conference.  My first international conference.  So pleased I was, and how grown up I finally felt, to have found something I thought was worth all the effort it took rearranging work, life, children, to attend.  The very first CFM Conference in Worcester.  A complete novice to mindfulness and meditation I was, but had felt an unarticulated pull to be right there that I had never felt before.  What a conference it was.  More of a meditation workshop over four days with some exciting research sprinkled in.  I encountered my first yoga session (three hours with Jon), introduction to walking meditation (seemed more like penguin walking to me at the time as the room was so jam packed with people), but also a place where I could finally learn to make some space for the I don’t know mind that I had been fleeing from for so many years.

Meet the I don’t know mind I did, as well as the yearning of many years to connect my head to my heart.  Little did I realise that connecting the head to the heart necessitated breaking open the heart that had defended itself against all things threatening.  Including the I don’t know.  It showed up though.  When all was going well, and I thought I was in the clear.  Feeling comfortable and welcomed.  On the very last day.  A teaching from one who would become a cherished mentor and teacher.  And lingered long with me through out the journey back home. One of my colleagues from home who witnessed the exchange commented on “the privilege of having an individual teaching moment!” Well yes.  Perhaps.  I was taught all about the surprise of unexpected guests showing up.  I was learning to just notice my feelings and sensations during that particular breakout session in a foursome.  Going around the group, each one having a turn to answer the question- “What do I do when I don’t know what to do?” The instructions were just to listen.  Pure attention.  No head nodding or interacting, or agreeing with etc.  To my mindful meditation novice brain this felt unnatural.  No welcome or connection in the interaction.  As we went around I was being attentive to body sensations – body tension rising, feeling defended, facial muscle tension increasing and mask like qualities descending and the arriving guest of I don’t know.  “I don’t know what to do when I don’t know what to do.”  My reactivity transported me many years earlier into stressful medical orals and with stony faced examiners sitting across the table from me and that moment of brain freeze and I don’t know.  It had been so unexpected this experience and to be so overwhelmed by it, yet again, and for some inexplicable reason I put up my hand in the feedback session.  Very unlike me.  To speak of this in public, so exposing.  My voice cracked, my eyes teared, and I wanted to withdraw.  But the teacher, used the occasion.  Inquiring.  Something I had yet to learn about.  That it was not synonymous with inquisition.  He said, to my mind dismissively – “But that is just a memory.”  Then paused, and asked. “Given that memory, what do you do?”  I replied hesitantly, not quite understanding, “I do no different.  I follow the parameters set out in the exercise.”  He asks, “What is that, what happens there?  In the memory, in the doing?”  The room is pin drop quiet.  The center point of unwanted attention.  The quiet stretches out, the moment goes on and on, reaching deep for “What happens there….?”,  and as he turns away from the ever extending moment, I speak, and he turns back, “I know what happens there.  I know what I do now.  Now, I just admit that I don’t know and the physiology resolves itself”,  and he nods and moves on. So simple, and in that moment everything broke open.  Including my heart.
So now more than ten years on I am presented daily, moment by moment, with the I don’t know mind.  From myself, as I query how to stay this course of my life one step at a time.  From my patients and their families facing life threatening events and wanting reassurance of comfort or hope.  From my dear friend I had lunch with today who twelve years after the death of her daughter still feels her loss as raw and present at times as before.  From my daughter with her JIA and ever increasing joint involvement wondering about the journey ahead. Even the question as I sit here into the night of “will the hypnotic african drumming and singing from the neighbors ever come to an end tonight?”  In these moments of wondering all I can do is accept that I don’t know.  And that is all there is to know.  And in this knowing I can be present to whatever arises, no matter how difficult, and in so doing bring courage, compassion, and presence to this moment.  Just as it is.  I may not always manage all of it today, or even every day.  But I can, as can you, gently, slowly, one breath at a time, put a toe in the vast ocean of I don’t know.  Get our feet wet and eventually wade in over our heads.  It may be like the ever present drumming tonight.  At times it stops and the pull of the rhythm ceases.  And then it starts up again, as does my response, but I know that in time it may stop again.  I don’t need to know when.  I can trust it will.

It’s a simple truth.  When you don’t know.  You don’t know.  But one we find hardest often to acknowledge.  Be with this truth as gently and as courageously as you can and perhaps discover what happens when the heart breaks open into this life of being with it just as it is.  One footstep at a time.

And in this moment the drumming stops and all is quiet.  For now.

Angeles Arrien states it best in her book The Four Fold Way  – Walking the paths of the Warrior, Teacher, Healer, and Visionary.  Simplicity itself.
Show up and choose to be present.
Pay attention to what has heart and meaning.
Tell the truth without blame or judgment.
Be open, not attached, to outcome.

Posted in Courage, difficult emotions & death in every moment | Tagged , , , , , | 2 Comments

Outside, looking in

September 11th.  Not possible to not write about this day.  A day etched and hardwired into my own memory, as it is in that of so many others.  A day of shock, confusion, grief and loss.  A day that precipitated so much more loss through out the world, for so many families, that we couldn’t even begin to count them.  We don’t even know many of their names.  Even as some names are lovingly, and rightly so, remembered and honored.  Many will stay forever nameless.  Forever lost to the sands of time.

On this day we too found ourselves in NY.  Our travels had started four days earlier.  We were on our way to attend my brother’s wedding and my husband had business to attend to in NY.  We were collected at JFK in quite grand style by a large white stretch Limo organised by the office.  So American. 🙂 So OTT! We drove along, feeling like royalty, wondering at our first glimpse of the Manhattan skyline.  The kids were enthralled.  We’d rented an apartment through the Internet (a new experience, online bookings, 11 years ago) on the Upper West Side, and my parents joined us from Germany for those few days.  Luckily they did, given what was to happen with flights later in the week.  The weather had not been great so we had been to all the wonderful museums, including a memorable visit to the Natural History Museum.  Being close to Central Park we were able to meet there with a family who used to attend our school back home, the husband a journalist, and explore the city play parks.  So different from our more controlled and circumscribed lives back in Jozi.  The evening of the 10th we’d had drinks with a friend and having watched the weather reports knew the 11th should be a good viewing day.  My parents and I were thinking of going up the Empire State building but our friend insisted we must go to the WTC as the view from there was spectacular!

Well, the 11th dawned, my husband having an early breakfast meeting, headed out very early.  The person he was meeting with had wanted to meet at the Marriott Hotel downtown at the WTC complex but fortuitously they decided he would come uptown to the office.  My dad, as he is wont to do, needed some fresh air away from the hustle of mothers and young children, and a decent cup of coffee.  He too was out the door at 7am!  Mom and I got the kids up, breakfasted, and ready for the day.  And absolutely gorgeous blue sky day. We headed out at 8am to get my dad and the train for downtown.  We had not made up our mind the evening before what exactly we planned to do so my husband had left for his day without knowing our plans.  In the end we chose to head for the Empire State building.

At about 8.45am we got to the tube station on 86th and were waiting for the train that would take us toward the Empire State Building.  Standing on the platform at 8.55am with my parents and all the kids, some person came hurtling down the stairway, looking completely out of sorts and yelled something like:..  “a plane has crashed into the World Trade Center!” and raced back up again.  There were only a few of us on the platform, but we all sank into stunned silence, completely taken aback, and did not quite know what to think about this piece of news.  My dad and I thought it was some prank… or something?  Our train came soon after that and we all got on.  Shortly after getting on there was an announcement stating that this particular train would not be stopping at the WTC due to an incident there.  Something seemed to have happened after all.  The announcements, slowly getting a bit more ominous about happenings at the WTC, were our first indication on that day that perhaps all was not completely right.  I was a bit unsettled about where the train line might stop and decided to get off early at the Rockefeller Center, not realising how far the walk would still be from there to the Empire State building.  Coming up to street level at the Rockefeller Center, right next to the NBC studios, we saw people running at full speed into the building.  I remember thinking, and saying to my dad, that something was definitely happening and that all the journalists were being recalled into work.  It seemed we had entered the subway that morning through a door of stability and certainty and exited through a door into confusion and disorder.  We continued walking down 5th Avenue where there was a distinctly agitated atmosphere, but having heard no real news, we were oblivious to what was going on.  We passed a TV in one of the shop windows that was showing the very early pictures of the first plane that had made it look like a smallish plane.  Dad was confident that all would be sorted out in no time and everything would be fine.  My dad, having spent his formative years on the Western Front in WW2, was a notorious under-reactor, forever calm in the face of raging storms, and had great faith in the capacity of Americans to solve their problems.  For him they had saved the day when they had eventually marched into his village in Germany, after many months of intense fighting and liberated them from that mad war.  And of course they had done the same at my mom’s village in France!  We continued walking down 5th Avenue.

Something strange started happening.  It seemed more and more people were going the other way, up town, and we were still walking down town.  Two elderly parents, a mother, three small children.  But no one paid any attention to us.  It seemed everyone was caught up in their own personal drama.  My mom, ever anxious, thought we should be turning back, was worried about what was happening.  My dad continuing on in his mild obstinate manner of, everything will be fine, and we continued our walk down toward the Empire State Building.  We now saw another TV screen showing a burning North Tower with another plane flying directly for and into the South Tower….”What!!?  How is that possible?  This can’t be an accident anymore?  Can it still be accidental?”  A little later we saw a news banner scrolling the news that the Pentagon had been hit by a plane.  People were streaming into the streets, cars stopping, everyone listening to car radios.  Something HUGE was going on!! I remember starting to worry about my brother.  I stopped to listen with a group huddled around a car radio and heard the news that both towers had been hit by planes, that the pentagon had been hit, but the speculation at that stage was all over the place as to what exactly had happened.  A short while on we finally got to the Empire State Building and found that 5th Avenue was cordoned off, the building closed for access, people were continuing to pour out of buildings and had completely taken over the roads by now.  I remember feeling shocked, confused and unable to really appreciate what was going on.  I asked the policeman standing out front how long he thought the building would be closed for??  He looked at me like I was crazy, a real idiotic tourist for sure!  It was dawning on me that this day had unraveled and spiraled completely out of control, and much, much, earlier in the day, and that somehow I was behind and only now slowly catching up.

The kids were tired and thirsty and we found a little cafe open around the corner of the building.  We ordered some cokes and sat down.  They had the radio on at the counter and I went over to catch up with the news.  The gravity of the situation started to seep into every pore of my body.  Both Towers, and the Pentagon, had been hit by planes, there was a lock down on US airspace, Manhattan has been closed off and public transport stopped.  There was concern more tall buildings may be targets. This was no small accident that was going to be fixed.  This felt like war had been declared and we had all suddenly been caught up in a war zone.  It was nearly 10am by now and I suddenly remembered my husband had no idea where we were.  That he could still be thinking we had headed for the Twin Towers and were caught up in the chaos there.  This was before the days of cell phone roaming so my SA phone was useless in NY.  Fortunately I had the office number on me.  I went outside to find a phone.  Tried asking someone to borrow their cell phone but was told the networks were all completely jammed.  I joined the ever growing queue for the two pay phones nearby.  There were fights breaking out amongst people over who had the more urgent phone calls to make, the police kept cutting in to make their own calls, and people were very frayed and anxious.  As we waited yet another man came screaming around the corner from 5th Avenue shouting “the towers have fallen, the towers have fallen….!!!”.  It was all too shocking and surreal.  I finally got my turn at the phone and having dialed the number was immediately put through.  I was met, of course, with such anxiety as to where I was with the family, concern about being caught up in the middle of what was going on, and relief that we had not gone further down town.

As we emerged from behind the Empire State Building, looking down 5th Avenue all we could see was a huge cloud of ash hanging over the horizon.  I stopped to take a photograph, the policeman constantly urging me to move aside, to keep the road clear.  The irony being that behind him the road was far from clear, it was a teeming mass of humanity.

Now started the long trek back up town toward the office.  It was another 60 block hike.  It felt like we had joined a column of refugees trudging away from a war zone.  All the shops boarded up.  The sidewalk jammed with people every which way.  People hanging out of buses.  The taxis full.  We just walked and walked, eventually making it and became absorbed into the fuller narrative of what was happening that day, with TV pictures getting ever more and more graphic.  After some time we decided to go back to the flat and crossed Central Park to West Side.  At about 3pm, turning into our street, we were greeted by the most amazing sight.  A total of five fire engines were pulled up outside our building.  It turned out to have been a simple kitchen stove fire.  We were amazed by the resource capacity.  With so many emergency personnel having been mobilised down town to the WTC, there still were five fire engines to deploy to a simple kitchen fire.  Anxieties were running high.

Coming into the apartment there were about twelve messages on the answering machine.  Light hearted ones from family earlier in the day…”hey, we just saw the news, hope you guys are fine.  Call us.”  Then as the day went on and we obviously were not home for hours the voices got more and more worried, more and more hesitant.  It was time to join another queue for the public phones and with a bag full of coins I finally made some national and international calls to reassure everyone, including our Manhattan landlords, we were okay.  I called my friend we had met the day before who lived in New Jersey.  Her husband was stuck in New York, like many others with the bridges and the transport system being closed down.  He would not get home for the next two days.  Driving out of NY the next morning over the Washington Bridge, we could still see the smoldering smoke rising from Ground Zero.  The gap in the skyline bleeding, a piece having been ripped out of its core.

As we drove south the views on the radio shows reflected anger, fear, and increasing nationalism.  Having had family and historical experience of the ravages of unfettered nationalism, we were distinctly uncomfortable with some of the views.  But we drove on to a wedding.  Quite a few family and friends ended up not being able to attend with flights grounded from Europe and air traffic taking time to resume even within the US.  A day in history that will not be forgotten, that for many has brought so much more trauma and loss, that was only the beginning.

On another day in September many more years ago, the 1st September 1939, my dad was 10 years old and living in a small village on the western border of Germany, in the long contested state of Saarland, the same village I was born into.  Just a stone’s throw away from the border with France.  With Alsace.  Another contested state.  Where many years later he would meet my mother.  It was a day that too changed the course of his life.  His mother, having gone to church at 7am, as all the village women used to do daily, came home with instructions from the Mayor.  “Pack up your homes and meet in the village square at 10 am.  All women, children, and those older men not working in the mines.  Only bring 30kg per family.”  At 10am everyone, including my father, his three younger siblings and my grandmother, congregated in the village square.  Trucks pulled up and everyone was loaded up and taken to a sorting camp a short distance away.  My grandfather would come home from his shift in the coal mines later that afternoon to find the village empty and his family evacuated.  The machinery of war has started.  Poland was invaded and two days later Britain and France declared war.  The ramifications of this day in history on so many people, continues to be felt.  Generations later.  The lives lost.  The immeasurable harm done.  A war experience that left my dad, and subsequently all of us, forever transformed by his intimate meeting with and understanding of state brutality, having learnt the importance of speaking out, the value of standing up for justice, and keeping strong ones own integrity, even in the face of overwhelming fear and difficulty, no matter the cost.

So as we remember the loss of lives and the transforming of our modern day landscape and understanding of the world, may we be mindful of how we move forward.  Mindful of how we daily engage with the world around us.  We may all be haunted by the harm that is handed down over the years and can never right the wrongs of the past.  We are, however, also influenced by compassionate action, generosity of spirit, courage of being, and determined resilience in the face of difficulty, that is present in all our lives and throughout humanity.  We can choose to live our own lives with courage, honesty and integrity, in service, with kindness, and with love.

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Trust in the difficult

So today these are definitely just musings.  Musings of something I have little experience with other than my personal, and cannot give any specific advice about. I am just musing about that which is here.  For me.  Right now.  I am not always quite sure how these themes show up for the day.  But show up they do.  Today’s theme seems to be about trusting in the difficult. Admittedly a common one for me. Trusting that life will hold us, even at its most difficult.  Aptly spoken about by Rainer Maria Rilke, one of my favorite poets.   “It is always what I have already said: always the wish that you may find patience enough in yourself to endure, and simplicity enough to believe; that you may acquire more and more confidence in that which is difficult, and in your solitude among others. And for the rest, let life happen to you. Believe me: life is right, in any case.”

So what else is there to say except that trust that life will hold you?  Let life happen to you and allow your confidence to grow in meeting that which is most difficult in every day.  My youngest informed me this evening that today was suicide day.  An update from her social media sites.  What a day to celebrate. But, quite correctly, she told me it was a day to remember those who had committed suicide, those who perhaps had attempted, and those that were struggling in very dark places of their lives and minds, as well as a focus on prevention.  Today is WHO World Suicide Prevention Day. Like many teenagers my daughter is not unaffected by the struggles of a developing and maturing emotional life, that of her own, as well as of her friends.  How many of us live lives of quiet desperation?  How many of us struggle through each and every day.  Especially in this world of great economic and practical difficulties.  A world that for some of us can change completely overnight.  A world where we may feel very alone.  We may not be willing or know how to reach out and share, or to ask for kindness and understanding. So even as you grow in your capacity to trust in life, and trust that it can hold you, be a little kinder.  In all things.  In how you interact with yourselves, your loved ones, those you work with.  Even just in random meetings through the day.

My own life has not been untouched by suicide.  Family members, friends from childhood, friends at medical school, and many in families I know, have ended their lives this way.  The WHO tells us almost 3000 people daily commit suicide. And for every one that succeeds, 20 more have tried.  One such act that has stayed with me over the years is that of a med school friend. A young man of such beauty and promise that it was very hard to comprehend.  An act perhaps possible only when we lose the belief in our capacity to meet that which is most difficult in our lives, and trust that this capacity can grow.  When we feel that kindness from this world is lost to us.  One of my favorite books I am re-reading at the moment is The Power of Kindness by Piero Ferrucci, the unexpected benefits of leading a compassionate life.  It reminds me constantly just to be kind.  In my own time of distress at medical school, when it seemed there was no one to reach out to, it was a simple act of kindness from an elderly professor that allowed me to trust that life would hold me.  That kindness was enough to allow me to believe that this capacity could be trusted and could grow.

So today, as you are irritable with your challenging teenagers, or find yourself distressed, angry or grieving. Be a little kinder and gentler that you need to be.  Kinder to yourself, as well as to others.  You never know what may be going on in another’s life.  Even those we think we know so very well.  Aldous Huxley once said, “People often ask me what is the most effective technique for transforming their life.  It is a little embarrassing that after years and years of research and experimentation, I have to say that the best answer is – just be a little kinder.”

Have patience enough to endure.

Simplicity enough to believe.

Confidence in that which is difficult.

And confidence in your solitude among others.

Trust that which is most difficult to lead you through to the other side.

With kindness.

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Dreams of a Dung Beetle

If you have been to one of my presentations these past few years you will recognise this photo.  I use it constantly and like to tell the story of the dung beetle, a scarab.  How it finds a nurturing environment for its young in material that others have discarded.  This particular one, the African Dung Beetle, is rolling elephant dung. For me a symbol of  no matter how difficult a situation may seem there is possibility for some joy or new discovery that may grow out of it.  The dung beetle reminds me of many things: of persevering in the face of the daily difficult; of continuing to dream and transform myself no matter how challenging the present may be.  It also for me somehow has come to symbolise the work I do.  That many may shy away from and do not want to dwell on.  The frontier territory of death, distress, difficult news, and dying.  Only recently did I actually look up the dung beetle on the web and was intrigued to find that the scarab of ancient Egypt,  was significantly associated with the ritual of funerals and signified transformation and renewal.  Somehow this powerful symbol has inadvertently occupied my imagination and my dreams.  Perhaps we all are collective in this dream world of ours as Jung has suggested.

So today the scarab again occupies my dream and day space as I sit with reflections of the week.  A week of starting this blog writing project.  A week of commitment to writing often.  Just writing. No matter the judging mind that keeps me away. A week of much difficulty and distress for family, and my other families too.  A week of being with pain and fatigue, of being with the grief of loss already experienced and continuing to experience, as well as overwhelming shock and the anticipatory grief of overwhelming loss.  A week of sitting with parents as they worked through the last moments of their son’s life and asked for reassurance that they had done everything right.  That there was nothing more or different that they could have done in those last moments.  Parents who intuitively listened to their son’s last wishes, who gave unconditional love and care with the utmost of gentleness.  Having responded to their desperate midnight call, I had the grace filled experience of being with them at the moment of their son’s death, helping them wash and lay out his young body, and sit with them as they lit candles and prayed with their other children.  Prayed for themselves, for strength to make it through the coming days, and gave thanks for the beautiful life that was their son.  A moment suspended in time, filled with peace and stillness.  A moment of being fully present that made all the difference.  A moment that reminded me that many a time nothing more is needed other than presence and love.

Reflecting too on how the week ended with the most difficult of conversations. One with a young mother facing possibly the death of both her son and her husband within the next six months.  Both with cancer – bone and brain.  Both, perhaps, with limited further treatment options, other than care, love, presence, and the attention of family, friends, and community.  Noticing how when all the trappings of life fall away, very little is left behind.  In these moments, the greatest gift is presence and kindness.  The gift of being present with an open heart that holds all things, no matter how difficult, and that even here are moments of joy and laughter.

KINDNESS by Naomi Shihab Nye

Before you know what kindness really is, you must lose things,
 feel the future dissolve in a moment
, like salt in a weakened broth.

What you held in you hand, what you counted and carefully saved, all this must go so you know
how desolate the landscape can be between the regions of kindness.
 How you ride and ride
, thinking the bus will never stop.
The passengers eating maize and chicken will stare out the window forever.

Before you learn the tender gravity of kindness, you must travel where the Indian in a white poncho lies dead by the side of the road.
You must see how this could be you.
 How he too was someone
 who journeyed through the night with plans 
and the simple breath that kept him alive.

Before you know kindness as the deepest thing inside, you must know sorrow as the other deepest thing. You must wake up with sorrow. You must speak to it till your voice catches the thread of all sorrows and you see the size of the cloth.

Then it is only kindness that makes sense anymore. 
Only kindness that ties your shoes and sends you out into the day to mail letters and purchase bread.
 Only kindness that raises its head
 from the crowd of the world to say 
‘it is I you have been looking for’,
 and then goes with you everywhere
 like a shadow or a friend.

Posted in Courage, difficult emotions & death in every moment | Tagged , , , , , | 4 Comments

The day your worst fear is true!

Each day demands that we show up with courage and humility, for it may start off well and end up in a completely different place.  One that we could not even have imagined and we may have little control over how that happens.  Even my own day today started in a particular way and then, given a decision I made, ended in quite another.  But that was my choice, even as I struggle with its consequences and impacts the clarity of my writing tonight.  Often, though, how our day unfolds is not in our control.

One of my little patients’ mothers called me this morning.  “I need your advice again doc,” she said.  I thought it was about her little boy, who had been struggling with gastro these past few days, was bed bound with end stage bone cancer at home.  But no!  It was her husband.  They had been to see the doctor yesterday and what had been a dreadful fear at the back of his mind has indeed become his reality.  Fear had delayed him going to the doctor.  But this week he had reluctantly gone, and was told yesterday that what was going on in his brain was most certainly a brain tumour.  No control over this, just courage and humility, to face this very moment of reality, breaking open upon itself.

Courage and humility.  And the capacity to know how to effect this in one’s life.  This young mother, for me, embodies the qualities of Hardiness as described by Suzanne Kobasa many years ago.  One of my favorite set of resilience attitudes.  The capacity to face whatever arises with strength, grace and equanimity.  The attitudes and qualities of control, commitment, and challenge.   Control being about an internal sense of control.  The ability to discriminate between what can and can’t be controlled.  About making decisions with conviction, no matter how small or large.  Commitment speaks to the meaning and purpose in our lives.  To being fully involved in what ever it is that we choose to do each and every day.  Challenge, the capacity to meet life’s inevitable demands and changing landscape with flexibility and determination that allows development and growth not just immobile problems.

My own sense is that all of this is necessarily held within a container of community and connection.  Within a strong sense of self as a participant of life through the many differing manifestations of self that support our complex natures and varying needs.  A strong sense of self that allows us to be known, assisted, and supported in many forms and that in this that we don’t isolate ourselves from the experience of life itself.  This is what I see and know with this little family.  That despite all their challenges, they have mobilised their community behind them to care for them, to love them, to fund raise for them, and to be there for every moment of need.  Including their doc!  So tomorrow I will be there again.  Checking up on my little charge laid up still in bed.  As well as walking with them through this new challenge and mobilising all our resources, love, and care, to deal with this hurdle too.

How is it that you choose your path today with your own necessary resilience attitudes of control, commitment, and challenge?  Even if your worst fear is true.  And what community do you have around you to support and love you in this?  And how do you offer this back in service to those around you in turn?  Remember, we all walk this road of life together and are all connected through our universality of being human, no matter how alone in this at times we may feel.

Posted in Courage, difficult emotions & death in every moment | Tagged , , , , | 3 Comments

The “bad news bear”

“Isn’t it hard?” my daughter asked.  “To always be the one doing that?  Doesn’t it affect you?”   Her question may perhaps be a simple one but I felt it, and knew it to be, a much deeper query.  Especially after this past weekend.  We had been discussing my day so far, having just arrived home.  Talking about how I so often feel like the ‘bad news bear’.  How when I finally get the hospital staff to meet to do some advanced care planning its often as our team has been called in so very late in the ‘proverbial day’ and we are having to change tack from chasing acute care results to discussing comfort care and trying to get a child home rather than die in the hospital.

Today my midday case conference with the ward doctors and my team was to discuss the way forward for a little three-month-old baby that had been recently transferred to their ward from the neonatal unit.  Somehow having slipped there through our net of care.  This little girl has been in the hospital since birth.  Her parents have yet to experience being able to take her home.  They may never get that.  Her mother has yet to spend any protracted amount of time away from her or from the hospital at that, or in the company of her partner and three year old son, since the night three months ago she went into early labour. Born with an abnormal brain.  Born without the cry of life, fitting, and destined never to be able to feed, or respond to her mother’s touch, or grow appropriately.  And more and more the little head is looking odd as the body grows, but not the brain.  So our team got involved.   Embarked on the discussion of prognosis, care plans, and talking with the family.  Spending time with the mother.  Hearing how she had only recently told her own parents the baby was not doing well.  How she had hoped against all hope but was starting to see the signs were not good.  Especially after the ‘bad news bear’ arrived and started her ever so gentle, ever so insistent dialogue, of starting to look at the reality of the life her baby girl has.  Starting to really broach the difficult issues at hand.  The ‘bad news bear’ indeed!

Well that be as it may.  It is my work.  My service.  What gives meaning to my every day.  Being good at being the ‘bad news bear’.  But my daughter’s query was prompted by a deeper question.  A concern for my own self-care. And how it affects the family if I slip up on it.  Like all health care workers I need debrief time.  Self-care strategies.  Not only the meetings I offer to the other docs in this field, as the one we had just this morning.  Not only to the medical staff I debrief on the wards, the nurses, my own team, my friends, and colleagues.  But self-care for me.  My daughter’s question was very pertinent today. I had spectacularly lost my cool this past weekend and behaved in a way no parent is proud of.  And while there may be many explanations, including pure unadulterated mindlessness,  an underlying factor is a constant demand to be present for others.  To deliver bad news so very often and be present for the resulting distress it brings.  So my own self-care gets called into question.  Especially when my equilibrium is so blatantly off kilter. Especially when my daughter has more words of wisdom than I do.  Or is that always the case with our children?  Our teachers constantly!

So what do you do for your own self-care?  I have no real helpful answers for you here.  Just questions of myself!  All the usual apply.  What little that I do perhaps know is this and is common knowledge but may need reminding on occasion:  Surround yourself with supportive friends and family.  I try to choose with greater discernment who and what I say yes to these days.  Have time with a friend who ‘gets’ you. Thanks K for that today! Journal. Meditate. It does help.  Trust me.  And if not me, trust the volumes of research that is being published about the positive effects of meditation.  I always know when I’m seriously off balance that my meditation hours/ minutes must be getting too low.  So those Zafus and Zabutans I’ve newly ordered are coming just at the right time.   Eat well.  Mindfully.  Only food you enjoy, but not too much of that either.  If you pay more attention to the experience of eating as you eat you may be surprised that you do enjoy the healthy food. Exercise.  Sleep.  Enough.  In a darkened room.  Do enough of whatever it is you love to do!  And nourish the part of you that needs nourishing.   Make sure that Love is a big part of all of this.  An absolute essential for us as human beings.  I see it with the kids on the ward.  And my own kids.   They just want love and attention.  As do I.  And lots of it!  Why do we forget that so often as adults and make do with less?  Ensure you are caring for the most important person in your life enough.  YOU!  Without that you can’t care well enough for all the others in your life.

Attached below is my poem for today.

By Mary Oliver.

Remember.

You do not have to be good.

You only have to let the soft animal of your body love what it loves

Tell me about your despair, and I will tell you mine.

Whoever you are, no matter how lonely, the world offers itself to your imagination

Calling to you.

Announcing your place in the family of things.

Remember to nourish yourself this day with some love.

But don’t be fooled.

Perhaps tomorrow we will all spectacularly fail again.

As we do if we are human.

And pick ourselves up again.

Beg forgiveness.

And begin anew.

Forgive me if I’ve rambled today.

And thank you if you read this far.

 

Wild Geese by Mary Oliver

You do not have to be good.
You do not have to walk on your knees
for a hundred miles through the desert, repenting.
You only have to let the soft animal of your body
love what it loves.
Tell me about your despair, yours, and I will tell you mine.
Meanwhile the world goes on.
Meanwhile the sun and the clear pebbles of the rain
are moving across the landscapes,
over the prairies and the deep trees,
the mountains and the rivers.
Meanwhile the wild geese, high in the clean blue air,
are heading home again.
Whoever you are, no matter how lonely,
the world offers itself to your imagination,
calls to you like the wild geese, harsh and exciting —
over and over announcing your place
in the family of things.

Posted in Caring for the Carers | Tagged , , , | 6 Comments

Acceptance

“I finally seem to be accepting it”, my dad said last night.  His voice warm, close, and caring in my ear, despite the distance of a continent’s span between us. “What?” I said.  “That you are old?”  We had been bantering, as we always do at the beginning of a phone call, about aging, eating, getting through the day in whatever form it found itself to be for that particular day.  “No.”  He said.  “I feel that I am finally accepting that your mother is no longer here with me.”

My mother died 19 months ago, shortly after my parents celebrated 50 years of marriage.  A sudden death, even as it came at the tail end of a protracted time in the company of “Mr Parkinson”, as she used to say.  In retrospect the signs were obvious, the body no longer willing, and the spirit ready.  At the time, none of us really wanted to see it fully or even planned for such a precipitous end.  It seems, however, that my mother had.  In the year preceding she had diligently kept a daily log of her physical and mental struggles, thoughts, memories, reflections, as well as many instructions.  In doing so she left my dad a book to live by, and a book to guide him through the year following her death.  A year and more of coming to terms with her loss.  Often, during this time, when I’d call, he would recite what she had written for that day, the year before.  What she had been thinking about.  What instructions she had left him with.  The abiding instruction being for us to care for each other, and that she would always be waiting for him.  This, now gives him comfort, and allows him slowly to start living again.  Many a time in the past 19 months he has told me that it is difficult.  The day has been filled with grief and the experience of loss.  He had also always insisted that this was absolutely correct to be so, for how could it be otherwise?   A life and a love and a loss so great needs time to be felt fully, time to fully be with, to be completely and viscerally, grieved for.  Time to find its own way to a new equilibrium, to a new way of being.  And now after 19 months he can truly say “I still wish to live to be 100.  There is so much more to be seen, to experience, and to do!”

Elizabeth Kubler-Ross famously described the steps we may traverse through in processing grief  – those of denial, anger, bargaining, depression, acceptance.  I have observed many, including myself, move through these stages of grief in varying ways, not necessarily always in a straight line.  Not everyone gets to acceptance.  Acceptance is the gift of being able to finally live in the present. To accept this moment as it is. Perhaps even with all its grief and loss, and make some new sense of how to be fully here, for now.

Even though we may think all of this applies just to the great loss through death.  We all experience many losses each and every day.  From losses perhaps of opportunities, dreams, friendships, illness, through to life changing events, and even life threatening illness.  All of these need time to process, grieve appropriately, live through and find a transformed way to be able to be here with this new reality.

For me, I find that moving through the spectrum and process of mourning and grieving can be facilitated if we perhaps have some knowledge of the tasks that may be involved.  I have found the work of J. William Worden instrumental in this as he set out more than 25 years ago the four tasks that may be involved in doing this work:  1. To accept the reality of the loss;  2. To process the pain of this grief;  3. To adjust to the world without the loved one, or the loss experienced;  4. To find an enduring connection with the lost person, or loss, in the midst of embarking on a new life.

We may often flounder in this work.  Especially if we think it should happen naturally and become impatient that we don’t feel any better.  Grief work is just that.  Work.  Like any other.  But as we take on this work and move through the process we may find ourselves in a new place without even anticipating it.  So just be here, for now, with this grief.  Give it your full attention and respect.  Hold on to it as lightly and as gently as you can.  With extreme kindness.  And in the process you may live yourself back into life and into living.

Wishing you much joy for today as you fully live each moment, no matter how much loss and grief you may be facing.

One of my favorite poems describes this process so well:

Be patient toward all that is unresolved in your heart                                            Be patient toward all that is unresolved in your heart                                                                      And try to love the questions themselves
Like locked rooms and like books that are written in a very foreign tongue
Do not seek for the answers that cannot be given
For you would not be able to live them
And the point is to live everything
Live the questions now
And perhaps without knowing it
You will live along some day into the answers

Rainer Maria Rilke

 

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Posted in Love & loss, grief & joy | Tagged | 2 Comments

Hello world!

Welcome to my musings in general on life as seen through my personal filter.  I make no pretense to know anything.  I write from my own lived experience and knowledge.  Perhaps you may find something to muse about for yourself within these posts.  If so let me know what you liked or didn’t.  If not happy to hear that too.

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