Starting the Day

How does technology mesh with mindfulness, or should I say is it possible to find some connection between the two? Yes, I do believe it is possible, but it must be deliberate use of technology. One of my favorite ways to connect technology with mindfulness is a daily practice I started several years ago. My very first email I open each day is one from Panhala (meaning "source of fresh water" in Hindi). Each day I spend a few moments of awareness with a new poem that speaks to mindfulness, compassion, life. Panhala is a free yahoo group, open to anyone who would like these moments of contemplation delivered to their inbox every day. Today's poem was especially appropriate:

life is a garden,

not a road

we enter and exit 

through the same gate

wandering,

where we go matters less 

than what we notice

~Bokonon~

Do We Need to Lose Things Before We Can Find Kindess?

I was pleased to learn that the award winning poet, Naomi Shihab Nye is the 2013 Robert Creeley Foundation Winner and will be presenting a reading of her poems in the Boston area (Acton-Boxborough High School, Acton MA) on Wednesday, March 6 at 7:30 PM.

One of her poems, Kindness, is a particular favorite of mine.  I was first introduced to this poem when I was training to teach mindfulness at the Center of Mindfulness in Medicine, Health Care, and Society. What struck me when I first read the poem and as I re-read the poem again and again is the notion that experiencing loss opens one to the ability to give and receive kindness more wholly.

What do you think? I would love to hear your thoughts and comments...do we need to lose things before we can find kindness?

Kindness
(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 your 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.

Season of Kindness

With the uber excess of the holiday season, it is easy to forget the gift that we each already possess, is renewable and transferable, doesn't need to be wrapped, always fits and doesn't cost a dime...the gift of kindness and compassion.  In the Buddhist tradition, this quality of loving kindness or compassion is called metta and is meant to be cultivated and nurtured both in ourselves and extended outward to include all living beings in the world. Self compassion is often the most difficult to nurture, but essential to be able to acknowledge and share your metta with the others.  During this season of giving, why not  save yourself a trip to the mall and consider giving the gift of kindness, compassion and presence?

Kindness
by Naomi Shahib 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 your 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 every where
like a shadow or a friend.

Choosing to Keep the Heart Open

Grief is universal.  As human beings we are fortunate that we can feel the emotion of love so strongly, but tightly bound to this intense love is the incredible grief we feel when one we love dies.  Some of you may know that my son, Nick, died of a rare form of cancer in 2001 when he was just 14 years old.  I was both humbled and honored when I was recently asked to deliver a speech at the 20th annual Pediatric Memorial Service at Massachusetts General Hospital to honor the children who had died and the parents, siblings, relatives, friends, and healthcare providers who they left behind.  A large part of my professional life is spent as a public speaker, so I am comfortable expressing myself before a large audience.  However, as you can imagine, this speech didn't come easily to me. As I worked on what I wanted to say to the audience gathered at Massachusetts General Hospital, it became clear that perhaps these words needed to travel further, so I am posting them here, in my blog, in hopes that someone who may find comfort in them will find them here.  It is with compassion, peace and hope that I offer these words to each of you ~ Pam

  

Sunday, November 6, 2011 ~ Massachusetts General Hospital, Boston, MA

"The only whole heart is a broken one...it lets the light in" ~Rabbi David Wolpe

There are few choices afforded to us in how to survive the loss of a child.  Well meaning friends, relatives and professionals may advise us "not to let this tragedy define who we are", but I will have to respectfully disagree with this advice.  The tragedy of losing a child is a life changing event like no other: We are confronted with not only the loss of one we deeply love, but with the loss of our future as we had envisioned.  We are shaken to the very core of our existence and essence. Yes, this event will define us for the rest of our lives whether we want it to or not.

When our loss is new, it is unfamiliar and terrifying in its intensity.  I vividly remember waking up the morning after Nick died and being absolutely amazed and incredulous that the sun had the audacity to rise, that the school bus continued on its scheduled route down my street, that  people went to the grocery store, commuted to work and  that the mail was delivered...the outside world continued to function as if nothing had occurred.  It was a surreal scene.  Because for me it was as if a nuclear bomb had been detonated.  The world as I had known it had been destroyed with the death of my son.  My world now was defined as a new normal even though I wished desperately for the old normal to return. 

Rabbi and author, David Wolpe, aptly describes the feeling of new loss in this way  "When we experience a loss, a hole opens up inside of us. It is almost as if the loss itself plows right through us, leaving us gasping for air" and we bleed profusely through this opening. During the early days, months and years after our loss, we focus on how to slow down this  hemorrhage, this continuous emptying of grief.  But then something begins to change, very, very slowly; the immediate agony subsides. Around the edges of that opening, things begin to heal and scar tissue begins to form.  This is the point at which we can choose how the tragedy of our loss will continue to define our lives...we can choose  to allow the scar tissue to continue to form and thicken, closing the hole within us -- hardening us to the world with the unfairness and unjustness of our loss; or we can choose to allow the hole to remain open, allowing not only the stream of grief to flow out but permitting light, hope and meaning to enter.  I have chosen to allow the hole within me to remain open and this is one of the gifts my son has given me. 

Rabbi Wolpe suggests that "The only whole heart is a broken one, it lets the light shine in."  Allowing the hole to remain open, has allowed me to be a more compassionate person to others and myself, perhaps a bit less judgmental and more empathetic than I was in my old normal.  Keeping the hole open has made it easier for me to prioritize what really matters and not what I think should matter -- it now OK to say no to mundane tasks and yes to things that feed my soul.  I do not fear many things now -- after all the worst has happened to me, so what do I have to be fearful of now?  And most important, by keeping the hole open, continuing to allow the grief out and the light in, I am able to hold Nick and the meaning of his life close.  

So, perhaps I have what the professionals call a "maladaptive coping strategy", but I embrace the notion that yes, I have let this tragedy define me in a way I never imaged would be possible; by allowing my heart to remain broken, and open, it is, in my new normal, whole once more.

I wish each of you peace, hope, and healing on your journeys.

Engaging with Grace this Thanksgiving

As you gather together with family and friends over the Thanksgiving holiday, what are you going to talk about? I am guessing that the topic end of life choices will not be on the list of conversation starters. But perhaps it can and should be. While none of us knows the exact choices we will need to make for ourselves or a loved one at the end of life, we can open an ongoing conversation about what is important for us, what we value, and what are our wishes. As someone who has had to face end of life choices in both my professional life and in my personal life, beginning the conversation around the dining room table is much more compassionate, and empowering than beginning the dialog in the intensive care unit.

For the past three years, I have been participating in the Engage with Grace Blog Rally at the invitation of Paul Levy, CEO and President of Beth Israel Deaconess Hospital in Boston and am thrilled to see that the number of health care bloggers supporting this effort has grown exponentially each year. As we consider the exciting possibilities of participatory medicine and an increased desire for more shared decision making between health care providers and patients/families, we also must recognize that we need to ask about our loved ones wishes for medical care and intervention; understanding that they may not be identical to our own. Please join me and my family as we Engage with Grace this Thanksgiving with one slide and five questions.

With gratitude,
Pam

Things we are grateful for this year

For three years running now, many of us bloggers have participated in what we’ve called a “blog rally” to promote Engage With Grace – a movement aimed at making sure all of us understand , communicate, and have honored our end-of-life wishes.

The rally is timed to coincide with a weekend when most of us are with the very people with whom we should be having these unbelievably important conversations – our closest friends and family.

At the heart of Engage With Grace are five questions designed to get the conversation about end-of-life started. We’ve included them at the end of this post. They’re not easy questions, but they are important – and believe it or not, most people find they actually enjoy discussing their answers with loved ones. The key is having the conversation before it’s too late.

This past year has done so much to support our mission to get more and more people talking about their end-of-life wishes. We’ve heard stories with happy endings … and stories with endings that could’ve (and should’ve) been better. We’ve stared down political opposition. We’ve supported each other’s efforts. And we’ve helped make this a topic of national importance.

So in the spirit of the upcoming Thanksgiving weekend, we’d like to highlight some things for which we’re grateful:

Thank you to Atul Gawande for writing such a fiercely intelligent and compelling piece on “letting go” – it is a work of art, and a must read.

Thank you to whomever perpetuated the myth of “death panels” for putting a fine point on all the things we don’t stand for, and in the process, shining a light on the right we all have to live our lives with intent – right through to the end.

Thank you to TEDMED for letting us share our story and our vision.

And of course, thank you to everyone who has taken this topic so seriously, and to all who have done so much to spread the word, including sharing The One Slide.

Engage with Grace: One Slide Project

Arts of Compassion

Mark your calendars! Arts of Compassion: Perspectives on Arts and Health is an upcoming symposium scheduled for Saturday, October 2, 2010 at the Berklee School of Music. The Longwood Symphony will also be performing after the symposium. The symposium is being sponsored by BACH (Boston Arts Consortium for Health). This promises to be a wonderful day of inspiring speakers and moving music!

Love after Love

February is a month of the heart...both our physical heart evidenced by very important public health campaigns such as the Go Red for Women initiative by the American Heart Association; as well as the metaphorical heart...the heart of love and compassion. Often we think of love as simply the commercial accoutrements of Valentine's Day with roses and chocolates, but can we think of it as much more? How do we create a culture of compassion and empathy for ourselves and others? Now that the Hallmark day of love has passed, I thought I would share this poem by Derek Walcott that touches upon the very difficult task of compassion for self. I have included an audio clip of Jon Kabat-Zinn reading the poem....enjoy!

What does the poem mean to you? How have you included compassion for self into your day to day life? I would love to hear your thoughts and comments!

Love After Love

by Derek Walcott

The time will come
when, with elation,
you will greet yourself arriving
at your own door, in your own mirror,
and each will smile at the other's welcome,

and say, sit here. Eat.
You will love again the stranger who was your self.
Give wine. Give bread. Give back your heart
to itself, to the stranger who has loved you

all your life, whom you ignored
for another, who knows you by heart.
Take down the love letters from the bookshelf,

the photographs, the desperate notes,
peel your own image from the mirror.
Sit. Feast on your life.

It's All About Connection

Each year The Kenneth Schwartz Center selects a Compassionate Caregiver who embodies the qualities of empathy, compassion, caring and presence in their work and life. This year's winner is Dr. Amy Ship, a primary care physician at Beth Israel Deaconess Medical Center in Boston. I was particularly moved by Dr. Ship's acceptance speech, where she explains that it is all about connection...connecting through presence, through compassion, through understanding as both the care-giver and care-receiver. “The longer I’ve practiced medicine, the more I’ve come to realize that we are all, as the years go on, ‘survivors,’” she said. “For some it is cancer, but for others it is diabetes, or seizures, or kidney failure, or all of the above. Others are survivors of loss – loss of a limb, loss of sight, loss of autonomy, loss of hope, loss of a loved one. And I have learned that many of us – like me – carry with us some secret sorrow – a loss or challenge that is not noticeable. Connecting with patients means looking for what is not immediately visible, listening for the hole in another’s heart.”

I encourage you to view Dr. Ship's speech by clicking here and see and hear what connection in healthcare is all about! Congratulations, Dr. Amy Ship, truly a compassionate caregiver.