Posts under ‘compassion’

5:30 am—woken by back pain, restless and uncomfortable. I had acupuncture yesterday for the fourth week in a row, and despite the application of specific needles for back pain, there is no relief (although I have a deep, deep restorative sleep on the table each time). My mood has been very uplifted, although the acupuncture is simultaneous with my leave of absence from work, so it’s difficult to parse out what is the true cause of these emotional shifts for the better. Anyway, does it even really matter?

Last night, we went to the local university to see a few more short films on the genocide in Darfur. As an individual, I still feel somewhat powerless in the face of such a human travesty, but I blog about Darfur regularly, sign petitions, boycott Chinese products to a large extent, call my legislators, and get involved however and whenever I can. How can this happen on our watch? Hatred and intolerance and greed are the great failings of the human condition.

Walking by our local radical collectively-owned bookstore, I picked up a copy of “His Holiness The Dalai Lama, Path of Wisdom, Path of Grace: A Personal Conversation” by Felizitas Von Schoenborn. For me, The Dalai Lama is one of the greatest embodiments of compassion on the planet at this time. His seemingly lighthearted and heart-centered approach to the human predicament belies the deeply rooted compassion and grace which are the underlying modus operandi of his life’s work. He is someone I venerate without reservation, and I try to embody his teachings in my own humble and imperfect way.

The struggles of back pain, chemical sensitivity, insomnia, financial concerns, and the upkeep of home, hearth and professional life all seem to pale in the face of the suffering of those in Darfur, Iraq, Afghanistan, Palestine, Niger, numerous American inner cities, and other troubled areas of the world. Still, one must approach one’s own life and accept its conditions, act sanely to correct those conditions if needed, simultaneously attempting to better the lives of others while never losing sight of one’s own relative privilege. Life is a challenge from the start, and suffering seems inevitable. Were it not so, would we even be capable of appreciating that which we do have? As Modest Mouse have so recently sung:

“As life gets longer
it also feels softer
and it feels pretty soft to me;
and if it takes shit to make bliss
then I feel pretty blissfully
If life’s not beautiful without the pain
well I’d just rather never see beauty again.”

I received the following email today, my mother’s 75th birthday, her first birthday as a widow……

Evoking the power of compassion in us is not always easy. I find myself that the simplest ways are the best and the most direct. Every day, life gives us innumerable chances to open our hearts, if we can only take them. An old woman passes you with a sad and lonely face and two heavy plastic bags full of shopping she can hardly carry. Switch on a television, and there on the news is a mother in Beirut kneeling above the body of her murdered son, or an old grandmother in Moscow pointing to the thin soup that is her only food. . . .

Any one of these sights could open the eyes of your heart to the fact of vast suffering in the world. Let it. Don’t waste the love and grief it arouses. In the moment you feel compassion welling up in you, don’t brush it aside, don’t shrug it off and try quickly to return to “normal,” don’t be afraid of your feeling or be embarrassed by it, and don’t allow yourself to be distracted from it. Be vulnerable: Use that quick, bright uprush of compassion—focus on it, go deep into your heart and meditate on it, develop it, enhance and deepen it. By doing this you will realize how blind you have been to suffering.

All beings, everywhere, suffer; let your heart go out to them all in spontaneous and immeasurable compassion.

—Sogyal Rinpoche

After eleven years of providing direct nursing care—all in ambulatory settings, mind you—I wonder when it will be time to take a break and approach my work in the healthcare field from another vantage point. While I, like many nurses, thrive on the interpersonal relationships which nursing engenders, I also long for a rest from the emotional tugging which is part and parcel of my work.

But what is it about that “emotional tugging” that is so exhausting, you ask? The answer, to a large extent, is vicarious traumatization, wherein the act of bearing witness to the trauma of others can lead to internalization of trauma and psychic distress by the clinician. Several studies cited on the American Psychological Association website conclude that clinicians with their own personal trauma histories are more likely to experience deleterious effects when working closely with patients experiencing trauma.

Taking into consideration that the majority of my patients have suffered multiple traumas and live chaotic and difficult lives, I am consistently in a place of feeling unable to fully relieve the suffering of those around me. Confronted day after day by individuals whose suffering continues largely unabated, I surmise that my own level of suffering appears to have concurrently elevated, perhaps in response to those for whom my efforts seem to have little effect.

Many of my patients experience depression, anxiety, PTSD, and other forms of mental illness and psychic distress, not to mention chronic pain. Interestingly, my own depression, distress and physical pain symptoms have become significantly exacerbated in the last few years, leading me to more fully appreciate and understand my patients’ suffering based on my own experience. Having been diagnosed myself with PTSD six years ago following a friend’s murder, I appreciate the long-lasting effects of such experiences and the immeasurable difficulty of recovery.

The concept of vicarious traumatization is one which we all—clinicians and non-clinicians alike—might understand, but it is only now, as my own physical and psychic suffering has become augmented, that I more fully comprehend the insidiousness of its impact on the unwary clinician.

Luckily, this Thursday, I will attend a “Behavioral Health Grand Rounds” at a local hospital, where several experts on vicarious traumatization will present their research, their findings, and their recommendations to those of us interested to know more. As my leave of absence approaches at the end of this week, this particular presentation could not be more timely. I welcome this information, and also welcome the self-realization that it may engender.

Compassion is not true compassion unless it is active. Avalokiteshvara, the Buddha of Compassion, is often represented in Tibetan iconography as having a thousand eyes that see the pain in all corners of the universe, and a thousand arms to reach out to all corners of the universe to extend his help.

—Sogyal Rinpoche

I am reading “My Grandfather’s Blessings: Stories of Strength, Refuge, and Belonging” by Rachel Naomi Remen, M.D., a book which appeared in our house from an unknown source. Many books grace our shelves and I personally have no recollection of how they landed there. More fool me. But these organically-acquired books which seem to grow from the very shelves out of nothing often seem to hold wisdom and messages far exceeding their exterior qualities or appearance. “My Grandfather’s Blessings” seems to be just one of those sorts of books indeed.

Dr. Remen writes: “We bless the life around us far more than we realize. Many simple, ordinary things that we do can affect those around us in profound ways: the unexpected phone call, the brief touch, the willingness to listen generously, the warm smile or wink of recognition. We can even bless total strangers and be blessed by them. Big messages come in small packages. All it may take to restore someone’s trust in life may be returning a lost earring or a dropped glove.”

About compassion, she adds: “Without compassion, the world cannot continue. Our compassion blesses and sustains the world.”

Through her recollections of her early childhood experiences with her grandfather, an Orthodox rabbi, Dr. Remen uses his wisdom—imparted through simple acts and simple words communicated to a little girl from a wise elder—to discuss simple axioms illustrating the beauty and simplicity of a life of compassion and service.

Not three chapters into the book, and I can feel in my bones that the lessons to be gleaned in the subsequent pages are many. My hope is that I can not only read the words and understand them intellectually, but truly hear them, integrate them, and embody them in daily life. This is the challenge—cultivating compassion, even in the moments when it seems far beyond one’s reach. That certainly must be the task at hand, and its fulfillment is not a mundane achievement. His Holiness The Dalai Lama has said that kindness is his religion. So, if kindness were to be one’s religion, I would venture to say that compassion would then by necessity be one’s commandment. And living by that commandment of kindness and compassion must be one of the greatest goals that anyone could ever strive to fulfill.

A new concept made its way into my personal and professional orbit today and I wanted to share it here. This concept is something called “Schwartz Center Rounds“, which, according to the official website, is “a multidisciplinary forum where caregivers discuss difficult emotional and social issues that arise in caring for patients.” The organization is doing some very interesting and thought-provoking work, and we are considering applying for a grant to bring Schwartz Center Rounds into our workplace, where the stress of our work takes its toll daily.

The Schwartz Center website explains further: “Over 26,000 clinicians across the country participate in these interactive discussions and share their experiences, thoughts and feelings on different topics. Schwartz Center Rounds take place at over 110 sites in 26 states.”

Developed at Massachusetts General Hospital, the center appears to focus its energies on communication skills, end-of-life care, cultural competency, and spirituality. Aside from the Schwartz Center Rounds model, other programs include specialized training for medical, nursing, and allied health students, a speaker series, The Compassionate Caregiver Awards, and a Clinical Pastoral Education Program for Health Professionals.

Simply the notion that an organization exists with the sole aim of “strengthening the patient-caregiver relationship” buoys my spirit. That we, as a group of professionals, may be able to apply and receive grant money to strengthen our connections with patients and support ourselves in our work is truly a beacon of hope. In a team discussion, we decided that, whether we receive the grant or not, we have to make it our mission to bring this level of healing and self-awareness into our midst. The work that we do—caring for the sickest, poorest, and most disenfranchised inner-city communities—can truly exact a heavy price on clinicians and administrative staff alike, on both the physical and emotional levels. Despite the stress of our endeavor to provide such cutting-edge care, our attrition rate is extremely low, a testament to the closeness and camaraderie that we share as a team. Many of us frequently remark how this group of people works so well under incredible duress with such grace. Still, no amount of camaraderie can counteract the stress-related illnesses that can develop when deeper needs go unmet. I am a walking example, and my healing journey is still ongoing.

Gone are the old-fashioned days of the private-practice physician who tends to the needs of a small geographic area from birth to death, delivering babies and pronouncing the deaths of elders at home. Healthcare has become a behemoth of specialization, splintered care, multiple caregivers, complex treatments, and a financial climate which often flies in the face of the essence of caregiving. Managed care often ties clinicians’ hands, and caring for patients is made all the more difficult as providers jump through flaming hoops of bureaucracy to obtain the optimal treatment for deserving and ailing patients. The explosion of obesity, addiction, mental illness, and multiple comorbidities further stresses the system and the caregivers, and dangerous communicable diseases have only increased patients’ fears and providers’ need for increasingly specialized knowledge. It’s a complex medical world in the 21st century, and fears of litigation only serve to make providing care that much more stressful.

Given the current healthcare climate, the complexity of patients with multiple illnesses, and the demands on all of us working in the field, there have to be valves through which the pressure is released. Addiction, alcoholism, workaholism, and burnout certainly do release pressure, but the subsequent damage done by these practices is all too real. Schwartz Center Rounds and similar models of self-reflection and development may be just what the doctor ordered, but it’s a medicine that will only work if we take it.

Today is the day to commemorate a hero, a true lion of hope and equality. So many, like him, have fallen at the hands of known and unknown purveyors of fear: Malcolm X, JFK, RFK, Gandhi, John Lennon, the students of Tiananmen Square and Ohio State, Rachel Corrie, and the Greensboro Five. Some theorists feel that Paul Wellstone could be added to that list. Still others are driven from their homelands around the world, their lives spared but their hopes for freedom dashed.

Famous or completely unknown and unsung, so many have dedicated their lives to the freedom of others, and to equality and justice. Actions small and large accumulate and exponentially multiply the effect.

At times I wonder if I’m not doing enough, if my candle should be burning more brightly. If we all cared enough, wouldn’t all the problems already be solved? We can’t all be Martin, John, Mother Teresa, or Rigoberta Menchu, but we can all be who we are, enacting change by embodying love and compassion in the world. Some do their part simply by living quiet lives of meditation. Others march in the streets and speak truth to power. Still others send money, write letters, or speak up for those without a voice.

And the others, you ask? Yes, there are still others who do nothing but fend for themselves and take all that there is to take. But even for these there must be compassion somewhere in one’s heart, even if for now that place is closed and inaccessible. As for those who are purveyors of fear and sowers of division, must we not also feel compassion for them as well? Some of us are capable of such compassion, some even attain the bliss of true forgiveness. Still others even more enlightened might realize that those brokers of fear are no different than ourselves and fully deserve our compassion.

As for me, I continue to struggle to forgive some in the world who have wronged me, like those who murdered my closest friend in the prime of his life and the rest who did their best to obfuscate the truth. My hatred and anger are still not dissipated, and I know that these emotions will only cause me harm in the end, no matter how human they may be. I also have strong vitriolic feelings for those who I feel are responsible for the raping and pillaging of our country, our culture, our economy, our ecology, our very soul as a nation. Will I some day feel compassion and forgiveness for them? It is a tall order, I must say.

But in the spirit of Martin, today is a day to hold forth a vision, even if the more difficult emotions serve to cloud that vista from time to time, like an emotional cataract. Without that vision, all is lost, and only the clouds and darkness hold sway. I’m sure Martin forgives his transgressors and sees the bigger picture from the vantage point of enlightenment. We can all catch a glimpse of that picture from time to time, and when we do, it’s a breath of fresh air. It may be a mad, mad world out there, but to paraphrase and twist the words of W.C Fields for my own purposes, “there’s a hero born every minute”. Let’s prepare the way for the the heroes of the New World, the world that’s just around the bend, the one which Arundhati Roy says that she can hear breathing.

This is today’s meditation which I received by email from Sogyal Rinpoche. I receive these missives daily, and this one touches my deepest heart on this day, my mother’s birthday.

Evoking the power of compassion in us is not always easy. I find myself that the simplest ways are the best and the most direct. Every day, life gives us innumerable chances to open our hearts, if we can only take them. An old woman passes you with a sad and lonely face and two heavy plastic bags full of shopping she can hardly carry. Switch on a television, and there on the news is a mother in Beirut kneeling above the body of her murdered son, or an old grandmother in Moscow pointing to the thin soup that is her <!– D(["mb","only\nfood. . . .

\n

Any\none of these sights could open the eyes of your heart to the fact of vast\nsuffering in the world. Let it. Don’t waste the love and grief it arouses.\nIn the moment you feel compassion welling up in you, don’t brush it aside,\ndon’t shrug it off and try quickly to return to “normal,”\ndon’t be afraid of your feeling or be embarrassed by it, and don’t\nallow yourself to be distracted from it. Be vulnerable: Use that quick, bright\nuprush of compassion—focus on it, go deep into your heart and meditate on\nit, develop it, enhance and deepen it. By doing this you will realize how blind\nyou have been to suffering.

\n

All\nbeings, everywhere, suffer; let your heart go out to them all in spontaneous and\nimmeasurable compassion.

\n\n\n\n\n\n\n \n\t\n\n\n

\n \n\n \n Home\n

\n\n\n\n\n

\n \n\t\n\t\tSubscribe to the Glimpse of the Day\n\t\t

\n \n Unsubscribe from Glimpse of the Day\n ",1] ); //–>only food. . . .

Any one of these sights could open the eyes of your heart to the fact of vast suffering in the world. Let it. Don’t waste the love and grief it arouses. In the moment you feel compassion welling up in you, don’t brush it aside, don’t shrug it off and try quickly to return to “normal,” don’t be afraid of your feeling or be embarrassed by it, and don’t allow yourself to be distracted from it. Be vulnerable: Use that quick, bright uprush of compassion—focus on it, go deep into your heart and meditate on it, develop it, enhance and deepen it. By doing this you will realize how blind you have been to suffering.

All beings, everywhere, suffer; let your heart go out to them all in spontaneous and immeasurable compassion.

When speaking of compassion, one must also speak of suffering. The two seem to go hand in hand, the former a frequent consequence of the latter.

Many forms of suffering pervade the human condition: war, hunger, illness, crime, loneliness, imprisonment, enslavement, poverty, natural disaster. Where do we turn to ameliorate the suffering of others? Whose suffering do we choose to do something about and to whose condition do we turn a blind eye?

The entreating envelopes arrive in the mail almost daily: Amnesty International, The Human Rights Campaign, Oxfam, the list is endless. There is global suffering, local suffering, the plight of animals, of children, of women, of the sick, of the environment. Which envelopes do you throw in the trash? Which ones live on your desk for weeks or months? Which ones are returned immediately with a check? How does one decide where one’s money is most needed? How does one not feel guilty about all of the worthy causes you just cannot afford to support?

For all the direct action in which an individual can take part, it seems that the soul, the very heart is the place for one to begin practicing compassion. One must first cultivate compassion for the self, learn to forgive ones self over and over again, assuage one’s own suffering, and perhaps then extend that energy to others. I am often much quicker to excuse the behavior or actions of others while digging deep holes of self-blame and recrimination in my own heart and mind. Thus for me, the question is not necessarily how to cultivate compassion for others per se, but more how to simultaneously allow myself that same level of acceptance and peace. Perhaps from that place, one’s actions towards the rest of the world come from a deeper, more grounded center built on self-love rather than guilt, on fullness rather than lack. Perhaps.

So, those envelopes that keep coming in the mail? I can guiltily drop them in the recycling box and hate myself for my shallow self-centeredness, I can send them each a pittance in an attempt to assuage my guilt, or I can simply send my money to the place to which I am guided by my heart, and continue to live a life driven by compassion, certain that what I produce and engender in this world will echo ever wider in ripples of compassion and love.

I think I’ll choose to forgive myself and others, do what I can, release the guilt, release the pain, and wake up tomorrow and start again.

One technique for arousing compassion for a person who is suffering is to imagine one of your dearest friends, or someone you really love, in that person’s place.

Imagine your brother or daughter or parent or best friend in the same kind of painful situation. Quite naturally your heart will open, and compassion will awaken in you: What more would you want than to free your loved one from his or her torment? Now take this compassion released in your heart and transfer it to the person who needs your help: You will find that your help is inspired more naturally and that you can direct it more easily.

—Sogyal Rinpoche

You can subscribe and receive a daily email meditation from Sogyal Rinpoche here.