Monday, March 31, 2008

Apparitions and Laughter

Since everything is but an apparition,
Perfect in being what it is,
Having nothing to do with good or bad,
Acceptance or rejection

You might as well burst out laughing!

LONGCHENPA

Sunday, March 30, 2008

Here With the Lord Beside Me

She sits on the double bed in her studio apartment with great dignity, the early morning light streaming in the window. Gospel music plays on a small CD player on a table by the kitchen door. This is our first meeting since I'm just covering for her usual nurse.

"How are you this morning, _________?"

"Oh, I'm OK. I'm here with the Lord beside me," she says with a nod of her head towards the CD player. The music plays on.

"Did you sleep well last night?" I ask.

"Well, I only slept a few hours. I can't sleep much since the doctors killed my daughter last year."

I look her in the eye, and she stares back. Her gaze makes me slightly uneasy, but I hold it.

"I am so sorry for the loss of your daughter. That must be so hard."

"Yes, but He sees me through."

We listen to the gospel music for a moment.

"The music is really beautiful," I say sincerely.

"Can I give you your meds now?"

"Sure, honey," she replies.

I put her morning meds together, prefill her evening meds to take with dinner, and ask if she needs anything else.

"No, I'll be alright. My PCA will be here in a few hours."

"OK. I hope to see you again some time, my dear."

"God bless you, and thanks for coming."

She stares at me with that unsettling gaze again. Sometimes the chronically mentally ill can be socially awkward or unaware of how they look at people or how they speak. But in this case, I just feel like she's looking at me very deeply, and I simply try to meet her gaze.

"God bless you, too, and I'm very sorry about your daughter."

"Thanks you. Bye bye, dear," she says as I close the door.

Walking to my car, the ubiquitousness of loss and grief hits me, and I take a deep breath as I open the car door.

Just another day on earth.

Saturday, March 29, 2008

A Neighbor, A Death, and Thoughts Thereof

This morning, I was walking our dog and noticed a line of cars in front of a neighbor's house. All of the people walking up to the house were dressed in dark colors and the mood seemed very somber. Arriving home, I told Mary that I had the feeling that someone had died. We checked the local obituary and discovered right away that our neighbor---a man of 57 in the prime of his life---had indeed died twelve days ago of cardiac complications. Luckily, the memorial service was today, and we were able to attend and join the community of mourners.

The service was held in a local church, the altar still brimming with Easter flowers. The music of Van Morrison played in the background as people filed in and found their seats amongst the pews, and the service itself was a lovely event, replete with moving readings, poignant music and poetry, funny stories, and shared remembrances. The wife of the deceased spoke of their thirty years of marriage, and his adult children each took a turn to honor their beloved father whose absence will be all too keen as they themselves move toward their own parenthood.

Over the course of the service, I remarked to myself how this particular event was just what it should be. For those familiar with the person who had died, it was a reminder of cherished stories and of his particular idiosyncrasies which made him unique. With friends coming from near and far, I'm sure some new stories came to light and provided even more elucidation of his very singular mark upon the world.

For those of us less familiar with our neighbor, the service provided a very intimate snapshot of a life well lived, and the varied sharings left one with a very strong impression of a man, a family, a life, and a brilliant personal legacy.

Mary and I did not know this gentleman well, but we would cross paths with him and his wife while we walked our dogs over the years, and I recall that she even came to our house for a party once upon a time. Luckily for us, the last time we saw him was in the autumn. We were sitting by the pond near our house, and he sauntered over with his dog and sat himself down next to us, something quite uncharacteristic for a man who was generally much more socially reserved. I recall that we were at first feeling rather private, but he was very good company that day and we enjoyed our conversation with him very much, and never saw him again throughout the subsequent long and cold winter. What a blessing that we had that opportunity to be with him, and how glad I am that we have that memory of our last interaction.

Now, a new widow is in our midst, and within the privacy of her home, she will continue this process of grieving that is only weeks old. She and her children will go to the university to clean out his office, go through his papers, and will perhaps be at once perplexed and overjoyed by the things that they discover. How little thought most of us must give to the fact that, upon our untimely death, our loved ones will need to rifle through our things and settle the dust of our lives. There will be much to settle in that household after such a creative and productive life, and I do not envy that family the difficult task at hand.

With two dear friends so recently in surgery and now the death of our neighbor, I'm reminded quite starkly of the fleeting nature of life. As I struggle with chronic pain and some recently significant depression, I hold my own life up for close examination and wonder what conclusions would be drawn about me at my own funeral. I know I need to smile and laugh more. I also know I need to have more fun and take time to relax. While I struggle to earn enough money, I can say with certainty that no one at my funeral would begrudge my earning power or lack thereof. Still, life proffers many challenges, and we strive to honor our earthly responsibilities while also taking time to smell the roses.

Life is tenuous at best, and this week's experiences in my own life demonstrate that it can be saved or snuffed out at any moment. I am aware of this tenuousness, and I only wish to make that awareness something that informs my every breath.

Friday, March 28, 2008

Friends at Risk

As I write this missive, two friends are undergoing surgery, placing their lives in the hands of doctors and nurses and anesthetists on this very morning.

One friend is having a total hysterectomy in order to control Dysfunctional Uterine Bleeding (DUB) which has been unresponsive to hormones and other non-invasive treatments.

The other friend has been suffering from severe headaches and back pain which could not be controlled with any medications. An MRI of the brain revealed a 2-centimeter tumor in the frontal lobe. There are many risks to the surgery, including nerve damage which could result in paralysis or other consequences.

I will also mention that the husband of an old friend has multi-organ cancer which has not responded to conventional chemotherapy and he will now undergo a clinical trial at a major East Coast cancer treatment center in an attempt to slow or reverse the disease process.

May the surgeons and nurses and other surgical staff be guided to perform at the height of their skill. May my friends recover from surgery fully healed, without negative side effects or complications. May the cancers be contained and eradicated. We prayed for them last night here in our house, and we will hold them in our thoughts this morning and throughout the day.

What are my problems in the face of such suffering and life-altering disease? May we all find perspective and some modicum of peace when we examine and consider the suffering of others.

Thursday, March 27, 2008

The Stream of Connection

(This is a piece written in my writing group this morning, prompted simply by a powerful photograph of a proud and beautiful African woman with deep, dark eyes staring directly into the camera.....)

She speaks of strength and focused determination. She tells me of deeds of goodness and good will. She says that I have the strength to move mountains. She says to not be afraid.

As the snows melt and the soil again becomes porous and moist, so too, she says, can my mind. Just as the stream is released from the grip of its icy prison, so too can my mind be released from the places where it has iced over with resistance.

She speaks to me of human loss and of what comes after. Her eyes tell the story of children taken from their parents, of women dying in childbirth, of people stricken with illness, pain and loss of independence. Still, she says, even in the face of catastrophic loss, we place one foot on the earth and step forward, and the other foot naturally follows.

There is a place that we can go, she says, where there is a well of strength that feeds us in times of sorrow. This well is a universal place of regeneration and recuperation, and it is available to us always. This well is our birthright, but all too often even our parents have forgotten its very existence, thus we must rely on other teachers to lead us to its benevolent grace.

So much of the time, she says, we feel so alone. We move in a world in which many of us feel isolated and unseen. People passing us on the street have no idea of the turmoil in our minds, but a kind look or a sincere smile from a stranger can actually alter the trajectory of our day. Sometimes, locking eyes with a stranger---perhaps on the train or on the street---some magic happens, she says. For a brief moment, we might actually see that person’s soul while they are seeing ours. It’s not like falling in love. It isn’t ESP. It is simply two people taking the briefest of fleeting moments to connect in a way that is beyond words, wherein an understanding occurs that has nothing to do with mind-reading or any conscious process. This type of connection is like stripping away the veneer of consciousness, and in that moment we see that separation is an illusion, and we are separated from oneness by the thinnest of veils.

Survival of the fittest has given way to survival of the most connected, the most interdependent, she says. Look for connection, she says, and you will be rewarded. Lose sight of connection, of interdependence, and you will suffer. Community is like a stream into which one dives, blending with others while maintaining your sense of self. Ignoring your innate thirst for connection will leave you parched, she says. Look for it, she says, at the bank, on a street corner, at the cafĂ©, in the park. A child, a dog, a busker on the sidewalk. The stream of connection is within reach at any given moment. Don’t you see it?

Wednesday, March 26, 2008

Back in the Saddle

Dear Readers,

I have been out of town for the long holiday weekend, visiting family along the Eastern Seaboard. If you and yours celebrate Easter, I hope it was joyous. And if you celebrated Purim, joy and merriment to you as well!

Traveling by Amtrak had its ups and downs, but overall it was worthwhile not having to drive all of those arduous miles. (I am also aware that train travel is a good choice vis-a-vis environmental impact). Still, getting around by train in the U.S. is nothing like it is in other countries, and I found myself pining for the timely, clean, and comfortable trains of Europe.

Now, here I am back at home, happy to be in my own space, and ready to get back to work once again. Stay tuned for the usual frequent blog posts, and please keep those comments, cards, and letters coming!

Blessings!

Friday, March 21, 2008

The Blanket of Mindfulness

The practice of mindfulness defuses our negativity, aggression, and turbulent emotions, which may have been gathering power over many lifetimes. Rather than suppressing emotions or indulging in them, here it is important to view them—your thoughts and whatever arises—with an acceptance and generosity that are as open and spacious as possible. Tibetan masters say that this wise generosity has the flavor of boundless space, so warm and cozy that you feel enveloped and protected by it, as if by a blanket of sunlight.


---Sogyal Rinpoche

Thursday, March 20, 2008

Change of Shift, Vol. 2, No. 19

The newest edition of Change of Shift is now available for your reading pleasure. Change of Shift, the brain-child of Kim McAllister at Emergiblog, brings you some of the best blogging by nurses anywhere in the blogosphere. I highly recommend a perusal, and many thanks to Kim for keeping Change of Shift active and dynamic.

Wednesday, March 19, 2008

Stand Up for Tibet

Considering the tragic circumstances occurring in Tibet, please consider clicking here to sign a petition urging the Chinese government to show restraint in its treatment of protesters who are calling for Tibetan freedom after fifty years of Chinese control. Another petition is available here, and many people are calling for a boycott of the summer Olympics which are scheduled to be hosted in China this summer. Meanwhile, protests are spreading around the world.

China has ruled Tibet since the 1950's after Chinese troops overran tho sovereign Tibetan nation and forced the Dalai Lama to flee or face imprisonment or death. The Tibetan government has been operating in exile since 1957. If you would like to learn more about the Tibetan Government in Exile, you can visit the official website for news, history, facts, and information about the human rights of Tibetans.

In its constant desire to control its citizens' access to information, the Chinese government has been blacking out any news about the Tibetan uprising, and hundreds, if not thousands, of websites have been blocked by Chinese censors, including YouTube, CNN, and Google News.

Meanwhile, Tibetan and Chinese protesters are being arrested, intimidated and killed as the protests continue, and His Holiness the Dalaia Lama is threatening to step down as Tibet's political leader if the violence does not stop.

It is a sad day for Tibet, H.H. The Dalai Lama, and for the world at large.

Monday, March 17, 2008

Three Minutes

"And what do I owe you?" she asked.

"Five thousand francs," he answered.

"But it only took you three minutes," she politely reminded him.

"No," Picasso said, "It took me all my life."

Sunday, March 16, 2008

Persepolis

Persepolis, the new animated film written and directed by Marjane Satrapi, chronicles her life in pre- and post-Revolution Iran, covering the overthrow of The Shah, the Iran-Iraq War, the rise of Islamic Fundamentalism, and the austerities and deprivations of living in a war zone and under a repressive regime.

Based on Satrapi's eponymous graphic novel, the film is lush and terribly poignant, and repeatedly brought my wife and I to tears. The title Persepolis refers to the Persian capital founded by Darius I in the 6th century BC and subsequently destroyed by Alexander the Great.

Seeing such a personal depiction of war, loss, grief, depression, violence and political repression was yet another reminder of how it is never too late to count our blessings. This film was also a stark reminder of how the United States government and other western powers have toyed with the East for centuries. In this case, we propped up the Shah---ostensibly a puppet of the West---armed Saddam Hussein in the 1980s when it was in our interest to do so, and fomented the Iran-Iraq War in a divide-and-conquer maneuver used by empires throughout the centuries. The film presents a perspective rarely seen by Americans, one filled with irony and a resigned acceptance of corruption and repression as natural human conditions.

I highly recommend the film, and the website is as lush and evocative as the film. You will not be disappointed.

The Ides of March

"Beware the Ides of March" was the soothsayer's warning to Julius Caesar prior to his assassination in 44 B.C., and the saying was apparently ingrained in the English language by William Shakespeare in his play Julius Caesar as a warning of impending doom.

According to Wikipedia, "the term ides was used for the 15th day of the months of March, May, July, and October, and the 13th day of the other 8 months" (in the Roman calendar).

In my life, the Ides of March signifies one of the most difficult times of the year. Living in New England, mid-March generally manifests as a blustery and damp time of fickle weather, fluctuating temperatures, chilly winds, and a deep longing for a Spring that is painfully slow to arrive. In the latter portions of March and early April, "mud season" arrives as the ground thaws and fills with the moisture from melting snow and ice. In March, our warmth- and sun-starved faces turn towards the sun whose appearances are still frustratingly brief. Still, with extended Daylight Savings Time and the natural course of solar events, sunset comes later and later, and the return of the light is upon us.

As I so recently opined, March also brings several death anniversaries, as well as the birthdays of a number of deceased loved ones, a potentially unfortunate synchronicity. But perhaps this inward and historically melancholy time is naturally and simply perfect for reflection and grief. One must remember that, on the heels of this most interminable winter, Spring is just around the corner, bringing with it longer days, brighter sun, blooming trees and grasses, and rising temperatures.

I wait with baited breath for those heady days when we can lay on soft earth and grass, soak in the sun, and turn our faces towards that beloved golden orb with relish and joy. Until then, we allow the Ides of March to come and go, looking forward towards the dawning of April and the coming of Spring.

Friday, March 14, 2008

Mindfulness Journal: Grief

Grief moves like a subterranean stream through my life, and its liquidity is a constant yet frequently unconscious presence. Days can pass wherein I dip nary a toe in the rushing waters. Yet other days, the waters rise, and the briny fluid reaches the wells of my eyes.

These past few weeks, that subterranean tributary is quite less than subterranean. Its level has risen, and the melting winter snows seem to have swelled the stream, feeding its depth, its breadth, and its velocity of movement.

This month of March brings with it the dying breaths of Winter, as well as the birthdays of three dearly departed loved ones. Grief is natural at this time of year, and the lack of sun in this New England late winter only adds to the challenge.

So, what to do in the face of grief's rise? Watch, breathe, cry, and breathe some more. It is, after all, simply an energy. Grief has no substance, no true physical form, although it will often manifest in the body as pain. Yet grief is a mind state, an emotional space, a spiritual state. But notwithstanding, I do not have to choose to live there. When grief moves through me, it is enough to simply be, to breathe, to cry, to breathe through grief to the next moment, and then the next, and the next. If grief is truly a stream, a tributary of the waters of life, then perhaps I can simply choose to enter---and exit---on the pillow of a mindful breath.

Thursday, March 13, 2008

Pain: The Unwanted Hitchhiker

Chronic pain is so very inconvenient. It is so limiting and restricting, like a belt worn unnecessarily tight.

Pain effects one's sleep, one's ability to exercise. It can curtail the enjoyment of sex, and even the most burgeoning appetite. It restricts one's activities, precludes some activities altogether, and can be a demoralizing agent whose influence cannot always be ignored.

Pain is like a hitchhiker who has worn out his welcome but cannot be extricated from the passenger seat. Perhaps his first appearance was not overly worrisome, and he exited peacefully when requested to do so. Maybe he was even helpful that time you had an emotional flat tire and needed an excuse to rest. But months later, thoroughly ensconced in the back seat, wearing an iPod, drinking a Coke and ignoring your every plea, this aberrant guest now refuses to let you be. The welcome mat---if it had ever been in place---was long ago jettisoned, but this vagabond ignores the rules and clings to you like a needy child.

When did this pain become such a burden? At what point did I realize that my life was being taken over? When was it that I picked up a passenger whose very presence makes me scream with impatience?

And so, with no other bright ideas, I embrace pain as a teacher. I follow his lead, peering into dark alleys which have long been ignored. He leads me to painful emotional places riddled with doubt and self-loathing. His mere presence is yet another vehicle for cultivating a mindful response to life, acceptance of what is, however difficult or ugly.

I am mindful of my pain, but also mindful of my innate ability to rise above its undo influence on my life. He is an unwanted hitchhiker, it's true. But even the most unwanted guest may hold in his hand a gift of great beauty, and since he is slow to reveal his secrets, I will continue to pursue them, even as I wish him gone.

So, dear Pain, my most aberrant passenger: reveal your gift and be done with it. I am ready for the message now, and ready for you to move on. The damage has been done, and I am poised to reclaim my life from your messy grasp. Relinquish me now, and leave your gift by the door. And please, don't look back. You will not be missed in the least.

Wednesday, March 12, 2008

A Brief and Pleasant Exchange

She's waiting for me in front of the tired clapboard house on a busy city street. I'm doing a visit for a colleague (in my new consultant position), dropping off some meds and checking in on this very lively couple with whom I am totally unacquainted.

"Hey! Thanks for coming over with the meds!" her partner yells. He is jovial and talkative, slapping my back and shaking my hand.

The house is a boarding house: shared kitchen, office downstairs with staff during the day. Pretty clean inside, a little rough around the edges. Their room is one large bedroom with a bathroom and a closet. A little small and dark, I think.

"How long have you been here?"

"About a month," she says.

"It's great. You both seem really happy. Can I check your blood pressure while I'm here?" I hand him his prefilled medication box and give her the rest of the things I've brought over: medicated shampoo and cream, Lidoderm patches for his muscle pain.

"It's so much better than the shelter," he adds. "I've been clean two, maybe three years now. See my tracks?" He shoves his arm at me as he rolls up his sleeve. I examine his forearm and the crook of his elbow, which he obviously wants me to inspect closely. Sure enough, track marks galore, but quite old and healed.

I take his blood pressure as he sits on their only chair. When it's time for me to check hers, she sits on his knee.

"This woman," he says, motioning to his partner. "She's my life. Don't know what I'd do without her."

"You all obviously care about each other a lot," I say in response.

"Yeah, through thick and thin," he says. She laughs.

We talk briefly about their health. I question them, nurse-style, about their bowels, their urinary status, pain management, respiratory status, the usual line of questioning. They answer each question with kindness and patience.

"Hey, thanks for coming, man. We really appreciate it." He shakes my hand and slaps my back again, just like he did when I arrived.

She leads me down the stairs.

"You have yourself a man who loves you, don't you?" I ask.

"Oh, he's the best. We've been though a lot together."

"Well, you keep taking care of each other. I hear you're both doing a great job."

She smiles. "Yeah, I guess so. We're tryin'. That shelter was awful, but things are better now. Thanks for bringin' our stuff over. Sometimes it's so hard to get to the clinic."

"No problem. Glad to help out," I reply. "I hope to see y'all again."

"You're always welcome here." She smiles as she closes the door.

So polite. So welcoming. So amenable to my presence, despite never having met me before. A thoroughly pleasant interaction, made easier by the fact that I bear no responsibility for their care, just for this brief and satisfying exchange.

Monday, March 10, 2008

A Letter to My Hospice Employer

Dear ____________,

It is with regret and disappointment that I am writing to officially resign my position as a per diem Registered Nurse at ___________. Apropos of our recent telephone conversation, I now feel that, in the interest of my health, I can no longer safely work at _________ under the current circumstances.

As you may recall my mentioning previously, at my interview I discussed with ______ my concerns regarding the use of strong chemical cleaning products at ___________, and I shared with him my diagnosis of Multiple Chemical Sensitivity (MCS). ______ reassured me that ____________ was very interested in “going green” (his words) and he indicated quite clearly that my input vis-a-vis this process would be greatly appreciated. Subsequently, you and I had several long conversations about this subject, and I gave you a plethora of printed materials outlining the health risks of chemical cleaners and relatively inexpensive ways to replace them with natural alternatives.

Following our last face to face conversation prior to your vacation, I was happy to see that the laundry detergent being used had been changed to a “free and clear” alternative, however dryer strips continued to show up in the laundry room despite my frequent requests for them to be removed.

In terms of other products, I have made repeated requests for ____________ to supply unscented hand soap, dish soap, and hand sanitizer, and I added these requests to various shopping lists, leaving additional notes that I could assist in finding the most economically reasonable alternatives. Insofar as this situation goes, I was informed a number of times that volunteers do the shopping and that what they purchase for use at ____________ cannot be completely controlled, an unfortunate sentiment that you reiterated on the phone the other day.

On the first page of The ___________ Employee handbook, it is made exceedingly clear that __________ honors the spirit of the Americans with Disabilities Act and that all reasonable accommodations will be made for individuals with disabilities protected under the ADA. For your information, MCS is indeed a diagnosis supported by the ADA, and it is my strong feeling that _____________has failed to make reasonable accommodations on my behalf, a clear violation of the ADA guidelines.

At this point, I would like to elucidate my point further via the illustration of a potential scenario. Suppose that _____________ hired a new office manager who either walks with a cane, uses a walker, or is perhaps wheelchair-bound. Or perhaps a current office employee became disabled while employed by ______________ and was subsequently confined to a wheelchair. Due to the nature of this person’s very visible disability, I would venture a guess that no stone would be left unturned in order to accommodate this person’s disability since, a) that person’s disability would be clearly visible, and b) the legal ramifications of not accommodating that individual’s disability would be enormous and costly. (For reasons of this illustration, I suggest an office employee being disabled, as it is clear that a physical disability would preclude the hiring of a clinical employee due to the physical demands of the work.)

In my particular case, I have an “invisible” disability which, while it does not interfere with my performance of my role as a nurse, does indeed cause me mental and physiological distress while working at _____________. The chemicals in use at ____________ cause symptoms including confusion, chest discomfort, shortness of breath, headache, and dizziness, all of which are documented symptoms of MCS. So, putting two and two together, we can see several aspects of this situation very clearly:

1) I informed _____ of my condition at my interview and he reassured me that accommodations would be made.

2) I spoke with you about my symptoms several times and provided you with printed material to corroborate my complaints.

3) ___________'s Employee Handbook clearly states that reasonable accommodations will be made for persons with conditions covered under the ADA.

4) You have made it clear that the volunteers’ shopping habits simply cannot be controlled (even though they are all reasonable and intelligent individuals), thus accommodations of my medical needs simply cannot be promised.

5) The cost of replacing the chemical cleaners and fragranced products used by _____________would not be in any way financially prohibitive, yet there seems to be a failure of will on the part of _______________ management to make an effort in this regard.

6) A patient with lung cancer at ______________has suffered documented respiratory symptoms from use of chemical cleaners by staff.

7) I can longer safely work at ______________ due to this situation.

8) If my (or another employee’s) disability was “visible”, this letter would not need to be written.

Based upon my reading of the situation, I see no recourse but to tender my resignation to ____________, effective immediately. I would strongly advise _____________ to revisit its commitment to the ADA and avoid potential future legal recourse from employees who might see fit to take action against ___________ vis-a-vis violations of the ADA, something that I have no plans to do at this time, despite the fact that my case is quite clear.

Thank you for the opportunity to be of service at ____________, and I am deeply regretful that I am forced to resign my position due to circumstances clearly beyond my control and apparently beyond __________'s desire for right action.


Sincerely,


NurseKeith

Sunday, March 09, 2008

Mindfulness Journal: Depression

Is mindfulness possible during periods of depression? Is it possible to be mindfully depressed? Can you experience depression but still remain aware that that state is only a transitory one akin to a veil draped over one's mind and heart?

I do believe that this is possible, and I believe that this is what I have experienced during the past week. After decades of suffering from depression, I am hyper-aware of its effects on my life, and with my condition in relative remission at this time, it's power over me is significantly diminished and I find that I can actually observe it with some level of detachment.

If I can observe my states of depression with detachment, then one would have to assume that there is also some modicum of attachment to depression as well. When the pall of depression makes itself known, I've been aware for decades that despite the discomfort that is part and parcel of depression, there is also a level of comfort that's experienced while one is depressed. Depression gives one permission to withdraw, creating a mask or a veil behind which one can hide and rest. And without knowing it's happening, the depressed person can begin to identify so strongly with that state of mind, that it becomes more and more difficult to detach from its grip. Sadly, some people consequently stay in that place for years.

This past week, I've been recovering from the flu, withdrawn from the world and mostly enclosed in the house. Having just visited family, my mind has been flooded with memories and feelings which have necessitated a great deal of emotional processing. Due to my acute illness, my chronic pain has been significantly flared, I've had trouble exercising, and my concentration has been poor. Watching movies during the day, my tears have fallen with little warning, and my floodgates seem to have opened, allowing some cleansing to occur.

Now, as my flu symptoms subside and I prepare to reenter the world tomorrow, I also find that the veil is lifting, and I am seeing more clearly. I have been mindful of how I have been feeling all week, and in this mild state of depression, I have felt no panic that it would become a protracted experience. I have remained aware that this state is transitory in nature, and I have felt assured that, just as the buds of Spring will make themselves known any day now, the buds of my self-awareness and clear, non-depressed mind would also manifest without much effort.

Saturday, March 08, 2008

International Womens Day

Today is International Womens Day, and I want to take this moment to recognize this very important day for women worldwide, a day which saw its genesis in the Socialist movement of the early 20th century. The website of the World Health Organization points out that this year's theme is "investing in women and girls". Investment can mean many things to many people. In my view, we could best invest in women's health, girl's education, violence eradication, an end to war, and socioeconomic justice for women, to name a few places to begin.

As the son of a woman, the husband of a woman, the uncle of several women, the brother of a woman, and the brother-in-law and son-in-law of several women, I feel that I have many significant and powerful women in my family and in my life, and I am grateful for them, as I am for all of the women who touch my life, both personally and professionally.

Having always considered myself a feminist, and working in a profession which is 95% women, I am sensitive to the plight of women and aware of the struggle for power and recognition which women have waged for hundreds of years. Today, in many countries worldwide, women still fight against the threats of rape and violence, not to mention the constancy of war. With rape being used as a tool of war, and human trafficking---mostly of girls---still widely prevalent, girls around the world are still at a great disadvantage.

International Womens Day is but one day when the world's attention is drawn towards the struggles of women for justice and parity in a world which has yet to fully offer either unequivocally. I urge you, dear Reader, to pause and consider how you might contribute---financially or otherwise---to the advancement of women's causes today and beyond, and then perhaps make a plan to follow through. Whether it be a contribution of time to a single young girl, or a check to a women's organization of your choice, consider how you can invest one small piece of yourself in the struggle, and honor yourself for being a part of the solution.

Happy International Womens Day.

Friday, March 07, 2008

Mindfulness Journal: The Time is Now

Just today I received an email from a gentleman named Adam Rothenhaus, who represents a new idea whose time, it appears, has come. In response to my recent post about mindfulness, he sent me a link to his website where a special watch is being sold which was designed to help the wearer tune into the present moment. Called the Now Watch, it offers the wearer the function of an analog watch with a constant reminder that, no matter what time it appears to be, the time is always "now". According to their website the Now Watch mission is "to bring more presence to people's lives".

Mr. Rothenhaus seems to have come upon a simple and brilliant idea which some may see as a gimmick, but which I see as a brilliantly simple but potentially effective tool for promoting mindfulness in a very direct way.

How many times a day do we habitually look at our watch? And why do we look at our watch? Is it to think about the past? Is it to ruminate about the present? I would venture a guess that, nine times out of ten, when we look at our watch, we are thinking or worrying about the future. Am I late? Will I be late? What will happen if I'm late? I, for one, am incredibly guilty of ruminating on both the past and the future ad nauseum, and any tool which can assist me in continuing to ground myself in the present is one that I desperately need.

Time as a construct is one which divides our days into segments which essentially assist others in controlling us. The hour and minute hand---or the digital equivalent---deconstruct our days into nothing more than slots into which we divide our attention and our energy. We set the alarm clock at night, wake to the alarm in the morning, "punch the clock" at work, eat our lunch in a hurried thirty minutes (if we're lucky), rush home to see the kids, watch our favorite TV show at its alloted time (unless, of course, we have TiVo), and watch the clock until it's time for bed again. A sad construct, but one to which we are thoroughly inured.

I am admittedly thoroughly controlled by time, and as such, I am currently looking for ways in which to secure my place in the present moment by any means possible. Mindfulness, meditation, Chi Gung and other practices are constant reminders to myself that the future is something which will never come. When my Now Watch arrives, I will wear it as a physical symbol of my new commitment to the present moment. But why can't I have it now?

Thursday, March 06, 2008

MCS Ad Nauseum

Over the last few years I have written a number of posts about Multiple Chemical Sensitivity (MCS), a condition from which my wife and I both suffer to varying degrees. MCS is essentially an invisible disability, which, although recognized by the Americans with Disabilities Act, is still not recognized by the American Medical Association. Thus, gaining recognition is a struggle, as is having people believe that it's even real.

Living with MCS presents layer upon layer of difficulty. Having our own families truly understand what a struggle it is for us to spend time in their homes is difficult at best, and we are often symptomatic with little feeling that we can truly address our symptoms' root causes. In our own home, we find we are deleteriously affected by our neighbors' use of fragranced dryer strips, charcoal, and lighter fluid, something that becomes much more problematic when we want to have our windows open in the nice weather. We love to travel, and this has become a challenge as well, since hotels, trains, buses and restaurants are simply deluged with chemicals and fragrances, and what little control we can exercise does not always seem like quite enough. It's no wonder that people with severe MCS often become socially isolated, losing friends and even family over a disability that so few people seem willing to understand and accommodate.

Working in the healthcare industry, I am equally challenged in trying to control my level of exposure to cleaning products while on the job. In my previous place of employment, a modicum of changes were made in order to accommodate my condition, although I still feel that they could have done much better. People are very unwilling to change, especially when it comes to cleaning products and personal care products, even if those very products are causing harm to someone they care about. Still, it was relatively tolerable, and now that I work at that office as a consultant, I come and go without spending forty hours per week in that poorly ventilated space, and it seems to have little negative effect on me in the bigger picture.

At this point in my career, one reason that I would still refuse to work in a hospital would be the level of exposure to toxic chemicals that such employment would necessitate. As a case manager, I have visited respiratory units where such strong cleaning products were being used that I couldn't imagine that patients were not being negatively impacted. And while many hospitals now proclaim themselves "smoke free" for the health of patients and employees, fumes of cleaning agents and disinfectants poison the lungs and immune systems of everyone who is exposed.

Safe and effective alternatives to these harmful products do indeed exist, but the petrochemical industry is a powerful lobby, and this relatively unregulated industrial giant has brainwashed Americans into thinking that they just can't live without the sickening smell of Tide, Bounce, Lysol, and Cascade. We have been duped into believing that strong fragrances bode cleanliness, when it is the absence of fragrance and chemical residues that is the cleanest and most healthy choice for humans and the environment. "Better living through chemistry" may be true in some instances (my successful use of Prozac for 20 years being a testament to that), but unbeknownst to most Americans, the vast majority of chemicals on the market in this country have never been tested for safety---and are indeed not legally required to be---and many are actually banned in the European Union due to their known carcinogenicity.

I am now in a position where I feel forced to make a decision to resign from my current position as a nurse in a residential hospice in my home town. This pending resignation is due to the fact that my employer is simply not willing to make reasonable accommodations for my (hidden) disability. Sure, desultory attempts have been made to replace the laundry detergent with a "free and clear" brand, and they have finally done away with dryer strips completely. Still, they are loathe to change all of the other products that contribute to what I call the "chemical aura" of the house, even though a patient with lung cancer recently had a respiratory reaction to a cleaning agent used by one of the home health aides on duty. If I had a visible disability, or if one of the office managers used a wheelchair, for instance, there would be no end of accommodations made for what is deemed a "real" condition. Also, the disabled community is a powerful lobby with a great deal of political clout, and an ADA violation is not a small thing with which to reckon. I am hesitant to bring an ADA lawsuit against this employer, and while I will communicate the reasons for my resignation, in the end, they will suffer no ill effects from my departure.

While my MCS has improved over the last few years due to dietary and lifestyle changes made under the guidance of a wonderful and progressive doctor who treats such conditions, the real road to improvement still lies in the avoidance of exposures. Life with MCS is quite simply a struggle which the vast majority of people simply do not understand---even family---and it is, in the bigger picture, a very isolating exercise which has far-reaching implications for lifestyle, travel, employment, friendships, and beyond.

Wednesday, March 05, 2008

Mindfulness Journal: The Rubber Meets the Road

Mindfulness is so very easy to write about. It's just as easy to talk about. But it's when the mindful rubber meets the road that the going gets tough.

I've been reading Full Catastrophe Living by Jon Kabat-Zinn and working on cultivating a mindfulness practice in my daily life. Sitting meditation has always been a struggle for me, and it's been something that I have particularly avoided over the last twenty years or so. Reading Kabat-Zinn's book and looking over the website of his Mindfulness-Based Stress Reduction Program, he makes it very clear that a commitment to forty-five minutes per day of sitting meditation is a reasonable amount of time to devote to such practice.

Forty-five minutes?

I am still struggling with meditating for five-minute increments, and I am amazed at the veritable riot going on in my mind. When I try to simply watch my breath go in and out as Kabat-Zinn recommends, it's inevitable that not five breath cycles go by before my mind has latched onto something that sends me into a tailspin of thought. Be it the fragment of a song in my mind, a random thought, remembering something something for my to-do list, or simply sudden awareness of physical discomfort (of which I have a great deal this week as I recover from the flu), the distractions of both body and mind are endless and rarely entertaining.

When sitting quietly, five minutes can seem like an eternity, and I can't count how many times even a brief five-minute meditation has yielded a twenty-minute nap. Now that's mindlessness in action.

Of course, every meditation teacher worth his or her salt will tell you that attachment to outcome will inevitably bring one stress, and meditation is more about non-attachment than anything. They will also remind the seeker that the absence of thought is not the goal. Rather, the absence of attachment to the thoughts as they go by is what one strives for. After all, it's hooking into the random thoughts that brings one out of the present moment. And the present moment is the only place one wants to be when meditating.

Perhaps I will completely let go of the word "meditating". Perhaps I will just say "sitting", like they do at many Buddhist retreats. That way, if one simply sits, then how can one fail? And if failure isn't even possible, then why become anxious because one's mind is simply crawling with random thoughts over which one apparently has little or no control? I think my mind is becoming attached to the notion that it must be clear and uncluttered during sitting, and my sitting is still riddled with distraction, much to my ego's chagrin and dismay.

Well, I'll keep sitting and breathing and then do it some more. And perhaps one day, I'll actually have one brief moment of clarity. Til then, I'll continue to detach from the attachment to non-attachment.

Monday, March 03, 2008

The Flu Still Fits....

The flu is infamous for making it seem like it's on the way out, and just when the unsuspecting victim begins to expend some extra energy----ZAP!----down he or she goes once again.

I am trying to avoid this pitfall by laying low, sticking to home, begging off all work, and basically treating myself like an invalid. Today's menu: a wonderful Israeli movie which I highly recommend (whether you're sick or not); a few ever-so-brief walks with Tina the dog; some emailing; some phone-calls; some computer-based work; a nap or two; another movie which I cried my way through; and an evening with Mary. All in all, not a challenging schedule by any stretch.

And tomorrow? I'm afraid to even plan........

Sunday, March 02, 2008

If the Flu Fits.......

Woe to anyone who suffers the flu this season, and I can now count myself among the chosen who have been visited by this most hard-hitting of viral illnesses. Arriving home from a trip to see my parents, I began to feel unwell on the train as I traveled through New York State. By the time I arrived home to New England, a fever, chills, and unbelievable muscle aches had taken over, and I moaned my way through the night as my amazingly patient and solicitous wife tended to my every need. Now I'm lethargic, with a head that feels like it's filled with cotton-candy, and muscles that ache unceasingly (although a hot bath worked wonders this afternoon).

According to the Centers for Disease Control, the week of February 23rd---the 8th week in this year's flu season---saw widespread reporting of influenza by epidemiologists in every state but Florida. You can see the epidemiological map here. According to the data, the entire country seems to have become "lit up" with flu, so to speak, during the month of February.

It is often difficult for people to tell whether they have the flu or a common cold. There are many tools available to assist you in making that determination before you call your doctor, and I offer several useful links forthwith.

A handy quiz on About.com will guide you through a series of questions to determine the potential source of your illness.

C Health offers this table comparing various symptoms.

The good ol' CDC offers general advice on the difference between the flu and the common cold.

And the U.S. FDA also chimes in with a basic table of symptoms.

As far as treatment for the flu, there's really nothing more to do than rest, hydrate, take a non-steroidal anti-inflammatory for pain and headache, and then rest some more. And did I mention rest? If your fever becomes precipitously high---especially in children and adults with other underlying conditions---a trip or telephone call to the doctor is probably in order. However, the majority of flu sufferers can usually stay home and recover without unnecessary use of medical resources.

As for me, even more rest is now in order, and I hope to be back to my usual self in a few days. Luckily, transmission of real viruses is impossible over the Internet, thus blogging while suffering from the flu is still allowed by the CDC.

More soon from Influenza Central.

Saturday, March 01, 2008

Thoughts and Happiness

We are what we think.

All that we are arises with our thoughts.

With our thoughts we make the world.

Speak or act with an impure mind
And sorrow will follow you As the wheel
follows the ox that draws the cart.

Speak or act with a pure mind
And happiness will follow you As your
shadow, unshakeable.


----THE BUDDHA