Compassionate Presence

October 11, 2010

There is a lot of sadness around us. As Buddhists would point out, that’s because of the almost constant attempts to control, predict, grasp or fearfully run away from (or avoid) it all. They also teach that everything is temporary but not to the point of existential meaningless where nothing seems to be connected or to have meaning. It is to teach that whatever is, will ultimately change. “Where moth and rust corrupt” in the tradition of your early years of teaching.

To say that compassion is the only thing that is ‘permanent’ is probably better understood if it is said that when all things and people are gone, what seems to endure is compassion.

We remember a person’s character of caring and self-sacrificial love for others. That seems to stay with us when they are gone. It won’t be their temporary ownership of a Heisman trophy in the trophy shelf of the back room of the mansion (that the next mansion owner will likely try to sell to the highest bidder on EBay). Neither will it be the amount of political or financial power one accumulates during this relatively short lifespan.

Instead, what will endure will be the extent we are able to be truly present in the moment with others in such a way that we can fully accept and take them in a loving and unconditional way. It is in those moments we find avenues of reaching out and truly connecting, as kindred spirits, so that we can be agents of compassion and healing. As we form a community (which knows no boundaries), we join in something that is greater than ourselves and become more fully mindful that we are truly connected with all others and all living things.

We gain a keener sense of this in the practice of meditation. That’s because in this sedentary activity, we first learn to be fully present with ourselves. (How many people in your life are really there with you – who aren’t frantically eying their Blackberry or looking at their watch while they speak at you with no eye contact?) Learning to be fully present in the moment with ourselves yields learning to be fully present with others. We need then learn to be open and present with the Spirit Who created us.

Now all of that sounds like a Hallmark card on steroids but a lifestyle of being truly present in the moment, . . . being at home with yourself, others and your Source . . . brings you to compassion. I believe this life of compassionate mindfulness is at the core of all world religions that seem authentic.

These core teachings are present in all religions but are more, in my opinion, intentionally taught in Buddhism. If you’re interested in reading some more on this, take a look at Jack Cornfield’s The Wise Heart. ISBN: 978-0-553-80347-1 (0-553-80347-6)

As I Transition Out of Your Care

A letter to the staff of the Western New York Cancer Care Center

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Dear staff members,

Today is the last of my 45 treatments for prostate cancer. The Maker should have recalled these defective parts centuries ago but a successful class-action suit has yet to be achieved. One out of six males – one out of four on African American models.

Then there’s the design flaws. The main fluid draining conduit runs right through the middle of this walnut-shaped little part but integral to one of the higher orders of human experience. Location, location, location. If you get any swelling or irritation in this flawed part, you’re stuck with the ridiculous drama of having  to know the location of every public drainage facility for miles around. Clearly Google and all of silicone valley partners should have resolved this problem by now.

The same should be said of breast cancer and those who blithely and casually dismiss the worthiness of 99% of the rest of humanity who don’t measure up, in their judgment, to their station in life. Didn’t society move beyond the 19th century classicism portrayed in PBS’s “Upstairs Downstairs?”

But you work at Cancer Care of Western New York and you are doing significant things to resolve these parts of the problems. You serve on a team of gifted individuals who are successfully battling cancer.

Now all of us are compensated for what we do in our careers. No matter where we go, they’ve got to pay us to work there. What is different about what you do is that you are called to be present in healing encounters. Those of us who come through your doors come with some brokenness. We are in transition, having learned that something in our bodies is in need of repair. Surgery, chemotherapy, radiation or a combination of them all.

We come into your office, as you well know, with a the waterfront of fears, unknowns, anxieties and sometimes depression being expressed by all the personality types of humanity.

The cancer, with which we’ve been diagnosed, lingers on like a giant outdoor billboard plopped down on our front yard. It says YOU HAVE CANCER! To our dismay, the giant billboard also appears in our living rooms, kitchens, certainly our restrooms, our cars and at work. CANCER no less. . . . Me, <em>for cripes sake</em>.

So your patients are jumping in and out of all of Kubler-Ross’ s stages of <em>On Death and Dying</em>. Denial, Anger, Bargaining, Depression and Acceptance. Regardless of our grasp on reality, everything is temporary. No matter how many years we’ve enjoyed the comfort of our personal lifestyle and all of its familiar coffee shops, dollar stores, local pubs, favorite shopping malls and TV shows, ‘we’re just a passin’ through.’ Everything changes.

As patients, we also carry into your office a real sense of loss. As we are jolted into realizing that we are in the ever-shortening last stage of our lifetimes, we sense that our lives are going to change. Our lives will never be the same as before.

What we all don’t immediately realize, after our biopsies, is that while you provide care and services for us, we become part of the Cancer Care of WNY team. The closer we follow the play book (the protocol advice of each module’s specialist), the smoother and more effective the results will be in bringing about our healing. But we’ve got to become team players ourselves.

In any spoken or printed words of what would help us, we are not quickly seeing all the work that has produced it. Unless we have benefitted from medical training, we don’t see the thousands of research and practice hours behind each aspect of treatment. We don’t know about the published and collegial-scrutinized research papers, the doctoral dissertations, the measured and evaluated clinical trials, the blind and double blind tests that thousands, before us, have undergone to determine the best courses of treatments. We don’t hear any of that but in a way, we trust that all of those things are behind everything we experience.

<strong>Trust.</strong> That’s something all of us patients cling to with a lot of motivation. Your white coats are actually not necessary. You’ve got 5 million dollar IMRT machines buzzing their merry way around our bodies like R2D2 on steroids. So we know your competence must precede your responsibilities amidst the mammoth financial investment in this life-sustaining infrastructure around you.

Hope is the holy grail of the healing process. Every one of us is looking for hooks on which to hang our hope for our futures.

By now, we know life will not be the same from this point on. Our frantic but unrealistic hope for lack of change always must yield to reality. “Life is what happens when you’re making other plans.” Reality always trumps and holds all winning cards. With whatever cards we hold, we optimistically call the other side of our transitions “the new normal.”

At Cancer Care of WNY, you are essentially working in a battle zone. You see a lot of suffering and pain. You see, on our faces, the fear, the pain, the depression. Sometimes the brokenness. You see some of us shuffling in and wonder how it is that we are still ambulatory. In nanoseconds, you can sadly see other eminent medical problems that will necessitate care in other clinics.

The other day, in the waiting area, an elderly woman was brought in for therapy in a wheelchair. Shortly after arriving, she began to cry. She was weeping from her unbearable pain. Whatever was the cause, the enormity of her internal pain could not remain silently contained in her frail body.

Fortunately, your staff colleagues rushed to her side and helped her into an examination room for immediate pain support.

Despite all the suffering you see in your patients, you stay focused and resilient. Your energy and fortitude in the midst of the suffering is remarkable. You are thoroughly professional and somehow you remain personable and caring.

But here is where you shine, not only here at the Cancer Care Center of WNY but on into your future.

Not only are your patients in the midst of transitions themselves, all of us experience transitions throughout life. You already have and will definitely undergo changes of your own. You’ll experience transitions in your relationships, in your careers. You’ll change your thinking on some of the things you once valued above all else. Some of the things you pursued will be left behind for other matters you will come to value as more important. As the old Simon and Garfunkel song said, “When I think back on all the crap I learned in high school, it’s a wonder I can think at all.”

As much as we like to embrace our seemingly unchanging world, it changes and we simply can’t control most of it. As do those of us who are patients, you, will go through transitions in your life.

Most of us already have migrated through changes, however old we may be. But when you think back through your transitions, you know there were some difficult ones. But who were the people who helped you most during those transitions?

Significant others. It was a friend or relative who was particularly present in your life when things got out of hand and were most scary. They listened to you when you made no sense. They stayed with you to help you get more information. They were there for you to take in and absorb your frustration, your denial, anger, bargaining, depression and ultimately your acceptance of the way things landed. They were “your person” as the Christina and Meredith characters portray in ABC’s <em>Grey’s Anatomy</em>.

As the same time, that’s not what your job is at work. You have a very medical, technical or clinical responsibility. Certainly the pain and uncertainty you witness on a daily basis causes you to sometimes leave work with your batteries totally drained. You’ve undoubtedly experienced burnout. You may have seriously wondered if there is another line of work that would call forth from you yet untapped yearnings and dreams without leaving you emotionally shredded and run through the wringer.

I was a Protestant minister for fifteen years. I loved the work. The teaching, the counseling, the writing and the many opportunities to be creative were at the center of my academic, intellectual and emotional career life for 60 to 80 hours a week. But I was burned out. I had to get away from the endless hours amidst funerals, crisis counseling and the usual petty skirmishes over which color to paint the lavatories or whether investments on the youth groups should triumph over architectural repairs.

One year, I changed careers. I went into marketing, advertising, writing, technology and videography.

At first, people were utterly shocked that I’d make such a change. Early on, though, I discovered nothing had changed in me. I found the obvious truth that customers (seeking my marketing or technological support) needed the same focus and caring as those who were once my  parishioners. Obviously different contexts and delivery of services but the same focused listening and human caring is needed.

So how is that relevant to your truly brief daily interactions with those of us who are your patients?

It’s clear that your patient encounters are not lengthy sessions on helping us sort through the problems and hardships of our lives. Your job is to empower the therapy and to teach how how to make adjustments that support the therapeutic protocols for our healing.

Your presence in the tasks at hand is the same as how you and I relate to a neighbor when we’re handing them a poorly aimed newspaper. It is the same when we exchange a few words with our mail carrier or a clerk at the store. We’re looking them in the eye and relating to them in an unconditionally accepting and open way. We are taking them fully in, in the moment, however brief the exchange may be.

Your patient encounters all seem to transpire in brief moments. It’s not the duration of the exchange. <em>It’s about how present you are in those moments</em>, even though there are many moments and many of us patients who interact with you throughout the day.

It can, and should, become routine because of the limitations on time and the narrow focus of your work. But the magic ingredient in every one of your patient encounters is you.

The magic that is taking place is in your extending of yourself. Your non-verbal communication. Your tone. Your full presence in those moments, as short as they may be.

In each of these moments, you have been genuine and friendly. It’s when you are being kind and patient with the guy who feels woefully inadequate because he doesn’t think he’ll be able to retain the water he consumed in order to suspend his bladder up out of the way of the soon-to-be radiated prostate. It has been years since he was frantically waiving his hand in second grade to get the teacher’s permission to go to the rest room. The feelings are still the same.

In each of your patient encounter moments, you are being flexible and open for any question that might come your way. When you use your energy and focus beyond your job task to be responsive in these moments, <strong>you are being truly present in the moments</strong> in this transition period of your patients. You’re putting your personality and humanness into the mundane acts. That makes our experience here, with your team, transformative and healing.

The way you are responding in these moments makes us feel that we are not just in a drive-through medical center, ordering up a cancer cure to go.

Instead, we feel that we are fortunate to be a part of a greater team that is committed to our personal healing. It makes us feel more whole, even though the hand we were dealt is not optimal. You make us remember that however brief the moments we are with you, we are part of something that is much bigger and more embracing than the smaller concerns that are just contained in ourselves. You are making us feel, and reminding us always, that we are all intricately connected to and part of the wonderful human race. <strong>You are doing this with your presence</strong>.

That’s what I want to thank you for. For what you do, I am grateful. But for who you are and have been, in the 45 days of treatments, for your personal presence in this segment of this transition for me, <em>thank you</em>.

 

Cerish the abilities you possess and are using in this current career. They are embodied in in your DNA. And nobody, no transition, no circumstance, can ever take away from you the unique aspects of who you are.

Thank you for your presence. I’m sure that many others will feel the same gratitude from your presence in the years to come – wherever you choose to live and work. It is in being mindful of this sense of presence, that you possess, that you will find the meaning of your life. Cherish it.

Transitions in Community

When a “For Sale”sign ” goes up in the neighborhood, it’s a little startling. When the home belongs to folks you have come to know, it is a little more unsettling. But when the “Sold” sign goes up ten days later, now there’s a bit of a tremor in the force.

That’s because we seem to spend most of our lives holding on to the “normal” images, sounds, shapes, people and places we often experience. We cling to what we feel is “normal” – the usual people and things we’ve come accustomed to having in our lives. Tradition. The familiar.

C.S. Lewis, the great religious writer of pieces like The Narnia Series and other books also wrote The Four Loves. In it, he described 4 kinds of love, most of which we all experience throughout our lives.

The first kind of love is the love of familiarity. We love our pet dog and its friendly smiling and slobbering face and wagging tail. The innocent look of confusion or incessant desire to play. We love the big lug falling asleep in the recliner with his hands firmly controlling the television remote. We love the same old streets, stores and places that we are used to seeing for years at a time. We love and we cling to the familiarity of it all.
The “For Sale” and “Sold” signs emit tremors. Someone is moving out – someone we frequently see day in and day out. We don’t like change. We don’t like to think that someday we will have to make changes ourselves. We like all our “stuff” and it is ours and we’ve always had it and not only do we not want to move it, (and have to set it all up again somewhere else) – we don’t ever want to get rid of some of it – make that ANY of it. We want things just the way they are!

The fact that some “older people” have gotten rid of their home and moved into some kind of subsidized, small, geriatric ghetto with other well-aged people: “that just will never happen to me!” we quickly tell ourselves (without saying it out loud.) “I’m going to stay in my house forever, not change ANYTHING, and if I die, either my kids will just take care of it or the town will come along and handle it.” We all seem to be change resistant and living with a hardened denial about transitions surely coming ahead of us.

Sometimes we have become familiar with folks on our block and neighborhood and it feels comfortable to see these same people walking by on their daily stroll. The familiar friendly greetings and exchanges through the years bring friendliness to the neighborhood.

The second kind of love Lewis discusses is that of friendship. It’s the sort of relationship where we have become close to another. This is where we find that we are accepted, forgiven and we find enjoyment in common values, activities and commitments.

Friendships we make in the neighborhood are forged from shared acts of concern. The natural and gentle laughter that flows from shared experiences. The casual times and the genuinely wonderful help we receive when we have a need when a neighboring friend has reached out to us.
There certainly have been times when we were overcome with sadness, the death of a friend or relative, the loss of a career, the frightening health diagnosis.

All these things add up, through the years, to yield the simple friendships that bind us together and give our lives stability and joy. We are indeed fortunate when we have found friendships in our neighborhood.

A more rare and meaningful form of love Lewis mentions is “Agapae.” It is the sort of love that one gives to another that is unconditional. No strings attached. Sometimes, a loving of the unlovable.

Perhaps it is the simple act of opening your home to welcome new or departing neighbors. It could extend to responding to a need (and sometimes to a very needy person) who is decidedly unlike you. Perhaps the kind of person whom you would never be like. But you give of yourself to them unconditionally. You are kind. You sacrifice to somehow quietly make their life better in some way. And you do it not expecting thanks or recognition. You just tough it out and do it because it is part of your DNA and you know that no matter what this person has done or where they have been, they are your neighbor. A fellow human being. A kindred spirit.

“If you do this to the least of these, you’re doing it unto Me.”
In our neighborhood, there have been quiet acts of unconditional love and they haven’t made the 6 o’clock news. They happened without fanfare. Yet they quietly soothed the heart of someone on your street.

The fourth kind of love Lewis mentions is the erotic. This is the wonderful stuff that Bruce Springsteen sings about being “the best time in my life.” Each of us know that some of us have been blessed to have some “best times in our lives” and yet others have not been so lucky. Yet we have come to trust our neighbors and most everyone seems have a genuine respect for the intimate, modest and cherished relationships that are part of the fabric of our lives.

So the “For Sale” and the “Sold” signs are a reminder that everything WILL change. No matter how much we live in denial of it, everything changes. The houses around us change. The people in the houses will change. The people in the rest of our lives change. We will change. Without noticing it, we are changing.

But the first three loves that CS Lewis talks about are the very things that enable us to weather these constantly changing lives of ours. While it always feels good to get back to the familiar, it’s the deepening friendships that carry us through the heartbreak and celebrate the joys of the small successes. It’s the unconditional love and acceptance and the random acts of kindness that give us a centering, right when we’ve felt we have hit bottom and there seems no way back.
These kinds of love are the very things that create a sense of community. They are the brick and mortar of our feelings that we are all connected. I think these diverse acts of love are subtle reminders of the presence of God. The genuine, compassionate, friendly presence that we have experienced in our neighborhood which have enriched the lives of each member of our family.

As our household makes a transition from our neighborhood here, we carry with us what we have learned from you. As we leave this neighborhood, we will seek to be a similarly compassionate and caring presence ourselves in the lives of others in our new community.

But we will have to work at it. There is a lot of joy and sorrow in life. Because of your presence in our lives in this neighborhood, we will try to be the same healing presence for others in our new community.

Thank you for all the kinds of love you have bestowed on us when we lived in your presence in NY. You have and are making life better for all of us.