Don’t sell your soul to buy peanuts for the monkeys.
—DOROTHY SALISBURY DAVIS
When I am sitting at a person’s deathbed, I feel my own fear. I’m in touch with my grief. In the service of healing, I draw on my helplessness as well as my strength, my wounds as well as my passion. This is how we discover an authentic meeting place with other people: through the vulnerable and courageous exploration of our own experience.
Years ago, back in 1989, I was caring for my dear friend John, who was dying of AIDS. I loved him very much and always wanted to offer him the best care possible. There were several of us in his support group. We took turns accompanying him for twenty-four-hour shifts.
Monday was my day. This one unforgettable Monday, a strange neurological complication swept through John, causing him utter confusion and forgetfulness, a sudden change in his thinking and speaking skills, and a loss of sensation in his hands and legs. In one fell swoop, John lost his ability to hold a spoon, stand, or communicate in any sort of intelligent way. When I entered his apartment, there he was, sitting in a plaid robe at his painted kitchen table, hunched over a bowl of Kellogg’s Cocoa Krispies, his hair a mess and his face absolutely blank.
I couldn’t find my friend. Where had he gone? A few nights before, we had been laughing as we watched Johnny Carson together. Now I couldn’t recognize him. Honestly, I was terrified.
As the day wore on and morning rolled into afternoon and then evening, a palpable darkness settled around us. I’m embarrassed to say that at times, in an attempt to manage John’s unfamiliar behavior, I was manipulative and cajoling. At other times, I treated him like a child. I didn’t know what to do. I was lost and confused.
Taking care of John in this condition was hard work. He had anal tumors and constant diarrhea. I had to move him from the toilet to the bath and lift him back to the toilet again dozens of times in the middle of the night.
When the dawn light finally began to cast shadows across the bathroom tiles, I was exhausted. I just wanted to go to bed. I longed for John to sleep and wake up as the man he used to be. I wanted this nightmare to be over.
Then, between one of those moves from the bath to the toilet, I was washing my hands in the sink. Looking in the vanity mirror, I could see John sitting behind me, his pajamas down around his ankles. He was mouthing words.
I turned.
Out of his garbled mind came a whisper. “You’re trying too hard.”
I stopped, sat down beside the toilet, and began to cry.
That moment turned out to be the most intimate of our whole friendship. There, next to the toilet, shit everywhere. You see, in that moment, there was no separation between us. We were both helpless together. We cried and after a while laughed at the complete absurdity of the circumstances.
Up until that point, I had been afraid to enter that territory of helplessness where John was living, fearing I would get lost there. Instead, I stayed busy trying to be helpful, to assert control and hide out behind my well-defined role: Mr. Hospice.
It’s common and perfectly natural when caught in the grips of fear to become defensive, controlling, emotionally unavailable and irritable, and to lose patience with ourselves and others. We want to feel safe, so we cling to roles with their established rules and prescriptive behaviors.
But in order to connect with and truly serve John, I had to see how my fear was triggering a sense of powerlessness. I needed to slow it all down, to soften and open to what was present, instead of continuing to insist that the situation conform to my preferences.
After all, we wouldn’t be helpless forever. The situation would show us what to do next. But we couldn’t see the road through until I relaxed my identification with the caretaking role and allowed my helplessness to enter the room.
* * *
We are social animals, and as such, each of us has multiple roles that we perform in society. I am a husband, father, and grandfather at home; a neighbor when I walk down my block; a customer when I step into a café; a teacher in my spiritual community; and a patient in the hands of my heart surgeon.
Roles are neither good nor bad. They are primarily functional and provide for some needed predictability in our lives, especially when it comes to interpersonal relationships.
Developmentally our roles change as we move through life. Until mid-life, we generally focus on accomplishment, creating our identities, rebelling, developing a career, building a family, and forging the structures we need to thrive in the world. When we find the courage to change in the second half of life, we often turn inward. The skills we developed to address first-half-of-life tasks are not sufficient or appropriate to support us on this next stage of our journey. In this period, we usually orient toward exploring the meaning of life, embracing mystery, cultivating wisdom, and relaxing a certain striving. It’s age-appropriate behavior.
Each role comes complete with its own expected set of behaviors, functions, and responsibilities (batteries not included). It gets complicated when one role conflicts with another. Single mothers who struggle to balance full-time work and parenting regularly report the emotional and physical exhaustion that accompanies role conflict. The night the massive San Francisco earthquake struck back in 1989, I was torn between my role as a father, caring for my family’s needs, and my role as a hospice director, needing to assure the safety of the patients and staff. It is harder still when personal beliefs conflict with our professional roles. Sometimes we know what is right, but feel powerless to act on our good judgment.
Roles are a choice. When we choose to be in one role, we also choose not to be in another. If, as a young girl, I commit to the one-pointed, rigorous life of becoming a professional ballet dancer, I may choose to give up a traditional education or certain aspects of my social life. If in my role as a lawyer, I think it’s important to project the image of a strong, knowledgeable male, that I am cool in a crisis, I may find it difficult to disclose my weaknesses or embrace my more nurturing qualities.
When we disown parts of ourselves, we tend to judge others who display those same qualities. We lay claim to moral superiority. Thus holding too tightly to a role can create a chasm between people that is difficult to cross.
Life asks us to continually adapt. Roles, like most things, are fluid. When parents get older, roles reverse and children frequently step into being caregivers. If I am the nurturer in my family and I get sick, someone has to agree to take care of me. If I am the decision-maker and now I have Alzheimer’s, someone else must take charge of certain decisions. Or let’s say I’m an alcoholic and I get treatment. Suddenly, I am no longer the black sheep of the family, and I have to be let back in to participate in decision-making.
When we over-identify with a role, it defines us, confines us, and reduces our capacity for conscious choice. It sets up an expectation about how life is supposed to proceed. That means more fragmentation, more fixed positions and entrenched beliefs, and less access to our innate wisdom. Often—especially in our public, professional roles—we don’t allow our whole self to show up.
When I go to a party, inevitably someone will ask, “What do you do?” But of course, if I only define myself by what I do, who am I when I am not doing? The truth is we are not what we do, what we think, what we feel, what we say, or what we have. We are more than all that.
Ram Dass says, “Don’t be a role; be a soul.”
We are not our roles, and we are not our conditions. You may have cancer or bi-polar disorder, but you are not your disease. You may be born into wealth or poverty, but you are not rich or poor. You may find yourself happy or sad, old or young, in supportive conditions or in conditions of despair, but you are not these things.
We are first and foremost human beings, with all of the complexity, fragility, and wonder that life encompasses. When we only look through the lens of a role, it narrows our vision of the world. We don’t see things and people as they actually are, but rather project our story onto them. This frequently causes us to attribute a particular significance to an experience and miss the true meaning that is trying to emerge.
* * *
Too often in caregiving and other helping careers, we find ourselves not so much looking to see what serves others, but to confirm our socially approved identity. We want to be somebody who helps. We say, for example, “I work with the dying,” with the emphasis on I. And so we invest in the role instead of the function. I call this “helper’s disease,” and in my view, it is a more rampant epidemic than cancer and Alzheimer’s put together.
I am speaking about the way that we try to set ourselves apart from other people’s suffering. We do this with our pity, our fear, our professional warmth, and even our charitable acts. It alters the way we make decisions.
Once there was a woman in our hospice who was just a few days from death. As she looked back on her life, she felt regret about many of her choices. As a result, she was quite sad—a little depressed, but not clinically. This seemed natural to me.
A visiting nurse pulled me aside after meeting with the patient and suggested that we start her on an antidepressant medication. This particular medication takes four to six weeks before its mood-altering benefits take effect.
“Why do you want to prescribe this medication?” I asked.
The nurse responded, “Well, she’s so uncomfortable, and it’s hard to see her this uncomfortable.”
I said, tongue in cheek, “Maybe you should take the medication.”
Helping can be egotistically or altruistically motivated. The social psychologist Dr. Daniel Batson identified two distinct emotions that motivate people to help others. The first is what he called “empathetic concern,” which he proposed could be considered altruistic in that it focuses on the other person. It is the tenderness and care that are evoked in us when we see another person suffering.
He called the second motivation “personal distress” and posited that this could be considered egoistic in that it is self-focused. Here, the motivation to help comes from the desire for personal gain, like improved self-esteem, or because we are trying to avoid the pain of guilt, self-criticism, or other unpleasant feelings. It is the opposite of empathy in that instead of fostering connection, it can lead to self-protection, withdrawal, or doing more, whether or not the extra interventions are wanted or have any real value.
It’s not uncommon in health care for physicians to fend off their own feelings of fear, futility, or helplessness by prescribing a treatment program, drug, or procedure that is unnecessary, ineffective, or unwanted.
* * *
Jackson worked in a wire-hanger factory. He had three TVs in his room, which he liked to watch all at once. Each had its own handmade rabbit ear antenna because of course Jackson had an unlimited supply of wire hangers. He preferred watching horror movies and thrillers at night. Often three at the same time. In the morning, he would wake groggy and complain of terrible nightmares. I suggested that maybe he could turn off the TVs before sleeping.
He looked at me like I was crazy and said, “No, man. The TV helps me go to sleep.” I realized that for Jackson, TV was company, perhaps his longest relationship, and that being left alone terrified him. His terminal cancer scared him for similar reasons. He was afraid that his disease would cause others to abandon him because there was no future in a friendship with him.
Jackson never wanted to disappoint others, especially his doctor, whom he believed held his future in her hands. He was adamant about keeping his commitments to her, even when it wasn’t in his own best interests. “You can’t expect people to help you if you don’t show up to be helped,” he said, insisting on making it to his oncologist’s office for a checkup that had been scheduled a month earlier. It was an ordeal for Jackson to make that trip to the hospital. He had stopped eating a week before, he felt nauseous much of the time, and he was very weak and unable to walk.
The physician clearly was upset when she saw the dramatic change in Jackson’s condition—his gaunt body, protruding eyes, and the changes in mood caused by his glioblastoma. Yet she barely made eye contact with him during the entire fifteen-minute visit. She kept her fear well concealed behind her white coat. Speaking abruptly, she suggested a new course of intensive radiation to shrink the brain tumor.
Jackson responded by saying that he was nauseous and tired and wanted to rest. The oncologist scribbled a prescription for an anti-nausea medication and scheduled the radiation treatment for the following day.
I took Jackson back to the hospice, where he died later that night.
It was difficult to watch the doctor’s cool, indifferent, almost robotic interaction with Jackson. She might have paused, taken a beat, listened when he said, “I’m tired. I need to rest.” But she railroaded right over him. She couldn’t let the pain in. And in so doing, she missed a healing opportunity—not only for Jackson, but also for herself. Glued to the safety and privilege of her medical role, she sacrificed a bit of her humanity that day.
In the increasingly technological environments of medical centers, where treatment protocols change rapidly, clinicians frequently are pressured to accomplish more with fewer resources. As a result, it’s easy for them to become exclusively task-focused. But human beings are not task delivery systems. In caring for each other, we must attend to both task and relationship. Without a relationship to each other and the realization of the intrinsic values of purpose, meaning, and spiritual growth, there is a loss of soul. We split off the secular from the sacred. We’ve all encountered a doctor or other clinician who is fulfilling the role, performing the job, but is not present with us. Soul is about presence. When we get stuck in our roles, we stop caring. Patients feel ignored and objectified, and their autonomy is lessened. Often, they actually end up suffering more from the treatment they receive, enduring their suffering without complaint while tolerating all sorts of unpleasant side effects.
Nurses and doctors, people with good hearts, also frequently become closed to their own pain. Driven ruthlessly by the unrealistic expectations of the systems in which they work, trained to use coping strategies that have them ignoring what hurts most, they lose touch with their compassionate hearts. Often, they meet their own discomfort and alienation with rejection instead of love. Like the oncologist treating Jackson, when they are overworked, they become shut down; molded by their training, they see only symptoms and not the person in front of them. All they have left to offer is their expertise.
Most of us are naturally inclined to help people; we want to try to reduce others’ suffering. Yet some of us reach too quickly for our version of a prescription pad, doling out unsolicited advice. Usually, our first instinct upon hearing of someone’s difficulties is to try to fix them. While our intentions may be genuine, we can be blissfully insensitive to the way we impact others. We’ve all been there. You meet a friend at Starbucks and mention in passing that you didn’t sleep well the night before. Your helpful, well-meaning friend launches into a discourse on the health risks of drinking coffee, maybe some diet tips, and the importance of an exercise regime.
We like our opinions. There is nothing wrong with having a point of view. What’s problematic is imposing it on others. Giving people advice that they can’t use and don’t want won’t make you feel less helpless. If you feel helpless, you might try acknowledging your helplessness first, at least to yourself, before you speak out or take any action. If you haven’t been specifically asked for suggestions, chances are they’re neither wanted nor appreciated. I always find it best to inquire before offering guidance. Respect a “No, thanks,” and move on.
The attachment to the role of helper goes deep for most of us. If we’re not careful, if we become wedded to this role, it will imprison us and those we serve. Because let’s face it: if I am going to be a helper, then somebody has to be helpless.
This was so clear to me when I was in the hospital recovering from my heart attack and surgery. People would come in to be with me—doctors, nurses, aides—and oftentimes, they were so busy doing whatever task they had to accomplish that they wouldn’t see me. I was touched all the time, but rarely did that touch feel healing. Mostly I was “monitored.” I’m sad to say that my health care providers often had more of a relationship with the devices and machines they were using than they did with me. The staff tried to manage their anxiety through well-constructed professional scripts and coping strategies that were meant to create a buffer, keeping my suffering at arm’s length. It rarely worked. Their anxiety simply got passed on to me.
No one really asked me how I felt, only, where was my pain on a scale of one to ten? Did I have a bowel movement yet? Was I doing my breathing exercises? I was information to be charted.
At one point in the hospital, I lost my stability. I couldn’t concentrate. I got swept up in the fear, the pain and dependency. I started identifying with the anxiety, with my shrinking world. I felt myself getting smaller and smaller.
Hospitals have a “fix it” mentality. They are environments of expectation. There is a protocol for everything and a plan to move you through the anticipated process. Some of this is necessary and helpful to recovery. I would not be alive today if it were not for the brilliance of medical procedures. However, the emphasis is completely future-oriented.
Immersed in such conditions, I found it difficult to stay present. The health care professionals who came into my room would ask, “How are you today?” But inevitably, when I said, “Not so good,” they would reply with the refrain, “You’re going to feel much better tomorrow.” Even when friends came to see me—including some lovely Buddhists who have beautiful souls and have steeped themselves for years in meditation and mindfulness—I found they mostly pointed my attention toward the future. “Tomorrow will be a better day,” they would say, intending to reassure me.
Gradually, I lost contact with myself. I got swept up in solution consciousness and joined with the predominant mind-set of using only external measures to evaluate my state of being. Stuck in my role as a patient, I was nothing more than a problem to be solved. It was hell.
After a few days, I finally got fed up. I said, “I don’t want to talk to anybody. I don’t want any visitors. I just want to go for a walk and listen to the Blind Boys of Alabama.” I pulled a set of headphones over my ears like a teenager slumped and sulking in the back of his parents’ car, and I shut them all out. My friends, the health care workers, everybody.
I love the Blind Boys of Alabama because of their contagious spirit and faith. They are a gospel group who first sang together in 1939. They have such confidence in the benevolence of God. I walked the hallway, listening to their music until their faith infused me. It’s not that I had to believe exactly what they believe, but I needed to be with somebody who had trust in the basic goodness of life. In that moment, for me, it was the Blind Boys. I borrowed their confidence until my own could rise up again.
Slowly, I started to feel the return of my capacity to be with my experience. I came back to my hospital room, went straight into the bathroom, closed the door, and cried. It was the first time since the operation that I’d had the ability to cry, and I just let the tears flow. I let my body shake and heave. At last, I could be with what was uncomfortable, miserable even. I felt so relieved because I—and everyone around me—had been deflecting the difficult stuff. But now I could access it. I could feel the helplessness and the fear and the pain and the “What is this going to mean about the rest of my life?” and the “Do I have any value anymore?” and “What will I be able to do after this?”—all those big questions that had arisen from the physical and emotional trauma of the heart attack.
A nurse came into the room. “Are you okay?” she asked, rapping loudly on the bathroom door. “You’re crying in there. Are you okay? You know it’s okay. We’re all out here. We’re here to support you.”
I said, “Please, just leave me alone.”
But she didn’t want to. Stuck in her helper role, she kept pushing her agenda. “You know it’s okay. Everything is going to be okay. You’re going to be fine tomorrow. Come back out here with us, and I’ll call a social worker.”
“No,” I said, more firmly this time. “Leave me alone. Let me be with this. I’ve been trying to get access to my feelings for days, and I’m finally here. Let me be with myself.”
And she left. She let me be.
I trusted that if I could touch my suffering, my own innate compassion would emerge as a loving response. It did.
Too often, caregivers tend to amplify the patient’s fear or exacerbate the condition of confusion by focusing exclusively on problem solving. In so doing, they may intensify the contraction. Soon, just as I had, the patient loses contact with their innate resourcefulness.
In the chaos of illness, one calm person in the room can make all the difference. In caring for someone who is sick, we use the strength of our arms and backs to move a patient from the bed to the commode. We lend the patient our bodies. We can also lend people the concentration of our minds and the fearlessness of our hearts. We can be a reminder of stability and confidence. We can expand our hearts in such a way that it can inspire the individual who is struggling to do likewise. Then we become a compassionate refuge. Our presence restores trust in the patient’s capacity to heal.
I don’t heal because my problems are being solved. I heal by reconnecting with what I feel I lost in the fear and contraction. I heal by connecting to my innate capacity to heal. This is felt as loving self-acceptance, a quality of openness to my condition that is expanded and strengthened through the dynamic companionship of compassion. It breeds courage and allows us to go toward and learn from the suffering. When we reflect this intrinsic wholeness in others, we can be a portal to a larger possibility. As caregivers, as friends, our work is to be portals, not just problem solvers.
I like the old word service better than caregiving. Service speaks to the depth of the heart’s intention, an embodiment of unselfish values, and the action that springs from wisdom. Service is always mutually beneficial. Caregiving too often turns into helping and fixing.
My friend Rachel Naomi Remen, M.D., says this better than anyone I know when she writes, “Helping, fixing, and serving represent three different ways of seeing life. When you help, you see life as weak. When you fix, you see life as broken. When you serve, you see life as whole. Fixing and helping may be the work of the ego, and service the work of the soul.”
Fixing and helping are draining. Over time, we may burn out. But service is renewing. When we serve, our work itself will renew us. In helping, we may find a sense of satisfaction, but in serving we find a sense of gratitude.
Try it sometime. Sit with another person without a solution to their problem, without playing a role. No analyzing, no fixing, no meddling, no mending. Listen generously, as if the other person has all of the resources that they need inside of them. Just respect and receive what is being offered. It’s not even important that you understand. Imagine your listening presence is enough, exactly what is needed. Often a receptive silence heals more than all the well-meaning words.
* * *
It’s not that roles have no value; it’s that they are not sufficient for our well-being. For that, we need the courage to be authentically whole.
What is authenticity? It is saying what is so when it is so. Showing up, doing what we say we will do, remembering our commitments, and honoring our agreements. Authenticity engages the will and points to what has heart and meaning, while simultaneously diminishing reactivity. It means taking personal responsibility for both the tasks at hand and the relationships we build as we perform those tasks. Acting authentically builds trust.
* * *
Sarah was a student at one of our trainings on compassionate caregiving. A skinny, shy white woman in her mid-twenties, she worked as an attendant in an inner-city hospice, Joseph’s House in Washington, DC, where she cared mostly for African-Americans on the verge of death. We had a wonderful talk about “helper’s disease” and showing up authentically as ourselves rather than hiding behind our roles. A few weeks later, she wrote me the following letter.
There is an excerpt I love from John O’Donohue. He asks, “What have you done with your wildness?” This experience has been wild for me. Radical. Learning to embrace the reality of what’s arising within me has required courage from my heart. I’ve witnessed myself going into scary, dark, overgrown, overwhelming places. I can’t believe it, but I’ve had moments of thrusting my head into Mara’s1 mouth, rather than running away from her. Of course, it’s hard, and I don’t do it all the time. But in my body a seed has been planted. I’m continuing to nourish that seed of understanding: the understanding that going into, not away from, those scary places is the very courageous act that enables my humanity, my sensitivity, my power, my authenticity, my own exciting and unpredictable wildness to be.
At work, I’ve noticed that the lovely residents intuit when I’m in that wild space. It’s at those times that they trust me most. I will take risks to be there for them. I will think outside the box. I will refuse to abide by limited conceptions of roles and regulations. I will be unapologetically myself. I will trust my intuition in giving care. Not only do I provide the care that’s actually needed by others, but I create healing—not draining—spaces for myself, too.
It’s that trusting intuition that guided me to jump into Ms. Helen’s bed with her and sit there for an hour with my hand on her leg, not asking her again if she’d please take her meds. It’s why I told everyone else that I was busy and I couldn’t come; even though it may have looked like I was just sitting doing nothing. It guided me to talk back to Helen when she swore at me, to shake my ass and say, “Oh, you know it’s hot, Helen,” when she told me how fat my ass is (she tried not to smile). The wild intuition enabled me, when she called me a “stupid white bitch,” to stand tall on my own two stupid white legs, and to do so while stretching my heart open and taking her in and taking in my own insecurity and self-loathing about my racial identity and racial privilege and managing to love us both through the whole inner drama.
Now Ms. Helen happens to be one of my favorite people I’ve ever met in my life. Without your training, I wouldn’t have had the courage to receive the gift of that relationship. I wouldn’t have had the courage to see, with as much clarity as I can muster, that it’s not personal, that love is there, and that the way to it is by really, truly showing up and being there with her, grounded in my own body and my whole self.
Authenticity requires trust in a deep inner wisdom and the willingness to bring that wisdom into conscious action. Wisdom is not about age or expertise, tools or roles. I have a lot of tools that I have collected over the years, but in serving, I don’t lead with my tools. I find that if I start pulling those tools out and setting them down between myself and my client, then one of us is sure to trip over them. So instead I lead with my humanity.
We tried to keep it simple at Zen Hospice. When someone new arrived, I would meet them at the front door and escort them to their room. I rarely told them my title, preferring to introduce myself by my first name. Roles might come later. What mattered more in the beginning was finding our common ground with one another.
Before we would bring in the nurse or start any medical evaluations or procedures, I would tell new people about the neighborhood. I’d explain about Mrs. Mahilia Kennedy, who lived two doors down with her granddaughter, or Jeffery and Francis, who lived just to the left. I’d mention the preschool down the street and how they might hear the children laughing as they passed by on their way to the park next door. Finding one’s place is important. In some cultures, it’s the way you introduce yourself to others. On our first meeting, one patient said, “I am the daughter of Hannah, and our people come from Tensas Parish in northeastern Louisiana. I’ve got seven brothers and sisters. They call me Jerline. Pleased to meet you.”
Before we talked about illnesses, we would talk about food. When you natter on about food together, you are equals. When a person speaks of what they most like to eat, you learn a lot from their face, the way their eyes open wide or they lick their lips or how their voice trails off. When we share about food, we share details about our families, the way we grew up, and how we were loved or not. What people used to love to eat but can’t anymore says a lot about their relationship to their health conditions.
I learned to see myself in each person that I serve, and I would try to see them in me. This was both a beautiful and challenging practice, especially when working in San Francisco’s multicultural communities. On the surface, it was easy to focus on our differences: they were black or Latina or Vietnamese, I am white; they shot heroin and had AIDS, I didn’t; they were homeless and alone, I paid a ridiculous amount of money for rent and was raising four teenagers. At one time, we might have walked past each other on the streets, unseen. But now in hospice, we were thrown together in the most intimate way.
And in the midst of the service activities—changing residents’ diapers or calling their long-estranged family members or advocating for services they needed—we found a meeting place. It wasn’t sameness; we didn’t need that to connect. It was a belonging that came about because all parts were honored. Honestly, we often failed miserably in connecting, blinded as we were by our privileged view. But we kept at it, and the people we worked with kindly taught us a bit more every day about respecting difference while aiming at inclusivity.
I was often guided by the good counsel of George Washington Carver, the African-American author who was born into slavery and later became a leading scientist, botanist, and educator. He said, “Anything will give up its secrets if you love it enough. Not only have I found that when I talk to the little flower or to the little peanut they will give up their secrets, but I have found that when I silently commune with people they give up their secrets also—if you love them enough.”
While service is natural, even instinctual, it isn’t always easy. Sometimes we wander away from what we love when we get caught in a role. We become drained. To find our way home, we have to remember what called our souls to serve in the first place. We have to discover how to love what we do, even if we don’t always do what we love.
A young woman came to one of my workshops. Athena worked as a physician in a large medical center on the night shift. Part of her job as an intern was to pronounce the deaths of patients she did not know. It was not a technically difficult task, but a sad one, especially in the wee hours of the night. Athena complained that she had grown indifferent to the task. She was exhausted, disheartened, and felt desperate because the practice of medicine had lost all meaning for her. She asked me to introduce her to a Buddhist ritual or practice that might help restore her sense of purpose, the love that had once inspired her to be a doctor.
I also told Athena that a Buddhist practice was unlikely to help. She needed to find the healing she longed for in her own lineage. I suggested that the practice of medicine could be seen as a spiritual path. I reminded her that she was a lineage holder, that the foundation of her practice went back to the Greeks and beyond. She had, after all, upon the completion of her medical school training, taken the Oath of Hippocrates. I offered the possibility that when she put on her white coat, she could imagine it to be a ceremonial robe of Asclepius, imbued with his wisdom and healing powers. She seemed content with these suggestions.
I did not see Athena again after that workshop. But almost a year later, I was teaching a workshop with Dr. Rachel Naomi Remen. She mentioned Athena by name, reporting that Athena had participated in a physician support group that Rachel facilitated. Rachel had been struck by Athena’s story. Rachel told me that Athena had become revitalized in her medical practice after she and I spoke. Apparently, when I told Athena to turn toward her own lineage to find the healing she sought, the direction had resonated with her. Athena came from a family of physicians. Her father and grandfather were both doctors, and both had recently died. But with their help, Athena had found her own healing ritual. Her grandfather had been a country doctor, and she had inherited his shabby old black doctor’s bag. In it, she placed her father’s stethoscope, a small candle, and some essential rose oil favored by her grandmother. She kept this kit in her locker at work.
Now when she was called upon to declare a death, Athena fetched her bag and carried it to the patient’s room. Often, she would pause quietly at the threshold to gather her breath and call on her ancestors for support. Sometimes there was a nurse present who pulled out the intravenous lines and removed the stickers that were used to track heart rhythms. Athena placed the small votive candle on the bedside table, lit it, and removed her father’s stethoscope from her grandfather’s bag. In silence, she examined the patient, listened for the sound of a heartbeat, and mindfully watched to see if the breath had stopped. She felt intimacy in these simple actions. Then she removed the small vial of rose oil and, taking a bit on her fingers, placed a few drops on the forehead of the person who had died, adding a short intuitive prayer: “May you be at peace, may you find rest, may all your suffering come to an end.”
Athena felt that she could no longer play the role of a doctor in the way she had been trained: to be self-denying; to trade her humanity in for expertise. However, finding this personal ritual had restored her love of medicine and inspired her to continue to be the healer she had always hoped she would become.
In listening to the call of her soul, Athena had found the courage to step out beyond her role and into her authentic self. There, as she cared for others, she found peace, contentment, renewed inspiration, and access to her innate kindheartedness.