SECTION IV
For years, I had been tuning into my body, beginning at my toes and working my way up to my head. The body never lied; if I was stressed, I’d feel tightness. It was often located in my neck and shoulders or sometimes my belly. Every now and then, I’d tune into my position as I sat in my chair, listening to patients. If I was working too hard or straining to make something happen, I’d find myself leaning forward with my shoulders by my ears and my chin thrust forward, my neck stiff. This told me to back off, relax, and stop pushing to make something happen. I’d take a deeper breath and physically move back into my chair and wait for my breath to slow.
I also tuned into thoughts and feelings (especially to what I didn’t like), in the hope of using that information to make better choices. When I meditated, I was discovering that my fatigue, though lessened by being off interferon, still had not disappeared. To continue living fully and being effective in my work, I had to make changes. I couldn’t do everything I wanted to do all at once; it needed to be incremental. I began to accept my restless, striving nature. My health stabilized, but ever present was the thought that this, too, was temporary. I wanted to squeeze in as much as I could, while I could.
I started thinking about leaving the University of Massachusetts and returning to private practice and being a consultant again. This would give me more flexibility and I could create new programs based on the mindfulness model. Yet, the thought of leaving my home, my family at The Center of Mindfulness, saddened me. It had been so much of my life for so many years, sustaining me through my single days in Cambridge, my marriage, the death of my father and now cancer. The Clinic and I had grown up together. Yet, Jon, the founder, had left the hospital, though he stayed connected to our program. Ferris, my buddy and co-teacher, had turned sixty and also left. The hospital was also changing. It had merged with another hospital in Worcester and, due to a financial crisis, had booted out our clinic. For six months, we didn’t know whether we’d survive. While Saki, who was now the director of the Center, negotiated with the medical school to house us as it had done before the hospitals merged, staff had to be cut and the number of classes reduced. Morale dipped down.
My teaching continued as a bright spot. I was doing new work on the transplant unit, which engrossed me. To my great surprise, I discovered that I had become an icon of courage and determination. A picture of me and my dog, Chaya, and the text of a newspaper article (see illustration on previous page) hung in the blood donor room to inspire people to give blood. The staff on the transplant unit had been impressed by my ability to use my breathing to calm myself and cope with the stresses of mouth sores, pneumonia, and low blood counts. It seemed that no one had been able to last solely on oxygen without going on a respirator, as long as I had — a testament to meditation and an accomplishment I would not care to repeat or boast about.
Pam Doyle, a nurse practitioner on the transplant unit who was interested in applying meditation to transplant patients, took our internship program and suggested we do a small research project on meditation’s effectiveness to reduce suffering. She asked if I’d be interested in bringing meditation to the unit. We met with Jon, who thought this was a great idea, and Dr. Karen Ballen, who headed the unit. Though we had no grant money, we decided to try it. This was a wonderful opportunity to give back to others some of what I had so generously received.
When I open the sealed door of the transplant unit for the first time since I had left, I felt as if I was walking into a fire . . .
my own. Memories of what it was like when I was the patient returned to me. As I walked down the hallway to the nurse’s station, unassisted and without tubes or an IV pole, gratitude filled me. I remembered my vulnerability and the intense discomfort of mouth sores, nausea, and general physical weakness. I also remembered those who sat with me and had been uplifting. I hoped that I could now convey some of the same peace.
The transplant unit was small. I felt joyous to be able to walk in and out of it freely. The study was experimental, so I had no set agenda. We had written up a protocol, but it was loose enough to give me the freedom simply to listen to patients and individualize the meditation instructions in words that would be meaningful to them.
My first patient was a woman who was very afraid and worried about her son who was now home alone. He had a drinking problem. As she calmed and quieted, tears came. She began talking about her fears and hurt. She didn’t think her son would visit her; she felt alone and scared. I listened and then had her gently move her attention back to her breath. Speaking in a soothing voice, I suggested that she release these worrisome thoughts on the exhalation and, on the inhalation, let herself settle more deeply into the bed. I recommended that she feel the bed supporting her and feel the covers around her and focus on the sounds in the room and my voice.
I meditated with this patient three times one week and twice the next and subsequent weeks. She reported she was practicing and had used her breath awareness when her catheter was taken out and replaced by a new one. She still worried, but felt comforted and more at ease in the hospital. Slowly, her mind quieted as she learned to redirect her attention to the here and now, one breath at a time, inhalation and exhalation. Slowly, she realized that it wasn’t productive to worry excessively; that her work was to survive and care for herself so she could recover and have the strength to deal with her problems later. We also called in a psych consult to talk to her further about her family situation. This woman was not psychologically oriented, nor would she have ever sought meditation on her own. It was impressive that she had learned to incorporate it into her day, using it when she got anxious or needed to sleep. She found it soothing.
When a patient elected to be in the study, I’d go over to the unit, explain meditation to them, and sit with them. Frequently, people wanted to isolate themselves when they felt sick or nauseous. I explained that that was often a time when it was most helpful to have a person present, someone who could sit with them and simply send them good wishes (a Metta meditation). There was no need to feel ashamed. Sometimes I gave permission to feel rotten and complain. Some people thought they were being bad or weak if they were having negative thoughts. It was a relief for them to know that this was normal.
I encouraged people to breathe in relaxation and peace and breathe out toxins, or “anything that doesn’t help you heal.” We would breathe together, my breath matching theirs, tuning into the rhythm of life in the room — breath, sounds, sensations, thoughts, and feelings. By simply observing the flow, we witnessed impermanence; no two moments were exactly alike. Sometimes a sense of a larger presence would enter, an experience of connection not only to family and friends or others in the hospital, patients and staff, but a force greater than ourselves, of God or nature, depending on a person’s belief system. There was room for awe.
Together, we sat and listened and observed, practicing, allowing whatever entered the stream of awareness. We also practiced sight meditation, looking at mementos from home, or inspirational cards, or photos of friends and family that were posted on the bulletin board in the patient’s room. I listened to descriptions of loved ones. In this preliminary study, there was no specific agenda other than being mindful and present to the moment as it unfolded. Whatever arose in conversation was fine.
One day when I was sitting with a patient, I got caught in fear. The patient’s skin was red, flushed by fever. She was very un-comfortable and breathing coarsely. It was clear she was scared. Outside, it was raining. I felt a tightening in my chest, a lump in my throat, the increased pounding in my heart. And then my gaze turned to the window, opaque with moisture. Droplets of water dotted the expanse of glass. I watched as the drops slowly and gently descended. I began quieting. I listened to the sound of the rain and calmed some more. My heartbeat slowed. I could guide the patient to shift her focus and watch the drops of moisture, as they gently rolled down the window in a rhythm, slow and steady. It was absorbing. We were both here, now in this moment, at peace.
Pam Doyle left the medical center for another position. The study continued with my good friend and colleague, Dr. Susan Bauer-Wu, as a principal investigator, now heading the Phyllis Cantor Institute at the Dana Farber Cancer Institute. We have extended this work to that institution. A feasibility study has been completed and published, and a more comprehensive study is being planned in conjunction with other hospitals.
Time passed without any major medical event. My goals and mottos did not change. In the year, 2000, on retreat, I kept no notes, but continued to walk and sit and tend the hurts of my heart and watch my mind observe the passage of time and change. I celebrated the twentieth anniversary of the Stress Reduction Clinic. The party to honor Jon, and his founding of the clinic, was in the backyard of our house under a huge tent. We had a live band and wonderful food. Friends and members of the stress reduction family were all gathered together in celebration. I marveled that I’d been a part of this community for all but three of its years. The work had been fulfilling and meaningful and the time had swiftly passed.
The study on the transplant unit came to an end and summer rolled around again. Once again, we went to the beach. This time Bekka didn’t visit, but her parents joined us for a few days. Each morning after my meditation, David and I would stop at the bakery on the way to the beach, eat a sugar donut (giving a small piece to Chaya), park the car at the small parking lot by the beach, and go for our walk. It was a daily ritual. David was grayer, with a little less hair, but he still walked faster than I did and was skinnier.
Chaya ran ahead of us as we lathered up with suntan lotion in the parking lot. We walked down the path to the beach, stopped where the path met sand, took off our sandals and lined them up with the other shoes shed by other dog owners. We moved on, climbing up a small incline to a ridge that overlooked the beach and a view of the nearby salt pond. At this point, David and I always paused and took in the view of sea and sky. We’d note the weather of the day and listen for the sound of birds. I’d notice the light and the complement of sky, sea and sand, and their colors of browns, blues and blue-grays, interspersed with greens of beach grass and reds from the iron rich soil. The perspective of bay, beach, sea, and sand never ceased to inspire us.
Hand-in-hand, David and I walked down to the shore, Chaya in the lead, running ahead to take her morning dip. We’d wait for her and then she’d run along with us, sometimes stopping to nuzzle or be sniffed by another dog, as we walked along the crescent-shaped beach to a large boulder about a mile down the shore. Sometimes we’d stop to chat with another dog owner. We walked carefully, stepping around the many small stones the waves had deposited on the beach.
Each morning, the light would be different, the tide at a different spot, and we’d spy new stones half-buried in the sand or glittering in the light. We made a game of spotting “perfect” white ones to carry home for the rock garden in our living room. We examined each stone carefully. They needed to be smooth and have a shape, pattern, or color that pleased us. A few we pocketed as treasures to carry home; the others we threw back into the sand.
As I walked, eyeing the stones, I reflected on the action of the waves that deposited them on the shore, carving and shaping them with the help of wind and weather, sea and air, to give them their distinctive character. I couldn’t help but compare them to our lives. Together, they formed the ground on which we walked.
The large boulder that was our destination had a large crack in it. Each year, we had noticed the crack’s deepening, as it began to cleave the rock in two. One week, we saw an artist perched beside it with his sketchpad and watercolors. At the end of the summer, we found his picture hanging in a gallery. It captured a moment of light and tide and rock, a moment in time that no longer exists.
As I write, the stones we chose to bring home rest in my living room by my plants and a small fountain. I have placed a laughing Buddha nearby. It is a reminder of sun and sand, days of leisure and the beauty to be found in the wear and tear of life. It also reminds me of impermanence.
During the summer of 2001 we went to the beach in July, not in August as is our custom. That August, three stress reduction teachers — Melissa, Ferris, and I — went to Wales to run a teacher-training program for the mindfulness teachers in the program that Mark Williams had created at the University of Bangor. He, John Teasdale, and Zindl Siegal, who had worked with us on their mindfulness-based cognitive therapy program for depression, were present, along with some other European teachers. Jon and Saki led a conference first and we followed them. Our training was in-depth and intimate, with perhaps twenty-five teachers, primarily those who worked with Mark. I was excited. Melissa and I traveled a bit first, stopping in Bath. I visited Stonehenge. Then we went to the retreat center. It was the first time I had traveled abroad to do a training session and I thought that if I were to leave the clinic, the trip to Wales would be a wonderful way to end my teaching years at the Center.
Throughout the training, as our minds quieted, mine thought, should I or should I not leave the clinic? Was it time for me to go? Melissa and Florence, who I had brought on, were now mature teachers. Jon had left, Ferris had left, and I’d be turning sixty in another couple of years. I still fatigued easily. Was it time for a change? By the end of the retreat I thought, “Yes, I can do this.” I planned to stay connected, but I was ready for a fresh relationship with the Center and my work. I decided to give notice. When I returned.
I walked into Saki’s office to resign. It was Tuesday morning, September 11, 2001.
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