Patience. The last 10 years have been a long, at times, painful lesson in patience. Literally 10 years ago, I applied to medical school (for the 3rd and last time), and 7 months later, I was accepted. And now, as I come near the end of my formal medical training, so many of the endeavors that I have worked so hard towards are now coming to fruition. But again, patience rears its omniscient head and teaches me: not yet. Because nothing has quite yet manifested… I am 5 weeks from completing residency. 3 months from taking the final board certification test for my specialty medical practice. 2 months from starting my job(s). 1 year from publishing my next book. And only now starting work as a medical advisor for a tech startup. It’s been a long time coming. And I am now only on the cusp of all these visions coming into being. All these manifestations that are bursting from my heart; it’s hard to contain it all. I am ready. So ready. Thanks for the lessons, patience. I know there are reasons for your “not yet”. I don’t know what they are, but I believe in your wisdom. And I’m listening. Ready in wait and ready to burst forth. Because when you’re ready to let me go, patience, I am going to be running down that road as fast as I can.
Almost all human cells reproduce on a cycle. Up to 10% of your heart is replaced each year. Red blood cells are replaced every three months. Skin cells, every two weeks.
But it has traditionally been accepted that neurons, the cells that make up the brain and spinal cord, do not regenerate. Based on recent discoveries, it turns out that, under the right conditions, neurons can indeed recover. They just need a break. That’s why, in modern medicine, we will sometimes induce comas and hypothermia in patients with brain injury; so that their brains can rest. It’s pretty incredible that if you can break your neurons from normal operations and focus on healing, they have a chance at regrowth.
So that just begs the question, how can we give our neurons a break, with less extreme measures such as induced hypothermia or coma state? How can we take a deep breath, in this moment, and stop all the bustling chaos in our brains and give our neurons the break they need in our muddled daily lives? It’s human nature to want to fix what’s broken. And we have the tools to fix it. Take a moment right now to close your eyes and take a deep breath in and out. Try it again. And one more time. We may not be able to replicate exactly what we lost. But in its place we can grow something new. And slowly, but surely, we can grow until we have everything we need.
During these last few weeks and months, dozens of opportunities have been proposed to me for future endeavors; from medicine, to yoga, to business, to real estate (yes I’m trying to buy a home, a whole new level of stress). It’s been a little overwhelming. And interesting. For the last 10 years, I have been waiting for this moment. This moment when my schedule would no longer be monopolized by impossibly long hours in the hospital, only to then go home and attempt to keep my eyes, swollen with exhaustion, open to study. All in the pursuit of being the kind of doctor that deserved to be of service to my fellow human.
For the last 10 years, I have sacrificed every free moment in my life in the pursuit of my medical education; declined social engagements, turned down romantic advances, missed important family functions, and sacrificed countless hours of sleep and self-care. And now my time has come. As I near the end of my formal medical training, the opportunities have started to reveal themselves. I sometimes ask myself if this will be my defining moment. In what direction will my life go from here? What kind of doctor/person/yogi/healer will I be? What am I capable of. The opportunities will come and go, but how will I stand steady within my values, yet allow myself to bend, but not break with the changing winds?
I am listening to it all; and opening myself up to whatever the universe has in store for me. I am trusting my instincts and following the path that reveals itself. I’m choosing to lean in. What comes next universe? Bring it
In our busy, modern lives, we have to rely on our innate automated system more and more each day. From our instincts when we get behind the wheel of a car, to our muscle memory when we unlock our phones, the efficiency of our autonomic nervous system is integral to our daily survival. On average, our hearts beat 70 times per minute. In that same 60-second period, we blink between 10 and 15 times, swallow once, and take up to 20 breaths. Our hearts beat. Our lungs breathe. Our bodies keep us alive.
And most of us barely notice. We just take it all for granted. So much of the world operates without us ever thinking about it. We just expect it to work out in our favor… and most of the time it does. We worry about the future and think about the past. But we hardly ever focus on the present; about what is right in front of us. And in doing this, we so often miss what is right in front of us. We take what’s good and easy and working for granted. Until it’s no longer good and easy and working for us… until we sprain our ankle and can no longer walk, until we get a cold and can no longer breathe, until we have a stroke and can no longer use our dominant hand. It’s normal. It’s part of being human.
But we can do better. I know we can. We can do better for us and for those around us. Because there are tiny, beautiful gifts we are given every day. The breath. The heart beat. The grace. It is up to us to appreciate them to the fullest while we can. In this one precious life, what can you notice to bring you more present; whether the breath, the heart, the perspective? Where can you be more present and more aware of the miracle of all the systems it takes to keep you alive? This life. This, that which we, just by the sheer act of paying attention, can be more present and connected to. This life.
The year started on hospital wards for me. On January 1st, 2019 at 6am, I arrived to work on that dark, winter morning and sat down in excited anticipation of 5 months remaining in my formal medical training. I logged into the EMR with quiet reverence that I will be independently performing this exact job later this same year with no formal supervision. It was a sobering thought. This month, the way in which I practiced medicine changed. Or maybe I just acknowledged how I have matured as a caregiver and physician. This last month, I had so many end of life discussions with patients, held their hands as they shared their wishes for their last few days/weeks. I have so many stories to share. From the daughter who embraced me before her mother was discharged home, tears rolling over her cheeks, and thanking me over and over again for making her mom better (thinking about this still makes tears well in my eyes). To the husband that broke down in sobs and gasps of overwhelming sorrow as his wife of 51 years was dying of metastatic cancer. To the family that yelled at me at the top of their lungs because they had no other way of expressing their fear over their father’s terminal diagnosis. It was a month of devastating heartache, inspiring hope and true humanity. Human suffering is so real. At times, it is overwhelmingly so… But there is no doubt that being privy and witness to it in such an intimate manner has made me a more patient, compassionate, thoughtful, generous human. What a privilege it is to serve my fellow humans. To be let in it with them like this. It has given me the opportunity to be truly present in my life, and to ask: How can we live in the moment and take everything we can out of the goodness it can hold for us?
Do you have a favorite Christmas song? We all do, even if we don’t celebrate Christmas. We all notice ourselves whistling or humming along to a tune on the radio with an inevitable shoulder wiggle to the happy tunes that seems to follow us into every venue during the month of December. Two weeks ago, when I was on shift in the intensive care unit (ICU), the family of a patient I had been caring for all week came in and surrounded her bed. I was sitting at a computer station close to her room, and suddenly heard “Last Christmas” by Wham! playing. It’s not often that one hears music in the ICU – the only sounds are typically a flurry of alarms that signal at different pitches and speeds to help the listener quickly decipher the acuity of the distress. Happy, winsome music is not the norm.
Then the family, which consisted of her adult children, their spouses and some nieces, all started singing. “Last Christmas, I gave you my heart… but the very next day, you gave it away….” They had horrible pitch; all singing at different tempos. “This year, to save me from tears… I’ll give it to someone special.” I noticed my forehead wrinkling as I tried to hold back tears, but they came anyway, a steady quiet stream of thick salty drops welled up in my eyes and down my cheeks. I wrapped it up and sent it… with a note saying, “I love you, ” I meant it”… Music unites us. It brings us together, and it’s what we recognize, even when we are about to take our last breaths. They were saying goodbye to their mom.
One of the daughters peeked out to me, and asked, “Is this ok? It’s her favorite song.” I sniffed back my tears, smiled and nodded, Of course it is. They played it over and over again and sang it to her, over and over again, for the next hour until she passed. They let her go with the embrace of music, and their united voices, in love and tribute to her.
The holidays are strange, aren’t they? We look forward to them for the time off, but we often forget that it is a time to connect and unite. Look to the person next to you and ask them what their favorite Christmas song is, then tell them yours. We never know when it may be our Last Christmas. And when it is, I hope they sing you your favorite song too.
Lately, I’ve been spending a lot of time waiting. Waiting for business emails, waiting for responses on job opportunities (I graduate in 6 months from residency! yikes!), waiting for patients to make time-sensitive decisions, waiting for vacation to arrive… it has been a strange season of waiting. And for someone who is used to getting things done the minute they are put on my plate, this has been an interesting exercise of letting go. This waiting has pushed me to let the outcome and response unfold as it will, without trying to influence the outcome. My best analogy is waiting for that wave. When I am surfing, I truly have no idea what will come at me next. It could be the sweetest, smoothest wave I’ve ever tasted… it could come at me with it’s jagged edge to remind me it is my master… it could peter out before it even meets the nose of my board…. Whatever it throws at me, it is an opportunity to let it be exactly what it is, and let the wave roll out the way it’s going to. I can’t control it, for goodness sakes; it’s the ocean! Do you know any surfer that has been able to control the wave coming at him? So I paddle out, I take in a deep breath of clean ocean air, and I wait. It has been so interesting these last few months watching each and everything in my life manifest into that wave that melts away before I am able to meet it. When I took a step back to examine my swelling frustration, I realized that the universe is sending me a message. This is my season of The Wait. My anticipation when sending out the energy, the hope, that this will be the wave I will ride into the beach… that has been replaced with a sense of acceptance, letting go, and contentment in the present moment. Rather than trying to force my timeline, I’ll let the outcome unfold the way it should when it’s ready for me. Because what’s the worse that could happen if I wait? In the wait, still in the ocean, on my board, breathing in the sea air, watching the sunset, and waiting. Sounds pretty good to me. How can you infuse a little more patience in your life and wait for the right things to unfold when the energy is right?
There is a story of these two young fish swimming along and they happen to meet an older fish swimming the other way, who nods at them and says “Morning, boys. How’s the water?” They nod politely, and the two young fish swim on for a bit, and then eventually one of them looks over at the other and asks “What the hell is water?”
These two fish, so innocent and unknowing merely show ya that the obvious, most important realities are often the ones that are hardest to see, and as a result, we miss simply paying attention to what is going on right in front of us and inside us. This very esoteric idea of being present is constantly bombarding us, but what it means really is learning how to think and learning how to exercise some control over how and what you think. It means being conscious and aware enough to choose what you pay attention to and to choose how you construct meaning from experience. So today, I encourage you to make the choice to be here and present in the exact space you are in right now. Knowing that the choice is yours. And whatever it is that you are feeling whether it is with fear or inadequacy or joy and elation; it is your job to be present with it. Be here now.
The outward benefits of yoga seem almost too obvious when we begin to practice: strength, focus, peace of mind, balance… if you’ve practiced, you’ve felt it too. As we begin to peel away the layers, we may also discover other unexpected and invaluable benefits such as the way in which we relate to ourselves. The term that my meditation teacher uses is “making friends with yourself”; it is the process of letting go of that recurrent voice inside that tells you that you have to be something different than you are, when in fact, you are already all that you need to be. It is about accessing your true self, and it is the ease that you build in a yoga practice that molds the key.
In this manner, yoga heals. I regularly teach Yoga for Cancer Recovery workshops and my students cannot sing enough praises about how yoga has healed their body, mind, and souls. For a cancer survivor, nothing feels better than to proactively participate in promoting her own good health. What is most exciting to me is that my recovery classes actually encourage the students to do less, and I incorporate this concept by starting each class with meditation. The whole practice, meditation combined with yoga, is about waking up. In our modern lives, we are programmed to think that we will be happier if we do more and accomplish more. I am personally guilty of the same mindset, and it seems radical to break this paradigm. Not that I am denouncing productivity – it is important to realize and pursue our goals. A meditation practice may actually help us achieve our goals by understanding that there is nothing we can do that will make us healthier or happier than something we’ll find is already inside us. This concept, which seems so enigmatic and unattainable at first, is actually something that we can wake up to while in our practice and learn to meet in each moment as it arises. There is nothing mystical or religious about it. In fact, it is the most pragmatic principle that exists. Our practice simply asks us to be ourselves. When we accept and make friends with our true selves, our goals become within reach because we truly understand our potential. The hard work of uncovering that true self is up to you.
So now that you are convinced a meditation practice can be part of your yoga practice, how do you begin? Start by committing yourself to 5 minutes a day for a week. Then build up to 10 minutes the following week, 15 minutes the following, and finally 20 minutes in your fourth week. Be patient with yourself. No one is able to run a marathon without training, and your brain is the most difficult part of your body to train. Start by sitting up straight. Some people like to have an icon to focus upon, their eyes closed, or their eyes slightly open. I am for all of the above – choose the method that works for you. Find a comfortable seat in a chair, on a block, or cushion, or the good old floor will do just fine. The reason we sit up straight is that we believe that there is something dignified about our practice, that it serves us as much as we submit to it too. While practicing, own it and commit to it. Fight the urge to get off your cushion or mat to check your phone or jot down that item on your to do list that you miraculously remembered while “clearing your mind”. This practice teaches us that there is no thought so brilliant that you must hold onto it. In this manner, you begin to forgive, let go, and create ease in both your body and mind. Remember, start in baby steps, but really engage in it. Consider it your mind’s commitment to train for the Iron Man-Brain. You’ll find the training will pay off as you begin to meet each moment as it arises, let go in challenging situations, and find the best in yourself.
Yogic breathing “pranayama” has been shown to be an effective treatment for cancer patients in improving their sleep, relieving anxiety and improving quality of life. In particular, a dose–response relationship has been found in numerous studies relating pranayama use and improvements in chemotherapy-associated symptoms and quality of life. Indeed, further studies have also shown that pranayama can have immediate down-regulating effects on the HPA axis response to stress. In the classes that I teach for cancer patients, I often teach a pranayama practice called “nadi shodhana,” or “alternative nostril breathing.” However, there is one key difference in the traditional practice – we do not hold breath. Due to the circumstances of their health, and all the other ancillary stresses that accompany a cancer diagnosis (financial, relational, occupational, etc.), cancer patients and survivors already experience vast amounts of stress. The “flight or fight” response of the nervous system is already on overdrive, and breath holding can intensify the feelings of stress and anxiety. So, no breath holding in the traditional nadi shodhana. But! We do want to practice alternative nostril breathing because it is the perfect tool to bring our attention to our breath and learn to control our breath, thus taking back control of our hyped up nervous systems. So try this with me today: Close your 2nd and 3rd fingers into your right palm, keeping the thumb and 4th and 5th fingers out. Take a deep inhale, and close your right nostril with your thumb, let go of your left nostril. Exhale out through your left nostril, close the left nostril with the 4th and 5th finger, open the right nostril, and inhale through your right nostril. Exhale through the left, and continue for 10 rounds. Switch hands for 10 more rounds, switching nostrils, exhaling through the right and inhaling through the left. Then let me know how it feels on your nervous system!