Monday, August 1, 2011

Your One Wild and Precious Life

A question popped into my head that I paused to ponder, despite the numerous tasks on my list waiting to be checked off (or more likely moved to the next day’s list)… how does one really describe self-care, fostering resilience, burnout avoidance, spirituality, humanities…? You get the idea.

When I think about them, it strikes me that they have large areas of overlap and often are one and the same. What helps us to keep doing what we are doing? What brings us joy? What helps us to be energized in our work and in our personal lives? What gives us a sense of peace and meaning? What helps us remember why we went into this field in the first place?

I’ve had a line from a song stuck in my head lately, one I hadn’t heard in a long time. Finally, while working at my desk, I listened to it. It is music which was gifted to me by Dale Lupu and sung by a lovely folk duet called A Glass of Water. The song is called “The Summer Day (Thompson)” and the lyrics are:

I don’t know exactly what a prayer is.
I do know how to pay attention,
How to fall down into the grass,
How to kneel down in the grass,
How to be idle and blessed,
How to stroll through the fields,
Which is what I have been doing all day.
Tell me, what else should I have done?
Doesn’t everything die at last, and too soon?
Tell me, what is it you plan to do with your one, wild, and precious life?

The lyrics are from Mary Oliver's poem, "The Summer Day," and it’s the last line which had been echoing in my head, probably because I recently got back from the Being With Dying course at Upaya. See the Journal of Palliative Medicine blog post by Stephen Liben called “Unconditional offerings – Antidote to burnout?” While the phrase Stephen quotes from Roshi Joan Halifax’s Boundless Abodes meditation is powerful for me (May I offer my care and presence unconditionally, knowing it may be met by gratitude, indifference, anger, or anguish), it is the evening Zen prayer that is taped on my wall next to the light switch.

Let me respectfully remind you,
Life and death are of supreme importance.
Time swiftly passes by, and opportunity is lost.
Let us awaken … Awaken!
Take heed. Do not squander your life.

I have been on a bit of a self care/spirituality-focused quest over the past few years, because I am curious about ways to conceptualize these things and they are inherently difficult to pin down. I am one of those people who considers herself both spiritual and religious, and I wanted to get a sense of how others are thinking about these issues as they pertain to serving others, especially in the face of serious illness and death.

Labyrinth at the AAHPM Annual Assembly 2011 - Vancouver
As part of that exploration, I have participanted in the Sacred Art of Living and Dying course, the George Washington Institute for Spirituality and Health (GWISH) Art of Presence retreat in Assisi, Italy, the Being with Dying program at Upaya Zen Center in Santa Fe, New Mexico, Hospice and Humanities events at San Diego Hospice and The Institute for Palliative Medicine - most recently in two programs with Michael Stillwater (you know his work from "Care for the Journey" and "Graceful Passages"), and co-presented at a preconference workshop called “Rediscovering Our Hearts” which involved these same threads at the last AAHPM Annual Assembly. I list them here as resources for you.

All of these have changed how I look at myself, my inner life, my colleagues and teammates, my students, and my patients and their families in some way. Each experience was revealing and powerful for different reasons. Like so many things, the more you gain insight and understanding, the more you realize you have so much to learn.

So, back to the semantics question… I think the only way I have been able to sum it up is “whole person care” for us, the health care providers. We strive to provide it for our patients and their families. Why? To create a space for them to reach self-realization, the top of Maslow’s hierarchy... 
from J Palliat Med, Oct 2006; 9(5):1049-52. help them live well... to realize in each soul: meaning, peace, joy, and fulfillment. Which begs the question: Shouldn’t we extend that same compassionate whole person care to ourselves? In fact, don’t we have to, in order to truly hold compassionate presence for others?

I have come to believe so.

So, the point of this post, is to remind you (and me) while you are busy out there working hard in the service of others, the very thing that I dare say most of us hold to be our vocation in the truest sense of the word…

Be kind to yourself.

We are blessed in our work as hospice and palliative medicine providers to not only serve and guide those who are knowingly living closer to death, but to learn from and be guided by them as well. Let us be gentle and compassionate with ourselves as we strive to improve the way people live and die, to be truly present in the face of suffering. Let us take care of ourselves and each other with the same whole person approach that we offer so generously to our patients. Let us awaken, so that we may take heed and not squander our one, wild and precious life.

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