Month: April 2019

It’s good to have a safe place. It’s also not guaranteed. Some people are born into situations of protection. Many others encounter strife from the start. Our paths to shelter vary.

Safe places are not necessarily geographic, place-based. They can be internal, state-based as well. In fact, over a human lifetime, some of the best refuges are those that we discover within. They are havens of being, senses of circumstance in which the lines between individual and social, me and other, why and how are blurred. These are the ultimate sanctuaries. They are the spiritual ones.

It isn’t easy to build such connections in our lives. It takes practice. It demands acceptance of failure. It requires courage.

All too often I’ve thought that I could construct myself, and my future, through personal will. Brute force. Sheer determination. These can be helpful qualities, to be sure. My life, however, has taught me that those qualities do not assure success in touching security. Effort and focus can lead to experiences that are satisfying, yes. But satisfaction in personal goal-accomplishment is not the same – over years of being – as the comfort associated with feeling part of something larger than oneself, the transcendent peace that may be entered when separations shatter and me-you dualities dissolve.

A memory stirred in me last night from thirty-three years ago. I was a surgical intern in a busy urban residency program. My days were challenging. There was limited time outside the hospital. There was independence in care delivery and decision-making that, by contemporary standards, would be considered dangerous to patients and detrimental to learning.

Daily rounds began at 4AM. Evening work typically ended well past dinner. And most months found the surgical intern on call every other night.

One day, well into the internship, we had a very heavy operating schedule. I had been up all night, doing pre-operative work for the seventeen or more patients on our service’s list. The intern’s job was to admit new patients to the hospital and make sure that all the screening, labs, intravascular lines, and other preparatory work was completed in time for anyone scheduled for procedures the next day. Depending on the complexity of patients and their conditions, this could take most of the night. Often it continued into the course of the actual operating day.

Fatigue was standard, of course; I could fall asleep standing and sometimes did, if I wasn’t careful. In order not to nap when it mattered most (such as in the operating room), I learned how to voluntarily cramp the muscles in the backs of my calves. The painful spasms kept me alert during surgeries when my only role was to hold retractors steady inside body cavities and spaces that I usually could not see.

“How about you finish this one?”

The vascular surgical fellow’s question snapped me to attention as quickly one of my leg cramps. The patient was one of the final planned operations for the day. He was prepped, draped, and under general anesthesia. Because of poor circulation in his foot, and multiple failed previous procedures to improve blood flow to his toes, we were performing a mid-foot amputation.

“Sure,” I replied.

The surgical fellow had prepared everything for the final stages of the distal foot removal. All I needed to do was finish. And yet the moment he handed me the reins for the remainder of the operation, something flipped inside me, a switch of uncertainty, a bolt of hesitation not relating to the mechanics of what-came-next in a mid-foot amputation but rather to the leg and foot that was having that amputation. I suddenly felt uncertain that we were operating on the correct side. My hands froze. Everything stopped.

Was it too late? I tried to gather myself, to orient to what was happening and to what I should do. We were standing on the brink of surgical no-return. Had we already crossed it? Noticing my hesitancy, the surgical fellow reassumed the surgical helm and deftly completed the amputation. “Sorry but we need to get this done quickly,” he muttered. “This guy’s heart won’t tolerate too much anesthesia.”

The surgical fellow probably assumed that I was tired; I was. He may have also wondered if I knew the surgical steps to perform the surgery; I did. What he didn’t know, what it was impossible for him to guess, was that my mind was racing over and among the previous night’s seventeen histories and physicals, left vs. right visual memories, a flood of paper consent forms and signatures, the process of reviewing consents before anesthesia, and the clear reality confronting me that half of what may have been the wrong foot was now permanently severed from our patient’s leg. I could barely stand. I couldn’t speak. I had no idea what to do next.

Except help the surgical fellow finish. Which I did. Saying nothing. Doing what I was told. Watching the anesthesia team to see if they had noticed anything awry. Scouring my memory banks to try to recall for certain which side was the patient’s poorly perfused one. I let my hands work while my insides screamed and my heart fell closer, ever closer, to the floor.

“Good work,” the fellow said, removing his gloves and gown and leaving the operating room. “Get him to post-op.”

I finished bandaging the patient’s toe-less foot, and then shuffled to the silver tray table where the man’s thick chart lay. Post-op orders were required. I sat on a stool, watched as the nursing staff readied to wheel the gurney to recovery and cautiously opened the chart to confirm what by then I was sure that I knew: we had operated on the wrong leg.

I was wrong. We had performed the correct procedure, and on the correct side.

The ensuing minutes are lost to my memory. I don’t recall writing the orders or leaving the operating suite. My next memory is being seated on the floor of the surgeon’s locker room, my head leaning back against my locker. Even though we had done the right thing, I still felt like I’d made a mistake. When had I first wondered if we were operating on the appropriate side? Had my uncertainty begun in time to have said something?

My pager buzzed. Call the operator. I reached for the wall phone, dialed “0”, and slid back to the tile floor.

It was my father. “Just thinking about you,” he said. Dad knew better than to call me in the middle of the day. I was almost never available. And yet here he was.

“Everything ok?” I barked.

“Oh yeah,” he said. “I just wondered how things were going.”

I wanted to tell him that I was bobbing in a stormy sea of emotion and instability. Instead I muttered that everything was fine. “Long night and day,” I offered.

There was a pause on the line. “Good,” Dad said. “I won’t keep you. I know you are doing important work.”

Important work. I was on the vascular service. We were trying to salvage people’s limbs, sometimes their lives, and occasionally witnessing our own wreckage piling up in the wake of our interventions.

“Oh, Mark.” Dad’s voice had that I-need-to say-something tone in it. “Mom and I understand that you’ll probably be too busy to make dinner on Sunday. Just know you can stop by if something changes. We’ll be around.”

Easter week of 1986 taught me many things. One lesson concerned safety checks for patients and speaking up for uncertainty; voice that is unexpressed is compassion that cannot be shared. Never again would I stand still and say nothing if someone’s well-being was on the line.

Another lesson – an insight that I feel as strongly today as I did thirty-three years ago – involved shelter. Somehow my father knew that his son was raw, that he was utterly and completely exposed to the elements of human experience. Somehow he trusted that instinct and reached out when his son needed it most. The young man was lucky that he answered the call.

Across space, and now through time, there can be safety. We need only roll back the boulders that block our access to such sanctuary to feel the peace that is possible in its embrace.

I thought she was dead. Apparently I was wrong. Included in a large email group, an acquaintance from years ago (let’s call her “Greta”) sent a message that was very much from someone who is alive.

This isn’t the first time that I’ve received email from people I never expected to hear from again; on two previous occasions, friends whom I’ve known quite well have sent me invitations to be Facebook friends long after I knew those friends to be gone. The difference was that those people were, in fact, deceased. Also, I had smiled when I received their emails because I wouldn’t have put it past either of those two to find a way to get my attention from the other side of the consciousness veil.

“The reports of my demise have been greatly exaggerated,” Mark Twain once quipped. I was glad to learn that the report stored in my memory about Greta was, similar to Twain’s, erroneous.

Feeling celebratory, I thought about sending Greta a congratulatory note. After some reflection, however, I decided against it. What do you say in such a situation? Hey there! I thought you were dead! So glad to hear that you aren’t. How’s life been treating you over these many years? Obviously, that’s not a very considerate communication, especially to someone who wasn’t a close friend. Besides, who knows why I “remembered” that Greta had died. Suppose she had, in fact, been seriously ill – or still was? Or suppose I’d confused someone else’s death with hers? I decided it was better to just feel warmed by the news that Greta was still with us and that she seemed well.

It’s not often that we have such opportunities. Most of the time, the situation is quite the opposite: we learn that someone has died and the information we receive is accurate. Sadly, as one gets older, not everyone else does. We lose each other too quickly.

I’d like to pretend that my belief system is sufficiently strong such that death doesn’t unnerve me. I cannot. Vital spiritual traditions and their texts teach that there is continuation after human life. It also feels like there should be. But absent the type of direct confirmation perhaps only possible through a relinquishment of this form and its useful sensory capabilities, there is no absolute way of knowing. I am left only with my experience, faith, and hopefulness.

That’s why it’s good to know that people like Greta – people I thought were gone – are alive. I don’t need to see or talk with her to understand that she is still with us. Her voice, through a single communication, is enough.

Despite the rumors that may waft on time’s winds, there is rebirth, renewal.

I had to laugh: my annoyance at missing a maneuver in a kung fu class resulted in a quick smack to the right cheek. A self-inflicted smack, that is. With the handle of a six foot sword known as a kwan dao.

It was my own fault. After I missed the move, I yelled internally at myself to focus and to pick it up! So I did: I picked up the end of the kwan dao, swung it with more force than I should have used, and promptly whacked myself in the face.

There was no stopping though. I pushed the error and any pain associated with it to the back of the mind. It nestled in next to the realization that my internal reaction to the first mistake had itself caused the second misstep – and in turn the contact of the kwan dao pole to my right temple and cheek. But weapons’ work requires the martial artist to be in “the now”; I understood that any conscious acknowledgement of the first or second mistake could lead to a third. So I kept moving.

Later, however, while massaging my bruised cheek on the drive home, I ran through the sequence of events and broke into laughter. Then I laughed some more. In our school, weapons are taught only as part of open forms and demonstrations. We don’t use them in any type of combat against one other. Nonetheless, I had still managed to find myself on the wrong side of a kwan dao. And the kwan dao that caused me the problem was my own.

Our world has plenty of challenge and tragedy; it seems there is no shortage in contemporary life of valid reasons for worry or sadness. The media airways are full of vitriol. Our leaders are increasingly alarming. The planet may be dying. We kill ourselves and each other with less crisis of conscience.

There is room for laughter. We must make space for fun.

Which is where my close encounter with my kwan dao comes in. Not a day goes by when I don’t do something unusual or unexpected that is deserving of at least a chuckle. Some of my foibles are worthy of small giggles. Others warrant eye-tearing fits of laughter.

When you consider us, we humans can sometimes be a silly species. And I, for one, am a prime example of that silliness, often when I’m trying my best not to be.

We are biased against the left.

Think about it: the dominant side for most people is called “right”. We label awkward behavior and ineptness as gauche – the French word for left. In Latin, sinister originally referred to the left. In Anglo-Saxon, the root for left (“lyft”) meant weak. To be a leftist has referred at different times in history to being evil, to being unstable, and even to being a communist. Humans have clearly harbored a longstanding prejudice against the left side.

This historical favoritism seems unfair. After all, at least ten percent of the world’s population is left-handed. Many other people have ambidexterous abilities or are born without any specific handedness. Yet cooking utensils and power tools are still typically made for the right-handed. And most scissors won’t cut properly when held in the left hand. Until not too long ago, we even made school children learn to write with their right hands.

So what have we got against our non-dominant sides?

Over the years, I have had occasion to face my right-sided preferences. There were the clavicle and sternal injuries in college and graduate school that inspired me to try new things with my left hand, such as tennis. There was the surgery on my right hand during residency training that taught me how to place iv’s and document in the medical chart as a leftie. There was the time working in rural Arizona when, just for fun, I taught myself how to throw with my left arm. These days, I will regularly brush my teeth, shave, or pour water with my left hand, rather than my right, as a reminder that both sides have potential.

The conscious experience of doing things opposite to their everyday feel is a positive one. I can feel my brain working differently. I can sense all sorts of reaction from diverse muscular-neuronal patterns and connections.

“Whoa!” the now unused right side sometimes exclaims. “What’s happening over there?”

Call me creatively conscious but I am sure that the experience is good for me – and for my brain. It is a form of calisthenics for my central nervous system. Although it’s not supposed to be possible physiologically, I can feel things buzz in my brain when I challenge it in new ways. The change helps me notice and address imbalances that have snuck into my daily ways of moving and being.

Not everyone has the luxury of symmetrical anatomy and capability; some of the people I admire most in this world have innate or acquired physical challenges that don’t afford them the luxury of two fully equipped and operational physical sides. It is amazing to witness these folks’ accomplishments. It is humbling to consider what less I can do with my own complete complement of extremities and physical components.

This inspires me to be less complacent with how things are and to exercise my abilities in dynamic and unique ways.

So consider trying something with a different hand, foot, or neuromuscular pattern, just as an experiment of change. If you are a righty, let yourself be gauche! It can be fun to pay more attention to our non-dominances. There are lessons to be learned in the infrequent, the ignored, and the sometimes forgotten abilities latent in all of us.