Maintaining Perfect Equanimity: My 10-Day Vipassana Retreat

Maintaining Perfect Equanimity: My 10-Day Vipassana Retreat

In The Myth of Sisyphus, Camus wrote that weariness awakens consciousness, that “Everything begins with consciousness. Nothing is worth anything except through it.”

In the last few months, I’d been weary—sleeping, eating, exercising, commuting, working, preparing for more work, sleeping, and repeat—but I didn’t feel any consciousness awakening, and I still felt like I was waiting for that “everything”, or at least something, to begin.

I wanted to immerse my bare hands in the soil of life—to feel the softness of joy, the moisture of awe, and the cool warmth of peace, between my fingers. I wanted to feel alive: for my soul to urgently thrust itself into each morning, as if the spinning world depended on it.

Instead, I was stuck in traffic.

In the world of natural health junkies, spiritual community dwellers, and backpacking hippies, a Ten-Day Vipassana Retreat is a right of passage. My friends, colleagues and fellow travellers all assured me that the experience changed them. They all reflected on their ten days spent in the woods in silence, sitting for excruciatingly long hours, as catalysts for growth. They’d burned off dead and stagnant parts of their egos, let go of their cravings, and emerged shiny, with a renewed zest for all their lives had to offer.

Listening to their stories, I imagined myself in their places: sitting mute and contemplative in the dark. Through eliminating all input, I expected the Universe (with a capital U, naturally) to reveal rich meaning beneath its monotonous surface. Plus, I heard the food was good. 

So, I signed up. A few months later, with a backpack filled with drab clothes and a meditation cushion, I was driving to the Dhamma Torana Vipassana centre, located outside of Barrie, Ontario.

A sleepy hippie greeted me as a I pulled into a virtually empty, gravel parking lot at the entrance to the centre.

I got out of my car and smiled at him, “I’m here for the Vipassana retreat.”

“Yeah, man,” He replied with eyebrows raised, as if searching his brain for what I was referring to. “Hey, though, do you mind parking your car closer to that truck? There’s going to be a lot of us trying to fit in here.”

I looked around for evidence of this meditation-hungry crowd. Instead, there were a handful of cars parked, including a large black pick-up truck and my own.

“Sure,” I said, “Do you mind just watching my bag?”

I squeezed my car up against the truck. Now we were two cars huddled side-by-side in the large, empty lot. It looked ridiculous but, you know, we were a community now.

“I couldn’t lift the bag,” Said the hippie-turned-parking-attendant, half-apologetically. He’d left it on its side in the dirt. The bag contained two pairs of pants, two t-shirts, some shampoo, and meditation cushion. It probably weighed three pounds.

I smiled tightly at him, hoisted the bag onto my shoulder, and made my way to the registration house to get my room key. Then I headed over to the women’s side of the property to find my cabin.


The cabin was a tiny room containing two beds separated by a shower curtain. I was supposed to share with a roommate, but she hadn’t arrived yet.

How do you room with someone you can’t talk to or look at? I prayed that my roommate wouldn’t show up and that I’d get the room to myself.

I put my things away and headed to the dining hall for dinner.

We were told to hand over our electronics, writing materials, and other valuables. I handed over my car keys so that I wouldn’t be tempted to escape. As my things were being placed into bins, I felt like Austin Powers preparing to be cryogenically frozen. 

In fact, the retreat centre, while beautiful, had prison-like undertones. Signs declaring “Course Boundary” stopped you from exploring—or going back to the parking lot. Days later I would stare at that sign longingly, dreaming of the freedom represented by my car. Men and women were segregated into completely separate areas of the property. We weren’t allowed to talk and make eye contact once the silence was imposed. We were also told not to bring flashy, tight or flamboyant clothes and so many of use looked like prisoners: heads down, attention turned inwards, clothes dark, loose and drab.

The experience made me realize that, when it comes to vehicles, I wanted something that symbolized that very freedom. That’s why I started looking into trusted services from BlainvilleChrysler. With their wide selection of Jeep models, known for their rugged performance and adventurous spirit, I knew I’d find something that could take me anywhere I wanted to go. The idea of owning a Jeep was more than just about getting from point A to point B—it was about reclaiming that sense of adventure and independence I’d been missing. It felt like the perfect time to make the leap.

Dinner was vegan food. It was good. However, having been a recovering vegan in the past, I wondered if I’d finish the retreat like the parking volunteer, too weak to lift my own three-pound bag.

After dinner we were given a speech on the rules: no talking, texting, touching, making eye contact, gesturing, wearing tight clothing, doing yoga, running, writing, reading, sunbathing, killing (even mosquitos), sex, drugs, rock ‘n’ roll (or any other music, for that matter), alcohol, eating dinner (just some fruit for newbies), and so on. No Phone, no pets, no cigarettes. It was going to be a long ten days. 

I couldn’t wait.

I wondered what amazing insights would emerge from these ten days of spacious silence.

It was time for the first meditation, after which we would observe the Nobel Silence. We settled onto our assigned cushions. I had brought my own meditation cushion and saw that others had brought their own supplies too. Many brought intricate contraptions for sitting: meditation benches, special blankets, chairs, back rests, and knee pads. Rather than preparing to sit for an hour, it looked like they were readying themselves to enter the Earth’s orbit.

The meditation started. The teacher of Ten-Day Vipassana retreats, S.N. Goenka, is dead and so instruction is delivered by a series of tapes he’d recorded, presumably, while still alive.

One of the two assistant teachers pressed play and Goenka’s chanting began. Goenka’s would be the only voice I’d really hear for ten entire days, and it had an alarming amount of vocal fry.

I fidgeted throughout the hour of our first meditation. My meditation practice up until that point consisted of daily thirty-minute sits. I don’t think I’d ever sat for an hour. In fact, after twenty minutes, I’d usually experience numbness in both legs that sent me crawling around on all fours painfully trying to restore blood flow. During this first hour I kept crossing and uncrossing my legs. It wasn’t just me; silence in the hall was punctuated by the cacophony of restless shuffling. 

Five more minutes of chanting followed by a gong finally signalled the end of my antsy misery. I slowly and silently got up, keeping my eyes inoffensively cast in front of me, and shuffled, among the tribe of other zombies, out of the hall and back to my quarters. It was barely 9 pm, but I flopped exhausted onto my little bed and immediately fell asleep. 


The next day, loud gonging heaved me into the pitch-dark early morning. It was 4:15 am. I dressed in the dark, shuffled to the bathroom to brush my teeth, and headed to the meditation hall for the first two-hour meditation of the First Day.

The schedule was terrifying. We were to wake at 4:15 in the morning to sit for the first meditation, two hours, at 4:30. A gong would then signal breakfast for 6:30 am, after which we’d sit for another hour of meditation. Then we were to return to the meditation hall or go to our rooms and sit for two more hours. Lunch was at 11:00 am, followed by another break. Then, four hours of meditation followed by a snack break, where new students were allowed to eat fruit and drink tea. There was no dinner. 

After the snack break, was another hour-long meditation, then a discourse where we were to watch Goenka lecturing—the only entertainment of the day. Then more meditation—45 minutes. Bedtime was 9:30 pm. Lights were to be out by 10 pm. With the first wake-up gong sounding at 4:15 in the morning, and nothing to do in the evenings, I doubted that the early bedtime would be a problem. 

The first thing I did was count: eleven hours of meditation. Each day I was to spend eleven hours sitting on a cushion, keeping my back straight, and watching my breath. Besides eating, and walking in the forest during breaks, that was to be my life for the next ten days. How was I going to handle this?

“I think you’ll make it to day seven and then decide you’ve had enough,” a skeptical friend had told me before I’d left. I’d been insulted. Now I doubted my own convictions. Day Seven seemed very far away. 

Most of my friends had told me that they’d wanted to leave by Day Three.

By Day Two, however, I was done. My legs and back ached and, halfway through the second day, I decided that I couldn’t do another second of meditation. “I can’t do this anymore!” I exclaimed in my head. Besides Goenka’s, the Voice in My Head was the only voice I’d had access to for the last two days. And it happened to be mistaken. I kept on. 


During my 32 years on the planet, I don’t believe I’d spent a day without communicating in some way, shape or form with another human being. Since I could put words together, I hadn’t spent a day in silence. Since I could read and write, there wasn’t a day in which I hadn’t engaged with some form of written text.

I missed it. While taking bathroom breaks, I stared intently at the sign outlining the shower rules. I fascinatedly read about using the hair catcher while showering. I read how we were to clean it out after and dump any hairs in the garbage. I studied the rules about drying and squigeeing the shower walls after use. “With Metta,” The notice signed off. With Metta. Withmettawithmettawithmetta. I read the words over and over again. Bathroom reading. It might as well have been War and Peace

I expected the days to soak me in serene silence. I was wrong. As it turned out, my head was louder than an elementary school cafeteria during lunch hour. But, unlike the lunch break, there was no end to the noise. 

“I eat brown food in the morning with brown tea and green food for lunch with green tea,” My inner monologue babbled gaily. It was true: breakfast was always oatmeal and prunes, which I accompanied with black tea. Lunch was a green salad and some soup or curry. I ate it with green tea. “Maybe I can be vegan,” The Voice in My Head chattered, optimistically, “The food here is so good. I could eat like this all the time. I don’t even miss dinner! Maybe I should start doing more intermittent fasting. I wonder if they sell a recipe book, oh, I can’t wait for breakfast tomorrow morning!”

And, “What colour pants am I going to wear tomorrow? The brown ones or the black ones? Brown or black? Black or brown? Should I wear the brown ones with the white shirt and the black ones with the blue shirt? Or the blue ones with the—” I’ll spare you the rest.

I had entire conversations with people in my head. I wrote, rewrote, and edited monologues, conversations and imaginary dramas. I crafted responses from the characters I was arguing with. I practiced my lines and honed them.

I humbly discovered that it was not a chaotic world, filled with sensory distractions, that stifled some creative genius locked somewhere within; the chaos was removed and no genius emerged. Instead, when left to its own devices, my mind became a shallow simpleton bouncing senselessly to topics like the clothes I was wearing, the things I was eating, and people I was dating. How disappointing.

During the eleven hours of meditation, my mind and body rebelled. Every itch, twitch and irritation, mental or physical, would send me crossing and uncrossing my legs, refolding my hands, opening my eyes, and stretching my neck—anything to avoid actually meditating. 

My only reprieve was meal times. I would wait for them, like Pavlov’s dog, salivating in anticipation of the gong that would release me from the hell of sitting.


On Day Three, however, I noticed something different. I was sitting in meditation and I wanted to move: do something, like cross my legs a different way. I felt tension and frustration rise within as I resisted the urge. The resistance was like a boulder to push against. It had edges, viscosity. I couldn’t push anymore. I relaxed, softened. I opened.

And with that, the resistance popped. I felt immediate relief.

It was as if my mind and body were wrapped in a crumpled fabric. Each knot and wrinkle resembled an agitation, a restlessness, a mania that arose from within my physical and emotional self. Pushing up against these wrinkles would only tighten them, causing more agitation. But, when I began to breathe, to dissolve their solidity, they began to soften, and pop, like bubble wrap. The fabric began to iron out. I was calm. 

I started to notice bigger knots: my relationship with uncertainty, for instance, that seemed too monstrous to pop, however the mini bubbles of impatience started to disappear as they arose, one by one.

Openness.

Openness provides relief from suffering. 

Maybe I could survive this.

On Day Three Impatience and I got to know each other. Impatience has been a theme in my life, a low-level agitation that manifests in restlessness: my desire to connect on social media, to distract with technology and day-dreaming, to tweeze hairs and do dishes instead of doing work, and to lurch through life with my head pushed forward, oblivious to my surroundings.

I moved through life like I ate: inhaling a fresh spoonful before swallowing the first. I wasn’t tasting my food. I wasn’t tasting life.

During one particularly turbulent moment in meditation, when a wave of impatience hit, so did a series of images: family weddings, babies being born, pets passing away, family members passing: images of events that had not yet occurred, but almost certainly would. I was racing towards the future, which would bring me both wonderful experiences and inevitable pain. And, of course, at the end of it all would be the end of me. What was the rush?

I brought my attention back to my breath. Some more knots in my mind’s fabric opened.

On Day Four I recognized that, at the heart of this impatience was a craving for certainty. Underneath that craving: fear.

What I am afraid of? I asked the blackness.

Almost immediately, from some depths of my psyche, the answer surfaced. 

I’m afraid to suffer.

Suffering, the Buddha’s first Nobel Truth. Life is suffering, or Dukkha. Like every other being who had ever lived, as long as I was alive I would suffer. If I craved certainty, then this was it.


We began to practice Vipassana on Day Four. For the past three days, my entire world had been reduced to the rim of my nostrils where my breath passed. The technique of focussing on the breath at the nostrils is called Anapana, and its goal is to sharpen and focus the mind. 

Vipassana, or the development of equanimity regarding the impermanence of nature, and the truth of suffering, focusses on body sensations. We first began to scan the body from the tips of the toes to the top of the head (“Staaart from. the. topofthehead. Top of. Thehead,” Chirped Goenka’s voice on the recordings), a relatively simple technique in theory that proved to be excruciating in practice. 

If the first few days had introduced me to the manifest agitations and disquiets in my body and mind, Day Four presented me with the full-on war raging within. For three hours a day we were to resist the urge to move. My body was on fire.

Demons in my head commanded me to move, get up, scream. Others shouted at me to stay still. Still others urged me to quit. Amidst their shouts was harrowing physical misery.

I felt like I was under the Cruciatus Curse. In fact, the whole retreat was starting to seem like a JK Rowling novel, or some other Hero’s Journey. I had set out to conquer evil only to find that all evil came from within, and was now being asked to face it bravely, conjuring up a Patronus of equanimity to protect me from being consumed by this hellish fire.

“The only difference between a Ten-Day Silent Vipassana Retreat and a Harry Potter novel is that ‘He Who Must Not Be Named’ is literally everything,” I thought, sardonically. 

From Days Four to Five, I emerged from every sitting broken and exhausted. Being on Day Five was like reaching the middle of a claustrophobic tunnel. I was halfway through and still had just as far to go. I scanned the deadpan faces of the crowd during mealtimes to see if anyone else had spent the last hour being electrocuted. 

Goenka said the sensations of fire and electricity were Sankaras, mental cravings that embed themselves in our physical bodies and cause suffering. An intense sensation was simply one of these Sankaras floating to the surface of the body. If we met it with “perfect equanimity”, it would be eradicated, and we would be cleared out for our next incarnation. 

These body sensations—the sharp, twitching, numb, searing, blinding, and even pleasurable— were a representation of nature itself. Sensations arise in the body and pass away; they are impermanent, Anitya. Through first being aware of them, and then meeting them with openness, without clinging or aversion, we can be free from suffering.

“Maintain perrrrrrfect equanimity. Perrrrrrfect equanimity, with the understanding of Anitya.

“Anitya…. Anitya….” Goenka’s recordings crooned.

Sapiens author Yuval Noah Harari, also a long-time Vipassana practitioner, states, “Meditation is about getting to know the most ordinary, daily, natural patterns of the mind, body and emotions, to observe reality as it is. If you can observe, to some degree, reality as it is, without running away to stories and fictions, you will be a more peaceful and happy person.”

Well, I certainly wasn’t happy.

On Day Five I was being burned at the stake. Someone had lodged a red hot poker into my right flank, just to mess with me. “I will never be able to walk again,” My mind blabbered, “This is torture. I’m becoming permanently injured. I can feel the meniscus in my knees slowly tearing—“

Goenka’s chanting began, indicating we had five more minutes of this hell. I relaxed, even though we still had five more minutes of this hell. The mind is a ridiculous thing.

—Donnnnng….

Freed by the beautiful, beautiful music of the gong, I sprang up. I expected to hobble, in pain, clutching at my back, working out stiffness in my knees. I anticipated the inevitable sharp pain that would appear in my ankles as I took my first step. 

Yet, as I walked out of the meditation hall to stand in the July sun, I noticed that there was not a twinge of pain, a tightness, nor an ache to be found. My body felt perfectly fine. On the contrary, I actually felt great: light and supple. It felt like I was floating.

Hm.


By the time Day Six arrived, I was greeting the pain like an old friend. I noticed that discomfort came, not from the sensations themselves, but from the mind’s anticipation of and resistance to them. If I expected an arising sensation to be painful, I would brace myself against it, creating tension. And, after the sensation had faded, my mind would still grip it, creating a story of aversion. 

So, I stopped calling it pain. Instead, it was a series of sensations: numbness, vibration, tingling, spark, heat, radiation, burning, but not pain. I noticed the sensations that disappeared as soon as they materialized, like shooting stars across my back. Others were solid, like clumps of cement hanging out in my body for the entire hour. I now easily sat for an hour without moving, watching this orchestra of sensations transpire across my flesh. 

The war was ending. I was winning.

I was free.

Four days to go.

Anitya. 

Sometimes impermanence isn’t fast enough.


On Day Seven, I settled into meditation, welcoming it now. I dropped into my breath, and began practicing Vipassana, sweeping my attention over my body, observing the sensations that were present, just as Goenka instructed.

Curiously, the sensations dissolved. There was no sensation, there were no Sankaras, there was no body. I could still feel the line where my lips met, and where my hands came together in my lap. Other than these two black outlines drawn in space, I had dissolved into ether, the atoms of my body emitting a subtle vibration that merged with those that surrounded it.

It wasn’t surprising. For the last seven days I’d been eating oatmeal and meditating in the woods without speaking to anyone. Now my entire body was evaporating. Nothing was surprising anymore.

I later learned that this phenomenon was called a “Free Flow”. It results from absolute openness: from a mind that is both equanimous and subtle. Solidity dissolves, and what is left is the vibration of atoms, all transient, anitya. All impersonal, Anatta.

The Three Buddhist Marks: Anitya, Anatta, Dukkha.

Impermanence, Non-Self, Suffering.

Now that I was One with, whatever it was I was one with, I figured I might as well seek some spiritual answers. Or at least make a wish or something.

I thought of what I most wanted in the world. “I want connection,” I told the Universe, “I want deep, connected relationship.” 

Amidst the vibrations, something answered. A simple, Why? 

Hm. Why, indeed? I’d never entertained the question.

I want to be loved, emerged my answer, from I-didn’t-know-exactly-where, since I was currently nothing. It was like my heart was speaking instead of my head. The utterance arose out of space, before dissipating, like smoke rings from a caterpillar’s hookah. Then, there was silence.

The energy, or entity, or my Higher Self, whoever I was talking to, seemed amused at my naivety. I could feel her compassionate chuckle vibrating into the atoms that buzzed where my body had once sat.

You already are,

the amused response manifested from the darkness into which I was dispersed.

You already are.

And, at that moment, nothing seemed more true. Nothing can give us what is already in our basic nature.

A Letter to Myself at 32

A Letter to Myself at 32

I often encourage my patients to write a letter to themselves on their birthdays for the following year using a website called FutureMe.org, where you can post-date emails to yourself to any date in the future. This exercise is great to do on any day, really. Tomorrow is my birthday. I’ll be 32. Here is my letter. 

This is it.

This is your life.

As Cheryl Strayed wrote, “The f— is your life. Answer it.”

There are some things that you thought were temporary, mere stepping stones on your way to someplace better, that you now realize are familiar friends, ever present in their essence, but varying in their specific details.

For instance:

1) You will ride buses.

You will never escape the bus. For a while taking the bus was seen as a temporary stop on your way to something else (a car?). You took the bus as a pre-teen, excited to finally be allowed to venture to parts of town alone. As a student, you took the bus to the mall, laughing at the ridiculousness of Kingston, Ontario, once you’d left the protective bubble of the student community, completely inappropriately, yet affectionately (and ignorantly) called The Ghetto.

You will visit other ghettos, also by bus, that are far more deserving of their names. However these ghettos will instead have hopeful names such as El Paraiso, or La Preserverancia. Those who live there will persevere. So will you.

Buses will take you over the mountains of Guatemala, to visit student clients in Bogota, Columbia. To desirable areas of Cartagena. You’ll ride them through India. They will carry you through Asia, bringing you to trains and airports.

You’ll ride buses as a doctor. You’ll ride the bus to your clinic every day.

Sometimes, on long busy days in Toronto, it’ll seem like you’ll spend all day trapped in a bus.

The bus is not a temporary reality of your life. The bus is one of the “f—s” of your life. You’ll learn to answer it. You’ll learn to stop dissociating from the experience of “getting somewhere” and realize you are always somewhere. Life is happening right here, and sometimes “right here” is on the seat of a bus. Eventually you start to open up, to live there. You start to live in the understanding that the getting somewhere is just as important as (maybe more than) arriving.

We breathe to fill our empty lungs. Almost immediately after they’re full, the desire to empty them overwhelms. Similarly, you board a bus to get somewhere, while you’re on the bus, you start to understand.

You’re already here.

Maybe you’ll graduate some day, to a car.

But sooner or later, you’ll board a bus.

And ride it again.

2). You’ll experience negative emotion, no matter who you are or what your life circumstance.

Rejection, worthlessness, sadness, and heart break, are constant friends. Sometimes they’ll go on vacation. They’ll always visit again.

You will never reach the shores of certainty. You will never be “done”. You may take consolation in momentary pauses, where you note your confidence has found a rock to rest its head against. But you’ll grow bored of your rock (it is just a rock, lifeless, after all). You’ll then dive back into the deep waters of doubt, risk despair, and swim again.

Happiness isn’t a final destination. Instead, it’s a roadside Starbucks: a place to refuel, and maybe passing through is an encouragement you’re headed in the right direction.

3). The people in your life are like wisps of smoke.

They will come and go. Some of them will simply whiff towards you, visiting momentarily. Their names you’ll hardly remember. You’ll share ice cream and one deep, healing conversation about love that you’ll remember for years to come. You’ll reflect on this person’s words whenever you consider loving someone again.

You’ll remember the ice cream, the warm sea breeze, the thirst that came afterwards, the laughter. But it will be hard to remember his name… David? Daniel? You won’t keep in touch, but you’ll have been touched.

There will be others who come to seek your help. You might help them. You might not. They might come back regardless, or never return. Many times it will have nothing to do with the quality of your help. Or you.

Sometimes the smoke from the flame will thicken as you breathe oxygen into it. People will come closer, you’ll draw them in, inhale them.

Sometimes you’ll cough and blow others away.

You’ll wonder if that was a wise choice. You’ll think that it probably was.

Does a flame lament the ever-changing smoke it emits? Does the surrounding air try to grasp it? Do either personalize the dynamic undulations of smoke, that arise from the candle, dance in the fading light and dissipate?

Flames don’t own their smoke. They don’t seem to believe that the smoke blows away from them repelled by some inherent deficiency in them. Flames seem to accept the fact that smoke rises and disappears, doing as it’s always done.

4). Not everything is about you.

There will be times when failure lands in your lap. You’ll wonder if it’s because there is some nascent problem with you, that only others can see. These failures will tempt you to go searching for it.

You’ll find these faults. These deficiencies. In yourself, in others, in life itself.

You’ll wonder if it explains your failures. You’ll wonder why the failures had to happen to you.

You think that people can smell something on you, that your nose is no longer able to detect, like overwhelming perfume that your senses have grown used to, but that assaults the senses of others around you.

Failure and rejection, cause your heart to ache. Your heart aches, as all hearts do. The hearts of the virtuous, famous, heroic, and rich ache just as hard. The hearts of those who have committed evil deeds also split apart. (The only hearts that don’t may be the truly broken, the irredeemable. And those people are rare.)

You will experience joys. Your heart will mend and break, a thousands times.

And it has nothing to do with you.

5). Success is not a final destination.

There are no destinations. You will ride buses, you will feel happy, you will feel joy. You will try. You will succeed.

And you won’t.

You’ll pick up the pieces of your broken heart. You will mend them. You will flag down the next bus.

You will board it.

You will grasp—you can’t help it. Grasping will only push the wisps of smoke away, causing it to disappear in your hands. This will frustate you, but you’ll keep doing it.

Over and over.

And failing.

You’ll grasp some more and come up empty, thinking that it is because something is wrong with me. There is lots wrong with you.

There is lots right with you.

Most things have nothing to do with you. (That might be just as painful to accept

But healing as well.)

No one said healing didn’t hurt. Sometimes it f—ing hurts! But, as Cheryl Strayed wrote, “the f— is your life”.

And answering it is your life’s process.

On Healing Regret

On Healing Regret

regretSomeone, I think it was Eckhart Tolle, once said that when it comes to mental illness, anxiety is about worry for the future, while depression is concerned with regret for the past. While, I’m not entirely (or even nearly) convinced that this is true, there is little doubt that those with both depression and anxiety can get caught in the paralysis of going over past events and regrets in their minds. Therefore, healing regret becomes important for reframing our past experiences and present identity and improving mood and self-esteem.

Regret is a sticky emotion. It reminds us of who we once were. It’s the cold hand on the shoulder and the voice that whispers “remember…” in our ear when we’re getting a little too confident, when we’re actually feeling happy with who we are now.

My patients will often tell me that when they find themselves in a spiral of low mood, their minds are often playing and replaying past events over and over. They mull over painful memories until they are distorted, painting themselves as the villain the more they rewind and press play. Remembering in this way smears grey over their entire sense of self, and discolours the possibilities they see for themselves in the future and, worse, their abilities to take meaningful action in the present. It leads to deep feelings of self-hate and worthlessness.  It causes feelings of hopelessness. And so I tell them this:

Regret, while painful, is not always bad. It is a reflection, a comparison between two people: the person you are now and the person you used to be. When this comparison is particularly vast, when the you you used to be is particularly painful to remember, then know this; you have changed. Regret comes with looking back with pain, wishing we’d taken a different course of action than the ones taken. However, when we flip this concept over and examine its shinier underbelly, we realize that in order to feel regretful about past events we are acknowledging that we (present we) would not have performed the same action or made the same choice now. The flip side is not that we’re bad, it’s a reflection of our goodness. We have learned and evolved. We’re different.

Looking back is different from looking forward. Our lessons are what shape us. The fact that we regret is proof that we learn, we grow and we change into better, preferred versions of ourselves. If we sit in the experience of regret, we can feel proud that, if faced with the same situation today, we’d be better. Regret doesn’t mean that we are bad people, it’s proof that we’re good people. In order to regret the past we’ve had to have changed.

To transform mulling over painful life choices and past actions, I recommend a writing exercise, inspired by Narrative Therapy. In every story of regret and “badness” there is also a story of values, skills, preferred identity and goodness. The next time you find yourself cycling through feelings of regret grab a pen and paper and answer the following questions:

1) What happened? What were the events that transpired? What did you do? What did other people in the story do? What were the events leading up to the action you and others took? What was the context surrounding you at the time? What influenced your decision to act as you did?

2) Looking back, what would you have done differently? What parts are particularly painful to remember? What actions or events do you regret?

3) What might these regrets say about you now? What might it say about you to know that you would have acted differently if you were faced with the same situation? What values do you embody that enable you to recognize that what you did in the past was regretful for you?

4) Looking at these values, how have you shown you have this value in the past in other situations? Do you have a particular story you remember?

5) How has that value or skill made an impact on the lives of others? In the story that you remembered, what might the actions you took in #4 have meant to the people around you?

6) How do you embody this value in the present? Where does it show up in the actions you take today? How might you embody this value in the future? What actions might you take while remembering this value? What does remembering this value and the story from #4 make possible for the future?

Going through this writing exercise can help us look back with more compassion for the person we were, who was growing into the person we are now. It might make possible ways that we can rectify anyone or anything was impacted in the past, if it means an apology, paying forward a good act, taking different steps in a similar present situation or even moving on and letting go of our tendency to hold onto the memory.

A Tale of Two Failures

Premature Ovarian Failure no longer bears that name. It’s not a failure anymore, but an insufficiency. POF becomes POI: Premature Ovarian Insufficiency, as insufficiency is apparently a softer term than “failure”. For me, it’s another telling example of how our society fears the names of things, and twists itself into knots of nomenclature and terminology rather than facing pain head-on. In this case, the pain is derived from the simple fact that the ovaries do not respond to hormones, that they for some reason die at an early age and cause menopause to arrive decades before it’s due, leading to infertility and risk of early osteoporosis.

Insufficiency, for me at least, fails to appease the sensitivity required for naming a problem. It reminds me of a three-tiered scoring system: exceeds expectations, meets expectations, insufficient performance. These reproductive cells have not been up to task. They’ve proven to be insufficient and, in the end, we’ve labelled them failures anyway—premature ovarian disappointments. Our disdain for the bodies we inhabit often becomes apparent in medical jargon.

What expectations do we have for our organs, really? For most of us that they’ll keep quiet while we drink, stay up late and eat what we like, not that they will protest, stop our periods, make us itch or remind us that we are physical beings that belong here, to this earth, that we can sputter and shut down and end up curb side while we wait for white coats to assist us. Our organs are not supposed to remind us of our fragile mortality. When it comes to expectations overall, I wonder how many of them we have a right to.

In one week I had two patients presenting with failures of sorts. With one it was her ovaries, in another it was his kidneys, first his left, now his right. Both of them were coming to me, perhaps years too late, for a style of medicine whose power lies mainly in prevention or in stopping the ball rolling down the hill before it gains momentum. When disease processes have reached their endpoint, when there is talk of transplant lists and freezing eggs, I wonder what more herbs can do.

And so, when organs fail, I fear that I will too.

In times of failure, we often lose hope. However, my patients who have booked appointments embody a hope I do not feel myself, a hope I slightly resent. In hope there is vulnerability, there is an implicit cry for help, a trust. These patients are paying me to “give them a second opinion”, they say, or a “second truth”.

I feel frustration bubble to the surface when I pore over the information I need to manage their cases. At the medical system: “why couldn’t they give these patients a straight answer? Why don’t we have more information to help them?” At my training: “Why did we never learn how to treat ovarian insufficiency?” At the patients themselves: “Why didn’t he come see me earlier, when his diabetes was first diagnosed?” And again at the system: “Why do doctors leave out so much of the story when it comes to prevention, to patient power, to the autonomy we all have over our bodies and their health?” And to society at large: “Why is naturopathic medicine a last resort? Why is it expensive? Why are we seen as a last hope, when all but the patients’ hope remains?”

Insufficiency, of course, means things aren’t enough.

I feel powerless.

There is information out there. I put together a convincing plan for my patient with kidney failure. It will take a lot of work on his part. What will get us there is a commitment to health. It may not save his kidneys but he’ll be all the better for it. My hope starts to grow as I empower myself with information, studies some benevolent scientists have done on vitamin D and medicinal mushrooms. Bless them and their foresight.

As my hope grows, his must have faded, because he fails to show for the appointment. I feel angry, sad and slightly abandoned—we were supposed to heal together. Feelings of failure are sticky, of course, and I wonder what story took hold of him. was it one that ended with, “this is too hard?” or “there is no use?” or “listen to the doctors whose white coats convey a certainty that looks good on them?”

A friend once told me, the earlier someone rejects you, the less it says about you. I know he’s never met me and it’s not personal, but I take it personally anyways, just as I took it personally to research his case, working with a healing relationship that, for me, had been established since I entered his name in my calendar.  In some way, like his kidneys, I’ve failed him. Since we’re all body parts anyways, how does one begin to trust another if his own organs start to shut down inside of him? Why would the organs in my body serve him any better than the failing ones in his?

I get honest with my patient whose ovaries are deemed insufficient (insufficient for what? We don’t exactly know). I tell her there aren’t a lot of clear solutions, that most of us don’t know what to do–in the conventional world, the answer lies mainly in estrogen replacement and preserving bone health. I tell her I don’t know what will happen, but I trust our medicine. I trust the herbs, the homeopathics, nutrition and the body’s healing processes. I admit my insufficiency as a doctor is no less than that of her ovaries, but I am willing to give her my knowledge if she is willing to head down this path to healing with me. Who knows what we’ll find, I tell her, it might be nothing. It might be something else.

It takes a brave patient to accept an invitation like the one above; she was offered a red pill or a blue pill and took a teaspoon of herbal tincture instead. I commend her for that.

There aren’t guarantees in medicine but we all want the illusion that there are. We all want to participate in the game of white coats and stethoscopes and believe these people have a godlike power contained in books that allows them to hover instruments over our bodies and make things alright again. Physicians lean over exposed abdomens, percussing, hemming and hawing and give us labels we don’t understand. The power of their words is enough to condemn us to lives without children, or days spent hooked up to dialysis machines. We all play into this illusory game. They tell us pills are enough… until they aren’t. This is the biggest farce of all.

I can’t participate in this facade, but I don’t want to rob my patient of the opportunity for a miracle, either. We share a moment in the humility of my honesty and admission of uncertainty. I know my patients pay me to say, “I can fix it.” I can try, but to assert that without any degree of humility would be a lie. How can one possibly heal in the presence of inauthenticity? How can one attempt to work with bodies if they don’t respect the uncertain, the unknown and the mysterious truths they contain? In healing there is always a tension between grasping hope and giving in to trust and honestly confessing the vulnerability of, “I don’t know.”

For my patient I also request some testing—one thing about spending time on patients’ cases and being medically trained is that you get access to information and the language to understand it. I notice holes in the process that slapped her with this life-changing diagnosis.

When her labs come back, we find she might not have ovarian insufficiency after all. Doorways to hope open up and lead us to rooms full of questions. There are pieces of the story that don’t yet fit the lab results. I give her a list of more tests to get and she thanks me. I haven’t fixed her yet, but I’ve given her hope soil in which to flower. I’ve sent her on a path to more investigations, to more answers. And, thanks to more information in the tests, I’ve freed her and her ovaries from the label of “failure” and “insufficient” and realized that, as a doctor, I can free myself of those labels too. The trick is in admitting, as the lab results have done in their honest simplicity, what we don’t know.

For the moment, admitting insufficiency might prove to be sufficient in the end.

Ode to NPLEX 2 (an acrostic poem)

Ode to NPLEX 2 (an acrostic poem)

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Nalexone or naproxen: one’s an NSAID. After a month, they’re not straight in my head.

Porphyria is different from diphtheria. Now who can remember which diagnostic criteria includes

Left shifts? Or is it left shunts? And what’s that condition where the intestinal villi blunt?

Emergent conditions and therapeutic nutrition leave little room for healer intuition. I wish I was dating an

X-ray technician. With less than

2 weeks to go, we’re left counting the hours. It’s been a while since I’ve had a shower. I wonder if there is a botanical flower that will give me superhuman studying power?

A Letter to an ND Graduate

A Letter to an ND Graduate

Graduation 2014.

Graduation 2014.

If any of you have been my patients you know that I love assigning letter-writing homework. There is something powerful in expressing yourself to some person or entity with the written word and then being able to look back and reflect on your thoughts and feelings at a later date.

In the first few weeks of my clinic internship at the Robert Schad Naturopathic Clinic, one of my supervisors, Dr. Wong, had us newbie interns write a letter to our future selves – our ND graduate selves. Sometimes it’s important to take a glance back to the start of our journey in order to fully appreciate how far we’ve come.

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On Climbing Mountains

On Climbing Mountains

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There is nothing wrong with living on flat ground. In fact, it can be quite gratifying and liberating. You can walk in whichever direction you choose: right, left, east, west, diagonally. Flat ground is safe. It’s familiar. However, after a while, it becomes inevitable that you’ll want to experience the world from different vantage points. You’ve heard that there is real beauty up there, above the clouds. And that’s when you decide to start mountain climbing.

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The Used Sweater (fiction)

I enter the used clothing store, my expectations healthily repressed; it is better to approach the vintage-shopping experience from a position of openness to possibility, devoid of excessive hope and need. If one starts in this way then one has nowhere to go but to the land of pleasant surprises and amazing finds for under a dollar.

I browse through the racks, taking in the moth-balled musty scent of used clothes. Perusing the garments is like visiting a library or a bookstore. The fabrics contain the memories of the people who bought them, wore them, loved and hated them (secretly) but remembered to always have it on when Grandma came to dinner. I wonder which blouse was tossed to the floor in anticipation of passionate lovemaking and which pieces of clothing have borne witness to arguments, death and divorce. Which sleeves contain the traces of desperate tears? If the clothing could talk, I can only imagine the stories they would tell about desire, disgust, revenge, passion, despair, loneliness, bitter disappointment and the tragedy of lives of promise that fade away unnoticed.

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C is for Cancer

This piece was meant for the CCNM Body Monologues during the 2014 Women’s Health Week. It is an important story for me to tell, so I decided to finish the final edits and publish it here. 

It was in Kingston, Ontario on the campus of Queen’s University, my alma mater, where I first met my roommate, C. We were both giddy with the nervous anticipation of coming face-to-face with the person we’d sleep beside for the next year. We were like two halves of a mail-order marriage; since divorce wasn’t an option, we were determined to make it work.

The pictures we pasted on the walls of our respective sides of the room highlighted the differences in our personalities and adolescent experiences. On her wall, there were sunny photos of rows of carbon copy, bikini-clad young women, posed in a way as to accentuate their lean abdomens and disguise obtuse hips. Their skin was bronzed from the sun. They could have been models. Why weren’t they models? I’m sure some of them were models. On mine, I plastered photos of my mishmash of weird friends. We wore sideways baseball caps, looked into the camera making cartoonish Zoolander faces or tucked our necks in to parody double-chins. We held up our hands in ironic peace signs. We emphasized our ugliness in order to assure our public that we were not trying to fit in. It was hilarious.

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The Guatemalan Doctor

The Guatemalan Doctor

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We take a chicken bus to the hospital in Sololá, Guatemala. The emergency room is simple: 5 beds in a row sheltered by curtains. The sanitation conditions are questionable. There are no respirators (patients are bagged manually, all through the night) or fancy medical equipment. The emergency room is a bustling gathering place for the daily misfortunes of any of the 500,000 residents of Lago Atitlán.

My classmates and I, fresh from the airport, are dressed in navy blue scrubs, shiny and new from Walmart. I have a stethoscope around my neck: a Littman Cardio III. I’d guess that it’s the most expensive stethoscope in the hospital. It’s also auscultated the least amount of hearts; I’d be willing to bet that too.

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