Tuesday, January 25, 2011

No Death, No Fear by Thich Nhat Hanh

No Death, No Fear by Thich Nhat Hanh

This book has become a primer for me as I face dual cancer threats. I could not have traversed through this nightmare-ish thicket without a 4 quadrant approach beginning first with the excellent medicasl treatment at Sloan-Kettering. But as we are all aware, when we go deeply into the scientific protocols of the LR and UR, the more we encounter the unknowable and the shades of gray. I will begin this blog by referencing my health challenges and then enlarging the applicability of this book's philosophy to every oen of us, and particularly to those who find resonance with Integral spirituality.

With my twin cancers, I find myself outside of the heavily researched protocol that dictates that I begin chemo 4 weeks after mastectomy. This was not possible with me, as I had two surgeries after, and now I am protocol-less. So here we enter into the art of medicine. My medical oncologist, DeenaGgraham, had nothing to tell me about my chances for survival with or without chemo, and will have to assemble her team to try to creatively assemble a treatment plan.

I presume that next Monday I will hear her best guess for as longer life span, but I also presume that any statistics she offers me will be a random median statistic which will not be at all predictive of my actual chances to stay alive for 5 years or more.

The best I can predict for my own well-being is fiound on p. 1:

"When conditions are sufficient we manifest and when conditions are not sufficient we go into hiding. "It's as simple as that."
"The Buddha has a very different understanding of our existence [than fears of our annihilation]. It is the underwstanding that birth and death are notions. They are not real. The fact that we think they are true makes a powerful illusion that causes our suffering.
"Buddha taught that there is no birth, there is no death; there is no coming, there is no going; there is no same, there is no different; there is no permanent self, there is no annihilation. We only think there is. When we understand that we cannot be destroyed, we are liberated from fear,. It is a greaat relief. Wse can enjoy life and appreciate it in a new way."
[more tomorrow]

Wednesday, January 19, 2011

Welcome to the Cancer Dance

  This is the view outside my office window today.  Gorgeous, magical and musically tinkling, illuminated with frozen light from within.


 These are humaan lungs.  The trachea divides into the two main bronchi that enter the roots of the lungs. The bronchi continue to divide within the lung, and after multiple divisions, give rise to bronchioles which are termed the bronchial tree.  This tree continues branching until it reaches the level of terminal bronchioles, which lead to alveolar sacs.

"Alveolar sacs are made up of clusters of alveoli, like individual grapes within a bunch. The individual alveoli are tightly wrapped in blood vessels and it is here that gas exchange actually occurs. Deoxygenated blood from the heart is pumped through the pulmonary artery to the lungs, where oxygen diffuses into blood and is exchanged for carbon dioxide in the hemoglobin of the erythrocytes. The oxygen-rich blood returns to the heart via the pulmonary veins to be pumped back into systemic circulation." (Wikipedia)

As without, so within.  Look at the resonance between the beautiful ice-frosted branches and the bronchial tree, which exists in the rainforest within the lungs.  Patterns repeat in nature in the most unexpected of places, as confirmed by my view outside and my lungs inside.

In Tuesday's, Jan. 18, 2011 Scinece Times p. D1, I read Roni Caryn Rabin's article on "A Pink-Ribbon Race, Years Long."  She tells the story of a woman who had metastatic breast cancer,  a sad category of 4 to 6 % of women who are found to be Stage 4 upon their original diagnosis. With her cancer already attacking her spine, she had come to a local support group.  Those in attendance were  "survivors" who had small localized cancers that were vanquished years before.  When it came to her turn, she could not stand to share her story.

Thus the success and the stalemate of dealing with cancer, that relentlessly kills 40,000 women annually.

What I did NOT know until I read this article is that 25% of all women who are diagnosed as Stage 1, the smallest, earliest and easiest to heal from, will battle with metastatic disease eventually.

I have figured out that the medical establishment in its wisdom does not lay out all of the grim statistics at the beginning.  For example, after my mastectomy, Rick and I sobbed with relief as the gentle genius Dr. Sacchini told me that I was Stage 1, and now all I had to do was prevent a recurrence.  Yes, I admit that I individually am not a statistic, yet I now understand that having this disease is not like getting the flu.  One cannot easily get "cured."

"All too often when people think about breast cancer, they think about it as a problem, it's solved, and you lead a long and normal life; it's a blip on the curve." said Dr. Eric Winer, Director of the Dana-Farber Cancer Institute in Boston.
"While that's true for many people, each year approximately 40,000 people die of breast cancer---and they all die of metastatic disease.  You can see why patients with metastatic disease may feel invisible within the advocacy community."

Those who are at Stage 4 are incurable, even though medical progress permits them to live incrementally longer.  Think of the late Elizabeth Edwards.  She survived for several years with the metastatic disease; but the median life expectancy is really 26 months, and fewer than 1 in 4 survive for more than 5 years. 

"This kind of uncertainty keeps many patients from throwing thenmselves wholeheartedly into the ethos of hope and empowerment that helps sustain many women with less aggressive forms of the disease.
Dr. Herbert says that while the pink-ribbon campaign has raised awareness about breast cancer, it masks a relentless killer.

"People like the pretty story with the happy ending.... You always hear stories about women who 'battled it' and 'how courageous' they were.  Cancer doesn't care if you're courageous.  It's an injustice to all of us who have this.  There are women who are no less strong and no less determined to be here, and they'll be dead in two years."

I was shaken after reading the article.  I am a somewhat awake and aware woman of moderate wisdom, and I need to position myself in relationship to this disease.  How can I create a new framework by which to live my life, and face challenges that come with this cancer?

My thoughts turned to this weekend and our last class where I will probably teach via Skype due to my level of continuing pain.  Then we host Terry Patten with Deborah Boyer and Michael in a substantial offering which I will describe in a bit, and shortly thereafter we launch into the major portion of our 2 and 3 year programs.

I can hardly digest all that has transpired for me personally since the launch of this first class. I left for Sedona at the end of September with the biopsy for breast cancer yet to be finalized; I became the first Integral Spiritual Minister; and the next day upon my return found out I did indeed have that diagnosis. A mastectomy was performed Nov. 4th. That in itself would have been quite enough to deal with, but it was followed by a serious infection leading to major emergency surgery; and having barely recovered from that experience, I had lung cancer surgery Jan. 10th.

I would like to give you a report in the 4 quadrants as to what transpired during and after my 5 day stay at Sloan-Kettering as it might serve to inform you for your futures as individuals and as members of a spiritual community..

I had been told that 90% of patients receive arthroscopic surgery for lung cancer which leaves the patient with very little pain and three small scars. Upon awakening I was informed that I was one of the 10% who had to have a formal thoracotomy, which is the most serious of the cancer procedures, and results in the greatest level of post-surgical pain.

 Was I entering ito a "why me" thought pattern? No, not at all. My mind-set remained one of curiosity moment to moment, and I watched for the moments of gratitude within my experience.  I was not happy about the level of pain, and am still not pleased with its slow dissipation, but it is a very tiny blip in the larger scope of gratitude for having discovered the cancer so early.

I was expecting the thorasic floor to be one populated by aged men with craggy faces and yellowed fingers from years of smoking, my stereotype.  I found instead many  healthy looking young men and women.  The range of the thorasic service covers esophogeal cancers which are experiencing a rapid increase, and my particular surgeon is an expert in handling them.  I spent some time looking at the faces of the rooms' occupants to get some sense of who might be there, and for what conditions.  I cannot say I gleaned any answers from my curiosity.

One condition that earned my everlasting gratitude for good fortune was my roommate.  The last time I had had a truly ratttling roommate experience.  I will not go into much detail about her or her extensive family; I have, though, become an advocate for careful selection of rommates for the health and well-being of the other party.  I am averse to loud noises, boisterous gatherings with loud cackling laughter, and a party-like atmosphere of relatives and friends ordering in copious food platters as if they were attending a Super Bowl party.  They basically had no boundaries about it being my room as well.

There---that exposes my petty side, but it also served to irritate my nervous system, deprive me of much-needed rest, and challenge me to race to my own bathroom before one of the 10 relatives got in there first.  When she was alone and fearful, however, I went over and talked with her and offered whatever insights or information that I could to ease her fears.  And in return, both she and her husband were gracious to me in other ways.

This time I was blessed with an elderly Roman Catholic woman who possessed that beatific smile, darling laugh, and continual bouyant life force that held her throughout her pain. We quickly bonded across our diversity, and when we both left, we cupped each others' face as we kissed on both cheeks.  I felt nourished by her presence, and I do stand by the belief that a quiet room setting can be a medical ncessity for some of us, an enviornmental factor that should be taken into account.

Engulfed with pain I had never experienced before, I was subdued as my husband walked with me into the family lounge. There seated across from us was a very handsome woman with red eyes. I am now familiar with the S-K dance, where someone really does want to unload their grief and story but also does not wish to intrude or place more on another sufferers' shoulders. After dodging one anothers' eyes for a while, my husband offered up the cold weather as an extended hand, and she and he found commonality in where they had both grown up, and where she now lived in Florida. Rick moved there during his youth and we are planning to buy a second home there, so the conversation formed a safe platform upon which to place her grief which came in due course.

Her 42 year old attorney daugther lives in Fla. with her husband and 2 young children. She had a lumpectomy and chemo 3 years ago. Last year she began to experience intense pain around the top of her spine. Long story: after many fruitless tests it turned out she had a metastasis of the breast cancer wrapped around her sternum, and a surgeon at S-K was the only one in the country who could safely perform the surgery. She had to charter a private plane to get her up here duirng our recent blizzard.

A short time after being put under, she was awakened, and told that the surgeon could not perform the surgery. The tumor could not be removed and must remain inside her....growing..... She might have 3 months....or longer...no one knew. The mother was in that white hot state beyond grief.

We spoke and cried for a long time. Then I went to speak to her daughter for a while. My husband noted that during that time, as I became involved in their situation, my entire body began to move with less agony, and once again it came to me that I could offer them the gift of an Integral perspective, gently and non-didactically offered, as soft as chick's down, that spoke of radical truth while infusing the message with hope and a different and elevated understanding of life.

I am still in great pain, but I have come to accept that those of us with cancer and other life threatening diseases are living within a 1st, 2nd, and 3rd person perspective on them and their particular pathological chaos.
Let me explain what I am noticing.....Before this surgery I had been in 3rd person relationship with both cancers.  They were "IT" to me, something that must be gotten rid of, as something alien to me.  It was a medical problem for the doctors to figure out the best medical and surgical interventions to free me from their tentacles so that my body might resume its happy rhythm.

But the reality that I have had 3 major surgeries in three months, one of them highly invasive that actually cut out and disposed of a lobe of my lung, shifted me into a 2nd person perspective of "You and Me".  The cancer has moved into being in interaction with me, and the cellular level work I have been doing plus the depth psychological evolutionary and generational analyses have shoved the cancers into my face, so to speak. YOU and I are in communication at a very deep level.

I have had repetitive dreams that have gone on for weeks, which I realized in a flash as this shift to 2nd person:

I am back at my school, but the 3 men who harassed me are just adults in the place; they have no energy around them, they are just people moving around and speaking.  It is my class that is giving me trouble...Night after night I try to get them under control, but try as I might, they are out of control, not responding to any force that I exert.  I can FEEL how strongly I try to wrestle them into their seats; into getting them to take notes; into comforming withg my expectations.  I cannot and do not succeed, night after night after night.

Welcome to Cancer 101.

Nothing that I can do will tame them or get them to be orderly or healthily functional.  It is beyond my ability to change them. I must address new UR realities that might not lead me toward a happy conclusion of "a cure".  I realize that in the LR I am no longer covered by any medical protocol where the oncologist can promise that "this chemo will lead to a 14% chance of metastases". I realize the truth that BOTH cancers can metastasize anywhere, at any time, and I will be called into their chaotic dance.

I have identified my Master Cancer Cell. That is when I own it as within my 1st person awareness.  I see that I cannot deal with it on any egoic or gross level myself.  I must surrender, more deeply than I did in my earlier awakening, and OOOH, there is far more that must be surrendered.  For my LL I will be most discerning about which groups I associate with so that I am not compelled to deny any part of my situation. I am not "the walking dead", nor am I a "she-ro", all chirpy and skipping around at race to the cure events with my bedazzled pink ribbon in tow.

Ken advised me that the huge discovery about healing is that much of it is under our control. Meditation, visualization, and affirmation all can play a key part in how we patterrn our dance steps. I will continue to revise and strengthen my UL and my entire ILP.

I will remain a vital part of my beloved program. I am excited to share what has become embodied within me. We will co-create so much of what is necessary as we Baby Boomers---I am the very first of us---hit the age when life issues and illnesses will confront us with urgency, and our skills will be called into practice.

Sunday, January 9, 2011

Meditation and Lung Surgery

Friday, Jan. 7, 2011
My lung surgery is scheduled for 11 am Monday morning, Jan. 10th.  I met with S-K personnel this past Monday, all day Wednesday, and for an hour today.  I am a bit worn out from all of the procedures.  Quite a bit of redundancy.  I did find out from the nurse that they are discovering more and more Stage Ia lung cancers as accidental findings from scans and X-rays.

I am also "growly", which is a combination of emotions characterized by frustration, disgust, annoyance, and a desire to remain just where I am.  I have created a sanctuary here in my house....The three plantings outside of my kitchen door, the upright and proud green and blue spruces with the tan drooping feathers of the ornamental grasses between them have been decorated by the recent snow in precisely the way I desired, and they offer their beauty to me at every glance.  The firs wear shrugs of puffy snow, while the trees behind them stand tall with icing on every branch. 

Deer, possum, raccoon, cat, and skunk tracks create intricate embroideries of paw and hoof prints in the snow up to the feeding platters we have set out for them for their winter picnic.  Chloe stands erect at ther door hoping to be incited by a fleeing or teasing grey or black squirrel, although I half believe that she woofs for the sheer exhuberance of the output.

I am also resentful that my meditation and my contemplation must be disrupted by a return to S-K where I am plopped amidst the busy-ness of the hospital, the every-3-hours vitals check, the lack of tranquility and of self-direction about every bodily functions.

Sat., Jan. 8, 2011
I immediately notice that this "growliness" has permitted suffering to re-enter my life!

"If we get caught in our notions and concepts, we can make ourselves suffer and we can also make those we love suffer," says Thich Nhat Hanh. 

Notice what I had been doing to myself----I was in a state of bliss while resting in the moment in my beloved kitchen with my 3 acre view outside; by choosing to switch out of the moment to Monday, all of that bliss has been replaced by a mild version of suffering, which manifests as agita as I cling to my seat and the view from my kitchen.  I lept forward to not-being there, to the loss of that moment.

 "Our freedom, peace and joy in the present moment is the most important thing we have.  But without an awakened understanding of impermanence, it is not possible to be happy."

I have put conditions on my happiness, which destroys it.  That which I am not looking forward to in the hospital---and it os neither the surgery or the pain, but rather some very pedestrian gripes---cannot be predicted as I sit here typing and ruminating.  The busy-ness of the hospital itself, the interruptions of tenuous sleep, the annoyance with rommates and their families, all these will manifest in ways I cannot even imagine, and I must allow them to do so without placing conditions or fears or anger upon them.

Was I not given an extraordinary gift during my last stay?  Did I not come to awaken to what others have so exquisitely crafted from their own experiences over the ages while striding the halls?

Sun., Jan. 9, 2011
I am happy and content. 

My husband and puppy (she is going to celebrate her 3rd birthday on Wed. but at 7 lbs. we still think of her as a perenntial puppy) are here with me as I tidy up before my 3-4 days away.  Chloe does not take her eyes off of me, as I am sure she fears the moment when the suitcase comes out and she senses that I will soon not be around.

I am doing routine "chop wood, carry water" tasks that fill me with love.  I am living in the moment and am taking pleasure from every glance out of my office window at the snow blanket with random naked spkes of plants resting until spring calls them once again to manifest their renewed life cycles.  Birds are flitting to and from our numerous feeders.  I am particularly attuned to avian life ( they represent spirit), and thrill at their aeronautical swoops, darts, and coordinated flight paths.  I surely have mirror neurons that light up as they flit within my vision, so that I am flying along with them in my body-mind.

And isn't that part of the Mystery?

"Touching the earth, I let go of the idea that I am this body and my life span is limited....I see that thius body, made up of the four elements, is not really me and I am not limited by this body.  I am part of a stream of life of spiritual and blood ancestors that for thousands of years has been flowing into the present and for thousands of years flows on into the future.  I am one with my ancestors.  I am one with all people and all beings, whether they are peaceful and fearless or suffering and afraid....The disintegration of this body does not touch me, just as when the plum blossom falls it does not mean the end of the plum tree.  I see myself as a wave on the surface of the ocean.  My nature is the ocean water."
No Death, No Fear, pp. 168-9

This is precisely what I experienced upon the birth of my daughter----being the midpoint of all of my ancestors, all of the mothers and fathers leading up to my manifestation, and then zooming into the future with all the mothers and fathers who are destined to manifest.

When my breast had to be removed, I felt no real personal connection to its loss.  I had successfully and lovingly nourished my daughter through it, and had experienced sexual pleasure from it.  In a sense, it had done its work in my 65 years, and could be removed with my deep bow to the role it played in my heart-body and the lives of those who shared it with me.  I would have had a different feeling had I been 35, however, I am sure.  So the loss was a sweet adieu, not a wrenching grief-stricken event.  Being involved in cellular meditation, I did grieve for the loss of the healthy cells surrounding the tumor, who had been doing their job s yet who had to be sacrificed for the good of the whole.  I hope that I paid my respects to those minute body parts laden with my consciousness so that there was an understanding of my intentions toward the surgery.

Tomorrow's surgery gets me into more serious and problematic territory---my lung.  The lower left lobe will be removed.  I will be heavily medicated with morphine, my first experience with it.

The surgery is done robotically and arthroscopically with three relatively small incisions in my back.  But this surgery is deep inside me, and it involves the very organ that makes meditation possible:  "breathe in, breathe out"

From No Death, No Loss again:

"Breathing in, I know that I am
breathing in.

Breathing out, I know that I am
breathing out....

Breathing in, I am only aware of my
in-breath.

Breathing out, I am only aware of my
out-breath."

But the very act of doing that will involve intense pain and effort.  What will I learn as I contemplate the paradox of the supposed ease of in-out breath being one that causes intense pain?  I am an asthmatic and tend to have bad brochial attacks. I know what fear I experience when I cannot take a breath.  I am phobic about suffiocating as a result, which is why I cannot scuba, and have to manage panic attacks when I snorkel, an activity I adore.  So the simplicity of the in-out breath will become a challenge for me beginning tomorrow, and I will have to sink into that feeling of suffocation with as much presence as I can.

No, I am not my body, but how far can I live within that understanding without the automatic ease of taking a breath?  I will become curious asbout that over the following days.

Monday, January 3, 2011

Relaxing Into Hopelessness

I have written the last two posts with the knowledge that they are centered around an optimistic time with the two cancers that have crept into my body's functioning. I dodged the bullet of impending death and hopelessness, so to speak.  I wanted an uplifting Oprah-esque narrative that told of hope in the face of despair which would coincide with the holiday and natural cycles of reborn light.

Yet I am keenly aware that this dodging of the hopelessness bullet was an illusion, and I must continue to work with the truth, rather than the temporary illusion. I turned to Pema Chodron's When Things Fall Apart to reorient me to both death and hopelessness as the motivation for my awakening in the hospital:

"When we talk about hopelessness and death, we're talking about facing facts.  No escapism...Giving up hope is encouragement to stick with yourself, to make friends with yourself, to not run away from yourself, to return to bare bones, no matter what is going on.  Fear of death is the background the whole thing...But if we totally experience hopelessness, giving up all hope of alternatives to the rpesent moment, we can have a joyful relationship with our lives, an honest, direct relationship, one that no longer ignores the reality of impermanence and death." 

That is precisely what led to my spiritual experience and resulting peace....

Today and Wednesday I return to Sloan-Kettering.  These visits have dominated my life for several months and will continue to do so.  The first time I heard of S-K it was in the context of an acquaintance going there for treatment who later died.  I associated anything to do with S-K with death and suffering.  It was, to me, the building of the walking dead.  Whenever I heard that someone had cancer, it was usually whispered, perhaps with the same underlying fear and panic that the inhabitants of the pre-modern world associated with lepers, and which the 1980s associated with AIDS sufferers.  The response from the recipients of the news of diagnosed cancer in someone they knew would be a bowed and shaking head followed by the muttered "poor bastard."

The first time I walked into the Valley Hospital Cancer Center in Paramus, NJ I dissociated.  This isn't my place, I silently affirmed as my body leaned away from the front entrance.  Not me, not here, I am not meant to have this health problem...Yet once inside I met caring, sweet, emotionally validating nurses, staff, and physicians.  I felt that this was not a charnal house, but a house of hope and promise.

My next stop was S-K and Dr. Sacchini who offered a second opinion about the breast cancer.  S-K was well beyond my imaginings.  It is decorated so welcomingly with waterfalls, soft oils and lithographs, and a color scheme reflecting the necessary polarities of hope and despair.  Too cheery with tropical colors would offend me if I were receiving a terminal diagnosis; too bland would pull me down into fretfull ruminations of bad news  Each floor has Internet, beverages and snacks, and a staff that is super-competent.  Their IT is incomparable....I went for a sophisticated biopsy only to have Dr. Sacchini reading me the results within the hour. The physician at Valley was awed when I told her this; she said that such a reading would have taken 3-4 days. 

My allegiance switched permanently to S-K, and for the 2 hospital stays and the biopsy I was cotninually astonished by the superb care of my body and mind, if not my spirit.  From tea and cookies served by a uniformed food service worker at 4:30 to the extensive and yummy meal selections, from the spacious hiospital rooms to the wondrous 15th floor activities center with 2 story windows overlooking York Avenue, from the nurses and physicians to the lady who emptied my garbage can, I could not have asked for more attentive or caring staff.

But consider where I was for those two hospuital stays---where women were recovering from surgery and then released....I never saw a death, never encountered a terminally ill patient.  The ICU is on another floor.  So for a while, a stay at S-K came to mean an average hospital event, except that everyone there has cancer.  And that also numbed and reassured me.  If everyone has cancer, it becomes the norm of your experience.  No more walking dead.  We all face the same peril.

This next time, which I will find out about on Wednesday, I will be on the 6th floor with other lung cancer patients.  When I told the nurse that my lung cancer was at Stage Ia, she teared up...She had never met anyone with beginning earliest and treatable stage lung cancer before.  So I know that I will be amongst very sick cancer patients, and my lessons in hopelessness will be even more grounded.

"Death and hopelessness provide proper motivation---proper motivation for living an insightful, compassionate life....We're always trying to deny...getting old, getting sick, losing what we love---we don't see those events as natural occurances."

Yes, I have dodged the cancer bullet.... for now.  That says nothing about what I can  hold onto, what the possible addiction to "my good luck" can lead to if more cancer is detected.  The awakening that I experienced must not be pushed aside by any temporary mindset of victory.

"Relaxing with the present moment, relaxing with hiopelessness, relaxing with death, not resisting the fact that things end, that things pass, that things have no lasting substance, that everything is changing all the time----that is the basic message."