Tuesday, September 25, 2012

Examining Our Lives

This is the time of year when, in the Jewish tradition, our lives are examined. We bring the previous year to mind in order to find its truth. What is the truth about myself? Were my words and actions what I meant them to be last year at Rosh Hashanah and Yom Kippur, when I made resolutions for the New Year?  Were there times my words were not as kind and compassionate, as patient as I wanted them to be (ask my teenage daughter!)? Could I have done more for the community, for the earth, for my mother?

Questions such as these are always answered in the affirmative. We could always do more, do better.  No archer, not even Robin Hood, can hit the center of the target every time.

The truth, however, is greater, and also requires other questions. Did my words make a difference for another person? What were my deeds that supported others and made the world a better place? What did I say or do that nobody else in the world could have done? How did I keep the promise that I made to myself last year?

Sometimes it is very hard to acknowledge the truth of misdeeds, and make amends. We do so in order to “clean the slate” and make ourselves ready to do better in the coming year. However, it can be even more challenging to acknowledge the truth of our good deeds, and thus accept ourselves as complete human beings.

Every culture has its own system of social rules. In ours, politeness dictates that we do not focus on our accomplishments or good deeds. When we speak of them, we don’t want others to think that we are “bragging.” We are taught that the highest form of giving is that which is anonymous. Similarly, it is expected that we will do the right thing without the expectation of praise; however, our mistakes are routinely criticized. In time, this is internalized, and we hardly notice our successes, while criticizing ourselves, sometimes repeatedly, for our mistakes.

And yet, it is the knowledge of ourselves as good people which allows us to understand when we have missed the mark and gone astray. In some way, the more we are aware of the times we have gone out of our way to help, the times we have made a difference, of when we have acted in accordance with our own ethical principles, we create a conscious pattern of good deeds.

So how has this last year been for you? How did you “hit the mark”? Can you remember when your words made a difference to another person, when your actions helped someone, when you did something to make the world better? Is it possible for you to accept your truth, and from the wholeness of self-knowledge, make choices for the coming year?

Focused on the wholeness of our beings, we awaken to another year, rededicating ourselves to strengthen the pattern that we create out of compassion, kindness and love, commitment to social justice, and our intention to make the world a better place for all life.

Shana tova – have a happy and healthy new year.


Thursday, June 28, 2012


“Star light, star bright,
First star I see tonight,
I wish I may, I wish I might
Have the wish I wish tonight.”

Tonight I wished upon a star, the first that caught my eye when I looked up into the night sky. I recited the verse, long cached in the storage closet of memory, with the ease of repetition, and felt a sense of relief. The worry that had prompted this particular wish was alleviated, at least for now.

We wish on stars, on pennies thrown into fountains, ponds, or wells, on eyelashes blown by our breath from a forefinger. We wish on birthday candles as we blow them out, on breaking the “wishbone”, on rainbows. These are some of the wishing traditions I grew up with, and there are so many different wishing traditions around the world.

We also create our own wishing traditions. When we were children staying with our grandparents in Nogales, Arizona, my sister and I would walk down the 2 hills to school or the library, and as we walked back up the hills, near the top there was a tree stump. We named it the “wishing stump” and always took a minute to take turns standing on the stump to make a wish, before continuing home. One of my friends has named and calls on the “parking goddess” to find a parking place, and I have developed my own version of the “parking goddess” ritual – I think it helps!

Wishing rituals are often outside traditional religions, though there are certainly wishing traditions within religions. In my religion, Judaism, there is a ritual of placing pieces of paper with wishes written on them into chinks in the Western Wall in Jerusalem.
We read all kinds of fairy tales in which wishes play a central part. Sometimes three wishes are granted. Sometimes the wrong wish is hastily made, and sends the story in a different direction. Powerful fairies grant wishes to a newborn baby, as in “Sleeping Beauty”. The central longing in “The Wizard of Oz”, one of my favorites as a child, is the wish to go home.

As modern scientific adults, we often think of wishes as childish and unproductive.  However, in actively wishing, we exercise a powerful tool that utilizes practices which are known to benefit physical and mental health. Hope and positive thinking have been studied and found to increase a sense of well-being and alleviate stress. Even the simple act of making a wish helps us to feel more in control, calmer, and without as much anxiety, more able to access creative problem-solving.

Furthermore, we are using imagery, which can positively affect the immune system and many other physiologic processes. The words we say actually can cause the body to activate release of transmitter chemicals and hormones, either harmful or healing, depending on what is said. Consider being in the kitchen, accidentally cutting your arm, calling out, and then someone comes to help you. If that person says “oh my God, I’ve never seen so much blood,” the sympathetic nervous system releases adrenaline, the “fight or flight” hormone, which can cause elevated blood pressure and heart rate, thus possibly increasing the bleeding. If that person says “I’m here to help, the worst is over, relax and let me see your arm,” the chemicals that are released are likely to be parasympathetic, which lower blood pressure and heart rate, which is likely to make it easier to stop bleeding.

Finally, there’s magic. All human cultures have some longing for magic – a way of using personal power to affect what is around you. We live with the reality of events which we cannot control. Perhaps wishing on a star is much more than a ritual of childhood. Perhaps the ability to do so is actually one of the heroic qualities that sustain us. When we really, really wish with all our strength, when we can imagine the future we want so much, and find a ritual into which we can channel our love and longing and hope and dreams, we internalize that hope and find a way to articulate our dreams. At the same time, by speaking the truth of our desires, by acknowledging them, we can unlock the creative thought process that will help us find a way to change or find peace with our lives.

Thursday, June 21, 2012

Ray Bradbury

Ray Bradbury died June 5, 2012, at the age of 91 years. I found out a few days later, in the morning, a snippet of the Times in my email, my thoughts immediately overtaken, remembering stories of windswept landscapes on Mars, and dark warm nights illuminated by fireflies.

Ray Bradbury was an icon to me -a writer whom I read from childhood to the present, whose stories contained elements of science fiction, fantasy, and poetry, who used deceptively simple clear images to portray complex ideas. He had been a friend of my father, Leonard Rosenman, who was a composer, and my mother, Adele Bracker Rosenman Essman.  He once inscribed a copy of "Switch on the Night" (about a child who is afraid of the dark):  "To Danielle and Gabrielle, who I am sure will never need this book, from a very old man named Ray Bradbury." (Gabrielle thinks he was about 30 years old at the time.) That copy of the book is long lost - but I read a newer copy to my children.

By happenstance, my family was visiting Los Angeles during the week-long celebration of Ray’s 90th birthday.  Gabrielle & Peter, my sister and her partner, took us to two wonderful events during that week.  We saw the initial performance of a play he had written, and a screening of the movie, Fahrenheit 451, and I was privileged to speak to him for the first time since I was a child. My son and daughter were able to hear him speak about being a writer. He recommended that anyone who wants to be a writer should write a story every week. He himself wrote every day.
Ray Bradbury wrote about magic in everyday life and the intersection of everyday life with magic, especially the fantastical experience of children. Of course, we didn't call it magic when we were children, and he doesn't call it magic either.  The New York Times said that he did not use the "technical jargon" that was prevalent in the science fiction of the day, and this helped his writing reach a broader audience. His writing used the evocative language of the imagination, and reading his stories felt like the images from his words on the page reached directly to me, and activated my own imagination, so that I could see, hear, feel, smell the landscapes and characters in his books.

Imagination is the quintessential human quality, and a longing for magic lives in the deepest part of our souls. Like Ray Bradbury, we may not call it “magic”, yet we find ourselves reaching out with a sense of wonder for that which is mystical, evanescent, transcendental, spirit, essence, God. We find ourselves asking the great questions about the meaning of life: what is the place of humans in existence, who inhabits the next galaxy, what happens after this life is over, and who switches on the night.

So I do not say to Ray Bradbury, “Rest in peace,” but rather, “Rest in wonder.”  

Saturday, April 14, 2012

A Change of Plan

Recently I learned that my friend Hester had been suddenly diagnosed with Stage 4 cancer.  She had been focused on daily living, her long road stretching out to the horizon, attending to friends, creativity, work, and related pleasures and struggles.  Within days, her life abruptly made a hairpin turn into a new path, narrow and poorly lit, and short.  One week after I spoke to her, she died.

It is at these times that the veil, which protects us from certain knowledge of our impermanence, draws back and we glimpse the evanescence of all life.  This happens rarely for most of us, and we usually focus our attention on the events and circumstances of our lives as if we will always be living, here on this Earth.  Younger people, especially, tend to feel personally immortal, even when they know people who have died.  At a certain age, that veil becomes thinner, and somewhat frayed.  We have family and friends who have life-threatening illness, or who have died.  The numbers increase with our own age.  It becomes easier to imagine “that could be me.” 

Still, the veil is there, even if thinner, and those moments when we recognize the brevity of life disappear back under the veil. 

How do we live life fully, completely, inhabiting each moment we are granted?  In those moments when the veil is drawn aside, can we still live in the present?  Is it possible to do so despite knowledge of what awaits us at the end?   Or is the veil necessary, like blinders, to keep us focused in the present?  Is this a universal phenomenon, or just a product of our own culture, which keeps illness and death at a distance, and encourages everyone to hold on to the appearance of youth?

Certainly there are other cultures in which illness and death are regarded as part of life in a different way from our own, in which people are cared for at home among family of all ages.  Also, there are places where death comes more frequently to people at a younger age, because of infectious diseases, hunger, and war.  In these circumstances, there may be very little left of the protective veil.

Though the many religions and spiritual traditions of our world offer guidance, ultimately we each find our own way to co-exist with these questions.  Like many of us, I spend most of my time focused on the details rather than the overview.  I attend to my family, do my exercises, see my patients, care for our pets, plan and cook dinners, go out with my husband, my attention directed to the events carefully listed, by color and category, on my phone calendar. 

These last two weeks, however, my veil has thinned, and I know that, as I go through my day of details, my life, too, could change suddenly and irrevocably.  This awareness brings so much discomfort that I immediately turn away into mindfulness practice, name it “anxiety,” and return my attention, not to my breath, but back to the specifics of daily life.

Still, I find my mind meandering at odd times, wondering about meaning.  What are humans here for?  Why does each life seems so expansive, and yet so brief?    When people die, how can they suddenly not be here?  What am I here for?

I sometimes see time stretching in a line from the past to the future, or not in a line at all, with everything happening, in some way, simultaneously, and all life connected into a vast web.  In some way, everyone who was ever here, is still here.   In some way, it is life itself that is the meaning.

Friday, January 27, 2012

Physicians Have a Natural Role as Advocates

This is an article I wrote that was published on Kevin Pho's blog:  KevinMD.com 

As physicians, we are often called upon to be advocates for our patients.  Sometimes they have no other person to turn to.  At those times, in particular, we evaluate their health in the context of relationship, family, and workplace.  Having practiced family medicine for so many years, and now in counseling medicine, I have had the responsibility of advocating for my patients with their health insurance companies, within their families, and with their employers.  I take this responsibility very seriously.   more


Wednesday, January 25, 2012

New Year’s Resolution

Tradition asks us to use the onset of the New Year as a time to make resolutions for changing our behavior for the better in the coming year.  In fact, making – and breaking – those resolutions is the topic for conversation and news articles every year at this time.

I actually get this opportunity twice a year: January 1, with everyone else, and in the fall during the Jewish holidays of Rosh Hashanah and Yom Kippur, with others of the greater tribe.  One would think that I would get used to it, perhaps even good at it – that somehow my resolutions, like the bare root trees of winter, would ground themselves in the fertile soil, and grow strong and leafy, signaling my success to everyone.

Instead, I find myself revisiting the same basic resolutions twice a year (at least!), though the context and details may vary slightly. 

So, again, it’s January, and I plan, over this next year, to take better care of myself and to put myself and my own needs, first.  Just writing that I will “put myself first” makes me so uncomfortable that I feel compelled to add, “most – or more- of the time.”  Then, feeling that I have chickened out, I go back to the stronger statement, and say “yes, I will put myself first.”

Why is this so hard for me that I must resolve, over and over again, to make these particular changes in my life?  The concept is not foreign to me; as a physician, I advise my patients not only to take care of themselves first, but how to do it.  With this advice, I have told my favorite parable (“Reflections”), familiar to all who travel by airplane, where, at the beginning of each flight, the flight attendant tells the passengers “In the unlikely event that the cabin should lose pressure, and the oxygen masks are released, put on your own mask first, before you help others who need assistance.”

What would it mean for me to put myself first?  Certainly, it means prioritizing behaviors and activities which make me strong and diminish pain, decrease stress and make me happy.  These include exercise, regular rest, meditation, creative expression, and attentive scheduling.  In reality, I actually do these things, but not consistently and not enough.

So it is ironic that I have counseled innumerable people, my patients, through these same lifestyle changes.   The results are varied - often people make at least some changes, but sometimes they don’t.   Perhaps most of them, similar to my own experience, do take on practices that help them focus on their own health, but can too easily get derailed by the needs of others.

Our personalities, experience, and training influence the direction of attention.  Some of us tend to turn our attention first to those around us who are in need.  As a woman, a mother, and a physician, my natural predisposition to notice and attend to those in need became more compelling.  It is what I tend to do first.  It becomes automatic. 

The antidote to automaticity is mindfulness.  When we notice our thoughts and feelings as they occur, we can recognize that we have options, and choose what to do in that moment.  In choosing, we do not react automatically, but thoughtfully.  If I plan to go to the gym and exercise, but before I leave my daughter tells me her computer isn’t working and I need to fix it so she can do her homework, my automatic response would be to try to fix the computer because her homework seems more important than my workout.  But if I stop and examine my options, I realize that this is the only time today I could go to the gym, that my exercise is very important, that she could clean her room first, or hand-write her work for now, and that I can easily look at the computer when I return, while I rest after exercise. 

We don’t usually think about heroes as making choices to care for themselves.  Heroes traditionally care for others at the expense of themselves.  Yet when we examine the qualities of heroism, we find courage, steadfastness, and the ability to make split-second choices which save lives.  The hero does what is right, regardless of the expectations of others. 

Sometimes we find the qualities of heroism inside ourselves, and apply them to situations which do not seem like the stuff of legends.  Still, they are the same qualities, which we use on a micro-scale every day.  With them, we do things to save our own lives, a little bit at a time.  In the Jewish tradition, the person who saves one life saves the world.