A Walk at the Lake in the Spring ...

... when you give yourself to places, 

they give you yourself back;

the more one comes to know them, 

the more one seeds them with 

the invisible crop of memories and associations

that will be waiting for you to come back ...

Rebecca Solnit

           Wanderlust: A History of Walking

I've just come back from a walk at the lake, something I do less frequently now that the arthritis in my toes, the legacy of years of nursing, over-powerwalking and hiking, makes itself known. The breeze was brisk in the bright sunlight as I stepped out of the car and strode the familiar route down the driveway, up the short hill and into the dappled shade of the lane leading to a green-tunnelled pathway down to the water. 

The bushes, shrubs and trees encircling the path were a plethora of tender Monet greens and the tree-lined fields that surrounded them were beginning to fill with dandelions, an advance guard for the buttercups and cow parsley to come. The air smelled like it does every spring - fresh and floral and clean. How many times had we walked these same steps over the years? Hundreds? A thousand?

I continued down the hill toward the water, under the spreading branches of two vast maple trees, their leaves still a little tented, waiting for another few days of full sun, and reminding me of partially-opened parachutes. The pathway curved to the left as it reached the bottom of the hill and morphed into the boardwalk that skirts much of the northern lake shore. Just before emerging into the sunlight, I noticed that the swallows were nesting, again, in bird boxes hung high on the trees for relative quiet and safety.

On I walked, past the canoe dock dancing happily on small sparkily waves, past the turtle log were no turtles warmed their backs today, up the little hill and past the well-kept gardens of the few houses remaining on the park property and, turning right,  I crossed over the small bridge above the now moderately-flowing stream leaving the lake for the sea.  (It had been in full spate the last time I'd walked this way.) I paused, bellied up to the cool stone wall of the bridge, and leaned over a little to watch the sun filtering through the leaves onto the surface of the running water.

As I continued on,  through the two old drystone fence posts, across the water meadows, along the shore, through the patch of woods and then back again, past the Arts Centre and through the botanical gardens resplendent in a blanket of cherry blossom, azaleas, rhododendrons, magnolias, bluebells and lily-of-the-valley, I  suddenly remembered a similar day several years ago, when I had also walked alone, my husband at home in bed, wishing he'd been able to share the morning walk with me - just one more time.

That morning, I'd grabbed my camera from the back seat of the car and, feeling both guilty for being out and free on such a beautiful day and excited at the thought of it, I determined to take pictures of each and every phase of the walk so I could share it with him when I got home. The memory of that sharing is, and was even then, both lovely and bittersweet. 

As I lay with my head beside Derrick's on the pillow, we looked at the pictures and smiled and cried and remembered other spring mornings filled with laughter, teasing, serious discussions and more than one raging argument. As Rebecca Solnit wrote so beautifully, our many walks at the lake had seeded an invisible crop of memories and associations that, even today, wait for me to come back to reclaim them.

3rd Compassion Fatigue Conference ...

Hi everyone! Here's a reminder of the annual Compassion Fatigue Conference to be held in Kingston, Ontario on June 4 & 5.

The conference, sponsored by Francoise Mathieu and her team at Compassion Fatigue Solutions, focuses on Organizational Health and Hands-on Wellness Strategies and will be held at the Ambassador Conference Centre on the outskirts of Kingston.

The speakers, this year, are varied and interesting including:

1.  Kristin Neff, PhD - Self Compassion and Emotional Resilience

2.  Francoise Mathieu, MEd - The Times, They Are Changing: How to Navigate the Changing Workscape

3.  Leslie Ann Ross, PsyD - Organizational Strategies for Workplaces With High Trauma Exposure

4.  Andree Jette - For Better and for Laughter: How to Manage Your Energy Capital


There will also be a variety of talks on train the trainer, workplace CF initiatives, mindfulness, stress control, managing conflict, vision boards for creative wellness, and change leadership.


Conference fee:  $350 + HST + 4.75 event fee
Group rates are available

If you have any questions, email or call Francoise:  info@compassionfatigue.ca  (613-547-3247)


(If you're planning to attend, please register NOW as the rooms are block-booked and will be released after May 3rd. You will only be able to book a room by contacting the Ambassador Resort directly. ie not through Expedia or Hotels.com. These websites will say that there are no rooms but, in fact, they are just being saved for the conference - until May 3rd.)

Enjoy!

A 5 Step Practice for Greeting the Morning ...

Now that spring is here, the mornings are arriving at an earlier and earlier hour. How we greet these mornings can make a significant difference to the rest of our day.

Here are some ideas for a simple morning practice that will help you to start your own day well:



1.  Open your eyes, smile and breathe:

Waking up this morning, I smile.

Twenty-four brand new hours are before me.

I vow to live fully in each moment

and to look at all beings with eyes of compassion.

Thich Nhat Hanh

In the Cherokee tradition, the element associated with

 the time of dawn and awakening is air or wind. As we rise

each morning we are reminded of our own call to awaken

to the needs around us. We inhale that first deep breath of the day

and remember that we are sustained moment by moment through

the gift of breath. The dawn is the time of promise,

when the world seems full of possibility.

We are invited to hope and new beginnings.

Christine Painter

If possible, wake yourself with gentle music. Smile as you return to consciousness and breathe some deep full breaths, in and out. (The word, inspiration comes from the Latin, spiritus, which means spirit or breath. Each moment of the day, we are in-spired with this sustaining breath or spirit.)

2.  S-t-r-e-t-c-h:

Stretching is easy to learn. But there is a right way and a wrong way

to stretch. The right way is a relaxed, sustained stretch with your 

attention focused on the muscles being stretched.

Bob Anderson

Now, take a satisfying, full-body stretch to increase the blood flow to sleep-cramped muscles then rise slowly from your bed. Stretch again by gently shaking out all the parts of your body you can comfortably shake. Then, holding your hands palms upward toward the sky, reach as high as you can for a count of ten. Then, let your arms and head hang down toward the floor. Finish with some waist twists, letting your arms swing, and then drink a glass of water to banish the dehydration of the night.

3.  Sit and give thanks:

Gratitude unlocks the fullness of life. It turns what we have

into enough and more.

Melodie Beattie

Sit in a quiet spot in your home, settling into a comfortable position. You might like to light a candle to welcome the coming day. Think of at least three things for which you are thankful - the beauty of the new day, the love of a partner, a roof over your head when the rain is falling, shoes for your feet, or the chair you're sitting on. Write each one in a gratitude journal or just let the thankfulness flow through you.

4.  Meditate and/or pray

Meditation brings with it inner peace.

Mayo Clinic

Prayer makes your heart bigger.

Mother Teresa

Spend a few moments in quiet meditation and/or prayer according to your faith tradition. If you haven't a regular practice, writer and teacher, Geri Larkin, suggests the following meditation in Spirituality and Health Magazine:

With your eyes slightly open, sit on the chair with your back straight, feet flat on the ground, and hands on your lap. Take a few deep belly breaths and wish the world well - allow images of the people, places, and things to randomly flit across your thoughts, and with each image simply think, Take good care of yourself.

 You'll find that there is a slight pause after the initial rush of images. When that happens all you have to do is to breathe quietly and deeply, listening to whatever sounds are filling the space around you. If you find yourself worrying or cranky about something just tell yourself, It's okay, and go back to listening.

 This is not a time for problem solving or for mentally writing that rebuttal to a tweet that nastified you. Instead, let yourself feel how good it feels to be taken care of by the world, which has given you this chair to sit on, the beauty of the light from the candle, and the energy of the sounds around you. 

Sit like this for a few minutes, or longer if you like. 

For those of you who would like to engage in a more formal practice, mindfulness meditation and centering prayer are two of many possibilities you can explore.

5.  Read something inspirational:

Man's reading should be intensely alive. The book

should be a ball of light in one's hand.

Ezra Pound

Reading a brief passage of something inspirational can help to set you off on the right foot for even the hardest day. I try to keep a number of books by my bed, and more by my meditation chair, to dip into each morning. Among my favourites are:

1. To Bless the Space Between Us: A Book of Blessings by John O'Donohue

2.  Quiet Mind: One-Minite Retreats from a Busy World by David Kundtz

3.  Moments In Between: The Art of a Quiet Mind by David Kundtz

4.  A Life of Being, Having and Doing Enough by Wayne Muller

5.  Morning Mist: Thoreau and Basho Through the Seasons by Mary Kullberg

6.  A Thousand Mornings: Poems  by Mary Oliver (And most of her other works)

7.  Listening Below the Silence: A Meditation on the Practice of Silence by Anne LeClaire

8.  Mitten Strings for God: Reflections for Mothers in a Hurry by Katrina Kenison

9.  99 Blessings: An Invitation to Life by Br David Steindl-Rast

10. Teaching With Fire: Poetry That Sustains the Courage to Teach - SM Intrator, Editor 

Now, like all other practices, this one will only help your day to go well if you actually practice it! So, may I suggest giving it a try for one week and then deciding for yourself whether the difference in your experience is worth the time (under 30 minutes)?

Perception ...

Hi everyone! This has been a busy week what with travelling back from a retreat at the Bethlehem Retreat Centre, (my favourite quiet get-away, which I highly recommend to any of you wanting a simple, beautiful, nurturing environment in which to recharge your batteries), and Easter weekend with my surrogate family in Nanaimo and then getting ready for a workshop with the Q'wemtsin Health Society in Kamloops next week.

Despite the busyness, I've had two opportunities to notice what a difference perception can make to any situation in our lives. The first opportunity was on Wednesday morning as I considered going to my thrice-weekly aquafit class. Looking at my to-do list, I knew I would have to rush to get to the pool on time and that going home to shower and change before my afternoon meeting would likely cut into my lunch break. All of a sudden, the class became just one more thing to fit in - more of a burden than a help. I eventually decided to go to the pool anyway and as I slipped into the water I was surprised to remember the wise words of a grief counsellor I worked with during Derrick's illness:

Jan, there are two ways of "being" in the water. You can go and slog through the exercise routine, feeling bored and worrying the whole time time about the things you should or could be doing at home. Or, you can be truly present in the moment, consciously perceiving the refreshing, cool, wetness of the water against your skin; its buoyancy as it supports and carries you; the exercises, themselves, gently stretching the tension from your neck and shoulders; the joy of the music and the waves, both enlivening your spirit.

Two very different perceptions of the same activity, one helpful and the other, not so much. When I consider the difference between the two, I realize that, for me, perception is a matter of choice. If I look at the class as something I "have" to do, I feel stressed and resentful. If I see it as a source of nurturing, buoyant support, and veriditas in the middle of my day, it feeds and refreshes me.

The second opportunity to notice perception at work came yesterday as I walked into Granville Market to have a latte while I did some writing. As I walked the length of the Market, I became aware of white and blue posters on each of the twelve thick wooden posts supporting the roof. The posters were labelled, Poetry in Transit, and each sported the work of a BC poet. The one I liked best was called I am not old by Samantha Reynolds from her book, bentlily: a collection of poems:


I am not old

I am not old, she said
I am rare

I am the standing ovation
at the end of the play

I am the retrospective
of my life
as art

I am the hours
connected like the dots
into good sense

I am the fullness
of existing

you think I am waiting to die
but I am waiting to be found

I am a treasure
I am a map
these wrinkles are imprints
of my journey

ask me
anything. 


Rare. Standing ovation. Art. Good sense. Treasure.  These are not the words we usually associate with aging and yet what a wonderful picture they paint of the second half of life. Once again, choice is at the core of perception. While we can't choose the manner or length of our aging, we can choose our perception of the process. Perceiving ourselves and aging others as rare treasures waiting to be found, with wisdom and good sense to offer, is much different from perceptions of helplessness, hopelessness, and infirmity. Once we become aware of our automatic perceptions, we have the opportunity to reframe them.

So, what about you? What are the areas in your life where you could use a perception tune-up? Think of the situations where you routinely feel discouraged or out-of-sorts. Is there a chance that becoming more conscious and reframing your perceptions could make a difference to those parts of your day? (I don't mean that we should "just put on a happy face" in difficult situations. But we might be able to find a way to put the best spin on things that integrity will allow and then reap the benefits in both mood and energy. Why not give it a try?

     

Connection ...

... love and intimacy are among the most powerful factors in health and illness, even though these ideas are largely ignored by the medical profession. ... I am not aware of any other factor in medicine - not diet, not smoking, not exercise, not stress, not genetics, not drugs, not surgery - that has a greater impact on our quality of life, incidence of illness, and premature death from all causes.

Dean Ornish, MD

Dean Ornish, an American cardiologist and founder of the Centre for Integrative Medicine in San Francisco, (best known for his use of a very low fat diet to reduce or reverse coronary artery disease), has also spent a number of years studying the effects of love and intimacy - an open heart - on our health and wellness.

In his 1997 book, Love and Survival: The Scientific Basis for the Healing Power of Intimacy, Ornish writes:

The real epidemic in our culture is not only physical heart disease, but also what I call emotional and spiritual heart disease - that is, the profound feelings of loneliness, isolation, alienation, and depression that are so prevalent in our culture with the breakdown of the social structures that used to provide us with a sense of connection and community.

He goes on to say that loneliness and isolation affect our health in several ways:

1.  They increase the likelihood that we may engage in behaviours like smoking and overeating that adversely affect our health and decrease the likelihood that we will make lifestyle choices that are life-enhancing rather than self-destructive. 

2.  They increase the likelihood of disease and premature death from all causes by 200-500 percent or more, independent of behaviours, through different mechanisms, many of which are not fully understood.

3.  They keep us from fully experiencing the joy of everyday life.   

In short, anything that promotes a sense of isolation often leads to illness and suffering. And anything that promotes a sense of love and intimacy, connection and community, is healing.

So, what does this say to us as helpers? It reminds us of the vital importance of creating and sustaining supportive relationships in which we can be ourselves, transparently and authentically. Compassion fatigue, burnout and accumulated grief all cause our hearts to close and we disengage from family and friends, colleagues, and care recipients. Wellness opens our hearts, enabling us to be emotionally aware, to disclose our emotions in a mindful way, to listen carefully to what the other person is feeling, and to acknowledge that person's feelings with empathy, caring and compassion.

It can be difficult, at times, to maintain healthy connections but, as we can see above, its worth making the effort. I remember becoming more and more isolated over the years of caring for my husband. I felt deeply connected to him but had only a few other  relationships that I continued to nurture actively. There just weren't enough hours or energy in the day.

It wasn't until the last three years of his life, when Derrick became confined to bed and I had to organize a rota of friends to stay with him whenever I left the house, that I realized how much I had missed and needed mes amis. As different folks came to the house on Wednesday and Saturday mornings, I went out to do errands and then returned to have a cuppa with whomever was there. Those visits were God-sends. Not only was I able to connect with loved ones, but with loved ones who got our situation because they'd just spend the morning with my husband. We were able to have honest, open-hearted conversations that allowed our care and compassion to flow and it was so good.

So, if you have been too busy, too tired, too scattered, too sad, too irritable or too fed up to connect with your friends for the past while, why not consider giving someone a call and arranging a date for lunch or coffee or a chat on the phone. It's always okay to limit the time from the onset if you're really tired or afraid of getting overwhelmed - "I only have twenty minutes, but I've been missing you and wanted to connect." Choose who you call wisely and you may be surprised to see just how much better you feel after the conversation.

ps  I will be re-connecting with loved ones over Spring Break and the Easter weekend, myself, so I won't be back in the office until Tuesday April 2nd. In the meantime, I wish each of you a very Happy Easter and all the blessings and veriditas of Spring.  Jan

Veriditas II ...

A person who toils more than her body can bear

is rendered useless in her spirit

by ill-judged roil and abstinence.

Living hopelessly and joylessly, that person's sense often fails.

Hildegarde of Bingen

Hi everyone...  Last spring, I wrote a blog post on self-care called, Veriditas. At the time, I understood veriditas to mean the greening force of spring but I was far from comprehending the depth and power of the concept.

This year, after almost twelve months of reading about Hildegarde of Bingen (an amazing German abbess who, at a time in the 1100's when few women could read, was an early feminist, ecologist, herbal healer, poet, playwright, mystic, and composer) and after a month-long mandala retreat based on her writings, I have a much deeper understanding of both the woman and her veriditas. And I think she has much to say to those of us who have become desiccated and arid (ariditas) through caring for others while not caring so well for ourselves.

The verse above, taken from one of Hildegarde's letters, is a perfect description of my own state in the last weeks of my husband's life. I was physically exhausted, my spirit was dry through roiling turbulence and abstinence from the things that might have kept me moist, juicy and verdant. I felt little hope or joy, and as many will tell you, my sense - common or otherwise - was definitely failing.

Hildegarde saw veriditas as that life force which unifies all of life. She was most interested in the sense of life, radiance, vitality and aliveness in all creatures. She saw veriditas as the green sap that makes life possible. As author, Christine Painter, writes:

This green fluid, that is the source of life, is hidden below the earth, in the the roots of things waiting to burst forth in springtime with newness. Rain elicits this response. Hildegarde believed that humans draw forth this same green sap into our beings through the breath and the soul. The breath is the animating force, drawing in moisture and life.

Though Hildegarde was, of course, bound by the "science" and theology of her times, there is still great wisdom in many of her ideas. Let's try to apply some of them to our own lives:

Imagine where in your life you experience the dryness of ariditas. Where do you encounter complete lack of nourishment or anything to sustain you? Does any part of you resonate with this notion of barrenness and desiccation? Where have you become depleted in yourself and in your service to others? (Be sure to hold these dry and arid places with the utmost gentleness and compassion. This is not a time for judgement or self-criticism.)

Then, breathe the moist and verdant energy of veriditas into your body, your mind, your emotions and your spirit. Allow it to fill your being with life-giving greening power. Then exhale, letting go of all the dryness and releasing its hold on you. Do this for several minutes.

Now, allow yourself to consider these three questions for reflection adapted from Christine Painter:

1.  Where in your life do you experience the greatest dryness or ariditas?

2.  Where is the greening of life most abundant for you? What are the things which bring you most alive and in connection with the greening life force at work in the world?

3.  Could you make some time to immerse yourself in one of these activities, or some small aspect of it, this week?

As you can see, veriditas isn't just a reflection of the greenness of nature, it is reflective of the very state of our true, authentic selves. We each have the capacity to bring forth new life just as the earth brings forth greenness. Becoming more aware of the quality of greenness of the earth helps us to see where in our aridity we need new growth.

When Your Family Physician Retires...

I went to my family doctor for my biannual physical a few weeks ago and was surprised and just a little shaken to learn that he will be retiring from the practice component of his work this coming September. I had been expecting to hear this news sooner or later but the reality felt worse than the anticipation.

I felt a little as though I was a four-legged stool that had had one leg kicked out. I have known our physician since he was an intern at the teaching hospital in which I worked in the 70's and, over the years of my husband's life with and death from cardiomyopathy, we spoke by phone several times a week and he visited us at home for the three years that Derrick was confined to bed. Over tea and cookies after he'd examined his patient, we came to know him better and liked him all the more. He visited us in hospital during the last week of Derrick's life and both called to check on me after Derrick's death and attended his funeral. He has walked an intense portion of life's journey with us and I will miss him and his kind, steady, support.

I don't think that people generally reflect deeply upon the importance of their relationships with family physicians until they or someone they love is really ill or until those physicians are leaving or have already left. We certainly don't do that as a society, a fact demonstrated by the absence of research into the emotional impact of physician retirement on seriously and/or chronically ill patients and their care partners. And yet, that impact can be great, even destabilizing in some cases.

As with any attachment, particularly a dependent one, the breaking of the physician-patient-family care partner relationship is a loss that evokes grief. In the case of patients and care partners already experiencing chronic sorrow and reduced social support, that grief can feel overwhelming. Even relatively short physician absences can evoke sadness, anger, anxiety and distress.

I remember when our physician played a game of hockey and badly injured his neck, requiring surgery and time off work for most of the last six months of Derrick's life. It was an enormous loss and source of concern for us - worry for our physician, himself; fear about loss of continuity of care and of all the facts rattling around in his head that I might or might not be able to remember on a given day; loss of his relatively easy availability, based on his belief that home palliative care was impossible without physician accessibility and home visits; and his willingness to entertain "outside the box" solutions for Derrick's longterm pain. His absence brought into sharp relief all the qualities with which he'd graced our lives over the years.

I think it is important that we make space to grieve the loss of such a significant relationship whenever a physician retires, is absent for a long period, or when a patient dies and the degree of contact with the care partner changes - space for the grief of physician, patient, and family care partner alike.

It matters that we give each other time to acknowledge the alteration in the previous pattern of life, to say goodbye, and to express unfinished business, concerns and gratitude - aside from all the administrative details. We need a chance to say what the relationship has meant to us. At it's best, the physician-patient-family care partner relationship is one of mutual care, compassion, learning and partnership - and, thus, one deserving of its grief.

So, as it draws to a close, I would like to take the opportunity to publicly acknowledge and thank Dale Stogryn, a fine man, a fine physician and an excellent medical educator, for a twenty-five year relationship of care, respect, compassion and great medicine. I am glad that you will continue with your work in medical education but those of us in your practice will be the poorer for your absence.