The "no consumption" thing is terrifically difficult.
Coffee and other beverages are being phased out.
My canvas bag travels with me to the fruit and vegetable aisle.
Takeout, carryout, order out, etc. has been crushed.
Books from Amazon have slowed to a trickle and will soon dry up.
And yet, there is still a small amount of recycling that I had to put out this morning...
I liken this attempt to my yoga practice. Or my meditation practice. Or my practice of medicine for that matter.
You keep trying. Despite some injuries here, or boredom. A setback. A steak dinner. A piece of styrofoam.
But, hopefully, with practice, you become the person you want to be.
I was listening to an audiobook about Confucius and his philosophy. Like all religious teachers before and after, like the Buddha or Jesus, Confucius emphasized behavior and attitude. Part of the emphasis on propriety and politeness is a recognition that as we perform the outer trappings of humility and compassion, eventually, they become part of our personality.
Our minds, like our bodies, are modifiable.
Habit. Samskara. Patterns of behavior. Patterns of thought.
Just like when we meditate and our mind is racing. We come back to our breath and begin anew. Eventually, it becomes natural and easier. But, there is always awareness that, without constant vigilance, the thoughts arise forcefully.
So, I begin again. And again.
Trash one day.
The odyssey of life another.
Friday, September 17, 2010
Monday, September 13, 2010
The Fatman
I don't know why I always think of this patient as the "Fatman".
Well, other than the obvious fact that he is quite overweight, tipping over 300 lbs on a 5-10 frame.
Maybe it's his lack of self-consciousness about it. His laughter and cheer and egolessness, if that is even a word.
Which spellchecker tells me it isn't.
A wonderful guy, a healer. A therapist. Not just any therapist, but an uber-therapist. Well regarded nationally, urbane, published, graceful, the Fatman is a mensch in every way, except in regards to himself.
I first met him more than 3 years ago. He came to me ostensibly for thrombocytopenia, or a low platelet count. After ruling out the various bad actors, I got an ultrasound of his liver.
Lo and behold, he had cirrhosis, probably from "fatty" liver, a growing problem in our society.
I explained the dietary things he needed to do, the lifestyle changes, the exercise, the low fat, the diabetic control, etc., etc.
He proceeded to gain 60 more pounds, develop congestive heart failure, eat like a pig and get horribly depressed.
All the while, he continued to counsel patients and even other therapists, serve on national committees, hob nob with rich and famous people and generally just carry on.
Every time I saw him, I would berate him. He would look at me patiently, full of remorse, with sad Eeyore, droopy eyes and promise to do better.
I admitted him to the hospital. Had him see multiple cardiologists. Got him a liver specialist at Johns Hopkins. Transfused him when he bled from an ulcer and then bled again from esophageal varices.
Just trying to die.
I couldn't understand it.
His IQ exceeds mine easily.
His EQ in theory is off the charts as well.
He lacks for not. His wife and family are sophisticated and supportive.
Why?
Today I finally understand why, after nearly 4 years.
I guess, in retrospect, predictably so... he, like most of us, is in a whole lot of pain.
A lifetime of helping others is only a mask for being unable to help himself. Of being masochistic.
Today we talked of his broken family.
His schizophrenic mother who tried to kill him more than once.
Of being beaten and starved.
Of viewing food as a safe place and a refuge emotionally.
Of abuse.
Of self-loathing despite brilliance academically.
Of his own depression and low self-worth.
Of a family genetic tendency towards mood disorder.
Manifesting in his only son as schizoaffective disorder.
Of him offhandedly turning down an offer to accompany his son to Montreal for a conference and then being called 24 hours later that his son had killed himself, blaming the father for leaving him.
Of 20 years of guilt and self-abnegation. Self-loathing.
Of wanting to die.
All the while, collecting accolades and wealth and the trappings of success.
I haven't cried in front of a patient in an exam room in a while.
And he doesn't even have cancer like most of my patients.
What a waste...
In all these years, he himself has NEVER seen a therapist.
It never ceases to amaze me how troubled we all are underneath the veneer of a placid home life. How the banal collides with the absurd and existential in all of us.
All the Fatman needed was someone to just listen to him and let him sit with the pain of his past life and just be okay with it.
No pushing. No pulling. Just letting it wash over him and recede. Again and again, until he learned to just sit with it.
Instead, he's going to die of liver failure. Yellow. A miserable death, slow, tortuous and painful.
I know he thinks he probably deserves it for failing his son and doing something to make his mother hate him so much.
But, I don't think so.
Why do some war veterans survive near death experiences, none the worse for wear?
And others are crippled mentally forever, victims of post traumatic stress disorder?
The more I do this job, the more I realize that we are all carrying some hidden shame inside of us.
That we all fear how our loved ones or society would reject us if our true selves emerged?
We are not free, for the most part. Not free to be truthful. Not free from fear.
It's not just the cancer that kills. It's the guilt or shame or anger or ignorance.
Physician, heal thyself, Hippocrates once admonished.
Heal thyself.
Heal.
Fatman, I pray you find some peace before you die. You've helped a lot of people in your life. Given a lot of love.
I hope you pour yourself some one of these days.
Heal yourself.
If you can, maybe I can too.
Well, other than the obvious fact that he is quite overweight, tipping over 300 lbs on a 5-10 frame.
Maybe it's his lack of self-consciousness about it. His laughter and cheer and egolessness, if that is even a word.
Which spellchecker tells me it isn't.
A wonderful guy, a healer. A therapist. Not just any therapist, but an uber-therapist. Well regarded nationally, urbane, published, graceful, the Fatman is a mensch in every way, except in regards to himself.
I first met him more than 3 years ago. He came to me ostensibly for thrombocytopenia, or a low platelet count. After ruling out the various bad actors, I got an ultrasound of his liver.
Lo and behold, he had cirrhosis, probably from "fatty" liver, a growing problem in our society.
I explained the dietary things he needed to do, the lifestyle changes, the exercise, the low fat, the diabetic control, etc., etc.
He proceeded to gain 60 more pounds, develop congestive heart failure, eat like a pig and get horribly depressed.
All the while, he continued to counsel patients and even other therapists, serve on national committees, hob nob with rich and famous people and generally just carry on.
Every time I saw him, I would berate him. He would look at me patiently, full of remorse, with sad Eeyore, droopy eyes and promise to do better.
I admitted him to the hospital. Had him see multiple cardiologists. Got him a liver specialist at Johns Hopkins. Transfused him when he bled from an ulcer and then bled again from esophageal varices.
Just trying to die.
I couldn't understand it.
His IQ exceeds mine easily.
His EQ in theory is off the charts as well.
He lacks for not. His wife and family are sophisticated and supportive.
Why?
Today I finally understand why, after nearly 4 years.
I guess, in retrospect, predictably so... he, like most of us, is in a whole lot of pain.
A lifetime of helping others is only a mask for being unable to help himself. Of being masochistic.
Today we talked of his broken family.
His schizophrenic mother who tried to kill him more than once.
Of being beaten and starved.
Of viewing food as a safe place and a refuge emotionally.
Of abuse.
Of self-loathing despite brilliance academically.
Of his own depression and low self-worth.
Of a family genetic tendency towards mood disorder.
Manifesting in his only son as schizoaffective disorder.
Of him offhandedly turning down an offer to accompany his son to Montreal for a conference and then being called 24 hours later that his son had killed himself, blaming the father for leaving him.
Of 20 years of guilt and self-abnegation. Self-loathing.
Of wanting to die.
All the while, collecting accolades and wealth and the trappings of success.
I haven't cried in front of a patient in an exam room in a while.
And he doesn't even have cancer like most of my patients.
What a waste...
In all these years, he himself has NEVER seen a therapist.
It never ceases to amaze me how troubled we all are underneath the veneer of a placid home life. How the banal collides with the absurd and existential in all of us.
All the Fatman needed was someone to just listen to him and let him sit with the pain of his past life and just be okay with it.
No pushing. No pulling. Just letting it wash over him and recede. Again and again, until he learned to just sit with it.
Instead, he's going to die of liver failure. Yellow. A miserable death, slow, tortuous and painful.
I know he thinks he probably deserves it for failing his son and doing something to make his mother hate him so much.
But, I don't think so.
Why do some war veterans survive near death experiences, none the worse for wear?
And others are crippled mentally forever, victims of post traumatic stress disorder?
The more I do this job, the more I realize that we are all carrying some hidden shame inside of us.
That we all fear how our loved ones or society would reject us if our true selves emerged?
We are not free, for the most part. Not free to be truthful. Not free from fear.
It's not just the cancer that kills. It's the guilt or shame or anger or ignorance.
Physician, heal thyself, Hippocrates once admonished.
Heal thyself.
Heal.
Fatman, I pray you find some peace before you die. You've helped a lot of people in your life. Given a lot of love.
I hope you pour yourself some one of these days.
Heal yourself.
If you can, maybe I can too.
Monday, September 06, 2010
This Is a Lot Harder Than I Thought
My list of violations so far:
1. forgetting my steel mug when i sometimes get coffee or tea (even though i'm trying to get rid of the habit altogether anyway)
2. forgetting to bring my reusable plastic bags to the health food store and then needing another bag
3. driving when i could easily walk or bike to my local coffee house/drug store/grocery
4. getting tired of composting, especially since i don't grow anything
5. forgetting to use my drying rack (better today, though)
6. having a constant urge to buy another lawnmower (my old-school push bladecutter just does a terrible job; i feel like i'm lowering my neighbor's property values with my inability to make the lawn look even semi-presentable)
this is challenging.
granted, i'm a lot more aware of consumption. it's like a constant reminder to stop getting things.
it's mind boggling when you think of the zero-sum nature of our planet. commodities get used up, like oil, gems, precious metals... they get turned into non-degradable and rarely recycled things like plastic-everything, rings and other jewelry, cans, toiletries, etc.
it's not even conspicuous consumption that's the problem.
it's consumption in general.
at our medical conferences, i've become very aware of the catered-food, and all the plastic cups and plastic utensils. the cans of soda. the plastic containers for the food... all of which is NOT recycled, just trashed.
all the paper that we use.
like, i said, it's mind-boggling.
i just saw this documentary, the "Age of Stupid".
A British tongue-in-cheek imaginary scenario set in the year 2055 or thereabouts.
the planet is in ruins. twelve feet or rising seas have engulfed the planet. warming is real. countries are destabilized. nations destroyed. famine, ruin.
an archivist or the sum total of world knowledge looks back to the beginning of the 21st century with real stories of people struggling with the reality of climate change.
an aging mountaineer near Mont Blanc. A British wind farm activist. an ironic retiring oil geologist for Shell/ecologist whose home is destroyed by Katrina. An aspiring medical student in Africa.
All real stories. Their struggles to survive, all the while confronting the day-to-day choices, the mundane, banal choices that we all face... that seem so insignificant, yet have huge, lasting impacts on our environment and ultimately, our very existence.
It is like that famous butterfly in chaos theory that gives rise to the hurricane.
It is so hard for each of us to be mindful of our daily impact, when we are just trying to make a living, find some love and happiness, have good time.
Yet, if we are not mindful, the consequences eventually will imperil us all.
I wish I weren't so damn addicted to Starbucks feta wraps...
1. forgetting my steel mug when i sometimes get coffee or tea (even though i'm trying to get rid of the habit altogether anyway)
2. forgetting to bring my reusable plastic bags to the health food store and then needing another bag
3. driving when i could easily walk or bike to my local coffee house/drug store/grocery
4. getting tired of composting, especially since i don't grow anything
5. forgetting to use my drying rack (better today, though)
6. having a constant urge to buy another lawnmower (my old-school push bladecutter just does a terrible job; i feel like i'm lowering my neighbor's property values with my inability to make the lawn look even semi-presentable)
this is challenging.
granted, i'm a lot more aware of consumption. it's like a constant reminder to stop getting things.
it's mind boggling when you think of the zero-sum nature of our planet. commodities get used up, like oil, gems, precious metals... they get turned into non-degradable and rarely recycled things like plastic-everything, rings and other jewelry, cans, toiletries, etc.
it's not even conspicuous consumption that's the problem.
it's consumption in general.
at our medical conferences, i've become very aware of the catered-food, and all the plastic cups and plastic utensils. the cans of soda. the plastic containers for the food... all of which is NOT recycled, just trashed.
all the paper that we use.
like, i said, it's mind-boggling.
i just saw this documentary, the "Age of Stupid".
A British tongue-in-cheek imaginary scenario set in the year 2055 or thereabouts.
the planet is in ruins. twelve feet or rising seas have engulfed the planet. warming is real. countries are destabilized. nations destroyed. famine, ruin.
an archivist or the sum total of world knowledge looks back to the beginning of the 21st century with real stories of people struggling with the reality of climate change.
an aging mountaineer near Mont Blanc. A British wind farm activist. an ironic retiring oil geologist for Shell/ecologist whose home is destroyed by Katrina. An aspiring medical student in Africa.
All real stories. Their struggles to survive, all the while confronting the day-to-day choices, the mundane, banal choices that we all face... that seem so insignificant, yet have huge, lasting impacts on our environment and ultimately, our very existence.
It is like that famous butterfly in chaos theory that gives rise to the hurricane.
It is so hard for each of us to be mindful of our daily impact, when we are just trying to make a living, find some love and happiness, have good time.
Yet, if we are not mindful, the consequences eventually will imperil us all.
I wish I weren't so damn addicted to Starbucks feta wraps...
Friday, September 03, 2010
Blue Gold
I was watching a documentary yesterday. "Blue Gold".
It was about water resources around the world and how competition for water will be a main battleground of this century.
So much focus has been on global warming and declining hydrocarbon resources.
Yet, one of the main consequences of both problems will be a decline in the amount of available freshwater in the world.
Some contributing factors:
1. contamination of available sources of groundwater and rivers by agricultural pollution.
2. growing worldwide population
3. a warming planet
4. privatization of water in the hands of multinational companies who have no incentive to maintain clean supply or to diminish pollution.
5. globalization of agriculture and other products resulting in production of non-native food that is potentially water intensive and depleting to the natural water cycle of a country (e.g. producing mega-flower farms in central Africa, or moving most US apple production to China)
The result is that there is increasing potential for military conflict over these resources.
Needless to say, I had to try hard not to slit my wrists after the show ended.
This documentary, as well as other wonderful modern facts like the Great Pacific Garbage Patch, just makes me want to veg out on the couch, eat Pringles and watch some PGA golf like the rest of society, blissfully chomping away as we careen towards the Apocalypse.
But, then, of course, the documentary has some positive ending notes.
Maybe we can find a way to reclaim water as a public good, a public right, instead of a commodity.
Maybe we can eat more sustainably and locally.
Maybe we can have fairer trade agreements with Third World countries, where our standard of life is not predicated on their living in squalor.
Maybe we can rise above petty commercial or religious or patriotic disputes and think more broadly about our planet as a whole, as something to cherish, now and forever.
Water. The stuff of life.
It was about water resources around the world and how competition for water will be a main battleground of this century.
So much focus has been on global warming and declining hydrocarbon resources.
Yet, one of the main consequences of both problems will be a decline in the amount of available freshwater in the world.
Some contributing factors:
1. contamination of available sources of groundwater and rivers by agricultural pollution.
2. growing worldwide population
3. a warming planet
4. privatization of water in the hands of multinational companies who have no incentive to maintain clean supply or to diminish pollution.
5. globalization of agriculture and other products resulting in production of non-native food that is potentially water intensive and depleting to the natural water cycle of a country (e.g. producing mega-flower farms in central Africa, or moving most US apple production to China)
The result is that there is increasing potential for military conflict over these resources.
Needless to say, I had to try hard not to slit my wrists after the show ended.
This documentary, as well as other wonderful modern facts like the Great Pacific Garbage Patch, just makes me want to veg out on the couch, eat Pringles and watch some PGA golf like the rest of society, blissfully chomping away as we careen towards the Apocalypse.
But, then, of course, the documentary has some positive ending notes.
Maybe we can find a way to reclaim water as a public good, a public right, instead of a commodity.
Maybe we can eat more sustainably and locally.
Maybe we can have fairer trade agreements with Third World countries, where our standard of life is not predicated on their living in squalor.
Maybe we can rise above petty commercial or religious or patriotic disputes and think more broadly about our planet as a whole, as something to cherish, now and forever.
Water. The stuff of life.
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