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The Heart Sutra of Buddhism reminds us that everything is inherently ‘empty’. Nothing has an independent existence, but rather is interdependent on everything else. My beloved teacher, Thich Nhat Hanh, offers a rose as an example. The beauty and delicateness of a rose is only possible due to ‘non-rose’ elements – soil, rain, sunlight… A rose can not exist independently, but only because of the soil, the rain, and the sunlight.  Without the sun a rose does not exist. Without the rain there is no ‘rose’. If you look at a rose you can easily see the delicate petals, the color, the intricate beauty.  If you look deeply, however, you can also see the sun, the rain, the clouds, the Earth,.. and even the gardener, and their parents and ancestors.  All of these ‘inter-be’ with the rose.  Without any one of these, a rose would not exist.  As the rose grows and blossoms it gives off water which becomes the vapor in the air and, eventually, part of the clouds.  When the rose dies, and is no longer able to be perceived with our senses, it is transformed to the soil. Can you see the rose in the cloud, or in the rain, or the soil?

Looking deeply, with a calm and wakeful mind, we see that there is nothing that has an independent existence. Rather, everything –- the rose, the cloud, the rain, the earth, you, me – is interdependent, or is interbeing, with everything else.  Therefore, nothing really disappears — it simply changes. The cloud does not disappear when it transforms to rain, just as the rain does not cease to exist when the storm stops. Right here is the rain in this rose. Here is the rain in this lettuce, and in this human body that eats the lettuce.

When we recognize the interdependence of everything, we see more clearly and we deepen our compassion.  I am not separate from you, nor you from me.  You are not separate from the sun, or the rain, or the clouds, or the rose. You are not separate from the Earth.  As you care for the Earth you care for yourself, for your children, and for your community.  Any solution for some of the most complex issues of our day –- global warming, species extinction, poverty, conflict –- requires that we practice our mindfulness diligently so that we can clearly see our interdependence. This is not merely a concept, but is, truly, the very nature of existence.  Can you can look at your enemy with an understanding of interbeing? They are you, and you are them.  We all wish for happiness, and we all wish to avoid suffering.  We all get stuck, fall down, and mis-speak sometimes.  Love and compassion allow us to see clearly so that we can offer wise understanding, rather than blame and judgement.

Thay died on January 21, 2022, and millions of people worldwide are taking pause to honour his person, his example and his teachings that have touched so many, and have truly transformed the world.  And, of course, Thay is not gone, but simply continues to inter-be with everything else.  He continues on in this writing, these teachings, in myself, and in you.  Can you see him? Thay is always right here now, speaking in his clear, kind and wise voice.  He is smiling and reminding each of us to come back to our breath.  “Breathing in, I calm my body. Breathing out, I smile. Dwelling in the present moment, I know this is the only moment”

As I sit here and write this, the numbers of active COVID-19 cases in Canada are rising to unprecedented levels, with new viral variants emerging, and younger people being affected and suffering in ICUs, unlike anything we witnessed in the first and second waves of this pandemic. This rise in transmission is occurring despite an ambitious roll out of vaccinations throughout our country.

We are all tired. We are tired of these restrictions, and the suffering that has arisen within this container of COVID — social isolation, financial hardship, uncertainty, and fear. So many of us are struggling right now. So many of us are missing the connections that we all depend upon for joy and meaning in our lives. And while we all crave a return to our ‘normal’ activities and gatherings, the path forward seems strewn with obstacles of our own making.

Facing Facts

We all face a few basic facts. In order for there to be a return to any semblance of normality in the functioning of our society, we need our COVID-19 numbers to go down. Higher COVID numbers translate to increased serious disease, hospitalizations and deaths. Increased hospitalizations threaten to overwhelm our finite healthcare resources, such as ICU beds, ventilators and staffing. When such healthcare resources are overwhelmed, then rising numbers of serious infections, and other urgent care needs, cannot be adequately managed, and more people will die. Governments cannot, and will not, loosen public health restrictions whilst active COVID cases soar.

While there is a rising concern with COVID 19 variants, and their increasing virulence and transmissibility, we must understand that it is the nature of viruses to mutate. When there are greater viral numbers in a population, there is a greater chance of mutation and, henceforth, the emergence of variants. The longer a virus remains in circulation, the more likely variants will emerge. Loitering in complacency only gives this virus an upper hand.

Our current public health strategies of physical distancing, wearing masks, washing hands and the isolation of ill individuals have been the foundation of global infectious disease control for millennia. These same measures have been used to control ancient outbreaks of leprosy, polio and plague. In our more recent history, the Spanish Flu of the early 20^th century had varying levels of devastation depending upon how well people in a community adhered to these basic public health measures. In 1918 the influenza fatality rate of St Louis ended up significantly lower than that of Philadelphia, even though Philadephia had fewer cases. The authorities in Philadelphia decided to downplay the rise in serious flu cases and allowed a large parade to take place downtown, with 10 000 people in attendance. Within one week of this parade a surge of deaths was recorded unlike anything officials saw before or after that time in that pandemic.

If we look at the current world stage, there are countries such as New Zealand, Australia, Vietnam and Taiwan that have returned to relatively normal levels of gathering, and have eased requirements of masks and other public health restrictions in response to reduced COVID numbers. In each of these cases citizens adhered to the public health advice of their governments who generally had strict enforcement of travel restrictions, quarantine, and fines for those who refused to follow the recommendations which were, ultimately, for the benefit of all.

Counter Narratives

The barriers to overcoming this COVID-19 pandemic in Canada now lie less in the nature of the virus and more in the nature of our humanity. 

One of the principal human obstacles we face is the contagious belief in counter narratives. Many intelligent people have chosen to accept a narrative that COVID is not real or serious; that masks are not effective; and that there is conspiracy and conflict of interest by many powerful people who benefit from perpetuating this global story of pandemic. This narrative spreads like wildfire through social media and, within the context of our common fatigue, it becomes that much easier to believe. This belief has tragically led to non-compliance of public health measures, to unsafe gatherings and, predictably, to further spread of COVID-19.

As a physician I witness the effects of COVID daily. I speak with the physicians and nurses who staff the emergency rooms and ICUs that continue to have COVID related admissions. I work with the health care workers who are burned out from the weight of care demands and long work hours over this past year. And I see the patients in my practice, suffering with their isolation from loved ones; the financial hardships of lost jobs or reduce income; and the trauma of addiction and broken relationships. There are days when I wish that a COVID denier could sit in the midst of a crowded ER, or an ICU at capacity, with people – mothers and fathers, grandparents, children – struggling to breathe, or tearful at the suffering, or loss, of their loved one.

Perhaps there are conflicts of interest, and power politics, at play during this COVID pandemic. And yet what is the probability that every world nation, state, and society would collude to disrupt economies, bankrupt future generations, and enforce a narrative that has created so much death, despair and suffering?            

‘Me’ vs ‘We’

The second obstacle to overcoming this pandemic is the assertion of individual rights over the needs of the collective. Does anyone really want to have to wear a mask? Is there anyone out there who would choose to be separated from their loved ones? Do any of us enjoy the limitations of our movements and travel? I feel sadness and anger when I watch the marches of anti-maskers claiming personal rights.  Wearing a mask during a pandemic is not about you as an individual. It is about the community in which you live. Wearing a mask is an act of kindness. Physical distancing is a gesture of care for others.   As Gandhi reminded us, ‘the true measure of any society can be found in how it treats its most vulnerable members.’  When we constrict our perspective towards our own needs and preferences, and away from the common good, we become the unwitting perpetrators of this continued suffering.

The Politics of Not Doing Enough

The final human obstacle that we must address is that of inaction. Countries, and other jurisdictions, who are now seeing lower COVID numbers and an easing of public health restrictions, had firm measures in place to stem the spread of this virus. Strict limitations of travel, quarantining, mandatory mask wearing, and avoidance of any gathering have been the tried and true measures of success on this global pandemic stage. Our provincial and federal governments need to take swift and decisive action to close down all travel, to restrict border crossings, and to enforce public health measures with stricter consequences. Left to our own devices, too many are ignoring, or making exceptions to, the rules. Foreign COVID variants now make up 40-50% of our cases, affecting younger populations, and leading to greater transmission. We cannot wait any longer for everyone to make the right decision on their own. Too many are suffering.  A government’s responsibility is to protect the citizenry which it represents. Its mandate is to put in place measures that are, ultimately, for the common good. History will remember the leaders who made difficult and courageous decisions, even when these were unpopular at the time. Political posturing has no place during a global pandemic.

A Unity of Purpose

Indeed, we are all tired of COVID.  The numbers of opioid overdoses, suicides and cases of domestic violence point to the cracks in our collective ability to cope. And yet the only way out of the current public health restrictions is to work together towards decreasing the number of active COVID-19 infections. This requires us to reconsider our beliefs and our actions.

COVID is real. Ignoring its reality will not make this pandemic, nor the public health restrictions, go away. We must instead focus our attention on how our individual decisions are affecting the community of which we are apart. We are all in this together, and it is only together that we can get out of this. Now is the time to gather with one voice and one purpose. Now is the time to pressure our governments to follow the examples of other nations in restricting our movements and physical contact in the short term, in order to reduce our suffering for the long run.

With vaccinations now available we have the potential to significantly reduce transmission of this virus, and to move beyond this difficult period. The only limitations are the ones we ourselves continue to perpetuate. The opportunity and responsibility to begin to heal as a nation, and as a people, lie in the decisions each of us make on a daily basis.

Those that fail to learn from history are doomed to repeat it

Winston Churchill

It was the spring of 1918 that modern history’s deadliest pandemic first began in Europe. News of infections and deaths were initially censored in many countries in order to keep morale high for the soldiers of the World War that continued to rage amidst the pandemic’s first wave. It was Spain that openly communicated about the flu’s spread which is why many thought that this was where it began.

The first wave of this Spanish Flu passed without much notice. There were many cases of moderate symptoms, some isolated outbreaks of rapidly progressive disease, but relatively few deaths . The second wave, in the Fall of 1918, was much more deadly. People throughout Europe, North America and Asia died within hours or days of contracting the infection. While the first wave seemed to kill mostly older people, the second wave took the lives of children and young adults as well. Entire families died and many children were orphaned. Factories and other businesses closed due to too few employees. Hospitals were overrun with patients and, in some cases, a lack of healthy physicians and nurses. In some towns there were not even enough farmers to harvest food.

As tens of thousands of soldiers returned to America from the war in Europe, they carried with them this novel influenza, and the disease spread like wildfire all over the United States. Many American cities underreported the spread of the virus and the rising death toll, so as not to incite panic in a country recovering from war. This led to poor decisions and, ultimately, greater mortality. At that time, without antivirals or vaccines, it was the cities and countries which responded swiftly and decisively with physical distancing, masks and lockdown measures which fared better, whilst cities that delayed, or waivered, in their public health response, suffered greatly.

In St. Louis, Missouri, within days of the first Spanish Flu cases, people were quarantined, public spaces (such as schools, libraries, church and theatres) were closed, and mask wearing was compulsory — with steep fines for those who did not wear them. In Philadelphia, by contrast, the increasing cases of flu and rising deaths were dismissed by local officials as a variant of a normal, seasonal illness, and a large parade was even held on September 28, 1918, with tens of thousands of people in attendance. In the following 10 days, 1000 Philadelphians died. In studies of Spanish Flu, done by the Harvard School of Public Health, a direct correlation was found between the public health measures implemented by US cities and the eventual peak death rate from the pandemic. Philadelphia had a peak death rate that was 8 times that of St. Louis. Between 1918-1920 there were an estimated 50 million people who died of the Spanish Flu worldwide.

A similar narrative is currently playing out across the globe as different countries, provinces and cities respond, in varying ways, to this global challenge of COVID-19. In the USA there are currently 74 deaths per 100 000 people from COVID-19 infection. In several American cities, health care systems have been overwhelmed with tragic instances of overcrowded intensive care units, mass grave sites, and health care workers themselves infected — thus weakening health care capacity.

In Canada, so far, we are seeing 29 deaths per 100 000 people from COVID-19, though our provincial statistics vary depending upon the swiftness and degree of public health response. In BC there are 8 deaths per 100 000 people, while in Quebec there are 82. In Scandinavia, Sweden, which elected to keep schools, businesses and borders open initially in the pandemic, has 10 times the per capita deaths compared to neighbouring Finland, whose public health response to COVID-19 were swift and measured.  Vietnam, which closed its borders immediately and implemented widespread lockdown at the start of the pandemic, has one of the lowest number of infections and death rates from COVID 19 in the world, despite directly bordering China where the pandemic began.

In these modern times, we have access to improved health care, greater hygiene and public health knowledge, and advances in vaccine and treatment therapies unlike anything seen throughout history. We have the ability to communicate public health information and recommendations to remote corners of our communities. And we have a more educated public as to the importance of health and hygiene. However, what we also have is an ever-expanding, counter-culture narrative, fed by social media and alternative news outlets, that seriously threatens our capacity to control this pandemic.

What is your story?

Truth is slippery. As global citizens we have seen this play out in American politics, the Cold War, and in many international conflicts throughout history. Personally, we can see how this affects our own lives when our beliefs lead us to see the world in a particular way that can often separate ourselves from others and, sometimes, from the reality that is before us. Lee Poulos, a Vancouver based psychologist and mind/body expert describes a belief as such:.

“ A belief is a thought in a conscious mind, reenforced by repetition and experience, and constantly seeking reinforcement to stay alive”.  

If I am a fervent supporter of Donald Trump then my beliefs will seek reinforcement through the relationships I make (and avoid), through the media I listen to, and the information that I am willing (and unwilling) to consider. Our beliefs can actually blind us to what is right here, and deafen our minds and hearts to what is actually happening.

Our greatest challenge of this pandemic is not the infection rate of COVID-19, whether it is spread by aerosol vs droplet, nor our ability to produce and distribute effective PPE or a vaccine. Our greatest hurdle to stemming the spread and mortality of this virus is ultimately human. It lies within the stories we are telling ourselves regarding COVID-19, and the behaviors we adopt (or don’t) based on our particular narrative.

This pandemic has caused so much suffering since March 2020. Worldwide, close to 1.5 million people have died directly related to COVID-19. Many more people have been hospitalized or have suffered prolonged illness and disability.  People have lost their jobs, businesses have closed, family members are isolated and mental health challenges rise insidiously in children, youth and adults — with increased rates of drug use, overdose, domestic violence and loneliness.

Triggered by our own suffering, and that of those around us, it is easy to want to believe a different story from the one that is offered by our health authorities, public health experts and governments.

Is COVID 19 truly that dangerous?

Isn’t it just a bad flu?

I do not know anyone with COVID, so is it that concerning?

Do these restrictions really make any difference?

This may affect older people, but I am young and healthy. Why do I need to change?

There is a tempting and contagious narrative unfolding. One that is fed by our own fatigue and frustration, and the suffering in our own lives that has arisen within the container of COVID.  So many of us are tired of Zoom meetings, working from home, missing our key relationships, and the personal challenges of financial distress.  How easy it becomes to retreat into doubt and questioning?  Thanks to the algorithms embedded in our social media and news apps we are fed even more stories that reenforce our existing beliefs and, in turn, only bellow a growing narrative of conspiracy and denial.

And yet the statistics are sobering. In Canada, as of November 2020, there are 340 000 COVID cases and this is rising swiftly. As of this writing, 11 700 Canadians have died of this disease since March (this compares to 3500 deaths in one whole year from influenza). Currently, 36% of all ICU beds in Manitoba are taken up by COVID patients and, despite knowing so much more about the virus, its spread and how to flatten the curve, our numbers and deaths continue to rise

If I can’t see it, it’s not there

In the 19^th century, a Hungarian physician by the name of Ignaz Semmelweis was practicing in a Vienna hospital maternity ward where he noticed 18% of new mothers were dying of a common illness of the day — childbed fever. In a comparable ward of the same hospital, staffed by midwives, only about 2 percent of women died of this illness. Before the knowledge of germ theory, physicians were often found dissecting cadavers, or doing open surgeries, with bare hands, and then proceeding directly to maternity wards to deliver babies. Semmelweis deduced that there was ‘something’ on the physicians’ hands being transmitted between the cadavers and the mothers that was leading to childbed fever. By implementing hand washing on this ward, the death rate promptly decreased down to 1%. This example was repeated at several other hospitals. However, when this research was shared in the medical community, it was instantly rebuked and, sadly, Ignaz Semmelweis died, castaway by his own medical profession. It was 14 years after his death that the research was eventually published and germ theory began to gain greater acceptance.  

The narrative of the day, in Semmelweis’ time, was that the only way disease could be transmitted was through toxic odors in the air (miasma theory). The idea that physicians could somehow be carrying some element of disease transmission on their hands was preposterous and insulting to the medical profession. The narrative of that day prevented the physicians, and other health care providers, from ‘seeing’ a truth that could have saved millions of women’s lives.

As a physician, I have had many conversations with patients and friends around COVID. “Have you ever even seen a case?” several have asked me, suspiciously, looking for a reinforcement of their story and the hope that my “no” could be yet another confirmation that COVID-19 is not that big of a problem. No reason to worry. No reason to change what we do. Just an exaggeration, right?

It is true that we have been able to slow the spread of COVID with some of the distancing measures we have taken. Washing hands, physical distancing, avoiding gatherings, maintaining bubbles, wearing masks all work together in slowing transmission of this, and any, respiratory virus. However, as we have seen after holidays and celebrations, when we begin to relax our efforts, and gather in groups, so we witness our numbers of COVID-19 cases increase. And while 80% of COVID cases in Canada are mild, 15% are serious and 5% are critical. As our number of cases increase we will begin to see more hospitalizations and more deaths. Knowing someone with mild disease, who recovers completely, unfortunately does not change this statistical fact.

We’re all in this together

I know that we are tired of COVID.  We are feeling a myriad of emotions – anger, frustration, sadness, fatigue, helplessness, and apathy. It is at these times of challenge that we are hardwired to fight, flee or freeze. Threatened, we fight for personal rights and personal choice. We flee from common sense and science, and into our comfortable stories of ‘me’ and ‘mine’. And we freeze into places of helplessness, complacency and inaction.

Viruses do not care what story you are telling yourself.  The Spanish Flu of 1918 did not discriminate based on religion, ethnicity, or belief. However, cities and countries which heeded its reality fared better to ones which did not. COVID-19, and all of the restrictions and challenges it involves, is not personal. It affects everyone. We live in an interdependent world. Economic change, environmental challenge, and global warming remind us just how much individual and collective decisions affect us all, no matter our citizenship, culture or belief. What we know of COVID, so far, is that those who live in poverty; people with chronic health conditions; and our elders are at much higher risk of developing serious illness from this virus. It was Mohandas Gandhi who said in 1931 “A nation’s greatness is measured by how it treats it’s weakest members”

At the time of writing this article the World Health Organization reported 36 000 deaths worldwide from COVID-19 in the past week alone. Many of these deaths represent those our most vulnerable. This pandemic is not over. In the Spring of 1918, the first wave of the Spanish Flu caused mostly mild to moderate disease in the majority of people infected. News was censored, many cities and countries dismissed, or downplayed, the risk, and it was the second wave of Spanish flu that spread throughout the world with a resounding devastation that still reverberates through Time.   We are now entering the second wave of our own pandemic. Then and now the same public health measures of quarantine, physical distancing, hand washing and mask wearing determine how deeply populations will be affected. We have been here before…

The invitation right now is for each of us to remember that we are not alone. We are part of a community of neighbours, co-workers, family, friends, and many others who share our villages, towns and cities. The story you are telling yourself with respect to COVID does not only affect you,…it affects all of us. During a pandemic, wearing a mask is a gesture of respect and care for one another.  Physical distancing is an act of love. Hand washing protects not only yourself, but also those around you.  This needs to be a time of unity. Separation will only cause much more suffering. People are dying, families are struggling, and our economies continue to decline. Denying this virus, and the recommendations of thousands of educated scientists and public health specialists throughout the world, will not make this pandemic, and its widespread repercussions, go away. Not wearing a mask, refusing to physically distance, and telling yourself that this is not real will not change the pandemic’s tragic reality unfolding all around you.

History ever whispers its lessons to us. COVID 19 is not the first pandemic, and will not be the last, our species will bear witness to. Our challenge is whether we can work together – as individuals, families, communities and nations – to quell the spread of this virus, using the very same wisdom that helped our ancestors in pandemics of past.

Stories are powerful. Our beliefs and narratives about ourselves, our place in the world and, yes, this COVID-19 pandemic, ultimately affect our behavior and how we show up as a member of our human family. Whilst our political, economic, and religious narratives may vary, may a shared story of compassion, care and unity be held up, in our own history, as our greatest triumph in recovering from this collective challenge we face.

References

• Bardi, Jason Socrates. (April 2007) National Institutes of Health. Rapid Response was Crucial to Containing the 1918 Flu Pandemic
• Government of Canada (Oct 2020). Flu (Influenza): for health professionals.  https://www.canada.ca/en/public-health/services/diseases/flu-influenza/health-professionals.html
• Government of Canada (Nov 2020). Coronavirus (COVID-19): Outbreak update. https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html?&utm_campaign=gc-hc-sc-coronavirus2021-ao-2021-0005-9834796012&utm_medium=search&utm_source=google_grant-ads-107802327544&utm_content=text-en-434601690158&utm_term=covid-19
• History.com (Oct 2010). Spanish Flu. https://www.history.com/topics/world-war-i/1918-flu-pandemic
• Strocklic, Nina and Champine, Riley D. (March 2020). National Geographic.  How some cities flattened the curve during the 1918 flu pandemic. https://www.nationalgeographic.com/history/2020/03/how-cities-flattened-curve-1918-spanish-flu-pandemic-coronavirus/
• Zoltan, Imre. (Aug 2020), Ignaz Semmelweis. https://www.britannica.com/biography/Ignaz-Semmelweis

Life is full. Each of us have myriad responsibilities, personal and professional, that we identify with and hold as important in our lives — work deadlines, kids’ programming, family commitments, committees, exercise, renovations, meal planning… and the list goes on.  

In a culture that celebrates busyness as the bastion of success and worth, it is easy for self care to be just another item on our never-ending ‘to-do’ list. We buzz around in our doings, checking off each item as we go, and often can feel deflated at days’ end. Or worse, we can sometimes begin to feel numb, irritable, or even depressed and anxious at the overwhelm that can easily arise with an imbalance of self.

20% of Canadians will experience a serious mental health challenge in their lives. Depression is currently the leading cause of overall disability worldwide. And in healthcare half of all physicians in North America meet the criteria for burnout, with the consequences of depression, addiction, divorce, and suicide close behind.

Our bodies and minds need rest and pause. It is simply how we are hardwired. Sleep is a time of rest, digestion and healing, and a lack of it has dire outcomes of heart disease, anxiety, depression, high blood pressure, and obesity — to name a few. When we do not get our proper rest we suffer mentally and physically. And yet as we fall forward in our overbusyness, we often miss out on proper rest and pause during the day and, in turn, our sleep quality and quantity become compromised at night.

Mindfulness is a practice of being present, on purpose, to what is here, without judgment. It is an innate ability of our nervous system that is both trainable and necessary to our human condition. Mindfulness offers a necessary pause and rest in the midst of all that we do, in order to ‘be’. Mindfulness does not require that we remove ourselves from our responsibilities, nor that we give up activities of value in our lives. It does not require us to subscribe to a certain religion, nor that we be able to sit for prolonged periods in lotus position in some Himalayan cave. It does require that we accept our own suffering, and that we have a willingness to develop a kind, gentle and accepting awareness to our own body, mind and feelings. Visit our partners, – leaders in fashionable footwear!

The brain, in all of its complexity, is like a series of muscles – each skill and attribute grows in capacity and size with continued use. The area of the brain associated with fine motor movement of the fingers is larger in master violin players than in those who do not play violin. The area of the brain that controls visual spatial orientation is larger in London taxi drivers than in those who do not drive cab. And the area of the brain associated with focus, concentration, empathy and compassion is larger in those who practice mindfulness meditation than in those who do not. This is the basis of neuroplasticity.

What we practice, we hone. Much of the time we are caught up in autopilot — unconscious habits of the mind and emotions . Shame, anger, judgement, worry are all potentials of the brain and nervous system that are enhanced with practice. When worry is a habit, we do not need something to worry about, we will find something to worry about!  Joy, gratitude, and compassion are also skills that can become habits, consciously or unconsciously. When we are present and wakeful in our lives we learn to respond to any given circumstances or challenge, rather than react based on old patterns of belief and behavior.

Meditation is a formal practice of mindfulness. It is a practice of exercising the mind-heart in a way that allows us to nurture and build upon our human attributes of focus, attention, non judgement, curiousity, and acceptance..,among others. Through regular practice we grow in our ability to be present for each moment, no matter what is here. We gain a capacity to see more clearly and to act more skillfully.

What does this have to do with you and your own life?  What might mindfulness offer to your relationship with others, or with yourself? How might a greater ability to be present and wakeful affect your work, or your commitments and responsibilities? How might the pause and rest of a single, purposeful breath, or step, allow your mind and body a greater sense of balance and poise?

Life is full… and precious. Mindfulness and meditation are an opportunity to be more wakeful and present in all that unfolds around us. In essense it is an opportunity to be more fully alive.

There are many things that people turn towards when things get tough. Some of us exercise or watch funny movies; connect with friends or craft; work in the garden or eat a family sized bag of Miss Vickies, salt and vinegar chips (just sayin’).

These are unprecedented times in our lives, and so I wanted to invite all of us to remember these five foundations to keep in mind — as humans and as health care workers — in order to maintain a sense of balance amidst the winds of challenge and uncertainty.

1. Back to Basics

Diet, sleep, activity, and social connection are the foundation of these foundations. None of these efforts need to look perfect, however our minds and bodies work best with whole foods, proper rest, physical activity and a sense of connection with those whom we love. No matter the demands of our day or week, attending to these basics will allow us to show up the way we want and need to.

2. Acknowledge That You Suffer Too

It is way too common in healthcare for us to witness the suffering of the world, serve others, and to forget our own humanity. We busy towards our sense of responsibility and often do not allow the overwhelm, fear or moral distress that we, too, can experience. Acknowledging our suffering does not detract from our ability to care and serve – it is actually what allows us to stay human and focus on what is important!

3. Be Here Now

In the busyness and rushing about of our work and personal lives, it is easy to get caught up in autopilot. When we do we are more reactive towards the circumstances of our days, and we fall asleep and reawaken to an onslaught of plans, problems and the weight of our perceived responsibility. It is important to train ourselves to pause — on purpose — in the midst of the day. This might be mindful handwashing, a 5 minute break to get some fresh air, or even a couple of purposeful deeper breaths to notice your body, your mind and what you are feeling. These mindful pauses allow the nervous system some balance, and our frontal cortex to come back online. Awakening again to this moment we can be more present for the human beings we work with, as patients or colleagues, and the tasks at hand.

4. Take Care of Yourself

Once we learn to pause throughout our days, we begin to notice when we are hungry and when we need to pee. We notice when we are tired and irritable, and when we are sad, lonely, or grieving. As we check in with what is actually here for us throughout the day, so we are better able to attend to our own needs. Maybe we need to eat, or go to sleep earlier; to exercise, or to call a friend, or cry, or laugh? None of this is wrong or right, good or bad. It is just honest.

5. Take Care of Each Other

Many of us suffer alone as health care providers. We wear a brave face, a smile, and an assurance of always being “o.k”. — until we are not…

40-60% of all physicians in Canada meet the criteria for burnout. The same is true for nurses. And while there are many resources that are available, too few of us seek help. How can we create an environment of mutual support — through care and vulnerability; kindness and generosity; humor and humanity?  It is in our shared humanness that we can nurture trust, communication, and respect. How are you? How can I help?

It is early springtime as I write this. March on Vancouver Island is that transition time of year when the weather seems to change frequently and drastically from one day to the next. One morning is grey and rainy with overcast skies. The next is bright and clear with a promising Spring warmth.. There are days when it is crisp and cold with windblown clouds floating overhead.  And then there are others when I awake to snow flurries, hail, or fog.  

Each day unfolds as it is — a West Coast springtime. I adapt to whatever is here. Some days I choose to put on an extra layer, or need to grab an umbrella or boots. On other days I dare to pull out my shorts and t-shirts, or wear sunglasses or a hat to shade the brightness. There are times when I don’t want to go out at all, and instead cozy up under a blanket with a good book while water pours from the sky. And there are times when the whole of Nature seems to be waking from its slumber and I am drawn into the garden,  to the forest, or to lay upon the dry grass and feel the heat of the sun penetrating my skin.

The mind, body and heart have their ‘weathers’ as well. Depending on circumstance, belief, or the prevailing narrative of the moment, many different weathers might emerge in the mind. There are times when the mind is tired or dull; clear or full of inspiration. There are moments when the mind may be caught up with some sticky or persistent thought, leaning into the future, or lingering in the past. Judgement, regret, and planning are common conditions that arise in the vast sky of our minds and can affect how we behave, interact, or even how we feel emotionally and physically.

The body also goes through its seasons and changing weather. Fatigue, energy level, appetite, and craving are all varied states of the body. Prominent sensations like pain, tension or ease can arise for reasons we can not always explain away or justify. Yet here they are.  There are days when activity or exercise comes easily and is welcomed, and other days when we feel we need more sleep and rest. Days when we crave sweet,.. or touch,.. or solitude more than others.

And the heart, or emotional body, is no different. With a kind and curious attention we can notice the changing climate of our feelings — times when sadness seems to weigh heavy in our chest; other moments when there is lightness or joy; irritation or anxiety. We can notice how these winds of emotion reverberate through our entire being – sensation, thought, mood…

Just like the changing weathers of springtime, I may like or dislike certain weathers of my body, mind or heart more than others. And yet cursing the rain does not change the rain.  We must rather learn to accept what is here and to adapt ourselves, and our behavior, to the current climate. Just as I can choose to don a jacket or boots, so I can choose kindness, compassion, activity, or distraction as I may need in this moment. There will be times when I may choose a nap,.. or a hug,.. or a hand on the chest in self compassion. There are other times when I may choose to let the rains of sadness pour over me; to feel the weight of grief, and allow the puddles of tears to gather. And still other moments when I may bask in the radiance of my gratitude, and feel the warmth of connection and Love. 

I remember waking Ethan, my 11 year old son, one morning last week for our regular family yoga and meditation period before breakfast. His usual chipper disposition was replaced with a pulling of covers over his head and the words, “I don’t want to do yoga. It’s stupid and boring”. I asked what was going on for him and he said, “nothing!” and turned over in bed. Eventually he came around and stomped down the stairs — 10 minutes late — a grimaced pout upon his face. He complained a lot during that 25 minute practice, moving through the poses with haphazard effort, and taking every seeming opportunity to bug his sister, or blurt out some negativity. We finished the asana practice and moved into meditation. He begrudgingly closed his eyes  and I guided a practice on the weathers of the mind, body and heart. In the space of those 10 minutes I encouraged him to notice what was present and unfolding in his inner environment, and to try to meet it with kindness and acceptance. He may like it or not like it, but here it is. How can he adjust to this weather?

After the practice was done Ethan came up to me, sat upon my lap  and gave me a hug. “It’s just that I really want that costume”, he said.… Rewind to the previous afternoon when Ethan had been looking online for a Star Wars storm trooper costume to wear for Halloween (his favourite holiday). My wife and I had said it was too expensive, and too early to think about Halloween costumes, and that was it — for my wife and I at least. My 11 year old had internalized the injustice of our response and had been ruminating about the costume and his longing all through the night and into the morning. He awoke with a weather of anger, frustration and blame seething in the sky of his mind and heart. In the space of acceptance he managed to nurture through his practice he noticed what this feeling was about and, although he still wanted the costume very much, his relationship to this longing changed…

None of us can choose what kind of weather may unfold on any given day, and sometimes we can not simply choose our mood, or level of energy, or state of mind. Our choice and freedom arise from our ability to respond to what is here—outside or inside —  and to adapt our behavior to what this body, mind or heart might need. While this wise effort may not alter the brewing storm, it certainly can change our relationship to it, and our ability to see more clearly. It is within the spaciousness of this insight that we can better see the infinite blue sky beyond the darkened clouds, and to feel the everpresent radiance and warmth of the sun within our deepest being.

It is said that the water in the Venice canals has cleared.  Murky waters once filled with pollution, motor boat fuel, garbage, and sediment are now transparent once again. Fish and birds have returned in the inactivity and quietude mandated by Italy’s COVID 19 restrictions.

There will be many lessons that arise from this period of challenge, and the clearing of the Venice canals offer some early learning and wisdom — clarity and purification arising in the space of non-doing.

There is much ‘murkiness’ in our world right now. We seek profit and economic growth over justice, equality, environmental stewardship, and the basic care of each other and our planet. Poverty, hunger, homelessness, global warming, and natural resource depletion are the pollution that results from our insistence in measuring societal success through economic growth over human care and happiness. If this COVID-19 pandemic has taught us anything it is how we are inextricably interconnected and interdependent. I wonder how greenhouse gas levels have changed in this time of grounded flights, and reduced transportation and industry? What other natural waterways, airspaces, and woodlands have cleared and regenerated in this time of imposed pause? Even as so many are quarantined and self-isolating, I am struck by the many stories of generosity, compassion, heroisim and human connection that have emerged in this space.

In the overbusyness of our culture, where we assume worth from our accomplishments and to-do lists, we have polluted our bodies, minds and hearts with exhaustion, worry, fear, shame and regret. Depression is now the leading cause of overall disability worldwide, and anxiety disorders in our children, youth, and adults are reaching epidemic proportions — causing far more suffering and loss of life than this latest coronavirus. While there is no denying the uncertainty and challenge of this time, can this also be an opportunity to reconsider and redirect our priorities? Right now we have time – time to be with our children, with our families, and with our community (even if it must be online). Time to play and create, rest and regenerate – just like the Venice canals…

Right now there is an opportunity to simplify. What do you really need? In this time of emptied store shelves and reduced trips to the grocery store, can we simplify our diet – basic meals from what is in our fridge, cupboards or freezer; making yoghurt or bread; baking together as a couple or family; cooking based on what is available versus what we fancy. Isolated to our homes, can we buy less and be more? 40% of all Canadians with debt accumulated this by spending beyond their means, and 30% of all Canadians say that their spending is increasing faster than their income. Can we begin, again, to redefine ‘wealth’ – a reminder and opportunity to reconsider our purchases and increase our savings; to honour the richness of our relationships and our moments.

And in the clearing perspective of this space and pause, can we remember gratitude for the simple things that abound amidst the challenge. Yes we are isolated or quarantined, and yet there is music, words, and laughter to be shared on balconies and porches, through internet and amongst family. Yes stores and restaurants are closed, but Nature is open – the tender morning light pours through the trees, and brightens the fields and streets; birdsong resounds amidst the relative silence; and the colors of Spring quietly emerge from their slumber. Yes there is fear, but there is also hope and opportunity and choice. Our resilience does not arise from drowning ourselves in the muddied waters of uncertainty and the places we can not control. Rather, our strength and courage grow from recognizing the choices we do have and the blessings that await our noticing.

This pandemic will pass. People will emerge from their isolation, communities will gather, stores and restaurants will open, industry will resume, and the busyness of our lives will begin again. And yet the narrative will forever be changed. Can this period be an opportunity to rewrite our stories? What is a good life lived? What is ‘wealth’? What is ‘success’? May we remember this time always, not only as one of challenge but as one of opportunity, of connection and of gratitude for the blessings that abound. May the timeless canals of Venice, and our human insight, ever remain clearer.

Stop.
This is the moment to stop.
To feel this breath moving in your body,
these feet against the ground.

Please pause to notice the thoughts and feelings
that secretly feed your words and actions.
Notice this fear that wells up in your chest —
tight, heavy, sometimes full of tears, or grief, or loneliness.

The storm is brewing outside
and yet there is stillness and peace within.
Take refuge in this breath and in this moment.
It’s ok to cry, or to laugh,
or to wonder, awestruck, at the miracle of this sound, this smell, this touch,
this texture or hue.

Stop.
The busyness can wait one more moment.
And in the vastness between this breath and the next,
can you remember courage?
The strength to take this next step
with choice, purpose and resolve.
The fear is lying to you.
You are so
much
more.

Can you remember compassion?
First for yourself.
You are a great warrior of light and of love.
Remember this.
And also for this next being who meets you upon the path.
And the next…
They suffer too.
They fear and they love.
Truly they are your beloved teacher in disguise.
Be kind.

Can you remember peace?
Not a peace without emotion, or narrative, or to-do lists.
Not a peace without question, or concern, or misstep.
Rather a quiet stillness that resides beneath, between and beyond the waves,
Always
waiting
for you…