Smell Of First Rain
May the Bridges We Burn Light the Way
Dear Ones,
Is it safe to say that if you are here you are ready for more candid reflections, noticings, and confessionals? Some of you have shared that my words have brought you to tears. I am hopeful they are hopeful tears.
Why does life always seem like a bracing? I am on alert, poised, and ready for the next big suffering. Gaining skills to move with grace despite outrage.
Break a bone and give it time to heal.
Break a heart and give it no time to heal.
I practice staying open during these seismic shifts. It takes practice. Hearts wide open. Vulnerable. Growth comes with goodbyes. Goodbyes of old ways. Goodbyes of old self. Old ideas. Old thoughts. Old everything.
Relief of goodbyes followed by hellos. Relief of change on the horizon. Something different. Something softer.
ROOT CAUSE ANALYSIS
Hospitals routinely conduct Root Cause Analysis or RCA to review and learn from difficult cases and deaths. The practice offers the potential for learning from medical errors, complications, and unanticipated outcomes —provided that the focus is on education and action, as opposed to culpability. I pay homage to that format of deep learning.
I did not know that I would proceed to spend years in battle with the health system- 20 years in a boxing ring. I despise boxing. Violent and bloody. Leaving us black and blue on cold concrete.
So here come my brave words (braver ones to come behind a paywall). May these letters stand for agents of change and transformative justice. Self catharsis if nothing else.
I am currently a student in a beautiful and intense class called Zen and the Art of Saving the Planet. It is taught by disciples of the late Zen Buddhist Master Thich Nhat Hanh -- affectionately referred to as Thay (which means teacher in Vietnamese) by his students -- and other great teachers. If his ideas of loving-kindness and inter-being are widely adopted, the world will cultivate more peace and we will have a better chance of healing ourselves and our beloved planet. Deep bow to this life-changing practice and to my Sangha brothers and sisters.
HOSPITAL WAR ZONES
Hospitals or what I call suffering houses and trauma centers are a window to the world- an underbelly. The recent hospital takeover and heartbreaking story of the brave doctor who risked his life in the Middle East is so very sad. Gang gunmen recently open fired on my old hospital in Haiti.
Just when we thought our hearts and souls could not bear it, more suffering slams into frame. Somehow we bear it.
Gun violence isn’t the only kind of violence that hospitals attract. I observe, after decades, that U.S. hospitals are engaged in other types of wars.
There are many battles being fought in U.S. hospitals- macro and micro wars of bodies and souls. Patients often enter facing visible and invisible terrorists (that is what I call sneaky infectious diseases).
Docs and patients feel voiceless in a battleground with zero army and zero armor. Empathy is critically endangered. We are drowning in the trenches now. I have never seen this degree of physical and mental dis-ease. It is unprecedented.
My job as an Infectious Disease doctor is to help put microorganism disrupters back in balance in humans. To help us all live in symbiosis with other living forces. Did you know that our physical bodies contain more bacterial cells than human cells? How cool is that? Worry not, my friends, I am a microbiome fanatic and there will be future posts on this extremely sexy topic.
There is structural violence in our systems. It is wild to see how we generally treat our own species (and other species). It is wilder to see how we treat our own species (and other species) at the most vulnerable time of life- when sick and dying. A terrible abundance of maltreatment. If it occurs in healthcare, then all other arenas are fair game.
Violence is violence is violence. Where sickness flocks, violence thrives. Vigilante violence.
According to my mentor, the late beloved Dr. Paul Farmer, structural violence “refers to the social structures that put people in harm's way.” The word “structure” refers to a pattern of collective social action that achieves a degree of permanence. A structure is an observable regularity in human social activity, that has become firmly entrenched (social relations, economics, habits, institutional practices, law, policy, and so forth). Time to say goodbye to these structures.
My vote is to bring back empathy, nature, and the art of healing in our practice of medicine and in the practice of being human.
Check out this video of Khoo Teck Puat Hospital in Singapore which uses greenery as medicine! Now that is the kind of future healing sanctuary that I envision! I am happy to consult for hospitals on what constitutes an actual healing space. If hospital administrators eventually discover that this is a good future endeavor, please feel free to get in touch.
*Nessa Tip: For the holidays, if you are around challenging and difficult humans, remember Viktor Frankl’s space between stimulus and response. Go there and follow your breath. Find refuge in your breath, take note of your body language, of the language of your body. It is the first step to deactivating your nervous system. This is essentially mindfulness. Over time, you just get better at it and it is a SUPERPOWER.
WHAT WILL IT TAKE TO BUILD BRIDGES TOGETHER?
MINDFULNESS
The future human will know that mindfulness is an elixir. It is a practice of true freedom. It is the ultimate thought detangler. And here I thought my wild Medusa hair was the only thing tangled. According to Thay, mindfulness is a “holy energy” that allows us to know what is happening.
I mean, who wants to know what is happening? Let’s be real: most people do not reallllllly want to know the dark truth. Truthtelling is like sandpaper. Can we embrace truth in its wholeness?
The truth is that once we fully move through the darkness of our own truth, we are free. It empowers and liberates us. Sages and prophets must have known some things and same things. In order to accept our dark truths, self-compassion must be fostered.
*Nessa Tip: Spend a day paying attention to how often you shame yourself for something. Focus on the quality of the language with which you speak to yourself. Be your own witness. Check out the color of the language of your thoughts. Is it harsh and critical? Or is it gentle and soft? If you continue this practice and learn from it, your consciousness changes. Brain wiring changes when you keep looking under the hood.
Self-compassion enables broad compassion to penetrate into our hearts. Do you believe that? It is like a key to empathy. Thay reminds us that “if we know how to suffer, we suffer less.”
WATERING GOOD SEEDS
What stories will be told in the future?
I hope stories of how we learned. How we witnessed some systems go against our nature. Systems we humans built. Some were helpful and some were harmful. Some made us very sick. How we decided to build different ones. Helpful ones. How we reclaimed our brain health once we realized the sickness. How we adapted to big changes as higher intelligent beings. How we found harmony within and therefore without. How we agreed upon a new global ethic. How we learned to persevere no matter how uncertain the path. How we created a less violent world.
I hope they are stories with a sense of reconnectedness, renewal, and regeneration. I hope our future stories are filled with reverence and obligation to life on earth and to life of the earth.
I hope they are stories of how the combination of systems entrenched in profit, widespread physical and mental health addiction and disease, destruction of ecosystems, progress of technology and AI, downstream effects of a global pandemic, and widespread bloody war led to our spiritual human revolution.
LEARNING FROM ANCESTORS
The sky is leaking. The rain feels sacred in California. A bit like holy water.
I love water. I always say that if the ocean can calm herself, then so can I!
My father taught me to love rain at a young age. Rain cleans the earth he said. He is a master gardener too by nature. It is in our DNA. Lofty inheritance. I inherited so much from him.
*Nessa Tip: Take a look at the traits of your parents. Bring awareness to their love, their shortcomings, their suffering, their history. Chances are you have inherited the good, the bad, and the ugly. With mindfulness practice, I see the inbred parts of my mother and my father.
Rain is here right now in southern California. Rare rain. I can smell it as I write this. Why does first rain smell so good?
The smell of rain is called petrichor. First named by two Australian researchers in the 1960s, the earthy fragrance we experience when rain hits dry ground is produced by bacteria. It is from a molecule called geosmin produced by Streptomyces. It’s true, I like to dork out on the chemistry of rain.
Do you see why being an Infectious Disease doctor is the coolest?
ON FOSTERING COMMUNITY AND EMPATHY
BORROW MY STETHOSCOPE -A Story by Nessa
Do you want to borrow my stethoscope? I even have a magnifying kind. It intensifies heartbeats.
I listen to hundreds of thousands of heartbeats. Adjusting the volume for each encounter. 20 years of hammering hearts. My eardrums perforate.
I hear brave hearts. Lion hearts. Persistent ones. Broken ones. Fat-laden ones. Kind ones. Weak ones. Skinny ones. Private hearts. Fluttering ones. Mighty hearts. Mean ones. Lost ones. Calm ones. Proud hearts. Violent ones and on and on.
Do you want to have a deep listen? I can’t hear you past the noise. No, I don’t have a reflex hammer or a scalpel. Just my heightening stethoscope and some sutures. Listen carefully. The sound of breaking hearts may mend your heart.
May we suffer less together,
Nessa
!!!!!!!WHOLESOME RECIPES!!!!!!!!!
If you want a pomegranate pistachio chicken recipe, click here and for my famous garden stew, check this link out!
Nessa, You write so poetically.
Thank you Nessa! Great reflections and insights!
Gratitude to rain, reflections on family origins, children, reflections on the inner dialogue, gratitude to the prospect of transforming hospital environments, and the possibility of bringing further healing!