Caring for the Heart

by Jen Lailey

It is New Year’s day , and I am snowshoeing on our trails wearing my red Atlas snowshoes. I ba-dump, ba-dump along. It has been a hard year and I feel the weight of it. When I get back to the house, I think I feel a small stirring of gratitude and write “snowshoes” on a piece of paper, fold it, and drop it in the Gratitude Jar. It lands on a handful of other pieces of paper that contain other words that have been eked out of reluctant pencils during the holidays.

These snowshoes are a small miracle. They hold me up on the trail. All of me. They have a matte red frame, like a large artery in the shape of a tear. The deck has a pivot point that allows for the toes to pedal push away the trail and thereby move my body along it. It is as though they have a magic that turns the worldly weight of me into celestial momentum. Carries me into a forest poem in a few short steps.

I have just had a hard visit with my family. I imagine I am not alone in this. I wanted to be good. I wanted my engagement with family to be informed by my wisdom. My heart work. I wanted to rest in loving detachment. I wanted to enjoy the season. I didn’t want to carry what wasn’t mine. I wanted to contribute to the benefit of all of our well-being. But all holiday I am cloaked in this neurotic veil, preoccupied by the question of whether I have been a good enough mother. The question comes on the heels of anxiety over whether the kids are ok. Whether they will manage to find fulfillment and peace in their lives. No small task. My mother asks me, “do you think you did too much for them”? We both react to their torpor. And I react to her concern. And before I can take a breath, I am carrying it all.

We are all but housebound in this small space, all seven of us. For nine days. My parents in their early eighties, my husband and I in our early fifties and our three quarterlife daughters, each in varying degrees of being lost, and found. I envy the families in which the children can present themselves as having found a clear and precise path in life. Even though I know, having been one of those children, that neither such a presentation nor such a path has much to do with fulfillment and peace. That nobody gets out of jail free.

My father is recovering from a broken patella. Frank Netter, the well-known medical illustrator draws the patella as a subtly heart-shaped bone that “caps” the knee joint. Dad has spent the fall immobilized in the hope that the bone would heal enough to be able to make this journey over the holidays to see our family and then my sister’s further West. He lays it out there that it will likely be his last visit. One day while he was here, I watched him sitting in his red sweater in the living room reading and marvelled at his kindness. Recognized how he opens and closes his heart as required but could see the spaciousness within it.

My husband, Jay, needed to have surgery on his heart last year. His aortic valve had become fibrotic. One morning his heart rate wouldn’t settle after a workout and two months later he was lying in an OR in Hamilton with his chest wide open. The deft surgeon performed a Ross procedure. He removed his defective aortic valve, replaced it with the pulmonary valve, then put a cadaveric valve where the pulmonary valve used to be. The surgeon was polite and clearly capable at his craft.

My husband’s work is caring for others’ hearts. In a non-surgical, healing sense. His patients often want him to fix them and he has to let them know that he doesn’t know how to do that. He can only sit there and open his own heart to them and hope that can be enough. Once or twice a week he works in the correction centre, where girls and boys who didn’t stand a chance make their way. He offers them resources. Some they want, pharmaceutical. Others they don’t recognize or need to learn to trust, his understanding, presence, willingness.

His other work is as a coroner. I think of this as his community service. Coroners don’t get paid much for what they do. Jay has always been fascinated by death. Unafraid to bear witness to loss and endings. I overhear him speak gently to family members and police sergeants. He doesn’t get in his own way. Neither plays small nor needs to be a hero. He knows it isn’t about him. I wonder what he carries in his body. What brutality of people’s lives his eyes have seen. Rarely, he talks about this.

We share a clinic, my husband and me. We both do psychotherapy with people who are willing to do the hard work of exploring their difficulties.  We are both doctors who were led to this kind of medical work because it felt the most meaningful, the most interesting, the most human. Yet it really is one of medicine’s backwaters. It pays relatively poorly, is often misunderstood, is difficult to explain, and the language of it doesn’t play well in most social or political climates. What does ‘holding space’ have to do with the economy? What does ‘sustained empathic inquiry’ have to do with moving forward? What does acceptance have to do with progress? The answer to each of these questions is both everything and nothing. Depending on where you stand.

One vocational hazard with doing work like ours is that it can make one feel like a stranger in one’s own life. Used to talking about the unspeakable things, having ‘normal’ social interactions can feel confusing. Where do we put all those parts of ourselves, hearts especially, within a casual conversation? We hadn’t expected to grapple with this in that Hamilton hospital as well. A hospital in which we had both trained as medical residents 25 years prior. I did a rotation there in the ER and he on the Internal Medicine and then Neurosurgery service. But there we were in that very hospital, talking to the surgeon, grateful for his work, yet very aware of this great chasm that he and his team didn’t know how to cross. Not once in my husband’s surgical journey did anyone on his care team ask him how he was doing.  Didn’t acknowledge that his heart wasn’t just a pump or even that it was just a pump that his life depended on.

I remember a course in undergrad. It was comparative biology, McGill, 1992. One of the lessons had to do with the ways trees have evolved to not be broken by the wind. The birch and poplar bend and flow with it while the oak and elm hold firm against it. It was a revelation for me then. Having been fed a steady diet of grit. I guess I still don’t know the best way for my heart not to be broken by life. But maybe that is the point. It is inevitable.

In fact, some Buddhists suggest that one’s spiritual path starts with a broken heart. This is how we can begin to participate fully in life. From a place of vulnerability. By staying open to this vulnerability and its accompanying difficult emotions, we can realize that our own vulnerability and pain is no different from the difficulty everyone feels. It can dissolve our trance of separateness. Leonard Cohen told us that there is a crack in everything and that that is how the light gets in. Pema Chodron, a renowned Buddhist nun and teacher asks whether protecting ourselves from our pain ever works? In the short term maybe. And goes on to explain that our attempts at shielding ourselves from the full experience of life can shrink our world. When our main goals are to gain comfort and avoid discomfort, we can begin to feel disconnected from, and even threatened by, others. She shares that if she really connects with her jealousy, anger or prejudice, she finds herself standing in the shoes of humanity. Tara Brach, another teacher of mindfulness and compassion, describes this in another way. That the main ways we protect ourselves from grief are with clinging or aggression. She shares the suggestion from Francis Weller that we become ‘apprentices to sorrow’. And in doing so discover the most deep and beautiful dimensions of our being.

I tell my mother that I started seeing my therapist again. After a 22-year hiatus. I saw her initially when in residency. It was 1996 and I had been struggling, as usual, with neurotic preoccupations, self-doubt and overwhelm. I don’t remember much from our sessions but I know I cried a lot at first. To arrive in a space and to put down the weight or not carry it alone, for even 45 minutes, came with relief. I remember I held back and didn’t know how to be honest about everything. But now after having spent some time in the therapist chair, I have a better understanding of what therapy is for. What it can hold.

Perhaps that is why I called her, out of the blue and from a distant location. I hoped that maybe I could revisit that fear, that resistance, and trust her now.

My mother asks me “why do you need to see her”? I pause, fortunately. “Because life is hard” I say. She might have guessed that my therapist and I spend time talking about her. Her failings. Her too much and not enough-ness. I could have answered in so many ways. “Because I want to be more aware of how I contribute to the suffering of my children”, “because of how you fucked me up”, “because you are human”, “because life has broken my heart”, “because I don’t know my children will be ok”, “because Jay could have died”. “Because we are all going to die some day”. “Because I feel lost”.  And all of these are true.

Another wise teacher, Jon Kabat-Zin, reminds us that there tends to be great resistance on the part of the mind and body to settle into things just as they are, even for a moment. And that this resistance may be even more compounded if we are meditating because we hope that by doing so, we can effect change, make things different, improve our own lives, and contribute to improving the lot of the world. This may explain why, after meditating for years and even teaching mindfulness courses to hundreds of people, I still fight reality, still have trouble opening my heart to it all. Even after hundreds of times of surrendering to moments and allowing things to be as they are, I so often still don’t want to. It feels like there will be no end to the grief. And I can’t seem to get out of my own way.

I am haunted by the experience of having been out of my own way after days of being on silent retreat. I see how I grasp at that state. How alive and at peace I felt. How beautiful life was. All of it. Even being completely open-hearted with my mother was possible then. I would have liked myself but that wasn’t even a question. There was no “self” to ask it. And yet the conditions of our lives don’t support that kind of abiding presence. Do I think they should? What does it say about me or my life if they don’t? Is this just another fantasy?

I have read that the point of having touched that state of grace is to know that it is possible. I suppose that is true which for me makes the weight of human suffering all the more difficult to bear. To recognize that we cause it with our own minds through how we relate to life. And so here is my chasm. Here is my work. Here is where we find ourselves. We stand at the edge of our chaos, thinking, knowing, feeling there is somewhere better. There is and there isn’t. The somewhere better is right here just a membrane away. And yet. We are getting in the way of that grace all the time. And we aren’t encouraged otherwise very often.

Imagine if a clothing ad read “you probably have things to wear and they may not look that great on you but that’s ok. Most of us feel inadequately garbed anyway. But if you want these pants they cost $100. Are they worth it to you or do you need that money for something else? Maybe you don’t have money like that at all. Its weird that some people reading this do. Fascinating isn’t it!”

And the news read “there is a war happening. It is sad, so sad……………….. there isn’t really anything we can do about that war. I am sure you can imagine for yourself the horror of what it means for people. We could talk all day about who’s fault it is and who should be punished. But maybe we can all take a moment to visit with those ravaged people and send them our good wishes for peace and well being. And maybe we can all go about our day with them in our hearts, even if in a minor atrium, with an awareness that how we treat each other matters. Sound ok? But if you can’t today. I get it. Look after yourself in the meantime.” “And yes the Earth is damaged. The systems are failing. Species and glaciers and shorelines lost. Be willing to grieve this. Let us all be apprentices to sorrow together.” And then offered us words like the following from David Whyte.

Those who will not slip beneath
the still surface on the well of grief,

turning down through its black water
to the place we cannot breathe,

will never know the source from which we drink,
the secret water, cold and clear,

nor find in the darkness glimmering,
the small round coins,
thrown by those who wished for something else.

Imagine if high school yearbook statements read like this: “Johnny seemed sad a lot. Sometimes when I had a bad day I would look at him and feel a bit less alone. Us both here feeling like everything sucks. I still think about him and hope he is doing ok. Hope he knows he is loveable and that he doesn’t need to feel like he failed. I mean, we all do at times, and man that hurts. But I hope he found a corner for himself in life that for moments at least felt like love and, hey, dream big, joy. Its not your fault Johnny.”

***

At the end of silent retreats I have had the distinct impression, have actually felt, a cloak being laid on my shoulders. It is the way it feels when the dental hygienist places the lead apron on your body before the x-rays are taken. I have felt aversion to this cloak, this yoke. Felt resentful and disappointed by its insistence.

But how could I rethink this departure cloak. This ‘what do I wear in the world’ garment that lands on my shoulders as the retreat wraps up, so to speak. As I consider this, I think about how much my mother would love to hear that I have been incredibly helpful, a salvation even, to my patients and how I am reluctant to discuss my work with her because of this fantasy. How I feel it doesn’t quite fit the role properly. And yet I recall her advice a few years ago. “You don’t need to be a hero Jen”. No Wonder Woman cape for me. How about a classic druid martyr cowl? No thank you. A shroud of duty? Armor mantle for the violence of the world? How about angel wings? Ha ha ha sorry mom.  I consider an Angel-in-Training poncho and perhaps I might soften the religious overtones with a subtitle. “Non-miracle stream.” Or “Willing to participate in awkward visitations, mood depending.” That, I could wear.

I got thinking about visitations one morning as I walked the dog. Most mornings, we walk along our country road and I wave at drivers who pass, never knowing, given the darkness, whether they wave back. This particular morning, a neighbour, who I had only recognized as “the grouchy old man that yells at his dog and drives an electrician’s van to work each morning”, switched the interior light on in this van as he drove by so that I could see him wave back at me. It felt like we saw each other across a distance. I felt blessed, lifted up and grateful. Such a small thing but it felt lovely to participate in this little visitation. I had a sense that if I could recognize such moments, see them as blessings, as tendrils of a textile that holds one in the world, that I could be ok.

One of the places I have found a sense of this participation in visitations in the past few years has been through poetry. I first connected in a heartfelt way with it because of how it resonated with the mindfulness and self-compassion work I was doing. Mary Oliver, David Whyte, John O’Donoghue, Naomi Shihab Nye, to name a few. And last May I was blessed with the opportunity to participate in a poetry retreat in Umbria, Italy, with my sister and her poet friends. Such a gift to spend time immersed in poetry and poetic sensibility in a place like that. My sister is a poet. A real one. She has been offering visitations on the regular for a while now. Has invited me into this mysterious world. It has allowed us a way to communicate with a new kind of intimacy around our lives. Poetry for me it isn’t always something I want to read or hear. Sometimes I am too closed off to receive it and at other times it can be too much. It can literally rip me open. My own mother likes to share that I ripped her open at birth. Does she mean her heart?

***

I didn’t think I was someone who clung to her children, but there have been signs along the way. Including my eldest, in her late teens telling me it felt like I didn’t want her to grow up. Ouch.  I am still working on letting them go. This may be my life’s work. I didn’t know we need to grieve our living children. Nor how hard this would be. I know I romanticize their childhoods. But it meant daily visitations from the very sources of love and life. It also meant a world of possibilities as yet unlived, so many doors open for them. So many places for their arrows to fly. As they get older and I see the truth that I can’t go with them on these flights, that they may not fly far, and that I can’t protect them as they go, it is easy to want to cling to them and focus on the threats, real and imagined, to their well-being. And all that openness to seeing that they are not mine but, as Ghibran said, the sons and daughters of life’s longing for itself, requires a stability that I often seem to lack. Tara Brach suggests that one of the ways we cling is through self-recrimination. Rather than feel our hearts break in grief for our children we indulge in all the ways we have failed them. All the ways we should have been better mothers. This cloak is a hairshirt. And so I see my task. To grieve our days lived closely alongside each other, all their wonder and challenge, and to grieve the fantasies I had that I could protect them from suffering. And in doing so, get out of their way.

Chodron suggests a practice called Tonglen. The idea is that you breathe in the difficulty, yours and everyone else’s who may be in a similar situation or feeling similar emotions and breathe out something you want to offer them. The idea isn’t to suppress the negative and force it to be something positive, not try to turn mud into lotus. But rather it is to work at making space in the heart to hold it all. You might send out enough space so that peoples’ hearts and minds feel big enough to live with their pain.  I experiment with Tonglen one morning in this new year. I breathed in the fear and concern parents feel for their children as they grow up and away from them. The faces of so many friends and family who I know or imagine struggle with this difficulty flashed through my mind.  As I breathed out equanimity and peace, I began to feel a profound connection and compassion. Tears fell onto my chest and I wondered how Netter might have depicted this practice and its anatomy.

As a therapist, I have found myself playing cheerleader, “you are doing so well, keep it up”. Grim reaper, “life is full of suffering”. Bubble burster, “oh what a lovely fantasy”. Other times I have played tour operator, “come with me to the land of peace, I will show you the way.” As if I know. Salesperson “just read this book, try this practice, and so on.”  I feel most helpful when I can find whatever dark hovel a patient is sitting in and light a match for a moment so we can see a little more of this spot. And almost always it is somewhere I recognize. And always I know it isn’t their fault they are there. Even if we both find it irritating that they are. And I also sometimes must break the news that there are no wings to fly across that chasm from despair to joy. And also, that if they jump, it won’t be far enough. What I want to give them is a pair of snowshoes. And some guidance on how to find something to help them ba-dump along, to help lift the weight of aloneness, and to accompany them for a time here and there to help them recognize that wherever they are on the trail, is somewhere worth being. And to keep moving along it. And hope, hope that that will be enough.

Jen Lailey came to writing a little later in life. She works as a GP-psychotherapist in Thunder Bay, Ontario and lives on a boreal forested property just outside the city where she gardens and walks the trails. She and her husband have 3 daughters and are about to experience an empty nest. Jen appreciates writing as a way of understanding her own experience and saying what can be difficult to express in the usual day to day conversations.