Imagine

Imagine for a moment living breathing beings, that we can observe from behind a hidden one way window.



We observe that these beings seems to have different "gears." That sometimes, the beings rest, and heal, and sometimes, the beings can sort of "turn up" the energy usage into a "higher gear." And faced with certain situations, seeking food, trying to defend oneself, when threatened or competing for something, that these beings can accomplish more tasks in a faster time, run faster, see more clearly, fight harder.



And what do you suppose happens? Some of these beings find this state of "heightened gear" attractive, and they seek to push their bodies to stay in this gear all the time. They think this makes them more successful, or makes them feel better (even as it wears them out to be in this heightened "gear" all the time)



Watching over a long period of time, we see that those beings that go back and forth between the different gears at different times seem to be healthier than those that always tend to stay in "resting gear," or always tend to stay in "heightened gear." (and we see there aren't only two gears, there are an infinite number of settings between one end and the other, and the beings who seem to be the healthiest over the longest periods of time are those who are able to maintain a balance.)



Long ago, the beings knew about this balance. It was part of an ancient wisdom of their bodies. They understood it. But over time, this wisdom was lost. Even as they learned new modern wisdoms, ways to use substances to "cure" themselves when they were "sick." They even learned how to cut into their bodies to "cure" some parts that had "worn out." Some parts could be "replaced." Like magic.



One day, some beings began to realize that there was a difference between the old natural way of "healing" by being in "balance," and the new "magic" ways of "curing" things that had become "sick." And some realized that the old wisdoms could be learned yet again, and used together with the new "magic." (it never had to be one or the other)

This is very much the situation we have today. The human body has an "autonomic nervous system" that is described as having 2 "settings." One setting is described as "fight or flight" and is called by health care professionals the "sympathetic nervous system." It can also be referred to as "adrenergic" since it is related to having surges of adrenaline. The other setting is described as for being at "rest" and is often called the "parasympathetic nervous system."

What we are finding is that within the sympathetic and parasympathetic nervous systems, they are variations and it is not so simply "one or the other." Some medications for example, like "beta blockers" can block the "beta" type effect of adrenaline, without blocking the "alpha" effect, and now we know different "selective" effects within those systems. And at the same time, we know that the parasympathetic system can sustain action and activity, not just "rest" - though at a "lower gear."

"Stress" can cause more adrenaline to circulate, and while this can have benefits short term ("fight or flight") it can wear someone out, so it may be best not to stay in one state (or the other) all the time. Resting all the time and not getting any exercise ever isn't healthy either. We seem to need a balance.

We really don't know for sure what happens when we do Reiki, but it sometimes seems as if we "reset" the balance between the elements of the autonomic nervous system in a healthier way.

Talking about "chakras" may make sense to us, but to physicians trained in a very conservative way, it may be hard for them to understand. Yet, if we talk about the effect of Reiki, in terms of causing relaxation, slowing the pulse, and placing our breathing in a more regular pattern, it may be easier for Western trained physicians to understand.

The other day I came home from after a long flight. I went right back to work, and a friend asked how I could do this. "I'm always tired for a couple of days after long flights" this person shared. Some time ago, I stopped worrying about flying. Once I decide to go somewhere, there simply is no sense to worrying and I may as well enjoy the journey. Now, I suppose, I use Reiki and relax. I don't let the waiting upset me and I don't let the security upset me, and when we are flying I don;t think about what might go wrong. It is sort of interesting to see how, human intellect and thinking, which should help us, can in some situations wear us out. Worrying about things we have no control over and can't do anything about wears us out. Being thankful for the opportunities we have seems to give us a chance to be calm, and to some degree heal ourselves.


Imagine.

Looking through a window

A few days ago, I walked back to my hospice unit late in the day, and found one of my patients sitting on a bench, dressed to leave, waiting for her ride. It was hard to imagine, as 17 days before she had been sent to us expecting to die, with widely metastatic cancer, and a bowel obstruction. "There's nothing that can be done," she had been told. And we worked with pain medication to assure comfort, and waited with her, and prayed with her.

Somehow, the bowel obstruction had relieved (at least for now). And she was sitting and waiting to go home.

I walked up to her and we took each other's hands and I told her that I prayed that she would be well and that I would see her again. I knew the cancer was not cured, and I knew this was a gift of very special time. And what I meant was really - I hope that you do not die soon, that this does not recur too soon, and she gave me this huge smile and said, "I do hope I see you again but not here, maybe walking down the street and we will pass each other by and wave hello, or, perhaps, I will be looking through a window from a store, and I will see you walking by, and I will wave!"

And I knew yet again that sometimes, things occur that we cannot understand - that while often curing is beyond our skill, caring is not.

Sometimes it is simply, as Art Buchwald wrote, "too soon to say goodbye."

Reiki and Manna

What do these two things have in common, Reiki, a form of healing which comes to us from Japan, and Manna, a type of food consumed by the Israelites in the desert, after they escaped from Egypt?

First of all, this Blog reflects meditation on a question that people are asking me, why don't you slow down? Aren't you worried you are going to exhaust yourself? Someone your age should take it easy!

And it is true that I have many days come to a realization that in hospice, half the patients I treat now are younger than I am - and so one would ask, what SHOULD I worry about? And it made me think of the story of the Manna in the desert. At least in the Bible as written in Hebrew, it appears that the "energy" in the Manna is not just "nourishment," it is a "food" that is spiritual and energetic as well as "material." And this food comes from Heaven and lasts only for one day - it cannot be stored or "saved for tomorrow." It appears that the lesson here differentiates between material food, grain and the like, that earlier in Genesis Joseph was able to store in warehouses, and save for the "rainy day" (or more likely in this case for the years of drought). Manna came as food that was "spiritual" in nature, and the energy needed to be consumed, more importantly, one needed to use the gift with the faith that more energy (or Manna) would come tomorrow.

So it seems to be for a Hospice worker. We are gifted with a certain amount of energy, and perhaps that is for a purpose, if we hold back and do not use that energy to assist others than it will spoil and do us no good. Holding back isn't playing it "safe" at all.

I am recurrently seeing people eager to move ahead in Reiki, attain more attunements, and accomplish more levels. And I am seeing people have concern that these leap forwards can be exhausting, and no doubt at some point clearing blocks and opening up can come with a need to rest and to integrate energies, to "rearrange the garden" if you will.

More and more for this reason I am tending to teach people over a longer period of time, and provide attunements at a point when I feel they are "really ready." There are benefits to "curriculum," and certainly standardization has its value and its place, but learning to perceive and work with "energy" is a long term commitment and an ongoing process. It seems to me more a journey than an attainment - and approached in this way I have found helping other people exhilirating, and long days rarely "exhausting."

For those who say I have a lot left to learn, I have tended to say I second that, or perhaps just a simple "thank you." In the meantime, I feel an obligation to continue to work hard and expend the spiritual energy I am gifted with "just for today." If we are doing a mission of kindness, we just need to have faith that the "Manna" will continue to fall - one day at a time.

And whether we use a curriculum, or attain a level, if we simply use the spiritual energy that is gifted us to give compassion to others, we ourselves will continue to grow.

Reiki and Transition

Last week I was having a meeting with a family in hospice. Superb specialists had told the family that his cancer could not be cured, and that he was near death. Everyone had fought as hard as they could. The patient as so often is the case, could no longer speak for himself, and fortunately, he was on a unit where relief of pain was a primary goal. Although further aggressive meaasures such as CPR (cardiopulmonary rescusitation) would no longer be useful, law still placed a burden on me to ask the family the ritual questions about doing or not doing CPR, and gave the family both the power and the emburdenment of deciding on whether to have something done or not, that in this circumstance would not be expected to work absent a celestial miracle.

Familes so often in this situation think they are deciding whether or not someone "will live." For them, to not do CPR implies to "let someone die" - and yet - they have already been told that medical treatments would not work in this circumstances.

We sometimes try a new approach - not directing the discussion at the technical aspects of CPR or why it wouldn't work - but rather, guided by a Reiki perspective focused on the moment, asking questions focused on the moment. Thinking in this moment of the five basic Reiki principles.

And the question I ask then is directed to the reality that is being lived "just for today." "You know him best, if he could speak for himself right now - what would he say he believed would happen to his spirit when his body ceased to function? Does he believe that death ends it all, or has he believed that a spirit continues after the body dies?"

Although no one knows what actually happens after death, and we cannot test or measure or have certainty, many many people think on this question. And as they approach "transition" - what they have believed in their life should matter - do they believe that the end of mortal life ends life, or do they believe they are moving forward to an exciting journey? Are they afraid or do they have faith?

While it is not for a health care professional to ever convert or convince at end of life, neither is it for a health care professional to silence or rebut faith - and so often, if patients and their families are not told that we are willing to listen to what their faith is, and accept their sharing, they think we are not interested, or do not care, or would judge.

Asking simply "what would he believe" can be a powerful act of respect. We can at the least learn a lot more about our patients and their families - and at the point where we cannot cure, demonstrating in this way that we care, at least enough to want to know about the life, can be important.

One day I was telling a friend about my plans to give a talk at a medical meeting on "end of life" care, and this gentleman who was a religious leader for many souls, perhaps tens of thousands of souls, told me as respectfully as he could that, "you young doctor are not an expert on life, only on mortal life. The life that happens after death is beyond doctors training and expertise."

And so, I was told, that if we used our skills to cure, at the point when we could no longer cure, we could at least have the humility to care to listen to what those we were caring for believed.

I have treated many patients who have been near death, and at least for a time returned to us. Almost every one described an experience of perceiving a bright light - like the brightest light they had ever seen. And here is a description of Mikao Usui's vision on Mount Kurama, in a classic version as told to Amy Rowland as told by Beth Gray, as told by Mrs. Takata ("The Complete Book of Traditional Reiki")- this occurs on Mount Kurama after a 21 day fast: "too weak to move and powerless to block the light, he surrendered to it, and he had his vision. He began to see that the intense bright light flowing into him was made of hundreds and hundreds of bubbles of light, like a river is made of droplets of rain. Each of these bubbles was one of the colors of the rainbow and glowed with iridescence."

When we were in Japan, and traveling to Kurama, we had the opportunity to talk with many people, and intentionally we did not simply ask about Reiki, but about Mount Kurama, and we found it had a deep spiritual meaning to many Japanese people - for generations, indeed for centuries, the remains of "noble souls" who might serve as examples and protectors to their families and villages, even in death, seem to have been brought there as a final resting place.

For many people's, places become "holy" based on the memory of the spirits who have gone before - the examples of their lives and joys and tears that went before us.

If we see Usui Sensei in Japanese terms, perhaps we can see the "bubbles of light" as Kami - noble spirits - intending to guide and give compassion to those of us still in mortal life.

There is simply this - Reiki method gives us a non sectarian structure for looking at a situation and a time we cannot control with science. It allows us to connect with people of different backgrounds and different religions and different cultures in a very simple way.

And what of my patient's family last week? I listened to their story of his life, and of what he believed, and of his faith, and his oft stated words that he was going to a "better place" - and they added, "he would not want to be on a machine and he would not want CPR."

Away from worry and in a place of gratefulness for his life, they had found a path to an easier way to face this moment. I had said very little, had asked a simple question, and sat and listened to a story.

On the NIH 5 year plan

This weekend I attended a continuing education meeting (CME) for conventional physicians, and while neither Reiki nor energy based healing were discussed, I could not help but reflect that the comnents of some of our speakers were, advertently or inadvertently, supporting the integration of complementary medicine into what we do in "evidence based medicine." The plain fact is, everyone wants access to the best of evidence based medicine when it works, but much of what we utilize every day is extremely expensive and has fairly high side effects.

I also cannot help but reflect upon the ill advised, poorly thought out, and regrettable decision by the NIH to focus research within its next 5 year plan of complementary medicine on pharmaceuticals rather than energy based medicine.

Here is what a highly prestigious speaker quoted to our conventional group of physicians this weekend" "Far too large a section of the treatment of disease is today controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudoscience."

Well - what is shocking is this quote was not from 2010, but rather from a contemporary of Usui Sensei, the quote is from Dr Osler, the founder of the Department of Medicine at Johns Hopkins and one of the father's of Modern Scientific Medicine.

And what does that mean in todays terms? The speaker went on to discuss the over usage of sedatives and antipsychotics in nursing homes today. In terms of sleep, scientific evidence was quoted that a major class of sleeping pills "decrease the time to onset of sleep, prolong the first two stages of sleep and shorten stages 3 and 4 (deep sleep) and REM sleep." (Medical Letter 1999)

Now deep sleep and REM sleep are what really "refresh" us, and the speaker went on to encourage us not to prescribe these medications adding, that for people having sleep induced by sleeping pills the report of daytime fatigue (next day) is "3.8 fold increase" compared to people not given a sleeping pill and continuing to report sleeplessness.

We were informed that in one recent case "the government charged that executives" (or a company which i will not name in the blog) "planned and executed schemes to illegally market (varying medications for pain and sedation). The fine in this case, "$2.3 billion amounts to less than 3 weeks" of the alleged companies sales.

These comments above, which I am reflecting on, are from a highly respected conventional teacher speaking at a very conservative and conventional physician meeting.

Conventional physicians are struggling to be "evidence based" - this is the best way for us to be, it is how we can best assist patients - but in the case of conventional medicine, we need more evidence about what complementary techniques can do and what they cannot do, especially - energy based and spiritual techniques.

The simple fact is that, complementary techniques like Reiki, Acupunture have very low costs and very low side effects.

I had a patient come in last month wishing a prescription for sleeping pills. I quoted the evidence to him, and tried to convince him that a medication was not a best option - it would take far less time to write a prescription! In the end, we agreed i would do a Reiki treatment on him, and not so surprisingly, he fell asleep. Now I have a conventional practice, not a Reiki practice, and except for terminally ill patients who I am treating in hospice, I am not day to day doing Reiki therapy - and so I offer options of colleagues who have Reiki practices.

In hospice we see cancer patients every day. And to make myself perfectly clear, if there is a chance that surgery and chemotherapy and radiation therapy will cure a patient, I am 100% supportive of educating to this option. "Cure" is a wonderful thing. Sadly - we do not yet have a cure for all cancers - and what happens when the conventional treatments are in fact not curative, and the patient is worsening in the face of such treatment? That is the dilemma. Can we "care" (or even as some say "heal") when we cannot cure?

This past week I was treating a patient whose oncologist had given up hope. Nonetheless, she wanted to continue aggressive treatment that would clearly not cure her and might well shorten her life. She came to hospice perhaps to die. We spent some time discussing the options, and she was very focused on what would happen after she died, what would her family do after she died, and in talking with her family we said to her, "please live the time you have. Please focus on the time you can share with your family now. Please don't give up the time you can live now."

She changed her focus - and went home. We do not know for how long. We only believe that each day someone can enjoy and share with loved ones is a precious day.

I can remember very early in my conventional practice, many years ago, having a very tough week. I had two patients with incureable brain tumors. I had long discussions with my neurosurgical colleague who did the biopsies, and he was clear that aggressive treatment would not succeed. In both cases, i had long discussions with the patient and with the family. One patient went to another surgeon, entered a hospital, had aggressive brain surgery and died that week in an intensive care unit. The other patient declined aggressive care, went on a vacation with her husband that they had always wanted to take together, and eventually, months later, died with hospice support and surrounded by her family at home.

It seems to me that a good physician is evidence based, and holistic - and isn't committed to forcing the use of one type of care or treatment. Medications can be lifesaving, i wouldn't want to have pneumonia and not take an antibiotic!

If conventional and complementary approaches can work together, and both be evidence tested, - care can be more sensible, and more holistic.

There was a recent article in the New York Times (10/2/10) quoted by our speaker this weekend, "For decades anitpsychotic drugs were a niche product. Today, they're the top selling class of pharmaceuticals in America, generating annual revenue of about $14.6 billion, and surpassing sales of even blockbusters like heart protecting statins."


The NIH should have had the wisdom to realize, the dollars spent on pharmacologic research is already extremely high, and the five year priority plan should have had the wisdom to be more balanced. More evidence based research on Complementary Medicine, especially energy based, should have been included. Osler. I think, would have understood that.

a Journey of Spirit

This Blog reflects on my journey, caring for hospice patients living the later days of their lives. It compares aspects of my own spiritual upbringing to that which I experienced in my journey to Japan, and reflects in some ways on the connections between Pure Land Buddhism and the challenges we sometimes face caring for patients in hospice.



Visiting Usui Sensei's resting place in Tokyo, one finds oneself at a peaceful, meditative place which is a Pure Land (Jodo sect) Buddhist cemetary. In biographies about Mrs Takata, an "Archbishop of the Jodo sect" is mentioned, but one cannot know with certainty exactly what this realtionship represented. Many of Mrs Takata's stories were allegorical, and she was writing at a time of intense prejudice in America.

Respected sources record Usui Sensei as a Tendai monk, and suggest that he was originally laid to rest in a Tendai cemetary and then moved to his current site. Others have recorded Usui Sensei as Christian, which is doubtful, or Pure Land Buddhist. The truth in history is beyond my grasp, but the fact is that Usui Sensei lays to rest at a Pure Land cemetary and that fact led me to reflection on the serenity and connection of Pure Land thought. I am not a Buddhist, but, people in moments of need seek a connectivity that seems to me best represented by what the great religions have in common, not in the qualities that make sects distinct.


Recently I was caring for a patient with cancer. Randy was unsconscious, he had suffered through surgery and chemotherapy and radiation therapy. Every conventional modality had been tried. He had been rejected for stem cell treatment (though I have had patients who have been through even that in their struggle). We were able to control Randy's pain, but his family family were suffering. They looked to the hospice team for help and support. Time and again in hospice, we are faced with patients and their families who look to us for guidance and for caring, when we have no tools for curing. What do we do? It just doesn't feel right to button up the "white coat" and walk away in these moments.



In these moments, all members of the hospice team become equally important. When all we can do is connect and support at a human level, there is no hierarchy. Every member of my Team is valued.


Honen was a Buddhist monk who lived from 1133 to 1212 Common era in Japan. He studied at Mt Hiei and was ordained a Tendai sect Monk at age 15. He founded the Japanese Pure Land or Jodo sect. Usui Sensei is laid to rest in a Pure Land cemetary in Tokyo. It is likely that Usui Sensei was a well educated man, aware of the teachings of many sects of Buddhism, and of Christian, Jewish and Muslim teachings as well.


One of Honen's principal teachings occurred when followers of his Jodo Shu sect saw both Honen, and his student Awanosuke, studying the meaning of "Nembutsu." "Of course," one said, "Honen's Nembutsu practice is better than Awanosuke's." Honen answered, "there is not the slightest difference between the two, because both of us have the same intention of wanting to attain birth in the Buddha's Pure Land."

What was the nature of this practice "Nembutsu?" It is repeating the affirmation, "Namu Amida Butsu" often translated as "homage to Amida Buddha," - a simple statement of faith. I have also seen this described as "save us oh Amida Buddha"using the term of Buddha as a manifestation of God the creator who is still active with compassion in the world.

There is a comparable Jewish prayer in the mystical "Hallel." It is a most basic affirmation of faith. "Ana (and then a Hebrew name for God) ho-shi-a na." It translates "please God (creator and ongoing ruler of the universe) save us."

In hospice, at moments when science has failed, a simple reaffirmation of faith and acknowledgement of a higher power that connects us can mean so much to patients and their loved ones. So much often pours out, "we didn't think we could talk about this with you." At a time when people need connection the most, and when more surgery is not an option, science should not "sterilize" the discussion of a creator from the room.


Honen was known for another teaching, and that was his belief that attainment of enlightment was not limited to the rich or to fellow Monks. Honen believed that women and men, rich and pure, fisherman and Samurai, Monks and laypersons, could all attain enlightenment, and this was revolutionary in his time at Mt Hiei. Honen defended his position based on stories and teachings from the historic Buddha, Shakyamuni.


Honen taught that in seeking enlightenment it was not enough to seek just for oneself. The search for enlightenment required assisting others. It was a similar dilemma that led the great Jewish scholar Hillel to teach, "if I am not for myself, who will be for me? but if i am only for myself, who am I?"

For those who do not believe in the revelation that there is a God who created and still cares for the world, and that all human beings are connected through that spirit - it is not for me to convince or convert. But in those moments when transition seems near, it is reasonable to talk about those strengths and connections by which the patient and the family have lived. Those who make simple affirmations of faith seem to suffer less, if at all.



Whether Sensei Mikao Usui was a Christian or a Buddhist, and if a Buddhist a Tendai or Pure Land follower, he lived a secular life and passed to the world a very non sectarian message that without religion allowed for connection to a Universal spirit through simple method.

These 5 affirmations seem consistent with most of the major religions, and seem to help reduce suffering.


1. We will not worry just for today (since we Affirm faith in a Creator)


2. We will not be angry just for today (since we ask the merciful Creator to forgive us all our errors just as we forgive others)

3. We will work hard today (since human beings of all stations in life can reach enlightenment, we all need to do our own share)

4. We will be grateful just for today (for what the Creator does for us)

5. We will do kindness just for today (to enlighten and connect oneself one must attempt to help others - we send ripples of compassion into the world)

When we return to that which we all have in common, rather than focus on that which makes us distinct, we are more able help others through a difficult part of their journey.

Sometimes Life seems hard

Sometimes Reiki meditation helps us in keeping a perspective, and understanding what it means to "be grateful." Right now, it is difficult to be a primary care doctor in this country, and in talking with colleagues every day, I hear and am aware of the frustrations. And this Blog is not intended to enumerate these concerns, nor to minimize them, when young physicians are choosing not to enter primary care, and experienced physicians are leaving their careers prematurely, it is a cause for concern, but the intention of this Blog is to reflect on other stories, of people who overcame tough challenges in life, and made a difference.

Reiki as we know it in North America became widespread due to the efforts of Mrs. Hawayo Takata. People are seeking to understand more about her allegorical stories about Reiki, and to understand more about her life. Much is private and some that was taught in allegory is not clear, but certain things are clear. Mrs Takata had many difficult challenges in her life. Things did not always come easy.

Before she was 30 years old, her beloved husband passed away of lung cancer, and she raised two children as a single parent. She had to work hard. She had health challenges herself. When she was 40 years old, her Reiki mentor died, and she was alone in Hawaii as a widow with children, an American of Japanese decent, at a time when Japan and America were going to war. Perhaps the truth most important to keep in mind as we seek to understand what she gifted the world with, was the simple fact that in the face of personal hardship she worked very hard, and gifted the world. Her biographies mention some of her hardships, and some of the prejudice that she faced, but do not dwell on them. The common thread to the stories about Mrs. Takata is that she maintained a cheerful countenance, used her talent to help other people, and sent forth ripples of compassion that still spread.

This past week, I had the honor to hear another such story. A nurse, Deb and I were making a home visit together to meet a new hospice patient. We went to her home, where her husband was caring for her, as she continued her long struggle against Alzheimers Disease.

With all the stresses on our time, we feel it is important to take the time to get to know our families, and in this case her husband gifted us with his story. He is a retired fellow physician, and the story of his life as a healer is one all doctors today need to keep in mind.

He went to Meharry Medical College, until the early 1970's, almost 25 years after Jackie Robinson played for the Brooklyn Dodgers, African Americans were only admitted to 2 medical colleges in America. It is hard to believe. But true.

He shared that his father was also a physician. And he remembers when his brother's high school was closed down, his brother had to walk 7 miles a day each way to go to school. His father, in 1947 began a lawsuit against the school district, but things moved slowly, and they lost at local court levels, with the justice system permitting racial segregation in schools and lack of equal opportunity in education. As a child, he remembers then NAACP lawyer Thurgood Marshall, coming to their home, and listening to his dad and brother's stories. When lawsuits from several states were "merged" to be presented by Thurgood Marshall to the Supreme Court, this case was one of the cases which became a part of what was named "Brown vs Board of Education." And in 1954, the Supreme Court of the United States declared that segregated schools were illegal.

Sitting in that room I felt a sense of awe and honor. I came to help this family, but his story was helping me. It was placing the challenges of my own day in perspective. My patients husband was facing life as he had always faced life, as his father had taught him to face life, without worry or anger, but with a determination to be a physician and spread kindness to others.

Deb and I were sitting in a room connected to a moment of history most important to our country, but we were being gifted as well with a perspective on how to face challenges.

When things are difficult as a health care provider, all I need to do is see the challenges my patients are facing. They are so often stories of courage.

In a prior Blog I wrote about one of my patients who was brought to my in patient unit, with the intensive care facility of a referring hospital expecting him to die in a day or two. He was bowel obstructed, and medically we saw no hope. We cared where we could not cure and our chaplain prayer with him, and did Reiki with him, and somehow, he did not die right away. After a month, we agreed to send him home, and he lived another five weeks - it seemed whenever we talked with him he was praying for other people he loved, Blessing other people, or thanking God for what he had been gifted with in life.

Some people see the challenges they face, and do not allow themselves to absorb the worry and anger of the moment. A doctor who had to face terrible prejudice just to be a doctor, persevered and took part in a quiet action that changed the soul of America, and Mrs Takata, a facing personal loss, and at times prejudice in her new land, left a legacy of compassion that has a very wide impact today.

Whatever the details of the stories, and however they are written or not written by history, there is a precious human lesson - we are gifted when we listen to it.

Reiki Treatment and a new evidence based article

An important event has occurred for those having an interest in Reiki treatment, and that event was the recent publication of an article by a team that included Reiki Master Pamela Miles, and a group of Yale researchers.

I urge Reiki practitioners - especially those attempting to integrate Conventional Medicine and Complementary techniques - to be aware of this new contribution.

Pamela Miles web site is http://reikiinmedicine.org/ and the discussion of this specific article is at

http://reikiinmedicine.org/clinical-practice/reiki-heart-attack-reik/

There have been prior preliminary studies suggesting possible interaction between Reiki treatment and the autonomic nervous system, but this study in the Journal of the American College of Cardiology is a significant randomized controlled study carried out at one of the most prestigious academic institutions and published as Pamela notes "by one of the most prestigious peer-reviewed conventional medical journals."

The article is "Effects of Reiki on Autonomkic Activity Early After Acute Coronary Syndrome," Rachel SC Friedman, Matthew M. Burg, Pamela Miles, Forrester Lee, and Rachel Lampert J Am Coll Cardiol 2010; 56; 995-996

This article leaves us much to ponder on - but just for today, consider the reasons for doing Reiki treatment on yourself.

Reiki Shares

In the last month I have been blogging less and learning more, my own perception both as a Hospice physician and as a Reiki practitioner is that continuing to learn, grow, evolve is an important part of living.

This month our own share had 9 masters and one new practitioner - since we are not teaching as a class within our share I will not say "student" - though I believe in fact we are all "students" learning from each other.

It is an incredible experience to "exchange" or "share" with many Reiki practitioners from different traditions. There are commonalities: - sharing a philosophy that flows from the five basic Usui principles - the fact that doing Reiki causes hands to heat up - and a sense that connecting to "energy" changes one's life for the better.

For some of us, having a very defined curriculum or method is very important - and for others of us, the energy that flows and the way we interact with it varies with the history and nature of the person, and what that person needs.

I think it is important to recognize the commonalities and to respect the differences.

We had a very special treat in our September 7 share as Hazel Numsen, who learned with both Dr John Upledger (cranio-sacral therapy) and Dr Fritz Smith (zero balancing) gave a demonstration. It seemed when I visited Japan that many people viewed a broad spectrum of spiritual approaches to energy as "Reiki" - but here in the United States it seems to follow a more defined approach - yet - there are many other approaches to what we call "energy."

Dr Upledger describes his own approach, SomatoEmotional Release, as follows in his book, "Your Inner Physician and You:" In SomatoEmotional Release , the approach is quite different. Here we simply place our hands on the patient. We then give silent permission for the patient's body to do whatever it deems appropriate at the time. We offer to put energy into the patient."

Now one may come to conclude that Dr. Upledger's approach is not Reiki, (or -perhaps one may conclude that it is - end of day not so important to me) he is an Osteopath, and comes from a traditional that does not include Usui, or Hayashi, or Takata. And yet reading his book, it seems fairly clear that his intention is to work on the same "energy" that Reiki works on - and that we can all learn from each other.

Last week I went to learn Reiki from a distinguished Reiki Master - notwithstanding that I have received the Master symbol four separate times now, formally, I still feel a benefit from continuing to learn. Seeing patient every day with incureable illnesses is simply a humbling experience for me. I use conventional medicine when ever it has a reasonable answer, but I simply cannot cease trying to "heal" because I am unable to "cure."

And this person pointed out that the energy he was working on with me "was different from Reiki." The intention is to grow and "be who you are." Or perhaps more "who you can be."

It is - perhaps naively - my hope that we can remain inclusive, and consider healing energies as being in synergy, when their intentions are to heal, and their techniques are not invasive, but rather gentle encouragements to what Dr Upledger would call "your Inner Physician."

My own sense - if this led one to avoid anger, just for today, to avoid worry just for today, to work hard, and to be grateful, and to offer a kindness today; if this caused your hands to heat up, if this had an intention to heal by gentle touch (or perhaps by energy not even transmitted by actual physical contact) - then the great masters would see it as their own.

If not, then we can still be grateful for the opportunity to assist others, and or the opportunity to continue to grow. My appreciation remains for all those who share this journey.

Just for Today

Patients often come to my Hospice unit, with a prediction of imminent death. "If you remove the ventilator they will die," but they not always do so; "if you stop dialysis they will die," but they do not always do so.

It does not mean that doctors' training is faulty, it simply means that we are trained to make decision based on statistical probabilities, and life does not always proceed as expected. I tend to answer questions as to prognosis as honestly as I can, but try to add, that in my job, I "hope to be wrong more often." If the Creator tosses a proverbial "pie in my face," I need to have joy for my patients good fortune.

Recently we received two patients coming to our unit with aggressive life support, their blood pressures maintained by articial intravenous medications. In both cases, excellent specialists spelled out correctly what the numbers meant, and what the expectations were. If the medications were stopped, they "would die." And there is no question how the numbers looked. In both cases though, as in so many of these cases, continuing aggressive medication was not a panacea; first of all such modalities only work for so long - they are not ongoing answers or cures. And secondly, the patient in such a situation is "hooked up" - loses all sense of freedom.

In some cases, such as being on a respirator, the patient is unable to talk, and often needs to be heavily sedated to keep the machinery in place.

In both of these cases this week, the patients decided to withdraw the "life sustaining medication." Our intention is never to "end their life," but to affirm their right to choice and empowerment over their own existence, and to give them a chance, a hope, an opportunity, to live free of being "connected" or "hooked up." Being "open" to Spirituality, helps us turn a certain death into a chance for life. Even if that living is only for a short time, sharing love and memories with loved ones can be precious and important.

Usually - the docs are right, but not always. And fortunately, everyone was wrong in our recent "dobutamine" cases. Slowly we weaned the patients off the medication, and one of them actually began to improve. He became more alert, he started eating, he got up, and started walking around our unit. He decided it is "time to go home."

Our other patient who stopped his aggressive medication is still with us. He is surrounded by family with love pouring into him. When we cannot cure, we can join a family in caring, and in prayer.

This is a part of the nature of Hospice; accepting that we use our scientific skills as best we can, but that human life is more than lab tests and numbers. Sometimes we can do nothing more than make someone comfortable. But sometimes, we can do something more, we can have someone prove us "wrong," even if "just for today."

Climbing the Reiki Mountain

It was only two months ago that we were in Japan, visited Kyoto, and climbed to the Temple on Mount Kurama. Mikao Usui had a vision there, which started a chain of events that led to many people, perhaps millions of people, being attuned to a spiritual energy and learning a method of healing.



It doesn't seem yet so long ago, nor in truth so far away (though the flight seemed to go on and on and on at the time). We live under the same sun (even if day here is night there) and the same energy flows through us all. Today I saw another "climb" - and it taught me something - that Kurama isn't only in Japan. The spirit surrounds us wherever we are.



Philip is a man who is living the last days of his life, i will not say dying because he does not think of himself in that way. He has a rapidly spreading cancer which has caused an intermittent internal blockage - the medical details really do not matter. He has wanted to receive artificial intravenous feeding, and we have followed his requests. In hospice my mantra is to empower the patient and follow their wishes as much as possible.



On the television it said today was going to be a sunny day, for me, that reminded me of my day climbing the steps of Kurama, but for Philip, it made him want to go outside. He has not been in the sun since he entered the hospital. He wanted to walk around his room, and walk to his wheelchair, and as he said, "I can only do that if someone helps me."



The effort that it took him to walk around his room, even with his walker, even with help, exceeded the effort it took for me to climb Kurama. More exhausting than the travel, the security, the flight, the bullet train, and finally the half day climb up the steps.



But today he made "the climb." Walked to his wheelchair, and a volunteer took him outside, and he sat in the sun for 15 minutes. I asked him how he felt, and he said simply, "good." He was focused on living - just for today.

Reiki and a Hospice Team

Every Hospice Team every week has a brief ceremony that memorializes the patients who passed away that week. Each name is read, and discussions often ensue on bereavement needs. We try to remember and learn from each and every person who entrusted us with their care.

Each week, we try to add something that makes the moment meaningful, sometimes a music therapist plays a song, sometimes a candle is lit, sometimes the chaplain says a prayer.

This week, one of our chaplains who is also a Reiki practitioner asked if she could do a different sort of reading. We each closed our eyes, and with her voice asking for energy to be open us, there was a feeling of a Reiki shower, and she read a form of a "Boddhisatva Vow"

"May I be a guard for those who are protectorless,
A guide for those who journey on the road,
For those who wish to go across the water
May I be a boat, a raft, a bridge.

May I be an isle for those who yearn for landfall
And a lamp for those who long for light
For those who need a resting place.

May I be the wishing jewel, the vase of plenty,
A word of power, and the supreme remedy
May I be the trees of miracles
And for every being, the abundant cow.

Like the great earth and the other elements
Enduring as the sky itself endures,
For the boundless multitude of living beings.
May I be the ground and vessel of their life.

Thus for every single thing that lives.
In number like the boundless reaches of the sky
May I be their sustenance and nourishment,
Until they pass beyond the bounds of suffering."

There is in hospice a very special bond, that has to do with the honor of being committed to relieving suffering in sentient beings. So often in healthcare, there exists a sense of loss and futility. In hospice there exists a sense of Purpose.

We can nurture people who we can no longer nourish, heal people who can no longer be cured, and care for people until they transition "beyond the bounds of suffering."

This brief ceremony is always very meaningful, and thank you to our chaplains and music therapists who add a special sense of spirit every week.

Near end of life

We do everything we possibly can that is evidence based, but we face challenges every day that exceed the evidence based tools we have.


As we talk openly about the challenges we face, and more importantly that our patients, and their loved ones face, we seek to understand what has happened in circumstances outside our ordinary experiences.



More and more physicians and nurses come to me and offer stories of their own experiences, things they are not quite sure that they believe, stories that they yet are fearful of sharing.



Sarah is a nurse caring for patients near the end of life. Last week one of her patients made transition. The next day she was walking in the hospital and thought that she saw the patient, and worse yet, that the patient was not wearing his oxygen.



How could this be? And as she hurried over to the patient, to do something, to replace the oxygen, she realized, first, that this was a different person, and second that the patient she was caring for had passed away the day before.



What had happened? She had been truly touched by this patient. For her, the spirit of the patient was still present. She returned to her unit, and found out that the patient was still in the morgue, no one had notified his family, the phone number on the medical record was incorrect. And yet another nurse remembered a niece having provided a different phone number. Sarah called the niece. The family was able to pick up the patient's remains, and, perhaps more importantly, Sarah and another nurse recalled a conversation with the patient, about wishes and instructions. And the family was moved by this, and everyone felt a sense of peace and closure.


"What happened," Sarah asked? Was this Reiki energy? And more importantly, how do we account for this? And perhaps more importantly, is it OK to talk about such experiences, or do we need to hold them in, and deny them. How often do such things happen? And does it reduce stress and burn out on nurses and doctors to talk about their own feelings about what happens near death?

A month ago, a nurse reported caring for a patient who arrived in tremendous pain. He had no family. He had suffered through a long hospitalization, and surgery that, however well intentioned had left him in a grotesque shape, and in a great deal of pain. The care team used medication, but as well, the staff sat with the patient, sometimes held his hand, sometimes just in presence, sometimes, with the music therapist, in song, sometimes with the pastor in prayer.

The grimaces left his face, his breathing became even and unlabored, and he lived peacefully for several days, and finally made transition. He did not die in pain and he did not die alone.



The day after he had died one of the nurses was walking down the hall. She heard a voice, "psst." But no one was there. "Psst, i'm over here." She walked back to the room where this patient had been living, and felt his presence, "its OK, you took away my pain, its OK now." She felt his presence, and then he was gone.

What has happened?

Is this OK to talk about?

Are these nurses "crazy" as they sometimes fear?


Is this Reiki?

When we provide Reiki near transition for treatment, does it rise to the level of attunement?

Does it hurt and cause stress to hold things in? Are we better off for talking about what we experience? Are we better off for sharing?

What do you think?

For those doctors and nurses caring for patients living the last days of their lives, thank you. Thank you for giving compassion, for caring when you cannot cure. For those who have shared experiences, talked about the perceptions and stresses, thank you. I find these days that more doctors and nurses find it "OK" to talk about their experiences.

I hope that sharing makes each day a little easier, reduces the stress, and allows you to continue this important work. Practicing health care with the best evidence based practices available to us, and at the same time, being open to human spirituality, seems a path worth pursuing.

Reiki and the Plastic Mask

I work on a Hospice in patient unit, and every day know we have taken to making rounds as a Team. We see about 100 new patients a month on this unit, and we are a symptom management and stabilization unit. While often, patients come to us "to die," many patients come for pain stabilization, and some that come to die ......well ......don't do what is expected.

There is a wonderful book, written by the late Art Buchwald, "Too Soon to Say Goodbye." Buchwald refused dialysis and was told that he had a week or less to live. He enrolled in hospice, lived almost a year, and wrote this book.

At one point he had a vision, he was standing in line at the airport waiting for a flight to heaven, when a loudspeaker voice said, "Because of the inclement weather, today's flight to heaven has been canceled. You can come back tomorrow and we'll put you on standby."

Many times we see patients with numbers that suggest they "should" die - but they don't. The creatinine is too high and they need dialysis, they refuse; the cancer is everywhere, there is nothing else to do; the blood gases won't support life; the CD 4 count is too low. Whatever it is, conventionally, we often treat numbers, and we are not correct 100% of the time. Sometimes, the flight to heaven is delayed and people are put on "standby."

This week we were making rounds and I came upon a man in a plastic mask. It was Bi-Pap, which is a device that helps people breathe, it is strapped tightly around their faces, and forces air and oxygen under pressure into the lungs. It is a step between a respirator, and well, breathing on one's own.

If a device like this is used on a temporary basis, let's say as someone recovers from pneumonia, or on a limited basis, let's say at night for folks with sleep apnea. It can be life saving. For others, as hours lead to days lead to weeks, it can be a sort of prison, just like a respirator.

In this case, I felt that with the Team present we could try taking the plastic mask off for a short period of time, and replace it if needed. We were right there, and as well, it would give us a chance to talk with the patient, with it on he could not hear us or speak to us. With the mask off he started to talk, and we started to listen. The patient was a high level professional, very bright, very much understood what he faced.

We negotiated. He hated the mask, but wasn't ready to give up on it, so being a Hospice, we empowered him to make decisions. He would wear it sometimes and not other times. "What if?" "I am ready to go," he said, "but I don't want to suffer or be gasping for air." "We can give you medication to prevent pain."

After half an hour of talking (he was on nasal oxygen only), one thing became obvious. The dire prediction by the lung specialists had not come to pass, and one of my nurses showing me "the numbers" asked "how can this be?" As with Art Buchwald, sometimes, the numbers don't tell the whole story.

The patient looked at us, and thanked us. He was at the least, now "in control" of some things. He was able to talk and be heard, people cared what he had to say. And here is what he added, "you are the first ones to talk with me about life and death. I'd been in the hospital a long time and no one talked about it. I think for doctors and nurses to talk about death, they need to face the idea of mortality, and of their own eventual mortality, and they have trouble doing that."

When I was learning Reiki, with my first master teacher Robin Hannon, I had a vision of being in a place of complete equaniminty. In Reiki terms we called it "Upekkha." Robin drew a picture of my vision, a tree with the leaves falling off, but coming through the tree an incredible light. Prior to learning Reiki, I had perceived this light, in 30 years of helping people nearing transition (or what we often call death).

Rarely we find something treatable, something which everyone else has missed (these are wonderful moments), often we relieve pain and suffering, and often we are just present in a compassionate way to share the moment, caring when we cannot cure.

We learn that sometimes, the creator of the universe sends a storm that forces the plane to heaven to be delayed, that we neither control nor know exact moments. But that the journey does not need to be faced with fear.

I think most people working in Hospice understand this, I think Reiki training helps us focus and share the moments. In thanks to those co workers who share the moments, and in thanks to those patients who continue to teach us, as long as we are open to learn.

Reiki and the Craniosacral Reflex

This past weekend I was sharing with friends, and was reminded of the importance of the incredible volume of work on Craniosacral therapy. The first portion of Hugh Milne's incredible book, "The Heart of Listening: A Visionary approach to Craniosacral work" presents interesting counterpoint to what we are doing in Reiki.

Imagine a series of bodily reflexes that motion of the eyes, or portions of the head or jaw, to the whole torse, down to the feet. Imagine a reflex wave that can be quantified. Imagine that such a wave follows the meridians discussed in bio-field healing. Imagine further, that Reiki training may be permitting the Reiki practitioner to "perceive" somehow, this wave.

To imagine this further, my recommendation for the moment is to find a copy of Hugh Milne's book, and to read the early sections. This book resonated for me.

In teaching, explaining or talking about Reiki, there is another question for which I do not have the answer. This past week, I gave a session on Simple Touch and Compassionate Presence for a group of employees at a nursing home. For many reasons, I was speaking about the simplest aspects of Reiki - and encouraging caregivers to clear their own minds of haste, anger or worry prior to approaching another person; to be certain they did not startle the other person, and to simply use a light tough of the hands to the person's hands to be calming, nothing "invasive," not "massage" and certainly not even a full "level 1" Reiki. This audience was a little sceptical even of techniques that border on main stream, and I decided to do a simple demonstration with two quite skeptical volunteers.

With their permission I performed a simple Reiju on each of them. In both cases they were surprised at the amount of heat that was generated, I had not physically touched either of them, nor intended a "Reiki level."

And one of them said,"my hands became really hot." And quickly someone in the front row said, "that's not possible." And the volunteer asked if she could touch that person's hands, and with permission did - she said, "how do you do that, her hands are really hot."

Well, in truth, we know in Reiki what we do, and we have "constructs" for what has occurred, but as yet, we do not truly know "for sure," nor perhaps does it really matter. What really matters is the intention of compassion.

In doing Reiki though, I have not really felt that I was becoming more "powerful" or that my "vibrations were faster" - I can feel the "heat" and I can transmit that, but it is more for me a sense of being a simple channel, a "catalyst" if you will, not really more powerful and not really a part of the healing itself. I don't believe that I am doing the healing.

And in convincing oneself that one is raising one's own "power," or making one's soul somehow more "advanced," I sometimes fear that we miss a part of the pathway to healing.

And to me there is an aspect of meditation in performing self Reiki, or Reiki on someone else, a connection with the world around.

And here is what Hugh Milne wrote of meditation: "medication is not concentration. It is not prayer, contemplation, hypnosis, or problem-solving. Meditation is the fine art of being here now; of holding an empty sacred space, mind shut down (because your mind is not you, consciousness is you). This is Kensho: the awareness that consciousness is the thing to focus on, not mind. Mind is made up of thoughts, feelings, and sensations; consciousness is the ground from which the mind springs. Consciousness has no components. Meditation is the art of being at one with yourself, your surrounding, and the world."

From this quiet sacred space within, one "listens" best, and perceives more. With no vibration, no motion, no power - simply with being and intention, one changes the world that one is a part of and radiates healing and compassion.

Takata's Usui

Since returning from Japan, I have been meditating on Takata's Usui. The familiar story of the Christian man who came to America, and was at the University of Chicago, and finally returned to Japan, to Kurama Yama, and achieved a form of enlightenment with Reiki.

The story, dear to so many for so long, debunked, in favor of the "historic Usui." But what of Takata's Usui? What was the point she was trying to teach.

I have just read Amy Rowland's newest book, "The Complete Book of Traditional Reiki" that includes both stories, and re read Virginia Samdahl's biography written by Barbara Lugenbeel. The story that Samdahl tells is slightly at variance to the story that Amy Rowland learned from her beloved teacher Beth Gray, so like the story told by Fran Brown and Helen Haberly.

But let us look at Takata's Usui for just a moment, not the historic person by any means, but the person Takata Sensei wanted us to know about. What was she trying to say to us?

Here is an analytic summary:

Takata's Usui, taught to an American audience was Christian, and although Japanese, had lived in the United States for some time - in some ways, he had become like many of those she was writing for, someone they could identify with. And he was seeking something, he was seeking "to heal."

Finally, unable to find the pathway to heal within Christian America, Usui returned to Japan. And he asked Buddhist monks, "do you believe that Buddha could do these things." And they answered, "we are a church, we are more concerned with the spiritual."

And so Takata's Christian Usui, coming back from the US, looked within Buddhism, not to be a Buddhist or to follow the Buddhist path but to find within Buddhism the lost secret of healing.

He was not seeking a religion, he was seeking a way to heal.

Takata's Usui was pointing the way for American's to see a pathway for themselves. The compassion and healing that were within Buddhism, but not the religion itself, simply the path to heal.

Seen in this way, Takata's Usui still speaks to us today, still has a value, the story, though lacking historic fact, gives a message from Takata Sensei.

I see people trying to go beyond Reiki. Seeking channeling and projection out of body of consciousness. And these things can be so easy yet so difficult. Here's an interesting fact, Virginia Samdahl was, prior to meeting Mrs Takata one of the most famous channelers of her time. She was a pyschic of considerable fame. Beth Gray also had fame in this area. What drew them to Reiki? A simple artform, meant simply to heal?

Here is what I have found. In trying to teach the arts where people "go beyond Reiki," the driving force that gives the capacity is compassion shown others. It all comes together. It is when we give compassion that we change ourselves, change our own substrate, raise our own potential as individuals and as a human race.

And so Reiki is the "Secret Method to invite Happiness" - it is the way to grow our own potential, to go beyond what we thought we were - not simply by raising our vibrational level, but by using a very simple method that passes compassion to others, the secret of "healing" that is common to all religions, but is not itself a religion.

We continue to seek the Mikao Usui who lived, but we should not forget the Usui that Takata taught us.

the Complete Book of Traditional Reiki

When I am asked "if you could only recommend one book on Reiki, what would it be" - I reply Amy Rowland's book, "The Complete Book of Traditional Reiki."

Originally published in 1998, this book has just been completely rewritten and re published, and if I valued it before even more so now.

Amy writes as she speaks and she is both an excellent teacher and an excellent writer. She has dedicated her life to teaching, writing and Reiki. This book is true to the history of Reiki, and bridges the challenges of our modern time.

Much has been learned in the past 12 years about the history of Reiki. And this whole section of the book has been not simply updated but rewritten. It makes me laugh at myself, because if had waited the past year, and not spent hours researching and reading biographies, I would have known more just by reading this book - the history is there and in simplicity and without agenda. Yet, at the same time, the "traditional history" of Reiki is still presented, as an appendix, and this is fittingly done. Learning is often about stories, and the traditional stories about Reiki, seem still to be true in spirit even if not fully accurate in facts.

Amy is respectful to the history of Reiki, not be deification as sometimes mistakenly happens, but by accurately and intellectually honestly placing founder Mikao Usui and Sensei Hawayo Takata in context of the personal struggles which they faced. It really doesn't matter whether or not Mikao Usui did or did not attend the university of Chicago, but it is meaningful that finding his life calling took years of search, and overcoming hardship. It really doesn't matter whether Mrs. Takata, living in the United States in a time when American citizens of Japanese decent were being wrongfully imprisoned, described Founder Usui as a Christian monk, rather than as a secular Buddhist, what matters is that both Usui and Takata sought not to teach religion, but to teach a method of healing for all man kind.

This book is about healing - healing oneself, healing others, and collectively, healing the world. . Amy writes, "what Reiki does provide is a direct, profound experience of the healing power of Spirit-guided life-force energy." She explains, "your only effort is to place your attuned hands on yourself or someone else." And again describing the practical nature of Reiki, "it is in just such simple ways that most Reiki practitioners learn to integrate Reiki into their everyday lives. As they do their lives begun to change because their perpsectives have changed."

The pespectives are the five basic teachings which permeate Amy's classes, and and the spirit of her book. From the Usui Memorial, "Firstly it reads, Today do not anger, secondly it reads, do not worry, thirdly it reads, be thankful, fourthly it reads, work with diligence, and fifthly it reads, be kind to others."

The book includes descriptions of the lineages of Reiki - it does so in an inclusive and fair way, leaving each student to be drawn to a method most comfortable for their own spirit.

Hand positions are discussed, but "symbols" are not, left for oral teaching by master to student in class.

As a hospice physician, I appreciate that "The Complete Book of Traditional Reiki" is healing in both its approach to human suffering, and its approach to respecting and bridging conventional and complementary healthcare. It helps remind me that the powers of healing are not within us, but come from a higher power. (whichever lineage of Reiki we use, whatever symbols or hand positions we use, and whatever medications or surgery we prescribe, we must accept that we learn as much as we can, and use our best intentions, emanate compassion, and a higher force determines the future).

In a world where people die of cancer, relationships sometimes are shredded apart, and the earth is ruptured by volcanos, and wounded by man made oil spills, Amy's book relates the struggles and methods that come from Founder Mikao Usui, Sensei Hawayo Takata, and her beloved teacher Beth Gray, and adds the experience of her 23 years learning and practicing Reiki - it is as sub titled "practical methods for personal and planetary healing." I second the review of William Lee Rand, who wrote of the book, "it grounds one in the here and now and inspires practitioners to look deeply into their own healing and to help others."

I encourage anyone interested in Reiki, or practicing it, to read this book.

Reiki stories - not just for today

Every so often a story has to be told, not because of a thrill of competition or attainment, but because someone worked hard, bettered himself, and dedicated his life to compassion toward other people. And twice this week I found myself telling the story of a Nurse who died slightly more than 10 years ago, Gerald Smith of Station 1 at Forest Haven Nursing Home in Catonsville. Gerald Smith was an inspiration and a presence to those he worked with, and a source of compassion and caring to his patients.

When I first met Gerald he was a nurse's aide on Station 1. Everyone knew him as a person who was calm and slow to anger, who had dreams of bettering himself, of rising above the struggles of his youth. While he worked he went to school, and eventually became an LPN. We were so proud. He came back and worked on the same unit. And he kept going to school. A few years later he had completed his RN! And a few years later he was the RN Unit manager of Station 1 at Forest Haven. A kind and gentle man.

One day he came to me and told me that he had kidney failure, and that he had decided against dialysis. Many of us tried to convince him to accept treatment, but he was adamant, and he was taken from amongst us.

Every so often I would come across a GNA of intelligence and compassion, someone who I thought could better him or herself, and I would tell the story - but - for the last few years it had slipped from my grasp. Until this past week. And twice, I met GNA's who brought Gerald to my mind, and twice I told the story again.

Today, I was visiting Seasons Hospice patients at a nursing home in northeast Baltimore - and an RN saw me, ran over and said "are you Dr Bob from Forest Haven?" I had not seen this nurse in over 10 years, since Gerald's funeral, but she recognized me clear as day.

"Do you remember Gerald Smith?" she asked. And we spent the next 20 minutes sharing recollections. She had visited him the day before he passed away. This past week, she had felt as if "his spirit had been visiting" her.

There is no logical way I can account for things like this when they occur. But on a day when billions of people all over the world were placing their hopes on matches of athletic prowess, and on a day when people all over the world were willing to fight for one cause or another, we were remembering one man who had dedicated his life to the simple values of educating and bettering himself, and using that knowledge for caring and compassion towards others.

One wonders what the world would be like, if more people were like Gerald, and if people like Gerald were recognized as the heroes. If the moment that was remembered, as something to live up to, admire and dream of, was not "the shot" or "the goal" but the caring and the compassion.

Anneli Twan quotes Barbara Brown, one of the early Reiki Masters, in her book Memories of Hawayo Takata. " The five tenets are the spiritual side of Reiki and the only spiritual matter that is discussed at any tie during a Reiki class. They are really common sense ways of managing your life without having to refer to anything deep or anything mysterious or mystic. They are very beautiful standards of living."

"Just for today, do not anger.
Just for today, do not worry.
Just for today be grateful.
Just for today, do an honest day's work.
Just for today, be kind to all living things."

Gerald Smith of Forest Haven was a person who exemplified these concepts. That's why I shared his story in my Blog.

If you come across such a person, or such a story, remember it, tell it, share it, and keep the memory alive. Not just for today.

Reiki Focus - "Let me call you sweetheart"

It is almost a month since we were visiting Kuramayama, and yet today I was in Brooklyn Park, not New York, but Baltimore, in an old section of the city with poverty and middle class homes near the city's sports palaces. Some lives play in front of large crowds in endeavors that perhaps have enduring meaning, some lives play out with family and friends with no spectators, but may in the eyes of the creator have more significant meaning. Who am I to tell? I make home visits to Hospice patients, and my GPS has brought me here. I have called ahead, the door is open, no door bell, I knock and wait. It is near 100 degrees outside and perhaps just as hot inside. There is a small fan. And my patient, and her caregiver.

I sit down and we begin to talk. Mary is nearly 90, she has congestive heart failure and the specialists have told her going to the hospital won't help anymore. She needs care for all her needs, and Sally is there to help her. Why? Sally's daughter is the niece of the patient, who has no children of her own. The patient's sister's son being the father. When times were tough, and the father wasn't around, Sally's daughter's grandmother helped out, and so did her sister, and now Sally is "there for them."

If there are heroes in this world Sally is one of them. It is time for me to go, and I am still thinking about what can be done to help this family.

I am off to another home, it is an assisted living not so far away. It is air conditioned, I notice this fact - there are two patients to see, one suffering from dementia and one from severe Parkinson's disease. Hospice brings light - sometimes we bring medicines that help make life more comfortable, more livable. While it is not our philosophy to either shorten or prolong life, as long as we can make someone comfortable, we all try to find ways to help someone live just a little bit longer when we can. If medicines won't work though (and often in Hospice that is the case) - we bring other modalities, Chaplains, Reiki, and today - Music therapy. Seasons Hospice of Maryland now has 30 staff members or volunteers trained to Level 1 Reiki or above, and 4 full time Music therapists. Karen was visiting this home, she plays guitar and sings with a gorgeous voice, never with a very large audience, but people who are moved (almost magically) and are very appreciative.

And so Karen started singing, "Let me call you Sweetheart, I'm in love with you. Let me hear you whisper, that you love me too." I was examining Sarah, her neurologist had certified her as having terminal Parkinson's disease and she appeared quite "locked in." But hearing the music, I decided to put my stethoscope down for a minute and sing along, what harm could it do? I took Sarah's hands and sang along with Karen - "Keep the love light glowing, in your eyes so blue. Let me call you Sweetheart, I'm in love with you."

And she began to mouth the words, and then Sarah began to sing along. Karen played through the whole song again, and Sarah sang the whole song, and looking at me gave me this biggest smile. The other patients and the caregivers all started clapping for her.

At the office the next day, we had a meeting with our Founder and National President. Marcia Norman had started a new Foundation, and had raised money to be used "not for day to day operations," but to do special things to make a difference in some people's lives. Not people you understand, who we read about in the newspapers, just people who are struggling to live, and compassionate people who care for them. Marcia said, "we want to find projects that make a difference, maybe buy an air conditioner for someone who is suffering and can't afford one."

And my mind turned to Mary, fighting for her life, with Congestive heart failure, too ill for the cardiologists to do anything, and in a 90 degree row house, and Sally, who out of compassion was taking care of a woman barely related to her, who had helped her earlier in life - and people do that sometimes, they remember and they pay back with caring and compassion. And I said, "I have a patient who needs an air conditioner." And Marcia listened patiently to me (as she often does), and said, "OK Dr Bob, the Seasons Hospice Foundation will help that patient get an air conditioner."

It may be a long way from Kurama Yama, but the light that comes from compassion and caring from one person to another through Hospice, through Reiki and through Music Therapy, through Churches and Synagogues and Mosques and Temples and through nurses and doctors who come to people's home and witness their struggles and their lives - that light comes through to us.

For all those who participate in this work, volunteers, caregivers, healthcareworkers -

"Let me call you Sweetheart
I'm in love with you
Let me hear you whisper
That you love me too.
Keep the love light glowing
In your eyes so blue
Let me call you Sweetheart
I'm in love with you."

Your compassion is recognized and appreciated.

On keeping focus in difficult times

The past few weeks have been difficult times for physicians. Congress has failed in a promise to correct a methodology called SGR that results in an effective 21.2% cut in revenues to physicians.

Some physicians frankly, no longer trust Medicare, and wish to leave the system, or retire altogether.

How does one deal with this? How does one care for others - when one feels under attack and lacking security oneself?

Reiki has been a help to me in these times. I start with Reiki for myself each day, and a part of this is avoiding worry, avoiding anger, and being grateful.

Whatever I am paid, I have felt for many years that it is an honor simply to be entrusted with the care of people who are near the end of life. I see that my patients are facing problems far more challenging than the one's I face, and I am surrounded by volunteers, who are working for no salary at all - just as someone wrote me today "the opportunity to give back."

Nurses and aides work very hard, and are never thanked enough. I have felt the need to keep working hard, thankful to have the energy and opportunities I have been gifted with.

The Dalai Lama writes, "After all, what is the meaning of our life? In itself, there is no intrinsic meaning. However, if we use life in a positive way, then even the days and the months and the aeons can become meaningful."

Hospice workers make their lives meaningful by gifting compassion to other people every day they work. Volunteers in Hospice (including Reiki volunteers) do this without pay.

I came to visit a patient earlier this week. She is in the late stages of her struggle against cancer. Never married, her work has been her life. I walked into her house and knew immediately that she had been a teacher. "What grade did you teach I asked" (perhaps taking a chance).

"High school" she said. She taught math, and beyond that helped young people at a critical transition point in their lives. She shared some vignettes. "Once a teacher always a teacher." Now, near the end of life, teaching whoever happened to come nearby, even her hospice doctor.

Mrs. Takata taught us that Reiki is simple, "Hands on hands off" and "Reiki on Reiki off." Sometimes it can be even more simply than that. Near the end of life, finding a place of equanimity or peace, what we sometimes call Upekkha, can help with a critical transition from this state of being to another. We can do Reiki sometimes without a full Reiki treatment, or worrying about where the hands should be. Simple touch, one hand just touching another, and compassionate presence can bring so much. We are not trying to create attachments at this time, we are trying to release them, yet we want "no patient to die alone."

Another family I visited was terrified with the rapid decline of their loved one. They didn't know what to do. I suggested that they simply touch her hand, and let her know with or without words that they loved her. They told me, "it really helped, when we just touched her hands and she knew we were there, she was calmer and in less pain."

All of this month, I have focused especially on the five principles of Reiki- not to worry, not to be angry, to be grateful for the wonderful opportunities which I have had, to focus on working hard, and to give as much compassion as I could to those around me. I haven't had time to add up the "wins" or "losses."

The Dalai Lama talks about a sense of "which carries a responsibility so that you are willing to take upon yourself the task of helping others."

In fact, the basic premises of Christianity and Islam and Judaism and Buddhism all contain similar precepts. The mission in Hospice embodies the central tenets of all our major religions, it is at the place that they share in common. "when death finally comes," the Dalai Lama adds, " then your practice truly gives you some kind of inner gaurantee. After all, death is a part of life; there is nothing strange about it; sooner or later we all have to pass through that gate. At that time, whether or not there is a life after, it is very valuable to have a peace of mind."

And so all month, very important solemn promises have been kept by health care workers and volunteers all over America. Care and compassion have gone on. The real heroes continue to "give back" every day.

Reiki and Listening

This week I returned from a Journey to the source of Reiki light in Japan, and returned to my Hospice unit. We made rounds together Friday, and as so often occurs, while we tried to help a patient, she at the same time gifted us. I think my Japan experience was helpful in some ways, as was my Reiki inclinations.

Thelma (I will call her Thelma here - for the purpose of my Blog I rarely if ever use patients true names to allow for privacy) is living through the late stages of her battle with cancer, and she was sent to our specialty unit for pain management. It is always important to learn something about the person, and about their life before illness - so that we can look past a broken body and connect with the spirit of the person inside. They live with the memories of their relationships and their work. I always reflect on my own experience nearly 20 years ago, when I sustained a serious neck injury and had surgery, was in the hospital and thinking to myself "but I'm a doctor."

"Thelma, I want you to think of yourself as someone living this time, not as someone waiting to die, " I said. I sensed their was something important she intended to say, and added, "you have something important to say, maybe to your daughter and maybe to us, but we want to listen to you."

And she lied there in silence, her daughter sat in silence, and my team stood in silence. And we waited. Finally she looked at me, and slowly, began talking. She had a very responsible job, quite a bit of authority in health, and she shared some of that. But then she stopped and said very slowly and very clearly (I can hear her now) " L-I - S - T - E - N and then she slowly spelled it again and then finally said the word. Listen. "

She explained that she knew that we could not make her better (she is a bright person and understood her situation very clearly) - but that when she had come in, the first evening, our staff had not listened to her. She had attempted to talk about her fears and her concerns and her pain. And they just patted her on the shoulder and told her not to worry, "everything will be OK."

She didn't need to be reassured, or told "everything will be OK," she very much knew which way things were heading. She knew that we could not cure her, and she had forgiven us that. She had forgiven God for putting her in this situation at a young age, and she was not all that fearful, yes indeed she wanted medication for her pain, but what she really wanted was for people to
" L - I - S - T - E - N. " Not to respond, not to make up something, not to do something futile, in fact not to do anything at all, but simply to LISTEN. That simple act, listening, would give her a sense of respect as a person, and let her know that we really cared.

We sat in silence for awhile. And I said finally all that I could think of saying. First "thank you," and second, we would remember this ourselves and help our staff understand more, so that as a result of her sharing, future patients would have more of a sense that we listened, and that we cared, and that they were respected.

Thelma had a smile on her face. We had not increased her morphine, we had not cured her, we had not done anything at all .............except to listen.

The simplicity of Reiki has helped "attune" me to this. There is an interesting short book "Early days of Reiki, Memories of Hawayo Takata" written by Anneli Twan. It compiles memories of Mrs Takata, who brought Reiki from Japan to North America. It is only available through the author at www.morningstarproductions.ca - from this book page 22



One of the lessons that I brought back with me from a Reiki journey to Japan, is we need more "technicians" who can help "adjust antennaes." Health care needs people with clinical skill and scientific knowledge, but we can never forget how to simply LISTEN.

Thank you to "Thelma" and to Hawayo Takata

Reiki at Yushukan (and other places)

Back from Japan, I am struggling to process memories and energy from a culture both different and synergistic to our own.

Recently, an article written by the Dalai Lama was published in the New York Times, and it called people of all faiths to respect each other and work toward understanding, and peace. He related that at first he thought of his own religion as unique, but as he learned and grew as a soul he came to recognize other paths as valid. He reflected on crying with a Jewish Rabbi on hearing stories of the Holocaust.

And I cannot help but reflect on two places where tears came to my eyes. The picture here is of the shrine of Yushukan (or Yasukuni Jinja), dedicated to Japan's war dead. There is a museum that tells a very different story of the period leading up to The Great Pacific Basin War, or the Pacific portion of what we know as World War II. And perhaps, what matters, is not squaring the differences that led to that War, but seeing the human commonalities. At Yushukan, I found not anger or resentment, but white doves flying from one Gate to another, and people being helpful and friendly.

There is a hall dedicated to Japanese pilots who wrote "last letters" prior to taking off on Kamikaze missions. Right or wrong, these human beings genuinely believed that their nation was under attack, and they freely gave their lives. In dying many of them believed that their spirits would continue to look after their towns and families in death, in a way they could not in life.

And what is so striking in all the time I spent in Japan, is how much this is a forgiving people, and how much, while ready to defend themselves they yearn for peace and compassion.

Reading these human stories brought me to tears, as Yad Vashem brings me to tears, human beings share a common spirit.

There is a place on Kurama Mountain (Kuramayama) described in the book by Jessica Miller, "Reiki's Birthplace." It is usually missed, but easily accessible - I went to this particular spot not through reading the passages in this book, but because a talented Reiki practitioner who we mety in Japan, and who climbed Kuramayama with us, suggested I do so.

The Jessica Miller book concludes that in spite of similarities, "the religion of the followers of Kurama Temple has nothing to do with Reiki" (page 36). On page 86 of this book is a translation of a plaque in this sacred private place that says, "This treasure palace simply exemplifies the teaching of Kurama Mountain. All beings, including humankind, are manifestations of Universal Energy and are created by the Universal Life Being. The teachings of Kurama Mountain are: Be grateful at being given life, and take good care of other lives. Let us live to the fullest in order to improve and evolve our lives as worthy high and profound aspects of the Universal Life Being."

Agreeing or disagreeing with conclusions, this book is worth reading and is highly recommended, but without visiting this place and actually feeling the energy - it is hard to describe. And for many, the challenge will be to get out of their own perspective, and understand that the Creator of Life made many paths.

As I was in Japan, and as I visited various places, I sent energy to friends and patients, family and colleagues - and as well to a private email list of former students of Rick Rivard. While I was in Japan, by chance, Tom Rigler was also criss crossing Japan, and sending energy.

In many places Tom noted the presence of important Reiki energy, and of the presence of statues to Kannon (in Chinese Buddhism Kwan Yin). A statue of Kannon is present on the walk to the grave site of Mikao Usui, and a statue of Kannon is present in the special private place on Kurama Mountain. But the most moving site for me involving a Kannon statue was in Kamakura, where a large ancient statue is present, and mothers pray for the health of their sick children, and for the souls of their departed children.

In Western society, the possibility of "miracles" exist, but we tend not on a day to day basis to expect them, or to really believe in them. At the same time, some people work at Meditation, and having spiritual experiences, connecting with the spirit of living things around them, or the spirits of amcestors looking after them - in our world, such things are "possible." In Japan, it seems to me such things are expected - people seem to generally believe in miracles.

It does not stop them from going to Western doctors, no not all all, since the Meiji restoration Japan has sought science and advanced medical care, it simply means that at the same time, they would seek spiritual support. Use the doctor - but help the doctor along. A holistic spirit, that is something we sometimes, seek, is something that exists in their culture, it is something a school child knows.

Home from Japan, I have a hope that all cultures can attempt to respect and understand each other. From ashes of having cities bombed, and nuclear weapons used against them, I sensed no anger in Japan - simply a desire to have a peace in which they are respected.

Each culture has something to offer others. In Japan, there exists a deep sense of spiritual connection to the world of living beings, all with one creator. There seems a desire to live in harmony with other living beings.

Reiki Origins and Reiki Universality

Kuramayama is one of the most powerful energy places I have visited - but it is important to keep in mind that the genius and originality of Sensei Usui was not with the intention of bringing Japanese religion to the world, but rather, simple concepts of a method of compassion and healing that can be taught to almost anyone, and do not require faith or conversion.

Sensei Usui from his own origins struck notes of universality. In this regard it is important to view another site in Japan, rarely discussed in Reiki circles, which is Meiji Jingu, a shrine dedicated to Emperor Meiji and Empress Shoken.

Sensei Usui was moved by the Emperor and Empress, and exhorted students to read from the Emperor's poetry. The Five Basic principles of Reiki are attributed to lessons from the Emperor. Who were these persons?

The Meiji emperor ended centuries of Shogun rule in Japan, and supported the opening of Japan to the western world. Cultural ties were established, especially with France. The Emperor made a point it is taught of leading his people by changing to Western dress and eating western food. He is quoted as wanting to share the best of cultures and bring peoples together.

Here is an example of "waka" poetry by Empress Shoken:
"By self-reflection
And questioning our own hearts
We should then perceive
The proper path to pursue
And nothing would confuse us."

The brochure to this immense wooded park, with ponds and gardens, says simply: "Meiji Jingu is a Shinto shrine. Shinto is called Japan's ancient original religion, and it is deeply rooted in the way of Japanese life. Shinto has no founder, no holy book, and not even the concept of religious conversion, but Shinto values for example harmony with nature."

The principle value which the Japanese attribute to the memory of these beloved leaders is "Magokoro" or "Sincere Heart."

The concept of a Good or Sincere Heart is central to Judaeo-Christian and Islamic thought, and in indigenous peoples throughout the world.

So when Mikao Usui descended from Kuramayama, what is most important is not the powerful and magnificent energy of the mountain, or the specific culture that he arose from, but the effort to reach beyond himself, and beyond his own culture, to offer relief of suffering to human kind.

In Hospice and Long Term Care, having a sincere heart is as important as having clinical skill. For those who work in Hospice, and for those practicing Reiki, energy is sent to you from Japan, in the hope that whatever your own background or lineage, you will see commonality in the human condition, and in the attempt to bring compassion to the world.