Parallels between Hospice and Reiki

As a medical director, I don't always have the opportunity to lead "Team," but when one of my Team Physicians is away it is one of the things I really enjoy doing. Hospice Teams are uplifting to be a part of!

This week I covered a Team, and as so often happens in Hospice, the meeting started with a commemoration of the lives of those persons who transitioned while under the care of the Team in the previous week. While our music therapist played guitar, the names of each of the transitioned patients was read out loud by our Chaplain, and team members added remembrances .....

In thinking on the words of the song from our music therapist, i had to work at the translation, i am "functional" (by no means fluent) in Spanish and French but this was close and neither ..... and so i found our it was Latin - not one of my skills .....

Ubi caritas    et amor     Ubi caritas    Deus ibi est ......

or loosely "Live in charity"   "and love"    "live in charity"     "God is there"

Although Reiki is certainly not a religion, (and i wouldn't want to imply it was), our basic Reiki precepts of avoiding Anger and Fear, and Being grateful - of trying to work hard and bring kindness to others .... all reflect a sense of faith and connection.

Perhaps then - not "God is there" but a faith that we are all connected, that everything will work out for the best, that we simply need to be present and to do our part ........

Hospice team members face this every day .... they are helping people every day who have no hope for cure and yet still need to be cared for ..... if we cannot cure someone we can care for them and be there with them at least "just for today."

I have had a number of patients in the past week very near transition, still quite alert - and i have asked them what they believe will happen when they transition..... and a very interesting dynamic happens ......my patients witness to what faith strengthens them, they share ..... and i listen ..... in some ways i do nothing but be present.

And so often they look at me and tell me that they "are not afraid." And they are in less pain.

It is not my place to witness to them my beliefs, nothing in this moment is about me - it is time for me to be there for them and about whatever they happen to believe in ....

People ask me - "what do you do when you find an atheist" .... and really - the answer is the same .... i listen. In every case of caring for an atheist I have found that they appreciate someone else listening to them related about their life - what we often call "life review" -

My own self Reiki helps me in these moments ...... it helps me stay calm myself, and focused, and in a place without anger or fear - so that i can provide the simplest gift of being present and listening.

And so Hospice teams for me connect so effortlessly for me to my Reiki .....

For those interested in reading studies that are evidence based supporting the use of Reiki i advise

www.centerforreikiresearch.org

and for a recent study on music therapy

http://jama.jamanetwork.com/article.aspx?articleID=1687827

Keeping in mind the Reiki precepts and the best practices of Hospice,

Ubi caritas    et amor      ubi caritas     deus ibi est

Thank you to all who share these journeys!!

Ripples

Today i received a call from a former colleague ..... we had lost touch ...... he had been ill, i had left messages of concern, he had not had the health or time in his struggle to call me back ......i sent him prayers and Reiki energy from afar, and today recovered and returned to full work he called to talk ......and shared that in his darkest hours he had read some of the hospice stories on my Blog ..... and it had been helpful to him ......

Today i gave a teaching rounds for young physicians on Hospice, their attention and interest was moving .....and one young docs told me privately that they had read my Blog and that it is moving them toward a career in Palliative care.

And today a Reiki teacher who hadn't heard from me in awhile and who had not seen me post a new Blog for awhile decided to call just to see if i was OK .....

Yesterday someone called  - i had cared for a relative of theirs - and they just needed to talk ..... it is something we do in  Hospice...... we are available to talk about things ...... bereavement is a part of the Journey, a Hospice workers job doesn't end with transition.

This afternoon i talked with one of my hospice nurses, she had been up all night, she didn't feel 100 percent herself, but a patient she had been working with transitioned this afternoon and she felt the need to be with this patient and this family, no matter how tired she was.......

The stories i am seeing every day are so inspiring, home health aids,  nurses, social workers, volunteers, chaplains, music therapists, doctors .....going into patient's homes and working with families ...... keeping focus that people who cannot be cured are still alive and still important, still worth our time and caring ......it sometimes simply brings me to a place of awe seeing the commitment and hard work of team mates around me ........

I received an email last month asking how i would respond to someone who had been told, "Reiki shouldn't be used in Hospice" ("why not?" we used it all the time") ....... whether it is Traditional or unTraditional Chaplaincy, Music therapy, Reiki ...... finding methods that bring us to a place of calm help us share that calm with our patients...... fear and loneliness add to pain and suffering, and calm and connection bring light to the time people have .......it is a gift that helps the Journey.

Sharing stories is a good thing ...... because stories of courage and caring send ripples that help others in their Journey...... It reminds us that what we do is worth doing ......

To my co workers thank you for the inspiration you provide every day, to my patients thank you for being my teachers in your courage, to those of you who share stories of caring thank you........and perhaps ripples will continue to spread.

Wisdom from patients

Every day on the Hospice unit we seem to learn from our patients. Just before Thanksgiving we were talking with a patient who came to us for pain symptom management related to the cancer she was suffering from. Her oncologist had pretty much told her to get ready to die ..... but without curing her we had gotten her pain and shortness of breath under control, and were talking about sending her home - possibly Thanksgiving at home and encouraging her to pray for Christmas at home - no guarantees - but we were optimistic. She smiled and said, "every day above ground is a good day."

We were all touched by her smile and her positive spirit!! And i started to look for similar quotations - it turns out a movie used the same quote my patient had used, and there were many other versions.

"Badger" Bob Johnson, a famous hockey coach, suffering from brain cancer lifted his team reminding them "today is a great day for hockey."

And the fictional character Worf, in Star Trek Next Generation before a battle was frequently reminding all who would listen "perhaps today is a good day to die."

But my recollections date back to philosophy courses when i was reading a book by Carlos Casteneda, he was learning Native American wisdom from don Juan Matus, and was taught that a "warrior" has a certain way of living such that, "if one quickly looks back over the left shoulder, then it is possible to catch a glimpse of death."

Whether it is from conventional religion where we learn of "heaven," or from don Juan who seemed to perceive a mystical world from which spirit guided signs could lead to a different perception of reality, to agnostics who don't "know for sure" but want to be connected to the spirit of others in the world they live in ..... there is a common focus not on the decline trajectory leading to death but a focus on the moment, that the time we have is a time to live a part of life, a focus not on how we die but how we live the time we have.

Science and conventional medicine often seem to speed everything up - the clock is "ticking," when what we need most is to "slow everything down." Einstein said that time was "relative," and indeed for patients much depends on how they perceive it .....

This past week we had another patient come in for pain management. She had tumors spread to her jaw and simple eating had become a painful chore. We were working on just making her comfortable - but guess what? - she did not want us to change her medication, she wanted us to talk with her and listen to how she felt about things. Two days later we had not made any changes in her medication - she had refused my medication suggestions - and she felt MUCH better ...... what did she say?  We "were so nice to her" we "cared about her" and for her it made "all the difference in the world." She was ready to go back home and face some of the time she had, knowing that if she needed to she could come back to our unit, and we "would respect her wishes."

Our unit has had quite a few visitors lately - we always enjoy other professionals coming to share experiences with us. Many have been on other hospice units, and consistently what they are saying they notice about our unit is "the sense of calm." Our unit has a lot of ICU "step down" so we really are not a "low acuity" unit - quite the opposite, but one consequence of offering Reiki on our unit was not simply the impact on patients but the impact on us ...... and how we approached each day. We started to refer to death as "transition" and started to think about what we do as helping people to live, rather than helping them to die. We started to focus on how they could find "golden moments" rather than how hard it was for us to watch their "suffering." (we also unless a patient wanted it very much banned loud TV shows from our unit and focused on calmer sounds).

And so we seek not a "good day to die," but whether today can be simply a good day to live.

A simple clay vessel

Hospice remains a special field of healthcare, be it conventional or alternative, because in general we understand that a condition exists that we do not have the knowledge or tools to cure. Recently, I have had the opportunity to present to hospitalist physicians, and to some other interested groups - as regards the dilemma that we continue to care in cases where we cannot cure.

While our training and accomplishments may give us pride, this situation draws from us another need .....sometimes hard to define within our western accomplishment driven, personal growth driven, credential driven culture. I am not reflecting that any of these values are lacking in importance - simply that some situations ask of us another pathway .....

Some years ago I heard a tape of a mainstream Protestant Bishop - I do not mention his name in respect of his own requests - he was speaking to a Bishop's convocation and both exhorting to a higher level of faith, yet at the same time in some regards reflecting on his own career - as the invitation to deliver such an address at such a convocation is an incredible honor reflecting accomplishments that touched (directly or indirectly) the lives of 10's of millions of people on several continents. And what he reflected was that in every single one of his accomplishments he had simply been "an empty clay vessel." It was not because of his hard work, or his talent, but in  his reflection simply that although he may have been unworthy the higher power (he would say God) acted through him for God's own purpose.

In the Bible we see this sort of reflection - Moses sees himself not chosen because of his worthiness, he has a speach impediment, he lacks faith, he killed a man, he ran away ...... he does not ask to be called or seek the role he is given - the spirit chooses the prophet .........

In this struggle to define ourselves - caught between a culture which views attainment often as personal, and a result of hard work or talent which lead to deserved credentials and authority - and a spirit tradition that those who are chosen are not so selected for talent or worthiness but for the spirit or creator's undiscernable reasons ......it is interesting to reflect on some work coming out of South America today, particularly the work of Nobel prize winner Mario Vargas Llosa .....

Llosa in an interesting person in his own right, lost in a bid to be president of Peru, and having written extensively with novels reflecting a tension consistent with the mixed culture of South America - the blood and the history of both indigenous people and European cultures mixed together ...... In "Death in the Andes" he reflects on cultural issues seeking to understand what is occurring in the high mountain country - certainly a different view of Incan tradition than we would receive from a purely "western" analytic rendition..... and in "The Way to Paradise: a novel" he reflects on the experiences of the famous impressionist artist Gaugin, in Tahiti, juxtaposed with reflections on Gaugin's less well known but fascinating grandmother of mixed Peruvian and French descent who was a founder of the socialist and feminist movements in France ......

In Llosa's novels there is this tension between the western culture - and the indigenous - both present within the same person. And this different way of looking at the world ...... spirit acts and moves through us, not as a result of our attainment or worthiness - but because it happens that way, or - we are who we are as a result of our talent, hard work, and earned attainment.

Do we call upon "spirit" or does "spirit choose the" recipient for its own purposes? When we have a patient who our skills and education and experience can no longer cure, does our simple presence offer both a human connection and - as one speaker at an American Hospice and Palliative Care Meeting once said - "create a sacred space within which miracles can happen."

We all see in hospice, some recoveries that scientifically we absolutely cannot explain - in these moments do we search what we have done to determine which skills of ours were at play, or do we accept that we simply had the honor to be "present" - and that which worked in our presence was not related to our talent or merit?

Humility and Hospice

It occurs both in Medicine and in Reiki, that as we learn methods we have a tendency to think we have acquired "power." It is a special situation to work in Hospice, because here we have an awareness of our own lack of "power," and yet when we bring a sense of calm caring we find that those people who we cannot cure yet feel better from our presence.

Mrs Takata taught, it seems to me, a method of elegant simplicity, where we simply place our hands and let "Reiki" do the work.

If in some way we are capable of "connection" to a great source, (however we may name it), does it matter how much finite power, or energy, or vibrational level we ourselves have?

My Mom transitioned in April, and our tradition has us repeat on many occasions a "mourner's prayer." But the translation of this prayer (from the Hebrew to English) does not reflect at all on being in "mourning," it simply reflects praising and glorifying God's name, and giving thanks to the Creator of the Universe. This same prayer in a slightly differerent format is used almost as a "punctuation" to begin and end prayer services.

This is very much as a "doxology" in Christian faith, for example added to the "Lord's prayer" - "thine is the kingdom and the power and the glory." Some thought reflects this prayer as coming from Chronicles 1 - 29:11 and this specific prayer is utilized as well in the Jewish prayer sequence upon removal of the Torah Scrolls - the sheepskin scrolls upon which are written the 5 books of Moses - "Yours Lord is the greatness, the strength, the splendor, the triumph and the Glory."

In Chronicles, in context, what is occurring is that King David is dedicating the beginning of the building of the Temple in Jerusalem, and telling "the entire congregation" that all his successes and acts belong to the Creator. "For we are like sojourners before you."

Well - as physicians we are taught method, and in an evidence based way we use this method as best we can. With Reiki, we are taught a method, and we use this .....and in some places and in some times we can see incredible results and we can think that we accomplished something!

In Hospice we walk with much more humility. Our patient is with us because they have been "certified" as being beyond the scope of cure by evidence based medicine, and yet ...... we ..... and our patients, feel a positive benefit from our presence and our caring. Every so often - against all odds and for reasons we often do not understand, people rally and improve!!

When this happens, we may be wise to reflect that ours was not the power or the cure .........ours is a journey, and we strive to share the methods we have learned, and our caring and our presence. Sometimes we have the awesome joy and honor to be present when healing happens.

Reiki for Roger

I have had the honor of knowing Roger for about 9 years, he held court, that's the best expression i can say for it, at one of my Nursing Homes. Although he was limited by paraplegia and suffered from many ailments from before i knew him, he was of indomitable spirit, and his transition saddened me.

I have for some time been on his email list and he kept me up to date on the parties he had in, or went out to ....few patients in all my years working in Nursing Facility Care have had as many visitors or been taken out for as many activities as Roger.

And he was forgiving of my limits, of the fact that we could not cure his illnesses, or even make his symptoms go away, but that we could continue to care for him and be present for him.

On day Roger showed me with the greatest pride a photo album his friends made of one of his birthday parties. The joy he received (and gave) from (to) other people was truly astounding.

When he sustained a leg fracture, his orthopedist recommended either very taxing surgery or amputation which i felt was not necessary ..... as i discussed it with Roger without the surgery he could never bear weight on the leg, and as he said "I"m not stupid, I haven't been able to walk on that leg in over 10 years." We tried Reiki and eventually we reduced the pain, and Roger got what would be called a "fibrous union" - it didn't allow him to bear weight, but allowed him to sit up in his wheelchair, and go out with his friends, and avoid a major operation.

Roger in spite of all that was stacked against him won, because he did not focus on his limits or wait to die, he lived the days he had and sent incredible ripples to his friends and through the world - people are sharing stories about this incredible loving human being and are inspired.

In another case, Molly one of our music therapists played (and recorded) a version of "Heavenly Days" - the favorite song of one of our patients who recently transitioned, Gwendolyn. Gwendolyn loved this song more than any other, and was going to be played at her funeral, and remind her friends and loved ones of her spirit - and send ripples through the world.

And i met with another family member today, we were just being present as we waited for her Mom to transition. Her hospice room was a peaceful and comfortable place, and family were present and sharing stories. They had some questions for us about the health care process, and i explained that there were no medical treatment options, but sometimes people improved when we least expected it, and encouraged their prayers in their own way. And after we talked the daughter told us, "Thank God I found believers here, this could have been much harder. What we can see with the spirit eye is amazing, there are spirits all around us - if i didn't believe in that I would have no hope."

And so in honor of Roger, i would suggest that we go beyond the tenets of "do no harm" and "practice evidence based medicine" and suggest that we never take away hope, and that we remember those who we have had the honor to be present for, and let them continue to live by telling their stories.

When we could not cure Roger's leg by conventional means, Roger asked me to provide him with Reiki, and, he was able to get out again with his friends. Now that he is outside my site, i will continue to remember him in my sending of Reiki, and remember the power of his hope when i find other patients who we cannot cure.

From the Heart

It was in 1987 that i visited Jerusalem for the first time, and visited "the wall" (the "kotel") for the first time. This is a place that is sacred to Jewish people, in that it is viewed as the last vestige of the wall from "the Temple" that stood in ancient times. And within about 200 yards of this place is both the Church of the Holy Sepulchre, felt to be the site of "Golgotha" - the place of the death of Jesus, and the Mosque built on the sacred site from which Muslim's believe that Mohammed ascended to Heaven.

Lore has it that if one writes a message on a small piece of paper and stuffs it between the cracks in "the wall" the first time one visits, that the dream is likely to "come true." There are stories of families being reunited, and all sorts of miraculous stories surrounding this legend of leaving a message in the wall, miraculous healing, you name it - and so i took this moment very seriously. I thought about it for a long time.

In the end the message which i left in the wall was simple and brief, and not for anything specific materially, it was simply "open my heart to you God" (or in Hebrew taken from a brief prayer - literally open my heart to your Torah, which at some levels could be translated as the sheepskin scroll upon which is written the 5 books of Moses, the centerpiece of the ancient Bible, and for some would reflect "the law" as specifically represented by 613 commandments, and for some the "letters" or tools with with God creates our world, but for me the simplest meaning would simply reflect on Torah as God since the essence and spirit and soul and thoughts and wishes of God make up all of our world and connect us........)

As i have tried in my Hospice journey to explain to the numerous people who have asked me "how can you do this work" and "isn't it depressing" - that no, it is an honor, and the having people allow me to share and assist them in their journey is both a mission and a chance to grow, a "job" for sure, but more that that, and bottom line a place for the heart, where beyond being a "science" person or applying skill, I am often simply present for people to keep them company or be a witness of their journey, to help in small ways not just to relieve their suffering but to assist in a focus for them not on "how they die" but how they live the portion of their lives that they are journeying through.

And in Reiki more and more i read and hear and feel the spirit of masters seeking their own highest potential through a journey that is centered and moved by our hearts.

For some it is attaining a higher level or a higher vibration or having more power or being able to heal, and for some it is simply being "present" and being in a state of acceptance or submission to the creative energy that sustains (not simply created but continues to create in each moment) us and our world.

Recently - in one of my favorite Reiki list servs, there has been an extended discussion about Reiki Tummo, a specific path taught by I Effendi ("Reiki Tummo, an effective technique for health and happiness"), and a quote from the master "you have written your book of Life from the perspective of your brain, are you now willing to re-write your book of life from the perspective of your Inner Heart?"

Having had the honor of being present and sharing countless journeys in hospice, and from the little i have learned of Reiki, i can't say that i have more specific answers to questions than on the day 25 years ago when a placed a small note in a crack between stones in a sacred wall, asking the creator to "open my heart" ...it has been and remains a Journey.