At one time if you looked up Type A Personality in the dictionary you would find my picture. To say that I was a ball of stress was to put it mildly. However, I knew that living with too much stress was not good for me and I set out to overcome stress and my reactions to it. In an effort to overcome stress, mellow out and basically improve myself as a human being I read every self-help book I could get my hands on. I read everything from Dale Carnegie to Dr. Wayne Dyer. As I pored over these books and tried everything imaginable I came to the realization that was I was getting really stressed trying to overcome stress itself. Oh, there was some improvement but not as much as I wanted; not until I came across a book titled Wherever You Go, There You Are by Jon Kabat-Zinn. First published in 1994, Wherever You Go, There You Are has made a big change in my life and it may literally have saved my life: more about that in a bit.
I have probably read the book somewhere near 20 times or more since I first read it in the mid-'90s. At first glance Wherever You Go, There You Are seems like a book about meditation. Indeed, a large part of the book is taken up with meditation practices and instructions on how to meditate. But, meditation is just a tool that is used to bring about the state of mindfulness. Mindfulness can be a difficult concept to grasp and can be confused with the practices of Zen, Buddhism and Taoism. There are similarities to those but mindfulness is in itself not a religious or moral philosophy. At its most basic, mindfulness is being acutely aware of your actions, yourself, your surroundings, your thoughts and your reactions to those thoughts. Once you get the hang of it, it is as though you are an observer; not only of yourself and things around you but also of your thoughts and actions. Those of you who are or were athletes can liken it to being in “the zone." It is a state of non-doing; effortless effort; a state where there is no you or action being performed by you, it is as though all is one and any activity you are engaged in is unfolding by itself and while you are engaged in that activity you are somehow disengaged and have become an observer of the unfolding of that activity. I wasn’t much of an athlete but I do remember being in the zone during one particular basketball game in high school and later in life I remember being in the zone several times while playing golf, especially during the two holes-in-one I had.
The most important thing in cultivating mindfulness is making use of your breath to center yourself during times of great stress. According to the general adaptation syndrome, one’s first reaction to a period of great stress is to either fight or flee. Mindfulness avoids both reactions by centering yourself on your breath and becoming an observer of what is happening and thereby avoiding what could be a catastrophic reaction to times of great stress. In the interest of brevity I will leave it to those of you who may be more interested in mindfulness to pick up a copy of Wherever You Go, There You Are and decide for themselves whether it mindfulness might help them.
Now on to how mindfulness might actually have saved my life; if not my life it certainly may have saved my sanity.
In October of 2006 my wife was diagnosed with breast cancer. One thing was apparent from the start: No matter how hard I wanted to help, no matter how much I cared, when someone you love develops cancer of any form there is really nothing that you can do. Sure, you can try to comfort that person. You can be there for the person you love but the reality is that each person who gets a cancer of any form must face it in his or her own way.
After the diagnosis my wife underwent a surgery procedure called a lumpectomy where the tumor was removed along with some lymph nodes. While she recovered from the surgery we waited for the results of the biopsy of the tumor. A few weeks after the surgery I accompanied my wife to her first visit to the oncologist. There we received the news that my wife’s form of cancer was a particularly aggressive form with a high rate of recurrence. She also tested positive and very high for something called the HER2 receptor. The oncologist determined that my wife’s treatment needed to be as aggressive as the cancer and my wife would have to undergo a year of treatment to combat the cancer. The oncologist prescribed a series of radiation treatments, along with several chemotherapy drugs and an antibody drug to combat the HER2 receptor. On somewhat of a bright note her surgeon had done a good job in removing the cancer and the removed lymph nodes showed no sign of the cancer having spread.
If going to a cancer center in the hospital wasn’t bad enough, the long walk down the hallway to the cancer center makes it all the worse. Once you reach the end of the hallway you enter the room where patients are waiting to receive their radiation treatment. It is pretty much a standard waiting room with the exception that it is packed wall to wall with people, all with cancer except for the few family members present. As I waited for my wife to get her radiation treatment I would sometimes talk to other patients awaiting treatment. Some were upbeat and open about their conditions. Others were resigned to having cancer and having to get the treatments that may or may not save their lives. There was one common thread: that was the feelings of the family members that were with the patients. For the most part the family members seemed to be at least emotionally suffering from the same mental state — one of helplessness. All would have gladly traded places with their loved one. But that wasn’t possible.
The treatment room at the oncology clinic was particularly depressing — at least to me. The room was one large open area with approximately 30 extremely uncomfortable recliners where the patients received their chemotherapy. The chairs were quite close to each other and there was no separation of any kind between patients. It was not uncommon to look across the aisle to see a patient being stuck with an IV needle and being hooked up to various sized bags containing the drugs prescribed for them. Being a bit squeamish I usually turned my eyes when a patient would be connected to their IVs. The ones I found most disturbing were when a patient had to receive his or her chemo via a port surgically installed in them or receive their chemo treatment via a needle in their abdomen.
My wife’s initial chemotherapy consisted of being connected to three IV bags, which at the start took up to four hours to empty into her veins. My wife was able to take her treatments in stride, and I as the dutiful husband went to her treatments with her. But, I at times felt that I was letting her down; not being able to do anything to make her chemotherapy more bearable.
The weekly treatments were interspersed with visits to her oncologist, followups with the surgeon and visits to various departments of the hospital for this test and that test. One of those tests was a thing called a MUGA scan (Multiple Gated Acquisition scan). In this procedure we had to once again descend into the bowels of the hospital and wind our ways through the labyrinths of the hallways that connect the outside world to the radiation center of the hospital. This test could not have been fun for my wife. She first had to have blood drawn. The blood was then treated with a radioactive material and was then injected back into her. Afterward, she had to lay perfectly still on a cold table so an overhead camera could check the condition of her heart. It seems as though one of the drugs she was being given had a history of possible heart damage and she had to have this scan every three months.
The weekly chemotherapy and intermittent tests were our routine for almost a year. My wife’s blood work showed that the chemotherapy was apparently working well and by October of 2007 we were looking forward to the end of her treatments late in December. Things were looking so good that she decided to buy a new car in October. God knows she deserved it. However she only got to drive it for a couple of weeks.
On Oct. 27, 2007, my wife had an appointment with her primary care physician. Since it was just a standard checkup not related to her cancer treatments I decided not to go with her and stayed home. About two hours later I got a call from her. She said that she had fallen in her doctor’s parking lot and needed to go to stat care. I got in my car and drove to the doctor’s office, which was only about five minutes away. When I got there my wife was sitting on the sidewalk with a sheet of paper in her hand. I asked what had happened and how badly she was hurt. She told me that she had slipped and fallen on a defective wheelchair ramp at her doctor’s office. She said that she had lain there for some time and when no one came by to help her she drug herself into her doctor’s office where her doctor examined her and gave her an order to have X-rays taken at stat care. To this day I am still mad as hell at her doctor for not calling the rescue squad and having her taken to the emergency room. Just looking at her with various cuts and bruises as well has what looked to be a broken foot should have warranted an ambulance ride to the emergency room. When I got her to stat care they did take her right in, checked her out and took X-rays.
This is where the story gets me a little more upset. The X-rays showed that she did have a broken foot as well as a fractured shoulder bone and a dislocated shoulder. Instead of treating her or sending her to the hospital they gave her another piece of paper and told her to go to an orthopedic doctor. Incensed, I drove her to Omni Orthopedics, where her broken foot was put in a cast and her shoulder was popped back into place. I found a sympathetic ear in the director of Omni Orthopedics and he called the stat care facility and chewed them out for letting my wife leave in her condition. If there was ever a day from hell, that was it.
A couple of days later it was time for her cancer treatment. This time the treatment was to be different. I had to wheel her into the clinic and help her into the chair for her treatment. If things weren’t bad enough for my wife, when the nurse tried to connect my wife to the IV she couldn’t find a vein for the needle. Her veins had been shrinking from the numerous IVs that she had to endure. Her veins were barely visible and so small that the nurse couldn’t get a needle in even using an ultra fine hypodermic needle. Two, three, four times the nurse tried — to no avail. Another nurse came and tried several times more. As I watched, I wanted to cry out, “Here, use my veins. Mine are large and getting a needle in them is no problem.” But no; following the principal of helplessness that governs the behavior of family members — no substitutions are allowed. Finally after what seemed to be eight or nine tries the nurse was able to get an IV into my wife and she was able to receive her treatment.
Later that evening after my wife had gone to bed, I took my shower and sat down in the living room to relax a little. As I sat in the darkness a strange feeling came over me. At first it just seemed like a little nervousness but then the feeling took an unexpected turn. Slowly but intensely I began to feel as though all emotion was being drained from me. It seemed as though my very being was being sucked out of my body. I remember thinking “so this is what a nervous breakdown feels like.” It was then that I remembered the practice of mindfulness that I had been working on. With what I had left in me I began to concentrate on my breathing. Just watching and experiencing my breath as it went in and out. I went into the mode of an observer, watching what was going on with my body and my emotions. No panic. No resistance. Just watching. Observing without emotion. Slowly the feeling of being drained subsided. Still watching my breath, normalcy started to return. It seemed like a lifetime but it probably only lasted a few minutes. I am sure that had I panicked and given into the fight or flee response of the general adaptation syndrome I might possibly not have made it through that episode and might actually have had a nervous breakdown.
About two months later after my wife’s treatments for cancer had finished and she was about to start physical therapy for her injuries from her fall she caught pneumonia and spent a week in the hospital. One evening after a particularly stressful day trying to deal with an hospitalist doctor with an attitude, I headed home. That night as I sat in my chair, the feeling of my very essence wanting to leave my body came back again. But this time I recognized what was happening and was able to deal with it much more easily. Early on I concentrated on my breath and went into observer mode. This time the feeling was much less intense and didn’t last nearly as long.
Shortly after, my wife had regained her health. My mother was diagnosed with a form of leukemia that would eventually take her life. During this time, another minor occurrence of this feeling returned, (See my blog Watching Momma Die). From the time my wife was diagnosed with breast cancer and the death of my mother was a period of almost three years. Three years of hell that I don’t think I could have coped with had it not been for Jon Kabat-Zinn’s book.
Wherever You Go, There You Are has changed the way I deal with difficulties in life both big and small. No longer do I throw wrenches against the wall when I can’t fix something. Nor do I curse and swear anymore while trying to make sense of the directions that came with my new gas grill. (Those inscrutable little Chinese, print equally inscrutable owner’s manual). I can now take almost anything with equanimity.
Even such a calamitous event as the July 19 deluge that hit our area and backed up the sanitary sewer into my basement didn’t cause me to lose control of myself. As my recreation room turned into a pool of sewer water I simply focused on my breath and became a nonjudgmental observer. I looked at the sewage coming up through my floor drain and calmly observed it without letting it control me. Trouble was I was so wrapped up in being an observer that I didn’t observe the water that was now up to my ankles and it was then that I remembered the electricity was still on. Sometimes fleeing is still an appropriate response.