The Hero's Journey

We are all on a hero's journey...a metaphor for our lives. At the recent Massachusetts Conference for Women, I became acquainted with a beautiful poem, Ithaca by Constantine Cavafy, which conveys the hero's journey in prose. How often are we only on a quest for Ithaca, the Holy Grail, Nirvana...you get the picture...goal driven without respect to the wisdom we gain along the way? May your journey be long and adventurous on your way to your Ithaca.

Ithaca (by Constantine Cavafy)

When you set out on your journey to Ithaca,

pray that the road is long,
full of adventure, full of knowledge.

The Lestrygonians and the Cyclops,

the angry Poseidon -- do not fear them:

You will never find such as these on your path,

if your thoughts remain lofty, if a fine

emotion touches your spirit and your body.

The Lestrygonians and the Cyclops,

the fierce Poseidon you will never encounter,

if you do not carry them within your soul,

if your soul does not set them up before you.

Pray that the road is long.

That the summer mornings are many,

when,with such pleasure, with such joy

you will enter ports seen for the first time;

stop at Phoenician markets,

and purchase fine merchandise,

mother-of-pearl and coral, amber, and ebony,

and sensual perfumes of all kinds,

as many sensual perfumes as you can;

visit many Egyptian cities,

to learn and learn from scholars.

Always keep Ithaca on your mind.

To arrive there is your ultimate goal.

But do not hurry the voyage at all.

It is better to let it last for many years;

and to anchor at the island when you are old,

rich with all you have gained on the way,

not expecting that Ithaca will offer you riches.

Ithaca has given you the beautiful voyage.

Without her you would have never set out on the road.

She has nothing more to give you.

And if you find her poor, Ithaca has not deceived you.

Wise as you have become, with so much experience,
you must already have understood what these Ithacas mean.

Click here to hear Sean Connery read Ithaca with video and musical imagery

I would love to hear your comments on how this poem speaks to you and your hero's journey.

Massachusetts Conference for Women

I was honored to be one of nearly 5,000 women filling the halls of the Boston Convention Center today for the fourth annual Massachusetts Conference for Women, featuring more than 85 speakers, including headliners Lesley Stahl of CBS 60 Minutes, columnist Liz Smith (who, by the way, is 85 years old and still going strong), publisher Joni Evans, columnist Judith Martin (Miss Manners) speaking about their new joint venture, wowOwow.com, Holly Robinson Peete and Marianne Williamson. The Conference’s theme, “The Next Chapter of You,” was highlighted throughout the day encouraging attendees to invest in themselves and give back to their communities.

Jessie M. Gaeta, M.D. was honored with the Conference’s Be the Change Award. The award recognizes a woman who rises above and beyond in the realm of service by shining light on an unmet need in her community. Dr. Gaeta dedicates her life to caring for the homeless. As a practicing internist at Boston University Medical Center and Boston Health Care for the Homeless Program, she treats homeless patients on the streets and in shelters. Dr. Gaeta also leads policy advocacy at the Massachusetts Housing and Shelter Alliance. By raising awareness of the public health implications of homelessness and the cost-effectiveness of a Housing First approach, she has successfully influenced lawmakers to create social change through the institution of new approaches to ending homelessness.

Click here for photos of the 2008 Massachusetts Conference for Women

I attended some amazing breakout sessions with speakers, Ariane deBonvoisin, Abby Seixas, and Marilyn Paul, whose strategies of change, self-care and organization of the inner and outer aspects of our lives expanded on Marianne Williamson's keynote statement: "The only antidote to the chaos is a deeper way of living".

The fifth annual Massachusetts Conference for Women is slated for Dec. 10, 2008 at the Boston Convention & Exhibition Center. I am planning on attending again, and would love to have some of you join me!

Did you attend the conference this year? I would love to hear your comments...what were the take home messages that resonated with you?

Engage with Grace

Thanksgiving is a time we traditionally gather together with family and friends to express our gratitude for being able to share food and companionship with one another. It can also be a wonderful opportunity to share with loved ones our most personal wishes for what we hold important to us at the end of life if we were unable to speak for ourselves. I was pleased to be invited to play a part in spreading the word on the Engage with Grace: One Slide Project by Paul Levy, CEO and president of Beth Israel Deaconess Medical Center in Boston. The goal is to begin this important conversation with loved ones before the need arises, so you can best carry out their wishes and choices if they cannot speak for themselves. From Nov 26-Nov 30, health bloggers across the globe will be sending out the same message to their readers, hoping that we can help you find the words to begin this compassionate conversation with your friends and family.

We make choices throughout our lives - where we want to live, what types of activities will fill our days, with whom we spend our time. These choices are often a balance between our desires and our means, but at the end of the day, they are decisions made with intent. But when it comes to how we want to be treated at the end our lives, often we don't express our intent or tell our loved ones about it.

This has real consequences. 73% of Americans would prefer to die at home, but up to 50% die in hospital. More than 80% of Californians say their loved ones “know exactly” or have a “good idea” of what their wishes would be if they were in a persistent coma, but only 50% say they've talked to them about their preferences.

But our end of life experiences are about a lot more than statistics. They’re about all of us. So the first thing we need to do is start talking.

Engage With Grace: The One Slide Project was designed with one simple goal: to help get the conversation about end of life experience started. The idea is simple: Create a tool to help get people talking. One Slide, with just five questions on it. Five questions designed to help get us talking with each other, with our loved ones, about our preferences. And we’re asking people to share this One Slide – wherever and whenever they can…at a presentation, at dinner, at their book club. Just One Slide, just five questions.

Lets start a global discussion that, until now, most of us haven’t had.

Here is what we are asking you: Download The One Slide and share it at any opportunity – with colleagues, family, friends. Think of the slide as currency and donate just two minutes whenever you can. Commit to being able to answer these five questions about end of life experience for yourself, and for your loved ones. Then commit to helping others do the same. Get this conversation started.

Let's start a viral movement driven by the change we as individuals can effect...and the incredibly positive impact we could have collectively. Help ensure that all of us - and the people we care for - can end our lives in the same purposeful way we live them.

Just One Slide, just one goal. Think of the enormous difference we can make together.

(To learn more please go to www.engagewithgrace.org. This post was written by Alexandra Drane and the Engage With Grace team)

Happy Thanksgiving and may your Thanksgiving table be filled with companionship, compassion and conversation.

Putting the Patient First

As much as I believe we currently have a very broken system of health care in this country that is in urgent need of healing; when I see an organization that is doing right by the patient and families it serves, I readily applaud their success. Such is the case with Beth Israel Deaconess Medical Center (BIDMC) in Boston. While not part of the mega-Partners Healthcare group in the Boston area, they have been an institution at the fore of patient centered care, being one of the first hospitals in the country to institute primary care nursing over 30 years ago. I regularly follow the blog written by the CEO of BIDMC, Paul Levy. Through his blog, Running a Hospital, he has added transparency, humanness and compassion to the commonly hidden world of hospital administration. He has also helped to create a culture of cooperation and patient centered care among hospital staff that is truly remarkable. This culture of cooperation is evident by the following letter from a patient Paul Levy posted on his blog:

"As far as I'm concerned, you can take all those posted quality metrics and throw them out the window when you get a letter like this one that I received from a patient:

BIDMC is a special place. The nursing care deflates your stress about being
in the hospital. The doctor's talent makes you believe you have the best
possible care. The atmosphere makes you feel that people like their jobs and
feel invested in them, so you feel that everybody is paying attention, whether
they are cleaners, food service, transport, department heads, trustees.I
especially noticed the employees' investment in their jobs. (NURSE: "Doctor, I
noticed you are testing Ms. X for TB. If we believe she might have TB, should we
institute those protocols now?" TRANSPORT: "The nurses are really busy. I'll
reconnect your oxygen so you can go back to bed and I'll tell them that I did."
NURSE: Let's not wait for the bed to be changed. I want it to be dry for you
when you have these fevers." She changed the bed and me three times that
night.)Symbol of cooperation regardless of rank or function: Nobody left my room
without taking my meal tray with them.

Posted by Paul Levy at 11/20/2008 10:28:00 AM"

Wow!!!!! All I can say is kudos to Paul Levy and the staff at BIDMC for creating and maintaining a culture of cooperation and compassion and showing us that it is possible.

Road to Hope

"Hope is like a road in the country; there was never a road, but when many
people walk on it, the road comes into existence." Lin Yutang 1895-1976

As I came across this quote, I immediately thought of the monumental election on November 4 in which we have just participated. With any change there can be natural resistance and fear of the unknown, but this can also be coupled with unexpected opportunity. No matter if you aligned yourself "Blue" or "Red" during the past year, let us come together in this historic time and build a road of hope together, by walking side by side until the road comes into existence. I wish you hope, healing and gratitude during this month of Thanksgiving.

Saying OM instead of Ahh in NYC

Kudos to fashion designer Donna Karan for putting her money where her mouth is by donating $850,000 for the initiation of a pilot program on integrative therapies at the Beth Israel Medical Center in New York City. The program, highlighted in today's New York Times ,will include yoga, reflexology and aromatherapy as integral parts of a patient's treatment plan, if they wish. I am a firm believer that we can enhance our healing process if we are given options and choices in creating our own care plan, including the best that modern medicine and traditional healing practices have to offer. What a wonderful resource to have a myriad of options available to the patients at Beth Israel. I wish the pilot program much success!

Opportunity Within Crisis

barn's burnt down;
now I can see the moon

~ Masahide

I came across this poignant haiku this morning. Mizuta Masahide was a samurai in the Zeze domain of Ohmi Province. In 1688 Masahide's house was burnt down, prompting him to write his most famous haiku. The haiku seems very current and relevant to our challenging present times. Can we also see the opportunity within the crisis?

There Is More To Life Than Increasing Its Speed

"There is more to life than increasing its speed"
Mohandas Gandhi (1869-1948)

Challenging times call for challenging the way we view life. Our natural instinct, when we perceive danger and crisis, is to speed up, try to escape, run away or attack...this works well if you are confronting an aggressive wild animal, but not so well if your "wild animal" looks like economic uncertainty, 24-7 technology, or lack of job security. As counterintuitive as it may seem, research supports mindfully slowing down in times of crisis to decrease the harmful physical effects of stress, increase mental focus and productivity and to regain a sense of internal equilibrium. While we cannot always change external forces in our lives, we can focus on skills to build our resiliency, slowing down, taking a breath, and challenging ourselves to create new ways of viewing life.

What are your thoughts about building resiliency during challenging times?

Lack of Empathy or Scared of Mortality?

An article in today's Boston Globe caught my eye....a small study conducted at the Veterans Affairs Hospital in Houston assessed verbal interactions between patients diagnosed with lung cancer and their physicians.

Here is an example of one of the verbal interactions:

During an appointment with his doctor, a man diagnosed with lung cancer sounded dispirited when talking about what cigarettes had done to him:

"I was always told I had a good strong heart and lungs. But the lungs couldn't withstand all those cigarettes...asbestos and pollution and secondhand smoke and all those other things, I guess", the man told his doctor.

"Do you have glaucoma?", the doctor responded, abruptly changing the subject."

In the study analysis researchers identified 384 times during these interactions when patients mentioned concerns, worries and emotions concerning their mortality and deadly diagnosis...their doctors responded with empathy only 39 times or approximately 10% of the time! Wow...how very sad for both the patients and the physicians, that they each missed an opportunity to make a human connection. However, when I thought about the study, was it really a lack of empathy on the physicians' part or were the physicians simply scared and unsure of what to do and say to a patient with a terminal diagnosis? Perhaps acknowledging and honoring the human emotions that exist for both the patient and the health care practitioner is the first step to providing competent and compassionate health care.

What do you think?

Let Me Down Easy....What is Grace?

What is grace?...That is the overarching theme and question that resonates in Anna Deavere Smith's new one woman dramatic work Let Me Down Easy: a play in evolution currently being performed through October 11 at the American Repertory Theatre (Loeb Drama Center Harvard Square) in Cambridge, MA. I had the incredible experience of being in the audience on September 16 to witness and share in the journey Anna leads us through during the two hour performance. Through the stories and voices as varied as Ann Richards, former governor of Texas to Matthieu Ricard, a Buddhist Monk; from Jean Damascene Uwikijie, a Hutu prisoner in Rwanda to Dr. Phil Pizzo, Dean of Stanford Medical School; we are confronted with looking at ways in which our bodies and souls are both resilient and vulnerable. A sense of wonder, beauty, stamina, fear, grief and courage shine through all the vignettes...a snapshot into simply being human. "The only whole heart is a broken one, it lets the light in..."says the voice of Rabbi David Wolpe in Let Me Down Easy. Perhaps this is the essence of grace, to open oneself to the frailty and resilience of the human spirit with compassion and awe. What does grace mean to you? I would love to hear from you!

September....NEW YEAR

"The purpose of life is to live it, to taste experience
to the utmost, to reach out eagerly and without fear for newer and richer experience."
Eleanor Roosevelt--diplomat & reformer (1884 - 1962)

For me, the beginning of September feels like "the new year". Perhaps this is a vestige from my school days when the anticipation of new notebooks, sharpened pencils and the carefully selected first day of school outfit loomed large in my life. I love the way September days seem bright with promise, even though nothing except the calendar page has changed. Do you also feel this way? Why not embrace this month of September as an eager learner again? As lifelong learners we can learn to observe the fear that accompanies any change, while also relishing in the fact that we are never too old to challenge ourselves with new ideas, dreams and goals. I invite you to take this opportunity to sharpen a new pencil or two, take out a fresh piece of notebook paper, and write down at least one new thing you will try during this "new year" that you have never tried before...I promise there will be no pop quizzes or graded exams this time around!

Enjoy the anticipation,
Pam

Graduations and Commencements

Graduation...

Commencement...

a time of taking measure and of new beginnings.

As you may have guessed, endings and beginnings are on my mind this month as my youngest child graduates from high school and prepares to start college in the fall. As parents, we measure each of the milestones we witnessed, marking each as "graduations" or intervals in our children's lives and our own. Now is the time for "commencement", a new beginning; stepping, running or leaping into the unknown and trusting the trajectory! May we all have the courage to let go and fly....

"Your children are not your children.

They are the sons and daughters of Life's longing for itself.

They come through you but not from you,

And though they are with you, yet they belong not to you.

You may give them your love but not your thoughts.

For they have their own thoughts.

You may house their bodies but not their souls,

For their souls dwell in the house of tomorrow, which you cannot visit, not even in your dreams.

You may strive to be like them, but seek not to make them like you.

For life goes not backward nor tarries with yesterday.

You are the bows from which your children as living arrows are sent forth.

The archer sees the mark upon the path of the infinite,

and He bends you with His might that His arrows may go swift and far.

Let your bending in the archer's hand be for gladness;

For even as he loves the arrow that flies, so He loves also the bow that is stable."

--Kahlil Gibran

May this be a season for your own commencement,
Pam

Happy Holidays

As I write this post, I am still glowing from the sight of 1200 luminaria lining the snowbanks and illuminating the night sky of our neighborhood on December 24. It is a tradition we have had in our little section of Concord, Massachusetts since 2001...and reminds us of community, hope and peace.

What struck me this year is how such simple and seemingly insignificant ingredients alone...a white paper lunch bag, a utility candle and some sand...can create such an amazing sight together. Perhaps from the simple luminary is a message for 2008....while each of us has a burning flame within us, imagine what an amazing light we can create together. May 2008 be filled with light, peace, and community for us all.

Many thanks to Rich Stevenson for these photos.

Happy Thanksgiving

Happy Thanksgiving...wishing you all a season of gratitude. A wonderful little book, Arriving at Your Own Door: 108 Lessons of Mindfulness by Jon Kabat-Zinn, happened to land on my desk this week. As I opened to the first page, a poem by Derek Walcott jumped out at me....reminding me once again of the gratitude I feel daily for the gift of life, love and mindfulness. May you arrive at your own door this Thanksgiving. With gratitude, I share with you Derek Walcott's poem:

The time will come

when with elation,

you will greet yourself
arriving

at your own door, in your own mirror,

and each will smile at the other's
welcome.

and say, sit here. Eat.

You will love again the stranger who was your
self.

Give wine. Give bread. Give back
your heart

to itself, to the stranger who has loved
you

all your life, whom you
ignored

for another, who knows you by
heart.

Take down the love letters from the
bookshelf.

the photographs, the desperate
notes,

peel your own image from the
mirror.

Sit. Feast on your life.

Derek Walcott, "Love after Love"

Integrative Therapies in Treatment of Chronic Pain

As many of you know, I have a clinical interest in integrative therapies in healthcare treatment. An interesting segment on chronic pain and its treatment aired on the 11/09/07 Today Show. Click here to view the video. Chronic pain is a huge issue in terms of quality of life, worker productivity, and overall health and wellbeing in the U.S. today. It is estimated that over 50 million people in the U.S. suffer from chronic pain conditions. Like many other maladies, chronic pain usually is not curable, but is treatable. We need to open our minds to integrating age old wisdom together with high tech medicine to acheive the best possbile outcomes.

We are "LIVE"

"LIVE"...What a curious way to describe getting a blog and website up and running! But, it is a wonderful way to kick off my new blog which I hope will inspire you to explore, learn and share insights and challenges on sustaining and building resiliency in our lives...work, home and health. I look forward to sharing some of my thoughts, news, and links with you. Let me know you are out there by commenting!