My understanding of what it means to live a spiritual life has evolved over years of practice and possibly to a greater extent, from my decade-long experience with breast cancer.
When I was first drawn to the dharma I was seeking the joy and peacefulness missing in my life. Now, moments of love, joy and acceptance are more plentiful—yet I don't regard them as the goal. For now, in the depths of my journey with illness, it is a wild dance of opposites: hope and despair, fear and acceptance, delusion and clarity, struggle and surrender.
Finding the courage to open my heart to these depths has been transforming and has often led not to more pain, but to more peace and acceptance. It is as if I entered the darkness and emerged into the light
Without illness, when all is well, it’s too easy to just intellectually accept the truth of suffering. Cancer has challenged me to practice dharma in the trenches. It has opened my heart to my own suffering which I now see as the suffering of all. It has been the birth of compassion and courage in my life, an unexpected gift.
A year-and-a-half ago, I developed a serious viral infection. I was in bed for three months, off work for six, and today I am still only about sixty percent better.
For many years, part of my daily practice included reciting metta phrases from the Theravadan tradition, phrases such as “May I be peaceful,” “May I be healthy,” “May I reach the end of suffering.” In these recitations, before I got sick, I emphasized the wished for thing: peace, health, and so on. After I got sick, however, my emphasis changed. What mattered, suddenly, was not the wished for result, but the “may I”—that "may I" soothed me, humbled me, and gave me hope.
As I lay in bed, I also discovered that when I said the phrase: “May I reach the end of suffering,” I was really wishing that I’d stop feeling sick, that the physical discomfort would go away. To wish for something over which I had no control, of course, brought only more suffering. I gradually saw that most of my suffering came not from the physical illness itself, but from the mind reacting to it with thoughts such as “I hate this discomfort,” “What if I can’t return to work?” Soon a shift occurred, and the end of suffering I asked for was the end of suffering in the mind.
My Buddhist mentor suggested that whatever happened at my upcoming retreat at Spirit Rock, regardless of what it was, was the retreat. This advice was followed by news from my doctor that results from my blood tests were unusual and that I was scheduled to see a specialist and to have an ultrasound the Monday following my retreat. The lab slip indicated something I couldn't read, followed by a question mark. I felt as though I was reading tea leaves, trying to decipher what the doctor might mean.
At my retreat interview, I wailed about how I was not getting the peaceful experience I had wanted. Instead I faced big fear. What if I had cancer? Vast waves of fear become my whole field. The dharma teacher helped me to acknowledge the "don't-know mind" in that moment. He encouraged me to sit with eyes closed and to see if there was anything else in my field. I labeled my experience “don't know,” and found my breath. Returning home after the retreat, I sat with some faith, and even a little ease, as I waited for my ultrasound, and then for the results.
The ultrasound was not conclusive, but it ruled out cancer. I was flooded with relief and gratitude.
Palo Alto, CA
I had been sick with a "mystery illness" for close to three years when the cancer diagnosis came. Until then no medical person had been able to find anything wrong with me. Now, cancer was something I could hang my hat on. I wrote a thank-you note to the doctor.
In fairness, it wasn’t until just before I went to see this doctor that my lump had appeared. Lumps are easier to deal with: you can cut them out, slice them up, slip them into test tubes, send them off to the lab. Vague, persistent aches and pains, overwhelming and incapacitating exhaustion, loss of attention and concentration—they're a bit harder to measure.
So I mobilized. I made the decision to be in the group that survives. But during those long months of chemotherapy, when my conviction was not as strong, it was the dharma I turned to. Not that I hadn't already, but lying in bed for days on end, I made friends with the idea of dying. I practiced dying. It became something not to fear, but to plan for and receive. What a relief.
The cancer was probably not the cause of the "mystery illness" but one of its results. The pain, exhaustion, loss of attention and concentration continue. Seven-and-a-half years into remission I have the daily opportunity to practice just as hard—to investigate, inquire, keep the mind that doesn't know, to have mercy, and to find freedom and joy in this moment, which may be all I have.
In 1985, my mother had a stroke that left her physically disabled and intellectually impaired. A second stroke in 1996 left her in a vegetative state requiring around-the-clock custodial care until she died in a nursing home in February 2002. For the past twenty years, my father has had Parkinson's disease, and four years ago was diagnosed with lymphoma.
I am forty-eight years old. For much of my adult life I have watched—and helped—my parents cope with chronic illness, and have struggled to accept why each of them has had to endure such slow, painful declines. Their illnesses have provided me with a powerful fuel for my practice and helped me to understand impermanence and the role of suffering in waking up.
The teachings illuminated a spiritual path that has been capable of holding, in an authentic way, the sense of pain and loss I have been living with for many years. Through daily sittings, weekly gatherings with sangha and a series of residential retreats, thoughts of "Why me?", "Why our family?" and feelings of resentment and anger toward particular causes and conditions have slowly diminished. I have come to truly accept that there is no explanation for some things. While that has been a great gift, the process of bringing the dharma into all facets of my life has proven to be a much greater one.
Five weeks ago my physician called to report abnormalities in my blood tests and he ordered my wife to rush me to the hospital. Unable to focus on rounding up clothes and toiletries, I stood frozen. Yet I do remember going into my study, scanning the shelves of dharma books, and finally picking out a copy of the Dhammapada.
A biopsy two days later yielded a diagnosis of multiple myeloma—bone marrow cancer. For two weeks I endured blood transfusions, IV drips and my first cycle of chemotherapy. I slipped in and out of awareness, too exhausted and disoriented to turn to that book, but reassured by its presence on my table.
Twelve days after the phone call, I was released to continue my treatment at home. The prognosis is "cautiously optimistic." Once the chemo runs its course and is backed up by a stem-cell transplant, I am expected to go into long-term remission.
My emotional state is uncharacteristically—almost oddly—serene. I feel no need whatsoever for anger, remorse or self-pity. Not once have I asked "Why me?" Family and friends have rallied to my side. Conversations usually kick off with the cancer. (I now permit only five minutes of that before I change the subject.) They are sorry that my wife and I have been burdened with all this pain and fear, all this upheaval. I try to be gracious, but think to myself, "Why should I be exempt from suffering?" I hardly mean to imply that I welcome and embrace the disease, but these past five weeks have brought to my wife and me a radical realignment of our values and priorities, as we simply fold the demands of this affliction and its treatment into our lives.
I’ve spent the past several years on an inter-faith team of chaplain interns at a large hospital in downtown Philadelphia. I am the only Buddhist in the group. The rest reflect Philadelphia’s diverse demographic, from Catholic to black Baptist. Most of the patients I visit are not Buddhist either.
In my work as a chaplain, I am reminded of the Four Noble Truths and particularly of the experience of birth, old age, sickness and death. On an inner level, these reminders have been visceral and immediate, and have provided tremendous ground for my personal practice. Interacting with patients has been more challenging, since they are often suffering deeply and may not have the inner resources to discuss Buddhism. Rather, my work has been a contemplation and exploration of “What is the basic goodness that resides in all beings?” and then “How can that be expressed in a meaningful way to this particular person?”
This spring, I myself became ill and spent a few days in the hospital. My Christian chaplain friends visited me and showered me with prayers that they struggled to articulate to their Buddhist friend. It was then I felt the exchange of self for other. It was strange, compelling and heart-warming to experience and welcome their expressions of basic goodness towards me.
“We call it dwindling,” my friend, a former nurse, told me. “People just let go and sink gradually down to death.”
It started with a back injury. The second time I fell, my wife couldn’t move me and had to call for help. When I found myself in intensive care, all I felt at first was the pain of any movement: I couldn’t sit or even roll onto my side. After x-rays and other tests, they found I had an ulcerated esophagus, my lungs were threatened by fluids, and I bordered on congestive heart failure. The strength and alertness I had when I came into the hospital gradually gave way to weakness and a feeling of helplessness.
One night I awoke with a sharp sense of my condition. I was getting a message from my body: “From here on the easiest thing to do is let go. This may be the end.” But I had a choice. I considered whether to struggle to survive. Upon careful reflection I thought, “I still have work to do. It will be difficult, but I need to make the effort.” It was probably the hardest decision I had ever made.
I healed very slowly. Now, ten months later, after spinal injections, wheelchairs and physical therapy, I walk with two canes and lead an otherwise normal life. The idea of death, however, has become for me an ever-present reality rather than a distant possibility.
The lung cancer diagnosis, and the waiting, have been two of the most unrelenting, compassionate teachers I've ever had. Confronting this illness has been extraordinary in terms of opening, acceptance, appreciation of the moment, and particularly in terms of seeing more clearly the many patterns that habitually run me. I feel blessed (although I can also say I don't necessarily want many more of these blessings!) to be forced to kneel before the altar of truth: this is what it is, whether I like it or not. And in that surrender, there is so much peace.
New York, NY