Deep Medicine

Adapted from a presentation at the Inaugural Ceremony

Dr. G. Venkataswamy Retreat Center (Nithyatha/Perpetuity)

AuroFarm, Aravind Eye Care System

Tamil Nadu, India

2 October, 2011

“Seeing is not merely a physical act. The heart of vision is shaped by the state of the Soul.”      John O’Donohue

Dr. “V” is a visionary, a pioneer, a teacher, a change agent, a healer, a holy man, and everyman. It is a deeply meaningful and humbling honor to have the opportunity to speak at the Inaugural Ceremony of this Retreat Center named in his memory.

When my wife, Susy, and I first came to India in 1983 with my friend and colleague, Dr. David Vastine, and his wife, Marcia, it was to teach ophthalmic surgery and to serve a recently formed eye hospital and a man with a deep commitment to service and a lofty vision – to eliminate needless blindness.

At that time, more than 25 years ago, the world was a different place. It was a time when a “cell” referred to a basic anatomic and physiologic component of the body or a small room in a jail to confine law-breakers – not a telephone. It was a time when “mail” required an envelope, stamps, and many days or even weeks to be delivered, not access to the “internet” and a few keystrokes for virtually instantaneous delivery to all corners of the planet. It was a time when we, and the first generation of the Aravind Eye Hospital “family” of ophthalmologists, administrators, and innovators, were younger than the second generation is today. That second generation, which is now accepting the reins of leadership, was out of diapers then, but not out of medical school, married, or actively in the process of raising the next generation.

We came to India to teach and contribute. We learned far more than we taught and were given far more than we left behind. The light that Dr. V brought into the eyes of his patients, into the lives of those around him, and into the world struck us like a bolt of lightning and opened, not only our eyes, but our minds and hearts – transforming us and adding us to his battle against needless blindness. Since our initial “inoculation” of the vision, mission, and people of the Aravind Eye Care System, we have become “addicted” to the compassionate service and spiritual aspiration they provide. This combination, which characterizes the “Aravind Family”, has strongly influenced our lives and has brought us back to India many times.

Dr. V’s battle against needless blindness, on the one hand, is fought in hospital clinics, outreach camps, community centers, operating rooms, and laboratories where the challenges of preventable and treatable diseases are daily encountered in endless quantity and the truths and principles of science predominate. On the other hand, seeing meant more to Dr. V than getting light to the retina. It was about illuminating the inner life and recognizing the deep spiritual reality which connects everything in the visible and ever-changing manifest world of our daily external reality. This inner battle against needless blindness acknowledges the direct experiences of the rishis of the Upanishads, the prophets of the Judeo-Christian-Islamic traditions, the masters of the ancient orient, the rationalists of the Mediterranean basin, and the shamans and medicine men and women of indigenous cultures across the globe. It is a battle against ignorance, anger, differences, intolerance, greed, unkindness, injustice and hatred – all forms of blindness.

Dr. V embodied the accumulated wisdom about the spiritual quest shared by seers and sages of all traditions from thousands of years ago up to present times as summarized and synthesized by Aldous Huxley in the “perennial philosophy”. This philosophy involves 3 main points. (1) There is an infinite, changeless, eternal reality underlying the constantly changing visible world. (2) This same reality lies at the core of every creature. We call it Soul or Self. (3) The purpose of life is to discover this reality experientially and to act on it. Our spirituality is a progressive awakening to this inner reality and a sign that this reality is seeking to emerge.

Dr. V’s battle against needless blindness is no less heroic than the battle immortalized in Arjuna’s conversation with Krishna on the battlefield of the Bhagavad Gita. Like Arjuna’s battle, Dr. V was engaging external and internal foes. Dr. V’s battle is a battle in the external world against eye disease and visual loss. A battle, no less fierce, is waged within for self-mastery and self-realization of our true self. Both battles are fought through our daily choices and actions.

When we act on this greater, underlying reality, which pervades the Universe, dwells within us, and connects us to each other and to a Unity or Divine consciousness, we act from love and do no harm. We live a caring, compassionate life, seeing ourselves in every person during every encounter. Unattached to selfish desires, egoistic pursuits, or greedy expectations, we act from a place of equanimity. When our seeing allows us to envision the deep connectedness in which we exist, we practice a deep medicine. This medicine has roots in the facts and truths of contemporary science and an appreciation of the truths of spiritual consciousness that give meaning, purpose, faith and power to our lives.

This union, this “yoga”, of the scientific and the sacred, which Dr. V embodied, brings us the tools to win the battle against needless blindness – in all its forms. Inspired and elevated by Dr. V’s transformative vision and work, may this Retreat Center always remind us in “perpetuity” of his living legacy so that we can bring light to wherever darkness exists.

“When we grow in spiritual consciousness,

We identify with all there is in the world.

Then there can be no exploitation.

It is ourselves we are helping.

It is ourselves we are healing.”

Dr. G. Venkataswamy (Dr. “V”)

1918 – 2006

The season of summer is the time of long warm days, summer vacation from school, holidays from work, and a time for dreaming.  Angeles Arrien in her classic book, The Four Fold Way (HarperSanFrancisco, 1993), defines summer by the direction of the East – where the sun rises; by the element of fire – which can warm us, cook our food, and burn or destroy.  Summer carries the resource of vision and the way of the visionary . This draws us to our dreams for the future, creativity, authenticity and truth. The way of living of the visionary asks us to be in right placement and to connect with our life’s dream, purpose and meaning. This requires slowing down, being quiet and going inward. All activities consistent with a lazy summer day.

During summer we are called to learn and know who we really are so that we can bring our authentic self and personal gifts, talents and contributions forward. Sometimes during our lives we are “forced” to hide our real selves (e.g. to conform to peer pressure, or join the corporate trance) to survive. This hiding may become a pattern of living and lead to self-abandonement and/or denial.

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From auto repair to healthcare, there is an emphasis on customer satisfaction. We are thus surveyed and tallied for any and every service we use and product we buy. The push for quantification and objective scoring is accompanied by the desire for a “wow” experience by client and provider alike.  In a culture where attention spans are short, quick fixes desired and multi-tasking the rule, this quest for excellence, if not perfection, seems somehow contradictory.

Where will these peak experiences and masterpiece-like products come from if we are unable or unwilling to invest the time and energy to nurture the creativity that ignites a flash of genius or embrace the years of training and practice that ultimately result in the master and the masterpiece?

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I have always been befuddled by the term “work-life balance”. Is our work not an integral part of our life? Is our work not part of the expression of our creativity? With or without a formal job, aren’t we involved in constructive pursuits? Is our work not an essential part of our service to our families, communities, and the “greater good” or “big picture”?

What is meant by work-life balance? What amount of work is too much or too little? Isn’t work truly part of a balanced life? Is the old adage that the only thing worse than having a job is not having a job true? Are we perhaps actually seeking work-rest or work-play balance?

In her book, The Four Fold Way (HarperSanFrancisco, 1993), Angeles Arrien describes 4 domains of life: work/creativity; health; relationship; and resources/blessings. Our work is not external to our life, it is integral. It is a part of our life, but not all there is to our lives.

Peter Block in The Answer to How is Yes: Acting on What Matters (Berrett-Koehler Publishers, San Francisco, 2003), provides insight to our relationship with work. When we are working or at work, it is still our life. Our working and non-working hours are not meant to be in opposition to or in conflict with each other. Rather what we are seeking is balance in our lives. We need balance among those aspects of our lives which are necessary, practical and useful and those that bring meaning, purpose, passion, joy and contentment. Our balance must support our individual needs and desires and the demands placed upon us by our “collectives”, i.e. our workplace, family, community and culture. This equilibrium is a moving target – a delicate “dance” between our personal objectives and the impact from the responsibilities which come our way from the various collectives in which we participate.

We exist in a constantly changing reality that repeatedly requires us to make choices and changes to achieve, maintain, or regain our equilibrium. In fact, a favorite definition of mine for health is balance. Finding, losing, and rediscovering balance educates us about impermanence, uncertainty, and the transient nature of life. Seeking balance along our own unique path we develop knowledge and skills that support our well-being, in the context of the natural and created environments in which we live.

When you are confronted with questions about your work-life balance, try to engage the question from the perspective of what really matters to you, supports your heart’s desire, your preferred vision of the future, and is a step in the direction of your life’s dream. Then the issue will be seen in its broadest context – is my life in balance?

 “Far and away the best prize that life has to offer is the chance to work hard at work worth doing.” – T. Roosevelt

Recently I awoke early with a good bit of unfinished business on my mind. My first scheduled appointment for the morning was at 9AM, and there I was awake and alert considerably earlier than I needed to be. I decided to take advantage of this early morning awakening and energy surge. I got up stimulated by the possibility of arriving at the office early and getting the jump on the day by tying up those loose ends that needed attention before the formally scheduled work day began.

As part of the preparation for this flurry of activity, I prepared my preferred morning eye-opener drink. This high powered beverage is a blend of a vital green powder, which began as algae and seaweed, augmented with macro- and micronutrients in the form of various fruits, vegetables and juices — with one’s complete well-being in mind. The final muddy green-blue color and hearty soup-like consistency (depending on the ingredients selected for the day) remind me of the rich and fertile broth characteristic of a swamp. Thus, I fondly call this breakfast beverage my “swamp shake.”

On this particular morning, rather than lingering over breakfast, I prepared a double batch, drank a small portion and chose to bring the rest with me to work. As I poured the remainder into my travel mug, I was very mindful that the mug I selected was one I usually only used for water or herbal tea, since its top was large and the lid somewhat unreliable. I made a mental note to treat this travel container and its contents with special regard.

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The individual always faces a dilemma in becoming part of a group or collective. Questions arise regarding the equation of what is given up by the individual in order to be part of the collective. Can I be free and in relationship? Can I be unique and compliant? Can I take risks, be innovative and be secure at the same time? Will my individuality be subverted to conformity within the group?

In fact, the reason each individual in a group is capable of making a difference is because we each are different. Our differences brought together with a common vision and mission give the collective, family, tribe, institution, corporation, community, city, state, country all the component parts to create a vehicle/container that moves the entire group forward with the creativity, generativity and resilency necessary to benefit the individual and the whole. To best serve the collective, rather than deny our differences and diversity, we must fully express ourselves. That is how we make a difference.

Ralph Waldo Emerson was a Unitarian minister, philosopher, and naturalist of the early 19th century who championed self-reliance and self-expression, and had a strong influence on Henry David Thoreau. Thoreau’s work on behalf of individualism, the natural world and civil disobedience inspired Gandhi, Martin Luther King and Nelson Mandala. In spite of his emphasis on individuality, Emerson saw our individuality in a collective context.  Read more…

“Every person born into this world represents something new, something that never existed before” -Martin Buber

Many indigenous cultures believe that each individual is “original medicine”.  A creation that nowhere else, never before has been created. Nor will it be again in the future. Though we share much of our genetic map, anatomy, biology and physiology with other humans and animals, no two people are the same. We may have the same number of chromosomes and bones, similar blood types and skin, eye or hair color. However, our particular genetic expression, voice, fingerprint, gait, and personality are all ours alone. No one else now, ever before or ever again, carries the same combination of gifts, talents, resources, opportunities and challenges. The unique formulation that we represent is our “original medicine”.

The term “medicine” in this usage connotes not simply a healing balm or potion, but our power. Our medicine feeds our “personal power”. It is our capacity to explore, discover, create, express, grow and heal. Our original medicine is also our “authenticity”. Our authenticity is who we are absent our roles, facades, opinions, and judgments. Authenticity represents our “true self” without self-deception or self-criticism, but with a fair and an honest assessment of what actually is, free of self-deprecation or inflation. Read more…

Every one makes a difference AND it takes a village. Both parts of the previous sentence are true. It is accepted and understood that every one matters by bringing a unique contribution to each setting and circumstance where we come together. It is also true that the whole is greater than the sum of its parts. This is so where we work and play, where there is celebration or conflict, disaster or delight, sickness or health. When individuals come together opportunities and challenges arise.

 For some time I have contributed a brief presentation at the monthly General Management Meeting at my Medical Center in San Francisco (California Pacific Medical Center) on self-care and well-being. These presentations have ranged from antioxidants to Zen, medications to meditations, and attitude to gratitude. Recently, I was asked to explore the theme of “each of us makes a difference” over the course of the calendar year 2011. This invitation both inspires and challenges me. It is an opportunity to link the vision and mission of the institution with the expectations and dreams of the individuals that together make up the contemporary healthcare team. What a phenomenal playing field. It is an interface where our independence bumps into our interdependence and where  personal autonomy and social justice may be at odds. Our personal desires and goals may need to be subverted to the institutional mission or the “greater good”. The need for compliance may not be in alignment with the motivation or values of the individual. Circumstances where comparison, competition and conflict can arise will be in juxtaposition with cooperation, sharing, and mutual support. The subject matter and the context create a fertile soil for study, reflection, learning and growth.

 “Rugged individualism” and “fierce independence” are valued concepts in the U.S.A.  In the world of Mother Nature the existence of the “lone wolf”, however, is something of an aberration and interdependence is the dominant theme. This is true not only from an ecologic perspective, but in geopolitics, economics, justice, and health. Absolute independence is illusory and interdependence is the rule. The balancing act between independence and interdependence, self and service, selfishness and selflessness capture the elemental challenge of our lives.

An often told parable about a small sparrow who overhears a barnyard conversation during which she hears that the sky is going to fall captures this challenge. Fearing the worst, the sparrow springs into action by lying down on her back and holding her legs up in the air. A traveler walking a nearby path sees the sparrow on its back and asks, “what are you doing little sparrow?” The sparrow replies, “the sky is going to fall and I am holding it up”. “But your feet are too small and weak to hold up the sky,” replied the traveler. “I may be small and weak,” said the sparrow, “but we each must do what we can.”

 We each must do what we can and together we can accomplish great things.

 Consider the impact of individuals such as Gandhi, Rosa Parks, Hitler, and Jesus.

Consider the impact of one stalled car on a busy freeway. What do you love to do that makes a contribution to others? What do you get from making that contribution?

 “To find yourself, lose yourself in service to others.”  -Gandhi

“We will open the book. Its pages are blank. We are going to put words on them ourselves. The book is called “opportunity” and its first chapter is New Year’s Day.” - Edith Lovejoy Pierce

My usual temptation at the beginning of a New Year is to think about and talk of New Year’s resolutions. However, in a recent CharityFocus posting (http://www.dailygood.org/more.php?n=4374) there was a call to consider the creative possibility of a new kind of resolution. The form of resolution they suggest is a resolution about serving and caring for others, rather than one about self improvement.

From a scientific and statistical perspective this makes sense. Since our usual personal improvement types of resolutions (eat less, exercise more; sleep more, stress less) are often unrealistic, frequently are unfulfilled, and may result in more disappointment than self-improvement. Furthermore, it is well accepted that acts of kindness and generosity as well as the giving of gratitude are all good for one’s personal well-being. Here is a win-win situation. In caring service to others, we benefit not only them but ourselves. This reality has been taught by wise men and women for millennia. Perennial wisdom, from the yoga sutras to the Old Testament, from the teachings of Jesus and the diverse formulations of the Golden Rule to the universal principles forwarded by indigenous cultures around the world, has taught us that service is joy and that if we treated others as we would like to be treated we could all “…sit in the same circle together… ” in peace and harmony and well-being.

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“We hold these truths to be self-evident that all Men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”  Second section of the Declaration of Independence adopted by the Second Continental Congress, July 4, 1776.

During this season greetings such as “happy holidays” and “happy new year” are commonly heard or read in casual conversations, greeting cards and advertisements.  These wishes for our happiness during the holiday season and in the new year may be well intentioned and sincere or may be nothing more than mindless seasonal discourse like saying “how’s it going” or “what’s up”.

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