PREAMBLE

William Shakespeare in Act V of his “Macbeth” wrote:

“Life is but a walking Shadow, a poor Player That
struts and frets his Hour upon the Stage,
And then is heard no more;
It is a tall tale, told by an Idiot,
full of Sound and Fury, Signifying nothing."

If we accepted this concept, then Life loses all its meaning and we are reduced to a pathetic, sorry state where, as many do believe, we are born, we live and die without any reason, any purpose.

I completely reject this position. To me, life is not a random series of transient, overlapping, unrelated experiences, destined to be consigned to oblivion upon completion. I believe instead, life is a precious expression of a greater plan in which our time spent on earth is but a short segment of a journey which began in eternity and will continue to eternity.

Throughout history this question has been the subject of much philosophical, scientific and theological speculation. There have been a large number of differing, conflicting and diverging answers reflecting the various cultural and ideological backgrounds, clearly indicating the true complexity of the problem. In my opinion, there will never be an answer that will satisfy every one, and so it should be. In the end, each one of us must arrive at our individual position and as such apply this to the expression of our own life. For it is only by understanding our own self, can we really appreciate the true meaning of our life.

For me, one of the most eloquent, complete and comprehensive description of Life and it's purpose, is this description by Mother Teresa:

“Life is an opportunity, benefit from it.
Life is a beauty, admire it.
Life is a dream, realize it. Life is a challenge, meet it.
Life is a duty, complete it. Life is a game, play it.
Life is a promise, fulfill it. Life is sorrow, overcome it.
Life is a song, sing it. Life is a struggle, accept it.
Life is a tragedy, confront it. Life is an adventure, dare it.
Life is luck, make it. Life is life, fight for it!”

With this in mind, in this blog I propose to briefly deal with random aspects of life as I have experienced them along the way. It is certainly not meant to be a guide for you to follow, but rather a reference that you may use as you see fit. I will also include quotations specially selected for each subject because of their impact upon me, and for no other reason.

I welcome your comments, criticisms and suggestions and active participation.

Friday, June 25, 2010

LIFE WITH MOLLY

A short story of Faith, Fate and Coincidence
“A bizarre accident occurred on the highway early this morning
claiming the life of three people, one of whom is yet to be identified.
A large “Hummer” crossed the median at high speed and plowed
into the smaller vehicle, killing all the occupants.
The driver of the Hummer, who was returning from an
all night “stag” celebrating his wedding due to be held today,
was unharmed. His breathalyzer test was very strongly positive.”
Violet sat up when she heard those words spoken by the radio announcer who was reporting a newsflash that had just been received. Something in her told her that this was not good and for some strange reason she thought of Molly. She listened carefully, but no more information was forthcoming.

That night as she sat down to have dinner with her husband, the phone rang. It was Virginia enquiring about her mother who had not arrived home yet, and none of her friends or family knew anything. Violet, shuddering with anticipation, blurted out “Have you called the police? Have you checked with the hospital? For some strange reason, ever since hearing the announcement she could not shift the thought that Molly was involved. She was not surprised when Virginia called early next morning confirming that Molly was indeed involved in the accident and had died before any help could arrive. She also added that the only way she could have identified her mother was by the silver cross she was wearing. This was the cross that was given to Molly last Xmas with love and appreciation for her dedicated care to his wife, who suffered from Advanced Alzheimer’s, by Violet’s father.

For more than five years Molly had been the live-in caregiver who would come to the house early Monday morning and leave early Saturday morning. A gentle, caring person in her late 50’s, she was a devotedly religious person who loved people and was dedicated to her role of caring for the weak and helpless. She endeared herself so deeply to the family that she became part of the family and was loved by all, as indeed, she loved them. Violet was particularly close to her, and they shared a bond as close as sisters. They would spend many hours sharing and praying together, as they jointly took care of the needs of the old people. They were sisters in spirit.

As she recalled the events of the hours before Molly’s death, Violet became increasingly overwhelmed with a sense of awe at the power of Fate in life, and wondered whether life is truly predestined and beyond our control. The night before, after dinner was completed and the old people settled, Molly informed Violet that she planned to leave much earlier than usual as she was getting a lift with some friends. She planned to leave at 6:00am. Violet could not understand why she felt compelled to caution her but recalled saying: “Are you sure that is a good idea. Why do you want to leave that early?”

The next morning Molly got up at the crack of dawn and was ready to leave as early as 5:00am. She called Violet who would normally come over to pay her and relieve her. However Violet was unable to get over because of a flare up of her ankle sprain and asked her to wait a little longer to allow the “Advil” she took to start working. Molly called back to inform her that her friends were insisting on leaving early and as a result she was committed to leave on time. Violet recalled her last words to Molly were, “Go with God, may he take care of you on your journey home!”

Molly left home at 5:45am and walked to the corner to wait for her friends. When she got there, she realized that she had left her cross at home and quickly retuned to retrieve it. On arriving home, she encountered the old man who was in the kitchen drinking a cup of coffee that Molly had prepared and left for him. After she explained why she had returned, he stood up, held her hand firmly and said with a deliberate, serious tone, “Molly please stay back for a while. In our culture it is a bad omen to begin a journey and to return before it is completed. I want you to stay!”

She chuckled and replied as she snapped the cross around her neck, “Grandpa I am protected with this cross. Nothing could happen to me!” She then quickly exited to meet her friends.

The police reported that the car was traveling south at normal speed in light traffic when the Hummer which was traveling north at very high speed suddenly swerved to the left, missed a light pole and crashed directly into the car. It was smashed beyond recognition and the occupants killed instantaneously.

The cross was found in Molly’s right hand as she apparently grasped it in her final moment.

Like Violet, we are all left to wonder the meanings of Fate and Faith. Many will be content to blame these events as merely coincidence that occur every day to every body. As my friend Lawrence will often reply in these situations, “No Big Thing!”

I prefer to think of these events as occurring beyond our control and as such beyond our human comprehension. In this context I am reminded of a statement made by a contributor on the “This I Believe” Series on National Public Radio which stated:

We, as humans, can do nothing but live in the present.
We cannot see what is to come in the future.
We can only guess and attempt to make the right choices.”

Tuesday, June 22, 2010

LIVING WITH DEATH AND DYING (II) The Final Journey


“There is a dignity in dying that doctors should not dare to deny.
For death begins with Life’s first breath”
The above statement by an unknown author has always impressed me for its profound simplicity and dramatic accuracy, and deserves much more than passing notice. Like the clergyman, the physician is expected to play a pivotal role in the life of the dying patient and the family, especially during the period of “the final journey” and beyond. Unfortunately this does not often happen because doctors are very rarely trained to recognize and deal with end-of-life issues. Dr. Ira Byock in his excellently written book, Dying Well, summarized this in the following manner:

“The medical profession most commonly approaches dying as if it were solely a
problematic medical event. From the first day in medical school, doctors are taught
to approach patients by defining a set of medical problems to be solved. People come
to doctors with "problems". For each case a problem list must be developed through
which both physical and psycho-social problems can be addressed”.
Dealing with dying is much more than just a consideration of the etiology of a collection of symptoms and signs, diagnosing the problem and providing a treatment plan. This is what physicians are trained to do and are generally confident in executing. Rather, it is a very personal experience that requires a very special and individual approach tailored to meet the needs of the patient and the family. The physician is uniquely placed to facilitate and ease the pain and uncertainty of the situation. By being available to answer questions, being honest and caring and above all, being especially sensitive to the fears and the anxieties of all concerned, he will go a long way in assisting everyone to cope with this daunting and terrifying period.

In my own personal experience, after actively practicing medicine for almost half a century, no aspect has given me as much satisfaction as the successful occasions when I was able to help my patient and the family cross over in peace, faith, dignity and acceptance. Because of my Psychiatric background, I was perhaps better equipped to understand, recognize and possibly identify cues from the patient and to deal with them. But I believe I was able to achieve greater success when I learned to accommodate the strict objective, scientific training I received in medical school with a personal subjective, faith-based viewing of life and death as a continuum, controlled by the hand of the Almighty.

As I have stated previously, I believe life is a precious expression of a greater plan in which our time spent on earth is but a short segment of a journey which began in eternity and will continue to eternity. Because of this, I see the process of dying, not as the end of the journey, but merely a stage along the path, and as such I view my role as a physician as doing my best to facilitate the change. Sri Chinmoy Kumar Ghose, the great Indian spiritual teacher and philosopher who recently died, described this concept exquisitely in the following quotation:

"Death is not the end.
Death can never be the end.
Death is the road.
Life is the traveler.
The Soul is the Guide."
As I see it, the approach to dealing with death and the dying patient is essentially eclectic, encompassing a variety of approaches from many sources including the attitude and expectations of the patient and family, the immediate and long term prognosis, society’s mores and the extent of religious and social support available. The physician’s role is crucial, not only in providing honest and accurate information concerning the prognosis and treatment options, but equally important, in assessing the real needs of the individual and providing understanding and strength without resorting to denial or lying. He must be available to prepare and to guide his patient through the difficult passage, to ease the pain and above all, to offer hope and reassurance.

It is generally assumed that patients would prefer not to hear the real truth, but rather be given hope of recovery even when the situation is hopeless. This is a mistake, for by encouraging this we rob the patient and the family of the opportunity of coming to terms without lingering regrets. I prefer to choose the approach of Rev. Forrest Church who before he died in 2006 wrote:
"Many people who are dying have an opportunity—but sometimes don't have
the imagination to seize. And that is to turn my life…into a prayer, to embrace life,
to accept my past and just say 'yes' to it. Not to let the future haunt me, but to be
in the moment, aware of the miracle, which is life itself, which would not exist if
death was not one of its hinges."

Events occur during this period for which we have no real explanation, but which seem to point to other influences actively manifesting itself. Anyone who has worked in this field will attest to occurences experienced by the dying patient which had profound effects on them. These paranormal episodes, often referred to as Near death experiences, have been extensively researched by several people, including Dr. Raymond Moody, MD who has written extensively on the subject.

In my own experience dealing with terminally ill patients, I have encountered many such incidents when my patients will report encounters which have profoundly affected them. These have ranged from visitations from deceased family members, to stange phenomena like brilliant lights, or Holy people, such as Jesus or Mary. They have invariably left the patient peaceful, calmer and more accepting and have served to reassure the family. While it would be easy to ascribe these occurences to subjective or hallucinatory causes resulting from the disturbed mind, I prefer to think of them as yet another example of the involvement of a higher power.

Too often we allow feelings of anger, petty rivalry, suspicion or revenge to cloud our thinking and prevent us from sharing and expressing our true feelings at this important time. This is a real shame, for by doing this we cheat ourselves and the patient, and set in motion negative feelings which stay with us long after the event. This is wrong! Instead we should strive to correct these feelings and remove these obstacles and make every effort to come to terms with ourselves, so that as the journey ends, so would our bitterness.
In the end, if we really believe in the continuity of life, we must agree with the words of the great Irish poet and author, Arthur Joyce Cary when he wrote:

“Look at life as a gift from God.
Now he wants it back, I have no right to complain.”

Tuesday, June 8, 2010

LIFE WITH INSPIRATION

“When I am inspired I work doubly hard without conscientiously
forcing myself to apply. I catch myself spotting problems
and errors faster and easier than normal.
Uninspired it sometimes takes me longer to overcome a problem,
whereas inspired, the solution jumps right out at me.
It's almost magical. When inspired, time flies and productivity skyrockets”.


This statement which was made by an un-named contributor in an internet site dealing with personal experiences in the work situation, has impressed me as an excellent example of the impact of Inspiration in the context of our living.

The phenomenon of Inspiration is an exceedingly interesting and widely researched activity that clearly affects human behavior in a variety of ways. Like so many other vital phenomena in our daily lives, it is only possible to describe its existence by its effects rather than appearance. Inspiration is defined as the act or power of stimulation or arousal of the mind resulting in the influencing of special or unusual activity or creativity. It also refers to a form of divine guidance or supernatural influence on the minds of an individual causing or giving rise to unexpected or unpredictable outcomes.

The direct effect of Inspiration is the acceptance of the individual as qualified to achieve at a level far above the expected level, or to communicate truth with an authority and influence far above the average human expectation. In short, it is the difference that makes the mundane become the exquisite, the stuff that allows the artist, the poet, the author or the leader to stand out and the prophet or the preacher appear as a chosen one.

But inspiration is much more than this. As I see it, it is very much a human component present, to a smaller or larger extent, in everything we do, or think or say. To me, inspiration is the trigger which initiates any action, but is not a guarantee of successful outcome. This can only occur with the concomitant expenditure of effort. In this respect, I am reminded of the oft-quoted statement, attributed to so many authors, ancient and modern, that says:

“Success is 10% Inspiration and 90% Perspiration”

In my experience both with regard to my own self, as well as my relationship with others, I am convinced this is indeed a truism, and that in life, every form of human expression is the result of a combination of these two components. Whether the intent is to do good or evil, the impact of inspiration is equally vital. The more inspired the individual, the more good or evil he will be able to achieve.

I have no doubt that everyone will have no difficulty in identifying multiple examples of people in their own lives who have used their inspiration to produce deeds that translate to helping people or their environment, and others who have channeled their effort to personal gain or to causing further suffering.

All the most successful people in the world inevitably achieved their success by virtue of their innate ability to draw upon the unique creativity conferred on them by the power of inspiration. It is this factor that allows them to stand over their peers and achieve such enviable results. The great artists and authors and thinkers and inventors and leaders have all been able to produce their work as a result of the drive initiated by their inspiration, which provided them with the foundation they needed. In the same way others have been able to use this ability to carry out the greatest injustices to humanity. Dictators like Stalin, Hitler, Castro, and the thousands of others who have appeared over the preceding centuries; Confidence tricksters like Ponzi, Madoff, and the multitude of lesser practitioners who have succeeded to cheating from millions of unsuspecting people, and Crooks and Mobsters, as individuals or part of an organization, who have dominated the society with fear and death have all done so as a result of their extraordinary ability to draw upon their innate inspiration and creativity.

There is also evidence that this ability is passed on from generation to generation, so that it is not unusual to see the same pattern of behavior repeating within families. This is not surprising since it is common to find that members of the same family often exhibit similar behavioral and mental attitudes.

In the end however, irrespective of our own personal attitudes or abilities, our lives are directly or indirectly, controlled by the impact of other people’s inspirations. They can be drawn from any corner of the world or from any person, or object or any emotion, and how we respond will depend to a large extent upon our personal beliefs and attitude. Most of us generally adopt an attitude of acceptance and are content to assign the outcome as a product of divine intervention. As the famous 16th century French apothecary, author and astronomer, Michel de Nostradame (Nostradamus) explained:

"Perfect knowledge cannot be acquired
without divine inspiration;
Given that all prophetic inspiration
derives its initial origin from God Almighty".


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But there is a spirit in man:
And the inspiration of the Almighty gives them understanding.
……Job 32:8


Action always generates inspiration.
Inspiration seldom generates action.
……Frank Tibolt

If you’re going to be an artist,
Real life is your inspiration.
……. Madonna

What that man creates by means of reason will pale,
Before the art of inspired beings.
……Pheadrus.

The greatest inspiration is often born of desperation.
……Comer Cotrell

In life you need either inspiration or desperation.
…..Anthony Robbins

No one was ever great without some portion of divine inspiration.
….Marcus Tullius Cicero

Inspiration comes from the Heart of Heaven to give the lift of wings,
and the breath of divine music to those of us who are earthbound.
….. Margaret Sangster

Method is much, technique is much, but inspiration is even more.
…..Benjamin Cardozo

Quotes are nothing but inspiration for the uninspired.
…….Richard Kemph

Find your inspiration and hone in on it.
……Susan Longacre

inspiration never arrived when you were searching for it.
…….Lisa Alther

Keep your fears to yourself,
but share your inspiration with others.
…..Robert Louis Stevenson

Inspiration is a guest who does not like to visit lazy people.
……Tchaikowsky

Inspiration follows aspiration.
…..Rabindranath Tagore

It is, after all, the dab of grit that seeps into an oyster's shell
that makes the pearl,
not pearl-making seminars with other oysters.
….. Stephen King

Inspiration kicks open the doors of the mind and says;
"I'm here!"
……Edwin Rutsch